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NCT02314052

Phase Ib/2, Multicenter, Dose Escalation Study of DCR-MYC in Patients With Hepatocellular Carcinoma

Terminated Phase 1, PHASE2 Results posted Last updated 11 July 2024
What this trial tests

Phase 1, PHASE2 trial testing DCR-MYC in Hepatocellular Carcinoma in 21 participants. Terminated before completion.

Timeline
27 January 2015
Primary endpoint
11 October 2016
11 October 2016

Quick facts

Lead sponsorDicerna Pharmaceuticals, Inc., a Novo Nordisk company
PhasePhase 1, PHASE2
StatusTerminated
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment21
Start date27 January 2015
Primary completion11 October 2016
Estimated completion11 October 2016
Sites6 locations across Singapore, United States, South Korea

Drugs / interventions tested

Conditions studied

Sponsor

Dicerna Pharmaceuticals, Inc., a Novo Nordisk company — full company profile →

Who can join

18 and older, any sex, with Hepatocellular Carcinoma. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Phase 1b: Number of Patients With Adverse Events as a Measure of Safety and Tolerability Primary · Cycle 1 (3 weeks), longer if DCR-MYC is continued; with 30 days follow-up after last dose

Part A: 3 patient cohorts with 50% dose increase between cohorts until study drug-related dose-limiting toxicity (DLT) during Cycle 1, then expand to 6 patients and move to Part B. Part B: 3 to 6 patient cohorts with 25% dose increase between cohorts until \> 1 study drug-related DLT, then stop escalation. Expand MTD cohort to 12 patients; tumor biopsies to be performed in this Phase 1b MTD Biopsy Cohort (6 patients).

GroupValue95% CI
Cohort 13
Cohort 23
Cohort 33
Cohort 43
Cohort 56
Cohort 63
Cmax (ng/mL) - DCR-MYC Levels in Blood (Phase 1b Only): Dosing Day 1 and Day 8 Secondary · Week 1 Day 1 AND Week 2 Day 8 Cycle PK Sampling Points: 0 min, 1/4 through infusion, 1/2 through infusion, end of infusion, 15 min, 30 min, 1h, 2h, 4h, 6h, 8h, 24h, Day 4

Samples to be collected Week 1 (Day 1, 2, and 4) and Week 2 (Day 8 and 11). A summary of outcome measures reported here are noncompartmental PK parameters (Cmax, dose-normalized Cmax (Cmax\_D), Tmax, AUClast, and dose-normalized AUClast (AUClast\_D)) for both infusion days (Day 1 and Day 8).

Cmax: Day 1
GroupValue95% CI
Cohort 12094.3± 1257.8
Cohort 24790.5± 3540.2
Cohort 36195.7± 744.75
Cohort 49807.1± 4094.5
Cohort 519399± 8211.4
Cohort 619829± 3686.2
Cmax: Day 8
GroupValue95% CI
Cohort 11755.7± 59.47
Cohort 25504.9± 3365.3
Cohort 36628.4± 1155.8
Cohort 413484± 2576.2
Cohort 520711± 13768
Cohort 627067± 9105.1
DCR-MYC Biological Activities (Phase 1b Only) Secondary · Cycle 1; Week 1

Collection of blood samples for cytokine measurements (Day 1, 2, and 4). No noteworthy increases were observed across dose groups or time for GM-CSF, IFNα, IFNɣ, or IL-1β. Changes that were observed for the other cytokines were not dose-dependent since they occurred sporadically and primarily in Cohorts 3 (0.3 mg/kg) and 4 (0.45 mg/kg). Pre-dose, 4 hours post-dose, and 24 hour post-dose results for TNF-α, IL-10, IL-6, IL-8, IL-1RA, and MCP-1 are summarized here.

TNF-α Pre-dose
GroupValue95% CI
Cohort 12.3± 1.3
Cohort 21.6± 0
Cohort 34.1± 0.7
Cohort 41.6± 0
Cohort 53.1± 3.0
Cohort 61.6± 0
TNF-α 4 hour post-dose
GroupValue95% CI
Cohort 11.6± 0
Cohort 21.6± 0
Cohort 315.9± 16.6
Cohort 423.1± 34.2
Cohort 51.6± 0
Cohort 61.6± 0
TNF-α 24 hour post-dose
GroupValue95% CI
Cohort 11.6± 0
Cohort 24.1± 0.5
Cohort 34.5± 1.2
Cohort 43.3± 2.9
Cohort 52.4± 1.7
Cohort 63.8± 3.8
IL-10 pre-dose
GroupValue95% CI
Cohort 1317.5± 60.9
Cohort 2239.4± 83.7
Cohort 3741.1± 46.7
Cohort 4574.3± 341.0
Cohort 5670.2± 369.4
Cohort 6599.7± 333.8
IL-10 4 hour post
GroupValue95% CI
Cohort 1241.1± 61.3
Cohort 2159.6± 104.2
Cohort 3933.1± 427.2
Cohort 41316.7± 1617.7
Cohort 5527.1± 225.5
Cohort 6533.7± 265.6
IL-10 24 hour post
GroupValue95% CI
Cohort 1322.5± 152.9
Cohort 2424.4± 296.4
Cohort 3939.3± 939.3
Cohort 4667.7± 362.7
Cohort 5541.8± 240.9
Cohort 6830.7± 333.3
IL-6 pre-dose
GroupValue95% CI
Cohort 11.6± 0
Cohort 21.6± 0
Cohort 31.6± 0
Cohort 41.6± 0
Cohort 51.6± 0
Cohort 67.9± 10.9
IL-6 4 hour post-dose
GroupValue95% CI
Cohort 11.6± 0
Cohort 21.6± 0
Cohort 338.3± 51.9
Cohort 4133.7± 228.7
Cohort 51.6± 0
Cohort 64.7± 5.3
Tmax (Hr) - DCR-MYC Levels in Blood (Phase 1b Only): Dosing Day 1 and Day 8 Secondary · Week 1 Day 1 AND Week 2 Day 8 Cycle PK Sampling Points: 0 min, 1/4 through infusion, 1/2 through infusion, end of infusion, 15 min, 30 min, 1h, 2h, 4h, 6h, 8h, 24h, Day 4

Samples to be collected Week 1 (Day 1, 2, and 4) and Week 2 (Day 8 and 11). A summary of outcome measures reported here are noncompartmental PK parameters (Cmax, dose-normalized Cmax (Cmax\_D), Tmax, AUClast, and dose-normalized AUClast (AUClast\_D)) for both infusion days (Day 1 and Day 8).

Tmax: Day 1
GroupValue95% CI
Cohort 12.4± 0.14
Cohort 22.7± 0.68
Cohort 32.6± 0.27
Cohort 42.9± 0.55
Cohort 52.3± 0.26
Cohort 62.2± 0.14
Tmax: Day 8
GroupValue95% CI
Cohort 12.6± 0.60
Cohort 22.4± 0.13
Cohort 32.7± 0.35
Cohort 42.2± 0.24
Cohort 53.0± 0.72
Cohort 62.2± 0.24
Cmax_D (kg*ng/mL/mg) - DCR-MYC Levels in Blood (Phase 1b Only): Dosing Day 1 and Day 8 Secondary · Week 1 Day 1 AND Week 2 Day 8 Cycle PK Sampling Points: 0 min, 1/4 through infusion, 1/2 through infusion, end of infusion, 15 min, 30 min, 1h, 2h, 4h, 6h, 8h, 24h, Day 4

Samples to be collected Week 1 (Day 1, 2, and 4) and Week 2 (Day 8 and 11). A summary of outcome measures reported here are noncompartmental PK parameters (Cmax, dose-normalized Cmax (Cmax\_D), Tmax, AUClast, and dose-normalized AUClast (AUClast\_D)) for both infusion days (Day 1 and Day 8).

Cmax_D: Day 1
GroupValue95% CI
Cohort 116832± 10192
Cohort 223952± 17701
Cohort 320652± 2482.5
Cohort 421794± 9098.8
Cohort 528527± 12076
Cohort 623384± 4241.4
Cmax_D: Day 8
GroupValue95% CI
Cohort 114045± 475.74
Cohort 227525± 16827
Cohort 322095± 3852.7
Cohort 429964± 5724.8
Cohort 530457± 20247
Cohort 631931± 10677
AUClast_D (hr*kg*ng/mL/mg) - DCR-MYC Levels in Blood (Phase 1b Only): Dosing Day 1 and Day 8 Secondary · Week 1 Day 1 AND Week 2 Day 8 Cycle PK Sampling Points: 0 min, 1/4 through infusion, 1/2 through infusion, end of infusion, 15 min, 30 min, 1h, 2h, 4h, 6h, 8h, 24h, Day 4

Samples to be collected Week 1 (Day 1, 2, and 4) and Week 2 (Day 8 and 11). A summary of outcome measures reported here are noncompartmental PK parameters (Cmax, dose-normalized Cmax (Cmax\_D), Tmax, AUClast, and dose-normalized AUClast (AUClast\_D)) for both infusion days (Day 1 and Day 8).

AUClast_D: Day 1
GroupValue95% CI
Cohort 1178997± 125460
Cohort 2299295± 312426
Cohort 3197244± 116908
Cohort 4195133± 56544
Cohort 5290201± 169069
Cohort 6201529± 45290
AUClast_D: Day 8
GroupValue95% CI
Cohort 1163478± 109924
Cohort 2739203± 698459
Cohort 3389653± 293467
Cohort 4350625± 132910
Cohort 5274941± 168548
Cohort 6383537± 84286
AUClast (hr*ng/mL) - DCR-MYC Levels in Blood (Phase 1b Only): Dosing Day 1 and Day 8 Secondary · Week 1 Day 1 AND Week 2 Day 8 Cycle PK Sampling Points: 0 min, 1/4 through infusion, 1/2 through infusion, end of infusion, 15 min, 30 min, 1h, 2h, 4h, 6h, 8h, 24h, Day 4

Samples to be collected Week 1 (Day 1, 2, and 4) and Week 2 (Day 8 and 11). A summary of outcome measures reported here are noncompartmental PK parameters (Cmax, dose-normalized Cmax (Cmax\_D), Tmax, AUClast, and dose-normalized AUClast (AUClast\_D)) for both infusion days (Day 1 and Day 8).

AUClast : Day 1
GroupValue95% CI
Cohort 122375± 15683
Cohort 259859± 62485
Cohort 359173± 35072
Cohort 487810± 25445
Cohort 5197337± 114967
Cohort 6171299± 38496
AUClast : Day 8
GroupValue95% CI
Cohort 120435± 13741
Cohort 2147841± 139692
Cohort 3116896± 88040
Cohort 4157781± 59810
Cohort 5186960± 114612
Cohort 6326006± 71643

Adverse events — posted to ClinicalTrials.gov

Time frame: Throughout entire duration of the study (e.g., approximately 3 month period). Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Cohort 1
Serious: 1/3 (33%)
Deaths: 2/3
Cohort 2
Serious: 0/3 (0%)
Deaths: 0/3
Cohort 3
Serious: 0/3 (0%)
Deaths: 3/3
Cohort 4
Serious: 1/3 (33%)
Deaths: 1/3
Cohort 5
Serious: 2/6 (33%)
Deaths: 3/6
Cohort 6
Serious: 1/3 (33%)
Deaths: 2/3

Serious adverse events (8 terms)

ReactionSystemCohort 1Cohort 2Cohort 3Cohort 4Cohort 5Cohort 6
Spinal cord compression/ Spinal Cord Compression Due To Pathologic Fracture Of T1Nervous system disorders
Oropharyngeal pain/ Sore ThroatRespiratory, thoracic and mediastinal disorders
Dyspnoea/ Increased DyspneaRespiratory, thoracic and mediastinal disorders
Influenza like illness/ Flu Like SymptomGeneral disorders
Acute coronary syndrome/ Acute Coronary SyndromeCardiac disorders
Cholangitis/ Cholangitis Due To PdHepatobiliary disorders
Metastases to bone/ Osteolytic Jaw Lesion Due To Progression DiseaseNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Hypovolaemic shock/ Hypovolemic HypoperfusionVascular disorders
Other adverse events (22 terms — click to expand)

ReactionSystemCohort 1Cohort 2Cohort 3Cohort 4Cohort 5Cohort 6
FatigueGeneral disorders
Oedema peripheralGeneral disorders
NauseaGastrointestinal disorders
VomitingGastrointestinal disorders
AST increasedInvestigations
Lipase increasedInvestigations
Platelet count decreasedInvestigations
Decreased appetiteMetabolism and nutrition disorders
HyperglycaemiaMetabolism and nutrition disorders
PyrexiaGeneral disorders
ChillsGeneral disorders
Influenza-like illnessGeneral disorders
PainGeneral disorders
DiarrhoeaGastrointestinal disorders
AscitesGastrointestinal disorders
Abdominal distentionGastrointestinal disorders
DyspepsiaGastrointestinal disorders
ALT increasedInvestigations
Blood bilirubin increasedInvestigations
Blood creatinine increasedInvestigations
GGT increasedInvestigations
HypophosphataemiaMetabolism and nutrition disorders

Most-reported serious reactions: Spinal cord compression/ Spinal Cord Compression Due To Pathologic Fracture Of T1, Oropharyngeal pain/ Sore Throat, Dyspnoea/ Increased Dyspnea, Influenza like illness/ Flu Like Symptom, Acute coronary syndrome/ Acute Coronary Syndrome, Cholangitis/ Cholangitis Due To Pd, Metastases to bone/ Osteolytic Jaw Lesion Due To Progression Disease, Hypovolaemic shock/ Hypovolemic Hypoperfusion.

Data from ClinicalTrials.gov NCT02314052 adverse events section.

Sponsor's own description

The purpose of this study is to assess the safety and tolerability of the investigational anticancer drug DCR-MYC. DCR-MYC is a novel synthetic double-stranded RNA in a stable lipid particle suspension that targets the oncogene MYC. MYC oncogene activation is important to the growth of many hematologic and solid tumor malignancies. In this study the Sponsor proposes to study DCR-MYC and its ability to inhibit MYC and thereby inhibit cancer cell growth.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Nanoparticles in the clinic: An update.
    Anselmo AC, Mitragotri S. · · 2019 · cited 976× · PMID 31572799 · DOI 10.1002/btm2.10143
  2. Nanoparticles in the clinic.
    Anselmo AC, Mitragotri S. · · 2016 · cited 773× · PMID 29313004 · DOI 10.1002/btm2.10003
  3. Smart nanoparticles for cancer therapy.
    Sun L, Liu H, Ye Y, Lei Y, et al · · 2023 · cited 474× · PMID 37919282 · DOI 10.1038/s41392-023-01642-x
  4. Advances in the delivery of RNA therapeutics: from concept to clinical reality.
    Kaczmarek JC, Kowalski PS, Anderson DG. · · 2017 · cited 467× · PMID 28655327 · DOI 10.1186/s13073-017-0450-0
  5. Lipids and Lipid Derivatives for RNA Delivery.
    Zhang Y, Sun C, Wang C, Jankovic KE, et al · · 2021 · cited 423× · PMID 34279087 · DOI 10.1021/acs.chemrev.1c00244
  6. Preclinical and clinical development of siRNA-based therapeutics.
    Ozcan G, Ozpolat B, Coleman RL, Sood AK, et al · · 2015 · cited 331× · PMID 25666164 · DOI 10.1016/j.addr.2015.01.007
  7. Lipid-Based Nanoparticles in the Clinic and Clinical Trials: From Cancer Nanomedicine to COVID-19 Vaccines.
    Thi TTH, Suys EJA, Lee JS, Nguyen DH, et al · · 2021 · cited 317× · PMID 33918072 · DOI 10.3390/vaccines9040359
  8. Therapeutic siRNA: State-of-the-Art and Future Perspectives.
    Friedrich M, Aigner A. · · 2022 · cited 256× · PMID 35997897 · DOI 10.1007/s40259-022-00549-3

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing