Pancreatic Cancer Clinical Trial
— OXIRIOfficial title:
Phase I Trial of OXIRI [Oxaliplatin (O), Xeloda (X) and Irinotecan (I)] Treatment in Patients With Advanced and/or Metastatic Pancreatic Adenocarcinoma
Verified date | May 2021 |
Source | National Cancer Centre, Singapore |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This is an exploratory Phase I study is to assess the safety and tolerability of the OXIRI regimen [oxaliplatin (O), xeloda (X) and irinotecan (I)] and to evaluate for preliminary evidence of efficacy, in patients with advanced and/or metastatic pancreatic adenocarcinoma. The investigators hypothesize that 2 of 3 weekly doses of oxaliplatin and genotype directed-dosing of irinotecan in combination with chronomodulated capecitabine (xeloda) administered continuously will be more tolerable than the FOLFIRINOX regimen (folinic acid, fluorouracil, irinotecan and oxaliplatin) while maintaining anti-tumour activity.
Status | Completed |
Enrollment | 33 |
Est. completion date | May 21, 2020 |
Est. primary completion date | May 21, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 21 Years to 75 Years |
Eligibility | Inclusion Criteria: 1. Patients between 21 to 75 years of age 2. A histopathologically or cytological confirmed diagnosis of locally advanced and/or metastatic PDAC that is unresectable 3. Measurable disease as per Response Evaluation Criteria in Solid Tumors (RECIST) ver 1.1 criteria 4. Life expectancy of at least 12 weeks 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 6. Adequate hematologic function (neutrophils count = 1.5 × 109/L, platelet count = 100 × 109/L) 7. Adequate hepatic function (total bilirubin = 1.5 x the upper limits of normal (ULN), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) = 3 x ULN 8. Adequate renal function (calculated creatinine clearance > 50 mL/min) 9. Able to give informed consent 10. Toxicity related to previous radiotherapy or chemotherapy resolved to = Grade 1 Exclusion Criteria: 1. History of prior malignancy except non-melanoma skin cancer within the last 5yrs 2. Uncontrolled central nervous system (CNS) metastases or carcinomatous meningitis 3. Uncontrolled concomitant medical illnesses (e.g. hypertension, myocardial infarct, heart failure, ventricular arrhythmia, diabetes, severe infection) 4. Major surgery within four weeks prior to study treatment 5. Patients on chronic immunosuppressive therapy 6. Pregnant or breast-feeding female patients 7. On anticoagulant therapy with vitamin K antagonists. 8. Dose-escalation cohort: - Patients homozygous for uridine diphosphate glucuronosyltransferase (UGT)1A1*6/*6 or UGT1A1*28/*28 - Previous oxaliplatin or irinotecan chemotherapy - Treatment with any of the following anti-cancer therapies prior to the first dose of OXIRI within the stated timeframes - Cyclical chemotherapy within a period of time that is shorter than the cycle length used for that treatment. Exception for weekly chemotherapy regimens, where a minimum of 2 week washout from the last dose is required. - Biological therapy (e.g., antibodies) within a period of time that is = 5 t1/2 or = 4 weeks, whichever is shorter, prior to starting study drug - Continuous or intermittent small molecule therapeutics within a period of time that is = 5 t1/2 or = 4 weeks (whichever is shorter) prior to starting study drug - Any other investigational agents within a period of time that is = 5 t1/2 or less than the cycle length used for that treatment or = 4 weeks (whichever is shortest) prior to starting study drug - Wide field radiotherapy = 4 weeks or limited field radiation for palliation = 2 weeks prior to starting study drug 9. Dose-expansion cohort: - Previous chemotherapy or radiotherapy |
Country | Name | City | State |
---|---|---|---|
Singapore | National Cancer Centre | Singapore |
Lead Sponsor | Collaborator |
---|---|
National Cancer Centre, Singapore | National Medical Research Council (NMRC), Singapore |
Singapore,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Circulating tumour cells (CTCs) analysis | CTC characterization, and the changes of CTCs number and their relationship to changes in serum CA19-9 levels, tumour response on imaging etc. will be analysed. | at pre-treatment, Day 1 of each cycle and during response evaluation by imaging | |
Primary | Safety and tolerability of the OXIRI regimen as measured by the frequency of significant adverse events incurred by the participants, using CTCAE ver. 4 grading system | The safety and tolerability of the regimen will be assessed when the patient is on treatment and till 30 days after treatment. | from first dose to 30 days after last dose | |
Secondary | Maximum tolerated dose (MTD) of capecitabine when administered in a continuous chronomodulated fashion with genotype-directed dosing of irinotecan and metronomic dosing of oxaliplatin, using a conventional 3+3 design | 2 years | ||
Secondary | Recommended Phase II dose (RP2D) of the OXIRI regimen which is the MTD | 2 years | ||
Secondary | Pharmacokinetics analysis of capecitabine | Plasma level of capecitabine, its intermediary metabolites (5'-deoxy-5-fluorocytidine [DFCR] and 5'- deoxy-5- fluorouridine [DFUR]) and 5FU will be measured at multiple time points on C1D1 | cycle 1 day 1 | |
Secondary | Pharmacokinetics analysis of Irinotecan | Plasma level of Irinotecan, SN-38 (active metabolite of irinotecan) and SN-38G will be measured at multiple time points on C1D1 | cycle 1 day 1 | |
Secondary | Efficacy of OXIRI as measured by response evaluation criteria in solid tumours (RECIST) version 1.1 | 3 years |
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