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Brief Title: 9-ING-41 in Patients With Advanced Cancers
Official Title: Phase 1/2 Study of 9-ING-41, a Glycogen Synthase Kinase-3 Beta (GSK-3β) Inhibitor, as a Single Agent and Combined With Chemotherapy, in Patients With Refractory Hematologic Malignancies or Solid Tumors
Study ID: NCT03678883
Brief Summary: GSK-3β is a potentially important therapeutic target in human malignancies. The Actuate 1801 Phase 1/2 study is designed to evaluate the safety and efficacy of 9-ING-41, a potent GSK-3β inhibitor, as a single agent and in combination with cytotoxic agents, in patients with refractory cancers.
Detailed Description: 9-ING-41 is a first-in-class, intravenously administered, maleimide-based small molecule potent selective GSK-3β inhibitor with significant pre-clinical antitumor activity. GSK-3 is a serine/threonine kinase initially described as a key regulator of metabolism and has a role in diverse disease processes including cancer, immune disorders, pathologic fibrosis, metabolic disorders, and neurological disorders. GSK-3 has two ubiquitously expressed and highly conserved isoforms, GSK-3α and GSK-3β, with both shared and distinct substrates and functional effects. GSK-3β is particularly important in tumor progression and modulation of oncogenes (including beta-catenin, cyclin D1 and c-Myc), cell cycle regulators (e.g. p27Kip1) and mediators of epithelial-mesenchymal transition (e.g. zinc finger protein SNAI1, Snail). Aberrant overexpression of GSK-3β has been shown to promote tumor growth and chemotherapy resistance in various solid tumors including colon, ovarian, and pancreatic cancers and glioblastoma through differential effects on the pro-survival nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and c-Myc pathways as well on tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and p53-mediated apoptotic mechanisms. GSK-3β helps maintain malignant cell survival and proliferation, particularly in terms of mediating resistance to standard anti-cancer therapies, through the NF-κB pathway. GSK-3β has been established as a potential anticancer target in human bladder, breast, colorectal, glioblastoma, lung, neuroblastoma, ovarian, pancreatic, prostate, renal and thyroid cancers as well as chronic lymphocytic leukemia and lymphomas. 9-ING-41 is a small molecule potent selective GSK-3β inhibitor with broad spectrum pre-clinical antitumor activity. It's modes of action include downregulation of NF-κB and decreasing the expression NF-κB target genes including cyclin D1, Bcl-2, anti-apoptotic protein (XIAP) and B-cell lymphoma-extra large (Bcl-XL) leading to inhibition of tumor growth in multiple solid tumor cell and lymphoma lines and patient derived xenograft (PDX) models. NF-κB is constitutively active in cancer cells and promotes anti-apoptotic molecule expression. NF-κB activation is particularly important in cancer cells that have become chemo- and/or radio-resistant. 9-ING-41 also has significant activity in pre-clinical models of pathological pleural and pulmonary fibrosis. 9-ING-41 has significant in vitro and in vivo activity as a single agent and/or in combination with standard cytotoxic chemotherapies in a spectrum of solid tumors and hematological malignancies including bladder, breast, glioblastoma, neuroblastoma, pancreatic, sarcomas, and renal cancers as well as lymphomas. The 1801 had three parts: * Completed: Part 1 (9-ING-41 as monotherapy): The standard 3+3 dose escalation design will be applied to all dose cohorts until the Maximum Tolerated Dose (MTD) or Recommended Phase 2 Dose (RP2D) is identified. * Completed: 9-ING-41 combined with standard anticancer agents: The 3+3 dose escalation study design will be used for 8 chemotherapy combination regimens (9-ING-41 plus gemcitabine, doxorubicin, lomustine, carboplatin, irinotecan, nab-paclitaxel plus gemcitabine, paclitaxel plus carboplatin, pemetrexed plus carboplatin) to identify the MTD/RP2D of each regimen. * Part 3: A randomized Phase 2 study of 9-ING-41 either once or twice weekly with gemcitabine and nab-paclitaxel (GA) versus GA alone for patients with previously untreated metastatic or locally advanced pancreatic cancer is now open.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Mayo Clinic, Phoenix, Arizona, United States
Arizona Oncology Associates, Tucson, Arizona, United States
The University of Arizona Cancer Center, Tucson, Arizona, United States
University of California Irvine Health, Orange, California, United States
UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California, United States
Christiana Care Health Services, Newark, Delaware, United States
Sibley Memorial Hospital, Washington, District of Columbia, United States
Florida Cancer Specialists - South, Fort Myers, Florida, United States
Miami Cancer Institute, Miami, Florida, United States
Florida Cancer Specialists - North, Saint Petersburg, Florida, United States
Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, United States
Des Moines Oncology Research Association, Des Moines, Iowa, United States
Kansas University Cancer Center, Kansas City, Kansas, United States
Ochsner Clinic Foundation, New Orleans, Louisiana, United States
University of Michigan, Ann Arbor, Michigan, United States
MetroMetro-Minnesota Community Oncology Research Consortium (MMCORC), Minneapolis, Minnesota, United States
Mayo Clinic, Rochester, Minnesota, United States
Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, United States
Morristown Medical Center, Morristown, New Jersey, United States
Capital Health Medical Center/ Hopewell, Pennington, New Jersey, United States
MD Anderson Cancer Center at Cooper, Voorhees, New Jersey, United States
Columbia University- Irving Medical Center, New York, New York, United States
Stony Brook University Hospital, Stony Brook, New York, United States
Duke University Medical Center, Durham, North Carolina, United States
Oregon Health and Science University, Portland, Oregon, United States
St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
Allegheny Health Network, Pittsburgh, Pennsylvania, United States
Rhode Island Hospital, Providence, Rhode Island, United States
Prisma Health Cancer Institute, Greenville, South Carolina, United States
Sanford Research, Sioux Falls, South Dakota, United States
West Cancer Center, Germantown, Tennessee, United States
Baptist Clinical Research Institute, Memphis, Tennessee, United States
Sarah Cannon Research Institute- Tennessee Oncology-Nashville, Nashville, Tennessee, United States
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, United States
Texas Oncology- Charles A. Sammons Cancer Center, Dallas, Texas, United States
UT Southwestern Medical Center, Dallas, Texas, United States
Utah Cancer Specialists, Salt Lake City, Utah, United States
Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
West Virginia University, Morgantown, West Virginia, United States
UW Carbone Cancer Center, Madison, Wisconsin, United States
UZA- Antwerpen, Edegem, Antwerp, Belgium
Imelda VZW, Bonheiden, , Belgium
UZ Gent, Gent, , Belgium
UZ Leuven Gasthuisberg, Leuven, , Belgium
Cross Cancer Institute, Edmonton, Alberta, Canada
QE II Health Sciences Centre, Halifax, Nova Scotia, Canada
Centre Intégré de Santé et de Services Sociaux de la Montérégie-Centre, Greenfield Park, Quebec, Canada
Jewish General Hospital, Montréal, Quebec, Canada
McGill University Health Centre, Montréal, Quebec, Canada
Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
Center Hospitalier Regional Universitaire de Besancon - Site Jean Minjoz, Besançon, Bourgogne-Franche-Comte, France
CHRU Brest Hopital Morvan, Brest, Bretagne, France
Hopital Claude Huriez, Lille, Hauts De France, France
Institute de Cancerologie de Lorraine, Vandœuvre-lès-Nancy, Meurthe-et-Moselle, France
Institut Bergonie, Bordeaux, Nouvelle Aquitaine, France
Insitut de Cancerologie de l'Ouest, Saint-Herblain, Pays-de-la-Loire, France
Hopital de la Timone, Marseille, , France
Netherlands Cancer Institute, Amsterdam, , Netherlands
Fundacao Champalimaud, Lisbon, , Portugal
Hospital Da Luz, Lisbon, , Portugal
Centro Hospitalar Universitario Sao Joao, Porto, , Portugal
Vall d'Hebron Institute of Oncology, Barcelona, , Spain
Institut Catala d'Oncologia, Barcelona, , Spain
Hospital Clinico U San Carlos (HSC), Madrid, , Spain
START Madrid-HM CIOCC Hospital Universitario, Madrid, , Spain
INCLIVA University of Valencia, Valencia, , Spain