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出境医 / 临床实验 / Trial of DFP-14927 in Advanced Solid Tumors

Trial of DFP-14927 in Advanced Solid Tumors

Study Description
Brief Summary:
This is a Phase I, open-label, single-arm, dose escalation study of DFP-14927 intravenous infusion administered to patients with refractory or relapsed solid tumors.

Condition or disease Intervention/treatment Phase
Solid Tumor Cancer Drug: DFP-14927 Phase 1

Detailed Description:

This study will determine the safety and efficacy of DFP-14927 in patients with refractory or relapsed advanced solid tumors. The study will be guided by a standard "3+3"dose escalation by observing the drug-related toxicities and dose-limiting toxicities following weekly IV infusion of DFP-14927 for each 28-day cycle (4 doses per cycle). In addition, the maximum-tolerated dose and recommended Phase II dose for DFP-14927 will be determined.

Furthermore, the study will determine the pharmacokinetics and bioavailability of DFP-14927 during the first cycle of treatment using the weekly dosing schedule.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I Study of DFP-14927 in Patients With Advanced Solid Tumors
Actual Study Start Date : September 30, 2019
Estimated Primary Completion Date : December 1, 2021
Estimated Study Completion Date : April 1, 2022
Arms and Interventions
Arm Intervention/treatment
Experimental: DFP-14927
DFP-14927: weekly IV infusion, 28 day treatment cycle
Drug: DFP-14927
DFP-14927 is a large 4-arm-PEGylated-DFP-10917 molecule. DFP-10917 is a nucleoside analog similar to deoxycytidine.

Outcome Measures
Primary Outcome Measures :
  1. Determine the maximum tolerated dose (MTD) [ Time Frame: From first dose (Day 1) up to 30 days after last dose ]
    The highest dose level at which less than one-third of at least 6 patients (i.e., 0 or 1 out of 6) experience a DLT

  2. Recommended Phase II Dose (RP2D) [ Time Frame: From first dose (Day 1) up to 30 days after last dose ]
    The maximum tolerated dose (MTD) of DFP-14927 at which the Phase II study will explore

  3. Dose-Limiting Toxicity (DLT) [ Time Frame: From first dose (Day 1) up to 30 days after last dose ]
    Determined through the frequency/severity of adverse events per CTCAE V5.0


Secondary Outcome Measures :
  1. Determine objective response rate (CR or PR) in response to DFP-14927 study treatment [ Time Frame: At pre-study and every 8 weeks through study completion, an average of 6 months ]
    Response to treatment will be assessed per RECIST 1.1

  2. Duration of response [ Time Frame: At pre-study and every 8 weeks through study completion, an average of 6 months ]
    Number of days from the time of initial response (CR or PR) to disease progression or death

  3. PK parameters to be determined using area under the concentration curve (AUC) [ Time Frame: Cycle 1 (each cycle is 28 days), Day 1: 0, 1, 2, 4, 8, 24, 48, and 96 hours post-dose; Day 8: 0,1, 2, 4, 8, 24, 48, and 96 hours post-dose and predose on Days 15, 22, and 29 (same as Day 1 of next Cycle) ]
    The concentration of DFP-14927 in blood plasma vs time

  4. PK parameters to be determined using maximum drug concentration (Cmax) [ Time Frame: Cycle 1 (each cycle is 28 days), Day 1: 0, 1, 2, 4, 8, 24, 48, and 96 hours post-dose; Day 8: 0,1, 2, 4, 8, 24, 48, and 96 hours post-dose and predose on Days 15, 22, and 29 (same as Day 1 of next Cycle) ]
    The maximum concentration of DFP-14927 in blood plasma


Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Patients must have histologically (or cytologically) confirmed diagnosis of solid tumor, refractory after standard therapy for the disease or for which conventional systemic therapy is not reliably effective or no effective therapy is available. Note: For expansion cohorts patients must have histologically (or cytologically) confirmed diagnosis of gastroesophageal cancer, pancreatic cancer, or cholangiocarcinoma that has relapsed or is refractory to standard therapy.
  2. Aged ≥ 18 years.
  3. ECOG Performance Status of 0 or 1.
  4. Adequate clinical laboratory values defined as:

    1. absolute neutrophil count ≥ 1.5 x 10⁹/L
    2. platelets ≥ 100 x 10⁹/L
    3. hemoglobin ≥ 9.0 g/dL (transfusions permissible)
    4. plasma creatinine ≤ 1.5 x upper limit of normal (ULN) for the institution or calculated clearance ≥ 60 mL/min (Cockcroft-Gault formula)
    5. total bilirubin ≤ 1.5 x ULN
    6. alanine transaminase (ALT) and aspartate transaminase (AST) < 2.5 x ULN (<5 x ULN if documented hepatic metastases)
    7. prothrombin time (PT) ≤1.2 x ULN, partial thromboplastin time (PTT) ≤ 1.2 ULN, and international normalized ratio (INR) ≤ 1.5
  5. Absence of uncontrolled intercurrent illnesses, including uncontrolled infections, cardiac conditions, uncontrolled diabetes mellitus, or other organ dysfunctions.
  6. Patients may have measurable or non-measurable disease as defined by RECIST 1.1.
  7. Signed Informed-consent prior to the start of any study specific procedures.
  8. Women of child-bearing potential must have a negative serum or urine pregnancy test. Male and female patients must agree to use acceptable contraceptive methods for the duration of the study and for at least one month after the last drug administration.

Exclusion Criteria:

  1. Patients will be excluded if they have received previous chemotherapy, immunotherapy, radiotherapy or any other investigational therapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) or 5 half-lives for targeted therapies prior to this study entry.
  2. Have not recovered from adverse events (must be Grade ≤1) due to agents administered more than 4 weeks earlier.
  3. Have had any major bleeding episodes (variceal bleeds, hemorrhagic strokes, internal abdominal bleeds, etc.) within 6 months prior to starting study drug.
  4. Known hypersensitivity to any study drug component (such as pegylated medications).
  5. Extensive prior radiotherapy, more than 30% of bone marrow reserves, or prior bone marrow/stem cell transplantation.
  6. Any concomitant condition that in the opinion of the investigator could compromise the objectives of this study and the patient's compliance.
  7. Pregnant or lactating individuals.
  8. Current malignancies of another type, with the exception of adequately treated in situ cervical cancer and basal cell skin cancer or other malignancies with no evidence of disease for 2 years or more.
  9. Known history of HIV, HBV or HCV infection.
  10. Documented or known bleeding disorder.
  11. Requirement for anticoagulation treatment that increases INR or aPTT above the normal range (low dose DVT or line prophylaxis is allowed).
  12. Clinically evident CNS metastases or leptomeningeal disease not controlled by prior surgery or radiotherapy; history of seizure disorder not controlled by anti-seizure medication at the time of enrollment. Patients with primary CNS malignancies are excluded.
  13. Patients with a significant cardiovascular disease or condition, including:

    1. Myocardial infarction within 6 months of study entry
    2. NYHA Class III or IV heart failure
    3. Uncontrolled dysrhythmias or poorly controlled angina.
    4. History of serious ventricular arrhythmia (VT or VF, ≥ 3 beats in a row) and/or risk factors (e.g., heart failure, hypokalemia, family history of Long QT Syndrome)
    5. Baseline prolongation of QT/QTc interval (repeated demonstration of QTc ≥ 450 msec for men and 470 msec for women). QTc values up to 500 msec will be acceptable where patient's medical history, e.g. bundle branch block, is known to cause mild QTc prolongation and the condition is well controlled
Contacts and Locations

Locations
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United States, California
UCLA Department of Medicine- Hematology/Oncology Recruiting
Los Angeles, California, United States, 90095
Contact: Lisa Yonemoto    310-582-4069    lyonemoto@mednet.ucla.edu   
Principal Investigator: Zev Wainberg, MD         
United States, Texas
MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: Jackie Smith, R.N.    713-745-3917    JSmith19@mdanderson.org   
Principal Investigator: Jaffer Ajani, M.D.         
Sponsors and Collaborators
Delta-Fly Pharma, Inc.
Investigators
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Principal Investigator: Jaffer Ajani, MD M.D. Anderson Cancer Center
Tracking Information
First Submitted Date  ICMJE April 25, 2019
First Posted Date  ICMJE May 8, 2019
Last Update Posted Date April 28, 2021
Actual Study Start Date  ICMJE September 30, 2019
Estimated Primary Completion Date December 1, 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 7, 2019)
  • Determine the maximum tolerated dose (MTD) [ Time Frame: From first dose (Day 1) up to 30 days after last dose ]
    The highest dose level at which less than one-third of at least 6 patients (i.e., 0 or 1 out of 6) experience a DLT
  • Recommended Phase II Dose (RP2D) [ Time Frame: From first dose (Day 1) up to 30 days after last dose ]
    The maximum tolerated dose (MTD) of DFP-14927 at which the Phase II study will explore
  • Dose-Limiting Toxicity (DLT) [ Time Frame: From first dose (Day 1) up to 30 days after last dose ]
    Determined through the frequency/severity of adverse events per CTCAE V5.0
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: May 7, 2019)
  • Determine objective response rate (CR or PR) in response to DFP-14927 study treatment [ Time Frame: At pre-study and every 8 weeks through study completion, an average of 6 months ]
    Response to treatment will be assessed per RECIST 1.1
  • Duration of response [ Time Frame: At pre-study and every 8 weeks through study completion, an average of 6 months ]
    Number of days from the time of initial response (CR or PR) to disease progression or death
  • PK parameters to be determined using area under the concentration curve (AUC) [ Time Frame: Cycle 1 (each cycle is 28 days), Day 1: 0, 1, 2, 4, 8, 24, 48, and 96 hours post-dose; Day 8: 0,1, 2, 4, 8, 24, 48, and 96 hours post-dose and predose on Days 15, 22, and 29 (same as Day 1 of next Cycle) ]
    The concentration of DFP-14927 in blood plasma vs time
  • PK parameters to be determined using maximum drug concentration (Cmax) [ Time Frame: Cycle 1 (each cycle is 28 days), Day 1: 0, 1, 2, 4, 8, 24, 48, and 96 hours post-dose; Day 8: 0,1, 2, 4, 8, 24, 48, and 96 hours post-dose and predose on Days 15, 22, and 29 (same as Day 1 of next Cycle) ]
    The maximum concentration of DFP-14927 in blood plasma
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Trial of DFP-14927 in Advanced Solid Tumors
Official Title  ICMJE A Phase I Study of DFP-14927 in Patients With Advanced Solid Tumors
Brief Summary This is a Phase I, open-label, single-arm, dose escalation study of DFP-14927 intravenous infusion administered to patients with refractory or relapsed solid tumors.
Detailed Description

This study will determine the safety and efficacy of DFP-14927 in patients with refractory or relapsed advanced solid tumors. The study will be guided by a standard "3+3"dose escalation by observing the drug-related toxicities and dose-limiting toxicities following weekly IV infusion of DFP-14927 for each 28-day cycle (4 doses per cycle). In addition, the maximum-tolerated dose and recommended Phase II dose for DFP-14927 will be determined.

Furthermore, the study will determine the pharmacokinetics and bioavailability of DFP-14927 during the first cycle of treatment using the weekly dosing schedule.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Solid Tumor
  • Cancer
Intervention  ICMJE Drug: DFP-14927
DFP-14927 is a large 4-arm-PEGylated-DFP-10917 molecule. DFP-10917 is a nucleoside analog similar to deoxycytidine.
Study Arms  ICMJE Experimental: DFP-14927
DFP-14927: weekly IV infusion, 28 day treatment cycle
Intervention: Drug: DFP-14927
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: May 7, 2019)
30
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE April 1, 2022
Estimated Primary Completion Date December 1, 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Patients must have histologically (or cytologically) confirmed diagnosis of solid tumor, refractory after standard therapy for the disease or for which conventional systemic therapy is not reliably effective or no effective therapy is available. Note: For expansion cohorts patients must have histologically (or cytologically) confirmed diagnosis of gastroesophageal cancer, pancreatic cancer, or cholangiocarcinoma that has relapsed or is refractory to standard therapy.
  2. Aged ≥ 18 years.
  3. ECOG Performance Status of 0 or 1.
  4. Adequate clinical laboratory values defined as:

    1. absolute neutrophil count ≥ 1.5 x 10⁹/L
    2. platelets ≥ 100 x 10⁹/L
    3. hemoglobin ≥ 9.0 g/dL (transfusions permissible)
    4. plasma creatinine ≤ 1.5 x upper limit of normal (ULN) for the institution or calculated clearance ≥ 60 mL/min (Cockcroft-Gault formula)
    5. total bilirubin ≤ 1.5 x ULN
    6. alanine transaminase (ALT) and aspartate transaminase (AST) < 2.5 x ULN (<5 x ULN if documented hepatic metastases)
    7. prothrombin time (PT) ≤1.2 x ULN, partial thromboplastin time (PTT) ≤ 1.2 ULN, and international normalized ratio (INR) ≤ 1.5
  5. Absence of uncontrolled intercurrent illnesses, including uncontrolled infections, cardiac conditions, uncontrolled diabetes mellitus, or other organ dysfunctions.
  6. Patients may have measurable or non-measurable disease as defined by RECIST 1.1.
  7. Signed Informed-consent prior to the start of any study specific procedures.
  8. Women of child-bearing potential must have a negative serum or urine pregnancy test. Male and female patients must agree to use acceptable contraceptive methods for the duration of the study and for at least one month after the last drug administration.

Exclusion Criteria:

  1. Patients will be excluded if they have received previous chemotherapy, immunotherapy, radiotherapy or any other investigational therapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) or 5 half-lives for targeted therapies prior to this study entry.
  2. Have not recovered from adverse events (must be Grade ≤1) due to agents administered more than 4 weeks earlier.
  3. Have had any major bleeding episodes (variceal bleeds, hemorrhagic strokes, internal abdominal bleeds, etc.) within 6 months prior to starting study drug.
  4. Known hypersensitivity to any study drug component (such as pegylated medications).
  5. Extensive prior radiotherapy, more than 30% of bone marrow reserves, or prior bone marrow/stem cell transplantation.
  6. Any concomitant condition that in the opinion of the investigator could compromise the objectives of this study and the patient's compliance.
  7. Pregnant or lactating individuals.
  8. Current malignancies of another type, with the exception of adequately treated in situ cervical cancer and basal cell skin cancer or other malignancies with no evidence of disease for 2 years or more.
  9. Known history of HIV, HBV or HCV infection.
  10. Documented or known bleeding disorder.
  11. Requirement for anticoagulation treatment that increases INR or aPTT above the normal range (low dose DVT or line prophylaxis is allowed).
  12. Clinically evident CNS metastases or leptomeningeal disease not controlled by prior surgery or radiotherapy; history of seizure disorder not controlled by anti-seizure medication at the time of enrollment. Patients with primary CNS malignancies are excluded.
  13. Patients with a significant cardiovascular disease or condition, including:

    1. Myocardial infarction within 6 months of study entry
    2. NYHA Class III or IV heart failure
    3. Uncontrolled dysrhythmias or poorly controlled angina.
    4. History of serious ventricular arrhythmia (VT or VF, ≥ 3 beats in a row) and/or risk factors (e.g., heart failure, hypokalemia, family history of Long QT Syndrome)
    5. Baseline prolongation of QT/QTc interval (repeated demonstration of QTc ≥ 450 msec for men and 470 msec for women). QTc values up to 500 msec will be acceptable where patient's medical history, e.g. bundle branch block, is known to cause mild QTc prolongation and the condition is well controlled
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03943004
Other Study ID Numbers  ICMJE D18-11161
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Delta-Fly Pharma, Inc.
Study Sponsor  ICMJE Delta-Fly Pharma, Inc.
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Jaffer Ajani, MD M.D. Anderson Cancer Center
PRS Account Delta-Fly Pharma, Inc.
Verification Date April 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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