The purpose of this study is to determine the maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D) of weekly dosing of CRLX101 (both as monotherapy; (Schedule 1) and in combination with bevacizumab every 2 weeks (Schedule 2) and weekly with a 3 week on / 1 week off schedule in combination with mFOLFOX6 (Schedule 3) to affirm the dose for future clinical studies.
This is an open-label, dose escalation study. Subjects enrolled in Schedule 1 will receive weekly CRLX101 alone. The starting dose for Schedule 1 is 12 mg/m\^2 and the next dose level is 15 mg/m\^2 (or 10 mg/m\^2 if 12 mg/m\^2 is not well tolerated). No other dose levels in Schedule 1 will be explored. Subjects enrolled in Schedule 2 will receive weekly CRLX101 in combination with bi-weekly bevacizumab (10 mg/kg) The starting dose for Schedule 2 is 12 mg/m\^ and the next dose is 15 mg/m\^2. No other dose levels in Schedule 2 will be explored Subjects enrolled in Schedule 3 will receive weekly CRLX101 for 3 of every 4 weeks in combination with bi-weekly mFOLFOX6 (oxaliplatin 85 mg/m\^2, leucovorin 400 mg/m\^2 and 5FU (fluorouracil) 400 mg/m\^2 bolus followed by 2400 mg/m\^2 continuous infusion). The starting dose for Schedule 3 is 12 mg/m\^2 and the next dose is 15 mg/m\^2. In the absence of dose-limiting toxicities (DLTs) additional subjects may be enrolled (expansion cohort) at the same, intermediate or lower dose levels following consultation between the Investigator and Sponsor. Enrollment of 6-8 subjects will occur in each cohort for all 3 Schedules. The MTD is defined as the highest dose level at which fewer than 2 out of 6 subjects experience a DLT. RP2D will be selected based on overall tolerability data from all subjects treated at different dose cohorts in this study. No intra-patient dose escalation is allowed. Approximately 61 evaluable subjects are anticipated to be enrolled: 15 subjects in Schedule 1, 15 subjects in Schedule 2 and approximately 31 subjects are anticipated in Schedule 3 (approximately 16 in the dose escalation cohort and up to 15 in the expansion cohort). The exact number of subjects is dependent on the actual number of subjects enrolled per cohort and the number of cohorts investigated.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
41
infusion CRLX101 weekly
infusion weekly CRLX101 + bevacizumab biweekly
infusion weekly CRLX101 for 3 or every 4 weeks and in combination with bi-weekly mFOLFOX6
START Midwest/Cancer & Hematology Centers of Western Michigan, PC
Grand Rapids, Michigan, United States
MD Anderson Cancer Center
Houston, Texas, United States
South Texas Accelerated Research Therapeutics (START), LLC
San Antonio, Texas, United States
Maximum Tolerated Dose (MTD), Recommended Phase 2 Dose (RP2D)
To determine the maximum tolerated dose (MTD) / recommended Phase 2 dose (RP2D) of CRLX101 when administered by intravenous (IV) infusion every week (QW) alone (Schedule 1), (QW) in combination with bevacizumab (Q2W) (Schedule 2) and weekly with a 3-week on / 1-week off schedule in combination with mFOLFOX6 (Q2W) (Schedule 3) in subjects with advanced solid tumor malignancies
Time frame: 15 months
Safety and Tolerability (Weekly Dosing) determined by reported adverse events, serious adverse events, physical exam findings, vital sign measurements,12-lead ECG readings, clinical lab evaluations, and treatment discontinuation due to toxicity.
Will be determined by reported AEs, SAEs, physical exam findings, vital sign measurements,12-lead ECG readings, clinical lab evaluations, and treatment discontinuation due to toxicity.
Time frame: 15 months
Pharmacokinetic Profile (PK) - Urine
Urine samples will be collected to evaluate the urinary excretion of total and unconjugated drug before, during, and after infusion. PK parameters in urine will include the maximum concentration (Cmax), amount of drug in the urine, % of drug eliminated in the urine. PK parameters will be calculated using non-compartmental analysis. Actual sampling times will be used to calculate PK parameters in this study.
Time frame: 15 months
Pharmacokinetic Profile (PK) - Plasma:CL
Plasma PK parameters will include clearance (CL) for both total and unconjugated drug.
Time frame: 15 months
Pharmacokinetic Profile (PK) - Plasma:Vd
The plasma PK parameters will include volume of distribution (Vd)
Time frame: 15 months
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Pharmacokinetic Profile (PK) - Plasma:t1/2
Plasma PK parameters will include half-life (t1/2)
Time frame: 15 months
Pharmacokinetic Profile (PK) - Plasma:Cmax
Plasma PK parameters will include maximum concentration (Cmax)
Time frame: 15 months
Pharmacokinetic Profile (PK) - Plasma:AUC
Plasma PK parameters will include area under the concentration versus time curve (AUC)
Time frame: 15 months
Anti-tumor Activity
To further explore preliminary signs of anti-tumor activity of CRLX101 when administered alone (Schedule 1) and in combination with bevacizumab (Schedule 2), and in combination with mFOLFOX6 (Schedule 3)
Time frame: 15 months