Phase 2 Ascending Dose Safety and Efficacy Study of RVP-001, a Manganese-based MRI Contrast Agent

Reveal Pharmaceuticals

Status and phase: Enrolling; Phase 2

Conditions: Acoustic Neuroma; Brain Metastases; CNS Lymphoma; Brain Tumor; Brain Tumor, Primary; Brain Neoplasm, Primary; Multiple Sclerosis Brain Lesion; Brain Cancer; Brain Neoplasms, Benign; Neurofibroma; Multiple Sclerosis; Brain Tumors; Brain Tumor, Recurrent; Central Nervous System (CNS) Lesions; CNS Cancer; CNS Metastases; CNS Lesion; CNS Tumor; Brain Neoplasms

Treatments: Drug: RVP-001

Study type: Interventional

Funder types: Industry; NIH

Identifiers

NCT06322342

9R44CA261240-04A1 (U.S. NIH Grant/Contract)

RVL-102-23

Details and patient eligibility

About

This Phase 2 clinical trial will study RVP-001, a new manganese-based MRI contrast agent, in people who are known to have gadolinium-enhancing central nervous system (CNS) lesions, for example stable brain tumors or multiple sclerosis.

The goal of this study is to assess safety, efficacy, and pharmacokinetics of RVP-001 at three dose levels. The study will also compare RVP-001 imaging to gadolinium-based contrast agent (GBCA) imaging. A single dose of RVP-001 will be administered to each subject. Subjects will have known gadolinium-enhancing CNS lesions and will be due to have a routine gadolinium-based contrast agent-enhanced MRI of the brain a few days before receiving RVP-001 with imaging.

The ultimate goal of this research program is development of a gadolinium-free alternative to current general purpose MRI contrast agents.

Full description

Subjects will be pre-screened by study site personnel based on their upcoming appointment date for standard of care GBCA-enhanced MR imaging. Subjects may include individuals who have a stable primary brain tumor, metastatic brain tumors, multiple sclerosis, or other gadolinium-enhancing CNS lesions. Screening to select subjects for study participation will occur at or around the time of the subject's scheduled appointment. The appointment for standard of care imaging should take place at the designated study site.

Following GBCA-enhanced MRI scan to confirm presence of target lesion(s), a baseline unenhanced MRI scan will be performed prior to RVP-001 injection. Dynamic imaging will be performed in conjunction with RVP-001 injection. Steady state imaging will follow at multiple time points during the first hour following dose administration to characterize the pharmacodynamics of RVP-001 and to assess its ability to enhance visualization of areas with disrupted blood brain barrier and/or abnormal vascularity of the central nervous system.

Three dose cohorts are planned.

An unenhanced MRI scan follow-up study will be performed between one week and six weeks following the administration of RVP-001.

Safety will be evaluated throughout the study by assessing the following parameters: adverse events (AEs), physical examinations, injection site monitoring, electrocardiograms (ECGs), vital signs, clinical laboratory evaluations, medical history, and prior and concomitant medications.

Enrollment: 24 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Adults of both sexes, aged 18-65 years
2. Patients with known enhancing CNS lesions, that are: (a) on an ongoing follow-up MRI at up to six week intervals, or (ii) are on imaging surveillance at longer intervals, but who are willing to return for unenhanced MRI at up to six weeks post-administration of RVP-001
3. Patients who have had a GBCA-enhanced MRI within the past 2 to 7 days which demonstrated focal areas of disrupted Blood Brain Barrier (BBB) (e.g., primary and secondary tumors, focal inflammatory disorders) including at least one enhancing lesion of minimum 5 mm (long axis)
4. Acceptable renal function

Exclusion criteria

1. Subjects who received either the linear GBCA, gadobenate dimeglumine, or high-relaxivity GBCA, gadopiclenol, for standard-of-care GBCA
2. Serious non-malignant disease that could compromise protocol objectives in the opinion of the investigator and/or the Sponsor
3. Patients with clinically significant cardiac disease
4. MRI incompatibility

Trial design

Primary purpose: Diagnostic

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: Single Blind

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24 participants in 3 patient groups

2 mg/Mn/kg

Experimental group

Description:

6 subjects each will receive RVP-001 at a dose of 2 mg Mn/kg

Treatment:

Drug: RVP-001

7 mg/Mn/kg

Experimental group

Description:

6 subjects each will receive RVP-001 at a dose of 7 mg Mn/kg

Treatment:

Drug: RVP-001

12 mg/Mn/kg

Experimental group

Description:

6 subjects each will receive RVP-001 at a dose of 12 mg Mn/kg

Treatment:

Drug: RVP-001