Description:
This research is being done to test the safety of the combination of the study drugs
fostamatinib and paclitaxel. This study tests different doses of the drugs to see which doses
are safest in people with ovaria cancer when given together.
Title
- Brief Title: Clinical Trial of Combined Fostamatinib and Paclitaxel in Ovarian Cancer
- Official Title: Phase I Clinical Trial of Combined Fostamatinib and Paclitaxel in Ovarian Cancer
Clinical Trial IDs
- ORG STUDY ID:
J1708
- SECONDARY ID:
IRB00110406
- NCT ID:
NCT03246074
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Fostamatinib and Paclitaxel | Fostamatinib and Abraxane | Fostamatinib and Paclitaxel |
Purpose
This research is being done to test the safety of the combination of the study drugs
fostamatinib and paclitaxel. This study tests different doses of the drugs to see which doses
are safest in people with ovaria cancer when given together.
Detailed Description
This is a phase I, open-label, non-randomized multicenter dose-escalation study with the
primary objective to determine the maximally tolerated dose (MTD) of fostamatinib when
administered with weekly paclitaxel in women with recurrent platinum-resistant ovarian,
fallopian tube, or primary peritoneal cancer.
Between 8 and 18 adult female subjects will be enrolled and receive weekly paclitaxel in
combination with increasing doses of fostamatinib. There will be three dosing intervals of
fostamatinib (100 mg bid, 150 mg bid, and 200mg bid) selected based on prior phase I studies
of single agent fostamatinib. Dose-escalation will follow a modified toxicity probability
interval (mTPI) design. In this study, up to 18 adult female subjects will be enrolled and
receive weekly paclitaxel in combination with fostamatinib at the MTD of the combination; at
least 6 patients with receive fostamatinib plus paclitaxel at the MTD.
Trial Arms
Name | Type | Description | Interventions |
---|
Fostamatinib and Paclitaxel | Experimental | Participants will receive paclitaxel on Days 1, 8 and 15 of each cycle and fostamatinib at a fixed oral dose twice daily throughout each 28-day cycle. The dose of fostamatinib will be determined by the enrollment dose level. Given the mTPI design, dose-escalation decisions will be made based on the three dosing intervals, where the underdosing interval corresponds to dose escalation (E), overdosing interval corresponds to dose de-escalation (D), and proper dosing corresponds to staying at the current dose (S). The initial dose level will be Level 1 of Table 1. Participants will be individually continually assessed for DLT. The associated dose-escalation decisions are presented in Table 2. For illustration, suppose a cohort of 3 patients is at the current dose. | - Fostamatinib and Paclitaxel
|
Eligibility Criteria
- Inclusion Criteria
1. Patients must have histologically or cytologically confirmed epithelial ovarian,
fallopian tube, or primary peritoneal carcinoma. Histologic documentation (via
the pathology report) of the original primary tumor is required.
2. Patients must have measurable disease, according to RECIST v1.1.
3. Patients must have recurrent, platinum-resistant disease (defined as having
relapsed within 6 months of last platinum-containing regimen) or be unable to
receive further platinum therapy. There is no limit on the number of prior
treatment regimens; however, patients may not have previously received weekly
paclitaxel in the recurrent setting. Previous dose dense paclitaxel as initial
therapy is allowable.
4. Patients must have the ability to take oral medications.
5. Females, age ≥18 years.
6. ECOG performance status ≤2 (Karnofsky ≥60%, see Appendix A).
7. Life expectancy of greater than 3 months.
8. Patients must have normal organ and marrow function.
9. The effects of fostamatinib on the developing human fetus are unknown. For this
reason, women of childbearing potential 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 she is participating in this study, she should
inform her treating physician immediately.
10. Patients who are willing and able to comply with the protocol and study
procedures including willingness to undergo tumor biopsy or paracentesis for
tumor cells before therapy (at baseline) and after initiation of treatment
(before Cycle 2) for all subjects if this is clinically and safely feasible to do
so.
11. Patients with known history or current symptoms of cardiac disease, or history of
treatment with cardiotoxic agents, should have a clinical risk assessment of
cardiac function using the New York Heart Association Functional Classification.
To be eligible for this trial, patients should be class 2B or better.
12. Patients with a prior or concurrent malignancy whose natural history or treatment
does not have the potential to interfere with the safety or efficacy assessment
of the investigational regimen are eligible for this trial, with permission of
the protocol chair.
13. Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral
therapy with undetectable viral load within 6 months are eligible for this trial
if the anti-retroviral therapy is not an excluded concurrent medication.
14. For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV
viral load must be undetectable on suppressive therapy, if indicated and the
suppressive therapy is not an excluded concurrent medication.
15. Patients with a history of hepatitis C virus (HCV) infection must have been
treated and cured. For patients with HCV infection who are currently on
treatment, they are eligible if they have an undetectable HCV viral load and the
HCV therapy is not an excluded concurrent medication.
16. Patients with treated brain metastases are eligible if follow-up brain imaging
after central nervous system (CNS)-directed therapy shows no evidence of
progression.
- Exclusion Criteria
1. Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for
nitrosoureas or mitomycin C) prior to entering the study or those who have not
recovered from adverse events due to agents administered more than 3 weeks
earlier. Hormonal therapy directed at the malignant tumor must be discontinued at
least one week prior to registration.
2. Patients who are currently receiving or have previously received any other
investigational agents within 3 weeks prior to entering the study.
3. Patients with known untreated brain metastases, as progressive neurologic
dysfunction may develop that would confound the evaluation of neurologic and
other adverse events.
4. Patients with Grade 2 or greater neuropathy.
5. History of allergic reactions attributed to compounds of similar chemical or
biologic composition to fostamatinib or paclitaxel. Patients who are able to
tolerate paclitaxel on a desensitization protocol will be allowed.
6. Strong CYP3A4 inhibitors or inducers should not be used within 3 days of Day 1
dosing until the end of study. Moderate CYP3A4 inhibitors or inducers should be
used with caution.
7. Uncontrolled intercurrent illness
8. Pregnant women are excluded from this study because the potential for teratogenic
or abortifacient effects of fostamatinib are unknown. Because there is an unknown
but potential risk for adverse events in nursing infants secondary to treatment
of the mother with fostamatinib, breastfeeding should be discontinued if the
mother is treated with fostamatinib. These potential risks may also apply to
other agents used in this study.
Maximum Eligible Age: | 100 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence of Treatment-Emergent Adverse Events |
Time Frame: | 3.5 years |
Safety Issue: | |
Description: | To determine the safety, tolerability, and maximum tolerated dose (MTD) of fostamatinib when administered in combination with weekly paclitaxel |
Secondary Outcome Measures
Measure: | Response rate of treatment with combination therapy |
Time Frame: | 3.5 years |
Safety Issue: | |
Description: | To estimate the objective response rate in the study population treated with the combination of fostamatinib and paclitaxel |
Measure: | Survival determination based on progression-free survival |
Time Frame: | 10 years |
Safety Issue: | |
Description: | To estimate the progression-free survival in the study population treated with the combination of fostamatinib and paclitaxel |
Measure: | Drug metabolism determination |
Time Frame: | 3.5 years |
Safety Issue: | |
Description: | To assess the drug metabolism of fostamatinib when combined with weekly paclitaxel using Peak Plasma Concentration (Cmax in ng/mL) |
Measure: | Drug metabolism determination |
Time Frame: | 3.5 years |
Safety Issue: | |
Description: | To assess the drug metabolism of fostamatinib when combined with weekly paclitaxel using Area Under the Curve (AUC) (ng*hr/mL) |
Measure: | Drug metabolism determination |
Time Frame: | 3.5 years |
Safety Issue: | |
Description: | To assess the drug metabolism of fostamatinib when combined with weekly paclitaxel using half life (hours) |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins |
Trial Keywords
- Phase I
- Ovarian Cancer
- Fostamatinib and Paclitaxel
Last Updated
October 26, 2020