search
Back to results

Safety, Tolerability and Pharmacokinetics of Oral Tablet of Irinotecan in Adult Patients With Solid Tumors

Primary Purpose

Metastatic Colorectal Cancer

Status
Completed
Phase
Phase 1
Locations
Denmark
Study Type
Interventional
Intervention
Irinotecan
Capecitabine
Sponsored by
Dorte Nielsen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Metastatic Colorectal Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Signed written Informed Consent
  • 18 years of age or older
  • Capable of understanding the protocol requirements and risk associated with the study
  • Patients must have histological confirmed malignancy (solid tumor) that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective
  • Patients with either measurable disease according to RECIST 1.1 or non-measurable disease
  • Performance status 0-1 (ECOG)
  • Life expectancy ≥ 3 months
  • Coagulation INR < 1.3 and APTT within normal limits
  • WBC ≥ 3000/mm3
  • Absolute neutrophil count ≥ 1500/mm3
  • Hemoglobin ≥ 6.0 mmol/L
  • Platelet count ≥ 100.000/mm3
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST and ALT ≤ 2.5 times ULN AST and ALT ≤ 2.5 times ULN. For patients with liver metastasis adequate hepatic function is defined by aspartate aminotransferase (AST) ≤ 5 x ULN and alanine aminotransferase ALT ≤ 5 x ULN
  • No severe or uncontrolled renal condition (creatinine ≤ than 1.5 ULN)
  • No significant cardiovascular disease (New York Heart Association Class III and IV)
  • No other severe cardiac condition not defined above
  • No significant cardiovascular disease (incl. myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) ≤ 1 year prior for patients to be enrolled and treated in combination with oral capecitabine
  • No severe or uncontrolled pulmonary condition
  • No known prior hypersensitivity reaction to irinotecan
  • No known prior hypersensitivity to capecitabine or 5-fluorouracil for patients to be enrolled and treated in combination with oral capecitabine
  • No chronic enteropathy (e.g. active inflammatory bowel disease, extensive intestinal resection or chronic diarrhea)
  • No bowel obstruction or sub-obstruction
  • No prior history of intestinal malabsorption
  • Patients have to be able to swallow normally and have to be willing to comply with the intake of tablets
  • No psychiatric condition that would preclude study participation
  • No co-existing active infection requiring antibiotics or any co-existing medical conditions likely to interfere with study procedures
  • No other condition that will preclude study participation
  • A negative pregnancy test for women of childbearing potential. For men and women of child-producing potential, the use of effective contraceptives methods during the study and at least 3 months after discontinuations of the study drug is required.
  • Not pregnant or nursing
  • Peripheral neuropathy NCI CTCAE grade less than 2 for patients to be enrolled and treated in combination with oral capecitabine
  • The patient is willing and able to comply with hospitalization for treatment and scheduled follow-up visits and examinations

Exclusion Criteria:

  • Simultaneous participation in any other study involving investigational drugs or having participated in a study within 4 weeks prior to start of study treatment
  • Symptomatic brain metastases
  • Intake of any prohibited concomitant medication
  • Known Dihydropyrimidine dehydrogenase (DPD) deficiency for patients to be enrolled and treated in combination with oral capecitabine.

Sites / Locations

  • Herlev Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Irinotecan

Irinotecan with Capecitabine

Arm Description

Dose escalation study in cohorts of minimum 3 patients of an Irinotecan tablet taken once daily for 14 days within 3 week treatment cycle

Dose escalation study in cohorts of minimum 3 patients of an Irinotecan tablet taken once daily in combination with Capecitabine tablet taken twice daily for 14 days within 3 week treatment cycle

Outcomes

Primary Outcome Measures

Maximal Tolerated Dose (MTD) and Dose Limiting Toxicity (DLT) of oral Irinotecan based on incidence of Treatment-Emergent Adverse Events
Number of patients with Treatment Related Adverse Events as assessed according to the NCI Common Terminology Criteria for Adverse events CTCAE version 4.0

Secondary Outcome Measures

Maximum Tolerated Dose (MTD) and the Dose Limiting Toxicity (DLT) of oral Irinotecan in combination with oral Capecitabine based on incidence of Treatment-Emergent Adverse Events
Number of patients with Treatment Related Adverse Events as assessed according to the NCI Common Terminology Criteria for Adverse events CTCAE version 4.0
Area under the Concentration-Time-Curve (AUC) for Irinotecan and its metabolites SN-38 and SN-38 glucoronide
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Maximum Serum Concentration (Cmax) for irinotecan and its metabolites SN-38 and SN-38 glucoronide
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Time to Maximum Serum Concentration (Tmax) for irinotecan and its metabolites SN-38 and SN-38 glucoronide
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Half-life (t½) for irinotecan and its metabolites SN-38 and SN-38 glucoronide
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Serum concentration 24 hours after dosing and prior to administration of the next dose (C24) for Irinotecan and its metabolites SN-38 and SN-38 glucoronide
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Objective tumor response to treatment based on RECIST 1.1 criteria
CT scans with tumor response as assessed using RECIST 1.1. criteria

Full Information

First Posted
September 11, 2017
Last Updated
October 1, 2020
Sponsor
Dorte Nielsen
search

1. Study Identification

Unique Protocol Identification Number
NCT03295084
Brief Title
Safety, Tolerability and Pharmacokinetics of Oral Tablet of Irinotecan in Adult Patients With Solid Tumors
Official Title
Irinotecan Gastro-resistant Tablet. An Open Label Phase I, Dose Escalating Study Evaluating Safety, Tolerability and Pharmacokinetics of Oral Administration of Irinotecan in Adult Patients With Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Completed
Study Start Date
July 15, 2015 (Actual)
Primary Completion Date
July 3, 2018 (Actual)
Study Completion Date
October 30, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Dorte Nielsen

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study evaluates the safety, tolerability and pharmacokinetics of oral administration of irinotecan in adult patients. Oral irinotecan will be administered as monotherapy in a dose escalation trial to establish the Maximal Tolerated Dose. Totally 25 patients will be treated with irinotecan tablets as mono-therapy. As an extension trial 12 patients will be treated with oral irinotecan in combination with oral capecitabine
Detailed Description
The study is a phase I, open-label, dose escalation single center study in patients with solid tumors. The study will investigate safety, tolerability and Maximal Tolerated Dose as primary end-points of an irinotecan tablet given as single agent or in combination with oral capecitabine. Secondary end-points are pharmacokinetics and preliminary anti-tumor response. Cohorts of 3 patients will be treated on selected dose level with oral irinotecan in order to identify Dose Limiting Toxicity (DLT) and Maximal Tolerated Dose (MTD). Totally 12 subjects will be treated at the MTD level. Patients will receive irinotecan tablets once daily in the morning for 14 consecutive days within 3 week treatment cycles. As an extension trial totally 12 subjects will be treated with oral irinotecan in combination with oral capecitabine. Patients treated in combination therapy will receive irinotecan tablets once daily in the morning for 14 consecutive days in combination with capecitabine dosed twice daily for 14 consecutive days within 3 week treatment cycles.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Cancer

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
Open labelled study with enrollment in the order of confirmation of eligibility. Escalating doses of study drug in sequential patient cohorts for identification of DLT and MTD (Phase 1)
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
39 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Irinotecan
Arm Type
Experimental
Arm Description
Dose escalation study in cohorts of minimum 3 patients of an Irinotecan tablet taken once daily for 14 days within 3 week treatment cycle
Arm Title
Irinotecan with Capecitabine
Arm Type
Experimental
Arm Description
Dose escalation study in cohorts of minimum 3 patients of an Irinotecan tablet taken once daily in combination with Capecitabine tablet taken twice daily for 14 days within 3 week treatment cycle
Intervention Type
Drug
Intervention Name(s)
Irinotecan
Intervention Description
Dose Escalation
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
Dose Escalation
Primary Outcome Measure Information:
Title
Maximal Tolerated Dose (MTD) and Dose Limiting Toxicity (DLT) of oral Irinotecan based on incidence of Treatment-Emergent Adverse Events
Description
Number of patients with Treatment Related Adverse Events as assessed according to the NCI Common Terminology Criteria for Adverse events CTCAE version 4.0
Time Frame
2 treatment cycles of 3 weeks
Secondary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) and the Dose Limiting Toxicity (DLT) of oral Irinotecan in combination with oral Capecitabine based on incidence of Treatment-Emergent Adverse Events
Description
Number of patients with Treatment Related Adverse Events as assessed according to the NCI Common Terminology Criteria for Adverse events CTCAE version 4.0
Time Frame
2 treatment cycles of 3 weeks
Title
Area under the Concentration-Time-Curve (AUC) for Irinotecan and its metabolites SN-38 and SN-38 glucoronide
Description
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Time Frame
Day 1 and Day 14 of first 3 weeks treatment cycle
Title
Maximum Serum Concentration (Cmax) for irinotecan and its metabolites SN-38 and SN-38 glucoronide
Description
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Time Frame
Day 1 and Day 14 of first 3 weeks treatment cycle
Title
Time to Maximum Serum Concentration (Tmax) for irinotecan and its metabolites SN-38 and SN-38 glucoronide
Description
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Time Frame
Day 1 and Day 14 of first 3 weeks treatment cycle
Title
Half-life (t½) for irinotecan and its metabolites SN-38 and SN-38 glucoronide
Description
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Time Frame
Day 1 and Day 14 of first 3 weeks treatment cycle
Title
Serum concentration 24 hours after dosing and prior to administration of the next dose (C24) for Irinotecan and its metabolites SN-38 and SN-38 glucoronide
Description
PK samples will be collected at predetermined time intervals and pharmacokinetic parameter calculated and reported based on the plasma concentration profile
Time Frame
Day 1 and Day 14 of first 3 weeks treatment cycle
Title
Objective tumor response to treatment based on RECIST 1.1 criteria
Description
CT scans with tumor response as assessed using RECIST 1.1. criteria
Time Frame
2 treatment cycles of 3 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed written Informed Consent 18 years of age or older Capable of understanding the protocol requirements and risk associated with the study Patients must have histological confirmed malignancy (solid tumor) that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective Patients with either measurable disease according to RECIST 1.1 or non-measurable disease Performance status 0-1 (ECOG) Life expectancy ≥ 3 months Coagulation INR < 1.3 and APTT within normal limits WBC ≥ 3000/mm3 Absolute neutrophil count ≥ 1500/mm3 Hemoglobin ≥ 6.0 mmol/L Platelet count ≥ 100.000/mm3 Bilirubin ≤ 1.5 times upper limit of normal (ULN) AST and ALT ≤ 2.5 times ULN AST and ALT ≤ 2.5 times ULN. For patients with liver metastasis adequate hepatic function is defined by aspartate aminotransferase (AST) ≤ 5 x ULN and alanine aminotransferase ALT ≤ 5 x ULN No severe or uncontrolled renal condition (creatinine ≤ than 1.5 ULN) No significant cardiovascular disease (New York Heart Association Class III and IV) No other severe cardiac condition not defined above No significant cardiovascular disease (incl. myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) ≤ 1 year prior for patients to be enrolled and treated in combination with oral capecitabine No severe or uncontrolled pulmonary condition No known prior hypersensitivity reaction to irinotecan No known prior hypersensitivity to capecitabine or 5-fluorouracil for patients to be enrolled and treated in combination with oral capecitabine No chronic enteropathy (e.g. active inflammatory bowel disease, extensive intestinal resection or chronic diarrhea) No bowel obstruction or sub-obstruction No prior history of intestinal malabsorption Patients have to be able to swallow normally and have to be willing to comply with the intake of tablets No psychiatric condition that would preclude study participation No co-existing active infection requiring antibiotics or any co-existing medical conditions likely to interfere with study procedures No other condition that will preclude study participation A negative pregnancy test for women of childbearing potential. For men and women of child-producing potential, the use of effective contraceptives methods during the study and at least 3 months after discontinuations of the study drug is required. Not pregnant or nursing Peripheral neuropathy NCI CTCAE grade less than 2 for patients to be enrolled and treated in combination with oral capecitabine The patient is willing and able to comply with hospitalization for treatment and scheduled follow-up visits and examinations Exclusion Criteria: Simultaneous participation in any other study involving investigational drugs or having participated in a study within 4 weeks prior to start of study treatment Symptomatic brain metastases Intake of any prohibited concomitant medication Known Dihydropyrimidine dehydrogenase (DPD) deficiency for patients to be enrolled and treated in combination with oral capecitabine.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Benny Vittrup
Organizational Affiliation
Herlev Hospital, Department of Oncology, Denmark
Official's Role
Principal Investigator
Facility Information:
Facility Name
Herlev Hospital
City
Herlev
ZIP/Postal Code
2730
Country
Denmark

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Safety, Tolerability and Pharmacokinetics of Oral Tablet of Irinotecan in Adult Patients With Solid Tumors

We'll reach out to this number within 24 hrs