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Part 1: Dose-Escalation Phase (Phase 1b) The primary objective is to assess the safety and tolerability of increasing doses of D07001 softgel in patients with unresectable locally advanced or metastatic gastrointestinal (GI) cancer.
Part 2: Dose-Expansion Phase (Phase 2) The primary objective is to assess the safety and tolerability of D07001 softgel in patients who have achieved stable disease or better following first line chemotherapy or combined chemoradiotherapy (CCRT) for unresectable metastatic or locally advanced biliary tract cancer (BTC)
This open label, multicenter study will be conducted in 2 parts: a dose-escalation phase (Part 1) and a dose-expansion phase (Part 2).
In both Part 1 and Part 2, eligible patients will be assigned to receive oral D07001-softgel on Days 1, 3, 5, 8, 10, 12, 15, 17, and 19 of a 21-day cycle (9 doses per cycle).
Part 1: Dose Escalation Phase (Phase 1b) Part 1 of the study will follow a 3+3 dose escalation scheme at predefined dose levels. There will be sequential cohorts of 3 to 6 patients each with increasing doses of 40 mg, 60 mg, 80 mg, 120 mg, and 160 mg per cohort. There will be no intra patient dose escalation. Cycle 1 (21 days) is defined as the dose limiting toxicity (DLT) assessment period.
Part 2: Dose Expansion Phase (Phase 2) In Part 2 of the study, eligible patients will be randomized in a 1:1 ratio to receive D07001-softgel in an open label manner at 1 of the 2 dose levels selected for expansion. Twenty (20) patients will be enrolled to each dose expansion cohort. Patients will be treated until withdrawal from treatment due to disease progression according to RECIST v1.1, withdrawn consent, or when another treatment discontinuation criterion is met. Patients who are discontinued from study drug for reasons other than disease progression or toxicity in the first 2 cycles of Part 2 will be replaced.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part 1:Dose-Escalation Phase | Experimental | 40 mg D07001-softgel capsules 60 mg D07001-softgel capsules 80 mg D07001-softgel capsules 120 mg D07001-softgel capsules 160 mg D07001-softgel capsules |
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| Part 2: Dose-Expansion Phase (Phase 2) | Experimental | higher dose-expansion of D07001-softgel capsules lower dose-expansion of D07001-softgel capsules |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| D07001-softgel capsules | Drug | Active Ingredient:Gemcitabine hydrochloride |
|
| Measure | Description | Time Frame |
|---|---|---|
| Part 1: Establish the Maximum Tolerated Dose (MTD) | MTD will be defined based on the number of dose limiting toxicities (DLT) in subjects at each dose level. DLT definition: In Part 1 of the study, any of the following AEs occurring during Cycle 1 will be classified as DLTs, if there is a reasonable possibility that it is related to the study drug
| During Cycle 1 of treatment (each cycle is 21 days) for each subject |
| Part 1 : Incidence of Adverse Events (AEs)/ Serious Adverse Event (SAEs) | AEs will be assessed via the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 | From date of informed consent to 30-day follow-up visit for each subject, an average of 10 months |
| Part 2: Incidence of Dose Modifications, Including Dose Reduction, Interruption, or Discontinuation of Study Drug | To measure ratio of total subjects who experienced the dose modifications including dose reduction, interruption, or discontinuation of study drug due to AEs. | First dose through last dose for each subject, an average of 8 months |
| Measure | Description | Time Frame |
|---|---|---|
| Part 1: Pharmacokinetics (PK)- Cmax | PK would be analyzed by maximum concentration (Cmax) of dFdC | Cycle 1 Days 1 and 15 |
| Part 1: PK- AUC | PK would be analyzed by Area Under Curve (AUC) of dFdC |
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Inclusion Criteria:
Provision of a signed and dated written Informed Consent Form (ICF) prior to any study specific procedures
Male or female patients aged 18 years or older at screening (aged 20 years or older in Taiwan)
Histopathological or cytologic diagnosis of unresectable, metastatic or locally advanced GI cancer (Part 1) or unresectable metastatic or locally advanced BTC (cholangiocarcinoma or gallbladder cancer; Part 2)
Part 1 only: Refractory to or have relapsed from all standard therapies of advanced GI malignancy
Part 2 only:
No more than 60 days have elapsed between completion of the prior line of chemotherapy or CCRT and enrollment
Part 2 only: Patient has not received intervening systemic therapy since first line treatment
Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0-2 in Part 1 and 0-1 in Part 2
Life expectancy is >12 weeks
Adequate bone marrow function, demonstrated by:
Adequate liver function, demonstrated by:
Adequate renal function, demonstrated by:
If a woman of childbearing potential, the patient has a negative serum pregnancy test at screening and is not breastfeeding
If a woman of childbearing potential, patient must use a medically acceptable form of contraception as 2 barrier methods (e.g., combination of condom, diaphragm, or intrauterine device), hormonal contraception (estrogen or progesterone agents) or 1 barrier method in combination with spermicide. Birth control is required 1 month prior to screening, for the duration of their study participation, and for 1 month after the end of the study; female partners of male patients must adhere to the same birth control methods.
Patient is willing to comply with protocol-required visit schedule and visit requirements
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Li-Tzong Chen, Ph. D | National Cheng-Kung University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| China Medical University Hospital | Taichung | 404 | Taiwan | |||
| National Cheng-Kung University Hospital |
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| ID | Title | Description |
|---|---|---|
| FG000 | Part 1:Dose-Escalation Phase_40mg | 40 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
| FG001 | Part 1:Dose-Escalation Phase_60mg |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 3, 2018 | Apr 11, 2023 |
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Part 1 of the study comprises a sequential dose escalation to identify dose-limiting toxicity (DLT) and establish the maximum tolerated dose (MTD), if any, of D07001-softgel in patients with unresectable locally advanced or metastatic GI cancer. Part 1 will follow a 3+3 dose escalation scheme at predefined dose levels. There will be sequential cohorts of 3 to 6 patients each with increasing doses of 40 mg, 60 mg, 80 mg, 120 mg, and 160 mg per cohort.
In Part 2 of the study, D07001-softgel will be administered at the 2 dose levels selected for expansion from Part 1 of the study.
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| Cycle 1 Days 1 and 15 |
| Part 2: Pharmacokinetics (PK)- Cmax | PK would be analyzed by maximum concentration (Cmax) of dFdC | Cycle 1 Days 1, 8, and 15; Cycle 1 Day 15 and Cycle 2 Day 1 for food-effect cohort only |
| Part 2: PK- AUC | PK would be analyzed by Area Under Curve (AUC) of dFdC | Cycle 1 Days 1, 8, and 15; Cycle 1 Day 15 and Cycle 2 Day 1 for food-effect cohort only |
| Tainan |
| 704 |
| Taiwan |
| National Taiwan University Hospital | Taipei | 100 | Taiwan |
| Taipei Veterans General Hospital | Taipei | 11217 | Taiwan |
60 mg D07001-softgel capsules
D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride
| FG002 | Part 1:Dose-Escalation Phase_80mg | 80 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
| FG003 | Part 1:Dose-Escalation Phase_120mg | 120 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
| FG004 | Part 1:Dose-Escalation Phase_100mg | 100 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride Due to safety concern, SMC members recommended adding a 100mg dose group instead of the 160mg dose. |
| COMPLETED |
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| NOT COMPLETED |
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Total 19 subjects
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| ID | Title | Description |
|---|---|---|
| BG000 | Part 1:Dose-Escalation Phase Level 1 | Cohort 1: 40 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
| BG001 | Part 1:Dose-Escalation Phase Level 2 | Cohort 2: 60 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
| BG002 | Part 1:Dose-Escalation Phase Level 3 | Cohort 3: 80 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
| BG003 | Part 1:Dose-Escalation Phase Level 4 | Cohort 4: 120 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
| BG004 | Part 1:Dose-Escalation Phase Level 5 | Cohort 5: 100 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
| BG005 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Part 1: Establish the Maximum Tolerated Dose (MTD) | MTD will be defined based on the number of dose limiting toxicities (DLT) in subjects at each dose level. DLT definition: In Part 1 of the study, any of the following AEs occurring during Cycle 1 will be classified as DLTs, if there is a reasonable possibility that it is related to the study drug
| Only Part 1 was conducted. 2 DLTs were happened in 120mg group, so the MTD is 100mg. | Posted | Number | mg | During Cycle 1 of treatment (each cycle is 21 days) for each subject |
|
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| Primary | Part 1 : Incidence of Adverse Events (AEs)/ Serious Adverse Event (SAEs) | AEs will be assessed via the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 | Please refer to the Adverse Event tables for specifics. | Posted | Number | participants | From date of informed consent to 30-day follow-up visit for each subject, an average of 10 months |
| ||||||||||||||||||||||||||||
| Primary | Part 2: Incidence of Dose Modifications, Including Dose Reduction, Interruption, or Discontinuation of Study Drug | To measure ratio of total subjects who experienced the dose modifications including dose reduction, interruption, or discontinuation of study drug due to AEs. | Only Part 1 was conducted. | Posted | First dose through last dose for each subject, an average of 8 months |
|
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| Secondary | Part 1: Pharmacokinetics (PK)- Cmax | PK would be analyzed by maximum concentration (Cmax) of dFdC | Only Part 1 was conducted. | Posted | Mean | Standard Deviation | ng/mL | Cycle 1 Days 1 and 15 |
| |||||||||||||||||||||||||||
| Secondary | Part 1: PK- AUC | PK would be analyzed by Area Under Curve (AUC) of dFdC | Only Part 1 was conducted. | Posted | Mean | Standard Deviation | h*ng/mL | Cycle 1 Days 1 and 15 |
| |||||||||||||||||||||||||||
| Secondary | Part 2: Pharmacokinetics (PK)- Cmax | PK would be analyzed by maximum concentration (Cmax) of dFdC | Only Part 1 was conducted. | Posted | Cycle 1 Days 1, 8, and 15; Cycle 1 Day 15 and Cycle 2 Day 1 for food-effect cohort only |
|
| |||||||||||||||||||||||||||||
| Secondary | Part 2: PK- AUC | PK would be analyzed by Area Under Curve (AUC) of dFdC | Only Part 1 was conducted. | Posted | Cycle 1 Days 1, 8, and 15; Cycle 1 Day 15 and Cycle 2 Day 1 for food-effect cohort only |
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The Adverse event information was collected and assessed in relation to baseline for study patients from the first dose of treatment until 30 days after discontinuation of treatment.
Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 The AEs/SAEs were collected in relation to study drug.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Part 1:Dose-Escalation Phase Level 1 | 40 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride | 0 | 4 | 0 | 4 | 2 | 4 |
| EG001 | Part 1:Dose-Escalation Phase Level 2 | 60 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride | 0 | 3 | 0 | 3 | 2 | 3 |
| EG002 | Part 1:Dose-Escalation Phase Level 3 | 80 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride | 0 | 3 | 0 | 3 | 3 | 3 |
| EG003 | Part 1:Dose-Escalation Phase Level 4 | 120 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride | 0 | 6 | 2 | 6 | 6 | 6 |
| EG004 | Part 1:Dose-Escalation Phase Level 5 | 100 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride | 0 | 3 | 1 | 3 | 3 | 3 |
| EG005 | Part 2: Dose-Expansion Phase (Phase 2) | higher dose-expansion of D07001-softgel capsules lower dose-expansion of D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride | 0 | 0 | 0 | 0 | 0 | 0 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhoea | Gastrointestinal disorders | Systematic Assessment |
| ||
| hepatotoxicity | Hepatobiliary disorders | Systematic Assessment |
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| Fever | General disorders | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Vomiting | Gastrointestinal disorders | Systematic Assessment |
| ||
| Fever | General disorders | Systematic Assessment |
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| Anorexia | Metabolism and nutrition disorders | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | Systematic Assessment |
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| Faitigue | General disorders | Systematic Assessment |
| ||
| Chills | General disorders | Systematic Assessment |
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| Malaise | General disorders | Systematic Assessment |
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| Alanine aminotransferase increased | Investigations | Systematic Assessment |
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| Aspartate aminotransferase increased | Investigations | Systematic Assessment |
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| Somnolence | Nervous system disorders | Systematic Assessment |
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There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Staff of Medical Affairs | InnoPharmax Inc. | 886-2-8797-7607 | yuan.lin@innopharmax.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 21, 2019 | Apr 11, 2023 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D001661 | Biliary Tract Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D001660 | Biliary Tract Diseases |
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| Male |
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| OG004 | Part 1:Dose-Escalation Phase Level 5 | 100 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
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| Part 1:Dose-Escalation Phase Level 5 |
100 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
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100 mg D07001-softgel capsules D07001-softgel capsules: Active Ingredient:Gemcitabine hydrochloride |
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