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This is an open-label, dose-escalation/de-escalation study of ARQ 197 administered orally in combination with gemcitabine. The study is designed to determine the safety, tolerability and maximum tolerated dose (MTD) or recommended Phase 2 dose (RP2D) of ARQ 197 when administered in combination with gemcitabine to patients with advanced solid tumors.
Enrollment of an initial cohort of 3 or 6 patients will follow the traditional "3 + 3" dose escalation scheme. These patients will be treated with ARQ 197 and gemcitabine. ARQ 197 will be administered by mouth BID continuously. Gemcitabine will be administered by intravenous infusion over 30 minutes once weekly for 3 consecutive weeks followed by a week of rest. The dosing schedules of ARQ 197 and gemcitabine will be as described below.
ARQ 197 will be administered per the following cohorts, starting from week 1 of treatment.
Cohort------ARQ 197 (mg BID)
0-----------120, continuously
1-----------240, continuously
A-----------120 (repeated treatments of 2 weeks followed by a 1 week pause)
B-----------240 (repeated treatments of 2 weeks followed by a 1 week pause)
C-----------360 (repeated treatments of 2 weeks followed by a 1 week pause)
D-----------360 (repeated treatments of 3 weeks followed by a 1 week pause)
E-----------360, continuously
In case of DLT, intermediate dosing cohorts will be explored, administering ARQ 197 for 5 days instead of 7 during the weeks of ARQ 197 administration.
For cohorts 0 and 1, gemcitabine is administered at the dose of 1000mg/sqm from week 1 of treatment, 4 weeks in a row for the first month, then for 3 consecutive weeks followed by a week of pause. For all other cohorts, gemcitabine will be administered starting from week 2 of treatment at the dose of 1000mg/sqm, for 3 consecutive weeks followed by a week of pause.
Additional treatment cohorts may be enrolled to explore intermediate, higher or lower doses of ARQ 197, as indicated by the tolerability, safety profile, and pharmacokinetic (PK) profile.
Once a safe and recommended dose level is determined, an Expanded Cohort of up to 60 patients with non-resectable cholangiocarcinoma (10 patients), breast carcinoma (10 patients), ovarian carcinoma (10 patients), endometrial carcinoma and carcinoma of the cervix (10 patients in total, at least five with endometrial carcinoma). Each group of 10 patients may enroll up to three patients who received at least 5-week gemcitabine treatment. The cohort will also include up to 20 patients with pancreatic carcinoma (up to five out of 20 patients may have received at least 5-week gemcitabine treatment).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ARQ 197 in combination with gemcitabine | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Treatment with ARQ 197 in combination with gemcitabine | Drug | Enrollment of an initial cohort of 3 or 6 patients will follow the traditional "3 + 3" dose escalation scheme. These patients will be treated with ARQ 197 and gemcitabine. ARQ 197 will be administered by mouth BID continuously. Gemcitabine will be administered by intravenous infusion over 30 minutes once weekly for 3 consecutive weeks followed by a week of rest. |
| Measure | Description | Time Frame |
|---|---|---|
| To determine the safety, tolerability and maximum tolerated dose (MTD) or recommended Phase 2 dose (RP2D) of ARQ 197 when administered in combination with gemcitabine. | Patients will remain on study until unacceptable toxicity, disease progression (clinical or radiological) or another discontinuation criterion is met. |
| Measure | Description | Time Frame |
|---|---|---|
| To determine the pharmacokinetic profiles of ARQ 197, gemcitabine and dFdU inactive metabolite of gemcitabine when administered in combination. | ||
| To assess the preliminary anti-tumor activity of ARQ 197 when administered in combination with gemcitabine. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atlanta | Georgia | 30341 | United States | |||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24737778 | Derived | Pant S, Saleh M, Bendell J, Infante JR, Jones S, Kurkjian CD, Moore KM, Kazakin J, Abbadessa G, Wang Y, Chen Y, Schwartz B, Camacho LH. A phase I dose escalation study of oral c-MET inhibitor tivantinib (ARQ 197) in combination with gemcitabine in patients with solid tumors. Ann Oncol. 2014 Jul;25(7):1416-1421. doi: 10.1093/annonc/mdu157. Epub 2014 Apr 15. |
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|
| Patients will remain on study until unacceptable toxicity, disease progression (clinical or radiological) or another discontinuation criterion is met. |
| To evaluate dynamic changes of hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), and soluble c-Met in patients' peripheral blood that are associated with treatment of ARQ 197 plus gemcitabine. | Patients will remain on study until unacceptable toxicity, disease progression (clinical or radiological) or another discontinuation criterion is met. |
| Oklahoma City |
| Oklahoma |
| 73104 |
| United States |
| Nashville | Tennessee | 37203 | United States |
| Houston | Texas | 77024 | United States |
| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D013812 | Therapeutics |
| C551661 | ARQ 197 |
| D000093542 | Gemcitabine |
| ID | Term |
|---|---|
| D006571 | Heterocyclic Compounds |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
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