Study of Weekly Paclitaxel With Ramucirumab in Participants With Advanced Gastric Adenocarcinomas
Primary Purpose
Adenocarcinoma
Status
Completed
Phase
Phase 1
Locations
Japan
Study Type
Interventional
Intervention
Ramucirumab (IMC-1121B )
Paclitaxel
Sponsored by
About this trial
This is an interventional treatment trial for Adenocarcinoma focused on measuring Adenocarcinoma, Gastroesophageal Junction
Eligibility Criteria
Inclusion Criteria:
- Has a histopathologically or cytologically confirmed diagnosis of gastric or gastroesophageal junction (GEJ) adenocarcinoma
- Has an advanced or metastatic solid gastric adenocarcinoma that has failed standard therapy
- Has resolution of all clinically significant toxic effects of prior therapy, surgery, treatment with an investigational agent or device, treatment monoclonal antibody or small molecule, and radiotherapy or chemotherapy.
- Has adequate organ function
- Eligible participants of reproductive potential (both sexes) agree to use adequate contraceptive methods (hormonal or barrier methods) during the study period and for 12 weeks after the last dose of study medication
Exclusion Criteria:
- Has undergone major surgery within 28 days prior to the study, or subcutaneous venous access device placement within 7 days prior to the study registration date
- Has elective or planned surgery to be conducted during the trial
- Has had treatment with an investigational agent or device, an antineoplastic small molecule, or antineoplastic radiotherapy or chemotherapy
- Was previously treated with a chemotherapy regimen containing nitrosoureas or mitomycin C
- Has had treatment with an antineoplastic monoclonal antibody within 8 weeks prior to the study registration date
- Has a history of deep vein thrombosis, pulmonary embolism, or any other significant thromboembolism prior to the study registration date
- Has experienced any arterial thrombotic event, including myocardial infarction, cerebrovascular accident, or transient ischemic attack, within 6 months prior to the study date
- Is receiving therapeutic anticoagulation with warfarin, low-molecular weight heparin or similar agents. (Participants receiving prophylactic, low-dose anticoagulation therapy are eligible provided that the coagulation parameters International Normalized Ratio (INR) ≤ 1.5, prothrombin time (PT) and partial thromboplastin time (PTT) or - Is receiving chronic therapy with nonsteroidal anti-inflammatory agents [Aspirin use at doses up to 325 milligrams/day (mg/day) is permitted]
- Has significant bleeding disorders, vasculitis, history of postoperative bleeding complications, hemoptysis or had a significant bleeding episode from the gastrointestinal (GI) tract within 3 months prior to the study date
- Has a history of GI perforation and/or fistulae within 6 months prior to the study date
- Has symptomatic congestive heart failure, unstable angina pectoris, or symptomatic or poorly controlled cardiac arrhythmia
- Has uncontrolled arterial hypertension despite standard medical management.
- Has a serious or nonhealing wound or peptic ulcer or bone fracture within 28 days prior to the study date
- Has a bowel obstruction, history or presence of inflammatory enteropathy or extensive intestinal resection, Crohn's disease, ulcerative colitis, or chronic diarrhea
- Has a serious illness or medical condition(s)
- Is pregnant or lactating
- Has received treatment with another investigational drug or participation in another interventional clinical trial within 28 days prior to the study date
Sites / Locations
- ImClone Investigational Site
- ImClone Investigational Site
- ImClone Investigational Site
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Ramucirumab (IMC-1121B ) and Pacitaxel
Arm Description
Each treatment cycle is 4 weeks (28 days)
Outcomes
Primary Outcome Measures
Number of Participants With a Dose-Limiting Toxicity (DLT) During Cycle 1
DLT based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCICTCAE v4.02) in Cycle (Cy) 1 due to study drug (SD) with (w/): Grade (Gr) ≥3 neutropenia w/fever ≥38.5°C or w/bacteremia or sepsis, thrombocytopenia w/bleeding and platelet substitution, prothrombin and/or partial thromboplastin time w/no anticoagulation, hyperbilirubinemia; Gr 4: neutropenia >5 days, thrombocytopenia, Gr 4 or uncontrollable hypertension QTc>500 milliseconds (ms) or increase ≥100 ms increase in 24 hours after SD or significant arrhythmia in this period; Gr ≥3 nonhematologic toxicity (tox), excluding Gr 3 hypersensitivity, hypertension, injection-site reaction, arthralgia/myalgia, asthenia/fatigue, diarrhea w/out loperamide/nausea/vomiting w/out antiemetic and transient aminotransferase elevation. SD tox=delay >1 week in ramucirumab (RAM) dose or omission of 1 dose of RAM or 2 paclitaxel doses due to tox in Cy 1 or delay >2 weeks between Cy 1 and Cy 2 due to persistent tox.
Number of Participants With Adverse Events (AEs)
The number of participants who experienced AEs of any grade, AEs of Grade ≥3 or AEs resulting in death that were considered to be related to ramucirumab [RAM (IMC-1121B)] or paclitaxel (PAC). A summary of serious adverse events (SAEs) and all other non-SAEs, regardless of causality, is located in the Reported Adverse Events module.
Number of Participants With Serious Adverse Events (SAEs)
The number of participants who experienced SAEs that were considered to be related to ramucirumab [RAM (IMC-1121B)] or paclitaxel (PAC). A summary of SAEs and all other non-SAEs, regardless of causality, is located in the Reported Adverse Events module.
Secondary Outcome Measures
Ramucirumab Maximum Serum Concentration (Cmax) for Cycle 1
Cmax after a single dose of ramucirumab (IMC-1121B).
Serum Anti-Ramucirumab Antibody Assessment (Immunogenicity)
The percentage of participants who were treatment-emergent positive for anti-ramucirumab (IMC-1121B) antibodies.
Ramucirumab Area Under the Concentration Time Curve (AUC) for Cycle 1
AUC from time 0 to infinity (0-∞) after a single dose of ramucirumab (IMC-1121B).
Ramucirumab Half-Life (t1/2) for Cycle 1
Terminal t1/2 (the time it takes for the concentration of ramucirumab (IMC-1121B) in plasma or serum to decline by 50%) after a single dose of ramucirumab (IMC-1121B).
Ramucirumab Clearance (CL) or Cycle 1
CL [the volume of plasma or serum cleared of ramucirumab (IMC-1121B) per unit time] after a single dose of ramucirumab (IMC-1121B).
Ramucirumab Steady State Volume of Distribution (Vss) for Cycle 1
Vss [distribution of ramucirumab (IMC-1121B) in the body at steady state] after a single dose of ramucirumab (IMC-1121B).
Ramucirumab Maximum Serum Concentration (Cmax) for Cycle 2
Cmax after multiple doses of ramucirumab (IMC-1121B).
Ramucirumab Area Under the Concentration Time Curve (AUC) for Cycle 2
AUC within the dosing interval (0-τ) after multiple doses of ramucirumab (IMC-1121B).
Ramucirumab Half-Life (t1/2) for Cycle 2
Terminal t1/2 [the time it takes for the concentration of ramucirumab (IMC-1121B) in plasma or serum to decline by 50%] after multiple doses of ramucirumab(IMC-1121B).
Ramucirumab Clearance (CL) for Cycle 2
CL [the volume of plasma or serum cleared of ramucirumab (IMC-1121B) per unit time] at steady state after multiple doses of ramucirumab (IMC-1121B).
Ramucirumab Steady State Volume of Distribution (Vss) for Cycle 2
Vss [distribution of ramucirumab (IMC-1121B) in in the body at steady state] is not calculated for multiple doses of ramucirumab (IMC-1121B).
Ramucirumab Maximum Serum Concentration (Cmax) for Cycle 3
Due to sparse pharmacokinetic sampling ramucirumab (IMC-1121B) Cmax could not be calculated in Cycle 3.
Ramucirumab Area Under the Concentration Time Curve (AUC) for Cycle 3
Due to the sparse pharmacokinetic sampling ramucirumab (IMC-1121B) AUC within the dosing interval (0-τ) could not be calculated in Cycle 3.
Ramucirumab Half-Life (t 1/2) for Cycle 3
Due to sparse pharmacokinetic sampling ramucirumab (IMC-1121B) t1/2 could not be calculated in Cycle 3.
Ramucirumab Clearance (CL) for Cycle 3
Due to sparse pharmacokinetic sampling CL could not be calculated for ramucirumab (IMC-1121B) in Cycle 3.
Ramucirumab Steady State Volume of Distribution (Vss) for Cycle 3
Due to sparse pharmacokinetic sampling Vss for ramucirumab (IMC-1121B) could not be calculated in Cycle 3.
Ramucirumab Maximum Serum Concentration (Cmax) for Cycle 4
Due to sparse pharmacokinetic sampling ramucirumab (IMC-1121B) Cmax could not be calculated in Cycle 4.
Ramucirumab Area Under the Concentration Time Curve (AUC) for Cycle 4
Due to sparse pharmacokinetic sampling AUC within the dosing interval (0-τ) for ramucirumab (IMC-1121B) could not be calculated in Cycle 4.
Ramucirumab Half-Life (t 1/2) for Cycle 4
Due to sparse pharmacokinetic sampling t1/2 for ramucirumab (IMC-1121B) could not be calculated in Cycle 4.
Ramucirumab Clearance (CL) for Cycle 4
Due to sparse pharmacokinetic sampling CL for ramucirumab (IMC-1121B) could not be calculated in Cycle 4.
Ramucirumab Steady State Volume of Distribution (Vss) for Cycle 4
Due to sparse pharmacokinetic sampling Vss for ramucirumab (IMC-1121B) could not be calculated in Cycle 4.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01253525
Brief Title
Study of Weekly Paclitaxel With Ramucirumab in Participants With Advanced Gastric Adenocarcinomas
Official Title
A Phase 1b Study of Weekly Paclitaxel With Ramucirumab (IMC-1121B) Drug Product in Patients With Advanced Gastric Adenocarcinomas
Study Type
Interventional
2. Study Status
Record Verification Date
May 2014
Overall Recruitment Status
Completed
Study Start Date
November 2010 (undefined)
Primary Completion Date
October 2011 (Actual)
Study Completion Date
October 2011 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eli Lilly and Company
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Investigate the safety and tolerability of ramucirumab (IMC-1121B) drug product (DP) in combination with paclitaxel.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adenocarcinoma
Keywords
Adenocarcinoma, Gastroesophageal Junction
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ramucirumab (IMC-1121B ) and Pacitaxel
Arm Type
Experimental
Arm Description
Each treatment cycle is 4 weeks (28 days)
Intervention Type
Biological
Intervention Name(s)
Ramucirumab (IMC-1121B )
Other Intervention Name(s)
LY3009806, IMC-1121B
Intervention Description
8 milligrams/kilogram (mg/kg) intravenously on Days 1 and 15 of each 28-ay cycle
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Intervention Description
80 milligram/square meter (mg/m2) intravenously Days 1, 8, and 15 of each 28 day cycle
Primary Outcome Measure Information:
Title
Number of Participants With a Dose-Limiting Toxicity (DLT) During Cycle 1
Description
DLT based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCICTCAE v4.02) in Cycle (Cy) 1 due to study drug (SD) with (w/): Grade (Gr) ≥3 neutropenia w/fever ≥38.5°C or w/bacteremia or sepsis, thrombocytopenia w/bleeding and platelet substitution, prothrombin and/or partial thromboplastin time w/no anticoagulation, hyperbilirubinemia; Gr 4: neutropenia >5 days, thrombocytopenia, Gr 4 or uncontrollable hypertension QTc>500 milliseconds (ms) or increase ≥100 ms increase in 24 hours after SD or significant arrhythmia in this period; Gr ≥3 nonhematologic toxicity (tox), excluding Gr 3 hypersensitivity, hypertension, injection-site reaction, arthralgia/myalgia, asthenia/fatigue, diarrhea w/out loperamide/nausea/vomiting w/out antiemetic and transient aminotransferase elevation. SD tox=delay >1 week in ramucirumab (RAM) dose or omission of 1 dose of RAM or 2 paclitaxel doses due to tox in Cy 1 or delay >2 weeks between Cy 1 and Cy 2 due to persistent tox.
Time Frame
Cycle 1 of 28-day cycle
Title
Number of Participants With Adverse Events (AEs)
Description
The number of participants who experienced AEs of any grade, AEs of Grade ≥3 or AEs resulting in death that were considered to be related to ramucirumab [RAM (IMC-1121B)] or paclitaxel (PAC). A summary of serious adverse events (SAEs) and all other non-SAEs, regardless of causality, is located in the Reported Adverse Events module.
Time Frame
Up to 47 weeks post baseline
Title
Number of Participants With Serious Adverse Events (SAEs)
Description
The number of participants who experienced SAEs that were considered to be related to ramucirumab [RAM (IMC-1121B)] or paclitaxel (PAC). A summary of SAEs and all other non-SAEs, regardless of causality, is located in the Reported Adverse Events module.
Time Frame
Up to 47 weeks post baseline
Secondary Outcome Measure Information:
Title
Ramucirumab Maximum Serum Concentration (Cmax) for Cycle 1
Description
Cmax after a single dose of ramucirumab (IMC-1121B).
Time Frame
Cycle 1 Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Serum Anti-Ramucirumab Antibody Assessment (Immunogenicity)
Description
The percentage of participants who were treatment-emergent positive for anti-ramucirumab (IMC-1121B) antibodies.
Time Frame
Cycle 1 through Cycle 5 (28-day cycles)
Title
Ramucirumab Area Under the Concentration Time Curve (AUC) for Cycle 1
Description
AUC from time 0 to infinity (0-∞) after a single dose of ramucirumab (IMC-1121B).
Time Frame
Cycle 1 Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Half-Life (t1/2) for Cycle 1
Description
Terminal t1/2 (the time it takes for the concentration of ramucirumab (IMC-1121B) in plasma or serum to decline by 50%) after a single dose of ramucirumab (IMC-1121B).
Time Frame
Cycle 1: Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Clearance (CL) or Cycle 1
Description
CL [the volume of plasma or serum cleared of ramucirumab (IMC-1121B) per unit time] after a single dose of ramucirumab (IMC-1121B).
Time Frame
Cycle 1: Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Steady State Volume of Distribution (Vss) for Cycle 1
Description
Vss [distribution of ramucirumab (IMC-1121B) in the body at steady state] after a single dose of ramucirumab (IMC-1121B).
Time Frame
Cycle 1: Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Maximum Serum Concentration (Cmax) for Cycle 2
Description
Cmax after multiple doses of ramucirumab (IMC-1121B).
Time Frame
Cycle 2: Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Area Under the Concentration Time Curve (AUC) for Cycle 2
Description
AUC within the dosing interval (0-τ) after multiple doses of ramucirumab (IMC-1121B).
Time Frame
Cycle 2: Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Half-Life (t1/2) for Cycle 2
Description
Terminal t1/2 [the time it takes for the concentration of ramucirumab (IMC-1121B) in plasma or serum to decline by 50%] after multiple doses of ramucirumab(IMC-1121B).
Time Frame
Cycle 2: Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Clearance (CL) for Cycle 2
Description
CL [the volume of plasma or serum cleared of ramucirumab (IMC-1121B) per unit time] at steady state after multiple doses of ramucirumab (IMC-1121B).
Time Frame
Cycle 2: Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Steady State Volume of Distribution (Vss) for Cycle 2
Description
Vss [distribution of ramucirumab (IMC-1121B) in in the body at steady state] is not calculated for multiple doses of ramucirumab (IMC-1121B).
Time Frame
Cycle 2: Pre-infusion, Days 1, 2, 3, 5, 8, 12, and 15 of 28-day cycle
Title
Ramucirumab Maximum Serum Concentration (Cmax) for Cycle 3
Description
Due to sparse pharmacokinetic sampling ramucirumab (IMC-1121B) Cmax could not be calculated in Cycle 3.
Time Frame
Cycle 3: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Area Under the Concentration Time Curve (AUC) for Cycle 3
Description
Due to the sparse pharmacokinetic sampling ramucirumab (IMC-1121B) AUC within the dosing interval (0-τ) could not be calculated in Cycle 3.
Time Frame
Cycle 3: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Half-Life (t 1/2) for Cycle 3
Description
Due to sparse pharmacokinetic sampling ramucirumab (IMC-1121B) t1/2 could not be calculated in Cycle 3.
Time Frame
Cycle 3: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Clearance (CL) for Cycle 3
Description
Due to sparse pharmacokinetic sampling CL could not be calculated for ramucirumab (IMC-1121B) in Cycle 3.
Time Frame
Cycle 3: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Steady State Volume of Distribution (Vss) for Cycle 3
Description
Due to sparse pharmacokinetic sampling Vss for ramucirumab (IMC-1121B) could not be calculated in Cycle 3.
Time Frame
Cycle 3: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Maximum Serum Concentration (Cmax) for Cycle 4
Description
Due to sparse pharmacokinetic sampling ramucirumab (IMC-1121B) Cmax could not be calculated in Cycle 4.
Time Frame
Cycle 4: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Area Under the Concentration Time Curve (AUC) for Cycle 4
Description
Due to sparse pharmacokinetic sampling AUC within the dosing interval (0-τ) for ramucirumab (IMC-1121B) could not be calculated in Cycle 4.
Time Frame
Cycle 4: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Half-Life (t 1/2) for Cycle 4
Description
Due to sparse pharmacokinetic sampling t1/2 for ramucirumab (IMC-1121B) could not be calculated in Cycle 4.
Time Frame
Cycle 4: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Clearance (CL) for Cycle 4
Description
Due to sparse pharmacokinetic sampling CL for ramucirumab (IMC-1121B) could not be calculated in Cycle 4.
Time Frame
Cycle 4: Pre-infusion, Day 1 of 28-day cycle
Title
Ramucirumab Steady State Volume of Distribution (Vss) for Cycle 4
Description
Due to sparse pharmacokinetic sampling Vss for ramucirumab (IMC-1121B) could not be calculated in Cycle 4.
Time Frame
Cycle 4: Pre-infusion, Day 1 of 28-day cycle
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Has a histopathologically or cytologically confirmed diagnosis of gastric or gastroesophageal junction (GEJ) adenocarcinoma
Has an advanced or metastatic solid gastric adenocarcinoma that has failed standard therapy
Has resolution of all clinically significant toxic effects of prior therapy, surgery, treatment with an investigational agent or device, treatment monoclonal antibody or small molecule, and radiotherapy or chemotherapy.
Has adequate organ function
Eligible participants of reproductive potential (both sexes) agree to use adequate contraceptive methods (hormonal or barrier methods) during the study period and for 12 weeks after the last dose of study medication
Exclusion Criteria:
Has undergone major surgery within 28 days prior to the study, or subcutaneous venous access device placement within 7 days prior to the study registration date
Has elective or planned surgery to be conducted during the trial
Has had treatment with an investigational agent or device, an antineoplastic small molecule, or antineoplastic radiotherapy or chemotherapy
Was previously treated with a chemotherapy regimen containing nitrosoureas or mitomycin C
Has had treatment with an antineoplastic monoclonal antibody within 8 weeks prior to the study registration date
Has a history of deep vein thrombosis, pulmonary embolism, or any other significant thromboembolism prior to the study registration date
Has experienced any arterial thrombotic event, including myocardial infarction, cerebrovascular accident, or transient ischemic attack, within 6 months prior to the study date
Is receiving therapeutic anticoagulation with warfarin, low-molecular weight heparin or similar agents. (Participants receiving prophylactic, low-dose anticoagulation therapy are eligible provided that the coagulation parameters International Normalized Ratio (INR) ≤ 1.5, prothrombin time (PT) and partial thromboplastin time (PTT) or - Is receiving chronic therapy with nonsteroidal anti-inflammatory agents [Aspirin use at doses up to 325 milligrams/day (mg/day) is permitted]
Has significant bleeding disorders, vasculitis, history of postoperative bleeding complications, hemoptysis or had a significant bleeding episode from the gastrointestinal (GI) tract within 3 months prior to the study date
Has a history of GI perforation and/or fistulae within 6 months prior to the study date
Has symptomatic congestive heart failure, unstable angina pectoris, or symptomatic or poorly controlled cardiac arrhythmia
Has uncontrolled arterial hypertension despite standard medical management.
Has a serious or nonhealing wound or peptic ulcer or bone fracture within 28 days prior to the study date
Has a bowel obstruction, history or presence of inflammatory enteropathy or extensive intestinal resection, Crohn's disease, ulcerative colitis, or chronic diarrhea
Has a serious illness or medical condition(s)
Is pregnant or lactating
Has received treatment with another investigational drug or participation in another interventional clinical trial within 28 days prior to the study date
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST)
Organizational Affiliation
Eli Lilly and Company
Official's Role
Study Director
Facility Information:
Facility Name
ImClone Investigational Site
City
Chiba
ZIP/Postal Code
277-8577
Country
Japan
Facility Name
ImClone Investigational Site
City
Osaka
ZIP/Postal Code
569-8686
Country
Japan
Facility Name
ImClone Investigational Site
City
Osaka
ZIP/Postal Code
589-5811
Country
Japan
12. IPD Sharing Statement
Citations:
PubMed Identifier
25888272
Citation
Ueda S, Satoh T, Gotoh M, Gao L, Doi T. A phase ib study of safety and pharmacokinetics of ramucirumab in combination with paclitaxel in patients with advanced gastric adenocarcinomas. Oncologist. 2015 May;20(5):493-4. doi: 10.1634/theoncologist.2014-0440. Epub 2015 Apr 17.
Results Reference
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Study of Weekly Paclitaxel With Ramucirumab in Participants With Advanced Gastric Adenocarcinomas
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