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Study Summary
No. 2008-0599:.......Solid Tumors......David S. Hong......Investigational Cancer Therapeutics
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Study Summary Title
Study Summary
Number:
2008-0599
Study Title:A Phase 1, First-in-Human Study Evaluating the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of AMG 208 in Adult Subjects with Advanced Solid Tumors
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Physician New Patient Referral
Name:David S. HongPatients Call:800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Dept:Investigational Cancer TherapeuticsReferring MD
Call:
800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Phone:713-563-5844
Contact us about clinical trials
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General Information
Disease Group:Solid TumorsSupported By:Amgen Inc.
Phase of Study:Phase IReturn
Visit:
screening, D1-3, 8, 15, 22, 27, 29, 36, 50, 64, Week 14, every 8 weeks after
week 18, end of study
Subjects in expansion do not come for the day 3 visit
Treatment
Agents:
AMG 208Home Care:n/a
Treatment Loc:Both at MDACC & outside MDACC at one or more Collaborating Sites or Institutions
Estimated
Length of Stay
in Houston:
n/a
Description/
Intervention:
The goal of this clinical research study is to find the highest tolerable dose
of AMG 208 that can be given to patients with an advanced solid tumor. The
safety of this drug will also be studied.
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Study Objectives / Outcomes
The primary objectives of this study are:

For the Dose Escalation and Dose Expansion:
• To evaluate the safety and tolerability of AMG 208 in subjects with advanced solid malignancies.
• To characterize the pharmacokinetic (PK) exposure of AMG 208 when administered orally to subjects with advanced solid malignancies.

For the Dose Escalation only:
• To determine the maximum tolerated dose (MTD) of AMG 208, if possible.

For the Dose Expansion only:
• To evaluate for clinical responses associated with AMG 208 treatment in subjects with advanced solid malignancies according to RECIST criteria.

The secondary objectives of this study are:

For the Dose Escalation and Dose Expansion:
• To evaluate for a decrease in tumor cell proliferation associated with AMG 208 treatment in subjects with advanced solid malignancies according to 18FLT-PET scanning.
• To assess tumor volume changes after AMG 208 treatment by computed tomography (CT) or magnetic resonance imaging (MRI).
• To assess skin specimens for potential biomarkers (e.g. p-c-Met, p-Erk, p-Akt, p-Fak) that reflect c-Met target coverage by AMG 208.
• To determine whether c-Met expression, mutation, or amplification in tumor specimens correlates with a response to AMG 208.

For the Dose Escalation only:
• To evaluate for clinical responses associated with AMG 208 treatment in subjects with advanced solid malignancies according to RECIST criteria.

The exploratory objectives of this study are:

For the Dose Escalation and Dose Expansion:
• To assess blood, skin, and tumor specimens for potential biomarkers (eg, proteins and transcripts) that predicts response to AMG 208.
• To obtain tumor samples for DNA extraction for analysis of potential predictors of response to AMG 208 and any related genes as suggested by emerging data.
• To evaluate the effect of AMG 208 on the number of circulating tumor cells in peripheral blood
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Study Status Information
Study Activation / Registration Date:12/12/2008
IRB Review and Approval Date:12/12/2008
Study Type:Phase I
Recruitment Status:Open
Projected Accrual:102
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Enrollment Eligibility
If you do not meet the enrollment eligibility, there may be other treatment options for you. Please Contact the Referral Office for more information.

Inclusion Criteria:1) Men or women >/= 18 years old

2) Subjects must have a pathologically documented, definitively diagnosed, advanced solid tumor that is refractory to standard treatment, for which no standard therapy is available or the subject refuses standard therapy

3) Part 2: Subjects with the following tumor types are eligible for Part 2 of the study: liver, pancreas, gastric, colon, and kidney cancer.

4) Subjects with hepatocellular carcinoma must have Childs class A liver disease

5) Measurable disease per RECIST guidelines (subjects with non-measurable, but evaluable disease are also eligible for Part 1 of the study). Examples include non measurable lesions (longest diameter <20 mm with conventional techniques or <10 mm with spiral CT scan) apparent on imaging, small skin nodules, bone lesions, cystic lesions, peritoneal studding, or pleural based plaques. These will be clinically evaluated and/or monitored by imaging techniques for tumor response

6) Eastern Cooperative Oncology Group (ECOG) Performance Status of </= 2

7) Life expectancy of > 3 months, in the opinion of the investigator

8) Female subjects who are post-menopausal (no menstrual period for a minimum of 12 months), or surgically sterilized. Female subjects of child bearing potential must remain abstinent or use highly effective methods of birth control and must be willing to use contraception 2 weeks following the last study drug administration and have a negative serum pregnancy test upon entry into this study. Highly effective forms of birth control include sexual abstinence or a condom used with spermicide in combination with barrier methods, hormonal birth control or intrauterine device (IUD).

9) Male subject is willing to use contraception upon enrollment, during the course of the study and for 12 weeks following the last study drug administration

10) Willing to provide existing and/or future paraffin-embedded tumor samples

11) Competent to sign and date an Institutional Review Board approved informed consent form

12) Hematological function, as follows: Absolute neutrophil count (ANC) >/= 1.5 x 10^9/L; Platelet count >/= 100 x 10^9/L; Hemoglobin > 9 g/dL; Prothrombin time (PT) or partial thromboplastin time (PTT) < 1.5 x institutional upper limit of normal (IULN)

13) Renal function, as follows: Serum creatinine < 2.0 mg/dL; Calculated creatinine clearance > 60 ml/min

14) Hepatic function, as follows: aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 3x ULN and total bilirubin < 1.5x ULN except if primary liver tumor is present. If primary liver tumor is present, AST or ALT< 5x ULN and total bilirubin < 2x ULN; Alkaline phosphatase < 2.0 x ULN (if liver or bone metastases are present, or primary liver tumor is present </= 5 x ULN)

Exclusion Criteria:1) Any disorder that compromises the ability of the subject to give written informed consent and/or to comply with the study procedures

2) Primary central nervous system (CNS) tumors or metastases

3) History or current diagnosis of a second neoplasm, except for those curatively treated with no evidence of disease for at least 1 year after the last treatment

4) History of bleeding diathesis

5) Myocardial infarction within 6 months of study day 1, symptomatic congestive heart failure (New York Heart Association > class II), unstable angina, or unstable cardiac arrhythmia requiring medication, or uncontrolled hypertension (systolic > 140 mmHg or diastolic > 90 mmHg);or left ventricular ejection fraction < 50%.

6) A baseline ECG QTcF > 480 ms

7) Active infection within 2 weeks of study enrollment (day 1)

8) Significant gastrointestinal disorder(s), in the opinion of the investigator, (e.g. Crohn's disease, ulcerative colitis, extensive gastrointestinal resection) that may influence drug absorption

9) Known positive test for HIV

10) Known acute or chronic hepatitis B or hepatitis C infection, determined by serologic tests except if a primary liver tumor is present. Subjects with a primary liver tumor may not be excluded provided there is no evidence of acute infection and hepatic function criteria are met. Exceptions to these criteria should be discussed with the sponsor prior to enrollment.

11) Unresolved toxicities from prior anti-tumor therapy, defined as not having resolved to Common Terminology Criteria for Adverse Events (CTCAE) grade 0 or 1, or to levels dictated in the eligibility criteria with the exception of alopecia

12) Anti-tumor therapy (chemotherapy, antibody therapy, molecular targeted therapy, retinoid therapy, hormonal therapy, or investigational agent) within 28 days of study day 1 (six weeks for nitrosureas, mitomycin C, or antibody or molecular targeted agents with t1/2 > 10 days); concurrent use of hormone deprivation therapy including but not limited to leuprolide acetate, anastrozole, letrozole, tamoxifen citrate for hormone-refractory prostate cancer or breast cancer is permitted.(cont. in # 13)

13) (cont. from # 12) Enrollment of subjects that have received molecularly targeted agents less than 28 days prior to study day 1 will be permitted if more than 14 days and at least 5 drug half-lives have passed prior to receiving the first dose of AMG 208.

14) Treatment with immune modulators including, but not limited to, systemic corticosteroids, cyclosporine and tacrolimus within two weeks prior to enrollment

15) Therapeutic or palliative radiation therapy within 2 weeks of study day 1

16) Concurrent or prior (within 7 days of study day 1) anticoagulation therapy (low-dose warfarin < 2 mg/day] or low molecular weight heparins for prophylaxis against central venous catheter thrombosis or aspirin [81 mg/day] is allowed)

17) Prior participation in an investigational study and/or procedure within 28 days of study day 1

18) Major surgery within 30 days of study day 1

19) Any co-morbid medical disorder that may increase the risk of toxicity, in the opinion of the investigator or sponsor

20) Concurrent or prior (within 14 days of study day 1) use of strong CYP3A4 inhibitors (including, but not limited to, ketoconazole, itraconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole)

21) Concurrent or prior (within 7 days of study day 1) Grapefruit products and other foods that are known to inhibit CYP3A4

22) Concurrent or prior (within 28 days of study day 1) use of strong CYP3A4 inducers (including, but not limited to, dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital). Subjects should also refrain from taking St John's Wort

23) Concurrent or prior (within 28 days of study day 1) use of strong P-glycoprotein and Breast Cancer Receptor Protein inhibitors (including, but not limited to elacridar and valspodar).
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Links
Registration Number: NCT00813384 Study Information on Clinical Trials Registry (clinicaltrials.gov)
Other Links:
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Results
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