A Phase I Trial of AVN944, an IMPDH Inhibitor, in Adults With Advanced Stage Solid Tumors

NCT00923728 | Withdrawn

• 2 other identifiers: 09011909-C-0119
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Background:

• AVN944 is an experimental cancer treatment drug, not yet approved by the U.S. Food and Drug Administration. To date, AVN944 as a single drug has been tested in several studies involving humans, including healthy volunteers, patients with leukemia, and patients with advanced pancreatic cancer.
• More research is needed to determine the safety and effectiveness of AVN944. Objectives:
• To determine the safety of AVN944.
• To determine the maximum tolerated dose (the highest dose that does not cause unacceptable side effects) of AVN944.
• To see if AVN944 has any effect on patients' tumors.
• To learn how the body breaks down AVN944. Eligibility:
• Patients 18 years of age and older who have advanced stage solid tumors for which standard therapies do not exist or are no longer effective. Design:
• Participants will have a screening visit and five clinic visits during the first treatment cycle. Additional treatment cycles will involve two clinic visits during each 28-day cycle. After participation in the study ends, patients will be asked to return within 28 days after the last dose of study drug for final study procedures.
• Evaluations before the treatment period:
• Physical examination, including vital signs and body weight checks, and pregnancy test for women who can become pregnant.
• Questions about medications and side effects.
• Blood and urine tests.
• Disease evaluation with CT, chest x-ray, and additional laboratory tests depending on the type of cancer.
• All patients will have blood samples taken at each visit.
• Patients will take specific doses of AVN994 as directed by researchers, and will be asked to keep a diary to record their doses and any side effects. They will be monitored with frequent blood draws at each study visit to provide information on the safety and effectiveness of the drug.
• During different cycles, patients will have their disease evaluated by researchers and will be asked if they wish to continue taking AVN994 as part of the study.

Conditions

Refractory Solid Tumors

Keywords

AVN - 944; Phase I; Adult Solid Tumors; Cancer; Solid Tumor

Outcome Measures

Primary Outcomes (1)

• 1. The dose limiting toxicities with AVN944 in patients with advanced stage solid tumors; 2. Maximum tolerated dose with AVN944 in patients with advanced stage solid tumors

Secondary Outcomes (1)

• 1. Single, repeat dose pharmacokinetics; 2. Inosine monophosphate dehydrogenase inhibition; 3. Anti-neoplastic responses

Interventions

AVN944 DRUG

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients must have histologically confirmed malignancy (histopathological documentation of cancer confirmed in the NCI Laboratory of Pathology at the National Institutes of Health, the Pathology Department at Walter Reed Medical Center, or the Pathology Department at National Naval Medical Center, prior to starting this study) that is metastatic or unresectable and for which standard therapies do not exist or are no longer effective.
• Patients must be at least 4 weeks since prior chemotherapy or radiation therapy and 2 weeks since prior hormonal therapy except for gonadotropin releasing hormone (GnRH) analogues and any acute or serious side effects of those therapies should be Grade less than 1 or returned to baseline
• Patients must be able and willing to take oral capsules.
• ECOG performance status less than or equal to 2
• Life expectancy of greater than 3 months
• Patients must have acceptable organ and marrow function as defined below:
• Leukocytes greater than or equal to 3,000/mcL
• Absolute Neutrophil Count greater than or equal to 1,500/mcL
• Platelets greater than or equal to 100,000/mcL
• Total Bilirubin less than or equal to 1.5 times institutional ULN (patients with known Gilberts syndrome may have values as high as less than or equal to 3.0 X ULN)
• AST(SGOT)/ALT(SGPT) less than or equal to 2.5 times institutional upper limit of normal
• Creatinine less than or equal to 1.5 times institutional upper limit of normal
• The effects of AVN944 on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
• Ability to understand and the willingness to sign a written informed consent document.
• Age greater than or equal to 18 Years. Because no dosing or adverse event data are currently available on the use of AVN944 in patients less than 18 years of age, children are excluded from this study.

You may not qualify if:

• Patients who are receiving concurrent investigational therapy or who have received investigational therapy within 14 days of the first scheduled day of dosing (investigational therapy is defined as treatment for which there is currently no regulatory authority approved indication). Clinically significant toxicities from this therapy must have resolved to less than Grade 2.
• Patients with known active brain metastases or other CNS involvement with less than 6 months since curative-intent treatment
• Patients receiving growth factors
• Prior treatment with an IMPDH-inhibitor e.g. Mycophenolate Mofetil, \& Tiazofurin
• Uncontrolled current illness requiring hospitalization or intravenous antibiotics within the past 7 days
• Pregnant women are excluded from this study because AVN944 agent has the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with AVN944, breastfeeding should be discontinued if the mother is treated with AVN944.
• History of solid organ transplant and are on IMPDH inhibitors (mycophenolate mofetil) therapy
• HIV-positive patients
• Any other investigational treatment
• Any cytotoxic chemotherapy
• Any other systemic anti-neoplastic therapy including, but not limited to, immunotherapy or monoclonal antibody therapy.
• Any radiotherapy, including systemically administered radioisotopes.
• Systemic corticosteroids.
• Any hormonal therapy except GnRH agonists / antagonists for patients with prostate cancer or medroxyprogesterone
• Growth factors

Sponsors & Collaborators

• Vertex Pharmaceuticals Incorporated: lead
• National Cancer Institute (NCI): collaborator

Study Sites (1)

National Institutes of Health Clinical Center, 9000 Rockville Pike

Bethesda, Maryland, 20892, United States

Location

Related Publications (3)

• Sintchak MD, Fleming MA, Futer O, Raybuck SA, Chambers SP, Caron PR, Murcko MA, Wilson KP. Structure and mechanism of inosine monophosphate dehydrogenase in complex with the immunosuppressant mycophenolic acid. Cell. 1996 Jun 14;85(6):921-30. doi: 10.1016/s0092-8674(00)81275-1.

  PMID: 8681386 BACKGROUND

• Allison AC, Hovi T, Watts RW, Webster AD. The role of de novo purine synthesis in lymphocyte transformation. Ciba Found Symp. 1977;(48):207-24. doi: 10.1002/9780470720301.ch13.

  PMID: 415850 BACKGROUND

• Jackson RC, Weber G, Morris HP. IMP dehydrogenase, an enzyme linked with proliferation and malignancy. Nature. 1975 Jul 24;256(5515):331-3. doi: 10.1038/256331a0. No abstract available.

  PMID: 167289 BACKGROUND

MeSH Terms

Conditions

Neoplasms

Interventions

AVN 944

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: INDUSTRY

Study Record Dates

• First Submitted: June 17, 2009
• First Posted: June 18, 2009
• Study Start: April 1, 2009
• Primary Completion: March 1, 2010
• Study Completion: March 1, 2010
• Last Updated: January 10, 2014

Record last verified: 2011-08

Locations

US (1)