1. Establish the MTD of Lintuzumab-Ac225 as monotherapy 2. Establish overall response rate (ORR) where ORR = CR + sCR+ VGPR+PR) 3. Confirm the safety profile of the treatment regimen 4. Estimate progression-free survival (PFS) and overall survival
The study is a multicenter, open label Phase I trial. Phase 1, dose-escalation : This study uses a 3+3 design to estimate the maximum tolerated dose (MTD). There will be 3 escalating dose levels in the trial (0.5 μCi/kg, 1 μCi/kg, and 1.5 μCi/kg). Each dose can be administered in up to 3-8 cycles providing that the total dose received per patient does not exceed 4.5 μCi/kg. De-escalation (decrease dose level to 0.25 μCi/kg) is planned if at the first dose level of 0.5 μCi/kg, after expanding the cohort to a maximum of 6 patients, ≥2 patient have DLTs. At the dose level of 0.25 μCi/kg, if eligible to continue receiving additional doses of the study drug, patients will receive up to 8 doses in total, with the total administered activity being 2 μCi/kg. The starting dose level will be 0.5 μCi/kg of 225Ac-Lintuzumab administered on day 1 of each cycle. If this dose level is safe, the second dose level of 1 μCi/kg will be explored. If the starting dose level results in DLTs in ≥2 patients, the dose level of 0.25 μCi/kg will be explored. Subjects will receive the investigational drug as a single infusion at the prescribed dose level. Intra cohort dose escalation/ decrease is not allowed. Minimum three to maximum six patients will be treated at each dose level, and dose escalation will proceed as follows: 1. Rules for dose escalation are: 1. If 0 of 3 patients have a DLT, escalate to the next dose level (Unless enrolling patients at the 0.25 µCi/kg dose level) 2. If 1 of 3 patients has a DLT, expand the cohort to 6 patients 3. If ≤1 of 6 patients has a DLT, escalate to the next dose level (Unless enrolling patients at the 0.25 µCi/kg dose level) 4. If ≥2 of 3 or ≥2 of 6 patients have a DLT, then the previous dose is the MTD (Unless enrolling patients at the 0.25 µCi/kg level, in which case the trial is terminated) 5. Three patients will start at the 0.50 uCi/kg dose. The next dose level will be 1.0 µCi/kg and the final dose level will be 1.5 µCi/kg. Dose de-escalation to 0.25 µCi/kg will occur if, at the 0.5 µCi/kg dose, there are ≥2 of 3 or ≥2 of 6 patients with a DLT. 2. If a patient has not progressed nor had CR by the end of a cycle, the patient can continue treatment for a maximum of three (1.5 µCi/kg), four (1.0 µCi/kg), or eight cycles (0.25 µCi/kg and 0.50 µCi/kg). All patients may receive GCSF support starting on Day 9 if clinically indicated and continuing until ANC\>1,000. After the dose escalation portion is completed, treat 3 additional patients at the highest established dose level to confirm MTD and establish that dose level as MTD.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
2
Lintuzumab-Ac225 is an immunoconjugate \[antibody: anti-CD 33 antibody and radioactive isotope: Actinium (225Ac)\] for the treatment of multiple myeloma.
UCLA
Los Angeles, California, United States
University Of Kansas Medical Center
Kansas City, Kansas, United States
Memorial Sloan Kettering Cancer CEnter
New York, New York, United States
Baylor Scott and White Research Institute, Charles A. Sammons Cancer Center
Dallas, Texas, United States
Maximum Tolerated dose of Lintuzumab-AC225
establish the maximum tolerated dose as monotherapy
Time frame: Through study completion, an average of 2.5 year
Adverse events- Treatment Emergent
safety of lintuzumab-Ac225
Time frame: Through study completion, an average of 2.5 year
Response rates (objective response rate, complete response rate, stringent complete response rate, very good partial response rate and partial response rate)
response rate, including ORR, CR, sCR, VGPR, and PR, PFS, and OS. Efficacy assessments will include serum and urine analyses for paraprotein levels and bone marrow analyses.
Time frame: Through study completion, an average of 2.5 year
Progression free survival
Progression free survival
Time frame: Through study completion, an average of 2.5 year
Overall survival
Overall survival
Time frame: Through study completion, an average of 2.5 year
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Medical College of Wisconsin
Milwaukee, Wisconsin, United States