Participants in this single-center, open-label, dose-escalation, Phase 1 study will initially receive intravenous (IV) cixutumumab every 2 weeks or every 3 weeks for 6 weeks (one cycle). After the first cycle, participants experiencing a best overall response of complete response (CR), partial response (PR), or stable disease (SD) will continue to receive cixutumumab at their cohort dose and schedule until there is evidence of progressive disease (PD), or until other withdrawal criteria are met.~A minimum of three participants will be enrolled in each cohort. The starting dose in Cohort 1 will be 6 mg/kg, administered every 2 weeks. Dose escalation from Cohort 1 to Cohort 2 (10 mg/kg administered every 2 weeks) will occur once at least three participants in Cohort 1 have completed one cycle of therapy (ie, completed the initial 6 week treatment period or discontinued therapy due to an cixutumumab - related adverse event [AE]).~Enrollment into Cohort 3 (starting dose: 15 mg/kg administered every 3 weeks) will not proceed until all participants have completed one cycle of therapy (as defined above) in Cohort 2. Similarly, participants will be enrolled in Cohort 4 once at least three participants have completed one cycle of therapy in Cohort 3;participants in Cohort 4 will receive 20 mg/kg administered every 3 weeks. Toxicity data for each cohort will be reviewed prior to any dose escalation. No intrapatient dose escalation is permitted. Participants in any cohort who do not complete the first 6 weeks of treatment for reasons other than an cixutumumab-related toxicity will be replaced.~A dose-limiting toxicity (DLT) is defined as one of the following events, if considered by the investigator to be definitely, probably, or possibly related to cixutumumab: Grade 4 neutropenia lasting > 7 days; Grade 4 anemia; Grade ≥ 3 thrombocytopenia; Grade ≥ 3 neutropenia associated with fever; Grade 3 or 4 nonhematologic toxicity, excluding electrolyte abnormality and Grade 3 hyperglycemia; Grade 4 hyperglycemia; and/or Grade 4 or uncontrollable hypertension.~If three participants complete the first 6-week cycle (according to the definition outlined above) with no DLTs, dose escalation to Cohort 2 may proceed. If one DLT is observed in the initial three participants of Cohort 1 (or any cohort) during Cycle 1, three additional participants will be enrolled into that cohort. If no additional DLTs are observed, dose escalation may continue as described above.~If two or more participants in Cohort 1 experience a DLT, six participants will be enrolled into Cohort 1A (receiving 4 mg/kg every 2 weeks). If two or more participants experience a DLT in dose Cohort 3, six participants will be enrolled into dose Cohort 3A (10 mg/kg every 3 weeks). If two or more participants experience a DLT in dose Cohorts 2 or 4, six additional participants will be enrolled into the previous cohort (Cohort 1 or Cohort 3, respectively), and the previous cohort will be considered the maximum tolerated dose for that dosing schedule. If two or more participants in any cohort experience a DLT on Week 7 or beyond (after Cycle 1), the data will be reviewed and enrollment may be suspended. The Sponsor and Principal Investigator, with reference to the review of the Independent Data Safety Evaluation Committee (established in a separate document), will determine whether enrollment should resume.
In this study, participants will initially receive intravenous (IV) cixutumumab (IMC-A12) every 2 weeks or every 3 weeks for 6 weeks (one cycle). After the first cycle, participants experiencing a best overall response of complete response, partial response, or stable disease will continue to receive cixutumumab at their cohort dose and schedule until there is evidence of progressive disease (PD), or until other withdrawal criteria are met. Participants will be enrolled at one study center, located in the National Cancer Center Hospital - East, Kashiwa, Japan. Approximately 20-30 participants are anticipated.