This is an open-label, single cohort study to confirm dose, assessments and timing of response, to support future studies. The primary objective of the trial is to evaluate cutaneous tumor response within total target treatment field to REM-001 therapy assessed using standardized digital photography
All participants must have stable or responding systemic disease for at least 3 months at screening. REM-001 Therapy: Day 1: REM-001 = 0.8 mg/kg (IV) at 2 mL/Kg/hr (over approximately 24 minutes) Day 2: Light treatment per treatment area= 100 J/cm2 (10 min per treatment field) - 24 hrs (± 2 hrs) after infusion of REM-001. Total area of target lesions treated will be \< 200 cm2. Participants will be assessed at week 1, 4, 8, 12, 16, 20 and 24 weeks. An additional 4 weeks follow up will be undertaken if confirmatory assessment is required after week 24. Assessments will include: * cutaneous lesion response using photographic imaging * area of ulceration using photographic imaging * presence or absence of ulceration, bleeding, discharge and eschar * patient-reported assessments for pain and itch, using numeric rating scales * quality of life assessments * safety On Day 1 of treatment, the participant will undergo an ECG assessment post-infusion and a blood sample for determination of concentration of REM-001 in plasma will be collected post-infusion.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Infusion of REM-001 (iv) followed by light treatment to treatment field 24 hrs after infusion of REM-001
Memorial Sloan Kettering Cancer Center
New York, New York, United States
Montefiore Einstein Center for Cancer Care
The Bronx, New York, United States
Best Overall Objective Response Rate (bORR)
Best Overall Objective Response Rate (bORR) \[complete response (CR) or partial response (PR)\] of target treatment fields at any time from treatment up to, and including, week 24.
Time frame: Up to week 24
Duration of best overall objective response
Duration of best overall objective response (CR or PR) based on initial target fields
Time frame: Up to week 24
Time from baseline to the date of the first objective response (PR or CR)
Time from baseline to the date of the first objective response (PR or CR)
Time frame: Up to week 24
Change from baseline in area of ulceration
How much the area of ulceration of initial target fields changes from that measured at baseline, when measured by standardized and calibrated digital photography.
Time frame: Up to week 24
Change from baseline in area and volume of lesions
How much the area and volume of lesions of initial target fields changes from that measured at baseline when measured by the standardized and calibrated 3D digital photography
Time frame: Up to week 24
Change from baseline in lesion discharge
Presence or absence of discharge of cutaneous lesion in initial target treatment field - investigator and independent review of photographs.
Time frame: Up to week 24
Change from baseline in lesion bleeding
Presence or absence of bleeding of cutaneous lesion in initial target treatment field - investigator and independent review of photographs.
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Time frame: Up to week 24
Change from baseline in lesion eschar
Presence or absence of eschar of cutaneous lesion in initial target treatment field - investigator and independent review of photographs.
Time frame: Up to week 24
Change from baseline in patient reported assessment of pain
Improvement or worsening of severity of pain using the Brief Pain Inventory-Short Form (BPI-SF) questionnaire over 24 weeks from start of treatment
Time frame: Up to week 24
Change from baseline in patient reported assessment of itch
Improvement or worsening of severity of itching using the Pruritus numerical rating scale (NRS) questionnaire over 24 weeks from start of treatment
Time frame: Up to week 24
Change from baseline participant-reported overall quality of life
Improvement or worsening over 24 weeks from start of treatment in participant-reported overall quality of life assessed using the EORTC QLQ-C30 (v3.0) questionnaire
Time frame: Up to week 24
Investigator-assessed objective response rate (ORR)
Investigator-assessed objective response rate (ORR) over of target treatment fields at any time from treatment up to and including week 24
Time frame: Up to week 24
Progression Free Survival (PFS)
Progression Free Survival (PFS) of systemic disease based on RECIST 1.1
Time frame: Up to week 24
Overall Survival (OS).
Overall Survival (OS).
Time frame: Up to week 24
Adverse events
Incidence and severity of adverse events using CTCAE v5.0 until 24 weeks from treatment
Time frame: Up to week 24
Safety assessments
Incidence and severity of clinically significant safety assessments: clinical laboratory examinations, vital signs, and physical exam
Time frame: Up to week 24
Electrocardiogram (ECG) - QT interval
The effect of REM-001 therapy on QT interval post-infusion
Time frame: Day 1 and 2
Plasma concentrations of REM-001
Determination of plasma concentrations of REM-001 at the end of infusion (15 min post-infusion on day 1) and 24 hrs post-infusion prior to light treatment on day 2
Time frame: Day 1 and 2