Phase IB Study to Evaluate the Biological Activity of Indibulin Using Positron-Emission Tomography (PET) Scans

Inclusion Criteria:

1. Histological or cytological confirmation of advanced cancer, refractory to standard
therapies.

2. Received at least one prior therapy and requires additional treatment.

3. ≥18 years of age.

4. ECOG performance score ≤ 2 (see Appendix 3).

5. At least one measurable lesion as defined by RECIST (Response evaluation criteria in
solid tumors) guidelines (see Appendix 4). If the measurable disease is restricted to
a solitary lesion, its neoplastic nature should be confirmed by cytology/histology.
Measurable lesions must NOT have been in a previously irradiated field or injected
with biological agents.

6. PET scan showing a standardized uptake value (SUV) of ≥5.0 in at least 1 lesion on an
18F-FDG (fluorine-18-labeled deoxyglucose) scale.

7. Life expectancy ≥12 weeks.

8. Adequate bone marrow, liver and renal function as assessed by the following
laboratory requirements, to be conducted <2 weeks prior to Day 1:

- Creatinine ≤1.5 × upper limit of normal (ULN) or calculated creatinine clearance
≥50 cc/minute

- Total bilirubin ≤1.5 × ULN

- Alanine transaminase (ALT) and aspartate transaminase (AST) ≤2.5 × ULN

- White blood cell count ≥3.0 × 109/L

- Absolute neutrophil count (ANC) ≥1.5 × 109/L

- Platelets ≥100 × 109/L

- Hemoglobin ≥10 g/dL

9. Ability to tolerate repeated blood sampling and adequate vascular access.

10. Serum glucose levels ≤200 mg/dL.

11. Provide written informed consent in compliance with ZIOPHARM policies and the
Independent Ethics Committee with jurisdiction over the site.

12. Subjects of childbearing potential must agree to use a barrier method of
contraception throughout the study and for 3 months after study drug administration.

Exclusion Criteria:

1. New York Heart Association (NYHA) functional class ≥3 or myocardial infarction within
6 months (see Appendix 5).

2. Uncontrolled diabetes mellitus

3. Uncontrolled cardiac arrhythmia other than asymptomatic atrial fibrillation.

4. Pregnancy and/or lactation.

5. Uncontrolled systemic infection (documented with microbiological studies)

6. Any other anti-cancer or immunological therapy during the study or within 4 weeks of
study entry. Mitomycin C or nitrosureas should not be given within 6 weeks of study
entry.

7. Radiotherapy during the study or within 3 weeks of study entry.

8. Surgery within 4 weeks of start of study drug excluding tumor biopsy for
pharmacodynamic parameters.

9. Investigational drug therapy outside of this trial during or within 4 weeks of study
entry.

10. History of an invasive second primary malignancy diagnosed within the previous 3
years, except for Stage I endometrial/cervical carcinoma or prostate carcinoma
treated surgically, and non-melanoma skin cancer.

11. Substance abuse, medical, psychological or social conditions that may interfere with
the subject's participation in the study or evaluation of the study results

12. Any condition that is unstable or could jeopardize the safety of the subject and
his/her compliance with the study protocol.