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A Study of IMC-A12 in Participants With Tumors Who No Longer Respond to Treatment or For Whom No Treatment is Available

Phase I Study of Anti-Insulin-Like Growth Factor-I Receptor (IGF-IR) Monoclonal Antibody IMC-A12 in Patients With Advanced Solid Tumors Who No Longer Respond to Standard Therapy or for Whom No Standard Therapy is Available

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00785538
Enrollment
24
Registered
2008-11-05
Start date
2005-10-31
Completion date
2011-01-31
Last updated
2019-01-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Advanced Solid Tumors

Keywords

Tumors, Antibodies, Monoclonal

Brief summary

The purpose of this study is to determine if IMC-A12 is safe for participants, and also to determine the best dose of IMC-A12 to give to participants.

Detailed description

The purpose of this study is to establish the safety profile and maximum tolerated dose (MTD) of the anti-IGF-IR monoclonal antibody IMC-A12 administered weekly in participants with advanced solid tumors who no longer respond to standard therapy or for whom no standard therapy is available

Interventions

BIOLOGICALIMC-A12

Cohort 1 3 milligrams/kilogram (mg/kg), I.V. once a week, for 4 weeks, followed by a 2-week observation period.

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Histopathologically-documented, measurable, advanced primary or recurrent solid tumors that no longer respond to standard therapy or for which no standard therapy is available. * Eastern Cooperative Oncology Group (ECOG) performance status score of ≤2 at study entry * Able to provide written informed consent * Life expectancy of \>3 months * Adequate hematologic functions, as defined by: absolute neutrophil count (ANC) ≥1500/cubic millimeter (mm³), hemoglobin level ≥10 grams/deciliter (gm/dL), platelet count ≥100,000/mm³ * Adequate hepatic function, as defined by: total bilirubin level ≤1.5 x the upper limit of normal (ULN), aspartate transaminase (AST) and alanine transaminase (ALT) levels ≤2.5 x the ULN or ≤5 x the ULN if known liver metastases * Adequate renal function, as defined by a serum creatinine level ≤1.5 x the ULN * Ejection fraction within the normal institutional limits * Use of effective contraception per institutional standard, if procreative potential exists * At least 28 days must have elapsed from major surgery, prior chemotherapy, prior treatment with an investigational agent or device, prior radiation therapy (palliative radiation therapy is allowed), an open biopsy, or a significant traumatic injury to allow for adequate recovery. Ongoing side effects due to these agents must be ≤Grade 2 prior to entering the study. * At least 6 weeks must have elapsed from nitrosoureas, mitomycin C, or monoclonal antibody \[not targeting the insulin-like growth factor receptor (IGFR)\] therapy to allow for adequate recovery. Ongoing side effects due to these agents must be ≤Grade 2 prior to entering the study. * Accessible for treatment and follow-up. Participants enrolled in this trial must be treated at the participating center.

Exclusion criteria

* Any concurrent malignancy other than non-melanomatous skin cancer or carcinoma in situ of the cervix. Participants with a previous malignancy but without evidence of disease for ≥3 years will be allowed to enter the trial. * Uncontrolled intercurrent illness including, but not limited to: ongoing or active infection requiring parenteral antibiotics, symptomatic congestive heart failure, unstable angina pectoris, angioplasty, stenting or myocardial infarction within 6 months, uncontrolled hypertension, clinically significant cardiac arrhythmia, psychiatric illness/social situations that would compromise participant safety or limit compliance with study requirements, participants with symptomatic brain metastases * Serious or nonhealing active wound, ulcer or bone fracture * Know human immunodeficiency virus (HIV)-positive * History of hemorrhagic or thrombotic disorder within 9 months * Proteinuria ≥1+ by routine urinalysis (participants with a protein value of ≤500 milligrams (mg) confirmed by a 24-hour urine collection are eligible) * Pregnant \[confirmed by serum beta human chorionic gonadotropin (βHCG)\] or breast feeding * History of prior treatment with other agents specifically targeting IGFRs * Known diabetes * Inability or unwillingness to interrupt steroidal or hormonal therapy for the duration of treatment with IMC-A12 * Positive anti-IMC-A12 antibody response * History of allergic reactions to monoclonal antibodies or other therapeutic proteins * Employees of the investigator or study center with direct involvement in this study or other studies under the direction of the investigator or study center, as well as family members of the employees.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Adverse Events (AEs) or DeathsEnrollment to study completion up to 215 weeksData presented are the number of participants who experienced serious adverse events (SAEs), other non-serious AEs and deaths during the study including the 30-day follow-up. A summary of SAEs and other non-serious AEs, regardless of causality, is located in the Reported Adverse Event module.
Maximum Tolerated Dose (MTD)6 weeksThe MTD was defined as the dose preceding the dose level at which 2 participants experienced a dose-limiting toxicity (DLT). A DLT was defined as any Grade 3 or 4 hematologic or nonhematologic toxicity based on Common Terminology Criteria for AE (CTCAE), excluding alopecia, which was considered by the investigator to be definitely, probably, or possibly related to IMC-A12.

Secondary

MeasureTime frameDescription
Area Under the Serum Concentration Versus Time Curve of IMC-A12 During One Dosing Interval (AUCτ) Following Multiple DosesPredose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1
Half-Life (t1/2) of IMC-A12 Following Multiple DosesPredose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1Half-Life (t1/2) is the time measured for the plasma concentration of the drug to decrease by one half. The analysis was not performed for the 6 mg/kg and 10 mg/kg dosing groups due to insufficient PK data.
Clearance Rate of IMC-A12 at Steady State (CLss) Following Multiple DosesPredose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1CLss is the volume of plasma (or blood) from which the drug is completely removed, or cleared, in a given time at steady-state.
Maximum Concentration (Cmax) of IMC-A12 Following Multiple DosesPredose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1
Serum Anti-IMC-A12 Antibody Assessment (Immunogenicity)Before the last infusion of each treatment cycleAnalysis was not performed due to lack of available assay.
Number of Participants With Best Overall ResponseEnrollment to study completion up to 215 weeksStable Disease (SD) is neither sufficient shrinkage to qualify for partial response (PR) nor sufficient increase to qualify for progressive disease (PD). PR and PD were assessed by investigators according to the Response Evaluation Criteria In Solid Tumors (RECIST) criteria version 1.0. PR is ≥30% decrease in sum of longest diameter of target lesions. PD is ≥20% increase in sum of longest diameter of target lesions and/or a new lesion. Participants with a global deterioration of their health status requiring discontinuation of treatment without objective evidence of disease progression at that time were to be reported as symptomatic deterioration
Volume of Distribution of IMC-A12 at Steady State (Vss) Following Multiple DosesPredose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1Vss is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired blood concentration of a drug at steady-state. The analysis was not performed for the 6 mg/kg and 10 mg/kg dosing groups due to insufficient PK data.
Observed Serum Concentration of IMC-A12 at 168 Hour Post End of Infusion Following Multiple DosesPredose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1

Countries

United States

Participant flow

Recruitment details

For participants enrolled under Protocol Versions 1.0 and 2.0, there was a 2-week pharmacokinetic (PK) period prior to Cycle 1.

Pre-assignment details

After completion of the 10 milligrams/kilogram (mg/kg) cohort, PK data were obtained that established a recommended dose for Phase 2 studies. Enrollment and dose escalation beyond 15 mg/kg was stopped. Participants with progressive disease (PD) or death were considered to have completed the study.

Participants by arm

ArmCount
3 mg/kg
3 mg/kg IMC-A12 administered I.V. on Day 1 of a 2-week PK period prior to Cycle 1. 3 mg/kg IMC-A12 administered I.V. once a week for 4 weeks, for a total of 4 doses per cycle. Cycle 1 was followed by a 2-week observation. Participants with an objective response after Cycle 1 could have received additional treatment cycles at the same dose and schedule until disease progression or withdrawal criteria were met. Participants with SD could have received up to 2 additional 4-week treatment cycles at the same dose and schedule.
7
6 mg/kg
6 mg/kg IMC-A12 administered I.V. on Day 1 of a 2-week PK period prior to Cycle 1. 6 mg/kg IMC-A12 administered I.V. once a week for 4 weeks, for a total of 4 doses per cycle. Cycle 1 was followed by a 2-week observation. Participants with an objective response after Cycle 1 could have received additional treatment cycles at the same dose and schedule until disease progression or withdrawal criteria were met. Participants with SD could have received up to 2 additional 4-week treatment cycles at the same dose and schedule.
9
10 mg/kg
10 mg/kg IMC-A12 administered I.V. on Day 1 of a 2-week PK period prior to Cycle 1. 10 mg/kg IMC-A12 administered I.V. once a week for 4 weeks, for a total of 4 doses per cycle. Cycle 1 was followed by a 2-week observation. Participants with an objective response after Cycle 1 could have received additional treatment cycles at the same dose and schedule until disease progression or withdrawal criteria were met. Participants with SD could have received up to 2 additional 4-week treatment cycles at the same dose and schedule.
6
15 mg/kg
15 mg/kg IMC-A12 administered I.V. once a week for 4 weeks, for a total of 4 doses per cycle. Cycle 1 was followed by a 2-week observation. Participants with an objective response after Cycle 1 could have received additional treatment cycles at the same dose and schedule until disease progression or withdrawal criteria were met. Participants with SD could have received up to 2 additional 4-week treatment cycles at the same dose and schedule.
2
Total24

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Treatment PeriodAdverse Event1220
Treatment PeriodWithdrawal by Subject0001

Baseline characteristics

Characteristic3 mg/kg6 mg/kg10 mg/kg15 mg/kgTotal
Age, Continuous65.7 years
FULL_RANGE 10.43
56.4 years
FULL_RANGE 6.3
59.4 years
FULL_RANGE 15.17
42.9 years
FULL_RANGE 15.13
57.2 years
FULL_RANGE 11.13
Race/Ethnicity, Customized
Asian
1 Participants0 Participants1 Participants0 Participants2 Participants
Race/Ethnicity, Customized
Black
1 Participants1 Participants0 Participants1 Participants3 Participants
Race/Ethnicity, Customized
Hispanic
0 Participants0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Unknown
1 Participants0 Participants0 Participants0 Participants1 Participants
Race/Ethnicity, Customized
White
4 Participants8 Participants5 Participants1 Participants18 Participants
Region of Enrollment
United States
7 Participants9 Participants6 Participants2 Participants24 Participants
Sex: Female, Male
Female
3 Participants5 Participants1 Participants1 Participants10 Participants
Sex: Female, Male
Male
4 Participants4 Participants5 Participants1 Participants14 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
7 / 78 / 96 / 62 / 2
serious
Total, serious adverse events
2 / 73 / 92 / 60 / 2

Outcome results

Primary

Maximum Tolerated Dose (MTD)

The MTD was defined as the dose preceding the dose level at which 2 participants experienced a dose-limiting toxicity (DLT). A DLT was defined as any Grade 3 or 4 hematologic or nonhematologic toxicity based on Common Terminology Criteria for AE (CTCAE), excluding alopecia, which was considered by the investigator to be definitely, probably, or possibly related to IMC-A12.

Time frame: 6 weeks

Population: All participants who received at least 1 dose of study drug and completed Cycle 1 and 2-week observation or discontinued treatment for an IMC-A12-related toxicity.

ArmMeasureValue (NUMBER)
3 mg/kgMaximum Tolerated Dose (MTD)NA mg/kg
6 mg/kgMaximum Tolerated Dose (MTD)NA mg/kg
10 mg/kgMaximum Tolerated Dose (MTD)NA mg/kg
15 mg/kgMaximum Tolerated Dose (MTD)NA mg/kg
Primary

Number of Participants With Adverse Events (AEs) or Deaths

Data presented are the number of participants who experienced serious adverse events (SAEs), other non-serious AEs and deaths during the study including the 30-day follow-up. A summary of SAEs and other non-serious AEs, regardless of causality, is located in the Reported Adverse Event module.

Time frame: Enrollment to study completion up to 215 weeks

Population: All enrolled participants who received at least 1 dose of study drug.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
3 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsDeath due to PD0 Participants
3 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsAEs7 Participants
3 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsSAEs2 Participants
6 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsAEs8 Participants
6 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsDeath due to PD1 Participants
6 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsSAEs3 Participants
10 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsSAEs2 Participants
10 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsDeath due to PD0 Participants
10 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsAEs6 Participants
15 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsDeath due to PD0 Participants
15 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsSAEs0 Participants
15 mg/kgNumber of Participants With Adverse Events (AEs) or DeathsAEs2 Participants
Secondary

Area Under the Serum Concentration Versus Time Curve of IMC-A12 During One Dosing Interval (AUCτ) Following Multiple Doses

Time frame: Predose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1

Population: All participants who received study drug and had PK data available to calculate AUCτ.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
3 mg/kgArea Under the Serum Concentration Versus Time Curve of IMC-A12 During One Dosing Interval (AUCτ) Following Multiple Doses19800 micrograms*hour/milliliter (µg*h/mLGeometric Coefficient of Variation 39
6 mg/kgArea Under the Serum Concentration Versus Time Curve of IMC-A12 During One Dosing Interval (AUCτ) Following Multiple Doses36350 micrograms*hour/milliliter (µg*h/mL
10 mg/kgArea Under the Serum Concentration Versus Time Curve of IMC-A12 During One Dosing Interval (AUCτ) Following Multiple Doses66700 micrograms*hour/milliliter (µg*h/mL
15 mg/kgArea Under the Serum Concentration Versus Time Curve of IMC-A12 During One Dosing Interval (AUCτ) Following Multiple Doses49300 micrograms*hour/milliliter (µg*h/mL
Secondary

Clearance Rate of IMC-A12 at Steady State (CLss) Following Multiple Doses

CLss is the volume of plasma (or blood) from which the drug is completely removed, or cleared, in a given time at steady-state.

Time frame: Predose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1

Population: All participants who received study drug and had PK data available to calculate CLss.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
3 mg/kgClearance Rate of IMC-A12 at Steady State (CLss) Following Multiple Doses0.0124 Liters/hour (L/h)Geometric Coefficient of Variation 40
6 mg/kgClearance Rate of IMC-A12 at Steady State (CLss) Following Multiple Doses0.0125 Liters/hour (L/h)
10 mg/kgClearance Rate of IMC-A12 at Steady State (CLss) Following Multiple Doses0.0114 Liters/hour (L/h)
15 mg/kgClearance Rate of IMC-A12 at Steady State (CLss) Following Multiple Doses0.0296 Liters/hour (L/h)
Secondary

Half-Life (t1/2) of IMC-A12 Following Multiple Doses

Half-Life (t1/2) is the time measured for the plasma concentration of the drug to decrease by one half. The analysis was not performed for the 6 mg/kg and 10 mg/kg dosing groups due to insufficient PK data.

Time frame: Predose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1

Population: All participants who received study drug and had PK data available to calculate t1/2. Zero participants were analyzed for the 6 mg/kg and 10 mg/kg dosing groups due to insufficient PK data.

ArmMeasureValue (GEOMETRIC_MEAN)
3 mg/kgHalf-Life (t1/2) of IMC-A12 Following Multiple Doses6.19 days
15 mg/kgHalf-Life (t1/2) of IMC-A12 Following Multiple Doses6.17 days
Secondary

Maximum Concentration (Cmax) of IMC-A12 Following Multiple Doses

Time frame: Predose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1

Population: All participants who received study drug and had PK data available to calculate Cmax.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
3 mg/kgMaximum Concentration (Cmax) of IMC-A12 Following Multiple Doses292 micrograms/milliliter (µg/mL)Geometric Coefficient of Variation 42
6 mg/kgMaximum Concentration (Cmax) of IMC-A12 Following Multiple Doses385 micrograms/milliliter (µg/mL)Geometric Coefficient of Variation 51
10 mg/kgMaximum Concentration (Cmax) of IMC-A12 Following Multiple Doses734 micrograms/milliliter (µg/mL)
15 mg/kgMaximum Concentration (Cmax) of IMC-A12 Following Multiple Doses965 micrograms/milliliter (µg/mL)
Secondary

Number of Participants With Best Overall Response

Stable Disease (SD) is neither sufficient shrinkage to qualify for partial response (PR) nor sufficient increase to qualify for progressive disease (PD). PR and PD were assessed by investigators according to the Response Evaluation Criteria In Solid Tumors (RECIST) criteria version 1.0. PR is ≥30% decrease in sum of longest diameter of target lesions. PD is ≥20% increase in sum of longest diameter of target lesions and/or a new lesion. Participants with a global deterioration of their health status requiring discontinuation of treatment without objective evidence of disease progression at that time were to be reported as symptomatic deterioration

Time frame: Enrollment to study completion up to 215 weeks

Population: All enrolled participants.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
3 mg/kgNumber of Participants With Best Overall ResponseProgressive Disease (PD)5 Participants
3 mg/kgNumber of Participants With Best Overall ResponseStable Disease (SD)2 Participants
3 mg/kgNumber of Participants With Best Overall ResponseSymptomatic Deterioration0 Participants
3 mg/kgNumber of Participants With Best Overall ResponseNot Evaluable0 Participants
3 mg/kgNumber of Participants With Best Overall ResponsePartial Response (PR)0 Participants
6 mg/kgNumber of Participants With Best Overall ResponseStable Disease (SD)1 Participants
6 mg/kgNumber of Participants With Best Overall ResponseProgressive Disease (PD)4 Participants
6 mg/kgNumber of Participants With Best Overall ResponseSymptomatic Deterioration3 Participants
6 mg/kgNumber of Participants With Best Overall ResponseNot Evaluable1 Participants
6 mg/kgNumber of Participants With Best Overall ResponsePartial Response (PR)0 Participants
10 mg/kgNumber of Participants With Best Overall ResponseStable Disease (SD)2 Participants
10 mg/kgNumber of Participants With Best Overall ResponsePartial Response (PR)0 Participants
10 mg/kgNumber of Participants With Best Overall ResponseNot Evaluable2 Participants
10 mg/kgNumber of Participants With Best Overall ResponseSymptomatic Deterioration0 Participants
10 mg/kgNumber of Participants With Best Overall ResponseProgressive Disease (PD)2 Participants
15 mg/kgNumber of Participants With Best Overall ResponseSymptomatic Deterioration0 Participants
15 mg/kgNumber of Participants With Best Overall ResponseNot Evaluable0 Participants
15 mg/kgNumber of Participants With Best Overall ResponsePartial Response (PR)0 Participants
15 mg/kgNumber of Participants With Best Overall ResponseStable Disease (SD)1 Participants
15 mg/kgNumber of Participants With Best Overall ResponseProgressive Disease (PD)1 Participants
Secondary

Observed Serum Concentration of IMC-A12 at 168 Hour Post End of Infusion Following Multiple Doses

Time frame: Predose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1

Population: All participants who received study drug and had PK data available to calculate Cmin.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
3 mg/kgObserved Serum Concentration of IMC-A12 at 168 Hour Post End of Infusion Following Multiple Doses74.8 µg/mLGeometric Coefficient of Variation 28
6 mg/kgObserved Serum Concentration of IMC-A12 at 168 Hour Post End of Infusion Following Multiple Doses154 µg/mL
10 mg/kgObserved Serum Concentration of IMC-A12 at 168 Hour Post End of Infusion Following Multiple Doses226 µg/mL
15 mg/kgObserved Serum Concentration of IMC-A12 at 168 Hour Post End of Infusion Following Multiple Doses122 µg/mL
Secondary

Serum Anti-IMC-A12 Antibody Assessment (Immunogenicity)

Analysis was not performed due to lack of available assay.

Time frame: Before the last infusion of each treatment cycle

Population: Zero participants were analyzed due to lack of available assay.

Secondary

Volume of Distribution of IMC-A12 at Steady State (Vss) Following Multiple Doses

Vss is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired blood concentration of a drug at steady-state. The analysis was not performed for the 6 mg/kg and 10 mg/kg dosing groups due to insufficient PK data.

Time frame: Predose, 0.5, 1, 2, 4, 8, 24, 48, 96, 168, 264 and 336 hours after the infusion of Cycle 1

Population: All participants who received study drug and had PK data available to calculate Vss. Zero participants were analyzed for the 6 mg/kg and 10 mg/kg dosing groups due to insufficient PK data.

ArmMeasureValue (GEOMETRIC_MEAN)
3 mg/kgVolume of Distribution of IMC-A12 at Steady State (Vss) Following Multiple Doses2.88 Liters (L)
15 mg/kgVolume of Distribution of IMC-A12 at Steady State (Vss) Following Multiple Doses5.19 Liters (L)

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026