MEK162 in Combination With Capecitabine in Advanced Biliary Tract Cancer
Phase Ib Study of MEK162 in Combination With Capecitabine in Gemcitabine-pretreated Advanced Biliary Tract Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Biliary tract cancer is one of rare cancers, which is relatively more frequent in east Asia. The frequency of KRAS mutation and/or BRAF mutation is reported at 40 to 60%. The prognosis is still very poor, with only limited treatment options. The most commonly used 1st-line chemotherapy is gemcitabine+cisplatin combination. In gemcitabine-pretreated advanced biliary tract cancer, fluoropyrimidine-based chemotherapy is used. However, the overall survival with these cytotoxic chemotherapies is still only about 8-10 months, calling for urgent development of efficient treatment options.
Recently, mitogen-activated extracellular signal regulated kinase kinase (MEK) inhibition was shown to have antitumor effects in KRAS mutated biliary tract cancers in preclinical model. In phase II study of MEK inhibitor (selumetinib) in metastatic biliary tract cancers, selumetinib displayed interesting activity and acceptable tolerability.
MEK162 is an oral, highly selective MEK inhibitor. It was shown to promote apoptosis and in vivo antitumor activity against human biliary tract cancer cell lines. So far, there has been no study to test the MEK inhibitor mainly in gemcitabine-pretreated advanced biliary tract cancer, especially in combination of capecitabine chemotherapy.
The aim of this study is to test the efficacy of MEK162 plus capecitabine in gemcitabine-pretreated advanced biliary tract cancer, and to explore the predictive biomarkers for future large-scale clinical trials using this combination.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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Seoul, Korea, Republic of, 110-744
- Seoul National University Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Histologically / cytologically verified, non-resectable, recurrent, or metastatic biliary tract carcinoma including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma and gallbladder carcinoma
- Patients who have previously treated with gemcitabine-based chemotherapy (Prior treatment regimen up to 2 is allowed)
- Patients must have measurable or evaluable disease by RECIST 1.1
- Eastern Eastern Cooperative Oncology Group (ECOG) performance status: 0, 1
- Age ≥ 20 years
- Adequate bone marrow function defined as: Hb ≥ 8 g/dl, absolute neutrophil count (ANC) ≥ 1500/microliter (mcL), Platelets ≥ 100 x10^3/mcL
- Adequate renal function defined as serum creatinine < 1.6 mg/dl and/or measured creatinine clearance from 24-hour urine collection of ≥ 60 ml/min
- Adequate hepatic function defined as total bilirubin ≤ 2 mg/dl, alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ≤ 5 x upper limit of normal (ULN)
- Patients with biliary obstruction can join if bilirubin corrects to required limit after adequate biliary drainage
- Women of childbearing potential must have a negative pregnancy test within 7 days prior to study treatment
- Men and women of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 3 months thereafter
- Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
- Evidence of another active cancer that may influence patient outcome, except for nonmelanoma skin carcinoma, melanoma in-situ, in-situ carcinoma of the cervix curatively treated, treated superficial bladder cancer, and adenocarcinoma of the prostate that has been surgically treated with a post-treatment prostate surface antigen (PSA) that is non-detectable
- Known brain metastases or primary central nervous system tumors with seizures that are not well controlled with standard medical therapy
- Uncontrolled intercurrent illness including, but not limited to psychiatric illness/social situations that would limit compliance with study requirements
- Known HIV positive patient
- Significant cardiovascular disease including congestive heart failure (New York Heart Association Class II or higher) or active angina pectoris
- Uncontrolled diabetes mellitus
- History of a myocardial infarction within 6 months
- History of a stroke or transient ischemic attack within 6 months
- Clinically significant peripheral vascular disease
- Major surgical procedure within 4 weeks
- Uncontrolled infection
- Known or suspected allergy to capecitabine
- Pregnant (positive pregnancy test)
- Breast-feeding should be discontinued if a nursing mother is to be treated on clinical trial
- Any condition that impairs patient's ability to swallow whole pills
- Malabsorption problem that may limit or inhibit the absorption of MEK162
- History of any organ or bone marrow transplant
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Phase 1 part
to assess the maximal tolerated dose (MTD) of MEK162+Capecitabine combination
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In phase 1 part: capecitabine(mg/m2) will be given twice a day, 2 week on/1week off Q 3weeks + MEK162 twice a day, continuously, starting at 1000mg/m2 and 30mg/m2 respectively.
Expansion part will be treated with the dose found at phase 1 part.
Other Names:
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Experimental: Expansion part
to assess the efficacy (PFS) of MEK162+Capecitabine combination
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In phase 1 part: capecitabine(mg/m2) will be given twice a day, 2 week on/1week off Q 3weeks + MEK162 twice a day, continuously, starting at 1000mg/m2 and 30mg/m2 respectively.
Expansion part will be treated with the dose found at phase 1 part.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Maximum tolerated dose (MTD)
Time Frame: 6 months
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MTD in all treated population (Phase 1 part)
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6 months
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Progression-free survival (PFS)
Time Frame: 3 months
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PFS in all treated population (Expansion part)
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3 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dose-limiting Toxicity (DLT)
Time Frame: 6 months
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DLT in all treated population, according to NCI-CTCAE v 4.0 (Phase 1 part)
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6 months
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Recommended Phase 2 Dose (RP2D)
Time Frame: 6 months
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RP2D to be used at Expansion part (Phase 1 part)
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6 months
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Response rate
Time Frame: 6 months
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Response rate in all treated patients (Expansion part)
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6 months
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Overall survival (OS)
Time Frame: 1 year
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OS in all treated patients
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1 year
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- BTC-MEK162
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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