Condition or disease | Intervention/treatment | Phase |
---|---|---|
Oesophageal Adenocarcinoma Squamous Cell Carcinoma Solid Tumor | Drug: M6620 Drug: Cisplatin Drug: Capecitabine Radiation: Radiotherapy | Phase 1 |
There is strong scientific rationale for combining ATR inhibitors with DNA damaging agents such as radiation and cisplatin. In particular, ATR inhibition has been shown to be cytotoxic to tumor cells with an impaired DNA damage response, such as those with deficiency in the ATM- or p53 pathway. The high incidence of p53 mutations and the fact that cisplatin and radiation are key therapeutics, makes oesophageal cancer an attractive tumor type to test the activity of an ATR inhibitor. Given the reported synthetic lethal relationship between ATM and ATR, it is likely that ATR inhibition in an ATM- or p53- deficient background will offer a specific and effective way of targeting OAC and SCC of the oesophagus, and enhance the current standard of care.
The trial will be divided into three stages. Stage A1 will explore the combination of M6620 plus radiotherapy in the palliative setting and Stage A2 will explore the combination of M6620 plus chemotherapy in the palliative setting. Stage B, will explore the combination of all 3 (M6620 plus chemoradiotherapy in the radical setting).
In Stage A1 of the study M6620 will be combined with radiotherapy for the first time and the starting dose will be 140mg/m2 M6620, which has been well-tolerated. M6620 will be administered with daily palliative radiotherapy during this stage in order to study the specific interaction of M6620 with radiotherapy (acting as the DNA damaging agent during this trial stage).
In Stage A2 of the study, M6620 will be combined with Cisplatin and Capecitabine combination chemotherapy for the first time; with a starting dose of 90mg/m2 M6620. M6620 will be administered 24 hours post cisplatin infusion, aiming to achieve maximum treatment benefit. Stage A1 and A2 together will help give an indication of a toxicity profile before administration with chemoradiotherapy (Stage B).
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 65 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Intervention Model Description: | CHARIOT will use a single arm, open-label, dose escalation, Time-To-Event Continual Reassessment Method (TiTE-CRM) to find the optimal treatment schedule. |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase 1 Dose Escalation Safety Study Combining the ATR Inhibitor M6620 With Chemoradiotherapy in Oesophageal Cancer & Other Solid Cancers Using Time to Event Continual Reassessment Method |
Actual Study Start Date : | December 4, 2018 |
Estimated Primary Completion Date : | September 2021 |
Estimated Study Completion Date : | May 2023 |
Arm | Intervention/treatment |
---|---|
Experimental: Stage A1, A2 & B
The trial is a single arm study. Different populations are recruited to each stage and the stages run independently of each other. Stage A1 & A2 will commence before Stage B so that safety data can be obtained in the palliative setting prior to Stage B commencing. Stage A1 may be ongoing when Stage B begins. Each Stage has a separate eligibility criteria. Stage A1: M6620 & palliative radiotherapy Stage A2: M6620 & palliative chemotherapy (Cisplatin & Capecitabine) Stage B: M6620 & definitive chemoradiotherapy |
Drug: M6620
M6620 is an unlicensed small molecule ATR inhibitor which can be used in combination with DNA damaging agents. In pre-clinical models it has substantial activity when given with DNA damaging drugs or ionising radiation. The clinical agent (M6620) is currently studied in a phase I trial in Oxford and other centres in combination with gemcitabine, cisplatin, gemcitabine/cisplatin and cisplatin/etoposide.
Drug: Cisplatin Cisplatin is a platinum based chemotherapy drug licensed to treat a number of different types of cancer. Cisplatin use is not considered standard practice in Stage A2 & B, therefore Cisplatin is considered an investigational medicinal product for the purpose of this trial.
Drug: Capecitabine Capecitabine is a chemotherapy drug licensed to treat a number of different types of cancer, it is a noncytotoxic pre-cursor of the cytotoxic 5-fluourouracil. Capecitabine use is not considered standard practice in Stage A2 & B, therefore Capecitabine is considered an investigational medicinal product for the purpose of this trial.
Radiation: Radiotherapy Stage A1 uses palliative radiotherapy. Stage B uses definitive radiotherapy.
|
Ages Eligible for Study: | 16 Years and older (Child, Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
INCLUSION CRITERIA:
For Stage A1:
Hematological and biochemical indices within the ranges below:
For Stage A2:
Hematological and biochemical indices within the ranges below:
For Stage B:
Staging CT scan*
*either CT or PET CT scan within 42 days of first study dose
Haematological and biochemical indices within the ranges below:
EXCLUSION CRITERIA:
Additional Exclusion Criteria for Stage A1 and B:
1) Previous radiotherapy to thorax or upper abdomen
Additional exclusion criteria for Stage A2 and B:
Additional Exclusion Criteria for Stage B:
1) Previous chemotherapy
Contact: Stephanie Levy | +44(0)1865 617084 | octo-CHARIOT@oncology.ox.ac.uk | |
Contact: Claire Brooks | +44(0)1865 617082 | octo-CHARIOT@oncology.ox.ac.uk |
United Kingdom | |
Velindre Cancer Centre | Recruiting |
Cardiff, United Kingdom, CF14 2TL | |
Contact: Paul Shaw | |
Beatson Cancer Centre | Recruiting |
Glasgow, United Kingdom | |
Contact: David McIntosh | |
The Christie | Recruiting |
Manchester, United Kingdom, M20 4BX | |
Contact: Ganesh Radhakrishna | |
The Churchill Hospital, Oxford University Hospitals Trust | Recruiting |
Oxford, United Kingdom, OX3 7LE | |
Contact: Somnath Mukherjee |
Principal Investigator: | Maria A Hawkins, MD FRCR MRCP | University College, London |
Tracking Information | |||||||||
---|---|---|---|---|---|---|---|---|---|
First Submitted Date ICMJE | July 10, 2018 | ||||||||
First Posted Date ICMJE | August 22, 2018 | ||||||||
Last Update Posted Date | November 5, 2019 | ||||||||
Actual Study Start Date ICMJE | December 4, 2018 | ||||||||
Estimated Primary Completion Date | September 2021 (Final data collection date for primary outcome measure) | ||||||||
Current Primary Outcome Measures ICMJE |
|
||||||||
Original Primary Outcome Measures ICMJE | Same as current | ||||||||
Change History | |||||||||
Current Secondary Outcome Measures ICMJE |
|
||||||||
Original Secondary Outcome Measures ICMJE | Same as current | ||||||||
Current Other Pre-specified Outcome Measures |
|
||||||||
Original Other Pre-specified Outcome Measures | Same as current | ||||||||
Descriptive Information | |||||||||
Brief Title ICMJE | M6620 Plus Standard Treatment in Oesophageal and Other Cancer | ||||||||
Official Title ICMJE | A Phase 1 Dose Escalation Safety Study Combining the ATR Inhibitor M6620 With Chemoradiotherapy in Oesophageal Cancer & Other Solid Cancers Using Time to Event Continual Reassessment Method | ||||||||
Brief Summary | This Phase I study will test the combination of a novel ATR inhibitor (M6620) with chemoradiotherapy in oesophageal cancer; utilizing three experimental cohorts (Stage A1, A2 and B). | ||||||||
Detailed Description |
There is strong scientific rationale for combining ATR inhibitors with DNA damaging agents such as radiation and cisplatin. In particular, ATR inhibition has been shown to be cytotoxic to tumor cells with an impaired DNA damage response, such as those with deficiency in the ATM- or p53 pathway. The high incidence of p53 mutations and the fact that cisplatin and radiation are key therapeutics, makes oesophageal cancer an attractive tumor type to test the activity of an ATR inhibitor. Given the reported synthetic lethal relationship between ATM and ATR, it is likely that ATR inhibition in an ATM- or p53- deficient background will offer a specific and effective way of targeting OAC and SCC of the oesophagus, and enhance the current standard of care. The trial will be divided into three stages. Stage A1 will explore the combination of M6620 plus radiotherapy in the palliative setting and Stage A2 will explore the combination of M6620 plus chemotherapy in the palliative setting. Stage B, will explore the combination of all 3 (M6620 plus chemoradiotherapy in the radical setting). In Stage A1 of the study M6620 will be combined with radiotherapy for the first time and the starting dose will be 140mg/m2 M6620, which has been well-tolerated. M6620 will be administered with daily palliative radiotherapy during this stage in order to study the specific interaction of M6620 with radiotherapy (acting as the DNA damaging agent during this trial stage). In Stage A2 of the study, M6620 will be combined with Cisplatin and Capecitabine combination chemotherapy for the first time; with a starting dose of 90mg/m2 M6620. M6620 will be administered 24 hours post cisplatin infusion, aiming to achieve maximum treatment benefit. Stage A1 and A2 together will help give an indication of a toxicity profile before administration with chemoradiotherapy (Stage B). |
||||||||
Study Type ICMJE | Interventional | ||||||||
Study Phase ICMJE | Phase 1 | ||||||||
Study Design ICMJE | Allocation: N/A Intervention Model: Single Group Assignment Intervention Model Description: CHARIOT will use a single arm, open-label, dose escalation, Time-To-Event Continual Reassessment Method (TiTE-CRM) to find the optimal treatment schedule. Masking: None (Open Label)Primary Purpose: Treatment |
||||||||
Condition ICMJE |
|
||||||||
Intervention ICMJE |
|
||||||||
Study Arms ICMJE | Experimental: Stage A1, A2 & B
The trial is a single arm study. Different populations are recruited to each stage and the stages run independently of each other. Stage A1 & A2 will commence before Stage B so that safety data can be obtained in the palliative setting prior to Stage B commencing. Stage A1 may be ongoing when Stage B begins. Each Stage has a separate eligibility criteria. Stage A1: M6620 & palliative radiotherapy Stage A2: M6620 & palliative chemotherapy (Cisplatin & Capecitabine) Stage B: M6620 & definitive chemoradiotherapy Interventions:
|
||||||||
Publications * | van Werkhoven E, Hinsley S, Frangou E, Holmes J, de Haan R, Hawkins M, Brown S, Love SB. Practicalities in running early-phase trials using the time-to-event continual reassessment method (TiTE-CRM) for interventions with long toxicity periods using two radiotherapy oncology trials as examples. BMC Med Res Methodol. 2020 Jun 22;20(1):162. doi: 10.1186/s12874-020-01012-z. | ||||||||
* 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 |
65 | ||||||||
Original Estimated Enrollment ICMJE | Same as current | ||||||||
Estimated Study Completion Date ICMJE | May 2023 | ||||||||
Estimated Primary Completion Date | September 2021 (Final data collection date for primary outcome measure) | ||||||||
Eligibility Criteria ICMJE |
INCLUSION CRITERIA: For Stage A1:
For Stage A2:
For Stage B:
EXCLUSION CRITERIA:
Additional Exclusion Criteria for Stage A1 and B: 1) Previous radiotherapy to thorax or upper abdomen Additional exclusion criteria for Stage A2 and B:
Additional Exclusion Criteria for Stage B: 1) Previous chemotherapy |
||||||||
Sex/Gender ICMJE |
|
||||||||
Ages ICMJE | 16 Years and older (Child, Adult, Older Adult) | ||||||||
Accepts Healthy Volunteers ICMJE | No | ||||||||
Contacts ICMJE |
|
||||||||
Listed Location Countries ICMJE | United Kingdom | ||||||||
Removed Location Countries | |||||||||
Administrative Information | |||||||||
NCT Number ICMJE | NCT03641547 | ||||||||
Other Study ID Numbers ICMJE | OCTO_072 | ||||||||
Has Data Monitoring Committee | No | ||||||||
U.S. FDA-regulated Product |
|
||||||||
IPD Sharing Statement ICMJE | Not Provided | ||||||||
Responsible Party | University of Oxford | ||||||||
Study Sponsor ICMJE | University of Oxford | ||||||||
Collaborators ICMJE | Merck KGaA, Darmstadt, Germany | ||||||||
Investigators ICMJE |
|
||||||||
PRS Account | University of Oxford | ||||||||
Verification Date | February 2019 | ||||||||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |