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Dovitinib Plus Docetaxel in Gastric Cancer

Primary Purpose

Gastric Cancer

Status
Completed
Phase
Phase 1
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Dovitinib and docetaxel
Sponsored by
Asan Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastric Cancer focused on measuring Gastric cancer, Phase I/II, Second-line chemotherapy, Dovitinib, Docetaxel, Refractory to first-line chemotherapy

Eligibility Criteria

18 Years - 74 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Pathologically proven metastatic or unresectable adenocarcinoma of stomach or gastroesophageal junction
  2. Patients with progressive disease (radiological confirmation required) after one line of chemotherapy except taxane for advanced gastric cancer in palliative setting
  3. Presence of at least one evaluable disease by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
  4. Age of 18 to 74 years
  5. Estimated life expectancy of more than 3 months
  6. Eastern Cooperative Oncology Group (ECOG) performance status 0~2
  7. Adequate bone marrow function (Absolute neutrophil counts ≥ 1,500/uL, hemoglobin ≥ 8.0g/dL, and platelet ≥ 100,000/uL)
  8. Adequate renal function (creatinine < 1.5mg/dL)
  9. Adequate hepatic function (total bilirubin < 1.5 mg/dL, transaminase < 3 times the upper normal limit [5 times for patients with liver metastasis])
  10. No prior anti-angiogenic therapy (anti-VEGF or VEGFR tyrosine kinase inhibitor etc) or FGF/FGFR inhibitor
  11. No prior radiation therapy within 4 weeks of the study (Irradiated lesions should not be included in the evaluable lesions.)
  12. Written informed consent

Exclusion Criteria:

  1. Past or concurrent history of neoplasm other than gastric adenocarcinoma, except for curatively treated non-melanoma skin cancer or in situ carcinoma of the cervix uteri
  2. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study treatment start
  3. Bowel obstruction
  4. Evidence of serious gastrointestinal bleeding
  5. Presence of central nervous system (CNS) metastasis
  6. History of significant neurologic or psychiatric disorders
  7. Significant cardiac disease within 6 months of the study (congestive heart failure uncontrollable by medication, symptomatic coronary heart disease, or arrhythmia, myocardial infarction)
  8. Left ventricular ejection fraction (LVEF) assessed by 2-D echocardiogram (ECHO) or multiple gated acquisition scan (MUGA), < 45%
  9. Uncontrolled hypertension defined by a SBP ≥ 160 mm Hg and/or DBP ≥ 100 mm Hg, with or without anti-hypertensive medication. Initiation or adjustment of antihypertensive medication (s) is allowed prior to study entry.
  10. QTc > 480 msec on screening ECG
  11. Proteinuria defined by NCI CTCAE grade > 1 at baseline as measured by a urine dipstick (2+ or greater) and confirmed by a 24 hour urine collection ( > 1g/24hrs). Subjects may be re-screened if blood pressure is shown to be controlled with or without intervention
  12. History of thrombotic or bleeding diathesis or coagulopathy
  13. Serious non-healing wound, peptic ulcer, or bone fracture
  14. Abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months
  15. Pregnant or lactating women, women of childbearing potential not employing adequate contraception
  16. Other serious illness or medical conditions

Sites / Locations

  • Asan Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dovitinib plus docetaxel

Arm Description

In phase I portion of the study Docetaxel 45-75 mg/m2, intravenous, every 3 weeks Dovitinib 200-500 mg, oral, 5 days on/2 days off In phase II portion of the study Recommended dose of docetaxel and dovitinib in phase I portion will be used.

Outcomes

Primary Outcome Measures

Maximum tolerated dose
If dose limiting toxicities are experienced in two or more out of six patients in the cohort (more than 33% of patient cohort), that dose will be defined as the maximum tolerated dose.
Progression-free survival
Progression-free survival is defined as the time from the first treatment to the onset of progressive disease or to the date of death whichever comes first.

Secondary Outcome Measures

Response rate
Proportion of patients with complete and partial response according to the Response Evaluation Criteria in Solid Tumors version 1.1
Toxicity
Adverse events caused by study drugs according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0
Overall survival
Time from start of study treatment to any cause of death
Biomarker
FGFR2 copy number will be evaluated in blood and tumor tissue. Treatment efficacy including overall response rate, progression-free survival, and overall survival will be compared according to FGFR2 copy number determined by both FISH and real time PCR using TaqMan probe.

Full Information

First Posted
August 10, 2013
Last Updated
July 13, 2017
Sponsor
Asan Medical Center
Collaborators
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01921673
Brief Title
Dovitinib Plus Docetaxel in Gastric Cancer
Official Title
A Phase I-II Trial of Dovitinib Plus Docetaxel as Second-line Chemotherapy in Patients With Metastatic or Unresectable Gastric Cancer After Failure of First-line Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Completed
Study Start Date
August 2013 (Actual)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
October 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Asan Medical Center
Collaborators
Novartis Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Docetaxel is currently one of standard second-line therapy in patients with gastric cancer. As angiogenesis and FGFR pathway has been suggested to be associated with gastric cancer, dovitinib, dual VEGFR and FGFR inhibitor, may have the potential to improve the outcomes of patients with gastric cancer. Therefore, we investigated the combination regimen of docetaxel and dovitinib.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Cancer
Keywords
Gastric cancer, Phase I/II, Second-line chemotherapy, Dovitinib, Docetaxel, Refractory to first-line chemotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dovitinib plus docetaxel
Arm Type
Experimental
Arm Description
In phase I portion of the study Docetaxel 45-75 mg/m2, intravenous, every 3 weeks Dovitinib 200-500 mg, oral, 5 days on/2 days off In phase II portion of the study Recommended dose of docetaxel and dovitinib in phase I portion will be used.
Intervention Type
Drug
Intervention Name(s)
Dovitinib and docetaxel
Intervention Description
In phase I portion of the study Docetaxel 45-75 mg/m2, intravenous, every 3 weeks Dovitinib 200-500 mg, oral, 5 days on/2 days off In phase II portion of the study Recommended dose of docetaxel and dovitinib in phase I portion will be used.
Primary Outcome Measure Information:
Title
Maximum tolerated dose
Description
If dose limiting toxicities are experienced in two or more out of six patients in the cohort (more than 33% of patient cohort), that dose will be defined as the maximum tolerated dose.
Time Frame
6 months
Title
Progression-free survival
Description
Progression-free survival is defined as the time from the first treatment to the onset of progressive disease or to the date of death whichever comes first.
Time Frame
2 year
Secondary Outcome Measure Information:
Title
Response rate
Description
Proportion of patients with complete and partial response according to the Response Evaluation Criteria in Solid Tumors version 1.1
Time Frame
2 year
Title
Toxicity
Description
Adverse events caused by study drugs according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0
Time Frame
2 years
Title
Overall survival
Description
Time from start of study treatment to any cause of death
Time Frame
2 years
Title
Biomarker
Description
FGFR2 copy number will be evaluated in blood and tumor tissue. Treatment efficacy including overall response rate, progression-free survival, and overall survival will be compared according to FGFR2 copy number determined by both FISH and real time PCR using TaqMan probe.
Time Frame
Baseline and 2 weeks after study treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
74 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pathologically proven metastatic or unresectable adenocarcinoma of stomach or gastroesophageal junction Patients with progressive disease (radiological confirmation required) after one line of chemotherapy except taxane for advanced gastric cancer in palliative setting Presence of at least one evaluable disease by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 Age of 18 to 74 years Estimated life expectancy of more than 3 months Eastern Cooperative Oncology Group (ECOG) performance status 0~2 Adequate bone marrow function (Absolute neutrophil counts ≥ 1,500/uL, hemoglobin ≥ 8.0g/dL, and platelet ≥ 100,000/uL) Adequate renal function (creatinine < 1.5mg/dL) Adequate hepatic function (total bilirubin < 1.5 mg/dL, transaminase < 3 times the upper normal limit [5 times for patients with liver metastasis]) No prior anti-angiogenic therapy (anti-VEGF or VEGFR tyrosine kinase inhibitor etc) or FGF/FGFR inhibitor No prior radiation therapy within 4 weeks of the study (Irradiated lesions should not be included in the evaluable lesions.) Written informed consent Exclusion Criteria: Past or concurrent history of neoplasm other than gastric adenocarcinoma, except for curatively treated non-melanoma skin cancer or in situ carcinoma of the cervix uteri Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study treatment start Bowel obstruction Evidence of serious gastrointestinal bleeding Presence of central nervous system (CNS) metastasis History of significant neurologic or psychiatric disorders Significant cardiac disease within 6 months of the study (congestive heart failure uncontrollable by medication, symptomatic coronary heart disease, or arrhythmia, myocardial infarction) Left ventricular ejection fraction (LVEF) assessed by 2-D echocardiogram (ECHO) or multiple gated acquisition scan (MUGA), < 45% Uncontrolled hypertension defined by a SBP ≥ 160 mm Hg and/or DBP ≥ 100 mm Hg, with or without anti-hypertensive medication. Initiation or adjustment of antihypertensive medication (s) is allowed prior to study entry. QTc > 480 msec on screening ECG Proteinuria defined by NCI CTCAE grade > 1 at baseline as measured by a urine dipstick (2+ or greater) and confirmed by a 24 hour urine collection ( > 1g/24hrs). Subjects may be re-screened if blood pressure is shown to be controlled with or without intervention History of thrombotic or bleeding diathesis or coagulopathy Serious non-healing wound, peptic ulcer, or bone fracture Abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months Pregnant or lactating women, women of childbearing potential not employing adequate contraception Other serious illness or medical conditions
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yoon-Koo Kang, M.D., Ph.D.
Organizational Affiliation
Asan Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Asan Medical Center
City
Seoul
ZIP/Postal Code
138-736
Country
Korea, Republic of

12. IPD Sharing Statement

Citations:
PubMed Identifier
17520252
Citation
Lee JL, Ryu MH, Chang HM, Kim TW, Yook JH, Oh ST, Kim BS, Kim M, Chun YJ, Lee JS, Kang YK. A phase II study of docetaxel as salvage chemotherapy in advanced gastric cancer after failure of fluoropyrimidine and platinum combination chemotherapy. Cancer Chemother Pharmacol. 2008 Apr;61(4):631-7. doi: 10.1007/s00280-007-0516-6. Epub 2007 May 23.
Results Reference
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PubMed Identifier
21711248
Citation
Wesche J, Haglund K, Haugsten EM. Fibroblast growth factors and their receptors in cancer. Biochem J. 2011 Jul 15;437(2):199-213. doi: 10.1042/BJ20101603.
Results Reference
background
PubMed Identifier
9701011
Citation
Yamamoto S, Yasui W, Kitadai Y, Yokozaki H, Haruma K, Kajiyama G, Tahara E. Expression of vascular endothelial growth factor in human gastric carcinomas. Pathol Int. 1998 Jul;48(7):499-506. doi: 10.1111/j.1440-1827.1998.tb03940.x.
Results Reference
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Dovitinib Plus Docetaxel in Gastric Cancer

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