This study will evaluate the safety of BXQ-350 and determine the maximum tolerated dose (MTD) in children with newly diagnosed DIPG or DMG. All patients will receive BXQ-350 by intravenous (IV) infusion and radiation therapy. The study is divided into two parts: Part 1 will enroll patients at increasing dose levels of BXQ-350 in order to determine the MTD. Part 2 will enroll patients requiring a biopsy in order to assess BXQ-350 concentrations in the biopsied tumor.
BXQ-350 is a novel anti-neoplastic therapeutic agent configured from two components: Saposin C (SapC), an expressed (human) lysosomal protein, and the phospholipid dioleoylphosphatidyl-serine (DOPS), a cell membrane phospholipid (clinical formulation BXQ-350). Given via intravenous IV, data indicate that the agent exhibits the propensity to enter the body and brain, target cells in the tumor mass, and induce cell death. DIPG and DMG present a treatment dilemma due to resistance to standard therapy (radiotherapy) and aggressive clinical course. The use of BXQ-350 provides a novel approach to the treatment of cancer through interaction with the cancer cell membrane. This drug appears to be well tolerated in previous clinical trials, and in combination with the standard of care radiation therapy, may help improve overall survival in these patients. The study is divided into 2 parts: Part 1: Dose Escalation and Safety - Sequential cohorts of patients 1-30 years of age with newly diagnosed DIPG or DMG will be treated with escalating doses of BXQ-350 until the MTD is established, or in the absence of a Maximum Administered Dose, the highest planned dose level is reached. Part 2: BXQ-350 Tumor and Plasma Concentrations - Patients undergoing neurosurgical biopsy prior to receiving radiation therapy will be enrolled and receive BXQ-350 at the MTD determined in Part 1, or at the highest planned dose level, and radiation therapy. Excised tumor tissue will be evaluated for SapC levels and pharmacodynamic effects. This clinical trial information was submitted voluntarily under the applicable law and, therefore, certain submission deadlines may not apply. (That is, clinical trial information for this applicable clinical trial was submitted under section 402(j)(4)(A) of the Public Health Service Act and 42 CFR 11.60 and is not subject to the deadlines established by sections 402(j)(2) and (3) of the Public Health Service Act or 42 CFR 11.24 and 11.44.)
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
10
BXQ-350 is a novel anti-neoplastic therapeutic agent configured from two components: Saposin C (SapC), an expressed (human) lysosomal protein, and the phospholipid dioleoylphosphatidyl-serine (DOPS), a phospholipid located on cell membranes (clinical formulation BXQ-350). During Part 1, BXQ-350 will be administered by intravenous (IV) infusion over twelve months.
BXQ-350 is a novel anti-neoplastic therapeutic agent configured from two components: Saposin C (SapC), an expressed (human) lysosomal protein, and the phospholipid dioleoylphosphatidyl-serine (DOPS), a phospholipid located on cell membranes (clinical formulation BXQ-350). During Part 2, BXQ-350 will be administered by intravenous (IV) infusion over twelve months.
Children's Hospital Colorado
Aurora, Colorado, United States
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States
Nationwide Children's
Columbus, Ohio, United States
Incidence of Treatment Emergent Adverse Events as Assessed by CTCAE v5.0
To determine the safety of BXQ-350 in children with newly diagnosed DIPG or DMG, as evidenced by the incidence of treatment emergent adverse events assessed by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
Time frame: 12 months
Part 1 - Maximum Tolerated Dose
To determine the maximum tolerated dose (MTD) of BXQ-350, when given with radiation therapy, according to the investigational product (IP) related dose limiting toxicities (DLTs) in children with newly diagnosed DIPG or DMG.
Time frame: 12 months
Part 2 - BXQ-350 Concentration in Tumor Samples
To determine the concentration of BXQ-350 in tumor samples as evidenced by laboratory analysis of excised tumor tissue for SapC levels (a component of BXQ-350).
Time frame: 12 months
Part 2 - BXQ-350 Concentration in Plasma Samples
To determine the concentration of BXQ-350 in plasma samples as evidenced by laboratory analysis of plasma samples for SapC levels (a component of BXQ-350).
Time frame: 12 months
Objective Response Rate (ORR)
To determine the ORR of BXQ-350 when given with radiation therapy in children with newly diagnosed DIPG or DMG. ORR is defined as the percentage of participants with evidence of a complete or partial response as per the Response Assessment in Neuro-Oncology (RANO) criteria.
Time frame: 12 months
Overall Survival (OS)
To evaluate OS in children with newly diagnosed DIPG or DMG receiving BXQ-350 with radiation therapy. OS is defined as the time from initiation of therapy to death from any cause. Participants still alive will be censored at the date of the last contact.
Time frame: 12 months
Quality of Life (QoL)
To evaluate QoL in children with newly diagnosed DIPG or DMG receiving BXQ-350 with radiation therapy. QoL will be measured utilizing the Patient-Reported Outcomes Measurement Information System (PROMIS) in participants 5 years of age or older. PROMIS measures use a T-score metric in which 50 is the mean of a relevant reference population and 10 is the standard deviation. A higher score equals more of the concept being measured (i.e. more fatigue, more physical function, etc.). This could be a desirable or undesirable outcome, depending on the concept being measured.
Time frame: 12 months
Concentration of drug at steady state (Css)
To assess exposure to BXQ-350 in children with newly diagnosed DIPG or DMG receiving BXQ-350 with radiation therapy. Exposure will be measured utilizing pharmacokinetic parameter of concentration of drug at steady state (Css).
Time frame: 12 months
Exposure to BXQ-350 - area under the curve (AUC)
To assess exposure to BXQ-350 in children with newly diagnosed DIPG or DMG receiving BXQ-350 with radiation therapy. Exposure will be measured utilizing pharmacokinetic parameter of area under the curve (AUC).
Time frame: 12 months
Exposure to BXQ-350 - clearance (CL)
To assess exposure to BXQ-350 in children with newly diagnosed DIPG or DMG receiving BXQ-350 with radiation therapy. Exposure will be measured utilizing pharmacokinetic parameter of clearance (CL).
Time frame: 12 months
Exposure to BXQ-350 - volume of distribution (Vd)
To assess exposure to BXQ-350 in children with newly diagnosed DIPG or DMG receiving BXQ-350 with radiation therapy. Exposure will be measured utilizing pharmacokinetic parameter of volume of distribution (Vd).
Time frame: 12 months
Exposure to BXQ-350 - half-life (t½)
To assess exposure to BXQ-350 in children with newly diagnosed DIPG or DMG receiving BXQ-350 with radiation therapy. Exposure will be measured utilizing pharmacokinetic parameter of volume of half-life (t½).
Time frame: 12 months
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