This is a nonrandomized, open-label, single group assignment, safety, tolerability and pharmacokinetic (PK) study to determine the MTD and optimal dosing regimen of Oraxol in combination with ramucirumab.
This is a sequential-group, dose escalation trial to determine the maximum tolerated dose of oral Oraxol in combination with intravenous ramucirumab. After a screening period of up to 28 days subjects will be enrolled into the treatment phase of the study. Each cycle of therapy will last 4 weeks. Subjects may continue in the study until they experience disease progression or unacceptable toxicity. Three to six subjects will be enrolled at each dose level. Once the tolerability of a dose level has been determined, an additional 3-6 subjects may be enrolled at a higher dose level, to determine the maximum tolerated dose. Safety will be monitored through recording of adverse events, serious adverse events, monitoring of laboratory tests including hematology, blood chemistry, urinalyses, physical examinations and electrocardiograms. Subjects will undergo radiographic assessments for tumor response at specified time points. Blood samples will also be obtained in the first cycle of therapy at multiple time points for determination of the amount of paclitaxel and metabolites and HM30181 in the circulation. After the treatment period, there will be a follow-up period during which the subject or family may be contacted every three months for follow-up.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
36
Oraxol (Paclitaxel and HM30181A) will be dosed orally. Paclitaxel will be supplied as capsules and HM30181A will be supplied as tablets.
Ramucirumab will be administered by iv infusion and supplied as a solution at a concentration of 10 mg/mL
CTRC-UT
San Antonio, Texas, United States
China Medical University Hospital
Taichung, Taiwan
Tri-Service General Hospital
Taipei, Taiwan
Taipei Veterans General Hospital
Taipei, Taiwan
Lotung Poh-Ai Hospital
Maximum tolerated dose (MTD)
The primary endpoint of determining the MTD will be based on DLT
Time frame: The first 4 weeks
To determine the safety and tolerability of Oraxol in combination with ramucirumab
Safety assessments will consist of determining and recording all AEs (including for both increasing and decreasing severity) and SAEs
Time frame: through study completion
The recommended Phase 2 dose of Oraxol in combination with ramucirumab
Evaluation of the 3-day MTD for Oraxol in combination with ramucirumab, including safety, tolerability, and pharmacokinetics, will be used to determine the recommended Phase 2 dose
Time frame: One month
To characterize the area under the blood concentration curve (AUCt) of Oraxol in combination with ramucirumab
Derived by noncompartmental analysis using the plasma concentration-time data of Oraxol (paclitaxel and its major metabolites, 3'-p-hydroxy paclitaxel and 6α-hydroxy paclitaxel, and HM30181 methanesulfonate monohydrate and its M1 metabolite)
Time frame: Day 1 and 3: Predose, 8 timepoints up to 8 hours postdose; Day 2: Predose; Day 8 and 15: Predose, and between 1 and 3 hours postdose
To characterize the area under the plasma concentration-time curve from 0 to 8 hours (AUC0-8h) of Oraxol in combination with ramucirumab
Derived by noncompartmental analysis using the plasma concentration-time data of Oraxol (paclitaxel and its major metabolites, 3'-p-hydroxy paclitaxel and 6α-hydroxy paclitaxel, and HM30181 methanesulfonate monohydrate and its M1 metabolite)
Time frame: Day 1 and 3: Predose, 8 timepoints up to 8 hours postdose; Day 2: Predose; Day 8 and 15: Predose, and between 1 and 3 hours postdose
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Yilan, Taiwan
To characterize the maximum observed plasma concentration (Cmax) of Oraxol in combination with ramucirumab
Derived by noncompartmental analysis using the plasma concentration-time data of Oraxol (paclitaxel and its major metabolites, 3'-p-hydroxy paclitaxel and 6α-hydroxy paclitaxel, and HM30181 methanesulfonate monohydrate and its M1 metabolite)
Time frame: Day 1 and 3: Predose, 8 timepoints up to 8 hours postdose; Day 2: Predose; Day 8 and 15: Predose, and between 1 and 3 hours postdose
To characterize the minimum observed plasma concentration (Cmin) of Oraxol in combination with ramucirumab
Derived by noncompartmental analysis using the plasma concentration-time data of Oraxol (paclitaxel and its major metabolites, 3'-p-hydroxy paclitaxel and 6α-hydroxy paclitaxel, and HM30181 methanesulfonate monohydrate and its M1 metabolite)
Time frame: Day 1 and 3: Predose, 8 timepoints up to 8 hours postdose; Day 2: Predose; Day 8 and 15: Predose, and between 1 and 3 hours postdose
To characterize the plasma half-life (t1/2) of Oraxol in combination with ramucirumab
Derived by noncompartmental analysis using the plasma concentration-time data of Oraxol (paclitaxel and its major metabolites, 3'-p-hydroxy paclitaxel and 6α-hydroxy paclitaxel, and HM30181 methanesulfonate monohydrate and its M1 metabolite)
Time frame: Day 1 and 3: Predose, 8 timepoints up to 8 hours postdose; Day 2: Predose; Day 8 and 15: Predose, and between 1 and 3 hours postdose
To characterize the accumulation factor (R) of Oraxol in combination with ramucirumab
Derived by noncompartmental analysis using the plasma concentration-time data of Oraxol (paclitaxel and its major metabolites, 3'-p-hydroxy paclitaxel and 6α-hydroxy paclitaxel, and HM30181 methanesulfonate monohydrate and its M1 metabolite)
Time frame: Day 1 and 3: Predose, 8 timepoints up to 8 hours postdose; Day 2: Predose; Day 8 and 15: Predose, and between 1 and 3 hours postdose
To characterize the apparent volume of distribution (Vd/F) of Oraxol in combination with ramucirumab
Derived by noncompartmental analysis using the plasma concentration-time data of Oraxol (paclitaxel and its major metabolites, 3'-p-hydroxy paclitaxel and 6α-hydroxy paclitaxel, and HM30181 methanesulfonate monohydrate and its M1 metabolite)
Time frame: Day 1 and 3: Predose, 8 timepoints up to 8 hours postdose; Day 2: Predose; Day 8 and 15: Predose, and between 1 and 3 hours postdose
To characterize the apparent total clearance (CL/F) of Oraxol in combination with ramucirumab
Derived by noncompartmental analysis using the plasma concentration-time data of Oraxol (paclitaxel and its major metabolites, 3'-p-hydroxy paclitaxel and 6α-hydroxy paclitaxel, and HM30181 methanesulfonate monohydrate and its M1 metabolite)
Time frame: Day 1 and 3: Predose, 8 timepoints up to 8 hours postdose; Day 2: Predose; Day 8 and 15: Predose, and between 1 and 3 hours postdose
Preliminary activity of Oraxol plus ramucirumab as determined by response rate
Tumor response will be evaluated according to RECIST v1.1 criteria
Time frame: Subjects will be evaluated for tumor response per RECIST v1.1 criteria after every 8 weeks (ie, at Weeks 9, 17, 25, etc).
Preliminary activity of Oraxol plus ramucirumab as determined by progression-free survival
Tumor response will be evaluated according to RECIST v1.1 criteria
Time frame: Subjects will be evaluated for tumor response per RECIST v1.1 criteria after every 8 weeks (ie, at Weeks 9, 17, 25, etc).
Preliminary activity of Oraxol plus ramucirumab as determined by overall survival
There will be a Follow-up Period during which survival data will be collected
Time frame: Investigator,telephone, or family member contact or public records access will be performed every 3 months for the purpose of assessing overall survival.