Recurrent Head and Neck Cancer Clinical Trial
Official title:
A Phase 1/2a Multicenter, Open-Label, Dose-Escalation, Combination Study of RM-1929 and Photoimmunotherapy in Patients With Recurrent Head and Neck Cancer, Who in the Opinion of Their Physician, Cannot Be Satisfactorily Treated With Surgery, Radiation or Platinum Chemotherapy
This is a two-part clinical study of patients with recurrent Head and Neck Cancer (HNC), who
in the opinion of their physician, cannot be satisfactorily treated with surgery, radiation
or platinum chemotherapy. The purpose of the study is to determine the safety and anti-cancer
activity of various doses and repeated cycles of the experimental treatment using the study
drug RM-1929 and fixed amounts of red light applied at the tumor site to activate the
pharmacodynamics of the drug.
The part 1 of the study has been completed and consisted in a single cycle, 3+3 dose
escalation safety study of the experimental drug RM-1929 using a fixed amount of 690 nm red
light. The part 1 was designed to determine the safety of the treatment as set by the maximal
feasible dose or the maximal tolerable dose of RM-1929. From the part 1 results, the maximal
feasible dose of RM-1929 was determined.
The part 2 of the study is currently ongoing and it is evaluating the safety and anticancer
efficacy of up to four repeated treatments of Photoimmunotherapy with RM-1929 at the maximal
feasible dose of RM-1929 activated with a fixed amount of red light.
Photoimmunotherapy (PIT) is a new cancer targeted technology invented at the National Cancer
Institute, USA. This clinical study evaluates the treatment of the experimental drug RM-1929
with Photoimmunotherapy (PIT).
The experimental drug, RM-1929, is a parental formulation consisting of a chemical conjugate
of the dye IR700 with the FDA approved antibody, Erbitux® (Cetuximab), that targets EGFR
receptors (EGFR is a cancer expressed protein, a cancer antigen). EGFR is highly expressed in
squamous cell carcinomas of the head and neck (HNSCC). It is expected that systemic
administration of RM-1929 will lead to tumor accumulation and binding to EGFR expressed at
cancer cells. It is expected that treatment with RM-1929 and Photoimmunotherapy can lead to
the selective destruction of the HNSCC cancer cells and provide an effective therapy to
manage the disease.
The treatment using RM-1929 with Photoimmunotherapy requires two steps:
(i) the administration by infusion of the drug RM-1929 targeting the cancer protein EGFR
AND
(ii) the illumination of the tumor with red light (690 nm) using sufficient energy to
activate the drug and induce cancer cell killing.
Light illumination is applied at 24 h post drug infusion to enable sufficient time for the
drug to distribute in the tumor after administration. Cell killing occurs only at cancer
cells expressing the protein EGFR that is bound to the drug RM-1929. The requirement of
binding of the drug to EGFR of cancer cells enables the selective destruction of cancer cells
with minimum damage of healthy tissue surrounding the tumor cells. Preclinical pharmacology
demonstrated that light-induced activation of RM-1929 elicits rapid tumor destruction of
human cancer xenografts implanted in mice and that the treatment is cancer specific.
The Part 1 study has been completed and consisted of a single cycle 3+3 dose escalation study
of RM-1929 to determine the safety of the treatment and the maximal feasible dose of RM-1929.
From the part 1 of this study, the maximal feasible dose for treatment with RM-1929 was
selected. The currently ongoing Part 2 of the clinical study is evaluating the safety and
anti-cancer activity of up to 4 repeat treatment cycles of Photoimmunotherapy with RM-1929.
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