Dose Escalation Study of Gemcitabine and ON 01910.Na in Solid Tumors
|Malignant Neoplasmas Solid Tumors||Drug: gemcitabine Drug: ON 01910.Na||Phase 1|
|Study Design:||Intervention Model: Single Group Assignment
Masking: No masking
Primary Purpose: Treatment
|Official Title:||Phase I Dose Escalation Study of Gemcitabine and ON 01910.Na in Patients With Advanced or Metastatic Solid Tumors|
- Adverse events [ Time Frame: Start of treatment to 30 days after end of treatment. ]Incidence of adverse events, including laboratory parameters, as assessed by NCI CTCAE v3.0.
- Maximum tolerated dose (MTD) of ON 01910.Na [ Time Frame: Escalation phase of protocol. ]MTD will be defined as the highest dose level of ON 01910.Na at which none of the first three patients or no more than one of six patients experienced dose limiting toxicity (DLT) in course 1.
- Pharmacokinetics [ Time Frame: Confirmation phase of protocol. ]Plasma concentration values of ON 01910.Na will be analyzed to determine if gemcitabine has an effect on pharmacokinetic parameters of ON 01910.Na.
- Tumor measurements [ Time Frame: Screening to 30 days after end of treatment. ]Tumors will be measured to determine response according to RECIST criteria.
- Pharmacodynamics, ex vivo [ Time Frame: Confirmation phase of protocol. ]Use tumor tissue obtained by biopsy to assess the pharmacodynamic activity of the ON 01910.Na and gemcitabine combination.
|Study Start Date:||January 2009|
|Study Completion Date:||September 2011|
|Primary Completion Date:||September 2011 (Final data collection date for primary outcome measure)|
|Experimental: gemcitabine and ON 01910.Na||
The dose of gemcitabine will be fixed at 1000 mg/m2 i.v. as a 30 minutes infusion on days 1, 8, and 15 every 28 days.
Other Name: GemzarDrug: ON 01910.Na
The starting dose of ON 01910.Na is 600 mg/m2 as a 2 hour intravenous (i.v.) infusion on days 1, 4, 8, 11, 15 and 18 of a 28-day course. The dose of ON 01910.Na will be escalated in increments in successive cohorts (dose level (DL) 1 = 600 mg/m2, DL 2 = 1200 mg/m2, DL 3 = 1800 mg/m2) of new patients.
Other Name: rigosertib sodium
The order of infusion on Days 1, 8, and 15 will be gemcitabine first, immediately followed by ON 01910.Na. The dose of gemcitabine will be fixed at 1000 mg/m2 i.v. as a 30 minutes infusion on days 1, 8, and 15 every 28 days. The starting dose of ON 01910.Na is 600 mg/m2 as a 2 hour intravenous (i.v.) infusion on days 1, 4, 8, 11, 15 and 18 of a 28-day course. The dose of ON 01910.Na will be escalated in increments in successive cohorts (dose level (DL) 1 = 600 mg/m2, DL 2 = 1200 mg/m2, DL 3 = 1800 mg/m2) of new patients. A course is defined as 4 weeks in length. Toxicity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE v3.0). A minimum of three new patients will be treated at each dose level with a minimum of a 1 week stagger between the dosing of the first and remaining patients in each new dose cohort. In exceptional circumstances (e.g. where there is one slot available in a cohort and two eligible patients have been screened), the Sponsor may allow four patients to enter a cohort (or seven patients to enter an expanded cohort). A DL -1A (ON 01910.Na = 400 mg/m2) is set in case dose de-escalation is required with the starting dose due to ON 01910.Na-related toxicity. A DL -1A gemcitabine = 750 mg/m2 and DL - 1B at 500 mg/m2 are set in case dose de-escalation is required with the starting and subsequent doses due to gemcitabine-related toxicity. If DLT is not observed in the first three patients, then the dose of ON 01910.Na will be increased to the next level (see Section 4.2 for definitions of DLT). If DLT occurs in any of the first three new patients in the first course, at least three additional new patients will be treated. If no further DLT is encountered, dose escalation will proceed. Alternately, if DLT is noted in one or more of three additional patients, dose escalation will be terminated and the MTD will be defined as the highest dose level at which none of the first three patients or no more than one of six patients experienced DLT in course 1. All patients receiving doses exceeding the confirmed MTD will have their dose reduced to the MTD; even if apparently tolerating their current dose. Intra-patient dose escalation of ON 01910.Na will be permitted. There will be no limit to the number of courses that could be administered to a patient who is both tolerating and benefiting from therapy.
A patient will be considered evaluable for the purposes of the dose escalation decision if the patient completes the first course of therapy without missing more than 1 dose of ON 01910.Na for reasons unrelated to toxicity, or if the patient is withdrawn due to a DLT. Non-evaluable patients will be replaced. Escalation to the next dose level will occur only after the third evaluable patient (or sixth, if an expanded cohort), on the previous dose level has been observed for 4 weeks. Dose escalation decisions will be made by a Cohort Review Committee (CRC). Intra-patient dose escalation of ON 01910.Na will be allowed after the third evaluable patient on the next dose level has been observed for 4 weeks with acceptable tolerability (ie, MTD has not been exceeded per criteria above).
Once the MTD has been defined, an expanded cohort of 20 to 23 additional patients (depending if 3 or 6 patients were enrolled on the previous cohort) will be enrolled at the MTD dose level in order to further define the safety and tolerability of this regimen, and characterize the pharmacokinetics of ON 01910.Na alone and after gemcitabine, and perform a tumor biomarker study.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01125891
|United States, Colorado|
|University of Colorado Cancer Center|
|Denver, Colorado, United States, 80045|
|United States, New York|
|Roswell Park Cancer Institute|
|Buffalo, New York, United States, 14263|
|Study Chair:||Antonio Jimeno, MD, PhD||University of Colorado at Denver Health and Sciences Center|