Description:
The purpose of this research study is to determine the safety and efficacy of CPI-613
(devimistat) in the treatment of advanced biliary tract cancer when used in combination with
standard of care chemotherapy (gemcitabine plus cisplatin) compared to gemcitabine plus
cisplatin alone.
This research study has two parts:
In the phase 1 portion of this study, patients will receive a combination of CPI-613 and
standard of care chemotherapy. Dose levels of CPI-613 will be adjusted to find the best dose,
which will be the recommended phase 2 dose level.
In the phase 2 portion of this study, patients will be randomized into two arms. Patients in
Arm A will receive the combination of the recommended dose level of CPI-613 and standard of
care chemotherapy. Patients in Arm B will receive standard of care chemotherapy.
At the end of the study, researchers will compare the health outcomes of the patients that
received CPI-613 + standard care to the outcomes of patients that received only standard
care.
Title
- Brief Title: Gemcitabine and Cisplatin With or Without CPI-613 as First Line Therapy for Patients With Advanced Unresectable Biliary Tract Cancer (BilT-04)
- Official Title: A Multi-Center Randomized Phase IB/II Study of Gemcitabine and Cisplatin With or Without CPI-613 as First Line Therapy for Patients With Advanced Unresectable Biliary Tract Cancer (BilT-04)
Clinical Trial IDs
- ORG STUDY ID:
UMCC 2019.116
- SECONDARY ID:
HUM00170490
- NCT ID:
NCT04203160
Conditions
Interventions
Drug | Synonyms | Arms |
---|
CPI 613 | Devimistat® | Phase 1 and Phase 2, Arm A (investigational) |
Gemcitabine | Gemzar® | Phase 1 and Phase 2, Arm A (investigational) |
Cisplatin | CDDP, Platinol®, NSC-119875 | Phase 1 and Phase 2, Arm A (investigational) |
Purpose
The purpose of this research study is to determine the safety and efficacy of CPI-613
(devimistat) in the treatment of advanced biliary tract cancer when used in combination with
standard of care chemotherapy (gemcitabine plus cisplatin) compared to gemcitabine plus
cisplatin alone.
This research study has two parts:
In the phase 1 portion of this study, patients will receive a combination of CPI-613 and
standard of care chemotherapy. Dose levels of CPI-613 will be adjusted to find the best dose,
which will be the recommended phase 2 dose level.
In the phase 2 portion of this study, patients will be randomized into two arms. Patients in
Arm A will receive the combination of the recommended dose level of CPI-613 and standard of
care chemotherapy. Patients in Arm B will receive standard of care chemotherapy.
At the end of the study, researchers will compare the health outcomes of the patients that
received CPI-613 + standard care to the outcomes of patients that received only standard
care.
Trial Arms
Name | Type | Description | Interventions |
---|
Phase 1 and Phase 2, Arm A (investigational) | Experimental | On Day 1 and Day 8 of each 3-week cycle, patients will receive CPI-613 + gemcitabine and cisplatin. Patients may continue gemcitabine, cisplatin and CPI-613 for up to 2 years in absence of disease progression or unacceptable toxicity. | - CPI 613
- Gemcitabine
- Cisplatin
|
Phase 2, Arm B (standard of care) | Active Comparator | On Day 1 and Day 8 of each 3-week cycle, patients will receive gemcitabine and cisplatin. Patients may continue gemcitabine and cisplatin for up to 2 years in absence of disease progression or unacceptable toxicity. | |
Eligibility Criteria
Inclusion:
- Patients must have a pathologically or cytologically confirmed carcinoma (except
neuroendocrine) of the biliary tract (intra-hepatic, extra-hepatic (hilar, distal) or
gallbladder) that is not eligible for curative resection, transplantation, or ablative
therapies. Tumors of mixed cholangiocarcinoma/hepatocellular carcinoma histology are
excluded.
- Patients may not have received prior systemic treatment (chemotherapy or targeted
therapy) for advanced BTC. Prior peri-operative chemotherapy is permitted provided it
was completed > 6 months from enrollment.
- Patients may have received prior radiation, chemoembolization, radioembolization or
other local ablative therapies or hepatic resection if completed ≥ 4 weeks prior to
enrollment AND if patient has recovered to ≤ grade 1 toxicity. Extrahepatic palliative
radiation is permitted if completed ≥ 2 weeks prior to enrollment AND if patient has
recovered to ≤ grade 1 toxicity
- Patients must have radiographically measurable disease (as per RECISTv1.1) in at least
one site not previously treated with radiation or liver directed therapy (including
bland, chemo- or radio-embolization, or ablation) either within the liver or in a
metastatic site.
- Must be ≥ 18 years of age.
- Must have an ECOG performance status of 0-1.
- Ability to understand and willingness to sign IRB-approved informed consent.
- Willing to provide archived tissue, if available, from a previous diagnostic biopsy.
- Must be able to tolerate CT and/or MRI with contrast.
- Adequate organ function (per protocol) obtained ≤ 2 weeks prior to enrollment.
- Women of child-bearing potential and men must agree to use 2 methods of adequate
contraception (hormonal plus barrier or 2 barrier forms) OR abstinence prior to study
entry, for the duration of study participation and for 6 months (for men and women)
following completion of study therapy.
Exclusions:
- Prior history of brain metastasis (unless previously treated, asymptomatic and stable
for at least 3 months) or organ transplant.
- Underwent a major surgical procedure < 4 weeks prior to enrollment.
- Active second malignancy other than in situ cancer or localized prostate cancer
(Gleason score <8). Patients with history of other malignancy are eligible provided
primary treatment of that cancer was completed > 1 year prior to enrollment and the
patient is free of clinical or radiologic evidence of recurrent or progressive
malignancy.
- Ongoing active, uncontrolled infection (must be afebrile for > 48 hours off
antibiotics) .
- Psychiatric illness, other significant medical illness, or social situation which, in
the investigator's opinion, would limit compliance or ability to comply with study
requirements.
- Pregnancy or breastfeeding. (Women must not be pregnant or breastfeeding since study
drugs may harm the fetus or child. All females of childbearing potential [not
surgically sterilized and between menarche and 1 year post menopause] must have a
negative screening pregnancy test.)
- Active heart disease including symptomatic heart failure (NYHA class 3 or 4), unstable
angina pectoris, uncontrolled cardiac arrhythmia or interstitial lung disease.
- Prisoners or subjects who are involuntarily incarcerated, or compulsorily detained for
treatment of either a psychiatric or physical (e.g. infectious disease) illness would
be excluded.
- Prolonged QTcF interval >480 msec.
- Known hypersensitivity to cisplatin, gemcitabine or CPI-613, or its inactive
components.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Phase 1: Incidence of dose-limiting toxicity |
Time Frame: | Up to day 22 |
Safety Issue: | |
Description: | Dose limiting toxicities will determine the maximum tolerated dose (MTD)/recommended Phase 2 dose (RP2D) of combination therapy with CPI-613 + gemcitabine and cisplatin. Assessed using the NCI CTCAE v5.0 |
Secondary Outcome Measures
Measure: | Median Progression Free Survival (PFS) |
Time Frame: | Until last dose of study treatment (up to 2 years) |
Safety Issue: | |
Description: | PFS will be determined from date of first study treatment until the date of radiological or clinical progression (leading to withdrawal from the study) or date of last disease evaluation (for patients without progression). It will be calculated using the product-limit method of Kaplan and Meier. All patients that receive at least one dose of study treatment will be considered evaluable. |
Measure: | Median Overall Survival (OS) |
Time Frame: | Up to 3 years after enrollment |
Safety Issue: | |
Description: | From date of first study treatment until date of last disease evaluation or until death from any cause. Using the product-limit method of Kaplan and Meier. |
Measure: | Incidence of Toxicities |
Time Frame: | Up to 100 days after last dose of study treatment |
Safety Issue: | |
Description: | To evaluate the safety of CPI-613 in combination with gemcitabine and cisplatin in this patient population, assessed using the Common Toxicity Criteria for Adverse Events (CTCAE) v5.0. All patients that receive at least one dose of study treatment will be considered evaluable. |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | University of Michigan Rogel Cancer Center |
Trial Keywords
- Cholangiocarcinoma
- Gallbladder cancer
Last Updated
June 4, 2021