Trial Outcomes & Findings for Study of the Trifunctional Antibody Catumaxomab to Treat Recurrent Symptomatic Malignant Ascites (NCT NCT00326885)

NCT ID: NCT00326885

Last Updated: 2018-10-17

Results Overview

The parameter to be estimated is the proportion of patients who achieve at least a 4-fold increase in their puncture/paracentesis-free interval. The pretreatment interval is defined as the length of time between the patient's most recent paracentesis (baseline) and the subsequent paracentesis necessitated by her increasing ascites-related symptoms. The post-treatment interval is defined as the time between the last dose of catumaxomab plus 1 day to the time of recurrence of ascites requiring therapeutic paracentesis or death, whichever occurred sooner.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

32 participants

Primary outcome timeframe

6 months

Results posted on

2018-10-17

Participant Flow

40 patients were recruited and 32 patients were treated and evaluable. For analyses, there were 32 patients in the Full Analysis Set (FAS), 14 patients in the Per-Protocol (PP) population, and 32 patients in the Safety population.

Eligible patients must have undergone at least 1 therapeutic paracentesis (the most recent paracentesis) within 4 weeks prior to the baseline paracentesis.

Participant milestones

Participant milestones
Measure
Catumaxomab
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Overall Study
STARTED
32
Overall Study
COMPLETED
25
Overall Study
NOT COMPLETED
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Catumaxomab
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Overall Study
Adverse Event
1
Overall Study
Withdrawal by Subject
3
Overall Study
Physician Decision
1
Overall Study
Hospice withdrew consent
2

Baseline Characteristics

Study of the Trifunctional Antibody Catumaxomab to Treat Recurrent Symptomatic Malignant Ascites

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Catumaxomab
n=32 Participants
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
18 Participants
n=5 Participants
Age, Categorical
>=65 years
14 Participants
n=5 Participants
Age, Continuous
60.3 years
STANDARD_DEVIATION 10.84 • n=5 Participants
Sex: Female, Male
Female
32 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
Region of Enrollment
United States
32 participants
n=5 Participants

PRIMARY outcome

Timeframe: 6 months

The parameter to be estimated is the proportion of patients who achieve at least a 4-fold increase in their puncture/paracentesis-free interval. The pretreatment interval is defined as the length of time between the patient's most recent paracentesis (baseline) and the subsequent paracentesis necessitated by her increasing ascites-related symptoms. The post-treatment interval is defined as the time between the last dose of catumaxomab plus 1 day to the time of recurrence of ascites requiring therapeutic paracentesis or death, whichever occurred sooner.

Outcome measures

Outcome measures
Measure
Catumaxomab
n=31 Participants
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
The Proportion of Patients Who Achieved at Least a 4-fold Increase of Puncture/Paracentesis-free Interval Following Catumaxomab Relative to Their Pre-treatment Interval.
0.226 proportion of patients

PRIMARY outcome

Timeframe: 180 days

The parameter to be tested is the ratio of the post-treatment puncture/paracentesis-free interval divided by the pre-treatment puncture/paracentesis-free interval. The pre-treatment interval is defined as the length of time between the patient's most recent paracentesis (baseline) and the subsequent paracentesis necessitated by her increasing ascites-related symptoms. The post-treatment interval is defined as the time between the last dose of catumaxomab plus 1 day to the time of recurrence of ascites requiring therapeutic paracentesis or death, whichever occurred sooner.

Outcome measures

Outcome measures
Measure
Catumaxomab
n=31 Participants
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Increase of Paracentesis/Puncture-free Interval (Ratio)
2 fold
Interval 0.15 to 60.0

SECONDARY outcome

Timeframe: ≥6 months

Population: Full analysis set (FAS) Per protocol (PP)

Puncture/Paracentesis-free Survival (PuFS), Defined as the Number of Days Between the Date of Last Dose and the Date of Documented End of Study (EoS) Paracentesis or Death, Whichever Occurred First

Outcome measures

Outcome measures
Measure
Catumaxomab
n=32 Participants
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Puncture/Paracentesis-free Survival (PuFS)
4.2 weeks
Interval 2.1 to 7.6

SECONDARY outcome

Timeframe: ≥ 6 months

Overall survival is defined as the interval from the date of first dose to the date of death.

Outcome measures

Outcome measures
Measure
Catumaxomab
n=32 Participants
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Overall Survival (OS)
3.6 months
Interval 2.2 to 4.6

SECONDARY outcome

Timeframe: 6 months

Patient-reported ascites symptoms were to be assessed using the patient questionnaire, Functional Assessment of Chronic Illness Therapy - Ascites Index (FACIT-AI). At 6 months following catumaxomab administration, the patient was requested to assess the severity of the following parameters during the past week using a 5-point scale with scores from "0 = not at all" to "4 = very much": anorexia, insomnia, decreased mobility, dyspnea, nausea, vomiting, abdominal pain, abdominal distention, fatigue, early satiety, urinary frequency, constipation, and emotional distress. For the parameters anorexia, insomnia, and decreased mobility, high scores mean good response, for the other parameters low scores mean good response.

Outcome measures

Outcome measures
Measure
Catumaxomab
n=4 Participants
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Ascites Signs and Symptoms
I have good appetite
1.5 units on a scale
Interval 1.0 to 2.0
Ascites Signs and Symptoms
I am sleeping well
1.0 units on a scale
Interval 1.0 to 2.0
Ascites Signs and Symptoms
I am able to get around by myself
1.0 units on a scale
Interval 0.0 to 3.0
Ascites Signs and Symptoms
I have been short of breath
1.0 units on a scale
Interval 1.0 to 1.0
Ascites Signs and Symptoms
I have nausea
0.5 units on a scale
Interval 0.0 to 2.0
Ascites Signs and Symptoms
I have been vomiting
0.5 units on a scale
Interval 0.0 to 1.0
Ascites Signs and Symptoms
I have pain in my stomach area
1.0 units on a scale
Interval 1.0 to 1.0
Ascites Signs and Symptoms
I have swelling in my stomach area
1.0 units on a scale
Interval 0.0 to 2.0
Ascites Signs and Symptoms
I have lack of energy
2.0 units on a scale
Interval 1.0 to 3.0
Ascites Signs and Symptoms
When I eat, I seem to get full quickly
2.0 units on a scale
Interval 2.0 to 3.0
Ascites Signs and Symptoms
I urinate more frequently
0.0 units on a scale
Interval 0.0 to 2.0
Ascites Signs and Symptoms
I am bothered by constipation
1.0 units on a scale
Interval 0.0 to 1.0
Ascites Signs and Symptoms
I have been emotionally distressed
0 units on a scale
Interval 0.0 to 0.0

SECONDARY outcome

Timeframe: 6 months

Ascites volume measurement were to be performed at screening (= prior to baseline), at baseline (= before start of therapy with catumaxomab) and during the 6-month follow-up period when the patient had recurrence of symptomatic ascites requiring therapeutic paracentesis. At each paracentesis, drainage to dryness was to be achieved and the exact volume was to be measured and documented.

Outcome measures

Outcome measures
Measure
Catumaxomab
n=32 Participants
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Ascites Volume
prior to baseline (at screening)
2800 mL
Interval 50.0 to 8675.0
Ascites Volume
baseline (start of therapy)
2050 mL
Interval 60.0 to 5500.0
Ascites Volume
at puncture visit/ end of study (day 180)
1500 mL
Interval 0.0 to 3100.0

Adverse Events

Catumaxomab

Serious events: 24 serious events
Other events: 32 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Catumaxomab
n=32 participants at risk
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Gastrointestinal disorders
Vomiting
18.8%
6/32 • Number of events 7 • 6 months
Gastrointestinal disorders
Nausea
15.6%
5/32 • Number of events 7 • 6 months
Gastrointestinal disorders
Small intestinal obstruction
12.5%
4/32 • Number of events 4 • 6 months
Gastrointestinal disorders
Abdominal pain
6.2%
2/32 • Number of events 2 • 6 months
Gastrointestinal disorders
Upper gastrointestinal haemorrhage
6.2%
2/32 • Number of events 2 • 6 months
Gastrointestinal disorders
Constipation
3.1%
1/32 • Number of events 1 • 6 months
Gastrointestinal disorders
Gastrointestinal haemorrhage
3.1%
1/32 • Number of events 1 • 6 months
Gastrointestinal disorders
Large intestinal obstruction
3.1%
1/32 • Number of events 1 • 6 months
Gastrointestinal disorders
Oesophagitis
3.1%
1/32 • Number of events 1 • 6 months
Gastrointestinal disorders
Peritonitis
3.1%
1/32 • Number of events 1 • 6 months
General disorders
Extravasation
6.2%
2/32 • Number of events 2 • 6 months
General disorders
Pyrexia
6.2%
2/32 • Number of events 2 • 6 months
General disorders
Chills
3.1%
1/32 • Number of events 1 • 6 months
General disorders
Device leakage
3.1%
1/32 • Number of events 1 • 6 months
General disorders
Injection site reaction
3.1%
1/32 • Number of events 1 • 6 months
Hepatobiliary disorders
Hepatic function abnormal
3.1%
1/32 • Number of events 1 • 6 months
Hepatobiliary disorders
Hyperbilirubinaemia
3.1%
1/32 • Number of events 1 • 6 months
Infections and infestations
Abdominal abscess
3.1%
1/32 • Number of events 1 • 6 months
Infections and infestations
Bacteraemia
3.1%
1/32 • Number of events 2 • 6 months
Infections and infestations
Sepsis syndrome
3.1%
1/32 • Number of events 1 • 6 months
Infections and infestations
Septic shock
3.1%
1/32 • Number of events 1 • 6 months
Metabolism and nutrition disorders
Dehydration
9.4%
3/32 • Number of events 3 • 6 months
Metabolism and nutrition disorders
Hyponatraemia
3.1%
1/32 • Number of events 1 • 6 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Malignant neoplasm progression
21.9%
7/32 • Number of events 7 • 6 months
Respiratory, thoracic and mediastinal disorders
Pleural effusion
9.4%
3/32 • Number of events 3 • 6 months
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
9.4%
3/32 • Number of events 3 • 6 months
Respiratory, thoracic and mediastinal disorders
Hypoxia
6.2%
2/32 • Number of events 2 • 6 months
Respiratory, thoracic and mediastinal disorders
Pneumonia aspiration
3.1%
1/32 • Number of events 1 • 6 months
Skin and subcutaneous tissue disorders
Rash
3.1%
1/32 • Number of events 1 • 6 months
Skin and subcutaneous tissue disorders
Rash macular
3.1%
1/32 • Number of events 1 • 6 months
Vascular disorders
Hypotension
3.1%
1/32 • Number of events 1 • 6 months

Other adverse events

Other adverse events
Measure
Catumaxomab
n=32 participants at risk
Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 4 days (10 μg, 20 μg, 50 μg, and 150 μg, respectively)
Blood and lymphatic system disorders
Anaemia
31.2%
10/32 • Number of events 10 • 6 months
Cardiac disorders
Tachycardia
15.6%
5/32 • Number of events 6 • 6 months
Cardiac disorders
Sinus tachycardia
6.2%
2/32 • Number of events 2 • 6 months
Eye disorders
Diplopia
6.2%
2/32 • Number of events 2 • 6 months
Gastrointestinal disorders
Nausea
75.0%
24/32 • Number of events 39 • 6 months
Gastrointestinal disorders
Vomiting
75.0%
24/32 • Number of events 37 • 6 months
Gastrointestinal disorders
Abdominal pain
50.0%
16/32 • Number of events 19 • 6 months
Gastrointestinal disorders
Constipation
43.8%
14/32 • Number of events 15 • 6 months
Gastrointestinal disorders
Diarrhoea
28.1%
9/32 • Number of events 11 • 6 months
Gastrointestinal disorders
Abdominal distension
15.6%
5/32 • Number of events 6 • 6 months
Gastrointestinal disorders
Small intestinal obstruction
15.6%
5/32 • Number of events 5 • 6 months
Gastrointestinal disorders
Abdominal discomfort
9.4%
3/32 • Number of events 5 • 6 months
Gastrointestinal disorders
Dyspepsia
9.4%
3/32 • Number of events 3 • 6 months
Gastrointestinal disorders
Gastrooesophageal reflux disease
9.4%
3/32 • Number of events 3 • 6 months
Gastrointestinal disorders
Abdominal pain upper
6.2%
2/32 • Number of events 2 • 6 months
Gastrointestinal disorders
Flatulence
6.2%
2/32 • Number of events 2 • 6 months
Gastrointestinal disorders
Upper gastrointestinal haemorrhage
6.2%
2/32 • Number of events 2 • 6 months
General disorders
Fatigue
59.4%
19/32 • Number of events 21 • 6 months
General disorders
Pyrexia
59.4%
19/32 • Number of events 34 • 6 months
General disorders
Chills
43.8%
14/32 • Number of events 22 • 6 months
General disorders
Oedema peripheral
28.1%
9/32 • Number of events 12 • 6 months
General disorders
Asthenia
18.8%
6/32 • Number of events 6 • 6 months
General disorders
Catheter site pain
15.6%
5/32 • Number of events 6 • 6 months
General disorders
Oedema
12.5%
4/32 • Number of events 5 • 6 months
General disorders
Performance status decreased
9.4%
3/32 • Number of events 3 • 6 months
General disorders
Catheter site erythema
6.2%
2/32 • Number of events 2 • 6 months
General disorders
Chest pain
6.2%
2/32 • Number of events 2 • 6 months
General disorders
Device leakage
6.2%
2/32 • Number of events 2 • 6 months
General disorders
Extravasation
6.2%
2/32 • Number of events 2 • 6 months
Infections and infestations
Candidiasis
9.4%
3/32 • Number of events 3 • 6 months
Infections and infestations
Urinary tract infection
9.4%
3/32 • Number of events 3 • 6 months
Infections and infestations
Pneumonia
6.2%
2/32 • Number of events 2 • 6 months
Investigations
Blood alkaline phosphatase increased
12.5%
4/32 • Number of events 4 • 6 months
Investigations
Haemoglobin decreased
12.5%
4/32 • Number of events 5 • 6 months
Investigations
Weight decreased
12.5%
4/32 • Number of events 4 • 6 months
Investigations
Alanine aminotransferase increased
9.4%
3/32 • Number of events 3 • 6 months
Investigations
Aspartate aminotransferase increased
9.4%
3/32 • Number of events 3 • 6 months
Investigations
C-reactive protein increased
9.4%
3/32 • Number of events 3 • 6 months
Investigations
Haematocrit decreased
9.4%
3/32 • Number of events 4 • 6 months
Investigations
Protein total decreased
9.4%
3/32 • Number of events 3 • 6 months
Investigations
Blood albumin decreased
6.2%
2/32 • Number of events 2 • 6 months
Investigations
Blood chloride decreased
6.2%
2/32 • Number of events 2 • 6 months
Investigations
Blood magnesium decreased
6.2%
2/32 • Number of events 2 • 6 months
Investigations
Coagulation time prolonged
6.2%
2/32 • Number of events 2 • 6 months
Investigations
Oxygen saturation decreased
6.2%
2/32 • Number of events 2 • 6 months
Investigations
Urine output decreased
6.2%
2/32 • Number of events 2 • 6 months
Investigations
White blood cell count increased
6.2%
2/32 • Number of events 2 • 6 months
Metabolism and nutrition disorders
Decreased appetite
34.4%
11/32 • Number of events 13 • 6 months
Metabolism and nutrition disorders
Dehydration
31.2%
10/32 • Number of events 11 • 6 months
Metabolism and nutrition disorders
Hyponatraemia
21.9%
7/32 • Number of events 7 • 6 months
Metabolism and nutrition disorders
Hypoalbuminaemia
18.8%
6/32 • Number of events 6 • 6 months
Metabolism and nutrition disorders
Hypokalaemia
12.5%
4/32 • Number of events 4 • 6 months
Metabolism and nutrition disorders
Hyperglycaemia
6.2%
2/32 • Number of events 2 • 6 months
Metabolism and nutrition disorders
Polydipsia
6.2%
2/32 • Number of events 2 • 6 months
Metabolism and nutrition disorders
Fluid overload
6.2%
2/32 • Number of events 2 • 6 months
Musculoskeletal and connective tissue disorders
Back pain
18.8%
6/32 • Number of events 7 • 6 months
Musculoskeletal and connective tissue disorders
Pain in extremity
9.4%
3/32 • Number of events 3 • 6 months
Musculoskeletal and connective tissue disorders
Arthralgia
6.2%
2/32 • Number of events 3 • 6 months
Musculoskeletal and connective tissue disorders
Muscle spasms
6.2%
2/32 • Number of events 2 • 6 months
Musculoskeletal and connective tissue disorders
Myalgia
6.2%
2/32 • Number of events 2 • 6 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Malignant neoplasm progression
25.0%
8/32 • Number of events 8 • 6 months
Nervous system disorders
Dizziness
12.5%
4/32 • Number of events 4 • 6 months
Nervous system disorders
Headache
9.4%
3/32 • Number of events 6 • 6 months
Nervous system disorders
Tremor
6.2%
2/32 • Number of events 2 • 6 months
Psychiatric disorders
Anxiety
15.6%
5/32 • Number of events 5 • 6 months
Psychiatric disorders
Confusional state
9.4%
3/32 • Number of events 3 • 6 months
Psychiatric disorders
Depression
9.4%
3/32 • Number of events 3 • 6 months
Psychiatric disorders
Insomnia
9.4%
3/32 • Number of events 3 • 6 months
Renal and urinary disorders
Proteinuria
9.4%
3/32 • Number of events 3 • 6 months
Renal and urinary disorders
Haematuria
6.2%
2/32 • Number of events 3 • 6 months
Renal and urinary disorders
Renal failure
6.2%
2/32 • Number of events 2 • 6 months
Respiratory, thoracic and mediastinal disorders
Dyspnoea
28.1%
9/32 • Number of events 10 • 6 months
Respiratory, thoracic and mediastinal disorders
Cough
25.0%
8/32 • Number of events 8 • 6 months
Respiratory, thoracic and mediastinal disorders
Pleural effusion
12.5%
4/32 • Number of events 4 • 6 months
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
9.4%
3/32 • Number of events 3 • 6 months
Respiratory, thoracic and mediastinal disorders
Pulmonary oedema
9.4%
3/32 • Number of events 3 • 6 months
Respiratory, thoracic and mediastinal disorders
Dyspnoea exertional
6.2%
2/32 • Number of events 2 • 6 months
Respiratory, thoracic and mediastinal disorders
Hypoxia
6.2%
2/32 • Number of events 2 • 6 months
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
6.2%
2/32 • Number of events 2 • 6 months
Skin and subcutaneous tissue disorders
Erythema
18.8%
6/32 • Number of events 7 • 6 months
Skin and subcutaneous tissue disorders
Rash
15.6%
5/32 • Number of events 5 • 6 months
Skin and subcutaneous tissue disorders
Dry skin
6.2%
2/32 • Number of events 2 • 6 months
Skin and subcutaneous tissue disorders
Night sweats
6.2%
2/32 • Number of events 2 • 6 months
Vascular disorders
Hypotension
12.5%
4/32 • Number of events 5 • 6 months
Vascular disorders
Hypertension
6.2%
2/32 • Number of events 2 • 6 months

Additional Information

Manager, Regulatory Affairs

Fresenius Biotech

Phone: 781-699-4652

Results disclosure agreements

  • Principal investigator is a sponsor employee The Site may publish the results of the Study after such cooperative publication, or 1 year after Sponsor's final evaluation of all the Study data from all sites, whichever occurs first. Prior to any submission for publication, presentation, or communication of results or information arising from the Study, Investigator shall provide Fresenius Biotech at least 90 days for review and comment upon the manuscript or other material for such publication or presentation.
  • Publication restrictions are in place

Restriction type: OTHER