This study has two portions. The main goal of the Phase I portion of this research study is to see what doses of CB-839 and capecitabine can safely be given to patients without having too many side effects. Other purposes of this research study will be to determine what side effects are seen with this combination of medicines. The Phase II portion of the study will test how many patients show shrinkage in their tumor with this combination of medicines and what changes occur inside the cancer cells and blood cells after treatment.
Phase I Primary Objective: To determine the safety, tolerability and recommended phase II dose (RP2D) of combination CB-839 and capecitabine chemotherapy in patients with advanced solid tumors for whom there are no remaining treatment options or for whom single agent capecitabine is an acceptable therapy. Phase II Primary Objective: To determine the disease control rate of combination CB-839 and capecitabine chemotherapy in patients with metastatic PIK3CA mutant colorectal cancers who are refractory to fluoropyrimidine based therapy. Phase I Secondary Objectives: To determine the dose-limiting toxicities and maximum tolerated dose of combination therapy with CB-839 and capecitabine in patients with advanced solid tumors for whom there are no remaining treatment options or for whom single agent capecitabine is an acceptable therapy. To determine the disease control rate as assessed by RECIST criteria of combination therapy with CB-839 and capecitabine in patients with advanced solid tumors for whom there are no remaining treatment options or for whom single agent capecitabine is an acceptable therapy. Phase II Secondary Objectives: To determine the progression free survival following treatment with CB-839 and capecitabine chemotherapy in patients with metastatic PIK3CA mutant colorectal cancer and are refractory to fluoropyrimidine therapy. To determine the overall survival following treatment with CB-839 and capecitabine chemotherapy in patients who have metastatic PIK3CA mutant colorectal cancer and are refractory to fluoropyrimidine therapy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Patients will receive CB-839 orally twice daily during each cycle. Each cycle will be 21 days long. Disease assessment will occur after cycle 3.
capecitabine will be given orally twice daily for 14-21 days of cycles. Each cycle will be 21 days long. Disease assessment will occur after cycle 3.
University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
Cleveland Clinic Taussig Cancer institute, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
PHASE I: Recommended Dose for Phase II Study
The Phase I study has been designed to define the recommended phase II dose of CB-839 and capecitabine. A traditional 3+3 dose escalation design will be adopted. Nine to twenty-four patients are expected to be enrolled, depending on the number of dose escalations and assuming that a total of 6 patients will be treated at the final recommended phase II dose level. Patients who complete the first 21 day treatment cycle of CB-839 and capecitabine chemotherapy will be included in the analysis.
Time frame: At least 21 days of treatment
PHASE II: Progression-free Survival (PFS)
The number of participants that achieved PFS will be analyzed. Progression free survival (PFS) on combination CB-839 and capecitabine as determined by clinical assessment and RECIST criteria in patients with metastatic PIK3CA mutant colorectal cancer who are refractory to fluoropyrimidine based therapy. Progression free survival is defined as the time from randomization to documented progression or death without progression.
Time frame: 6 months
PHASE I: Proportion of Patient Who Respond to Treatment
Disease control rate will be determined using RECIST criteria. RECIST response categories: Progressive disease (PD): \>=20% increase in sum of longest diameter (LD) of target lesion(s), taking as reference smallest sum LD recorded since treatment started. Complete response (CR): disappearance of all target lesions. Partial response (PR): \>=30% decrease in sum of LD of target lesion(s), taking as reference baseline sum LD. Stable disease (SD): neither sufficient shrinkage to qualify as PR nor sufficient increase to qualify as PD.
Time frame: At least 21 days of treatment
PHASE I: Dose-limiting Toxicities
Phase I: Dose-limiting toxicities as assessed by CTCAE version 4 of combination CB-839 and capecitabine in patients with advanced solid tumors with no remaining treatment options or patients for whom single agent capecitabine is an acceptable therapy
Time frame: Up to 18 months after beginning treatment
PHASE II: Number of Patients With Response to Treatment
In the phase II component of this study, the primary endpoint is response rate. Disease control rate will be determined using RECIST criteria. RECIST response categories: Progressive disease (PD): \>=20% increase in sum of longest diameter (LD) of target lesion(s), taking as reference smallest sum LD recorded since treatment started. Complete response (CR): disappearance of all target lesions. Partial response (PR): \>=30% decrease in sum of LD of target lesion(s), taking as reference baseline sum LD. Stable disease (SD): neither sufficient shrinkage to qualify as PR nor sufficient increase to qualify as PD.
Time frame: Up to 18 months after beginning treatment
PHASE II: Overall Survival
The number of participants to achieve overall survival will be analyzed. Overall survival of patients with metastatic PIK3CA mutant colorectal cancer who are refractory to fluoropyrimidine based therapy following treatment with CB-839 and capecitabine chemotherapy. Overall survival is defined as the time from randomization to death from any cause.
Time frame: Up to 18 months after beginning treatment
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