Phase 1/2a Study of DTA-H19 in Advanced Stage Ovarian Cancer

This is a Phase 1/2a, open label, dose escalation, repeat dose study in 11 subjects with recurrent, platinum resistant advanced stage ovarian cancer or primary peritoneal carcinoma designed to determine the tolerability, safety, quality of life, PK, and preliminary efficacy of DTA-H19 administered intraperitoneally(IP).

Primary Objective: The primary objectives of this study are:

• To determine the maximum tolerated dose (MTD) of IP DTA-H19; and,
• To identify any dose limiting toxicities (DLTs).

Secondary Objectives: Secondary objectives of this study are:

• To determine quality of life of subjects with advanced ovarian cancer, primary peritoneal carcinoma treated with IP DTA-H19;
• To determine the the reduction in malignant ascites as measured by Ultrasound and change in frequency of parecenteses necessary.
• To determine the overall survival distribution.

Inclusion criteria

• Provide written informed consent and be at least 18 years of age.
• Have histopathologically documented epithelial ovarian carcinoma or primary peritoneal carcinoma with evidence of ascites.
• Have either a) platinum-refractory disease (i.e. persistent disease following completion of platinum-based primary chemotherapy) and have failed at least primary platinum-based chemotherapy; or b) platinum-resistant recurrent disease and have failed at least one regimen of second line chemotherapy.
• Be able to tolerate placement of IP catheter.
• Be at least 2 weeks from last treatment to allow recovery from prior toxicity but in the judgment of the investigator with sufficient time to ensure that the effects of prior treatments will not confound safety evaluations.
• Have a Karnofsky performance status score of ≥ 70%.
• Not be of child-bearing potential.
• Have a life expectancy of ≥ 3 months.
• Have serum creatinine < 2.0 mg/dL, total bilirubin less than the institution's 3x upper limit of normal (ULN); AST and ALT <= 2.5 x ULN,total albumin ≥ 2.5 g/dL, PT, PTT, and PT/INR within normal limits, absolute neutrophil count (ANC) > 1,500 x 103 cells/mL, platelets ≥ 100,000/mL, and hemoglobin ≥ 10 mg/dL.
• Have a biopsy specimen or an ascites fluid that is positive for H19 expression.
• Have screening procedures completed within 6-weeks before starting treatment.
• No significant history of cardiac disease, i.e., uncontrolled hypertension, unstable angina or congestive heart failure.
• - No plans to receive concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy or any other type of therapy for treatment of cancer while on this protocol.

Exclusion criteria

• Have evidence of extra abdominal disease with the exception of isolated small nodules (e.g., liver or pulmonary nodules) that are not causing symptoms.
• Have known brain metastases.
• Have known HIV infection.
• Have known active viral or bacterial infections.
• Have presence of any psychological, familiar, sociological, or geographical condition potentially hampering compliance with the study protocol or follow up schedule.
• Have a medical condition contraindicated for laparotomy, laparoscopy, or surgery.
• Have significant bowel involvement denoted by persistent grade 3 vomiting (≥6 episodes in 24 hrs; IV fluids, or total parenteral nutrition (TPN) indicated ≥24 hrs) after removal of ascites, inability to tolerate oral diet or medications, requirement for total parenteral nutrition, or recent (past six weeks) episode of bowel obstruction.
• Have a history of coagulopathy.