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Study of DKN-01 and Gemcitabine/Cisplatin in Patients With Carcinoma to Primary to the Intra- or Extra-Hepatic Biliary System or Gallbladder

Primary Purpose

Carcinoma of Intrahepatic and Extra-hepatic Biliary System, Carcinoma of Gallbladder, Bile Duct Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
DKN-01
gemcitabine
cisplatin
Sponsored by
Leap Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma of Intrahepatic and Extra-hepatic Biliary System

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient has carcinoma primary to the intra- or extra-hepatic biliary system or gall bladder.
  2. Patient must have sufficient tumor tissue available for submission.
  3. For patients who have received prior cryotherapy, radiofrequency ablation, radioembolization, ethanol injection, transarterial chemoembolization (TACE) or photodynamic therapy, at least 28 days must have elapsed since that therapy, and lesions that have not been treated with local therapy must be present and measurable.
  4. Patients may have received prior adjuvant chemotherapy with gemcitabine with or without cisplatin, as long as 6 months have elapsed since last treatment.
  5. Patients must have one or more tumors measurable on radiographic imaging as defined by RECIST.
  6. ECOG PS of 0 or 1. Patients with an ECOG PS of 2 may be entered upon review and approval of the medical monitor.
  7. Estimated life expectancy of at least 3 months.
  8. Disease-free of active second/secondary or prior malignancies for ≥ 2 years with the exception of currently treated basal cell or squamous cell carcinoma of the skin, or carcinoma in-situ of the cervix or breast.
  9. Adequate hematological, renal, hepatic and coagulation laboratory test results.
  10. Women of child bearing potential and men must agree to use adequate contraception during the study and for 6 months after their last dose of study drug.
  11. Available for the duration of the study and are willing to follow study-specific procedures.
  12. Provide written informed consent

Exclusion Criteria:

  1. New York Heart Association Class III or IV cardiac disease, myocardial infarction within the past 6 months, or unstable arrhythmia.
  2. Have Fridericia-corrected QT interval (QTcF) > 470 msec (female) or > 450 (male), or history of congenital long QT syndrome.
  3. Active, uncontrolled bacterial, viral, or fungal infections.
  4. Known to be human immunodeficiency virus (HIV) positive or has untreated, active hepatitis B.
  5. History of major organ transplant.
  6. History of an autologous/allogenic bone marrow transplant.
  7. Serious nonmalignant disease.
  8. Pregnant or nursing.
  9. History of osteonecrosis of the hip or have evidence of structural bone abnormalities in the proximal femur on MRI scan that are symptomatic and clinically significant.
  10. Symptomatic central nervous system (CNS) malignancy or metastasis.
  11. Clinically significant peripheral neuropathy
  12. Known osteoblastic bony metastasis.
  13. Treatment with surgery or chemotherapy within 21 days prior to study entry or radiation within 14 days of study entry.
  14. Previously treated with an anti-Dkk-1 therapy.
  15. Other exclusions apply

Sites / Locations

  • University of Southern California
  • Yale University
  • Massachusetts General Hospital
  • Beth Israel Deaconess Medical Center
  • Dana Farber Cancer Institute
  • Columbia University Medical Center
  • University Hospitals, Case Medical Center
  • Cleveland Clinic
  • University of Texas Health Science Center at San Antonio

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

150 mg DKN-01 Part A

300 mg DKN-01 Part A

MTD mg DKN-01 Part B

Arm Description

Patients will receive 150 mg of DKN-01 followed by gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on Days 1 and 8 of each 21-day cycle.

Patients will receive 300 mg of DKN-01 followed by gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on Days 1 and 8 of each 21-day cycle.

Patients are treated at the maximum tolerated dose (MTD) of DKN-01 (or highest dose tested in Part A if the MTD is not defined) followed by gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on Days 1 and 8 of each 21-day cycle.

Outcomes

Primary Outcome Measures

Maximum tolerated dose and dose-limiting toxicities as determined in Part A.
Toxicities will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE v 4.03).
Composite Safety parameters as assessed by new or changing physical examinations, vital signs, electrocardiograms (ECGs), clinical laboratories, concomitant medication reviews, and assessment of adverse events.

Secondary Outcome Measures

Pharmacokinetics - AUC
Plasma levels will be measured during the treatment period.
Pharmacokinetics - Cmax
Plasma levels will be measured during the treatment period.
Pharmacokinetics - Tmax
Plasma levels will be measured during the treatment period.
Efficacy - Response to treatment evaluated using the Response Evaluation Criteria in Solid Tumors guidelines (RECIST 1.1)
Response to treatment evaluated using the Response Evaluation Criteria in Solid Tumors guidelines (RECIST 1.1).

Full Information

First Posted
February 18, 2015
Last Updated
September 6, 2018
Sponsor
Leap Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02375880
Brief Title
Study of DKN-01 and Gemcitabine/Cisplatin in Patients With Carcinoma to Primary to the Intra- or Extra-Hepatic Biliary System or Gallbladder
Official Title
A Dose Escalation and Cohort Expansion Study of DKN-01 in Combination With Gemcitabine and Cisplatin in Patients With Advanced Carcinoma Primary to the Intra- or Extra-hepatic Biliary System or Gallbladder
Study Type
Interventional

2. Study Status

Record Verification Date
September 2018
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
July 2018 (Actual)
Study Completion Date
July 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Leap Therapeutics, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
DKN-01 is a humanized monoclonal antibody (Mab) with neutralizing activity against Dkk-1 and is being developed as an anti-neoplastic agent. This study is designed to evaluate the safety, tolerability, pharmacokinetics, and anti-tumor activity of DKN-01 in combination with gemcitabine and cisplatin in patients with carcinoma primary to the intra- or exta-hepatic biliary system or gallbladder.
Detailed Description
In Part A, escalating doses of DKN-01 will be administered to different cohorts of patients to evaluate safety and dose limiting toxicities (DLTs) and to establish the maximum tolerated dose of DKN-01 when administered in combination with gemcitabine and cisplatin. Part B is an expansion cohort in which patients are treated at the MTD of DKN-01 (or highest dose tested if the MTD is not defined) to further characterize safety, tolerability, pharmacokinetics and efficacy within the defined patient population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma of Intrahepatic and Extra-hepatic Biliary System, Carcinoma of Gallbladder, Bile Duct Cancer, Cholangiocarcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
51 (Actual)

8. Arms, Groups, and Interventions

Arm Title
150 mg DKN-01 Part A
Arm Type
Experimental
Arm Description
Patients will receive 150 mg of DKN-01 followed by gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on Days 1 and 8 of each 21-day cycle.
Arm Title
300 mg DKN-01 Part A
Arm Type
Experimental
Arm Description
Patients will receive 300 mg of DKN-01 followed by gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on Days 1 and 8 of each 21-day cycle.
Arm Title
MTD mg DKN-01 Part B
Arm Type
Experimental
Arm Description
Patients are treated at the maximum tolerated dose (MTD) of DKN-01 (or highest dose tested in Part A if the MTD is not defined) followed by gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on Days 1 and 8 of each 21-day cycle.
Intervention Type
Drug
Intervention Name(s)
DKN-01
Other Intervention Name(s)
LY2812176
Intervention Description
Administration by intravenous (IV) infusion.
Intervention Type
Drug
Intervention Name(s)
gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Description
Administered by IV infusion.
Intervention Type
Drug
Intervention Name(s)
cisplatin
Other Intervention Name(s)
Platinol
Intervention Description
Administered by IV infusion
Primary Outcome Measure Information:
Title
Maximum tolerated dose and dose-limiting toxicities as determined in Part A.
Description
Toxicities will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE v 4.03).
Time Frame
End of Cycle 1 (Day 21)
Title
Composite Safety parameters as assessed by new or changing physical examinations, vital signs, electrocardiograms (ECGs), clinical laboratories, concomitant medication reviews, and assessment of adverse events.
Time Frame
Parts A and B: at a minimum Days 1, 8, 15 of each treatment cycle.
Secondary Outcome Measure Information:
Title
Pharmacokinetics - AUC
Description
Plasma levels will be measured during the treatment period.
Time Frame
Cycle 1 - Days 1 and 8, Cycle 2 - Day 1
Title
Pharmacokinetics - Cmax
Description
Plasma levels will be measured during the treatment period.
Time Frame
Cycle 1 - Days 1 and 8, Cycle 2 - Day 1
Title
Pharmacokinetics - Tmax
Description
Plasma levels will be measured during the treatment period.
Time Frame
Cycle 1 - Days 1 and 8, Cycle 2 - Day 1
Title
Efficacy - Response to treatment evaluated using the Response Evaluation Criteria in Solid Tumors guidelines (RECIST 1.1)
Description
Response to treatment evaluated using the Response Evaluation Criteria in Solid Tumors guidelines (RECIST 1.1).
Time Frame
At baseline, prior to the start of Cycle 3, and every 2 cycles thereafter until disease progression or death

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient has carcinoma primary to the intra- or extra-hepatic biliary system or gall bladder. Patient must have sufficient tumor tissue available for submission. For patients who have received prior cryotherapy, radiofrequency ablation, radioembolization, ethanol injection, transarterial chemoembolization (TACE) or photodynamic therapy, at least 28 days must have elapsed since that therapy, and lesions that have not been treated with local therapy must be present and measurable. Patients may have received prior adjuvant chemotherapy with gemcitabine with or without cisplatin, as long as 6 months have elapsed since last treatment. Patients must have one or more tumors measurable on radiographic imaging as defined by RECIST. ECOG PS of 0 or 1. Patients with an ECOG PS of 2 may be entered upon review and approval of the medical monitor. Estimated life expectancy of at least 3 months. Disease-free of active second/secondary or prior malignancies for ≥ 2 years with the exception of currently treated basal cell or squamous cell carcinoma of the skin, or carcinoma in-situ of the cervix or breast. Adequate hematological, renal, hepatic and coagulation laboratory test results. Women of child bearing potential and men must agree to use adequate contraception during the study and for 6 months after their last dose of study drug. Available for the duration of the study and are willing to follow study-specific procedures. Provide written informed consent Exclusion Criteria: New York Heart Association Class III or IV cardiac disease, myocardial infarction within the past 6 months, or unstable arrhythmia. Have Fridericia-corrected QT interval (QTcF) > 470 msec (female) or > 450 (male), or history of congenital long QT syndrome. Active, uncontrolled bacterial, viral, or fungal infections. Known to be human immunodeficiency virus (HIV) positive or has untreated, active hepatitis B. History of major organ transplant. History of an autologous/allogenic bone marrow transplant. Serious nonmalignant disease. Pregnant or nursing. History of osteonecrosis of the hip or have evidence of structural bone abnormalities in the proximal femur on MRI scan that are symptomatic and clinically significant. Symptomatic central nervous system (CNS) malignancy or metastasis. Clinically significant peripheral neuropathy Known osteoblastic bony metastasis. Treatment with surgery or chemotherapy within 21 days prior to study entry or radiation within 14 days of study entry. Previously treated with an anti-Dkk-1 therapy. Other exclusions apply
Facility Information:
Facility Name
University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02214
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
University Hospitals, Case Medical Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
University of Texas Health Science Center at San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
32878766
Citation
Goyal L, Sirard C, Schrag M, Kagey MH, Eads JR, Stein S, El-Khoueiry AB, Manji GA, Abrams TA, Khorana AA, Miksad R, Mahalingam D, Zhu AX, Duda DG. Phase I and Biomarker Study of the Wnt Pathway Modulator DKN-01 in Combination with Gemcitabine/Cisplatin in Advanced Biliary Tract Cancer. Clin Cancer Res. 2020 Dec 1;26(23):6158-6167. doi: 10.1158/1078-0432.CCR-20-1310. Epub 2020 Sep 2.
Results Reference
derived

Learn more about this trial

Study of DKN-01 and Gemcitabine/Cisplatin in Patients With Carcinoma to Primary to the Intra- or Extra-Hepatic Biliary System or Gallbladder

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