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Brief Title: Phase 1 and 2 Study of PX-866 and Cetuximab
Official Title: Phase 1/2 Study of PX-866 and Cetuximab
Study ID: NCT01252628
Brief Summary: The purpose of this Phase 1/2 open-label study is to determine the safety and efficacy of a cetuximab and PX-866 combination treatment. In the Phase 1 part of the study, the dose of PX-866 to be given in combination with cetuximab will be determined in patients with incurable metastatic CRC or incurable progressive, recurrent or metastatic SCCHN. The Phase 2 part of the study is a randomized evaluation of the antitumor activity and safety of PX-866 in combination with cetuximab versus cetuximab alone in patients with either incurable metastatic CRC who have a history of progression or recurrence following prior irinotecan and oxaliplatin containing regimens or are intolerant of irinotecan (Group 1) or incurable progressive, recurrent or metastatic SCCHN (Group 2).
Detailed Description: Phase 1 will determine the maximally tolerated or recommended dose of PX-866 to be given orally on Days 1-21 in combination with cetuximab 250 mg/m2 administered IV weekly on Days 1, 8, and 15 of a 21-day cycle. All patients will receive an initial loading dose of 400 mg/m2 cetuximab rather than 250 mg/m2 on Cycle 1 Day 1. Patients may receive premedication with an H1 antagonist per the cetuximab package insert. Up to 3 dose levels of PX-866 will be evaluated to determine the MTD/RD in cohorts of up to 6 patients using a standard 3+3 dose-escalation design. At least 6 patients will be treated at the MTD/RD. All patients in Phase 1 will be required to undergo PK assessments during Cycle 1 Week 3 to measure cetuximab levels. Exploratory PD assessments will include evaluation of changes in levels of fasting C-peptide as well as changes in EGFR and PI-3K signaling pathways in peripheral blood mononuclear cells (PBMC) and platelets. Additional optional evaluations will include changes in EGFR and PI-3K signaling in paired tumor biopsies provided before and after one cycle of treatment. All patients will be asked, but not required, to provide an archived tumor biopsy sample for evaluation for potential biomarkers of response to PX-866 and cetuximab. Phase 2 is an open-label, randomized evaluation of the antitumor activity and safety of PX-866 administered orally or via PEG tube (if applicable) at the MTD/RD in combination with cetuximab, versus cetuximab alone in cetuximab-naïve patients with incurable metastatic CRC who have a history of progression or recurrence following prior irinotecan and oxaliplatin containing regimens or are intolerant of irinotecan (Group 1) or patients with incurable progressive, recurrent or metastatic SCCHN (Group 2). Seventy two evaluable patients (36 patients per arm) will be evaluated per indication. Patients will be randomized 1:1 to receive PX-866 + cetuximab or cetuximab alone.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Birmingham Hematology and Oncology Assocs., Birmingham, Alabama, United States
University of Alabama Birmingham, Birmingham, Alabama, United States
Southwest Cancer Care, Escondido, California, United States
Monterey Bay Oncology, Monterey, California, United States
Ventura County Hematology Oncology Specialists, Oxnard, California, United States
University of Colorado Denver, Aurora, Colorado, United States
Rocky Mountain Cancer Centers, Denver, Colorado, United States
Eastern Colorado Health Care System - (Denver VA), Denver, Colorado, United States
George Washington University - Medical Faculty Associates, Washington, District of Columbia, United States
Integrated Community Oncology Network, Jacksonville, Florida, United States
Advanced Medical Specialties, Miami, Florida, United States
Pasco Pinellas Cancer Center, New Port Richey, Florida, United States
Peachtree Hematology-Oncology Consultants, Atlanta, Georgia, United States
Center for Cancer and Blood Disorders, Bethesda, Maryland, United States
Tufts Medical Center, Boston, Massachusetts, United States
Karmanos Cancer Institute, Detroit, Michigan, United States
Saint Louis Cancer Care LLP, Bridgeton, Missouri, United States
Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, United States
Northwest Cancer Specialists, P.C., Tualatin, Oregon, United States
University of Pennsylvania, Philadelphia, Pennsylvania, United States
MUSC Hollings Cancer Center, Charleston, South Carolina, United States
Mary Crowley Cancer Center, Dallas, Texas, United States
Texas Oncology - Baylor Charles A. Sammons, Dallas, Texas, United States
Texas Oncology - Fort Worth, Fort Worth, Texas, United States
Texas Oncology - Seton Williamson, Round Rock, Texas, United States
Virginia Cancer Specialists, PC, Fairfax, Virginia, United States
Peninsula Cancer Institute, Newport News, Virginia, United States
Virginia Oncology Associates, Newport News, Virginia, United States
Oncology and Hematology Associates of Southwest Virginia, Roanoke, Virginia, United States
Columbia Basin Hematology and Oncology, Kennewick, Washington, United States
Medical Oncology Associates, Spokane, Washington, United States
Cross Cancer Institute, Edmonton, Alberta, Canada
British Columbia Cancer Agency - Vancouver Centre, Vancouver, British Columbia, Canada
Royal Victoria Regional Health Centre, Barrie, Ontario, Canada
London Regional Cancer Program, London, Ontario, Canada
Northeast Cancer Centre of Health Sciences North, Sudbury, Ontario, Canada
Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
Hôpital Charles-LeMoyne, Greenfield Park, Quebec, Canada
Cité de la Santé de Laval, Laval, Quebec, Canada
Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
Name: Diana Hausman, MD
Affiliation: Cascadian Therapeutics Inc.
Role: STUDY_DIRECTOR