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A Phase II Study of Gimatecan (ST1481) in Locally Advanced or Metastatic Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Gimatecan
tegafur, gimeracil and oteracil potassium
gemcitabine
Sponsored by
Lee's Pharmaceutical Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring Pancreatic Cancer, chemotherapy, gimatecan

Eligibility Criteria

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

Key inclusion Criteria:

  1. Histologically or cytologically confirmed pancreatic cancer originating from pancreatic ductal epithelium, excluding pancreatic endocrine tumor;
  2. Locally advanced or metastatic pancreatic cancer in no condition for radical radiotherapy or operation;
  3. Failed in first-line gemcitabine or fluorouracil drugs chemotherapy (Recurrence within 6 months after treatment, progression or toxicity intolerance during treatment);
  4. Chemotherapy, targeted therapy or radical radiotherapy should be stopped 3 weeks ago, immunotherapy should be stopped 4 weeks ago, and previous toxicity recovered (CTCAE ≤ level 1);
  5. Measurable cancer lesion according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1;
  6. No younger than 18 years old of either gender;
  7. Eastern Cooperative Oncology Group (ECOG) performance status score 0-1;
  8. Estimated life expectancy >3 months;
  9. The function of important organs meets the following requirements:

    1. absolute neutrophil count (ANC) ≥ 1.5×109/L, platelets ≥ 85×109/L, hemoglobin ≥ 90g/L;
    2. serum creatinine ≤ 1.5×ULN, creatinine clearance rate ≥60 mL/min, U-pro < 2+ or 1.0g/L; if U-pro ≥2+ or 1.0g/L, 24 hours U-pro ≤ 1.0g/L can be included;
    3. total bilirubin ≤ 1.5×ULN, obstructive jaundice with biliary drainage: total bilirubin ≤ 2.0×ULN; alanine transaminase and aspartate aminotransferase ≤ 2.5×ULN, liver metastasis ≤ 5.0×ULN; serum albumin ≥ 30g/L;
  10. Without a history of allergy or hypersensitivity to camptothecin drugs;
  11. Taking drugs orally;
  12. Serum human chorionic gonadotropin negative in premenopausal women; female patients of childbearing potential and male patients with female partners of childbearing potential must be willing to avoid pregnancy;
  13. Ability to understand the study and sign informed consent.

Key exclusion Criteria:

  1. Patients who have been previously treated with camptothecin drugs or topoisomerase I inhibitor within 6 months before enrollment;
  2. Patients who have been previously treated with gemcitabine and fluorouracil in first-line treatment within 6 months before enrollment;
  3. Patients who have been previously treated with other investigational drugs within 4 weeks before enrollment;
  4. Patients with brain or meningeal metastasis;
  5. Patients with a history of gastrointestinal disease which affects drug absorption;
  6. Patients with serous cavity effusion with clinical symptoms (such as pleural effusion, peritoneal effusion, pericardial effusion, etc.), which continue to increase after two-week conservative treatment (excluding puncture drainage);
  7. Patients with hypertension that cannot be controlled by drugs (≥ 160/100mmhg); angina pectoris within 3 months before enrollment or unstable angina pectoris; myocardial infarction within 1 year before enrollment and cardiac insufficiency (NYHA ≥ II);
  8. Patients with active infections requiring systemic treatment or pyrexia of unknown origin prior to initial administration (except neoplastic fever);
  9. Patients with hepatitis B surface antigen positive and peripheral blood hepatitis B virus DNA ≥1.0×103 copy/mL; positive of hepatitis C antibody and peripheral blood hepatitis C virus RNA;
  10. Patients with active pulmonary tuberculosis or uncontrolled pulmonary tuberculosis after anti-tuberculosis treatment;
  11. Patients with a history of immunodeficiency (including a positive HIV test result), or other acquired or congenital immunodeficiency diseases;
  12. Patients with a history of malignancies other than pancreatic cancer before enrollment, excluding non-melanoma skin cancer, in situ cervical cancer, or malignant tumors that have been cured for 5 years;
  13. Pregnant or lactating women;
  14. Patients with a history of mental diseases (including epilepsy or dementia).

Sites / Locations

  • Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Gimatecan group

placebo group

Arm Description

All patients will receive gimatecan (0.8mg/m2, on days 1 to 5, PO, every 4 weeks) until progressive disease (PD).

All patients will receive tegafur, gimeracil and oteracil potassium (40-60mg, twice daily, on days 1 to 14 , PO, every 3 weeks) or gemcitabine (1000mg/m2, on days 1、8, IV, every 3 weeks) until progressive disease (PD).

Outcomes

Primary Outcome Measures

Progression free survival (PFS)
The 2-year progression free survival of the whole group.

Secondary Outcome Measures

Overall survival (OS)
The 2-year overall survival of the whole group.
Objective response rate (ORR)
Percentage of patients with objective response assessed by best overall.
Duration of Response (DoR)
The duration is measured from the first documented response (CR or PR, whichever is first recorded) until the first assessment of Progressive Disease (PD).
Disease control rate (DCR)
Percentage of patients with disease control as assessed by best overall.
Patient-reported outcome (PRO)
Change from baseline assessed according to the quality of life questionnaire C30.

Full Information

First Posted
September 25, 2020
Last Updated
September 29, 2020
Sponsor
Lee's Pharmaceutical Limited
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1. Study Identification

Unique Protocol Identification Number
NCT04571489
Brief Title
A Phase II Study of Gimatecan (ST1481) in Locally Advanced or Metastatic Pancreatic Cancer
Official Title
Gimatecan (ST1481) as Second-line Treatment for Locally Advanced or Metastatic Pancreatic Cancer: an Open-label, Randomized, Controlled Phase II Study
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Not yet recruiting
Study Start Date
December 1, 2020 (Anticipated)
Primary Completion Date
December 1, 2021 (Anticipated)
Study Completion Date
December 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lee's Pharmaceutical Limited

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This phase II clinical trial studies the safety and effect of as second-line treatmen in local advanced or metastatic pancreatic cancer. The Gimatecan will be given every four weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Pancreatic Cancer, chemotherapy, gimatecan

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Gimatecan group
Arm Type
Experimental
Arm Description
All patients will receive gimatecan (0.8mg/m2, on days 1 to 5, PO, every 4 weeks) until progressive disease (PD).
Arm Title
placebo group
Arm Type
Placebo Comparator
Arm Description
All patients will receive tegafur, gimeracil and oteracil potassium (40-60mg, twice daily, on days 1 to 14 , PO, every 3 weeks) or gemcitabine (1000mg/m2, on days 1、8, IV, every 3 weeks) until progressive disease (PD).
Intervention Type
Drug
Intervention Name(s)
Gimatecan
Other Intervention Name(s)
ST1481
Intervention Description
Patients will receive gimatecan orally at 0.8mg/m2 on day 1-5 every 4 weeks.
Intervention Type
Drug
Intervention Name(s)
tegafur, gimeracil and oteracil potassium
Intervention Description
Patients will receive tegafur, gimeracil and oteracil potassium orally at 40 or 60mg twice daily on days 1 to 14 every 3 weeks.
Intervention Type
Drug
Intervention Name(s)
gemcitabine
Intervention Description
Patients will receive gemcitabine IV at 1000mg/m2 on days 1、8 every 3 weeks.
Primary Outcome Measure Information:
Title
Progression free survival (PFS)
Description
The 2-year progression free survival of the whole group.
Time Frame
From date of randomization until the date of death from any cause or the date of first documented disease progression whichever came first, assessed up to 24 months.
Secondary Outcome Measure Information:
Title
Overall survival (OS)
Description
The 2-year overall survival of the whole group.
Time Frame
From date of randomization until the date of death from any cause or the date of last follow-up whichever came first, assessed up to 24 months.
Title
Objective response rate (ORR)
Description
Percentage of patients with objective response assessed by best overall.
Time Frame
To evaluate objective response rate every 6 weeks after the initiation of chemotherapy, up to 24 months.
Title
Duration of Response (DoR)
Description
The duration is measured from the first documented response (CR or PR, whichever is first recorded) until the first assessment of Progressive Disease (PD).
Time Frame
First documented CR or PR, whichever is first recorded until the first assessment of PD, assessed up to 24 months.
Title
Disease control rate (DCR)
Description
Percentage of patients with disease control as assessed by best overall.
Time Frame
To evaluate disease control rate every 6 weeks after the initiation of chemotherapy, up to 24 months.
Title
Patient-reported outcome (PRO)
Description
Change from baseline assessed according to the quality of life questionnaire C30.
Time Frame
To evaluate every 6 weeks after the initiation of chemotherapy, up to 24 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key inclusion Criteria: Histologically or cytologically confirmed pancreatic cancer originating from pancreatic ductal epithelium, excluding pancreatic endocrine tumor; Locally advanced or metastatic pancreatic cancer in no condition for radical radiotherapy or operation; Failed in first-line gemcitabine or fluorouracil drugs chemotherapy (Recurrence within 6 months after treatment, progression or toxicity intolerance during treatment); Chemotherapy, targeted therapy or radical radiotherapy should be stopped 3 weeks ago, immunotherapy should be stopped 4 weeks ago, and previous toxicity recovered (CTCAE ≤ level 1); Measurable cancer lesion according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1; No younger than 18 years old of either gender; Eastern Cooperative Oncology Group (ECOG) performance status score 0-1; Estimated life expectancy >3 months; The function of important organs meets the following requirements: absolute neutrophil count (ANC) ≥ 1.5×109/L, platelets ≥ 85×109/L, hemoglobin ≥ 90g/L; serum creatinine ≤ 1.5×ULN, creatinine clearance rate ≥60 mL/min, U-pro < 2+ or 1.0g/L; if U-pro ≥2+ or 1.0g/L, 24 hours U-pro ≤ 1.0g/L can be included; total bilirubin ≤ 1.5×ULN, obstructive jaundice with biliary drainage: total bilirubin ≤ 2.0×ULN; alanine transaminase and aspartate aminotransferase ≤ 2.5×ULN, liver metastasis ≤ 5.0×ULN; serum albumin ≥ 30g/L; Without a history of allergy or hypersensitivity to camptothecin drugs; Taking drugs orally; Serum human chorionic gonadotropin negative in premenopausal women; female patients of childbearing potential and male patients with female partners of childbearing potential must be willing to avoid pregnancy; Ability to understand the study and sign informed consent. Key exclusion Criteria: Patients who have been previously treated with camptothecin drugs or topoisomerase I inhibitor within 6 months before enrollment; Patients who have been previously treated with gemcitabine and fluorouracil in first-line treatment within 6 months before enrollment; Patients who have been previously treated with other investigational drugs within 4 weeks before enrollment; Patients with brain or meningeal metastasis; Patients with a history of gastrointestinal disease which affects drug absorption; Patients with serous cavity effusion with clinical symptoms (such as pleural effusion, peritoneal effusion, pericardial effusion, etc.), which continue to increase after two-week conservative treatment (excluding puncture drainage); Patients with hypertension that cannot be controlled by drugs (≥ 160/100mmhg); angina pectoris within 3 months before enrollment or unstable angina pectoris; myocardial infarction within 1 year before enrollment and cardiac insufficiency (NYHA ≥ II); Patients with active infections requiring systemic treatment or pyrexia of unknown origin prior to initial administration (except neoplastic fever); Patients with hepatitis B surface antigen positive and peripheral blood hepatitis B virus DNA ≥1.0×103 copy/mL; positive of hepatitis C antibody and peripheral blood hepatitis C virus RNA; Patients with active pulmonary tuberculosis or uncontrolled pulmonary tuberculosis after anti-tuberculosis treatment; Patients with a history of immunodeficiency (including a positive HIV test result), or other acquired or congenital immunodeficiency diseases; Patients with a history of malignancies other than pancreatic cancer before enrollment, excluding non-melanoma skin cancer, in situ cervical cancer, or malignant tumors that have been cured for 5 years; Pregnant or lactating women; Patients with a history of mental diseases (including epilepsy or dementia).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
WANG LIWEI, MD
Phone
86-021-68385559
Email
lwwang2013@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
WANG LIWEI, MD
Organizational Affiliation
RenJi Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200127
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
WANG LIWEI, MD
Phone
86-021-68383364

12. IPD Sharing Statement

Citations:
PubMed Identifier
9196156
Citation
Burris HA 3rd, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, Cripps MC, Portenoy RK, Storniolo AM, Tarassoff P, Nelson R, Dorr FA, Stephens CD, Von Hoff DD. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997 Jun;15(6):2403-13. doi: 10.1200/JCO.1997.15.6.2403.
Results Reference
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PubMed Identifier
17150998
Citation
Sessa C, Cresta S, Cerny T, Baselga J, Rota Caremoli E, Malossi A, Hess D, Trigo J, Zucchetti M, D'Incalci M, Zaniboni A, Capri G, Gatti B, Carminati P, Zanna C, Marsoni S, Gianni L. Concerted escalation of dose and dosing duration in a phase I study of the oral camptothecin gimatecan (ST1481) in patients with advanced solid tumors. Ann Oncol. 2007 Mar;18(3):561-8. doi: 10.1093/annonc/mdl418. Epub 2006 Dec 5.
Results Reference
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PubMed Identifier
23232808
Citation
Hu J, Wen PY, Abrey LE, Fadul CE, Drappatz J, Salem N, Supko JG, Hochberg F. A phase II trial of oral gimatecan for recurrent glioblastoma. J Neurooncol. 2013 Feb;111(3):347-53. doi: 10.1007/s11060-012-1023-0. Epub 2012 Dec 12.
Results Reference
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PubMed Identifier
19906760
Citation
Pecorelli S, Ray-Coquard I, Tredan O, Colombo N, Parma G, Tisi G, Katsaros D, Lhomme C, Lissoni AA, Vermorken JB, du Bois A, Poveda A, Frigerio L, Barbieri P, Carminati P, Brienza S, Guastalla JP. Phase II of oral gimatecan in patients with recurrent epithelial ovarian, fallopian tube or peritoneal cancer, previously treated with platinum and taxanes. Ann Oncol. 2010 Apr;21(4):759-765. doi: 10.1093/annonc/mdp514. Epub 2009 Nov 11.
Results Reference
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A Phase II Study of Gimatecan (ST1481) in Locally Advanced or Metastatic Pancreatic Cancer

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