Part 1: Dose-Escalation Phase (Phase 1b) The primary objective is to assess the safety and tolerability of increasing doses of D07001 softgel in patients with unresectable locally advanced or metastatic gastrointestinal (GI) cancer. Part 2: Dose-Expansion Phase (Phase 2) The primary objective is to assess the safety and tolerability of D07001 softgel in patients who have achieved stable disease or better following first line chemotherapy or combined chemoradiotherapy (CCRT) for unresectable metastatic or locally advanced biliary tract cancer (BTC)
This open label, multicenter study will be conducted in 2 parts: a dose-escalation phase (Part 1) and a dose-expansion phase (Part 2). In both Part 1 and Part 2, eligible patients will be assigned to receive oral D07001-softgel on Days 1, 3, 5, 8, 10, 12, 15, 17, and 19 of a 21-day cycle (9 doses per cycle). Part 1: Dose Escalation Phase (Phase 1b) Part 1 of the study will follow a 3+3 dose escalation scheme at predefined dose levels. There will be sequential cohorts of 3 to 6 patients each with increasing doses of 40 mg, 60 mg, 80 mg, 120 mg, and 160 mg per cohort. There will be no intra patient dose escalation. Cycle 1 (21 days) is defined as the dose limiting toxicity (DLT) assessment period. Part 2: Dose Expansion Phase (Phase 2) In Part 2 of the study, eligible patients will be randomized in a 1:1 ratio to receive D07001-softgel in an open label manner at 1 of the 2 dose levels selected for expansion. Twenty (20) patients will be enrolled to each dose expansion cohort. Patients will be treated until withdrawal from treatment due to disease progression according to RECIST v1.1, withdrawn consent, or when another treatment discontinuation criterion is met. Patients who are discontinued from study drug for reasons other than disease progression or toxicity in the first 2 cycles of Part 2 will be replaced.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
19
Active Ingredient:Gemcitabine hydrochloride
China Medical University Hospital
Taichung, Taiwan
National Cheng-Kung University Hospital
Tainan, Taiwan
National Taiwan University Hospital
Taipei, Taiwan
Taipei Veterans General Hospital
Taipei, Taiwan
Part 1: Establish the Maximum Tolerated Dose (MTD)
MTD will be defined based on the number of dose limiting toxicities (DLT) in subjects at each dose level. DLT definition: In Part 1 of the study, any of the following AEs occurring during Cycle 1 will be classified as DLTs, if there is a reasonable possibility that it is related to the study drug * Hematologic: * Grade 4 neutropenia lasting \>7 days * Febrile neutropenia (defined as neutropenia Grade ≥3 and a body temp ≥38.3°C) * Grade ≥3 neutropenic infection * Grade 4 anemia * Grade ≥3 thrombocytopenia with bleeding * Grade 4 thrombocytopenia * Non-hematologic: o Grade ≥3 toxicities that are considered clinically significant, except those that have not been maximally treated (e.g., nausea, vomiting, diarrhea\*) or can be easily treated (e.g., electrolyte abnormalities). * Failure to deliver at least 6 of the planned 9 doses during Cycle 1 due to treatment-related toxicities. * Upon the second occurrence of a toxicity leading to a dose hold.
Time frame: During Cycle 1 of treatment (each cycle is 21 days) for each subject
Part 1 : Incidence of Adverse Events (AEs)/ Serious Adverse Event (SAEs)
AEs will be assessed via the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03
Time frame: From date of informed consent to 30-day follow-up visit for each subject, an average of 10 months
Part 2: Incidence of Dose Modifications, Including Dose Reduction, Interruption, or Discontinuation of Study Drug
To measure ratio of total subjects who experienced the dose modifications including dose reduction, interruption, or discontinuation of study drug due to AEs.
Time frame: First dose through last dose for each subject, an average of 8 months
Part 1: Pharmacokinetics (PK)- Cmax
PK would be analyzed by maximum concentration (Cmax) of dFdC
Time frame: Cycle 1 Days 1 and 15
Part 1: PK- AUC
PK would be analyzed by Area Under Curve (AUC) of dFdC
Time frame: Cycle 1 Days 1 and 15
Part 2: Pharmacokinetics (PK)- Cmax
PK would be analyzed by maximum concentration (Cmax) of dFdC
Time frame: Cycle 1 Days 1, 8, and 15; Cycle 1 Day 15 and Cycle 2 Day 1 for food-effect cohort only
Part 2: PK- AUC
PK would be analyzed by Area Under Curve (AUC) of dFdC
Time frame: Cycle 1 Days 1, 8, and 15; Cycle 1 Day 15 and Cycle 2 Day 1 for food-effect cohort only
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