A Phase Ib/2 Clinical Study of Fruquintinib Combined With Paclitaxel in the Treatment of Advanced Gastric Cancer

Study Description

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Brief Summary:

An open-label, dose escalation and maximum tolerated dose (MTD) and/or recommended phase II dose (RPTD) study of fruquintinib combined with paclitaxel in patients with advanced gastric cancer who did not respond to first-line standard chemotherapy.

Condition or disease	Intervention/treatment	Phase
Gastric Cancer	Drug: fruquintinib+paclitaxel	Phase 1; Phase 2

Detailed Description:

In dose escalation period, 12-24 patients with advanced gastric cancer will be enrolled. Patients meeting enrollment eligibility will receive 28-day cycles of fruquintinib 2-5 mg qd combined with paclitaxel 80 mg/m2. Safety information and pharmacokinetic data will be collected till disease progression or intolerable toxicity to determine MTD and/or RPTD of fruquintinib combined with paclitaxel in patients with advanced gastric cancer. This period will include the following 4 dose groups from low to high:

A: Fruquintinib 2 mg qd for 3 weeks followed by 1-week break + paclitaxel 80 mg/m2 once a week during the first three weeks of each cycle B: Fruquintinib 3 mg qd for 3 weeks followed by 1-week break + paclitaxel 80 mg/m2 once a week during the first three weeks of each cycle C: Fruquintinib 4 mg qd for 3 weeks followed by 1-week break + paclitaxel 80 mg/m2 once a week during the first three weeks of each cycle D: Fruquintinib 5 mg qd for 3 weeks followed by 1-week break + paclitaxel 80mg/m2 once a week during the first three weeks of each cycle This study will use traditional 3+3 trial design (3 subjects will be enrolled in each dose group first. If 1 case of DLT is observed, additional 3 subjects will be enrolled in the same dose group to further evaluate toxicity) to observe DLT and evaluate MTD. If there are 2 or more cases of DLT in one dose group, the group lower than this dose group by one level is MTD dose group. At least 6 subjects are required in MTD dose group for confirmation. If MTD is not achieved at the end of dose escalation and there are 6 subjects in the highest dose group, RPTD can be determined based on obtained safety, tolerability, PK and efficacy information. Dose escalation and study in the next dose group can be initiated only after the first treatment cycle (DLT window observation period) is completed and subject safety and tolerability are confirmed in this dose group (0/3 or ≤1/6 subjects experience DLT).

Subjects in the original dose group will continue to receive the next cycle of treatment at the original dose till disease progression or treatment withdrawal due to any of the following reasons: 1) death, 2) intolerable toxicity, 3) pregnancy, 4) the investigator considers the study should be terminated for the subject's best interests, 5) the subject or legal representative requests withdrawal, 6) loss to follow-up, 7) the subject has poor compliance and cannot comply with the study protocol.

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	34 participants
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Treatment
Official Title:	A Phase Ib/2 Clinical Study to Evaluate the Safety, Pharmacokinetic Characteristics and Preliminary Efficacy of Fruquintinib Combined With Paclitaxel in Patients With Advanced Gastric Cancer
Actual Study Start Date :	November 9, 2014
Actual Primary Completion Date :	March 31, 2017
Actual Study Completion Date :	March 31, 2017

Arms and Interventions

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Arm	Intervention/treatment
Experimental: fruquintinib+paclitaxel; fruquintinib combined with paclitaxel. Fruquintinib treatment: administration for 3 weeks followed by 1-week break, and administration every day for the first 21 days.Paclitaxel is administered once weekly in the first three weeks of each cycle.	Drug: fruquintinib+paclitaxel; 28-day cycle of fruquintinib qd for 3 weeks followed by 1-week break combined with paclitaxel 80 mg/m2; Other Name: HMPL-013+paclitaxel

Outcome Measures

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Primary Outcome Measures :

1. incidence of DLT [ Time Frame: every subject's DLT observation window is 4 weeks ]
2. progression free survival of RP2D [ Time Frame: from first dose up to progressive disease or EOT due to any cause, assessed up to 1 year ]
   using RECIST v1.1 progressive disease (PD), using RECIST v 1.1
3. safety and tolerance [ Time Frame: From first dose to within 30 days after the last dose ]
   Safety and tolerance will be evaluated by incidence, severity and outcomes of adverse events (AEs) and categorized by severity in accordance with the NCI CTC AE Version 4.0.

Secondary Outcome Measures :

1. Objective response rate (ORR) [ Time Frame: from first dose up to progressive disease or EOT due to any cause, assessed up to 1 year] ]
   using RECIST v 1.1
2. Disease control rate (DCR) [ Time Frame: From first dose up to progressive disease or EOT due to any cause, assessed up to 1 year] ]
   using RECIST v 1.1
3. Pharmacokinetic profiles of Fruquintinib combined with Paclitaxel [ Time Frame: From first dose up to day 15 in the first 28-day cycle ]
   PK sampling of Fruquintinibwill include a pre-dose and 1,2,4,8,24 hours time-point at Day 2 and day 15 of dosing in the first 28-day cycle; PK sampling of Paclitaxel will include a pre-dose and at 0.25,1,2,4,8, and 24 hours time-point on day 1 and day 15 of dosing in the first 28-day cycle

Eligibility Criteria

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Ages Eligible for Study:	18 Years to 70 Years (Adult, Older Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

1. Fully understand the study and sign the informed consent form voluntarily;
2. Patients with local advanced and/or metastatic gastric cancer confirmed by histology and/or cytology;
3. Fail in previous first-line standard chemotherapy
4. Aged 18-70years (inclusive);
5. Body weight ≥40 kg;
6. At least one measurable lesion (according to RECIST1.1);
7. Physical status score (ECOG score) 0-1;
8. Expected survival >12 weeks.

Exclusion Criteria:

1. Who are participating in another drug clinical trial in the past 4 weeks; or receive systemic anti-tumor chemotherapy, radiotherapy or biotherapy within 4 weeks prior to administration of the study drug;
2. Who previously received VEGF/VEGFR inhibitors;
3. Who have not recovered from toxicity caused by previous anti-cancer treatment (CTCAE>grade 1), or not completely recovered from previous surgery;
4. Active brain metastasis(with clinical symptom);
5. Other malignancies except squamous-cell or basal cell carcinoma, and cervical carcinoma in situ in the past 5 years;
6. Uncontrolled clinical active infection, e.g. acute pneumonia, hepatitis B or active hepatitis C;
7. Dysphagia, intractable vomiting or known drug malabsorption;

Contacts and Locations

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Locations

China, Guangdong
Sun Yat-sen University Cancer Center
Guangzhou, Guangdong, China, 510060
China
Hutchison Medi Pharma Investigational Site
Beijing, China, 100142
Hutchison Medi Pharma Investigational Site
Shanghai, China, 200032

Sponsors and Collaborators

Hutchison Medipharma Limited

Investigators

Study Director:	Songhua Fan, M.D.	HMP

More Information

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Publications of Results:

1. The 16th Annual Meeting of Chinese Society of Clinical Oncology (CSCO) 2013 2. Elkerm YM, Elesaid A, AL-Batran, et al. Final results of a phase II trial of docetaxel-carboplatin- FU in locally advanced gastric carcinoma[abstract]. Presented at the 2008 gastrointestinal cancers symposium 2008.

Responsible Party:	Hutchison Medipharma Limited
ClinicalTrials.gov Identifier:	NCT02415023 History of Changes
Other Study ID Numbers:	2014-013-00CH3
First Posted:	April 14, 2015
Last Update Posted:	February 23, 2018
Last Verified:	February 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:	Undecided

Additional relevant MeSH terms:

Stomach Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases	Paclitaxel; Albumin-Bound Paclitaxel; Antineoplastic Agents, Phytogenic; Antineoplastic Agents; Tubulin Modulators; Antimitotic Agents; Mitosis Modulators; Molecular Mechanisms of Pharmacological Action