This study evaluates the combination of SCO-101 to FOLFIRI for the treatment of metastatic colorectal cancer patients who have developed resistance to FOLFIRI treatment. The study is divided in two parts, where the first part evaluates the safety and toxicity of increasing doses of SCO-101 in combination with FOLFIRI at the same dose as the patient has previously developed resistance to. The second part of the study evaluates the safety and efficacy of the combination of FOLFIRI and SCO-101 at the dose level established in the first part.
This is a multi-center, open label, dose escalation, Phase 2 study of SCO-101 in combination with FOLFIRI in up to 50 mCRC patients. All patients included have previously had effect from treatment with FOLFIRI, but have now progressed (i.e. treatment failure due to acquired resistance). FOLFIRI is a key anti-cancer chemotherapeutic combination in the treatment of several solid tumor cancers, e.g. colorectal cancer. Cancer resistance to FOLFIRI exposure is a well known phenomenon and can often be attributed to upregulation of cellular efflux pumps, e.g. ATP-Binding Cassette (ABC)G2 and ABCB1, involved in the efflux of the chemotherapeutic agents from the cancer cells and resulting in treatment failure. SCO-101 is an inhibitor of ATP-Binding Cassette (ABC) efflux pumps and SRPK1 kinase which is responsible for phosphorylation of splicing factors, a key element involved in tumour growth. The combination of SCO-101 with FOLFIRI is expected to inhibit the active efflux of chemotherapy molecules from the cancer cell thereby re-sensitizing it to the chemotherapeutic agents.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
35
FOLFIRI standard treatment on day 5 to 7 (both days included) of a 14 day period. repeated bi-weekly
Investigational Medicinal Product, oral tablet administered on day 1 to 6 (both days included) of a 14 day period. repeated bi-weekly
Aalborg Universitetshospital - Region Nordjylland
Aalborg, Denmark
RECRUITINGHerlev Hospital
Herlev, Denmark
RECRUITINGHillerød Hospital
Hillerød, Denmark
RECRUITINGSjællands Universitetshospital, Roskilde
Roskilde, Denmark
RECRUITINGSygehus Sønderjylland
Sønderborg, Denmark
RECRUITINGVejle Sygehus
Vejle, Denmark
NOT_YET_RECRUITINGCharité
Berlin, Germany
NOT_YET_RECRUITINGCatholic Hospital Bochum - St. Josef-Hospital
Bochum, Germany
NOT_YET_RECRUITINGUniversity Hospital Of Ulm
Ulm, Germany
NOT_YET_RECRUITINGHospital de la Santa Creu in Sant Pau
Barcelona, Spain
NOT_YET_RECRUITING...and 2 more locations
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] of combination of SCO-101 and FOLFIRI
Safety and tolerability by assessing the number, frequency, and severity of adverse events (AEs) collected from the time of first treatment until four weeks after end of treatment to evaluate safety of SCO-101 in combination with FOLFIRI determined according to CTCAE version 5.0
Time frame: 4 cycles (each cycle is 2 weeks)
Maximum Tolerated Dose
Maximum tolerated dose (MTD) by evaluation of dose-limiting toxicities (DLTs) of SCO-101 in combination with FOLFIRI evaluated by CTCAE v. 5.0 (part 1 only)
Time frame: 1 cycle (each cycle is 2 weeks)
Objective Response Rate
Objective response rate (ORR) defined as CR and PR using the RECIST v. 1.1
Time frame: 4 cycles (each cycle is 2 weeks)
Progression Free Survival (PFS)
Progression free survival (PFS) defined as time in months from the date of first study treatment to the date of disease progression or death from any cause, whichever comes first.
Time frame: Start of treatment to first objective sign of progression, assessed up to 100 months
Duration of Response
Duration of response (from first response to progression)
Time frame: From first response to progression, assessed up to 100 months
Duration of Response compared to prior Duration of response
Duration of response (DOR) after administration of SCO-101 compared to DOR from patients initial FOLFIRI treatment regimen (without SCO-101).
Time frame: From first response to progression, assessed up to 100 months
Overall Survival
Overall survival (OS) defined as time in months from the date of first study treatment to the date of death;
Time frame: Up to 2 years
Clinical Benefit Rate
Clinical benefit rate (CBR) defined as the number of patients obtaining CR, PR, or SD \> 16 weeks according to RECIST v.1.1.
Time frame: from benefit (CR, PR or SD > 16 weeks) to progression, assessed up to 100 months
Pharmacokinetic profile of SCO-101 in combination with FOLFIRI
Pharmacokinetic profile of SCO-101 in blood samples
Time frame: First week of administration (study part 1 only)
ctDNA
Change in ctDNA from baseline (prior first dose of SCO-101) until first CT scan
Time frame: First 4 cycles of treatment (each cycle is 2 weeks) (study part 2 only)
Biomarker UGT1A1
Evaluation of Selected UGT1A1 polymorphism in a pre-treatment blood sample
Time frame: Baseline (pre-treatment (all study parts))
Biomarker IndiTreat(TM)
Efficacy of IndiTreat® to predict clinical response to SCO-101 treatment in combination with FOLFIRI from a tumor biopsy sample.
Time frame: Baseline (pre-treatment tumor biopsy (study part 2 only))
Biomarkers ABCG2, ABCB1, SRPK1
Efficacy of molecular biomarkers ABCB1/ABCG2/SRPK1 determined by immunohistochemistry to predict clinical response to SCO-101 treatment
Time frame: Baseline (Pre-treatment biopsy (study part 2 only))
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.