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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02667873
Other study ID # STML-801-0115
Secondary ID
Status Completed
Phase Phase 1
First received
Last updated
Start date February 23, 2016
Est. completion date October 13, 2021

Study information

Verified date May 2024
Source Stemline Therapeutics, Inc.
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Study SL-801-0115 is a dose-escalation study evaluating multiple doses and schedules of orally administered SL-801 in patients with Advanced Solid Tumors


Description:

Study SL-801-0115 is a first-in-human, dose-escalation study in patients with advanced (i.e., metastatic or locally advanced and unresectable) solid tumors that are resistant to or relapsed following available standard systemic therapy or for which there is no standard systemic therapy and additional radiation therapy or other loco-regional therapies are not considered feasible. Eligible patients will be enrolled and receive treatment with SL-801 in a 28-day cycle. SL-801 will be administered orally and the dose regimen will depend on the cohort in which the patient is enrolled. The study plans to enroll approximately 70 adult patients at multiple study centers in the US.


Recruitment information / eligibility

Status Completed
Enrollment 72
Est. completion date October 13, 2021
Est. primary completion date October 6, 2021
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - The patient must have histologic or cytologic evidence of a malignant solid tumor and must have disease that is resistant to or relapsed following available standard systemic therapy, or for which there is no standard systemic therapy or reasonable therapy likely to result in clinical benefit. - The patient must have advanced disease, defined as cancer that is either metastatic, OR locally advanced and unresectable (and for which additional radiation therapy or other locoregional therapies are not considered feasible). - The patient must have disease that is measurable by standard imaging techniques, per the Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1), or evaluable per RECIST 1.1. (For patients with prior radiation therapy, measurable lesions must be outside of any prior radiation field[s], unless disease progression has been documented at that disease site subsequent to radiation.) - The patient is =18 years old. - The patient has an ECOG PS of 0-2. - The patient has adequate baseline organ function, as demonstrated by the following: - Serum creatinine =1.5 × institutional upper limit of normal (ULN) or calculated creatinine clearance >30 mL/min. - Serum albumin =2.5 g/dL. - Bilirubin =1.5 × institutional ULN. - Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =2.5 × institutional ULN (patients with hepatic metastases must have AST/ALT =5 times ULN). - International normalized ratio (INR) =1.5 or prothrombin time (PT) =1.5 × ULN; and either partial thromboplastin time or activated partial thromboplastin time (PTT or aPTT) =1.5 × ULN. - The patient has adequate baseline hematologic function, as demonstrated by the following: - Absolute neutrophil count (ANC) =1.5×10?/L - Hemoglobin =8 g/dL, with no red blood cell (RBC) transfusions within the prior 14 days. - Platelet count =100×10?/L, with no platelet transfusions within the prior 14 days. - If the patient is a woman of child bearing potential (WOCBP), she has had a negative serum or urine pregnancy test within 1 week prior to treatment. - The patient (male and female) agrees to use acceptable contraceptive methods for the duration of time on the study, and continue to use acceptable contraceptive methods for 1 month after the last dose of SL-801. - The patient has signed informed consent prior to initiation of any study-specific procedures or treatment. - The patient is able to adhere to the study visit schedule and other protocol requirements, including follow-up for survival assessment. Exclusion Criteria: - The patient has persistent clinically significant =Grade 2 toxicities from previous anticancer therapy (excluding Grade 2 chemotherapy-related neuropathy which is permitted, and excluding Grade 2-3 laboratory abnormalities if they are not associated with symptoms, are not considered clinically significant by the Investigator, and can be managed with available medical therapies). - The patient has received treatment with chemotherapy, external-beam radiation, or other systemic anticancer therapy within 28 days prior to study entry (Patients with advanced prostate cancer who are receiving luteinizing hormone releasing hormone [LHRH] agonists are permitted onto the study and should continue use of these agents during study treatment). - The patient has received treatment with an investigational systemic anticancer agent within 28 days prior to C1D1. - The patient has previously received treatment with SL-801 or another investigational agent that inhibits the XPO1/CRM1 pathway. - The patient has an additional active malignancy that may confound the assessment of the study endpoints. Patients with a past cancer history (active malignancy within 2 years prior to study entry) with substantial potential for recurrence must be discussed with the Sponsor before study entry. Patients with the following concomitant neoplastic diagnoses are eligible: non-melanoma skin cancer, carcinoma in situ (including transitional cell carcinoma, cervical intraepithelial neoplasia), organ-confined prostate cancer with no evidence of progressive disease. - The patient has clinically significant cardiovascular disease (e.g., uncontrolled or any New York Heart Association Class 3 or 4 congestive heart failure [Appendix 1], uncontrolled angina, history of myocardial infarction, unstable angina or stroke within 6 months prior to study entry, uncontrolled hypertension or clinically significant arrhythmias not controlled by medication). - The patient has uncontrolled, clinically significant pulmonary disease (e.g., chronic obstructive pulmonary disease, pulmonary hypertension) that, in the Investigator's opinion, would put the patient at significant risk for pulmonary complications during the study. - The patient has known active or suspected brain or leptomeningeal metastases. (Central nervous system [CNS] imaging is not required prior to study entry unless there is a clinical suspicion of CNS involvement). Patients with stable, treated brain metastases are eligible provided there is no evidence of CNS disease growth on imaging for at least 3 months following radiation therapy or other locoregional ablative therapy to the CNS. - The patient is receiving immunosuppressive therapy for prophylaxis following a prior organ transplant (solid organ or allogeneic stem cell) or management of immune-mediated toxicities due to immunotherapy. Low-dose corticosteroid (defined as < 10mg/day of prednisone or equivalent) therapy is permitted. - The patient has uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, disseminated intravascular coagulation, or psychiatric illness/social situations that would limit compliance with study requirements. - The patient is pregnant or breast feeding. - The patient has known positive status for human immunodeficiency virus active or chronic Hepatitis B or Hepatitis C. - The patient is oxygen-dependent. - The patient has any medical condition which in the opinion of the Investigator places the patient at an unacceptably high risk for toxicities.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
SL-801
SL-801 is a small molecule inhibitor of the nuclear export protein Exportin-1 (XPO1).

Locations

Country Name City State
United States Mary Crowely Cancer Research Centers- Medical City Dallas Texas
United States University of Texas Southwestern Medical Center Dallas Texas
United States Sarah Cannon Research Institute Nashville Tennessee
United States Yale Cancer Center New Haven Connecticut
United States Florida Cancer Specialist Sarasota Florida
United States University of Washington, Seattle Cancer Care Alliance Seattle Washington

Sponsors (1)

Lead Sponsor Collaborator
Stemline Therapeutics, Inc.

Country where clinical trial is conducted

United States, 

References & Publications (24)

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Kojima K, Kornblau SM, Ruvolo V, Dilip A, Duvvuri S, Davis RE, Zhang M, Wang Z, Coombes KR, Zhang N, Qiu YH, Burks JK, Kantarjian H, Shacham S, Kauffman M, Andreeff M. Prognostic impact and targeting of CRM1 in acute myeloid leukemia. Blood. 2013 May 16;121(20):4166-74. doi: 10.1182/blood-2012-08-447581. Epub 2013 Apr 5. — View Citation

Lapalombella R, Sun Q, Williams K, Tangeman L, Jha S, Zhong Y, Goettl V, Mahoney E, Berglund C, Gupta S, Farmer A, Mani R, Johnson AJ, Lucas D, Mo X, Daelemans D, Sandanayaka V, Shechter S, McCauley D, Shacham S, Kauffman M, Chook YM, Byrd JC. Selective inhibitors of nuclear export show that CRM1/XPO1 is a target in chronic lymphocytic leukemia. Blood. 2012 Nov 29;120(23):4621-34. doi: 10.1182/blood-2012-05-429506. Epub 2012 Oct 3. — View Citation

Lassen UN, Mau-Soerensen M, Kung AL, Wen PY, Lee EQ, Plotkin SR, et al. A phase 2 study on efficacy, safety and intratumoral pharmacokinetics of oral selinexor (KPT-330) in patients with recurrent glioblastoma (GBM). J Clin Oncol 33, 2015 (suppl; abstr 2044)

Noske A, Weichert W, Niesporek S, Roske A, Buckendahl AC, Koch I, Sehouli J, Dietel M, Denkert C. Expression of the nuclear export protein chromosomal region maintenance/exportin 1/Xpo1 is a prognostic factor in human ovarian cancer. Cancer. 2008 Apr 15;112(8):1733-43. doi: 10.1002/cncr.23354. — View Citation

Pathria G, Wagner C, Wagner SN. Inhibition of CRM1-mediated nucleocytoplasmic transport: triggering human melanoma cell apoptosis by perturbing multiple cellular pathways. J Invest Dermatol. 2012 Dec;132(12):2780-90. doi: 10.1038/jid.2012.233. Epub 2012 Jul 26. — View Citation

Saito N, Sakakibara K, Sato T, Friedman JM, Kufe DW, VonHoff DD, Kawabe T. CBS9106-induced CRM1 degradation is mediated by cullin ring ligase activity and the neddylation pathway. Mol Cancer Ther. 2014 Dec;13(12):3013-23. doi: 10.1158/1535-7163.MCT-14-0064. Epub 2014 Sep 24. — View Citation

Sakakibara K, Saito N, Sato T, Suzuki A, Hasegawa Y, Friedman JM, Kufe DW, Vonhoff DD, Iwami T, Kawabe T. CBS9106 is a novel reversible oral CRM1 inhibitor with CRM1 degrading activity. Blood. 2011 Oct 6;118(14):3922-31. doi: 10.1182/blood-2011-01-333138. Epub 2011 Aug 12. — View Citation

Senapedis WT, Baloglu E, Landesman Y. Clinical translation of nuclear export inhibitors in cancer. Semin Cancer Biol. 2014 Aug;27:74-86. doi: 10.1016/j.semcancer.2014.04.005. Epub 2014 Apr 19. — View Citation

Siddiqui N, Borden KL. mRNA export and cancer. Wiley Interdiscip Rev RNA. 2012 Jan-Feb;3(1):13-25. doi: 10.1002/wrna.101. Epub 2011 Jul 27. — View Citation

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Tan DS, Bedard PL, Kuruvilla J, Siu LL, Razak AR. Promising SINEs for embargoing nuclear-cytoplasmic export as an anticancer strategy. Cancer Discov. 2014 May;4(5):527-37. doi: 10.1158/2159-8290.CD-13-1005. Epub 2014 Apr 17. — View Citation

Tan DSP, Pang M-Y, Yong WP, Soo RA, Chee CE, Thian YL et al. Phase I study of the safety and tolerability of the Exportin 1 (XPO1) inhibitor Selinexor (SXR) in Asian patients (pts) with advanced solid cancers. J Clin Oncol 33, 2015 (suppl; abstr 2542).

Turner JG, Dawson J, Sullivan DM. Nuclear export of proteins and drug resistance in cancer. Biochem Pharmacol. 2012 Apr 15;83(8):1021-32. doi: 10.1016/j.bcp.2011.12.016. Epub 2011 Dec 20. — View Citation

van der Watt PJ, Maske CP, Hendricks DT, Parker MI, Denny L, Govender D, Birrer MJ, Leaner VD. The Karyopherin proteins, Crm1 and Karyopherin beta1, are overexpressed in cervical cancer and are critical for cancer cell survival and proliferation. Int J Cancer. 2009 Apr 15;124(8):1829-40. doi: 10.1002/ijc.24146. — View Citation

Walker CJ, Oaks JJ, Santhanam R, Neviani P, Harb JG, Ferenchak G, Ellis JJ, Landesman Y, Eisfeld AK, Gabrail NY, Smith CL, Caligiuri MA, Hokland P, Roy DC, Reid A, Milojkovic D, Goldman JM, Apperley J, Garzon R, Marcucci G, Shacham S, Kauffman MG, Perrotti D. Preclinical and clinical efficacy of XPO1/CRM1 inhibition by the karyopherin inhibitor KPT-330 in Ph+ leukemias. Blood. 2013 Oct 24;122(17):3034-44. doi: 10.1182/blood-2013-04-495374. Epub 2013 Aug 22. — View Citation

Wang W, Budhu A, Forgues M, Wang XW. Temporal and spatial control of nucleophosmin by the Ran-Crm1 complex in centrosome duplication. Nat Cell Biol. 2005 Aug;7(8):823-30. doi: 10.1038/ncb1282. Epub 2005 Jul 24. — View Citation

* Note: There are 24 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary safety and tolerability: percentage of patients experiencing treatment-related and treatment-emergent adverse events The percentage of patients experiencing treatment-related and treatment-emergent adverse events up to 5 years
Primary maximum tolerated dose To identify the maximum tolerated dose (MTD) of SL-801 or determine the maximum tested dose at which multiple dose-limiting toxicities (DLTs) are not observed. up to 5 years
Secondary Duration of Response to evaluate the duration of response up to 5 years
Secondary Progression Free Survival to evaluate progression free survive up to 5 years
Secondary Overall Response Rate to evaluate overall response rate up to 5 years
Secondary Overall Survival to evaluate overall survival up to 5 years
Secondary Pharmacokinetic Profile Determine the maximum concentration of SL-801 in plasma up to 5 years
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