Lung Cancer, Lung Metastases
Conditions
Keywords
Lung Cancer, Metastatic Cancer in Lung
Brief summary
This is a Phase 2, multi-center, open-label study to evaluate the safety and efficacy of VGT-309, a tumor-targeted, activatable fluorescent imaging agent, in subjects undergoing surgery for proven or suspected cancer in the lung. Approximately 100 subjects will be enrolled to ensure at least 86 subjects are evaluable with the option to expand enrollment by protocol amendment if deemed necessary by the DSC to meet primary and/or secondary objectives.
Detailed description
This is a Phase 2, multi-center, open-label study to evaluate the safety and efficacy of VGT-309, a tumor-targeted, activatable fluorescent imaging agent, in subjects undergoing surgery for proven or suspected cancer in the lung. Approximately 100 subjects will be enrolled to ensure at least 86 subjects are evaluable with the option to expand enrollment by protocol amendment if deemed necessary by the DSC to meet primary and/or secondary objectives. Following agreement with and signing of the informed consent, subjects will undergo screening measurements for the study within 4 weeks prior to the anticipated dosing: 1. Medical, surgical and medication history. 2. Complete physical exam, including vital signs and height 3. Weight (needed for dose calculation) 4. Chemistry, hematology, coagulation and urinalysis with microscopy clinical laboratory studies. 5. 12-lead ECG. 6. Serum pregnancy test for females of child-bearing potential. After meeting all enrollment criteria, each subject will receive 0.32 mg/kg VGT-309 by IV administration 12-36 hours prior to surgery (refer to section VGT-309 Dosing, below). Subjects will be observed for 1 hour after dosing is completed and asked about possible treatment emergent adverse events. Subjects will undergo surgical resection within 12-36 hours after completion of VGT-309 dosing. Measurements of efficacy will be taken during surgery and during the pathological examination of all surgical specimens. (Refer to Efficacy Endpoints and Efficacy Assessments sections). Following surgery, subjects will be monitored for safety during their hospitalization. Between 7 to 14 and 25 to 35 days after surgery, the subjects will return to the clinic or have a telehealth visit for final safety assessments. At the last visit, if there are no adverse events requiring further follow up, subjects will then be released from the study.
Interventions
DRUGVGT-309
Intravenous drug to be given over 15-20 minutes by syringe pump.
Sponsors
Vergent Bioscience, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This is an open label study in which all subjects will receive a dose of 0.32mg/kg VGT-309 (based on their weight) at 12-36 hours pre-surgery.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Be willing and able to sign the informed consent and comply with study procedures. 2. Be at least 18 years of age. 3. Meet the following conditions: Female participants must be of non-childbearing potential, or, If of childbearing potential, be non-pregnant or non-lactating and agree to use highly effective contraception from screening through Day 30 after treatment. Male participants, if not surgically sterilized, and if engaging in sexual intercourse with a female partner of childbearing potential, must be willing to use highly effective contraception from screening through 30 days after treatment and agree not to donate semen during this waiting period. Highly effective contraception involves the use of a condom for the male, plus one of the following for the female: Oral, injectable, implantable, intravaginal, or transdermal hormonal contraceptives, or Intrauterine device or intrauterine hormone-releasing system NOTE: Subjects who abstain from heterosexual intercourse as their usual and preferred lifestyle, will not be required to use contraception as described above. They are required to maintain abstinence from screening through Day 30 after treatment. Note: Subjects in a same sex relationship, must use a barrier form of contraception (e.g., condom, diaphragm) to protect against the transfer of the study drug in any bodily fluids. 4. Have a lung nodule or mass that might be considered primary lung cancer or lung metastases whether or not it is biopsy-proven before surgery. 5. Be scheduled to undergo standard of care surgical resection for a lung nodule or mass with diagnostic and/or curative intent 6. Have acceptable kidney and liver functions at study entry as evidenced by: ALT/AST \< 1.5 times the upper limit of normal Calculated Creatinine Clearance (CrCl) ≥ 50 ml/min Total bilirubin \< 1.5 times the upper limit of normal Have an ECOG score of 0-2. Meet all standard of care surgical and general anesthesia requirements. 7) Have not participated in an interventional clinical trial within the last 30 days. \-
Exclusion criteria
1. Not a candidate for standard of care surgery based on opinion of the surgeon, anesthesiologist, or other consulting physician. 2. Have a known allergy or reaction to ICG, other radiographic contrast agent, or any component of VGT-309. 3. Have congenital long QT syndrome or QTcF \> 470ms by history or at Screening ECG. 4. Prisoners, institutionalized individuals, or are unable to consent for themselves. 5. Have any other co-morbidity or habit that the Investigator believes will interfere with their ability to comply with and complete the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinically Significant Events (CSE) | Day of surgery | Proportion of subjects with at least one Clinically Significant Event (CSE) as defined by: A. Intraoperative localization of one or more preoperatively identified lung lesions using VGT-309 with NIR imaging not found w/SOC; and confirmed by histologic examination to be other than normal lung tissue. B. Identification of one or more synchronous or occult lung lesions using VGT-309 with NIR imaging not found with SOC; and confirmed by histologic examination to be cancerous or precancerous. C. Identification of fluorescence within ≤10 mm from the inside edge of the closest staple line as measured by the investigator ex vivo in the operating room using NIR imaging, with pathologic margin confirmed by histologic examination to be ≤ 10 mm. D. Identification of lymph nodes by VGT-309 with NIR imaging confirmed by histologic examination to be cancerous. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 1 - Positive Predictive Value | Day of Surgery | 1 - Positive predictive value (1 - PPV) is defined as the probability that a tissue sample does not contain cancer when it fluoresces in vivo. 1 - PPV = (False Positives) / (True Positives + False Positives) |
| Positive Predictive Value | Day of Surgery | Positive predictive value (PPV) is defined as the probability that a tissue sample contains cancer on histologic exam if it fluoresces in vivo. PPV = (True Positives) / (True Positives + False Positives) |
| Sensitivity | Day of Surgery | Sensitivity is defined as the probability that the tissue fluoresces in vivo when it is cancer, as confirmed by histology. Sensitivity = (True Positives) / (True Positives + False Negatives |
Countries
Australia, United States
Contacts
STUDY_DIRECTORCurtis Scribner, MD
Vergent Bioscience
Participant flow
Recruitment details
Participants were recruited by the Cardiothoracic surgeons acting as Principal Investigators. They were offered participation in the trial if they met basic criteria for known or suspected cancer in the lung and the PI believed they were sufficiently healthy to undergo the planned anesthesia. 105 subjects were consented and 89 received the study drug and underwent planned surgery for removal of a lesion or lesions seen on pre-operative CT and thought to be cancer in the lung.
Pre-assignment details
105 subjects were consented and screened, 16 subjects failed screening and were not considered to be enrolled. The remaining 89 subjects were marked as enrolled in the EDC and received study drug. This is different that the description in the Study Design section of the protocol where all consented were to be defined as enrolled. Programming of the EDC followed certain requirements and the difference between the protocol definition and the resulting assignment was not noted until now.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Categorical <=18 years | 1 Participants |
| Age, Categorical >=65 years | 65 Participants |
| Age, Categorical Between 18 and 65 years | 23 Participants |
| Age, Customized Age | 66.9 years STANDARD_DEVIATION 10.66 |
| Body Mass Index | 28.08 kg/m^2 STANDARD_DEVIATION 6.611 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 9 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 77 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 3 Participants |
| Height | 167.16 cm STANDARD_DEVIATION 9.681 |
| Packs Smoked Per Day | 0.909 packs STANDARD_DEVIATION 0.4281 |
| Pack Years | 29.985 pack years STANDARD_DEVIATION 20.8719 |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants |
| Race (NIH/OMB) Asian | 10 Participants |
| Race (NIH/OMB) Black or African American | 4 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 4 Participants |
| Race (NIH/OMB) White | 70 Participants |
| Region of Enrollment Australia | 18 participants |
| Region of Enrollment United States | 71 participants |
| Sex: Female, Male Female | 57 Participants |
| Sex: Female, Male Male | 32 Participants |
| Smoking History Current | 11 Participants |
| Smoking History Missing | 0 Participants |
| Smoking History Never | 33 Participants |
| Smoking History Previous | 45 Participants |
| Weight | 78.79 kg STANDARD_DEVIATION 20.232 |
| Years of Smoking | 32.3 years STANDARD_DEVIATION 16.36 |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 89 |
| other Total, other adverse events | 89 / 89 |
| serious Total, serious adverse events | 12 / 89 |
Outcome results
None listed