Background:
Mesothelioma is cancer of the tissue that lines some organs. A new drug, LMB-100, may bind to
a protein on mesothelioma tumors and kill cancer cells. But sometimes the body makes
antibodies that reduce how well LMB-100 works. Researchers want to see if adding the drug
SEL-110 to LMB-100 will prevent these antibodies from forming.
Objective:
To learn how safe and tolerable LMB-100 plus SEL-110 is in people with advanced mesothelioma.
Eligibility:
Adults ages 18 and older who have pleural or peritoneal mesothelioma that has not responded
to prior platinum-based therapy
Design:
Participants will be screened with
- Medical history
- Physical exam
- Blood and urine tests
- Sample of tumor tissue. This can be from a previous procedure.
- Scan of the chest, abdomen, and pelvis. Participants will lie on a table in a scanner
that takes pictures. A special dye may be injected in a vein.
- Positron emission tomography (fludeoxyglucose positron emission tomography (FDG-PET))
scan. A sugar attached to a chemical that gives off a signal will be injected before the
scan.
- Heart function tests
The study will be done in 21-day cycles. Participants will get the study drugs for up to 4
cycles. They will get them through an intravenous (IV) catheter (a tube inserted in a vein,
usually in the arm):
- LMB-100 for about 30 minutes on day 1, day 3, and day 5 of each cycle
- SEL-110 for about 1 hour on day 1 of each cycle
Participants will get standard medicines to help prevent side effects.
Participants will repeat some screening tests during each cycle and about 5 weeks after the
last dose of study drug.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT03436732.
Background:
- LMB-100 and a closely related immunotoxin also targeting mesothelin have been studied in
previous Phase 1 clinical studies for mesothelioma and pancreatic cancer.
- Results from these studies showed that the majority of patients formed
anti-drug-antibodies (ADAs) that neutralized subsequent injection of the product making
it ineffective.
- In a small subset of patients that did not form ADAs to the product, good response and
regression of tumors was seen.
- In a different application SEL-110, a biodegradable nanoparticle containing rapamycin,
has been shown in clinical trials to prevent the formation of ADAs to an immunogenic
enzyme when co-administered. Preclinical data show that SEL-110 also prevents the
formation of ADAs to LMB-100.
- This clinical trial will investigate whether SEL-110 when administered with LMB-100 is
able to prevent the formation of ADAs and thus allow patients to receive multiple,
effective injections of LMB-100.
Objectives:
-The primary objective of the study is to assess the safety and tolerability of LMB-100 in
combination with SEL-110.
Eligibility:
Primary Inclusion Criteria
- Greater than or equal to 18 years of age
- Histologically confirmed epithelial or biphasic pleural or peritoneal mesothelioma not
amenable to potentially curative surgical resection.
- Patients must have measurable disease per Response Evaluation Criteria in Solid Tumors
(RECIST) 1.1.
- Patients must have had at least one prior chemotherapy regimen that includes pemetrexed
and cisplatin or carboplatin. There is no limit to the number of prior chemotherapy
regimens received.
- Patients for whom no standard curative therapy exists
Primary Exclusion Criteria:
- Known or clinically suspected central nervous system (CNS) primary tumors or metastases
including leptomeningeal metastases.
- Evidence of significant, uncontrolled concomitant diseases which could affect compliance
with the protocol or interpretation of results.
- Evidence of active or uncontrolled infections.
- Live attenuated vaccinations 14 days prior to treatment
- Pregnant women are excluded from this study
Design:
- This is a Phase I, single center, dose escalation study of LMB-100 in combination with
SEL-110
- Patients will receive the combination using a dose escalation scheme in which different
doses of LMB100 and SEL-110 will be evaluated.
- Patients will receive 4 cycles of LMB-100 with SEL-110. A cycle will consist of
intravenous (i.v.) infusion of SEL-110 on Day 1 of the cycle followed immediately by an
i.v. infusion of LMB-100, then on Days 3 and 5 of the cycle patients will receive an
i.v. infusion of LMB-100 only. Treatment cycles will be separated by 21 days.
Lead OrganizationNational Cancer Institute
Principal InvestigatorRaffit Hassan