A Phase Ib/II Trial of ALT-801 in Combination With Cisplatin and Gemcitabine in Muscle Invasive or Metastatic Urothelial Cancer
Bladder cancer is the fourth most common malignancy in men and the ninth most common in
women in the US, with an estimated 68,810 new cases and 14,070 deaths for the year 2008.
Approximately 90% to 95% of newly diagnosed patients are with transitional cell carcinomas
(TCC). Approximately 20% to 25% contain advanced (muscle invasive or metastatic) disease.
Muscle invasive bladder cancer is life threatening. Clinical trials have demonstrated that
TCC is a chemotherapy-sensitive malignancy. Most current cancer treatment strategies involve
the use of chemotherapeutic or biological drugs that have a low therapeutic ratio. The
limitations are a consequence of effects of the therapeutic drug on normal tissues. One
approach to control systemic exposure effects is to target the drug itself into the site of
the tumor. For example, antibodies have been developed for use as tumor targeting agents and
have had success in the clinic. However, despite the promise of antibody-based
immunotherapy, there are limitations with these class of reagents. Even so, immunotherapy
remains a promising approach to treat cancer.
One strategy that has received attention is treatment with cytokines such as IL-2 to enhance
anti-tumor immunity. IL-2 has stimulatory effects on a number of immune cell types including
T and B cells, monocytes, macrophages, lymphokine-activated killer cells (LAK) and natural
killer (NK) cells. Based on the ability of IL-2 to provide durable curative anti-tumor
responses, systemic administration of IL-2 has been approved to treat patients with
metastatic melanoma or renal carcinoma. Unfortunately, the considerable toxicity associated
with this treatment makes it difficult to achieve an effective dose at the site of the tumor
and limits the population that can be treated. Thus, there is critical need for innovative
strategies that enhance the effects of IL-2, to reduce its toxicity without compromising the
clinical benefit, and to treat other diagnoses.
The study drug, ALT-801, is a biologic compound of interleukin-2 (IL-2) genetically fused to
a humanized soluble T-cell receptor directed against the p53-derived peptides expressed on
tumor cells. The p53 protein is one of the most important factors that protects from
developing cancer and is also one of the most frequently mutated genes in many cancers,
which include muscle-invasive bladder cancer. For any given cancer type, p53 dysfunction
generally correlates with poor prognosis versus other the same site-of-origin. In some
tumors, p53 mutation and over-expression also is associated with resistance to chemotherapy.
This study is to further evaluate whether directing IL-2 activity using ALT-801 to the
patient's tumor sites that over-express p53 results in clinical benefits
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Maximum Tolerated Dose (MTD) and/or the recommended dose (RD) for dose expansion of ALT-801 in combination with cisplatin and gemcitabine or ALT-801 in combination with gemcitabine alone
8 weeks
Yes
Hing C Wong, PhD
Study Chair
Altor Bioscience Corporation
United States: Food and Drug Administration
CA-ALT-801-01-10
NCT01326871
June 2011
June 2014
Name | Location |
---|---|
H. Lee Moffitt Cancer Center and Research Institute | Tampa, Florida 33612 |
University of Iowa Hospitals and Clinics | Iowa City, Iowa 52242 |
Carolinas Medical Center | Charlotte, North Carolina 28232-2861 |
Emory University | Atlanta, Georgia 30322 |
St. Luke's Hospital and Health Network | Bethlehem, Pennsylvania 18015 |
Thomas Jefferson University Hospital | Philadelphia, Pennsylvania 19131 |
University of Kansas Cancer Center | Kansas City, Kansas 66160 |
M.D. Anderson Cancer Center Orlando | Orlando, Florida 32806 |
Karmanos Cancer Center | Detroit, Michigan 48201 |
Robert Lurie Comprehensive Cancer Center of Northwestern University | Chicago, Illinois 60611 |
Martin Health System | Stuart, Florida 34994 |
University of Rochester Wilmont Cancer Center | Rochester, New York 14642 |