절제 불가능한 진행성, 전이성 또는 재발성 담도암 성인 환자에서 파클리탁셀과 CTX-009 병용요법에 대한 연구
이전에 전신 화학 요법을 한 번 받은 적이 있는 절제 불가능한 진행성, 전이성 또는 재발성 담도암이 있는 성인 환자를 대상으로 한 CTX-009와 파클리탁셀 병용 대 파클리탁셀 단독의 2/3상 무작위 대조 연구
This is a multi-center, open-label, randomized, phase 2/3 trial of the bispecific antibody CTX-009 plus paclitaxel versus paclitaxel in patients with previously treated, unresectable advanced or metastatic biliary tract cancers.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
연구 유형
연구 유형
등록 (실제)
등록
단계
단계
- 2 단계
- 3단계
연락처 및 위치
연구 장소
-
-
Arizona
-
Phoenix, Arizona, 미국, 85054
- Mayo Clinic Arizona
-
Tucson, Arizona, 미국, 85724-5024
- University of Arizona
-
-
California
-
Los Angeles, California, 미국, 90033
- University of Southern California Norris Comprehensive Cancer Center
-
Palo Alto, California, 미국, 94305
- Stanford Medicine Cancer Center
-
San Francisco, California, 미국, 94143-1770
- University of California San Francisco
-
-
Colorado
-
Aurora, Colorado, 미국, 80012
- Rocky Mountain Cancer Centers, LLP
-
-
Florida
-
Gainesville, Florida, 미국, 32611
- University of Florida
-
Jacksonville, Florida, 미국, 32224
- Mayo Clinic Jacksonville
-
Orlando, Florida, 미국, 32804
- AdventHealth Orlando
-
-
Illinois
-
Chicago, Illinois, 미국, 60611
- Northwestern University
-
Chicago, Illinois, 미국, 60637
- University of Chicago
-
-
Louisiana
-
New Orleans, Louisiana, 미국, 70121
- Ochsner Clinic Foundation
-
-
Maryland
-
Baltimore, Maryland, 미국, 21287
- Johns Hopkins University
-
-
Massachusetts
-
Boston, Massachusetts, 미국, 02141
- Massachusetts General Hospital
-
-
Minnesota
-
Rochester, Minnesota, 미국, 55905
- Mayo Clinic Rochester
-
-
Missouri
-
St Louis, Missouri, 미국, 63110
- Washington University School of Medicine, Siteman Cancer Center
-
-
New Jersey
-
New Brunswick, New Jersey, 미국, 08854
- Rutgers Cancer Institute
-
-
New Mexico
-
Albuquerque, New Mexico, 미국, 87131
- The University of New Mexico
-
Las Cruces, New Mexico, 미국, 88011
- Memorial Medical Center
-
-
New York
-
Buffalo, New York, 미국, 14263
- Roswell Park
-
New York, New York, 미국, 10032
- Columbia University
-
The Bronx, New York, 미국, 10461
- Montefiore Medical Center
-
-
Ohio
-
Canton, Ohio, 미국, 44718
- Gabrail Cancer Center
-
Cleveland, Ohio, 미국, 44195
- Cleveland Clinic
-
-
Tennessee
-
Knoxville, Tennessee, 미국, 37920
- University of Tennessee Medical Center
-
Nashville, Tennessee, 미국, 37203
- SCRI Oncology Partners
-
-
Texas
-
Austin, Texas, 미국, 78705
- Texas Oncology - Austin
-
Dallas, Texas, 미국, 75246
- Texas Oncology - Baylor Charles A. Sammons Cancer Center
-
Denison, Texas, 미국, 75020
- Texas Oncology - Dension
-
Houston, Texas, 미국, 77030
- The University of Texas MD Anderson Cancer Center
-
San Antonio, Texas, 미국, 78217
- Texas Oncology - San Antonio
-
Tyler, Texas, 미국, 75702
- Texas Oncology - Northeast Texas
-
-
Washington
-
Seattle, Washington, 미국, 98101
- Virginia Mason Franciscan Health
-
Vancouver, Washington, 미국, 98684
- Northwest Cancer Specialists, P.C.
-
-
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
INCLUSION CRITERIA
-
18 years of age or older
-
Histologically or cytologically confirmed unresectable advanced, metastatic, or recurrent biliary tract cancers (including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder cancer, and ampullary carcinoma)
-
Patients must have radiologically documented progression after a prior gemcitabine and platinum containing chemotherapy regimen as first line therapy for locally advanced unresectable or metastatic disease.
- Patients who received perioperative treatment (adjuvant and neoadjuvant) may be eligible, as determined by the Sponsor Medical Monitor.
- Patients whose first line regimen was modified due to toxicity before disease progression, may be eligible, as determined by the Sponsor Medical Monitor.
-
At least one lesion measurable as defined by RECIST v1.1
-
Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1
-
Predicted life expectancy of at least 12 weeks
-
No evidence of ongoing infection and adequate biliary excretion or patients whose adequate biliary excretion can be confirmed with the following procedures:
- Patients who underwent endoscopic retrograde biliary drainage (ERBD) at least 1 week before the investigational drug treatment
- Patients with endobiliary stents are eligible, provided there is no evidence of obstruction
- Patients free of any signs of active or suspected uncontrolled infection after a drainage procedure
- Patients free of any risk of hemorrhage and with incision completely healed
-
Adequate bone marrow, hepatic, and renal function within 14 days of randomization as described below. (Patient must be free of G-CSF treatment and blood transfusion within 14 days prior to the lab test):
- Absolute neutrophil count (ANC) ≥ 1,500/mm3
- Hemoglobin ≥ 9.0 g/dL
- Platelet count ≥ 100,000/mm3
- Total bilirubin ≤ 1.5 X ULN
- AST/ALT ≤ 3.0 X ULN (≤5 X ULN in case of hepatic metastasis)
- Estimated creatinine clearance ≥ 30 mL/min based on Cockcroft-Gault
- Urine protein ≤ 1+ by Dipstick (Only when urinalysis shows a protein dipstick result of > 1 positive (+), the total protein volume (<1.0 g/24hr) can be confirmed with a 24-hour urine test.)
- Serum amylase and lipase level ≤ 3X ULN
- Serum Albumin ≥ 3.0 g/dL
-
Female patients who are women of childbearing potential (WCBP) must have a negative pregnancy test (serum-hCG or urine-hCG performed at the Investigator's discretion) within 14 days of randomization
-
Female patients must be surgically sterile (or have a monogamous partner who is surgically sterile) or be at least 2 years postmenopausal or commit to use 2 acceptable forms of birth control (defined as the use of an intrauterine device (IUD), a barrier method with spermicide, condoms, or any form of hormonal contraceptives) or abstinence for the duration of the study and for 6 months following the last dose of study treatment. Male patients must be sterile (biologically or surgically) or commit to the use of a reliable method of birth control (condoms with spermicide) for the duration of the study and for 6 months following the last dose of study treatment.
-
Signed and dated Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved Informed Consent Form (ICF) before any protocol-directed screening procedures are performed
EXCLUSION CRITERIA
-
Patients who are eligible to be treated with a molecularly targeted therapy on a labelled regimen after receiving first-line chemotherapy. Patients who received a molecularly targeted therapy as part of their first line treatment may be eligible, as determined by the Sponsor Medical Monitor.
-
From the time point of screening,
- Less than 4 weeks have elapsed since patients had a surgery or major procedure
- Less than 2 weeks have elapsed from the last treatment date since patients had any radiation therapy
-
Patients with percutaneous transhepatic biliary drains (PTBD)
-
Prior to the initial treatment of study drug,
- Less than 2 weeks have elapsed since patients had chemotherapy or hormone therapy
- Less than 2 weeks have elapsed since patients had anticancer immunotherapy or investigational drug treatment
- Less than 4 weeks since cryotherapy, radiofrequency ablation, anhydrous alcohol therapy, or photodynamic therapy, including TACE and TARE
-
A history of the following cardiovascular diseases (please, consult the Sponsor Medical Monitor for a case by case evaluation):
- Congestive heart failure (CHF) that corresponds to Class II or a higher class under New York Heart Association (NYHA) classification, or less than 50% of left ventricular ejection fraction (LVEF)
- Uncontrolled hypertension (SBP/DBP >140/90 mmHg) (e.g., patient with SBP/DBP >140/90 mmHg despite the best care including optimizing the anti-hypertensive medication regimen)
- Patients with any history of hypertensive crisis or pre-existing hypertensive encephalopathy
- Pulmonary hypertension
- Myocardial infarction
- Uncontrolled arrhythmia
- Unstable angina
- Patients with any significant vascular diseases (e.g., aortic aneurysm requiring surgery or recent peripheral artery thrombosis) within 6 months prior to the initial treatment of the investigational product
-
History of hypersensitivity reactions to any components of the investigational product or other drugs of the same class (humanized/human monoclonal antibody drugs) or paclitaxel
-
Patients with contraindications to paclitaxel therapy
-
Patients with persistent, clinically significant toxicities (excluding hair loss) from previous anticancer treatment that corresponds to Grade 2 or a higher grade under NCI-CTCAE v5.0
-
Symptomatic or uncontrolled central nervous system (CNS) metastasis (However, patients with asymptomatic CNS metastasis that have been treated with either surgery or radiation can participate provided that systemic corticosteroid treatment was discontinued at least 4 weeks prior to screening and that the patient is radiologically and neurologically stable or improving)
-
A history of the following hemorrhage-related or gastroenterological disease:
- Active hemorrhage, hemorrhagic diathesis, coagulopathy or tumor in great arteries
- History of clinically significant gastroenterological disease, such as peptic ulcer, GI bleeding, GI or non-GI fistula, perforation, abdominal abscess, clinical symptoms, and signs of GI obstruction, need for parenteral hydration or nutrition, or inflammatory bowel disease (IBD)
-
Current or recent (within 10 days prior to study treatment) use of full-dose oral or parenteral anticoagulants or thrombolytic agents for therapeutic (as opposed to prophylactic) purpose will be excluded.
a. Prophylactic (i.e., for the patency of venous access devices) use of low molecular weight heparin (i.e., enoxaparin 40 mg/day) is allowed if patient has INR < 2 or aPTT </=2x ULN within 14 days of study treatment
-
Patients with current or recent (within 10 days of study treatment) use of aspirin (>81 mg/day), or other nonsteroidal anti-inflammatory drugs (NSAIDs), or other antiplatelets (i.e., dipyramidole, ticlopidine, clopidogrel, and cilostazol) will be excluded.
-
Severe infection requiring ongoing systemic antibiotics, antivirus drugs, etc., or other uncontrolled acute active infectious diseases
-
Patients with evidence of active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. Patients with positive HBsAg and/or detectable HBV DNA are eligible only if adequately controlled on antiviral therapy according to institutional standards and liver function eligibility criteria are also met. HCV patients showing sustained viral response or patients with immunity to HBV infection may enroll.
-
Patients with other severe diseases or uncontrolled illnesses that warrant the exclusion from the study (permitted only if medically controlled) including but not limited to:
- Pre-existing hemoptysis (≥ 1/2 teaspoon of bright red blood per episode) within 28 days prior to screening
- Major, unhealed injury, active ulcer, or untreated fracture
- Pre-existing conditions of cerebrovascular incident (ischemic or hemorrhagic stroke), transient ischemic attack or subarachnoid hemorrhage within 6 months prior to screening.
- Moderate to severe ascites and/or pleural effusion. However, enrollment is permitted for patients with ascitic fluid as long as paracentesis is not required to improve the condition.
- Interstitial lung disease or pulmonary fibrosis
-
Patients expected to require anticancer treatment other than the investigational product during the clinical study
-
Pregnant or lactating patients, or patients planning to become pregnant during the clinical study
-
A history of primary malignancy other than BTC will be excluded, except for malignancies with a negligible risk of metastasis or death (e.g., 5-year OS rate >90%). Prior malignancy history will be evaluated on a case-by-case basis by the Sponsor Medical Monitor.
-
Clinically significant abnormal ECG findings or history determined as clinically significant by the Investigator
-
QT interval (Fridericia's formula) (QTcF) interval > 450msec at the time of screening
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
팔의 수
무기와 개입
참가자 그룹 / 팔참가자 그룹 / 팔 |
개입 / 치료개입 / 치료 |
|---|---|
|
실험적: CTX-009 플러스 파클리탁셀
|
IV infusion on day 1 and 14 of every 28 day cycle IV infusion on day 1, 8, and 15 of every 28 day cycle |
|
활성 비교기: Paclitaxel
Patients randomized to receive paclitaxel only have the option to crossover to the CTX-009 plus paclitaxel arm after documented disease progression per RECIST v1.1. |
IV infusion on day 1, 8, and 15 of every 28 day cycle |
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Best Overall Response
기간: From randomization to treatment discontinuation for any reason, average 6 months
|
Percentage of patients whose Best Overall Response (BOR) is assessed as Complete Response (CR) or Partial Response (PR). Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT or MRI: CR: disappearance of all target lesions; PR: >=30% decrease in the sum of the longest diameter of target lesions. |
From randomization to treatment discontinuation for any reason, average 6 months
|
2차 결과 측정
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Progression Free Survival
기간: From randomization to first documented objective PD or death if PD does not occur, average 6 months
|
Time from randomization until the date of objective PD or the date of death (by any cause in the absence of disease progression). Progression of diseases is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. |
From randomization to first documented objective PD or death if PD does not occur, average 6 months
|
|
Duration of Response
기간: From first confirmed CR or PR to confirmed PD, average 6 months
|
Time from the CT or MRI that first confirmed complete (CR) or partial response PR) to the CT or MRI that first confirmed progression of disease progression (PD). Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT or MRI: CR: disappearance of all target lesions; PR: >=30% decrease in the sum of the longest diameter of target lesions; PD = 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. |
From first confirmed CR or PR to confirmed PD, average 6 months
|
|
Overall Survival
기간: From randomization to death from any cause, average 12 months
|
Time from randomization until the date of death by any cause. Patients who are still alive at the time of the analysis, or who have become lost to follow-up or withdrawn consent will be censored at their last date known to be alive |
From randomization to death from any cause, average 12 months
|
|
Disease Control Rate
기간: From randomization to treatment discontinuation for any reason, average 6 months
|
Percentage of all treated patients whose best overall response was complete response (CR), partial response (PR), or stable disease (SD) for a minimum of 6 weeks. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT or MRI: CR: disappearance of all target lesions; PR: >=30% decrease in the sum of the longest diameter of target lesions; SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease. |
From randomization to treatment discontinuation for any reason, average 6 months
|
|
Incidence of Treatment Emergent Adverse Events (TEAEs) and changes in clinical abnormalities
기간: From the first dose of either study drug to 30 days after the last dose of study treatment, average 7 months
|
TEAE is defined by occurrence of an adverse event that started or worsened in severity on or after the first dose of CTX-009 or paclitaxel through 30 days after the last dose of CTX-009 or paclitaxel. Change in clinical abnormalities is defined as an increase in abnormality grade in a laboratory result, vital sign, or ECG parameter from predose result to worst postdose result (graded according to the Common Terminology Criteria for Adverse Events v5.0 for all analytes except for brain natriuretic peptide and troponin subtypes, which are interpreted in reference to the laboratory reference range for each), a post-baseline potentially clinically significant vital sign abnormality, or a post-baseline potentially clinically significant ECG abnormality. |
From the first dose of either study drug to 30 days after the last dose of study treatment, average 7 months
|
|
Efficacy of CTX-009 in combination with paclitaxel in patients who crossed over from the paclitaxel only arm
기간: From the first dose of CTX-009 following crossover to the subsequent radiographic progression confirmed by the ICR or death, whichever occurs first
|
Evaluation of ORR, DCR and progression free survival 2 (PFS2) in the crossover set (COS). PFS2 is defined as the time from the first dose of CTX-009 following crossover to the subsequent radiographic progression confirmed by the ICR or death, whichever occurs first |
From the first dose of CTX-009 following crossover to the subsequent radiographic progression confirmed by the ICR or death, whichever occurs first
|
|
Quality of Life (QoL)
기간: From randomization to treatment discontinuation for any reason, average 6 months
|
Changes in QoL scores, as measured using the EORTC QLQ-C30 and BIL21, from baseline in patients treated with CTX-009 in combination with paclitaxel vs. paclitaxel alone |
From randomization to treatment discontinuation for any reason, average 6 months
|
공동 작업자 및 조사자
수사관
수사관
- 연구 책임자: Cynthia Sirard, MD, Compass Therapeutics
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
기타 연구 ID 번호
- CTX-009-002
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .