CancerPhase 1NCT03307629
Safety and Tolerability of NOX66 in Combination With Palliative Radiotherapy in Patients With Late-Stage Prostate Cancer
A Phase 1 study testing NOX66 and Irradiation Therapy in people with Cancer, run by Noxopharm Limited at 10 sites in 3 countries.
Trial summary
The study is intended as a Proof of Concept and dose confirmation study. The primary objective of this study is to observe safety and tolerability of idronoxil (NOX66) in combination with radiotherapy (at palliative doses) in patients with metastatic castrate-resistant prostate cancer (CRPC) and to confirm dose in… Read more about this study
- Who is it for?
- Ages 18 years and older, men only
- Conditions the study is for
- Cancer
- What is being tested?
- NOX66 and Irradiation Therapy
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 25 participants
- Where
- 10 sitesin 3 countries
- Study dates
- 1 Nov 2017to 15 Sep 2020
- Phase
- Phase 1
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Men only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Provision of informed consent
- ≥ 18 years of age
- Histologically confirmed prostate cancer and/or PSA of >100 ng/mL at original diagnosis
- Metastatic disease evidenced by either CT/MRI imaging or bone scan
- Objective evidence of disease progression as defined by either:
- Radiographic progression of in nodal or visceral metastases and bone disease progression with 2 or more new lesions ii. Rising PSA value ≥2ng/ml in at least 3 measurements, at least 1 week apart, with castrate levels of serum testosterone.
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- Eligible to receive palliative radiation therapy for management of disease
- At least one symptomatic lesion which is suitable for radiation therapy
- ECOG Performance status 0-2
- A minimum life expectancy of 24 weeks
- Adequate bone marrow, hepatic and renal function as evidenced by:
- Absolute neutrophil count (ANC) > 1.5 x 109/L
- Platelet count > 100 x 109/L
- Hemoglobin > 9.0 g/dL
- Serum bilirubin < 1.5 x ULN
- AST/ALT (SGOT/SGPT) < 2.5 x ULN for the reference laboratory or < 5 x ULN in the presence of liver metastases
- Serum creatinine < 1.5 x ULN
- Ongoing androgen deprivation therapy with luteinizing hormone-releasing hormone (LHRH) agonist or antagonist
- At least 4 weeks must have elapsed prior to commencement of NOX66 treatment since prior chemotherapy, investigational drug or biologic therapy and any toxicity associated with these treatments has recovered to ≤ NCI-CTCAE (version 4.03) Grade 1.
- At least 21 days must have elapsed following major surgery and any surgical incision should be completely healed.
Who cannot join
- Tumour involvement of the central nervous system
- Uncontrolled infection or systemic disease
- Clinically significant cardiac disease not well controlled with medication (e.g. congestive heart failure, symptomatic coronary artery disease, angina, and cardiac arrhythmias) or myocardial infarction within the last 12 months
- Patients with a QTc > 470 msec on screening ECG
- Concurrent systemic chemotherapy or biological therapy
- Any situation where the use of suppository therapy is contra-indicated or impractical (eg. chronic diarrhoea, colostomy, ulcerative colitis).
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- Known human immunodeficiency virus (HIV) or Hepatitis B or C (active, previously treated or both)
- Any subject whose testosterone is not suppressed i.e. is > 0.5nmols/L
- Any other reason which, in the opinion of the investigator, will preclude suitable participation in the study.
Trial locations and contacts
10 sites in 3 countries.
10 sites in 3 countries
Australia5 sites
Radiation Oncology Centres Gold Coast
Gold Coast, Queensland, 4215
Genesis Cancer Care - Newcastle
Newcastle, New South Wales, 2290
Central West Cancer Care Centre - Orange Health Service
Orange, New South Wales, 2800
Genesis Cancer Care Mater Hospital
Sydney, New South Wales, 2060
North West Cancer Centre, Tamworth Hospital
Tamworth, New South Wales, 2340
Georgia4 sites
Research Institute of Clinical Medicine
Tbilisi, 0112
TSMU The First University Clinic
Tbilisi, 0141
National Center of Urology
Tbilisi, 0144
Institute for Personalised Medicine
Tbilisi, 0186
About this study
Official title: NOX66 and Palliative Radiotherapy in Patients With Late-Stage Prostate Cancer - a Phase 1b Proof of Concept and Dose Confirmation Study
The study is intended as a Proof of Concept and dose confirmation study. The primary objective of this study is to observe safety and tolerability of idronoxil (NOX66) in combination with radiotherapy (at palliative doses) in patients with metastatic castrate-resistant prostate cancer (CRPC) and to confirm dose in order to progress to Phase 2/3.
Read the detailed description
This study will investigate three escalating doses of NOX66 in combination with palliative dose of radiation therapy to establish safety profile and / or obtain efficacy signals and to determine the optimal dose for future radiation therapy combination studies.
The key hypotheses to be tested in this study are:
- That NOX66 can be safely added to palliative dose radiation therapy.
- That NOX66 may sensitise tumours to palliative doses of radiation therapy
- That NOX66 in combination with radiation therapy may trigger or augment an abscopal effect
Participants will have a minimum of 1 symptomatic lesion amenable to radiation therapy.
Radiation therapy will be delivered at a 20Gy dosage over 5 fractions. NOX66 will be taken on 13 consecutive days starting 1 day prior to radiotherapy.
The response of irradiated and non-irradiated target tumour lesions will be measured by CT/MRI scan and RECIST1.1 criteria at three time points post treatment. Pain response will be evaluated using the Brief Pain Inventory-Short Form (BPI-SF) instrument at five time points post treatment.
Patients will be suitable for the study as they become indicated for palliative radiation therapy for management of their cancer.
This study will enrol up to 24 patients in 3 NOX66 dose level cohorts of 4 patients (n=12) and an expansion cohort of 12 patients. Dose escalation decisions will be based on patients who experience adverse events directly related to NOX66 treatment.
Following the review of accumulated safety data, disease status and treatment efficacy signals at WEEK 6 for the first 12 patients, the Study Steering Committee will determine the dose at which to continue treatment for the expansion patient Cohort 4 in the study. A further 12 patients will be recruited at this dose level.
- Conditions
- Cancer
- Being tested
- NOX66, Irradiation Therapy
- Medical subject headings
- Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
NOX66Drug
NOX66 delivered as rectal suppository.
Irradiation TherapyRadiation
Radiation per selected tumour lesion.
| Study group | Role | What they receive |
|---|---|---|
| NOX66 + Radiation treatment (combined) in cohorts 1-3 | Experimental | NOX66 administered on Days 1-16 and radiation treatment given on Day 2 to 9 of 2-week cycle.
NOX66 treatment given to 3 cohorts of 4 patients as 1 of 3 doses, 400mg, 800mg and 1200 mg.
Radiation treatment of 20Gy given over 5 daily fractions to selected target lesion/s for all cohorts. Receives: Drug: NOX66; Radiation: Irradiation Therapy |
| NOX66 + Radiation treatment (combined) in cohort 4 | Experimental | NOX66 administered on Days 1-16 and radiation treatment given on Day 2 to 9 of 2-week cycle.
NOX66 dose will be either one of 3 doses 400mg, 800mg and 1200 mg based on interim analyses of safety data and tumour response at WEEK 6 of 3 dose cohorts of 12 total patients. The Safety Steering Committee will inform on dose for cohort expansion.
Radiation treatment of 20Gy given over 5 daily fractions to selected target lesion/s for all cohorts. Receives: Drug: NOX66; Radiation: Irradiation Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Treatment-Emergent Adverse Events Including SAEs [Safety and Tolerability] of NOX66 Combined With Radiation Therapy at Multiple Timepoints
Safety will be assessed through reported incidence of treatment emergent adverse events (AEs), including SAEs, dose limiting toxicities, AEs leading to withdrawal, events that are greater than CTCAE Version 4.03 Grade 2 in severity. Treatment emergent AEs are those with an onset on or after the initiation of therapy. Timepoints for AE /SAE assessment are Day 2 (start of radiation therapy treatment and one day after start of NOX66 treatment), Day 6, End of treatment (Day 16), Week 6, Week 12, and Week 24.
Measured: Day 2, Day 6, EOT (Day 16), Week 6, Week 12, and Week 24
Assessment of Laboratory Results
Mean change from Baseline in absolute value of safety laboratory results (haematology and biochemistry) assessed at End of Treatment (Day 16), Week 6, Week 12, and Week 24.
Measured: From Baseline to End of Treatment (Day 16), Week 6, Week 12, and Week 24.
Assessment of ECG Results
Mean change from Baseline in ECG intervals (msec) which are assessed at End of treatment (Day 16), Week 12, and Week 24.
Measured: Baseline to End of treatment (Day 16), Week 12, and Week 24.
Secondary outcomes (7)
Change of Target Lesions in Participants According to RECIST 1.1 Criteria
RECIST response in target irradiated and non-irradiated lesions based on radiographic CT/MRI scan. RECIST 1.1 criteria are Complete Response (CR), Partial Response (PR), Stable Disease(SD) and Progressive Disease (PD). Not Applicable (NA) indicates that a participant did not have measurable target lesions at Screening.
Measured: Week 6, Week 12, and Week 24
Change of Non-Target Lesions in Participants According to RECIST 1.1 Criteria
RECIST 1.1 assessment of response in Non-Target Lesions as Complete Response (CR), Non-CR/Non-PD, or Progressive Disease (PD). Not Applicable (NA) signifies that the participant did not have non-target lesions at Screening.
Measured: Week 6, Week 12, and Week 24
Overall Response According to RECIST 1.1 Criteria
Overall RECIST 1.1 response based on combined assessment criteria for target, non-target and new lesions as Complete Response (CR), Partial Response (PR), Stable Disease(SD), or Progressive Disease (PD)
Measured: From enrolment up to Week 6, Week 12, and Week 24
Change in Overall Pain Score Using the Brief Pain Inventory - Short Form (BPI-SF)
Percentage change from baseline in overall pain score based on responses to the BPI-SF, which is scored from 0 to 10, with 0 = no pain and 10 = the most severe pain imaginable.
Measured: From enrolment up to Day 16, Week 6, Week 12, and Week 24
Change in Prostate Specific Antigen (PSA) Levels
Percentage change from baseline in serum PSA levels (ng/mL) at Week 6, Week 12, and Week 24
Measured: From enrolment up to Week 6, Week 12, and Week 24
Change of ECOG Performance Status
Assessment of patient via ECOG Performance Status, which has a scale scored from 0 (Fully Active) to 5 (Dead).
Measured: From enrolment up to Week 6, Week 12, and Week 24
Assessment of Change in Physical Appearance (Physical Exam) by Measuring HEENT, Gastrointestinal, Abdominal Status at Multiple Timepoints
Assessment of patient via physical exam comparing Day 2, End of Treatment (Day 16), Week 6, Week 12, and Week 24 to baseline. Physical exam included abdominal, cardiovascular, dermatologic, gastrointestinal, genitourinary, HEENT (head, eyes, ears, nose, throat), lymphatic, musculoskeletal, neurological, other, and pulmonary exams.
Measured: From enrolment up to Day 2, End of Treatment (Day 16), Week 6, Week 12, and Week 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Oct 2017
- Study start1 Nov 2017
- Primary completion1 Dec 2019
- Study completion15 Sep 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 25 participants (actual)
Sponsor and investigators
- Lead sponsor
- Noxopharm Limited
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Marinella Messina, PhD, Study chair, Noxopharm Limited
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03307629
- Sponsor's protocol ID
- NOX66-002A
- Status last verified
- Jul 2025
- First submitted
- 27 Sep 2017
- Last updated
- 29 Jul 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: De-identified individual participant data for primary and secondary outcome measure will be made available within 12 months after study completion.
Study at a glance
From the registry record, last updated by the sponsor on 29 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- NOX66 and Palliative Radiotherapy in Patients With Late-Stage Prostate Cancer - a Phase 1b Proof of Concept and Dose Confirmation Study
- ClinicalTrials.gov ID
- NCT03307629
- Acronym / sponsor ID
- NOX66-002A
- Conditions
- Cancer
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 25 participants (actual)
- Lead sponsor
- Noxopharm LimitedIndustry (pharma, biotech, devices)
- Study start
- 1 Nov 2017 (actual)
- Primary completion
- 1 Dec 2019 (actual)
- Study completion
- 15 Sep 2020 (actual)
- First posted
- 12 Oct 2017 (actual)
- Results
- Posted 29 Jul 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The study is intended as a Proof of Concept and dose confirmation study. The primary objective of this study is to observe safety and tolerability of idronoxil (NOX66) in combination with radiotherapy (at palliative doses) in patients with metastatic castrate-resistant prostate cancer (CRPC) and to confirm dose in order to progress to Phase 2/3.
Detailed description
This study will investigate three escalating doses of NOX66 in combination with palliative dose of radiation therapy to establish safety profile and / or obtain efficacy signals and to determine the optimal dose for future radiation therapy combination studies.
The key hypotheses to be tested in this study are:
- That NOX66 can be safely added to palliative dose radiation therapy.
- That NOX66 may sensitise tumours to palliative doses of radiation therapy
- That NOX66 in combination with radiation therapy may trigger or augment an abscopal effect
Participants will have a minimum of 1 symptomatic lesion amenable to radiation therapy.
Radiation therapy will be delivered at a 20Gy dosage over 5 fractions. NOX66 will be taken on 13 consecutive days starting 1 day prior to radiotherapy.
The response of irradiated and non-irradiated target tumour lesions will be measured by CT/MRI scan and RECIST1.1 criteria at three time points post treatment. Pain response will be evaluated using the Brief Pain Inventory-Short Form (BPI-SF) instrument at five time points post treatment.
Patients will be suitable for the study as they become indicated for palliative radiation therapy for management of their cancer.
This study will enrol up to 24 patients in 3 NOX66 dose level cohorts of 4 patients (n=12) and an expansion cohort of 12 patients. Dose escalation decisions will be based on patients who experience adverse events directly related to NOX66 treatment.
Following the review of accumulated safety data, disease status and treatment efficacy signals at WEEK 6 for the first 12 patients, the Study Steering Committee will determine the dose at which to continue treatment for the expansion patient Cohort 4 in the study. A further 12 patients will be recruited at this dose level.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| NOX66 + Radiation treatment (combined) in cohorts 1-3 | Experimental | Drug: NOX66, Radiation: Irradiation TherapyNOX66 administered on Days 1-16 and radiation treatment given on Day 2 to 9 of 2-week cycle. NOX66 treatment given to 3 cohorts of 4 patients as 1 of 3 doses, 400mg, 800mg and 1200 mg. Radiation treatment of 20Gy given over 5 daily fractions to selected target lesion/s for all cohorts. |
| NOX66 + Radiation treatment (combined) in cohort 4 | Experimental | Drug: NOX66, Radiation: Irradiation TherapyNOX66 administered on Days 1-16 and radiation treatment given on Day 2 to 9 of 2-week cycle. NOX66 dose will be either one of 3 doses 400mg, 800mg and 1200 mg based on interim analyses of safety data and tumour response at WEEK 6 of 3 dose cohorts of 12 total patients. The Safety Steering Committee will inform on dose for cohort expansion. Radiation treatment of 20Gy given over 5 daily fractions to selected target lesion/s for all cohorts. |
Who may qualify
- Ages
- 18 years and older
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (20 listed)
- Provision of informed consent
- ≥ 18 years of age
- Histologically confirmed prostate cancer and/or PSA of >100 ng/mL at original diagnosis
- Metastatic disease evidenced by either CT/MRI imaging or bone scan
- Objective evidence of disease progression as defined by either:
Key exclusion criteria (9 listed)
- Tumour involvement of the central nervous system
- Uncontrolled infection or systemic disease
- Clinically significant cardiac disease not well controlled with medication (e.g. congestive heart failure, symptomatic coronary artery disease, angina, and cardiac arrhythmias) or myocardial infarction within the last 12 months
- Concurrent systemic chemotherapy or biological therapy
- Any situation where the use of suppository therapy is contra-indicated or impractical (eg. chronic diarrhoea, colostomy, ulcerative colitis).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| NOX66NOX66 delivered as rectal suppository. | Drug | NOX66 + Radiation treatment (combined) in cohort 4, NOX66 + Radiation treatment (combined) in cohorts 1-3 |
| Irradiation TherapyRadiation per selected tumour lesion. | Radiation | NOX66 + Radiation treatment (combined) in cohort 4, NOX66 + Radiation treatment (combined) in cohorts 1-3 |
Primary outcome
Number of Participants With Treatment-Emergent Adverse Events Including SAEs [Safety and Tolerability] of NOX66 Combined With Radiation Therapy at Multiple Timepoints
Time frame: Day 2, Day 6, EOT (Day 16), Week 6, Week 12, and Week 24
Safety will be assessed through reported incidence of treatment emergent adverse events (AEs), including SAEs, dose limiting toxicities, AEs leading to withdrawal, events that are greater than CTCAE Version 4.03 Grade 2 in severity. Treatment emergent AEs are those with an onset on or after the initiation of therapy. Timepoints for AE /SAE assessment are Day 2 (start of radiation therapy treatment and one day after start of NOX66 treatment), Day 6, End of treatment (Day 16), Week 6, Week 12, and Week 24.
Assessment of Laboratory Results
Time frame: From Baseline to End of Treatment (Day 16), Week 6, Week 12, and Week 24.
Mean change from Baseline in absolute value of safety laboratory results (haematology and biochemistry) assessed at End of Treatment (Day 16), Week 6, Week 12, and Week 24.
Assessment of ECG Results
Time frame: Baseline to End of treatment (Day 16), Week 12, and Week 24.
Mean change from Baseline in ECG intervals (msec) which are assessed at End of treatment (Day 16), Week 12, and Week 24.
7 secondary outcomes
Change of Target Lesions in Participants According to RECIST 1.1 Criteria
Time frame: Week 6, Week 12, and Week 24
Change of Non-Target Lesions in Participants According to RECIST 1.1 Criteria
Time frame: Week 6, Week 12, and Week 24
Overall Response According to RECIST 1.1 Criteria
Time frame: From enrolment up to Week 6, Week 12, and Week 24
Change in Overall Pain Score Using the Brief Pain Inventory - Short Form (BPI-SF)
Time frame: From enrolment up to Day 16, Week 6, Week 12, and Week 24
Change in Prostate Specific Antigen (PSA) Levels
Time frame: From enrolment up to Week 6, Week 12, and Week 24
Change of ECOG Performance Status
Time frame: From enrolment up to Week 6, Week 12, and Week 24
Assessment of Change in Physical Appearance (Physical Exam) by Measuring HEENT, Gastrointestinal, Abdominal Status at Multiple Timepoints
Time frame: From enrolment up to Day 2, End of Treatment (Day 16), Week 6, Week 12, and Week 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jul 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: Yes. De-identified individual participant data for primary and secondary outcome measure will be made available within 12 months after study completion.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Marinella Messina, PhD study chair
Noxopharm Limited
10 sites in 3 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing NOX66 and Irradiation Therapy in people with Cancer, run by Noxopharm Limited at 10 sites in 3 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 20 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 10 sites in Australia, Georgia, New Zealand. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 29 Jul 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With Treatment-Emergent Adverse Events Including SAEs [Safety and Tolerability] of NOX66 Combined With Radiation Therapy at Multiple Timepoints (time frame: Day 2, Day 6, EOT (Day 16), Week 6, Week 12, and Week 24). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jul 2025.