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Combination Therapy With NC-6004 and Gemcitabine in Advanced Solid Tumors or Non-Small Cell Lung, Biliary and Bladder Cancer

Primary Purpose

Solid Tumors

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
NC-6004
Gemcitabine
Sponsored by
NanoCarrier Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Tumors

Eligibility Criteria

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

Inclusion Criteria:

  • (Part 1 only) Have a histologically or cytologically confirmed diagnosis of advanced solid tumor that has relapsed or is refractory to standard curative or palliative therapy or has a contraindication to standard therapy.
  • (Part 2 only) Cohort 1: Have histologically or cytologically confirmed diagnosis of Stage IV squamous NSCLC and have not received prior chemotherapy or immunotherapy for metastatic disease and are not known to be PD-L1 positive (known high PD-L1 expression defined as Tumor Proportion Score [TPS] greater than or equal to 50%). Patients with known sensitizing mutation in the epidermal growth factor receptor (EGFR) gene or anaplastic lymphoma kinase (ALK) fusion oncogene must have received at least 1 and up to 2 targeted therapies prior to enrollment.
  • (Part 2 only) Cohort 2: Have histologically or cytologically confirmed diagnosis of nonresectable, recurrent, or metastatic biliary tract carcinoma (intrahepatic or extrahepatic cholangiocarcinoma, gallbladder cancer, or ampullary carcinoma) and have not received prior systemic anticancer therapy for advanced or metastatic disease.
  • (Part 2 only) Cohort 3: Have histologically or cytologically confirmed diagnosis of metastatic or locally advanced TCC of the urinary tract (bladder, urethra, ureter, renal pelvis) (T3b-T4 N0 M0, Tany N1-N3 M0, or Tany Nany M1) and are not candidates for surgery.
  • Have measurable disease per RECIST version 1.1.
  • Have an ECOG PS of 0 to 1, with the exception of patients in Part 2 (Cohort 3, unfit bladder cancer patients) who may have an ECOG PS of 2
  • Adequate bone marrow reserve, liver and renal function
  • Have a negative pregnancy test result at Screening for females of childbearing potential
  • Male patients must agree to use a condom during treatment and for 90 days after dosing and must agree not to donate sperm for 90 days after dosing
  • Women of childbearing potential are willing to agree to use 1 of the study defined effective methods of birth control from the time of study entry to 6 months after the last day of treatment
  • Reasonably recovered from preceding major surgery as judged by the investigator or no major surgery within 4 weeks prior to the start of Day 1 treatment

Exclusion Criteria:

  • Have received prior platinum therapy in the past 3 months (Part 1) or 6 months in the adjuvant or neoadjuvant setting (Part 2).
  • Have received prior cisplatin and gemcitabine concomitantly within the last 6 months or are refractory to cisplatin and gemcitabine.
  • Unresolved toxicity from prior radiation, chemotherapy, or other targeted treatment, including investigational treatment
  • Have evidence suggesting pulmonary fibrosis or interstitial pneumonia.
  • Have a history of thrombocytopenia with complications
  • Have known hypersensitivity to platinum compounds or gemcitabine.
  • Have uncontrolled diabetes or have hypertension requiring more than 3 medications for control of hypertension.
  • Have pre-existing alcoholic liver injury or significant liver disease.
  • Pregnant or breast feeding

Sites / Locations

  • California Cancer Associates for Research and Excellence
  • UC San Diego Moores Cancer Center
  • Pacific Hematology Oncology Associates
  • Northwestern University Feinberg School of Medicine
  • Tufts Medical Center
  • University of North Carolina at Chapel Hill
  • University Hospitals Case Medical Center
  • University of Oklahoma Health Sciences Center
  • University of Texas Southwestern Medical Center
  • MD Anderson Cancer Center
  • Multiprofile Hospital for Active Treatment Serdika EOOD
  • Complex Oncology Center - Shumen EOOD
  • Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori IRST
  • ASST Grande Ospedale Metropolitano Niguarda - Presidio Ospedaliero Ospedale Niguarda Ca' Granda
  • Wojewodzki Szpital Specjalistyczny im. Ludwika Rydygiera w Krakowie
  • Med-Polonia Sp. z o.o.
  • Fundeni Clinical Institute
  • Coltea Clinical Hospital
  • Prof Dr I Chiricuta Institute of Oncology
  • Oncology Center Sfantul Nectarie
  • Euroclinic Oncology Center SRL
  • Institutul Regional de Oncologie Iasi

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

NC-6004 and Gemcitabine

Arm Description

Outcomes

Primary Outcome Measures

Determine the RPII dose of NC-6004 in combination with gemcitabine
In the dose-escalation phase of the study (Part 1), to determine the dose-limiting toxicities (DLTs), MTD, and RPII dose of NC-6004 in combination with gemcitabine
Activity of NC-6004 measured by progression-free survival (PFS)
In the expansion phase of the study (Part 2), to evaluate the activity of NC-6004 in combination with gemcitabine in patients with first-line Stage IV squamous NSCLC, first-line advanced or metastatic biliary tract cancer, and first-line metastatic or locally advanced bladder cancer compared with historical control as measured by local investigator/radiologist-assessed progression-free survival (PFS), according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.

Secondary Outcome Measures

Overall response rate
To evaluate ORR, DCR (DCR = complete response [CR] + partial response [PR] + stable disease [SD]), DOR, PFS, and OS
Therapy-related AEs
Incidence and severity of therapy-related AEs
EORTC QLQ-C30
To evaluate QoL using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Safety and tolerability as measured by severity of AEs and laboratory abnormalities
The safety endpoints for this study are the incidence and severity of AEs and laboratory abnormalities, according to the NCI CTCAE version 4.03, the occurrence of SAEs and treatment discontinuations due to AEs, and nausea severity and vomiting incidence obtained from the patient diary

Full Information

First Posted
August 19, 2014
Last Updated
February 27, 2020
Sponsor
NanoCarrier Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02240238
Brief Title
Combination Therapy With NC-6004 and Gemcitabine in Advanced Solid Tumors or Non-Small Cell Lung, Biliary and Bladder Cancer
Official Title
A Phase 1b/2 Dose Escalation and Expansion Trial of NC-6004 (Nanoparticle Cisplatin) Plus Gemcitabine in Patients With Advanced Solid Tumors or Non-Small Cell Lung, Biliary Tract, and Bladder Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
May 2014 (Actual)
Primary Completion Date
May 6, 2019 (Actual)
Study Completion Date
May 6, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NanoCarrier Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
In the dose escalation phase (Part 1), this study will determine the dose-limiting toxicities (DLTs), the maximum tolerated dose (MTD) and recommended Phase 2 (RPII) dose of NC 6004 in combination with gemcitabine. In the expansion phase of the study (Part 2), study will evaluate the activity, safety, and tolerability at the RPII dose identified in Part 1 in patients with squamous NSCLC, biliary tract, and bladder cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Tumors

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
NC-6004 and Gemcitabine
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
NC-6004
Intervention Description
NC-6004 - given at escalating doses of 60, 75, 90, 105, 120, 135, 150, 165, or 180 mg/m2 according to observations of dose-limiting toxicity.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Gemcitabine 1250 mg/m2 will be administered as a 30 minute intravenous infusion on Day 1 after the completion of the NC 6004 infusion and on Day 8 of each cycle.
Primary Outcome Measure Information:
Title
Determine the RPII dose of NC-6004 in combination with gemcitabine
Description
In the dose-escalation phase of the study (Part 1), to determine the dose-limiting toxicities (DLTs), MTD, and RPII dose of NC-6004 in combination with gemcitabine
Time Frame
1 year
Title
Activity of NC-6004 measured by progression-free survival (PFS)
Description
In the expansion phase of the study (Part 2), to evaluate the activity of NC-6004 in combination with gemcitabine in patients with first-line Stage IV squamous NSCLC, first-line advanced or metastatic biliary tract cancer, and first-line metastatic or locally advanced bladder cancer compared with historical control as measured by local investigator/radiologist-assessed progression-free survival (PFS), according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Overall response rate
Description
To evaluate ORR, DCR (DCR = complete response [CR] + partial response [PR] + stable disease [SD]), DOR, PFS, and OS
Time Frame
every 6 weeks tumor assessments for response and disease progression after treatment discontinuation and telephone calls for survival every 12 weeks until disease progression.
Title
Therapy-related AEs
Description
Incidence and severity of therapy-related AEs
Time Frame
1 year
Title
EORTC QLQ-C30
Description
To evaluate QoL using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Time Frame
1 year
Title
Safety and tolerability as measured by severity of AEs and laboratory abnormalities
Description
The safety endpoints for this study are the incidence and severity of AEs and laboratory abnormalities, according to the NCI CTCAE version 4.03, the occurrence of SAEs and treatment discontinuations due to AEs, and nausea severity and vomiting incidence obtained from the patient diary
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: (Part 1 only) Have a histologically or cytologically confirmed diagnosis of advanced solid tumor that has relapsed or is refractory to standard curative or palliative therapy or has a contraindication to standard therapy. (Part 2 only) Cohort 1: Have histologically or cytologically confirmed diagnosis of Stage IV squamous NSCLC and have not received prior chemotherapy or immunotherapy for metastatic disease and are not known to be PD-L1 positive (known high PD-L1 expression defined as Tumor Proportion Score [TPS] greater than or equal to 50%). Patients with known sensitizing mutation in the epidermal growth factor receptor (EGFR) gene or anaplastic lymphoma kinase (ALK) fusion oncogene must have received at least 1 and up to 2 targeted therapies prior to enrollment. (Part 2 only) Cohort 2: Have histologically or cytologically confirmed diagnosis of nonresectable, recurrent, or metastatic biliary tract carcinoma (intrahepatic or extrahepatic cholangiocarcinoma, gallbladder cancer, or ampullary carcinoma) and have not received prior systemic anticancer therapy for advanced or metastatic disease. (Part 2 only) Cohort 3: Have histologically or cytologically confirmed diagnosis of metastatic or locally advanced TCC of the urinary tract (bladder, urethra, ureter, renal pelvis) (T3b-T4 N0 M0, Tany N1-N3 M0, or Tany Nany M1) and are not candidates for surgery. Have measurable disease per RECIST version 1.1. Have an ECOG PS of 0 to 1, with the exception of patients in Part 2 (Cohort 3, unfit bladder cancer patients) who may have an ECOG PS of 2 Adequate bone marrow reserve, liver and renal function Have a negative pregnancy test result at Screening for females of childbearing potential Male patients must agree to use a condom during treatment and for 90 days after dosing and must agree not to donate sperm for 90 days after dosing Women of childbearing potential are willing to agree to use 1 of the study defined effective methods of birth control from the time of study entry to 6 months after the last day of treatment Reasonably recovered from preceding major surgery as judged by the investigator or no major surgery within 4 weeks prior to the start of Day 1 treatment Exclusion Criteria: Have received prior platinum therapy in the past 3 months (Part 1) or 6 months in the adjuvant or neoadjuvant setting (Part 2). Have received prior cisplatin and gemcitabine concomitantly within the last 6 months or are refractory to cisplatin and gemcitabine. Unresolved toxicity from prior radiation, chemotherapy, or other targeted treatment, including investigational treatment Have evidence suggesting pulmonary fibrosis or interstitial pneumonia. Have a history of thrombocytopenia with complications Have known hypersensitivity to platinum compounds or gemcitabine. Have uncontrolled diabetes or have hypertension requiring more than 3 medications for control of hypertension. Have pre-existing alcoholic liver injury or significant liver disease. Pregnant or breast feeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joao da Silva, MD
Official's Role
Principal Investigator
Facility Information:
Facility Name
California Cancer Associates for Research and Excellence
City
Encinitas
State/Province
California
ZIP/Postal Code
92024
Country
United States
Facility Name
UC San Diego Moores Cancer Center
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Pacific Hematology Oncology Associates
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Northwestern University Feinberg School of Medicine
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
University of North Carolina at Chapel Hill
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
University Hospitals Case Medical Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44121
Country
United States
Facility Name
University of Oklahoma Health Sciences Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Multiprofile Hospital for Active Treatment Serdika EOOD
City
Sofia
State/Province
Sofia-Grad
ZIP/Postal Code
1632
Country
Bulgaria
Facility Name
Complex Oncology Center - Shumen EOOD
City
Shumen
ZIP/Postal Code
9700
Country
Bulgaria
Facility Name
Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori IRST
City
Meldola
ZIP/Postal Code
47014
Country
Italy
Facility Name
ASST Grande Ospedale Metropolitano Niguarda - Presidio Ospedaliero Ospedale Niguarda Ca' Granda
City
Milano
ZIP/Postal Code
20162
Country
Italy
Facility Name
Wojewodzki Szpital Specjalistyczny im. Ludwika Rydygiera w Krakowie
City
Krakow
ZIP/Postal Code
31826
Country
Poland
Facility Name
Med-Polonia Sp. z o.o.
City
Poznan
ZIP/Postal Code
60693
Country
Poland
Facility Name
Fundeni Clinical Institute
City
Bucharest
ZIP/Postal Code
22328
Country
Romania
Facility Name
Coltea Clinical Hospital
City
Bucharest
ZIP/Postal Code
30171
Country
Romania
Facility Name
Prof Dr I Chiricuta Institute of Oncology
City
Cluj-Napoca
ZIP/Postal Code
400015
Country
Romania
Facility Name
Oncology Center Sfantul Nectarie
City
Craiova
ZIP/Postal Code
200347
Country
Romania
Facility Name
Euroclinic Oncology Center SRL
City
Iasi
ZIP/Postal Code
700106
Country
Romania
Facility Name
Institutul Regional de Oncologie Iasi
City
Iasi
ZIP/Postal Code
700483
Country
Romania

12. IPD Sharing Statement

Citations:
PubMed Identifier
29030354
Citation
Subbiah V, Grilley-Olson JE, Combest AJ, Sharma N, Tran RH, Bobe I, Osada A, Takahashi K, Balkissoon J, Camp A, Masada A, Reitsma DJ, Bazhenova LA. Phase Ib/II Trial of NC-6004 (Nanoparticle Cisplatin) Plus Gemcitabine in Patients with Advanced Solid Tumors. Clin Cancer Res. 2018 Jan 1;24(1):43-51. doi: 10.1158/1078-0432.CCR-17-1114. Epub 2017 Oct 13.
Results Reference
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Combination Therapy With NC-6004 and Gemcitabine in Advanced Solid Tumors or Non-Small Cell Lung, Biliary and Bladder Cancer

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