Dose-Escalation, Safety, Pharmacokinetics Study of Cabazitaxel With Gemcitabine In Patients With Solid Tumor

This study has been terminated.
Sponsor:
Information provided by (Responsible Party):
Sanofi
ClinicalTrials.gov Identifier:
NCT01001221
First received: October 23, 2009
Last updated: September 24, 2012
Last verified: September 2012
  Purpose

Primary Objectives:

  • Part 1: To determine the Maximum Tolerated Dose (MTD) and the Dose Limiting Toxicities (DLTs) of cabazitaxel administered as a 1-hour infusion in combination with gemcitabine, every 3 weeks in patients with advanced solid malignancies.
  • Part 2: To determine the antitumor activity of cabazitaxel in combination with gemcitabine, in an additional extended cohort of 15 patients with advanced solid malignancies treated with the defined MTD, as assessed by objective response rate (ORR) according to the revised guideline for Response Evaluation Criteria in Solid Tumours (RECIST 1.1 criteria).

Secondary Objectives:

  • To assess the safety profile of the combination regimen of cabazitaxel with gemcitabine.
  • To assess the pharmacokinetics (PK) of cabazitaxel, gemcitabine and its metabolite, and 2,2 difluoridine when given in combination.
  • To determine Time to Progression (TTP), Objective Response Rate (ORR), and Duration of Response (DR), in the extended cohort of patients treated at the MTD in Part 2 of the study and the patients who received the MTD in Part 1 component.
  • To assess the potential inhibitory effect of cabazitaxel on CYP3A4 using midazolam, a CYP3A4 probe since cabazitaxel inhibits CYP3A4 in vitro.

Condition Intervention Phase
Neoplasms, Malignant
Drug: cabazitaxel (XRP6258)
Drug: gemcitabine
Drug: midazolam
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Dose-Escalation, Single Arm, Combination Study of Cabazitaxel With Gemcitabine to Determine The Safety, And Pharmacokinetics In Subjects With Advanced Solid Malignancies

Resource links provided by NLM:


Further study details as provided by Sanofi:

Primary Outcome Measures:
  • Part 1: DLTs of the combination of cabazitaxel and gemcitabine [ Time Frame: 3 weeks (cycle 1) ] [ Designated as safety issue: Yes ]
  • Part 2: Anti-tumor activity based on RECIST1.1 criteria [ Time Frame: up to a maximum of 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time To Progression (TTP) [ Time Frame: up to a maximum of 12 months ] [ Designated as safety issue: No ]
  • Overall Response Rate (ORR) [ Time Frame: up to a maximum of 12 months ] [ Designated as safety issue: No ]
  • Duration of Response (DR) [ Time Frame: up to a maximum of 12 months ] [ Designated as safety issue: No ]
  • Safety profile of the combination in terms of AEs/SAEs and laboratory parameters [ Time Frame: on-treatment period + 30 days ] [ Designated as safety issue: Yes ]
  • PK of cabazitaxel, gemcitabine and its metabolite (2,2 difluoridine) and, of midazolam. [ Time Frame: 3 weeks (cycle 1) ] [ Designated as safety issue: Yes ]

Enrollment: 19
Study Start Date: November 2009
Study Completion Date: October 2011
Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Cabazitaxel/gemcitabine

Study is conducted in 2 parts both in combination with gemcitabine : in part 1, Cabazitaxel dose is escalated and in part 2, Cabazitaxel is administered at the MTD assessed in part 1.

Schedule of administration is :

  • on D1, required cabazitaxel premedication, then cabazitaxel IV infusion over 1 hour then gemcitabine IV infusion over 30 minutes
  • on D8, gemcitabine IV infusion over 30 minutes Cycle length is 3 weeks in both part 1 and part 2.

In addition, in part 2, at cycle 1 in fasting conditions, midazolam (2 mg solution) will be administered orally once a day; on day -1 or 24 hours before cabazitaxel infusion; and on Day 1 at the end of cabazitaxel infusion.

Drug: cabazitaxel (XRP6258)

Pharmaceutical form: solution

Route of administration: Intravenous

Drug: gemcitabine

Pharmaceutical form: solution

Route of administration: Intravenous

Drug: midazolam

Pharmaceutical form: solution

Route of administration: oral


Detailed Description:

The study consists of a screening phase (maximum length of 21-day), a treatment phase with 21-day study treatment cycles. Cycle lengths may be extended up to maximum of 2 additional weeks in case of unresolved toxicity. Patients will be treated until disease progression or unacceptable toxicities, withdrawal of consent or Investigator's decision.There will be a 30-day follow-up visit after the last dose of study medication. Patients who discontinue study treatment prior to disease progression will continue to have tumor assessments every 6 weeks until disease progression or start of an other anticancer therapy.

The cut off date for the study is defined as follows: all patients will be followed up until disease progression, unacceptable toxicity, consent withdrawal or when the last patient had completed 26 weeks or 6 cycles on study treatment, whichever comes first. Patients may continue to be treated on study as long as they are benefiting from study treatment and have not met study withdrawal criteria. After withdrawal from study treatment, further treatment, if any, is at the discretion of the Investigator.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria:

  • Histologically or cytologically confirmed advanced solid malignancy that is metastatic or unresectable, and for which standard curative measures do not exist.

Exclusion criteria:

  • ECOG performance status (PS) > or =2
  • Anticipation of need for a major surgical procedure or radiation therapy during the study treatment
  • Absence of completion of all prior chemotherapy, biological therapy, targeted non-cytotoxic therapy > or = 3 weeks; and radiotherapy > or = 4 weeks prior to registration. For part 2 only, prior treatment with radiotherapy, chemoembolization therapy, or cryotherapy is allowed if these therapies are not directed to the areas of measurable disease being used for the purposes of this protocol. (4 weeks of washout period is required prior to start the treatment in Part 2)
  • Concurrent treatment in another clinical trial or with any other cancer therapy or patients planning to receive these treatments during the study
  • Other concurrent serious illness or medical condition, including active infection or HIV disease
  • History of any other malignancy with the exception of adequately treated basal cell or squamous cell skin cancer, or in situ carcinoma of the cervix uteri
  • Patients without resolution of all clinically significant toxic effects (excluding alopecia) of any prior therapy to grade < or = 1 by NCI-CTCAE, version 3.0 or to within the limits listed in the specific inclusion/exclusion criteria
  • Other severe acute or chronic medical or psychiatric condition, or significant laboratory abnormality requiring further investigation that may cause undue risk for the patient's safety, inhibit protocol participation, or interfere with interpretation of study results, and in the judgment of the investigator would make the patient inappropriate for entry into this study
  • Symptomatic brain metastases or leptomeningeal disease. Patients with asymptomatic or stable brain metastases are allowed
  • Women of childbearing potential not protected by highly effective contraceptive method of birth control. All patients of childbearing potential that do not have a negative pregnancy test within the 7 days prior to registration
  • Patients who are pregnant or breastfeeding
  • For part 2, absence of measurable disease as defined by the most current version of the RECIST 1.1. For the Part 1 component, patients with non-measurable disease are accepted
  • Inadequate bone marrow or liver or renal organ function
  • Any condition which is considered a contraindication to gemcitabine in the local labelling
  • Prior treatment with cabazitaxel within the last 2 years
  • History of severe hypersensitivity grade 3 or 4 to taxanes, Polysorbate-80, or to compounds with similar chemical structures
  • Any treatment known to potentially interact with midazolam

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01001221

Locations
United States, Michigan
Investigational Site Number 840002
Detroit, Michigan, United States, 48201
United States, Ohio
Investigational Site Number 840005
Cincinnati, Ohio, United States, 45267-0542
United States, Pennsylvania
Investigational Site Number 840004
Philadelphia, Pennsylvania, United States, 19111
United States, Tennessee
Investigational Site Number 840001
Nashville, Tennessee, United States, 37232
Sponsors and Collaborators
Sanofi
Investigators
Study Director: Clinical Sciences & Operations Sanofi
  More Information

No publications provided

Responsible Party: Sanofi
ClinicalTrials.gov Identifier: NCT01001221     History of Changes
Other Study ID Numbers: TCD11068
Study First Received: October 23, 2009
Last Updated: September 24, 2012
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Neoplasms
Midazolam
Gemcitabine
Adjuvants, Anesthesia
Central Nervous System Agents
Therapeutic Uses
Pharmacologic Actions
Anti-Anxiety Agents
Tranquilizing Agents
Central Nervous System Depressants
Physiological Effects of Drugs
Psychotropic Drugs
Hypnotics and Sedatives
Anesthetics, Intravenous
Anesthetics, General
Anesthetics
GABA Modulators
GABA Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Antimetabolites, Antineoplastic
Antimetabolites
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Radiation-Sensitizing Agents

ClinicalTrials.gov processed this record on May 21, 2013