A Trial for Treatment of Cancer Patients With Multiple Brain Metastases Undergoing Whole-Brain Radiotherapy

Purpose

This protocol is for a lead-in safety study of 5 patients followed by a randomized Phase 2 clinical trial of BMX-001, a new class of pharmaceutical, in 64 patients with multiple brain metastases (MBM) undergoing whole brain radiation therapy (WBRT). Preliminary studies have demonstrated that BMX-001 provides protection of normal tissues from radiation-induced injury and augments tumor growth inhibition.

Condition

  • Multiple Brain Metastases

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Subjects must have histologically confirmed diagnosis of a non-small cell lung cancer, breast cancer, melanoma or renal cell cancer primary - Subjects must have >5 contrast-enhancing lesions, never previously treated with SRS and/or surgical resection, on a contrast-enhanced T1-weighted brain MRI performed within two weeks of enrollment, with at least one lesion >0.5cm in greatest dimension - Physical examination by a radiation oncologist or medical oncologist within 14 days of the start of WBRT - Plan to be treated with WBRT to a dose of 30 Gy in 10 fractions - Age * 18 years - Karnofsky Performance Status (KPS) ≥ 70 - Hemoglobin ≥ 9.0 g/dl, ANC ≥ 1,500 cells/*l, platelets ≥ 125,000 cells/*l - Serum creatinine ≤ 1.5 mg/dl, serum SGOT and bilirubin ≤ 1.5 times upper limit of normal - Signed informed consent approved by the Institutional Review Board - If sexually active, patients must agree to use appropriate contraceptive measures for the duration of the study and for 6 months afterwards as stated in the informed consent - Able to provide study specific informed consent - Willing to follow study procedures, complete QOL questionnaires and neurocognitive testing as described in the protocol - Negative serum pregnancy test for women of child bearing potential within 48 hours of first dose of BMX

Exclusion Criteria

  • Active infection requiring IV antibiotics 7 days before enrollment - Hypertension requiring 3 or more anti-hypertensive medications to control - Requirement for concurrent treatment with nitrates or other drugs that may, in the judgment of the treating investigator, create a risk for a precipitous decrease in blood pressure - History of syncope within the last 6 months - Subjects receiving prohibited medications listed in Section 6.4.2 of this protocol are not eligible. Subjects who can safely stop taking a prohibited medication at least 7 days prior to the first dose of BMX may participate at the discretion of the treating physician. - Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic - Women who are breast feeding - Known hypersensitivity to compounds of similar chemical composition to BMX-001 - Prior surgical resection for brain metastases and/or stereotactic radiosurgery for up to 5 brain metastases in total are permitted if performed at least 1 month prior to planned WBRT under this protocol. - Prior whole brain radiation therapy - Patients with diffuse leptomeningeal disease (carcinomatous meningitis) - A marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval >480 milliseconds (ms) (CTCAE grade 1) - A history of additional risk factors for TdP (e.g., congestive heart failure, hypokalemia, known family history of Long QT Syndrome)

Study Design

Phase
Phase 1/Phase 2
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
WBRT + BMX-001
Whole brain radiation therapy in combination with BMX-001 (subcutaneous injection of 28 mg loading dose, followed by subsequent 14 mg twice per week for 2 weeks).
  • Drug: BMX-001
    Manganese butoxyethyl pyridyl porphyrin
    Other names:
    • Whole Brain Radiation Therapy
  • Radiation: Whole Brain Radiation Therapy
    Whole Brain Radiation Therapy per standard of care.
No Intervention
Whole Brain Radiation Therapy
Whole brain radiation therapy per standard of care.

Recruiting Locations

UK Center for Clinical and Translational Science and nearby locations

University of Kentucky
Lexington, Kentucky 40506
Contact:
Judy Guinn
859-323-2368
Judy.Guinn@uky.edu

More Details

NCT ID
NCT03608020
Status
Recruiting
Sponsor
BioMimetix JV, LLC

Study Contact

Sara Penchev
303-862-7268
contact@bmxpharma.com

Detailed Description

This protocol is for a Phase 1 safety lead-in clinical trial of BMX-001 in combination with WBRT in 5 patients with MBM. Demonstrating safety of the selected MTD of BMX-001 in patients with MBM undergoing standard protocol WBRT will be the "go/no-go" criteria for proceeding to Phase 2. Phase 2 is a randomized open-label Phase 2 clinical trial of 64 patients with MBM, half receiving BMX-001 in combination with WBRT and half receiving WBRT alone. Subjects are treated with BMX-001 for a total of 19 days, during which time they receive radiation therapy. Following completion of radiation therapy, subjects will be followed for an additional one year.