Quinacrine-Capecitabine Combinatorial Therapy for Advanced Stage Colorectal Adenocarcinoma

Colorectal Adenocarcinoma Clinical Trial

Official title:

Quinacrine-Capecitabine Combinatorial Therapy for Advanced Stage Colorectal Adenocarcinoma:A Phase I/II Investigator-Initiated Clinical Trial

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT01844076
• Other study ID #: GI-078
• Status: Terminated
• Phase: Phase 1/Phase 2
• Start date: January 14, 2016
• Est. completion date: August 9, 2019

Study information

• Verified date: March 2021
• Source: Fox Chase Cancer Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Establish the tolerability and safety of aimed dose of both quinacrine and capecitabine in combination to treat patients with advanced colorectal adenocarcinoma.

Description:

Because of the well published safety profiles of both quinacrine and capecitabine, the Phase I portion of our study will aim to determine the tolerability of both agents in combinations when used at established clinical doses. This portion of the study will more closely resemble a pilot study or feasibility study rather than a dose escalation Phase I trial. The objective is to determine toxicities and adverse reactions, not a maximally tolerated dose. The investigators hypothesize that there will be no toxic interactions at the pharmacokinetic or pharmacodynamic level, and want to know the feasibility of using quinacrine and capecitabine at their respective recommended single agent doses. Because capecitabine is already regarded as standard treatment for colorectal cancer, the investigators will begin the study with a full dose of capecitabine combined with a slightly lower dose of quinacrine. If the safety-interim analysis does not detect an excess of toxicity, then subsequent patients will be enrolled using the full dose of both drugs.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 19
• Est. completion date: August 9, 2019
• Est. primary completion date: August 9, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients much have histologically confirmed adenocarcinoma of the colon or rectum.

• Patients must have measurable recurrence or metastases in the liver and/or lungs.

• Patients must have prior chemotherapy for advanced colorectal cancer and have previously received both an oxaliplatin and an irinotecan based regimen.

• Age > 18 years.

• Life expectancy greater than 4 weeks.

• ECOG performance status <3.

• Patients must have normal organ and marrow function.

• Patients must be able to swallow capsules.

• Patients must be able to understand and willing to sign a written informed consent document.

• Patients are included regardless of KRAS/BRAF status.

Exclusion Criteria:

• Patients who have had chemotherapy or radiotherapy within 4 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier.

• Patients may not be receiving any other investigational agent.

• Patients with know brain metastases should be excluded from this clinical trial because they often develop progressive neurological dysfunction that would confound the evaluation of neurologic and other adverse events.

• History of allergic reactions attributed to compounds of similar chemical or biologic composition to quinacrine, capecitabine or fluorouracil.

• The concomitant use of quinacrine and primaquine is contraindicated.

• Uncontrolled intercurrent illness including but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.

• Pregnant women are excluded from this study.

• Patients with a baseline creatinine clearance of < 50 mL/min.

• Patients must be currently not treated with quinacrine or drugs related to quinacrine.

• Patients who require anti-arrhythmic treatment with amiodarone or any drug with a quinidine-like effect on the heart or who have history of a malignant ventricular arrhythmia unless they have a functioning automatic implantable cardio defibrillator implanted.

• Patients who have a history of noninfectious hepatitis or alcoholism.

• Patients with a lifetime history of porphyria or psoriasis because it can exacerbate these conditions.

• Patients with documented glucose-6-phosphate dehydrogenase deficiency.

• Patients with a lifetime history of seizure disorder.

• Patients with a lifetime history of dermatitis as an allergic/toxic reaction to any medication.

• Patients with know dihydropyrimidine dehydrogenase deficiency.

Related Conditions & MeSH terms

• Adenocarcinoma
• Colorectal Adenocarcinoma

Intervention

Drug:
• Quinacrine and Capecitabine
The Phase I portion of the study will aim to determine the tolerability of both agents in combinations when used at established clinical doses. This portion of the study will more closely resemble a pilot study or feasibility study rather than a dose escalation.

Locations

Country	Name	City	State
United States	Fox Chase Cancer Center	Philadelphia	Pennsylvania

Sponsors (1)

Lead Sponsor	Collaborator
Fox Chase Cancer Center

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Phase II - Time to Progression (TTP)	Determine time to progression from start of treatment in patients receiving quinacrine in combination with capecitabine. Using Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1), progression is defined as a 20% increase in sum of target lesions, with at least a 5 mm absolute increase.	2-3 years
Primary	Phase I - Number of Participants Who Experienced Dose Limiting Toxicities and Adverse Reactions	Establish the tolerability of both agents in combination when used at established clinical doses. The objective is to determine toxicities and adverse reactions of patients in each group with different dose levels to find the maximum tolerated dose (MTD).	One year
Secondary	Phase II - Rate of Response	Determine rate of response in patients receiving quinacrine in combination with capecitabine. Using Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1) complete response (CR) is a disappearance of all target lesions, partial response (PR) is at least 30% decrease in the sum of diameters of target lesions, and overall response is the number of patients who experience a complete response or partial response.	2-3 years