Study of TKI 258 in Combination With Xeloda and Oxaliplatin in Advanced Colorectal and Gastric Cancer

A Phase 1 Study of TKI 258 in Combination With Xeloda and Oxaliplatin in Upfront Treatment of Advanced Colorectal and Gastric Cancer With a Dose Expansion Cohort in Advanced Gastric Cancer

Standard "3+3" dose escalation design of TKI258/XELOX in advanced gastric/gastro-oesophageal and colorectal cancer.

Study Overview

• Status: Terminated
• Conditions: Gastric Cancer; Colorectal Cancer
• Intervention / Treatment: Drug: Xeloda,; Drug: Oxaliplatin; Drug: TKI258

Detailed Description

This is a "3+3" dose escalation design with 4 pre-defined TKI258 dose levels (200mg, 300mg, 400mg and 500mg daily with 5 days on and 2 days off schedule) in combination with a fixed standard dose of XELOX (Capecitabine and Oxaliplatin) to establish the recommended phase 2 dose.

• Study Type: Interventional
• Enrollment (Actual): 3
• Phase: Phase 1

Contacts and Locations

Study Locations

• Singapore
  • Singapore, Singapore
    • National Cancer Centre Singapore

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Patients must have histologically confirmed gastric, gastro-oesophageal or colorectal adenocarcinoma.
2. The gastric or gastro-oesophageal cancer must be locally advanced unresectable or metastatic. Colorectal cancer must be metastatic and for which subsequent resection of all metastatic disease is assessed not to be feasible.
3. Age >18 years.
4. Eastern Cooperative Oncology Group (ECOG) performance status <2 (Karnofsky >60%, see Appendix A).
5. Life expectancy of greater than 3 months

6. Patients must have normal organ and marrow function as defined below:

   • leukocytes >3,000/mcL
   • absolute neutrophil count >1,500/microliter (mcL) TKI258/XELOX phase 1 protocol version 3.3 Dated 30 November 2011 1 3
   • platelets >100,000/mcL
   • total bilirubin <= 1.5 x upper limit of normal (ULN)
   • aspartate aminotransferase (AST)/alanine aminotransferase (ALT) <2.5 X institutional upper limit of normal
   • creatinine within normal institutional limits OR
   • creatinine clearance >55 mL/min for patients with creatinine levels above institutional normal.
7. The effects of TKI258 and XELOX on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
8. Baseline left ventricular ejection fraction (LVEF) >= 50%
9. Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

1. Patients are not considered to have a "currently active" malignancy if they have TKI258/XELOX phase 1 protocol version 3.3 Dated 30 November 2011 1 4 completed therapy and are considered to have a less than 30% risk of relapse.
2. Pregnant women are excluded from this study because of the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with TKI258 or XELOX, breastfeeding should be discontinued if the mother is treated with TKI258 or XELOX.
3. Patients with prior history of transient ischemia attack or cerebrovascular disease or prior history of ischemia heart disease or myocardia infarction and 2 or more risk factors: ever smoker with > 30 packs per year exposure or on medication for diabetes mellitus or hypertension or hyperlipidemia.

4. In addition for the Beginning at dose expansion cohort, the following exclusion criteria apply:

   • Patients who are not agreeable for collection of tumor tissue for correlative studies
   • Patients from whom tumor tissue for correlative studies cannot be safely obtained.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: TKI258 combined with Xeloda/Oxaliplatin; TKI258 200 mg once a day (OD) 5 days on/2 days off Capecitabine (Xeloda) 2000 mg/m2 bid d1-14 Oxaliplatin 130mg/m2 d1 q21days	Drug: Xeloda,; Capecitabine (xeloda): 2000mg/m2, twice a day on Day 1-14; Other Names: capecitabine; Drug: Oxaliplatin; Oxaliplatin: 130mg/m2 day 1 every 21days; Drug: TKI258; 4 dose levels of TKI258: 200mg, 300mg, 400mg, 500mg once daily, 5days on and 2 days off;

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Determine the recommended phase 2 dose of TKI258 in combination with XELOX (Capecitabine and Oxaliplatin)	42 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Describe the toxic effects of TKI258 when administered in combination with XELOX chemotherapy.	Toxicity will be graded using CTCAE version 4.0	one year
Measure the Area under the plasma concentration versus time curve (AUC) of TKI258 at specific timepoints		42 days

Collaborators and Investigators

• Sponsor: National Cancer Centre, Singapore
• Collaborators: Novartis
• Investigators: Principal Investigator: Iain BH Tan, Dr, National Cancer Centre, Singapore

Study record dates

Study Major Dates

• Study Start: September 1, 2011
• Primary Completion (Actual): January 1, 2012
• Study Completion (Actual): January 1, 2012

Study Registration Dates

• First Submitted: May 14, 2012
• First Submitted That Met QC Criteria: March 25, 2016
• First Posted (Estimate): March 28, 2016

Study Record Updates

• Last Update Posted (Estimate): March 28, 2016
• Last Update Submitted That Met QC Criteria: March 25, 2016
• Last Verified: March 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms; Neoplasms by Site; Gastrointestinal Neoplasms; Digestive System Neoplasms; Gastrointestinal Diseases; Stomach Diseases; Stomach Neoplasms; Molecular Mechanisms of Pharmacological Action; Antimetabolites, Antineoplastic; Antimetabolites; Antineoplastic Agents; Capecitabine; Oxaliplatin
• Other Study ID Numbers: NCC 10-03

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No