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A Study of KX2-391 With Paclitaxel in Patients With Solid Tumors

Primary Purpose

Unspecified Adult Solid Tumor, Protocol Specific, Gastric Cancer, Breast Cancer

Status
Unknown status
Phase
Phase 1
Locations
Korea, Republic of
Study Type
Interventional
Intervention
KX2-391 and Paclitaxel
Sponsored by
Hanmi Pharmaceutical Company Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Unspecified Adult Solid Tumor, Protocol Specific focused on measuring Stomach Neoplasms, Breast Neoplasms, Carcinoma, Neoplasms, Paclitaxel, Tubulin Modulators, Antimitotic Agents, Protein Kinase Inhibitors, Enzyme Inhibitors, Pharmacologic Actions

Eligibility Criteria

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

Inclusion Criteria:

Phase I Portion:

- Diagnosis of solid tumors on histopathological examination or cytological examination for which no standard of care is available or conventional treatment modalities have no therapeutic effect at the time of entering into the study

Phase II Portion:

  • Diagnosis of advanced/metastatic/recurrent stomach cancer or breast cancer on histopathological examination or cytological examination for which no standard of care is available or conventional treatment modalities have no therapeutic effect at the time of entering into the study
  • Subjects with stomach cancer without prior taxane therapy
  • Subjects with breast cancer with prior taxane therapy
  • (Optional) Providing exploratory biomarker informed consent form to obtain archival tumor tissue and/or new tumor biopsy sample

Common:

  1. Based on clinical screening,

    ① If radiotherapy was given, at least 4 weeks should have passed from the last treatment date and the patient should have recovered from the toxicity (However, for limited regional radiotherapy, at least 2 weeks from the last treatment date)

    ② If hormonal therapy was given, at least 2 weeks should have passed from the last treatment date and the patient should have recovered from the toxicity.

    ③ If chemotherapy was given, at least 3 weeks should have passed from the last treatment date and the patient should have recovered from the toxicity (However, for nitrosourea or mitomycin, at least 6 weeks)

  2. Aged ≥ 20 years
  3. ECOG (Eastern Cooperative Oncology Group) ≤ 2
  4. Life expectancy ≥ 12 weeks
  5. Should meet the followings,

    ① Bone marrow function ANC (Absolute Neutrophil Count) ≥ 1.5 X 109/L, PLT (Platelet Count) ≥ 100 X 109/L, Hemoglobin ≥ 9.0 g/dl (In the case of hemoglobin of < 9.0 g/dl, the patient can be enrolled if the value is reversed to ≥ 9.0 g/dl.)

    ② Kidney function Creatinine Clearance > 50 ml/min or Serum Clearance ≤ 1.5 mg/dl

    ③ Liver function AST (Aspartate Aminotransferase)/ALT (Alanine Aminotransferase)/ALP (Alkaline Phosphatase) ≤ 3.0 X UNL and Total bilirubin ≤ 2.0 mg/dl (With bone metastasis, ALP ≤ 5.0 X UNL)

  6. At least one measurable lesions with the length of the longest diameter of ≥ 10 mm on spiral CT or multidetector CT or ≥ 20 mm on conventional CT
  7. Subjects who voluntarily consent to participate in this study and sign the written informed consent form

Exclusion Criteria:

  1. Uncontrolled central nervous system metastasis
  2. Malignant ascites requiring surgical treatment
  3. Subjects who have blood malignancies including leukemia; or who have received or will receive bone marrow transplantation
  4. Severe concurrent diseases as follows,

    ① History of unstable angina, heart failure, atrial or ventricular arrhythmia requiring pharmacological treatment, or having received treatment for myocardial infarction within 6 months (however, may be included under the judgment of the investigator if medically controlled), heart failure of Class III or IV by New York Heart Association Classes, or left ventricular ejection fraction of < 40%

    ② Receiving therapeutic dose administration of coumarin-type anticoagulants (however, up to 2 mg daily is permitted for line opening)

    ③ Uncontrolled diabetes (fasting plasma glucose > 2.0 X UNL), severe hypertension, thyroid disorder and active infectious disease

    ④ Psychiatric or neurological history including dementia or epilepsy which may threaten the compliance with this protocol

    ⑤ A condition not allowing oral application of tablet formulation, and any clinically significant gastrointestinal abnormalities which may interfere with taking, passing or absorption of the study drug

  5. Using disallowed concomitant medications (strong CYP3A4 (Cytochrome P450 3A4) inhibitors or inducers) (When a patient is using any of the disallowed concomitant medications below, wash-out of 1 week from the medication date is required)
  6. Received other investigational product within 4 weeks prior to the administration of this study drug
  7. Pregnant or breast-feeding women (however, women with 12 months of natural (spontaneous) amenorrhea or surgical bilateral oophorectomy (alone or with hysterectomy) at least 6 weeks ago, with appropriate clinical profile (e.g., appropriate age, history of vasomotor symptoms), will be considered women postmenopausal and of non-childbearing potential. In the case of oophorectomy alone, a woman will be considered to be of non-childbearing potential only if her reproductive condition is confirmed by follow-up hormone level assessment)
  8. History of hypersensitivity to paclitaxel, compounds with similar chemical structure, or cremophor (polyoxyethylated castor oil) ingredient
  9. Neuropathy of grade ≥ 3 based on clinical screening
  10. Known history of hepatitis B or C and known history of HIV serum positive
  11. Others unable to participate in the study under the judgment of the investigator

Sites / Locations

  • Seoul National University Bundang HospitalRecruiting
  • Seoul National University HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

KX2-391 and Paclitaxel

Arm Description

The phase I portion is a standard, three-patient per cohort, dose escalation schedule will be used. 3 or 6 subjects with solid tumor per dose group will likely be necessary to determine the MTD of KX2-391 in combination with weekly paclitaxel. With paclitaxel dose fixed at 80 mg/m2/weekly, KX2-391 treatment will be started at 20 mg dose once daily (QD) The phase II portion of this trial has a design to determine the efficacy of KX2-391 when administered in combination with paclitaxel in 20 subjects with stomach cancer and 20 subjects with breast cancer

Outcomes

Primary Outcome Measures

Dose-limiting Toxicities (DLTs) in Phase I Portion
Maximum tolerated dose (MTD) of KX2-391 in combination with weekly paclitaxel as determined by number of participants With DLTs related to KX2-391 in combination with weekly paclitaxel
Tumor Overall Response Rates (ORRs) in Phase II Portion
The efficacy (overall response rate; ORR; complete response (CR) + partial response (PR)) of KX2-391 in combination with weekly paclitaxel at the MTD established during the phase I portion of this trial based on Response Evaluation Criteria in Solid Tumor (RECIST) 1.1

Secondary Outcome Measures

Pharmacokinetic (PK) Evaluation in Phase I Portion
PK parameters, including but not limited to, plasma concentration, AUC (Area Under Curve) 0-t, Cmax, Tmax, and T1/2 of KX2-391 alone and in combination with weekly paclitaxel
The Preliminary Efficacy Data in Phase I Portion
The preliminary efficacy of KX2-391 in combination with weekly paclitaxel as determined by ORRs based on RECIST 1.1
Safety in Phase II Portion
Adverse events and their frequency, duration and severity, physical examination, laboratory parameters, vital signs and ECG change monitoring as determined based on CTCAE (Common Toxicity Criteria for Adverse Effects) 4.03
The Efficacy Data in Phase II Portion
Overall survival (OS), progression free survival (PFS), time to tumor progression (TTP) and duration of response
Pharmacokinetic (PK) Evaluation in Phase II Portion
PK parameters, including but not limited to, plasma concentration, AUC0-t, Cmax, Tmax, and T1/2 of KX2-391 alone and in combination with weekly paclitaxel

Full Information

First Posted
January 2, 2013
Last Updated
May 15, 2015
Sponsor
Hanmi Pharmaceutical Company Limited
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1. Study Identification

Unique Protocol Identification Number
NCT01764087
Brief Title
A Study of KX2-391 With Paclitaxel in Patients With Solid Tumors
Official Title
An Open-label Phase I/II Study of KX2-391 in Combination With Paclitaxel in Patients With Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
March 2014
Overall Recruitment Status
Unknown status
Study Start Date
December 2012 (undefined)
Primary Completion Date
December 2015 (Anticipated)
Study Completion Date
May 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hanmi Pharmaceutical Company Limited

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of this study is to determine the maximum tolerated dose (MTD) of KX2-391 in Combination with paclitaxel in Phase I, and to evaluate the efficacy of KX2-391 in combination with paclitaxel in patients who are diagnosed as gastric and breast cancer, respectively in Phase II.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Unspecified Adult Solid Tumor, Protocol Specific, Gastric Cancer, Breast Cancer
Keywords
Stomach Neoplasms, Breast Neoplasms, Carcinoma, Neoplasms, Paclitaxel, Tubulin Modulators, Antimitotic Agents, Protein Kinase Inhibitors, Enzyme Inhibitors, Pharmacologic Actions

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
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
KX2-391 and Paclitaxel
Arm Type
Experimental
Arm Description
The phase I portion is a standard, three-patient per cohort, dose escalation schedule will be used. 3 or 6 subjects with solid tumor per dose group will likely be necessary to determine the MTD of KX2-391 in combination with weekly paclitaxel. With paclitaxel dose fixed at 80 mg/m2/weekly, KX2-391 treatment will be started at 20 mg dose once daily (QD) The phase II portion of this trial has a design to determine the efficacy of KX2-391 when administered in combination with paclitaxel in 20 subjects with stomach cancer and 20 subjects with breast cancer
Intervention Type
Drug
Intervention Name(s)
KX2-391 and Paclitaxel
Other Intervention Name(s)
KX01, Taxol
Intervention Description
A treatment cycle in phase I will consist of 28 days, according to the following schedule: KX2-391 20 mg PO once daily, Weekly paclitaxel 80 mg/m2 given intravenously over 1 hour on day 1, 8, and 15 of a 28 day cycle. The trial will initially test the combination of weekly paclitaxel and KX2-391 given PO, once daily , continuously. In case of 2 dose-limiting toxicities (DLT) in the first cohort, this intervention will be terminated A treatment cycle in phase II will consist of 28 days, according to the following schedule: KX2-391 MTD PO once daily, Weekly paclitaxel 80 mg/m2 given intravenously over 1 hour on day 1, 8, and 15 of a 28 day cycle.
Primary Outcome Measure Information:
Title
Dose-limiting Toxicities (DLTs) in Phase I Portion
Description
Maximum tolerated dose (MTD) of KX2-391 in combination with weekly paclitaxel as determined by number of participants With DLTs related to KX2-391 in combination with weekly paclitaxel
Time Frame
From start of the treatment to end of cycle 1, which are 4 weeks
Title
Tumor Overall Response Rates (ORRs) in Phase II Portion
Description
The efficacy (overall response rate; ORR; complete response (CR) + partial response (PR)) of KX2-391 in combination with weekly paclitaxel at the MTD established during the phase I portion of this trial based on Response Evaluation Criteria in Solid Tumor (RECIST) 1.1
Time Frame
In every 2 cycles up to end of the treatment, an expected average of 16 weeks
Secondary Outcome Measure Information:
Title
Pharmacokinetic (PK) Evaluation in Phase I Portion
Description
PK parameters, including but not limited to, plasma concentration, AUC (Area Under Curve) 0-t, Cmax, Tmax, and T1/2 of KX2-391 alone and in combination with weekly paclitaxel
Time Frame
Time points at day 0, 1 and 8 in cycle 1
Title
The Preliminary Efficacy Data in Phase I Portion
Description
The preliminary efficacy of KX2-391 in combination with weekly paclitaxel as determined by ORRs based on RECIST 1.1
Time Frame
In every 2 cycles up to end of the treatment, an expected average of 8 weeks
Title
Safety in Phase II Portion
Description
Adverse events and their frequency, duration and severity, physical examination, laboratory parameters, vital signs and ECG change monitoring as determined based on CTCAE (Common Toxicity Criteria for Adverse Effects) 4.03
Time Frame
From start of the treatment to end of the treatment, an expected average of 16 weeks
Title
The Efficacy Data in Phase II Portion
Description
Overall survival (OS), progression free survival (PFS), time to tumor progression (TTP) and duration of response
Time Frame
Up to die, an expected average of 24 weeks
Title
Pharmacokinetic (PK) Evaluation in Phase II Portion
Description
PK parameters, including but not limited to, plasma concentration, AUC0-t, Cmax, Tmax, and T1/2 of KX2-391 alone and in combination with weekly paclitaxel
Time Frame
Time points at day 1 and 8 in cycle 1
Other Pre-specified Outcome Measures:
Title
Pharmacodynamic (PD) Evaluation in Phase I Portion
Description
Pre-dose and post-dose tubulin inhibition in peripheral blood monocytes extracted from blood samples, as measured by immunofluorescence staining
Time Frame
Time points at day 0 and 1 in cycle 1
Title
Exploratory Biomarker Evaluation in Phase II Portion
Description
Pre-dose and post-dose Src signaling inhibition (p-Src and Ki-67) in archival tumor tissue and new biopsy sample, as measured by immunohistochemistry
Time Frame
Time points at day -6 and day 0

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Phase I Portion: - Diagnosis of solid tumors on histopathological examination or cytological examination for which no standard of care is available or conventional treatment modalities have no therapeutic effect at the time of entering into the study Phase II Portion: Diagnosis of advanced/metastatic/recurrent stomach cancer or breast cancer on histopathological examination or cytological examination for which no standard of care is available or conventional treatment modalities have no therapeutic effect at the time of entering into the study Subjects with stomach cancer without prior taxane therapy Subjects with breast cancer with prior taxane therapy (Optional) Providing exploratory biomarker informed consent form to obtain archival tumor tissue and/or new tumor biopsy sample Common: Based on clinical screening, ① If radiotherapy was given, at least 4 weeks should have passed from the last treatment date and the patient should have recovered from the toxicity (However, for limited regional radiotherapy, at least 2 weeks from the last treatment date) ② If hormonal therapy was given, at least 2 weeks should have passed from the last treatment date and the patient should have recovered from the toxicity. ③ If chemotherapy was given, at least 3 weeks should have passed from the last treatment date and the patient should have recovered from the toxicity (However, for nitrosourea or mitomycin, at least 6 weeks) Aged ≥ 20 years ECOG (Eastern Cooperative Oncology Group) ≤ 2 Life expectancy ≥ 12 weeks Should meet the followings, ① Bone marrow function ANC (Absolute Neutrophil Count) ≥ 1.5 X 109/L, PLT (Platelet Count) ≥ 100 X 109/L, Hemoglobin ≥ 9.0 g/dl (In the case of hemoglobin of < 9.0 g/dl, the patient can be enrolled if the value is reversed to ≥ 9.0 g/dl.) ② Kidney function Creatinine Clearance > 50 ml/min or Serum Clearance ≤ 1.5 mg/dl ③ Liver function AST (Aspartate Aminotransferase)/ALT (Alanine Aminotransferase)/ALP (Alkaline Phosphatase) ≤ 3.0 X UNL and Total bilirubin ≤ 2.0 mg/dl (With bone metastasis, ALP ≤ 5.0 X UNL) At least one measurable lesions with the length of the longest diameter of ≥ 10 mm on spiral CT or multidetector CT or ≥ 20 mm on conventional CT Subjects who voluntarily consent to participate in this study and sign the written informed consent form Exclusion Criteria: Uncontrolled central nervous system metastasis Malignant ascites requiring surgical treatment Subjects who have blood malignancies including leukemia; or who have received or will receive bone marrow transplantation Severe concurrent diseases as follows, ① History of unstable angina, heart failure, atrial or ventricular arrhythmia requiring pharmacological treatment, or having received treatment for myocardial infarction within 6 months (however, may be included under the judgment of the investigator if medically controlled), heart failure of Class III or IV by New York Heart Association Classes, or left ventricular ejection fraction of < 40% ② Receiving therapeutic dose administration of coumarin-type anticoagulants (however, up to 2 mg daily is permitted for line opening) ③ Uncontrolled diabetes (fasting plasma glucose > 2.0 X UNL), severe hypertension, thyroid disorder and active infectious disease ④ Psychiatric or neurological history including dementia or epilepsy which may threaten the compliance with this protocol ⑤ A condition not allowing oral application of tablet formulation, and any clinically significant gastrointestinal abnormalities which may interfere with taking, passing or absorption of the study drug Using disallowed concomitant medications (strong CYP3A4 (Cytochrome P450 3A4) inhibitors or inducers) (When a patient is using any of the disallowed concomitant medications below, wash-out of 1 week from the medication date is required) Received other investigational product within 4 weeks prior to the administration of this study drug Pregnant or breast-feeding women (however, women with 12 months of natural (spontaneous) amenorrhea or surgical bilateral oophorectomy (alone or with hysterectomy) at least 6 weeks ago, with appropriate clinical profile (e.g., appropriate age, history of vasomotor symptoms), will be considered women postmenopausal and of non-childbearing potential. In the case of oophorectomy alone, a woman will be considered to be of non-childbearing potential only if her reproductive condition is confirmed by follow-up hormone level assessment) History of hypersensitivity to paclitaxel, compounds with similar chemical structure, or cremophor (polyoxyethylated castor oil) ingredient Neuropathy of grade ≥ 3 based on clinical screening Known history of hepatitis B or C and known history of HIV serum positive Others unable to participate in the study under the judgment of the investigator
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Seock-Ah Im, M.D., Ph.D.
Phone
+82-2-2072-0850
First Name & Middle Initial & Last Name or Official Title & Degree
Jee Hyun Kim, M.D., Ph.D.
Phone
+82-31-713-5132
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Seock-Ah Im, M.D., Ph.D.
Organizational Affiliation
Seoul National University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Seoul National University Bundang Hospital
City
Seongnam
State/Province
Gyeonggi-Do
ZIP/Postal Code
463-707
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yun Jin Kim
Phone
+82-31-787-1421
Facility Name
Seoul National University Hospital
City
Seoul
ZIP/Postal Code
110-744
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Eunkyung Kim
Phone
+82-2-2072-7616

12. IPD Sharing Statement

Learn more about this trial

A Study of KX2-391 With Paclitaxel in Patients With Solid Tumors

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