A Dose Finding Study of XRP6258 in Patients With Advanced Solid Tumors

Study Overview
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Brief Summary
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Primary Objective: - To determine the maximum tolerated dose (MTD) and the dose-limiting toxicity (DLT) of XRP6258 when given as a weekly 1-hour intravenous (i.v.) infusion for the first 4 consecutive weeks of each 5-week treatment cycle (Day 1, Day 8, Day 15, Day 22 of each 5-week treatment cycle). Secondary Objectives : To define the safety profile of the drug To establish the recommended dose and time interval for future Phase II trials To determine the pharmacokinetic (PK) profile of XRP6258 in man To assess the absolute oral bioavailability of XRP6258 at the i.v. recommended dose (following Protocol Amendment No. 2) To look for evidence of antitumor activity

Detailed Description
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The duration of the study will include the following periods: Pretreatment: 28 to 7 days before first infusion Treatment: Weekly for the first four consecutive weeks during 5-week treatment cycle Post-treatment: 3 - 4 weeks after last infusion. Treatment may be continued until disease progression or unacceptable toxicity or patient refusal.

Official Title
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A Phase I Dose Finding Study of XRP6258 Administered as a Weekly 1-hour Intravenous Infusion to Patients With Advanced Solid Tumors

Conditions
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Advanced Solid Tumor

Intervention / Treatment
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* Drug: Cabazitaxel (XRP6258)


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Signed informed consent prior to beginning protocol specific procedures Histologically proven cancer at the first diagnosis. At study entry, it was desirable but not required to have histological or cytological proof of metastasis in the case of a 1 single metastatic target lesion. Advanced neoplastic disease that was refractory to conventional treatment or for which no standard therapy existed Progressive disease Age 18-70 years ECOG (Eastern Cooperative Oncology Group) performance status of 0 to 2 Off previous anticancer (radio- or chemo-) therapy for at least 4 weeks and 6 weeks if prior nitrosoureas, mitomycin C; recovery from the toxic effects of prior treatment (Grade ≤1, except alopecia any grade) Off previous immunotherapy for at least 1 week provided that patients did not have any residual signs of any toxicity Adequate organ function including: neutrophils ≥2.0 × 109/L; platelets ≥100 × 109/L, creatinine <120 μmol/L (if borderline creatinine values, the creatinine clearance had to be ≥60 mL/min); total bilirubin within normal limit; alanine aminotransferase (ALT)/aspartate aminotransferase (AST)/alkaline phosphatase (ALP) ≤2.5-fold the upper normal limits of the institutional norms (ALP ≤2.5 UNL) Patients registered in this trial had to be treated and followed at the participating centers Patients who had received previous treatment with paclitaxel or docetaxel could be included provided that they did not have any residual signs of taxane toxicity (except alopecia any grade and peripheral neuropathy Grade 1) Exclusion Criteria: Hematological malignancies Pregnant or lactating women or women of childbearing potential (eg, not using adequate contraception) Symptomatic brain metastases Previous extensive radiotherapy (>20% of bone marrow area) Current peripheral neuropathy of any origin including significant residual symptoms due to the use of eg, vinca-alkaloids or platinum ≥Grade 2 according to the National Cancer Institute common terminology criteria for adverse events. Other serious illness or medical conditions: Congestive heart failure or angina pectoris even if medically controlled, previous history of myocardial infarction within 1 year from study entry, uncontrolled hypertension or arrhythmias Existence of significant neurological or psychiatric disorders including dementia or seizures Active infection Uncontrolled peptic ulcer, unstable diabetes mellitus, or other contraindications for the use of corticosteroids Concurrent treatment with other experimental drugs. Participation in another clinical trial with any investigational drug within 30 days prior to patient registration Concurrent treatment with any other anticancer therapy Concomitant radiotherapy Concomitant treatment with corticosteroids. However, patients receiving chronic treatment with corticosteroids (≤20 mg of methylprednisolone or ≤4 mg of dexamethasone or equivalent dose of other corticosteroids), for whatever reason, were eligible. More than 2 prior chemotherapy regimens containing mitomycin C or nitrosoureas More than 2 prior chemotherapy regimens for advanced disease Prior history of severe allergic reaction to docetaxel or paclitaxel Prior intensive chemotherapy with autologous stem cell rescue The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cabazitaxel<br>IV escalation part: XRP6258 administered as a 1-hour IV infusion on Days 1, 8, 15 and 22 of each 5-week cycle until evidence of disease progression, unacceptable toxicity or patient's withdrawal. Oral bioavailability part: XRP6258 administered at the dose of 8.4 mg/m² as an oral administration on Day 1 Cycle 1 and as a weekly 1-hour i.v. infusion at the subsequent weeks of treatment. Patients receiving oral administration at Day 1, Cycle 1 are to fast for 12 hours before and 4 hours after administration. | Drug: Cabazitaxel (XRP6258)<br>* Pharmaceutical form: infusion solution Route of administration: Intravenous<br>* Other names: Jevtana;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dose-limiting toxicity |  | Up to 35 months | 
| Maximum tolerated dose |  | Up to 35 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with adverse events |  | Up to 35 months | 
| Antitumor activity | Measured by X-ray, ultrasound and/or scans | Up to 35 months | 
| Pharmacokinetic parameters including Cmax, AUC(0-t), AUC, t, t1/2λz (h), Vss, CL, accumulation ratio, Tmax metabolite ratio and F (bioavailability) |  | Up to 35 months |