FUS1-nanoparticles and Erlotinib in Stage IV Lung Cancer
Conditions
Lung Cancer
Conditions: official terms
Lung Neoplasms
Conditions: Keywords
Lung Cancer, Non-small cell lung cancer, NSCLC, FUS1-nanoparticles, DOTAP:Chol-fus1, DOTAP:Cholesterol-Fus1 Liposome Complex, Erlotinib, Erlotinib Hydrochloride, OSI-774, Tarceva, Dexamethasone, Decadron, Diphenhydramine, Benadryl, Benylin Cough SyrupPharmacokinetic, PK
Study Type
Interventional
Study Phase
Phase 1/Phase 2
Study Design
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Intervention
Name: DOTAP:Chol-fus1 Type: Drug
Name: Erlotinib Type: Drug
Name: Dexamethasone Type: Drug
Name: Diphenhydramine Type: Drug
Overall Status
Recruiting
Summary
The goal of phase 1 of this clinical research study is to find the highest dose of DOTAP:Chol-fus1 that can be safely given in combination with Tarceva (erlotinib hydrochloride) to patients with NSCLC.

The goal of phase 2 of this clinical research study is to learn if the combination of DOTAP:Chol-fus1 and erlotinib hydrochloride can help to control NSCLC.

The safety of this drug combination will also be studied in both phases.

DOTAP:Chol-fus1 is a drug that helps transfer a gene called fus1 into cancer cells. Researchers think that cells without this gene may be involved in the development of lung cancer tumors. They want to find out if replacing the gene in these cells may keep the tissue from forming cancer cells.

Erlotinib hydrochloride is designed to block a protein on tumor cells that may control tumor growth and survival. This may stop tumors from growing.
Detailed Description
Study Groups:

If you are found to be eligible to take part in this study, you will be assigned to a dose level of DOTAP:Chol-fus1 and erlotinib hydrochloride based on when you join this study. Up to 4 dose levels of the study drug combination will be tested. Three (3) participants will be enrolled at each dose level. The first group of participants will receive the first dose combination level. After this dose is given, the participants will be watched for 3 weeks to check for any serious side effects at that dose level. If any participants in this first group have intolerable side effects, 1-2 lower dose combinations of the study drugs may be tested.

If no intolerable side effects are seen in the first group, the second study group will receive the next planned dose combination. If no intolerable side effects are seen in this group, the last dose combination will be tested.

If you are enrolled in the Phase II portion, you will receive the highest study combination dose that was tolerated in the Phase I portion.

During the Phase II portion of the study, half of the participants will not start receiving erlotinib hydrochloride until Day 8 of Cycle 1 (+/- 1 day). Every odd-numbered participant (1, 3, 5, and so on) enrolled in Phase II will receive this delayed schedule for erlotinib hydrochloride.

Study Drug Administration:

You will receive the drugs dexamethasone and diphenhydramine before each infusion of DOTAP:Chol-fus1, to try to lower the risk of possible allergic reactions to the study drug. Dexamethasone will be given by mouth about 24 hours before your dose of DOTAP:Chol-fus1, and by vein about 30 minutes before the dose. Diphenhydramine will also be given (either by mouth or as an injection) about 30 minutes before the dose.

DOTAP:Chol-fus1 is given by vein as an infusion over 25-35 minutes, on Day 1 of every 3-week study cycle.

You will take erlotinib hydrochloride by mouth in tablet form every day you are on study (except for first week of Cycle 1, if you are enrolled in the Phase II delayed-schedule group).

Erlotinib hydrochloride tablets should be taken at about the same time each day. Each erlotinib dose should be taken with about 8 ounces of water, and should be taken 1 hour before or 2 hours after meals. The whole dose must be taken at one time. If you vomit after taking the tablet(s), you should only re-take the dose if the tablet(s) can still be seen and counted.

Study Tests:

Each study cycle is 3 weeks.

On Day 1 of each cycle:

- Your vital signs (blood pressure, heart rate, temperature, and breathing rate) will be measured.

- Urine will be collected for routine tests.

- You will have a test to measure the level of oxygen in your blood.

On Day 1 of Cycle 1 only, blood (about 4 tablespoons total) will be drawn before your first dose of DOTAP:Chol-fus1 and then about 24 hours later (+/- 4 hours), for research tests to check your immune system.

On Day 2 of each cycle:

- Blood (about 2 teaspoons) will be drawn for routine tests and tests to check your immune system.

- Your vital signs will be recorded, and you will be asked about any side effects you may have.

On Day 7 of Cycle 1, you will have a tumor biopsy for genetic research tests.

On Day 21 of each cycle:

- You will have a physical exam, including measurement of your vital signs.

- Your medical history will be recorded, and you will be asked about any side effects you may be having.

- Blood (about 2 teaspoons) and urine will be collected for routine tests.

On Day 21 of every other cycle (Cycles 2, 4, 6, and so on), you will have either a chest CT or PET/CT scan to check the status of the disease. Other scans may be performed, if your doctor thinks they are needed.

PK Testing:

If you are in Phase 1 and are one of the first 6 participants to be enrolled on this study, blood (about 2 teaspoons each time) will be drawn for pharmacokinetic (PK) testing. PK testing measures the amount of study drug in the body at different time points. PK samples will be drawn during Cycle 1, at the following times:

- Day 1--before the dose of DOTAP:Chol-fus1, at 15 and 30 minutes after the dose, and then 1, 3, and 6 hours after the dose

- Day 2

- Day 4

- Day 8

- Day 15

Length of Treatment:

You may continue taking the study drug for as long as the doctor thinks it is in your best interest. You will no longer be able to take the study drug if the disease gets worse, intolerable side effects occur, or you are unable to follow study directions.

Long-Term Follow-up:

You will be called by the study staff every 3 months after you stop taking the study drugs. The study staff will ask you questions to find out how you are doing and to collect information on any other therapies you have received for cancer. The call should take about 15 minutes.

This is an investigational study. Erlotinib hydrochloride is commercially available and FDA approved for the treatment of non-small-cell lung cancer. At this time, DOTAP:Chol-fus1 is only being used in research.

Up to 57 patients will take part in this study. All will be enrolled at MD Anderson.
Criteria for eligibility
Healthy Volunteers: No
Maximum Age: N/A
Minimum Age: 18 Years
Gender: Both
Criteria: Inclusion Criteria:

1. Histologically or cytologically documented non-small cell lung cancer (NSCLC) .

2. Stage IV NSCLC, or recurrent NSCLC that is not potentially curable by radiotherapy or surgery whether or not they have received prior chemotherapy. There is no limit to the number of prior chemotherapy regimens received.

3. All patients must have tumor specimens adequate for analysis of EGFR mutations and have tumor accessible to biopsy and must consent to biopsy.

4. Karnofsky Performance Status of 70% or greater, or Zubrod Performance Status of 1or less.

5. Age >/= 18 years.

6. Patients must have voluntarily signed an informed consent in accordance with institutional policies.

7. Negative serum pregnancy test (serum HCG) within 7 days of study treatment if female and of childbearing potential (non-childbearing is defined as greater than one year post-menopausal surgically sterilized). Since beta-HCG may be falsely elevated as a result of malignancy, women of child-bearing potential who have an elevated serum beta-HCG level are eligible for enrollment if they have two Transvaginal Ultrasound (TVUS) scans one week apart along with serial beta-HCG levels two weeks apart that are inconsistent with pregnancy and a Gynecology consult to ensure that the beta- HCG level was at a value high enough to see pregnancy with TVUS.

8. Subjects are required to agree to practice effective birth control (i.e. abstinence, intrauterine device for female subjects) during the study period.

9. Patients must be 4 weeks or greater, beyond major surgical procedures such as thoracotomy, laparotomy or joint replacement, and must be 1.5 weeks or greater, beyond minor surgical procedures such as biopsy of subcutaneous tumors, pleuroscopy, etc, and must not have evidence of wound dehiscence, active wound infection, or comparable major residual complications of the surgery.

10. ANC > 1500/mm3, plt count > 100,000/mm3

11. PT and PTT < 1.25 times the institutional upper limit of normal.

12. Adequate renal function documented by serum creatinine of 1.5 mg/dl or less, or calculated creatinine clearance > 50 ml/min.

13. Adequate hepatic function as documented by serum bilirubin< 1.5 mg/dl and SGOT and SGPT 1.5 or less x upper limit of normal.

14. Patients with asymptomatic brain metastases that have been treated are eligible if the following criteria are met: No history of seizures in the preceding 6 months. Definitive treatment must have been completed >/= 4 weeks prior to registration. Subjects must be off steroids that were being administered because of brain metastases or related symptoms for >/= 2 weeks. Post-treatment imaging within 2 weeks of registration must demonstrate stability or regression of the brain metastases.

15. Stable cardiac condition with a left ventricular ejection fraction of 40% or greater.

16. FEV1 and corrected DLCO of 35% or > of predicted.

17. Absence of an activating mutation (Exon 19 deletion or Exon 21 L858R mutation) in the epidermal growth factor receptor (EGFR) in the pre-treatment biopsy of the tumor. Patients with activating EGFR mutations are eligible if they have progressed following treatment with erlotinib. A pretreatment tumor biopsy must be available for analysis. If a biopsy has not been performed prior to entry, then a biopsy will be required.

Exclusion Criteria:

1. Females who are pregnant or breast-feeding.

2. "Study entry" is defined as the date of informed consent. Patients who received investigational therapy (agents that are not FDA approved), monoclonal antibody such as bevacizumab or cetuximab, or who received radiotherapy to the skull, spine, thorax or pelvis within 30 days of entry into the protocol. Patients are permitted to have received palliative radiotherapy to an extremity provided at least 14 days has elapsed since completion of therapy, provided the patient received no more than 10 radiotherapy fractions and a dose no higher than 30 Gy to that site, and provided skull, spine, thorax or pelvis were not in the radiotherapy field.

3. Patients who have received standard chemotherapy with FDA approved agents within 21 days of entry into the protocol.

4. Patients who have received therapy with an oral tyrosine kinase inhibitor (eg, erlotinib) within 14 days prior to entry into the protocol.

5. Active systemic viral, bacterial or fungal infections requiring treatment.

6. Patients with brain metastases (except as allowed in section 4.1.14 of the protocol. Neurological assessment will be used to determine brain metastases.

7. Patients with serious concurrent illness or psychological, familial, sociological, geographical, or other concomitant conditions that, in the opinion of the investigator, would not permit adequate follow-up and compliance with the study protocol.

8. Prior gene therapy.

9. History of myocardial infarction within 6 months or unstable angina within the past 6 months.

10. Patients known to be HIV positive are ineligible.
Location
UT MD Anderson Cancer Center
Houston, Texas, United States
Status: Recruiting
Start Date
February 2014
Sponsors
Genprex, Inc.
Source
Genprex, Inc.
Record processing date
ClinicalTrials.gov processed this data on July 28, 2015
ClinicalTrials.gov page