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Futibatinib Vs Gemcitabine-Cisplatin Chemotherapy as 1st-Line Treatment of Patients With Advanced Cholangiocarcinoma (CCA) Harboring FGFR2 Gene Rearrangements (FOENIX-CCA3)

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ClinicalTrials.gov Identifier: NCT04093362
Recruitment Status : Not yet recruiting
First Posted : September 18, 2019
Last Update Posted : February 7, 2020
Sponsor:
Information provided by (Responsible Party):
Taiho Oncology, Inc.

Brief Summary:
The purpose is an open-label, multinational, parallel 2-arm, randomized Phase 3 study evaluating the efficacy and safety of futibatinib versus gemcitabine-cisplatin chemotherapy as first-line treatment of patients with advanced, metastatic, or recurrent unresectable iCCA harboring FGFR2 gene rearrangements

Condition or disease Intervention/treatment Phase
Advanced Cholangiocarcinoma FGFR2 Gene Rearrangements Drug: TAS-120 Drug: Cisplatin/Gemcitabine Phase 3

Detailed Description:

Study TAS-120-301 is an open-label, multinational, parallel 2-arm, randomized Phase 3 study evaluating the efficacy and safety of futibatinib versus gemcitabine-cisplatin chemotherapy as first-line treatment of patients with advanced, metastatic, or recurrent unresectable iCCA harboring FGFR2 gene rearrangements. Eligible patients will be randomized on a 1:1 basis to the following study arms:

  • Experimental Arm: Patients will receive futibatinib at an oral dose of 20 mg, administered daily (QD) on every day of a 21-day cycle.
  • Control Arm: On Days 1 and 8 of a 21-day cycle, patients will receive:

    • Cisplatin 25 mg/m2 in 1000 mL 0.9% saline by intravenous (I.V.) infusion over 1 hour, followed by 500 mL 0.9% saline over 30 minutes; and
    • Gemcitabine 1000 mg/m2 in 250-500 mL 0.9% saline by I.V. infusion over 30 minutes, beginning after completion of the cisplatin and saline infusions.

Patients in the Experimental Arm may continue to receive continuous futibatinib until documentation of progressive disease (PD) per RECIST 1.1, or until other withdrawal criteria are met, whichever comes first. However, treatment may continue following PD per RECIST 1.1 if the patient is clinically stable and is considered by the Investigator to be deriving continued clinical benefit from futibatinib.

Patients in the Control Arm may receive gemcitabine-cisplatin chemotherapy for up to 8 cycles or until PD or other withdrawal criteria are met, whichever comes first. Patients who discontinue gemcitabine-cisplatin due to documented disease progression (by ICR) may receive treatment with futibatinib ("crossover"), if medically appropriate in the opinion of the Investigator and if criteria for futibatinib treatment are met.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 216 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 3, Open-Label, Randomized Study of Futibatinib Versus Gemcitabine-Cisplatin Chemotherapy as First-Line Treatment of Patients With Advanced Cholangiocarcinoma Harboring FGFR2 Gene Rearrangements FOENIX-CCA3
Estimated Study Start Date : March 1, 2020
Estimated Primary Completion Date : March 31, 2022
Estimated Study Completion Date : June 30, 2022


Arm Intervention/treatment
Experimental: TAS-120
TAS-120 tablets, oral; 21-day cycle
Drug: TAS-120
TAS-120 is an oral FGFR inhibitor
Other Name: Futibatinib

Active Comparator: Cisplatin/Gemcitabine

• On Days 1 and 8 of a 21-day cycle, patients will receive:

  • Cisplatin 25 mg/m2 in 1000 mL 0.9% saline by intravenous (I.V.) infusion over 1 hour, followed by 500 mL 0.9% saline over 30 minutes; and
  • Gemcitabine 1000 mg/m2 in 250-500 mL 0.9% saline by I.V. infusion over 30 minutes, beginning after completion of the cisplatin and saline infusions.
Drug: Cisplatin/Gemcitabine
Cisplatin/Gemcitabine is currently 1st line standard of care




Primary Outcome Measures :
  1. PFS [ Time Frame: up to 12 months ]
    defined as the time from date of randomization to the date of documentation of disease progression by ICR per RECIST (version 1.1, 2009) or date of death, whichever comes first.


Secondary Outcome Measures :
  1. ORR [ Time Frame: up to12 months ]
    defined as the proportion of patients experiencing a best overall response of partial response (PR) or complete response (CR) (per RECIST 1.1), based on ICR.

  2. DCR [ Time Frame: up to 12 months ]
    defined as the proportion of patients experiencing a best overall response of partial response (PR) or complete response (CR) (per RECIST 1.1), based on ICR.

  3. OS [ Time Frame: up to 12 months ]
    defined as the time from the date of randomization until the date of death due to any cause.

  4. Safety and Tolerability [ Time Frame: up to 12 months ]
    Treatment-emergent adverse events (TEAEs) as assessed by CTCAE v5.0, including serious adverse events (SAEs)



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

A patient must meet all of the following inclusion criteria to be eligible for enrollment in this study:

  1. Provide written informed consent.
  2. Is >=18 years of age (or meets the country's regulatory definition for legal adult age).
  3. The patient has histologically confirmed, locally advanced, or metastatic, or recurrent unresectable iCCA harboring FGFR2 gene rearrangements based on testing performed by the designated central laboratory.
  4. Patient has radiographically measurable disease per RECIST 1.1.
  5. Patients who have received treatment for locally advanced disease (for example, trans-arterial chemoembolization, selective internal radiation therapy, external beam radiation) must have evidence of radiographic progression with measurable disease outside the previously-treated lesions.
  6. Eastern Cooperative Oncology Group performance status (ECOG PS) 0 or 1.
  7. Adequate organ function as defined by the following criteria:

    • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 ×upper limit of normal (ULN); if liver function abnormalities are due to underlying liver metastasis, AST and ALT ≤ 5 × ULN.
    • Total bilirubin ≤ 1.5 × ULN, or ≤ 3.0 × ULN for patients with Gilbert's syndrome.
    • White Blood Count (WBC) ≥ 2000/mm3 (≥ 2.0 × 109/L)
    • Absolute neutrophil count (ANC) ≥ 1000/mm3 (ie, ≥ 1.0 × 109/L by International Units [IU])
    • Platelet count ≥ 100,000/mm3 (IU: ≥ 100 × 109/L)
    • Hemoglobin ≥ 9.0 g/dL
    • Phosphorus ≤ 1.5 × ULN
    • Creatinine clearance: ≥ 60 mL/min
  8. Women of child-bearing potential (WOCBP) must have a negative serum pregnancy test within 7 days prior to administration of the first dose of futibatinib. Female patients are not considered to be of child bearing potential if they have a history of hysterectomy or are post menopausal defined as no menses for 12 months without an alternative medical cause. Both males and females of reproductive potential must agree to use effective birth control during the study prior to the first dose and for 6 months after the last dose.
  9. Willing and able to comply with scheduled visits and study procedures.

Exclusion Criteria:

A patient will be excluded from this study if any of the following criteria are met:

  1. Patient has received previous systemic anticancer therapy.

    • Patients receiving adjuvant or neoadjuvant treatment and completed ≥6 months prior to randomization are eligible.

  2. Patient has mixed hepatocellular carcinoma - iCCA disease.
  3. History and/or current evidence of any of the following disorders:

    • Non-tumor related alteration of calcium-phosphorus homeostasis that is clinically significant in the opinion of the Investigator.
    • Ectopic mineralization/calcification, including but not limited to soft tissue, kidneys, intestine, or myocardia and lung, considered clinically significant in the opinion of the Investigator.
    • Retinal disorder confirmed by retinal examination and considered clinically significant in the opinion of the ophthalmologist.
  4. History or current evidence of uncontrolled ventricular arrhythmias
  5. Fridericia's corrected QT interval (QTcF) > 470 ms on electrocardiogram (ECG) conducted during Screening.
  6. Treatment with any of the following within the specified time frame prior to the first dose of study therapy, or failure to recover from side effects of these prior therapies:

    • Major surgery within the previous 4 weeks (the surgical incision should be fully healed prior to the first dose of study therapy).
    • Radiotherapy (any dose) for extended field within 4 weeks or limited field radiotherapy within 2 weeks, and/or has not recovered from acute impact of radiotherapy.
    • Patients with locoregional therapy, e.g. transarterial chemoembolization (TACE), selective internal radiotherapy (SIRT) or ablation within 4 weeks.
    • Any history of liver transplant.
  7. A serious illness or medical condition(s) including, but not limited to, the following:

    • Brain metastases that are untreated or clinically or radiologically unstable (that is, have been stable for <1 month).
    • Known acute systemic infection.
    • Myocardial infarction, severe/unstable angina, or symptomatic congestive heart failure within the previous 6 months.
    • Chronic nausea, vomiting, or diarrhea considered to be clinically significant in the opinion of the Investigator.
    • Congenital long QT syndrome, or any known history of torsade de pointes, or family history of unexplained sudden death.
    • Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that in the judgment of the Investigator would make the patient inappropriate for entry into this study.
  8. Patients with a history of another primary malignancy that is currently clinically significant, and has potential for metastases or currently requires active intervention.
  9. Pregnant or breast-feeding female.
  10. The patient is unable to take oral medication.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04093362


Contacts
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Contact: Karim Benhadji, MD 609-285-5232 clinicaltrialinfo@taihooncology.com

Locations
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United States, Arizona
Mayo Clinic
Phoenix, Arizona, United States, 85004
Contact: Mitesh Borad, MD       borad.mitesh@mayo.edu   
Contact: Cassandra Castellaneta       Castellaneta.Cassandra@mayo.edu   
Sponsors and Collaborators
Taiho Oncology, Inc.
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Responsible Party: Taiho Oncology, Inc.
ClinicalTrials.gov Identifier: NCT04093362    
Other Study ID Numbers: FOENIX-CCA3 TAS-120-301
First Posted: September 18, 2019    Key Record Dates
Last Update Posted: February 7, 2020
Last Verified: February 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Taiho Oncology, Inc.:
Futibatinib
Advanced Cholangiocarcinoma
FGFR2
Fusion
Rearrangement
TAS-120
Additional relevant MeSH terms:
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Cholangiocarcinoma
Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Gemcitabine
Antineoplastic Agents
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs