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Lung CancerPhase 1/2NCT01455389

TUSC2-nanoparticles and Erlotinib in Stage IV Lung Cancer

A Phase 1/2 study testing DOTAP:Chol-TUSC2, Erlotinib and Dexamethasone in people with Lung Cancer, run by Genprex, Inc. at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The goal of phase 1 of this clinical research study is to find the highest dose of DOTAP:Chol-TUSC2 that can be safely given in combination with Tarceva (erlotinib hydrochloride) to patients with NSCLC. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Lung Cancer
What is being tested?
DOTAP:Chol-TUSC2, Erlotinib and Dexamethasone
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
25 participants
Where
1 siteUnited States
Study dates
Feb 2014to 28 Sep 2020
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically or cytologically documented non-small cell lung cancer (NSCLC)
  • Stage IV NSCLC or recurrent NSCLC that is not potentially curable by radiotherapy or surgery. There is no limit to the number or form of prior therapy regimens received, but patients must have received at least one.
  • All subjects must have tumor specimens adequate for analysis of EGFR mutations or have tumor accessible for pretreatment biopsy, and must consent to post-treatment Guardant ctDNA liquid biopsy. Subjects must have specimens adequate for analysis of EGFR mutations (and other clinically relevant biomarkers)
  • All subjects with an activating EGFR mutation (exon 19 deletion or exon 21 L858R mutation) are eligible IF they have progressed following treatment with a first, second, or third generation EGFR inhibitor. All subjects who are EGFR negative or have wild-type EGFR or another non-activating mutation are eligible.
  • ECOG or Zubrod Performance Status ≤1
  • Age ≥18 years
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  • Subjects must have voluntarily signed an informed consent in accordance with institutional policies.
  • Female subjects of childbearing potential (non-childbearing is defined as greater than one year post-menopausal or surgically sterilized) must have a Negative serum pregnancy test (serum beta-HCG) ≤7 days of study treatment. 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 (2) Transvaginal Ultrasound (TVUS) scans one (1) week apart along with serial beta-HCG levels two (2) 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.
  • Subjects are required to agree to practice effective birth control (i.e., abstinence, intrauterine device for female subjects) during the study period.
  • Subjects must be ≥4 weeks beyond major surgical procedures such as thoracotomy, laparotomy or joint replacement, and must be ≥1.5 weeks 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. Note: placement of pleurex catheter is not considered minor surgery for this study.
  • ANC >1500/mm3, platelet count >100,000/mm3 ≤14 days of study treatment
  • PT and PTT <1.25 times the institutional upper limit of normal ≤14 days of study treatment
  • Adequate renal function documented by serum creatinine of ≤1.5 mg/dl or calculated creatinine clearance >50 ml/min ≤14 days of study treatment
  • Adequate hepatic function as documented by serum bilirubin <1.5 mg/dl and SGOT and SGPT ≤2.5 X upper limit of normal ≤14 days of study treatment
  • Subjects 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 start of study treatment. Subjects must be off steroids that were being administered because of brain metastases or related symptoms for ≥2 weeks prior to start of study treatment. Post-treatment imaging ≤2 weeks of informed consent must demonstrate stability or regression of the brain metastases.
  • Stable cardiac condition with a left ventricular ejection fraction ≥40% ≤28 days of study treatment

Who cannot join

  • Subject is female who is pregnant or breast-feeding.
  • Subject received investigational therapy (i.e., agents that are not FDA-approved), including monoclonal antibodies such as bevacizumab or cetuximab, or has received radiotherapy to the skull, spine, thorax or pelvis within ≤30 days of start of study treatment. Subjects are permitted to have received palliative radiotherapy to an extremity provided ≥14 days have elapsed since completion of radiotherapy, provided the subject received ≤10 radiotherapy fractions and a dose ≤30 Gy to that site, and provided skull, spine, thorax or pelvis were not in the radiotherapy field.
  • Subject received standard chemotherapy with FDA-approved agents within ≤21 days of start of study treatment.
  • Subject received a targeted therapy within ≤14 days prior to start of study treatment.
  • Subject has active systemic viral, bacterial or fungal infection(s) requiring treatment.
  • Subject has brain metastases (except as allowed in Section 3.2.1). Neurological assessment will be used to determine brain metastases.
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  • Subject has 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.
  • Subject received prior gene therapy or cell therapy.
  • Subject has history of myocardial infarction or unstable angina ≤6 months of start of study treatment.
  • Subject is known to be HIV positive.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • UT MD Anderson Cancer Center

    Houston, Texas, 77030

Other trials in United States

About this study

Official title: Phase I/II Clinical Trial Combining TUSC2-nanoparticles and Erlotinib in Stage IV Lung Cancer

The goal of phase 1 of this clinical research study is to find the highest dose of DOTAP:Chol-TUSC2 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-TUSC2 and erlotinib hydrochloride can help to control NSCLC.

Read more

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

DOTAP:Chol-TUSC2 (previously FUS1) is a drug that helps transfer a gene called TUSC2 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.

Read the 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-TUSC2 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. NOTE: For all participants dosing of erlotinib has been changed to begin on Day 8 of Cycle 1 and then daily.

Study Drug Administration:

You will receive the drugs dexamethasone and diphenhydramine before each infusion of DOTAP:Chol-TUSC2, 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-TUSC2, 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-TUSC2 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 were 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-TUSC2 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 liquid 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-TUSC2, 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-TUSC2 is only being used in research.

Up to 57 patients will take part in this study. All will be enrolled at MD Anderson as well as additional clinical sites.

Conditions
Lung Cancer
Being tested
DOTAP:Chol-TUSC2, Erlotinib, Dexamethasone, Diphenhydramine
Keywords
Lung Cancer, Non-small cell lung cancer, NSCLC, FUS1-nanoparticles, DOTAP:Chol-TUSC2, DOTAP:Cholesterol-TUSC2 Liposome Complex, Erlotinib, Erlotinib Hydrochloride, OSI-774, Tarceva, Dexamethasone, Decadron, Diphenhydramine, Benadryl, Benylin Cough SyrupPharmacokinetic, PK
Medical subject headings
Lung Neoplasms, Carcinoma, Non-Small-Cell Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DOTAP:Chol-TUSC2Drug

    Also called DOTAP:Cholesterol-TUSC2 Liposome Complex

    Starting Dose 0.045 mg/kg by vein on day 1 of each 21 day cycle; Phase II is Maximum Tolerated Dose from Phase I.

  • ErlotinibDrug

    Also called Erlotinib Hydrochloride, OSI-774, Tarceva

    Starting Dose 100 mg by mouth each day of a 21 day cycle (except for first week of Cycle 1, if enrolled in Phase II delayed-schedule group). Phase II is Maximum Tolerated Dose from Phase I.

  • DexamethasoneDrug

    Also called Decadron

    8 mg orally 24 and 12 hours and 20 mg by vein 30 minutes before DOTAP:Chol-TUSC2 treatment followed by 8 mg orally at 12, 24 and 36 hours after treatment (total number doses = 5).

  • DiphenhydramineDrug

    Also called Benadryl, Benylin Cough Syrup [OTC]

    50 mg by mouth or by vein 30 minutes prior to treatment with DOTAP:Chol TUSC2

Study groups in NCT01455389
Study groupRoleWhat they receive
DOTAP + ErlotinibExperimentalDOTAP:Chol-TUSC2 0.045 mg/kg by vein over 25-35 minutes on day 1 of each 21 day cycle; and Erlotinib 100 mg by mouth daily for each 21 day cycle.
Receives: Drug: DOTAP:Chol-TUSC2; Drug: Erlotinib; Drug: Dexamethasone; Drug: Diphenhydramine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximum Tolerated Dose (MTD) Level for Drug Treatment Combination

    MTD defined as dose level at which less than 2 participants experience dose-limiting toxicity (DLT). Toxicity graded according to National Cancer Institute (NCI) Common Toxicity Criteria (CTC) Version 4. DLT will be grade > 3 toxicity occurring during the first cycle of therapy (i.e., within the first 3 weeks).

    Measured: First 21 day cycle

Secondary outcomes (1)
  1. Response Rate

    Responses determined by RECIST criteria. Responses will include only complete response (CR) + partial response (PR). Participants considered as non-responders when tumor progression by RECIST is observed. Measurable disease is defined as tumor masses with identifiable diameters measurable in two dimensions by computed tomography. Best overall response is best response designation recorded from the start of treatment until disease progression. Complete and partial responses have to be confirmed by two evaluations of the disease taken at least four weeks apart.

    Measured: After two, 21 day cycles

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Oct 2011 (estimated)
  2. Study startFeb 2014
  3. Primary completion27 Oct 2016
  4. Study completion28 Sep 2020

Why it stopped: Trial terminated by sponsor after decision to evaluate combination of quaratusugene ozeplasmid and osimertinib instead of further evaluating quaratusugene ozeplasmid and erlotinib.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
25 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01455389
Sponsor's protocol ID
ONC-002
Status last verified
Feb 2022
First submitted
17 Oct 2011
Last updated
2 Mar 2022
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing DOTAP:Chol-TUSC2, Erlotinib and Dexamethasone in people with Lung Cancer, run by Genprex, Inc. at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 16 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 2 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Trial terminated by sponsor after decision to evaluate combination of quaratusugene ozeplasmid and osimertinib instead of further evaluating quaratusugene ozeplasmid and erlotinib.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximum Tolerated Dose (MTD) Level for Drug Treatment Combination (time frame: First 21 day cycle). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Mar 2022.

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