Phase 1: Assessment of safety and tolerability of ADI-PEG 20 in combination with folinic acid (leucovorin), fluorouracil and oxaliplatin (FOLFOX) in advanced GI malignancies. Phase 2: Assessment of the objective response rate (ORR), measured by RECIST 1.1 criteria as assessed by blinded independent central review (BICR).
Phase 1:The primary objective of the dose escalation portion of this study was to assess the safety and tolerability of ADI-PEG 20 in combination with folinic acid (leucovorin), fluorouracil (5-FU), and oxaliplatin (mFOLFOX6) in advanced GI malignancies. The primary objective of the maximum tolerated dose (MTD) expansion phase (recommended phase 2 dose \[RP2D\]) of this study was to determine preliminary estimates of efficacy, measured by RECIST 1.1 criteria, for ADI-PEG 20 in combination with FOLFOX in hepatocellular carcinoma (HCC), gastro-esophageal cancer (GEC), and colorectal cancer (CRC). Phase 2: The primary objective of this single arm trial is ORR. Based on a two-sided exact test of a one-sample proportion with an alpha of 0.05, under a presumed ORR of 22%, there is 80% power to yield 95% confidence interval of 15-26%, which will require 46 objective responses in 225 subjects. A futility analysis will be described in the Statistical Analysis Plan.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
140
Objective response rate (ORR)
The percent of subjects who exhibit each level of tumor response, measured by RECIST 1.1 criteria as assessed by blinded independent central review.
Time frame: Date of first study drug administration to the date of disease progression (measured every 8 weeks) or death (whichever occurs first), up to 24 months
Progression free survival (PFS)
Time from the first dose until objective tumor progression or death from any cause
Time frame: Date of first study drug administration to the date of disease progression (measured every 8 weeks) or death (whichever occurs first), 12 months anticipated
Overall survival (OS)
The time from first treatment with ADI-PEG 20 until death or censoring
Time frame: Date of first study drug administration through study completion
Duration of response (DoR)
the time in weeks between the first occurrence of objective response and the development of progressive disease or death
Time frame: From date of first response until the date of documented progression or date of death, 12 month in average
Disease control rate (DCR)
the proportion of subjects at each post-baseline assessment who exhibit tumor response of complete response, partial response or stable disease
Time frame: Date of first study drug administration to the date of disease progression (measured every 8 weeks) or death (whichever occurs first), up to 24 months.
Pharmacodynamics
Blood levels of arginine and citrulline
Time frame: At week 1, 5, 9, 13, 17, 21 prior to ADI-PEG 20 administration
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California Pacific Medical Center
San Francisco, California, United States
Emory University
Atlanta, Georgia, United States
The University of Chicago Medical Center
Chicago, Illinois, United States
The University of Kansas Cancer Center
Westwood, Kansas, United States
Masonic Cancer Center
Minneapolis, Minnesota, United States
Washington University
St Louis, Missouri, United States
Memorial Sloan-Kettering Cancer Center
New York, New York, United States
Oregon Health and Science University
Portland, Oregon, United States
UPMC Hillman Cancer Center
Pittsburgh, Pennsylvania, United States
University of Washington
Seattle, Washington, United States
...and 25 more locations
Pharmacokinetics Variable
Peripheral blood levels of ADI-PEG 20
Time frame: At week 1, 5, 9, 13, 17, 21 prior to ADI-PEG 20 administration
Immunogenicity
antibodies to ADI-PEG 20
Time frame: At week 1, 5, 9, 13, 17, 21 prior to ADI-PEG 20 administration
AFP (alpha feto-protein) changes
Maximal percent changes of AFP during the course of study compared to AFP at baseline
Time frame: At baseline, week3, 7, 11, 15, 19, 23 and end of treatment