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ThermoDox

Phase 3

Hepatocellular Carcinoma | Small molecule | Oncology |Imunon, Inc.|Last Updated: Aug 20, 2024

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindSHAM_CONTROLLEDDMC
Total Trials3
Total Enrollment1,285

FDA Designations

No designations recorded

Clinical trial landscape

ThermoDox · 4 trials · 3 indications

Phase 3 2Phase 1 2
NCT02112656Study of ThermoDox With Standardized Radiofrequency Ablation (RFA) for Treatment of Hepatocellular Carcinoma (HCC)Hepatocellular Carcinoma
COMPLETED554 Analytics
NCT00617981Phase 3 Study of ThermoDox With Radiofrequency Ablation (RFA) in Treatment of Hepatocellular Carcinoma (HCC)Hepatocellular Carcinoma
COMPLETED701 Analytics
PHASE3COMPLETED
Study of ThermoDox With Standardized Radiofrequency Ablation (RFA) for Treatment of Hepatocellular Carcinoma (HCC)
Hepatocellular CarcinomaUnlock trial analytics
PHASE3COMPLETED
Phase 3 Study of ThermoDox With Radiofrequency Ablation (RFA) in Treatment of Hepatocellular Carcinoma (HCC)
Hepatocellular CarcinomaUnlock trial analytics

Study Endpoints

Primary Endpoints

Overall Survival (OS)
All subjects to be contacted every 3 months after radiological progression for vital status reporting. Subjects were followed for OS up to 68 months from randomization.

Overall survival is defined as the time (in months) from the date of randomization to the death from any cause or the end of the study.

Progression Free Survival Will be Measured From the Date of Randomization to the First Date on Which One of the Following Occurs. o Local Recurrence o Any New Distant Intrahepatic HCC Tumor o Any New Extrahepatic HCC Tumor o Death From Any Cause
3 years
Concentration of Total Intratumoral Doxorubicin in Liver Tumour (Biopsies) Following Targeted Release of Doxorubicin From ThermoDox® ('Drug') Using Mild Hyperthermia Generated Non-invasively by Focused Ultrasound (FUS)
Post-intervention sample (Day 1) compared to pre-intervention sample (Day 1)

Analytical chemistry (High Performance Liquid Chromatography) for total doxorubicin (including both released and unreleased forms) was performed on section of intratumoral biopsy samples in Good Clinical Practice Laboratory, using a validated assay. Doxorubicin concentration was evaluated in biopsy samples both post-LTLD and post-LTLD+FUS. Tumour samples were not analysed same day and were frozen at -80\^oC for subsequent analysis. Required to evaluate the primary endpoint.

Patients Demonstrating >Two-fold Increase in the Amount of Intratumoural Doxorubicin Before and After Focused Ultrasound
Post-LTLD+FUS sample (Day 1) compared to Post-LTLD sample (Day 1)

To satisfy the primary endpoint, a demonstrable two-fold increase in\*, or value exceeding 10μg/g of, the concentration of intra-tumoural doxorubicin at the treated tumour site following FUS-induced mild hyperthermia, was required in at least 50% of evaluable participants. \* As per the a priori protocol design, in Part II the biopsy prior to FUS-induced mild hyperthermia is not performed and therefore the average value for all evaluable tumours receiving intervention in Part I is used as a comparison for the two-fold increase from pre-FUS to post-FUS biopsy.

To determine the maximum tolerated dose (MTD) of systemically delivered, heat-activated liposome encapsulated doxorubicin (ThermoDox) in combination with radiofrequency ablation (RFA) of liver neoplasms.
1 month
To test alternative infusion reaction prophylaxis regimens
48 hours
To assess the safety of ThermoDox plus RFA afer administration of potential multiple cycles
3 years
To determine the Pharmacokinetics (PK) of ThermoDox
48 hours

Secondary Endpoints

Progression-free Survival (PFS)
CT or MRI scan (Chest, Abdomen, Pelvis) done at Baseline and Day 28. Additional imaging done at months 5, 9, 13, 17, 21, 25, then every 6 months until disease progression is seen. Study subjects were followed up to 63 months after randomization.
Overall Survival as Measured by Time From Randomization to Death or the End of the Study.
3 years
Number of Participants With Definite Worsening as Per Patient-Reported Outcomes
3 years
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
ThermoDox 50 mg/m2EXPERIMENTALThermoDox plus standardized RFA using standardized treatment dwell time for solitary HCC lesions ≥ 3.0 cm to ≤ 7.0 cm
Dummy infusionPLACEBO_COMPARATORstandardized RFA alone using standardized treatment dwell time for solitary HCC lesions ≥ 3.0 cm to ≤ 7.0 cm
ThermoDox + RFAEXPERIMENTALThermoDox 50 mg/m2 start infusion over 30 minutes about 15 minutes before radiofrequency ablation begins.
Sham + RFASHAM_COMPARATORSham infusion over 30 minutes about 15 minutes before radiofrequency ablation begins.
Part IEXPERIMENTALAll participants in Part I received: Pre-LTLD Biopsy of Target Liver Tumour ThermoDox® (LTLD) Post-LTLD Biopsy of Target Liver Tumour Focused Ultrasound of Target Liver Tumour Thermometry of Target Tumour Post-LTLD+FUS (Post-FUS) Biopsy of Target Liver Tumour Part I of the study was designed to identify optimal focused ultrasound (FUS) exposure parameters for a range of tumour locations within the liver, using real-time thermometry data from an implanted thermometry device (a thermistor or thermocouple). Plasma and biopsy samples of the target liver tumour were taken pre-LTLD, post-LTLD and post-LTLD+FUS.
Part IIEXPERIMENTALAll participants in Part II received: ThermoDox® (LTLD) Focused Ultrasound of Target Liver Tumour Post-LTLD Biopsy of Target Liver Tumour Following a minimum of 5 Part I cases, and subject to Trial Management Group approval, Part II of the study was opened to run in parallel to Part I. Part II did not require implantation of a thermometry device, and instead used predictions from Part I data to set the FUS parameters. Targeted drug delivery in Part II thus proceeded completely non-invasively, and this part of the study was designed to more closely reflect how the therapy might be implemented in routine clinical practice. Plasma samples were taken pre-LTLD, post-LTLD and post-LTLD+FUS. Biopsy samples of the target liver tumour were taken only post-LTLD+FUS.

Interventions

NameTypeDescription
ThermoDoxDRUGThermally Sensitive Liposomal Doxorubicin 50 mg/m2 Single 30 minute intravenous infusion
Dummy infusionDRUGSodium Chloride 0.9% or 5% Dextrose (D5W), Single 30 minute intravenous infusion
5% Dextrose SolutionDRUGSingle 30 minute intravenous infusion
ThermoDox® (LTLD)DRUGThermoDox® (LTLD) infusion at a dose of 50mg/m2 whilst under general anaesthetic during intervention (Day 1)
Focused Ultrasound of Target Liver TumourDEVICEWhilst the ThermoDox® was circulating in the blood stream, the JC200 Therapeutic Ultrasound device was used to induce mild hyperthermia in a single (region of) a target liver tumour.
Pre-LTLD Biopsy of Target Liver TumourDIAGNOSTIC_TEST -
Post-LTLD Biopsy of Target Liver TumourDIAGNOSTIC_TEST -
Post-LTLD+FUS (Post-FUS) Biopsy of Target Liver TumourDIAGNOSTIC_TEST -
Thermometry of Target TumourDEVICEA clinically approved thermistor or thermocouple was placed in the target liver tumour for real-time thermometry.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites61

Inclusion Criteria: 1. Male or female ≥ 18 years of age. 2. Diagnosed with a single HCC lesion ≥ 3.0 cm but ≤ 7.0 cm in maximum diameter based on diagnosis at screening. * Subjects meeting the American Association for the Study of Liver Disease (AASLD) criteria may be randomized without a biops...

Countries:United StatesCanadaChinaGermanyHong KongItalyMalaysiaPhilippinesSingaporeSouth KoreaSpainTaiwanThailandVietnamJapanUnited Kingdom
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Frequently asked questions about ThermoDox

What is ThermoDox used for?

ThermoDox is an investigational small molecule being studied for the treatment of hepatocellular carcinoma and liver tumors. It is administered in combination with radiofrequency ablation or focused ultrasound to deliver targeted chemotherapy. ThermoDox is not yet approved and remains in clinical development.

Who makes ThermoDox?

ThermoDox is being developed by Imunon, Inc., a biopharmaceutical company traded on the NASDAQ under the ticker symbol IMNN. The company is conducting clinical trials to evaluate the drug's safety and efficacy in patients with liver cancer.

What phase is ThermoDox in?

ThermoDox is in Phase 3 clinical development for hepatocellular carcinoma. Two Phase 3 trials have been completed, along with two Phase 1 trials. The drug remains investigational and has not received FDA approval.

What clinical trials is ThermoDox in?

ThermoDox has been studied in four completed clinical trials. NCT00617981 and NCT02112656 are Phase 3 trials in hepatocellular carcinoma, while NCT00441376 and NCT02181075 are Phase 1 trials in liver tumors. All trials have been completed.

How does ThermoDox work?

ThermoDox is a heat-activated liposomal formulation of doxorubicin. When combined with radiofrequency ablation or focused ultrasound, the heat triggers release of the chemotherapy drug directly at the tumor site, potentially increasing local drug concentration while reducing systemic exposure.

Is ThermoDox the same as doxorubicin?

ThermoDox is not the same as standard doxorubicin. It is a liposomal formulation that encapsulates doxorubicin and releases it when heated. This targeted delivery approach is designed to concentrate the chemotherapy effect at the tumor while potentially limiting damage to healthy tissue.