Phase Ib part of this study determines the recommended phase II dose schedule based on ASLAN001-004 phase Ib (dose-confirmation study of Varlitinib combined with weekly paclitaxel and carboplatin or trastuzumab (Herceptin) in advanced solid tumours). Phase II part of this study further assesses the safety and clinical efficacy of this combination treatment as a second line treatment in EGFR/HER2 co-expressing advanced or metastatic gastric cancer.
This is a two-part, Phase Ib/II, Open label, single arm, multicenter study to determine the maximum tolerated dose (MTD) and the recommended dose schedule of varlitinib in combination with paclitaxel and to further ASLAN001-017\_Clinical Study Protocol Version 01\_09 Oct 2018 CONFIDENTIAL 7 assess the safety and clinical efficacy of this combined treatment in EGFR/HER2 co-expressing advanced or metastatic gastric cancer after first line treatment. The objective of this trial is to allow development of an effective chemotherapeutic regimen in patients with advanced/metastatic gastric cancer with EGFR/HER-2 co-expression. This trial will also be included in second line Umbrella trial in Yonsei Cancer Center (YCC) (Figure 1). Patients with EGFR and HER2 co-expression will be confirmed by immunohistochemistry (IHC) and NGS in a central laboratory (Yonsei Cancer Center), and those who meet all eligibility criteria will be enrolled in this study. The patients enrolled in the study will receive combined treatment with varlitinib and paclitaxel until progressive disease is confirmed or at least 1 discontinuation criterion is met (i.e development of intolerable toxicities, patient"s refusal or consent withdrawal or death). Based on previously reported study results, we arrived at an assumption that about 20-25% of screened patients will be categorized as EGFR and HER2 co-expressing gastric cancer.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
27
Varlitinib will be administered orally to the study participants at doses 300mg, BID in combination with the weekly intravenous infusion of Paclitaxel for 3 weeks with a rest period of 1 week.
Yonsei University Health System, Yonsei Cancer Center
Seoul, South Korea
(Phase Ib) Maximum Tolerated dose
Time frame: 3 years
(Phase Ib) Dose limiting Toxicity
Time frame: 3 years
(Phase II) Progression-free survival
Progression-free survival (PFS): Defined as the time from start of study treatment until the date of objective disease progression or death (by any cause in the absence of disease progression) Progression is defined in accordance with the RECIST v1.1 criteria.
Time frame: 3 years
Overall Survival
Overall Survival (OS): Defined as the time from start of study treatment until death by any cause. Any subject not known to have died at the time of the analysis will be censored based on the last recorded date on which the subject was known to be alive.
Time frame: 3 years
Objective Response Rate
Objective Response Rate (ORR)- Objective response rate is defined as the number (%) of patients with at least one confirmed visit response of CR or PR.
Time frame: 3 years
Disease Control Rate
Disease Control Rate (DCR): Defined as the proportion of subjects with a best objective response (BOR) of complete response (CR) or partial response (PR), or stable disease maintained for a minimum of twelve weeks (± 5 days) from start of treatment, as defined by the RECIST v1.1 criteria.
Time frame: 3 years
Progression-free survival
Progression-free survival (PFS): Defined as the time from start of study treatment until the date of objective disease progression or death (by any cause in the absence of disease progression) Progression is defined in accordance with the RECIST v1.1 criteria. Determination of PFS rate at 24 weeks.
Time frame: 3 years
Number of Participants With Adverse Events That Are Related to Treatment
Safety and tolerability of the Varlitinib and Paclitaxel combination therapy as determined by adverse events categorized in accordance with CTCAE 4.03 Criteria.
Time frame: 3 years
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