Carbonic anhydrase IX (CA IX) has been implicated in the progression of most solid tumours and expression has been demonstrated in clinical samples from a variety of solid cancers. High expression is often associated with high grade or metastatic disease and poor prognosis. CA IX is not expressed in normal tissue, potentially providing a cancer-associated target that would not likely result in significant interruption of normal biologic function in organs not affected by cancer. A humanized monoclonal antibody CA9hu-1 has shown robust activity in a variety of tumour models including models of ovarian, prostate, breast, pancreatic, colon and lung where tumour growth and metastasis are inhibited when CA9hu-1 is used as a monotherapy. Enhancement of chemotherapy has also been demonstrated in several models in combination with CA9hu-1. CA IX is also expressed by tumour-associated cells (angiogenic endothelium, tumour-associated macrophages), which also drive cancer progression. Thus, targeting CA IX with CA9hu-1 in cancer patients is expected to affect multiple pathways and multiple tumour compartments that are important to tumour progression. Taken together, there is strong rationale for developing hu-CA91 for the treatment of advanced cancer. The present study was designed to establish safety and toxicity profile and maximum tolerated dose of CA9hu-1, evaluate pharmacokinetics, investigate the presence of anti-drug antibody, to document anti-tumour activity at a clinically relevant dose, and to document the use of \[18F\]FLT-PET as a biomarker for detection of early tumour response at a clinically relevant dose.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Humanized monoclonal antibody to human carbonic anhydrase IX
Number of adverse events to CA9hi-1 and grading their severity according to the National Cancer Institute's Common Terminology Criteria for adverse Events (NCI CTCAE) Version 4.02.
The primary objective of this outcome is to establish the safety and toxicity profile of hu-CA91.
Time frame: 6 months
Number of patients reaching the dose levels of 750 mg of CA9hu-1 without any dose limiting toxicities.
The objective of this outcome is to perform a dose escalation of of CA9hu-1 to levels of 750mg without any dose limiting toxicities.
Time frame: 4 weeks
Number of patients reaching pharmacologically active dose measurement of CA9hu-1
The objective of this outcome is to determine number of patients in whom the pharmacologically active dose of CA9hu-1 wil be reached by measurement of plasma concentrations of the CA9hu-1. In order to reach the proposed pharmacologically active dose, the plasma levels of 200 +/- 100 nM are necessary.
Time frame: 4 weeks
Maximum tolerated dose of CA91hu-1
The objective is to determine a dose at which no more than one patient out of up to six patients at the same dose level experience a highly probable or probable CA9hu-1 related dose limiting toxicity.
Time frame: 4 weeks
Half-life of CA9-hu-1
Measurement of CA9hu-1 half-life after human administration provides basic PK descriptive data.
Time frame: 4 weeks
Peak Plasma Concentration (Cmax) of CA9hu-1
The measurement of Cmax after CA9hu-1 administration will provide basic PK descriptive parameter of the drug.
Time frame: 4 weeks
Area under the plasma concentration versus time curve (AUC)
The measurement of AUC after CA9hu-1 administration will provide basic PK parameter of the drug.
Time frame: 4 weeks
Anti-drug antibodies
Analyses of plasma samples for presence of anti-drug antibodies following CA9hu-1 administration
Time frame: 6 months
Anti-tumour activity of CA9hu-1
Evaluate response (stable disease, partial response or complete response) in any of the patients as determined by the Response Evaluation Criteria in Solid Tumours Version 1.1 (RECIST).
Time frame: 6 months
Biomarker for detection of early tumour response
Determination of the magnitude of change in apparent standard uptake volume (SUV) calculated from the uptake of FLT by tumour tissue quantified by \[18F\]FLT-PET during the second cycle of CA9hu-1 treatment and the relation with response
Time frame: 6 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.