The purpose of this research study is to determine the safety and efficacy of CPI-613 (devimistat) in the treatment of advanced biliary tract cancer when used in combination with standard of care chemotherapy (gemcitabine plus cisplatin) compared to gemcitabine plus cisplatin alone. This research study has two parts: In the phase 1 portion of this study, patients will receive a combination of CPI-613 and standard of care chemotherapy. Dose levels of CPI-613 will be adjusted to find the best dose, which will be the recommended phase 2 dose level. In the phase 2 portion of this study, patients will be randomized into two arms. Patients in Arm A will receive the combination of the recommended dose level of CPI-613 and standard of care chemotherapy. Patients in Arm B will receive standard of care chemotherapy. At the end of the study, researchers will compare the health outcomes of the patients that received CPI-613 + standard care to the outcomes of patients that received only standard care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
75
Given intravenously
Given intravenously
Given intravenously
University of Arizona Cancer Center
Tucson, Arizona, United States
Northwestern University -- Lurie Comprehensive Cancer Center
Chicago, Illinois, United States
University of Michigan Rogel Cancer Center
Ann Arbor, Michigan, United States
Atlantic Health System
Morristown, New Jersey, United States
University Hospitals - Seidman Cancer Center
Cleveland, Ohio, United States
Allegheny Health Network
Pittsburgh, Pennsylvania, United States
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, United States
University of Texas Southwestern -- Simmons Comprehensive Cancer Center
Dallas, Texas, United States
Fred Hutch/University of Washington Cancer Consortium
Seattle, Washington, United States
University of Wisconsin - Carbone Cancer Center
Madison, Wisconsin, United States
Phase 1: Incidence of Dose-limiting Toxicity
Dose limiting toxicities will determine the maximum tolerated dose (MTD)/recommended Phase 2 dose (RP2D) of combination therapy with CPI-613 + gemcitabine and cisplatin. Assessed using the NCI CTCAE v5.0
Time frame: Up to day 22
Phase 2: Overall Response Rate (ORR)
Objective response assessment will be determined by review of CT or MR scans of the chest, abdomen and pelvis. ORR (Partial Response + Complete Response) will be assessed per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, during active study treatment. All enrolled patients who receive at least 1 cycle of therapy and have their disease re-evaluated will be considered evaluable for response. (Note: Patients who exhibit objective disease progression prior to the end of cycle 1 will also be considered evaluable.)
Time frame: Until last dose of study treatment (up to 2 years)
Median Progression Free Survival (PFS)
PFS will be determined from date of first study treatment until the date of radiological or clinical progression (leading to withdrawal from the study) or date of last disease evaluation (for patients without progression). It will be calculated using the product-limit method of Kaplan and Meier. All patients that receive at least one dose of study treatment will be considered evaluable.
Time frame: Until last dose of study treatment (up to 2 years)
Median Overall Survival (OS)
From date of first study treatment until date of last disease evaluation or until death from any cause. Using the product-limit method of Kaplan and Meier.
Time frame: Up to 3 years after enrollment
Incidence of Toxicities
To evaluate the safety of CPI-613 in combination with gemcitabine and cisplatin in this patient population, assessed using the Common Toxicity Criteria for Adverse Events (CTCAE) v5.0. All patients that receive at least one dose of study treatment will be considered evaluable. Number of patients experiencing the maximum graded toxicity (Grade 2 or higher).
Time frame: Up to 100 days after last dose of study treatment
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