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At step 1, patients with advanced solid tumors will receive CP-4126 capsules following a dose escalation schedule until the maximum tolerated dose is reached. At step 2, 20 patients will be randomized. They will receive at days 1 and 8 in a double cross design either oral CP-4126 at the recommended dose or gemcitabine 1000mg/m2 intravenously. At both steps, the schedule of treatment will be day 1, 8, 15 q4w until complete response or disease worsening/ progressing. All further treatment at step 2 will be oral CP-4126.
This is a multicentre clinical study conducted in Belgium and in The Netherlands. The study is a phase I divided in 2 steps: The first step is a dose escalation to define the RD. At the second step the PK profile of oral CP-4126 will be compared with the PK profile of IV gemcitabine. In addition, the study is conducted to characterize the tolerability of oral CP-4126, to evaluate its bioavailability, and to make a preliminary assessment of antitumor activity in patients with solid tumours.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Experimental | Step 1: Dose escalation - oral CP-4126 Step 2: Oral CP-4126 on day 1 and 15 in a 4 week schedule. One dose (only) gemcitabine IV on day 8. |
|
| 2 | Experimental | Step 1: Dose escalation - oral CP-4126 Step 2: Oral CP-4126 on day 8 and 15 in a 4 week schedule. One dose (only) gemcitabine IV on day 1. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CP-4126 | Drug | Step 1: Dose escalation oral CP-4126 until maximum tolerated dose. Step 2: Oral CP-4126 day 1 and 15 + IV Gemcitabine 1000 mg/m2 day 8 in a 4 week schedule until complete response or disease worsening / progression |
| Measure | Description | Time Frame |
|---|---|---|
| Step 1: MTD of oral CP-4126 in patients with advanced solid tumours, followed by establishing the recommended dose | 6 months | |
| Step 2: Pharmacokinetic parameters comparison of oral CP-4126 with IV gemcitabine | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Tolerability of oral CP-4126 | 12 months | |
| Biovailability of oral CP-4126 | 12 months | |
| Preliminary assessment of antitumor activity of oral CP-4126 |
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Inclusion Criteria:
Exclusion Criteria:
Symptomatic brain metastases
Current peripheral neuropathy of grade > 1 according to the National Cancer Institute (NCI) - Common Terminology Criteria for Adverse Events (CTCAE) Version 3.0
Radiotherapy
Mucositis of the upper digestive tract, including stomatitis
Participation in another therapeutic clinical study within 30 days of enrolment or during this clinical study
Previous anticancer therapy (chemotherapy, hormone therapy or immunotherapy) within 30 days prior to the first dose of oral CP-4126 [6 weeks for mitomycin C and BCNU (= carmustine) and CCNU (=lomustine)]
Requirement of concomitant treatment with a non-permitted medication including alternative drugs and high doses of vitamins
History of allergic reactions to gemcitabine
Presence of any serious concomitant systemic disorders incompatible with the clinical study (e.g. uncontrolled inter-current illness including ongoing or active infection)
Presence of any significant central nervous system or psychiatric disorder(s) that would hamper the patient's compliance
Pregnant or breast feeding women
Absence of adequate contraception for both male and female fertile patients for the duration of the study; and also for six months after last treatment
Known positive status for HIV and/or hepatitis B or C
Any reason why, in the investigator's opinion, the patient should not participate
Condition that impairs ability to swallow pills
Coeliac disease or any other lipid malabsorption syndrome
Drug and/or alcohol abuse
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| Name | Affiliation | Role |
|---|---|---|
| Ahmad H Awada, MD | Institute Jules Bordet | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institute Jules Bordet | Brussels | 1000 | Belgium | |||
| The Netherlands Cancer Institute |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23345000 | Derived | Stuurman FE, Voest EE, Awada A, Witteveen PO, Bergeland T, Hals PA, Rasch W, Schellens JH, Hendlisz A. Phase I study of oral CP-4126, a gemcitabine derivative, in patients with advanced solid tumors. Invest New Drugs. 2013 Aug;31(4):959-66. doi: 10.1007/s10637-013-9925-z. Epub 2013 Jan 24. |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D009362 | Neoplasm Metastasis |
| ID | Term |
|---|---|
| D009385 | Neoplastic Processes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C538828 | CP 4126 |
| D000093542 | Gemcitabine |
| ID | Term |
|---|---|
| D006571 | Heterocyclic Compounds |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
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| Gemcitabine | Drug | Step 1: Dose escalation oral CP-4126 until maximum tolerated dose Step 2: Oral CP-4126 day 8 and 15 + IV Gemcitabine 1000 mg/m2 day 1 in a 4 week schedule until complete response or disease worsening / progression |
|
| 18 months |
| Amsterdam |
| Netherlands |
| University Medical Centre Utrecht | Utrecht | Netherlands |
| D011743 |
| Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |