A Phase 1/2 Trial of CBL0137 (NSC# 825802) in Patients With Relapsed or Refractory Solid Tumors Including CNS Tumors and Lymphoma
Summary
This phase I/II trial evaluates the best dose, side effects and possible benefit of CBL0137 in treating patients with solid tumors, including central nervous system (CNS) tumors or lymphoma that has come back (relapsed) or does not respond to treatment (refractory). Drugs, such as CBL0137, block signals passed from one molecule to another inside a cell. Blocking these signals can affect many functions of the cell, including cell division and cell death, and may kill cancer cells.
Detailed description
PRIMARY OBJECTIVES: I. To estimate the maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D) of Facilitates Chromatin Transcription (FACT) complex-targeting curaxin CBL0137 (CBL0137) administered via infusion on Day 1 and Day 8 of a 21-day cycle to children with recurrent or refractory solid tumors, including CNS tumors and lymphoma. (Phase 1 Dose Escalation) II. To preliminarily determine the antitumor effects as measured by objective response rate of CBL0137 in children with progressive/recurrent diffuse intrinsic pontine glioma (DIPG) and other H3 K27-altered diffuse midline gliomas (DMG). (Phase 2) SECONDARY OBJECTIVES: I. To preliminarily determine the antitumor effects of CBL0137 in children with refractory solid tumors and other CNS tumors, to the extent possible in the context of a Phase 1 study. II. To define and describe the toxicities of CBL0137 in children with recurrent or refractory solid tumors, including CNS tumors. III. To characterize the pharmacokinetics of CBL0137 in children with recurrent or refractory solid tumors, including CNS tumors. EXPLORATORY OBJECTIVES: I. To measure biologic marker FACT in tumor specimens with potential for correlation with disease response. II. To evaluate the effect of CBL0137 on immune response by measuring the effects on the interferon response pathway in peripheral blood mononuclear cells. III. To preliminarily determine the effect of treatment with CBL0137 on overall survival of children with DIPG or other diffuse midline gliomas, H3 K27-altered, in comparison with historical controls. OUTLINE: This is a phase I, dose-escalation study followed by a phase II study. Patients receive CBL0137 intravenously (IV) over 30 minutes on days 1 and 8. Treatment repeats every 21 days for up to 17 cycles in the absence of disease progression or unacceptable toxicity. Patients with pseudoprogression may remain on treatment, as per the treating physician. Patients also undergo echocardiography (ECHO) collection of blood samples throughout the trial. Patients may also undergo bone marrow aspirate and/or biopsy as clinically indicated. After completion of study treatment, patients are followed up at 3, 6, 9, 12, 18, 24, 36, 48 and 60 months.
Arms & interventions
- ProcedureBiospecimen Collection
Undergo collection of blood samples
- ProcedureBone Marrow Aspirate
Undergo bone marrow aspirate
- ProcedureBone Marrow Biopsy
Undergo bone marrow biopsy
- ProcedureEchocardiography Test
Undergo ECHO
- DrugFACT Complex-targeting Curaxin CBL0137
Given IV
Outcome measures
Primary
Maximum tolerated dose and/or Recommended Phase 2 dose of CBL0137
Maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D) of CBL0137 in children with relapsed or refractory solid tumors including central nervous system (CNS) tumors and lymphoma.
Time frame: Up to 21 days
Frequency of dose limiting toxicities of CBL0137 (Phase I)
The frequency (%) of patients experiencing a cycle 1 dose limiting toxicity attributable to CBL0137 by study part and dose level.
Time frame: Up to 21 days
Anti-tumor effect of CBL0137 in children with diffuse intrinsic pontine glioma (DIPG) or other H3 K27-altered diffuse midline gliomas (Phase II)
Frequency (%) of patients with at least partial response to CBL0137 at the maximum tolerated dose/recommended phase II dose (MTD/RP2D) in children with progressive or recurrent diffuse intrinsic pontine glioma (DIPG).
Time frame: Up to 4 months
Secondary
Anti-tumor effect of CBL0137 in children with solid tumors (Phase I)
Time frame: Up to 4 months
Frequency of adverse events attributable to CBL0137
Time frame: Up to 60 months
Area under the drug concentration curve of CBL0137
Time frame: Up to 3 days
Eligibility criteria
Study locations (34)
Children's Hospital of Alabama
Birmingham, Alabama, 35233
Phoenix Childrens Hospital
Phoenix, Arizona, 85016
Children's Hospital Los Angeles
Los Angeles, California, 90027
Children's Hospital of Orange County
Orange, California, 92868
UCSF Medical Center-Mission Bay
San Francisco, California, 94158
Children's Hospital Colorado
Aurora, Colorado, 80045
Children's National Medical Center
Washington D.C., District of Columbia, 20010
Johns Hopkins All Children's Hospital
St. Petersburg, Florida, 33701
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta, Georgia, 30329
Lurie Children's Hospital-Chicago
Chicago, Illinois, 60611
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
Riley Hospital for Children
Indianapolis, Indiana, 46202
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
C S Mott Children's Hospital
Ann Arbor, Michigan, 48109
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
Washington University School of Medicine
St Louis, Missouri, 63110
Roswell Park Cancer Institute
Buffalo, New York, 14263
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York, 10032
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
New York Medical College
Valhalla, New York, 10595
Duke University Medical Center
Durham, North Carolina, 27710
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
Oregon Health and Science University
Portland, Oregon, 97239
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
Saint Jude Children's Research Hospital
Memphis, Tennessee, 38105
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
Cook Children's Medical Center
Fort Worth, Texas, 76104
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
Primary Children's Hospital
Salt Lake City, Utah, 84113
Seattle Children's Hospital
Seattle, Washington, 98105
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226