An open-label, dose escalation and maximum tolerated dose (MTD) and/or recommended phase II dose (RPTD) study of fruquintinib combined with paclitaxel in patients with advanced gastric cancer who did not respond to first-line standard chemotherapy.
In dose escalation period, 12-24 patients with advanced gastric cancer will be enrolled. Patients meeting enrollment eligibility will receive 28-day cycles of fruquintinib 2-5 mg qd combined with paclitaxel 80 mg/m2. Safety information and pharmacokinetic data will be collected till disease progression or intolerable toxicity to determine MTD and/or RPTD of fruquintinib combined with paclitaxel in patients with advanced gastric cancer. This period will include the following 4 dose groups from low to high: A: Fruquintinib 2 mg qd for 3 weeks followed by 1-week break + paclitaxel 80 mg/m2 once a week during the first three weeks of each cycle B: Fruquintinib 3 mg qd for 3 weeks followed by 1-week break + paclitaxel 80 mg/m2 once a week during the first three weeks of each cycle C: Fruquintinib 4 mg qd for 3 weeks followed by 1-week break + paclitaxel 80 mg/m2 once a week during the first three weeks of each cycle D: Fruquintinib 5 mg qd for 3 weeks followed by 1-week break + paclitaxel 80mg/m2 once a week during the first three weeks of each cycle This study will use traditional 3+3 trial design (3 subjects will be enrolled in each dose group first. If 1 case of DLT is observed, additional 3 subjects will be enrolled in the same dose group to further evaluate toxicity) to observe DLT and evaluate MTD. If there are 2 or more cases of DLT in one dose group, the group lower than this dose group by one level is MTD dose group. At least 6 subjects are required in MTD dose group for confirmation. If MTD is not achieved at the end of dose escalation and there are 6 subjects in the highest dose group, RPTD can be determined based on obtained safety, tolerability, PK and efficacy information. Dose escalation and study in the next dose group can be initiated only after the first treatment cycle (DLT window observation period) is completed and subject safety and tolerability are confirmed in this dose group (0/3 or ≤1/6 subjects experience DLT). Subjects in the original dose group will continue to receive the next cycle of treatment at the original dose till disease progression or treatment withdrawal due to any of the following reasons: 1) death, 2) intolerable toxicity, 3) pregnancy, 4) the investigator considers the study should be terminated for the subject's best interests, 5) the subject or legal representative requests withdrawal, 6) loss to follow-up, 7) the subject has poor compliance and cannot comply with the study protocol.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
34
28-day cycle of fruquintinib qd for 3 weeks followed by 1-week break combined with paclitaxel 80 mg/m2
Sun Yat-sen University Cancer Center
Guangzhou, Guangdong, China
Hutchison Medi Pharma Investigational Site
Beijing, China
Hutchison Medi Pharma Investigational Site
Shanghai, China
incidence of DLT
Time frame: every subject's DLT observation window is 4 weeks
progression free survival of RP2D
using RECIST v1.1 progressive disease (PD), using RECIST v 1.1
Time frame: from first dose up to progressive disease or EOT due to any cause, assessed up to 1 year
safety and tolerance
Safety and tolerance will be evaluated by incidence, severity and outcomes of adverse events (AEs) and categorized by severity in accordance with the NCI CTC AE Version 4.0.
Time frame: From first dose to within 30 days after the last dose
Objective response rate (ORR)
using RECIST v 1.1
Time frame: from first dose up to progressive disease or EOT due to any cause, assessed up to 1 year]
Disease control rate (DCR)
using RECIST v 1.1
Time frame: From first dose up to progressive disease or EOT due to any cause, assessed up to 1 year]
Pharmacokinetic profiles of Fruquintinib combined with Paclitaxel
PK sampling of Fruquintinibwill include a pre-dose and 1,2,4,8,24 hours time-point at Day 2 and day 15 of dosing in the first 28-day cycle; PK sampling of Paclitaxel will include a pre-dose and at 0.25,1,2,4,8, and 24 hours time-point on day 1 and day 15 of dosing in the first 28-day cycle
Time frame: From first dose up to day 15 in the first 28-day cycle
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