Clinical trial NCT03790111: A Safety and Efficacy Study of XERMELO® + First-line Chemotherapy in Patients With Advanced Biliary Tract Cancer
Official title: A Phase 2, Multicenter, Open-label, Safety and Efficacy Study of XERMELO® (Telotristat Ethyl) Plus First-line Chemotherapy in Patients With Locally Advanced, Unresectable, Recurrent or Metastatic Biliary Tract Cancer (BTC)
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
Conditions: Biliary Tract Cancer (BTC)
Lead sponsor: TerSera Therapeutics LLC
Sponsor class: INDUSTRY
First posted: 2018-12-31
Enrollment: 53
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: A Phase 2, multicenter, open-label, 2-stage study to assess the safety, tolerability, and efficacy of XERMELO in combination with first-line (1L) therapy (cisplatin \[cis\] plus gemcitabine \[gem\])

Detailed description: A Phase 2, multicenter, open-label, 2-stage study to assess the safety, tolerability, and efficacy of XERMELO in combination with first-line (1L) therapy cis plus gem in patients with unresectable, locally advanced, recurrent or metastatic biliary tract cancer (intrahepatic or extrahepatic cholangiocarcinoma, gallbladder cancer), who are naïve to tumor-directed therapy in the locally advanced or metastatic setting, and for which treatment with 1L therapy (defined as a combination of cis plus gem) is planned.

Eligibility criteria: Inclusion Criteria:

* Male or female adults, ≥18 years of age. Patients of childbearing potential must agree to use an adequate method of contraception during the study and for 30 days after the last dose of XERMELO
* Histopathologically or cytologically-confirmed, unresectable, locally advanced, recurrent, or metastatic biliary tract cancer (BTC)
* Naïve to tumor-directed therapy in locally advanced, unresectable, or metastatic setting
* Measurable disease
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1
* Plans to initiate treatment with 1L therapy (cisplatin plus gemcitabine)
* Ability to provide written informed consent prior to participation in any study-related procedure

Exclusion Criteria:

* Prior exposure to XERMELO, telotristat ethyl, telotristat etiprate, LX1032, or LX1606
* Primary tumor site in the ampulla of Vater
* Treatment with photodynamic therapy for localized disease or to relieve biliary obstruction in the presence of metastatic disease within the past 30 days
* Hematology laboratory values of: a. Absolute neutrophil count (ANC) ≤1,500 cells/mm\^3; or b. Platelets ≤100,000 cells/mm\^3; or c. Hemoglobin (Hgb) ≤9 g/dL; or d. White blood count (WBC) ≤3,000 cells/mm\^3
* Hepatic laboratory values of aspartate aminotransferase (AST) or alanine aminotransferase (ALT): a. \>5 x upper limit of normal (ULN) if patient has documented history of hepatic metastases; or b. \>2.5 x ULN if no liver metastases are present
* Serum albumin \<2.8 g/dL
* Total bilirubin \>1.5 x ULN or \>1.5 mg/dL
* Prothrombin time (PT) or international normalized ratio (INR) \>1.5 x ULN
* Serum creatinine or serum urea \>1.5 x ULN
* Estimated glomerular filtration rate (eGFR) \<50 mL/min
* Positive pregnancy test, pregnant, or breastfeeding
* Any other clinically significant laboratory abnormality that would compromise patient safety or the outcome of the study
* Any clinically significant and/or uncontrolled cardiac-related abnormality that would compromise patient safety or the outcome of the study
* Myocardial infarction within the past 6 months
* Active bleeding diathesis
* Life expectancy ≤3 months
* Current complaints of persistent constipation or history of chronic constipation, bowel obstruction or fecaloma within the past 6 months
* Receiving chronic treatment with corticosteroids ≥5 mg of prednisone per day (or equivalent) or other immunosuppressive agent(s)
* History and/or uncontrolled hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV Ab), or human immunodeficiency virus (HIV)-1 or HIV-2
* History of substance or alcohol abuse within the past 2 years
* History of galactose intolerance, deficiency of Lapp lactase, or glucose-galactose malabsorption
* History of malignancy or active treatment for malignancy within 5 years
* Receipt of live, attenuated vaccine or close contact with someone who has received a live, attenuated vaccine within the past 1 month
* Receipt of any investigational agent or study treatment (ie, any treatment or therapy not approved by the FDA for the treatment of BTC) within the past 30 days
* Receipt of any protein or antibody-based therapeutic agents within the past 3 months
* Treatment with any tumor-directed therapy within the past 6 months with curative intent
* Existence of any surgical or medical condition that, in the judgment of the Investigator, might compromise patient safety or the outcome of the study
* Presence of any clinically significant findings (relative to the patient population) during review of medical history or upon physical exam that, in the Investigator's or Medical Monitor's opinion, would compromise patient safety or the outcome of the study
* Evidence of brain metastases
* Unable or unwilling to communicate or cooperate with the Investigator for any reason
* Employee of Sponsor or clinical site, or relative of any member of a clinical site's staff

Primary outcomes:
measure: Number of Participants With Progression-free Survival (PFS) as Evaluated by Central Radiologist's Assessment
timeFrame: Month 6
measure: Project Overall Survival Rate at Month 6
timeFrame: 6 Months
Secondary outcomes:
measure: Overall Survival (OS)
timeFrame: First dose of study treatment until the date of death due to any cause, whichever came first, a median of approximately 17.67 months
measure: Project Overall Survival Rate at Month 12
timeFrame: 12 Months
measure: Median Progression Free Survival
timeFrame: Month 12
measure: Disease Control Rate (DCR), Central Radiologist's Assessment
timeFrame: Month 6
measure: Disease Control Rate (DCR), Central Radiologist's Assessment
timeFrame: Month 12
measure: Disease Control Rate (DCR), Central Radiologist's Assessment
timeFrame: End of Study up to 24 months
measure: Overall (Objective) Response Rate (ORR), Central Radiologist's Assessment
timeFrame: Month 6
measure: Overall (Objective) Response Rate (ORR), Central Radiologist's Assessment
timeFrame: Month 12
measure: Overall (Objective) Response Rate, Central Radiologist's Assessment
timeFrame: End of Study as defined up to 24 months
measure: Summary of Duration of Progression Free Survival, Local Radiologist's Assessment
timeFrame: up to 7 months
measure: Progression Free Survival, Local Radiologist's Assessment
timeFrame: Month 12
measure: Progression Free Survival, Local Radiologist's Assessment
timeFrame: End of Study as defined up to 24 months
measure: Overall (Objective) Response Rate, Local Read
timeFrame: 6 Months
measure: Overall (Objective) Response Rate, Local Reader's Assessment
timeFrame: 12 Months
measure: Overall (Objective) Response Rate (ORR), Local Reader's Assessment
timeFrame: End of Study as defined up to 24 months
measure: Disease Control Rate (DCR), Local Reviewer
timeFrame: Month 12 as defined by 1 year
measure: Disease Control Rate (DCR), Local Reviewer
timeFrame: Month 6
measure: Disease Control Rate End of Study, Local Reviewer
timeFrame: End of Study as defined up to 24 months
measure: Mean Change From Baseline in Plasma 5-hydroxyindoleacetic Acid (5-HIAA)
timeFrame: Month 6
measure: Mean Change From Baseline in Plasma 5-hydroxyindoleacetic Acid (5-HIAA)
timeFrame: Month 12
measure: Mean Change From Baseline in Plasma 5-hydroxyindoleacetic Acid (5-HIAA)
timeFrame: End of Study as defined up to 24 months
measure: Change From Baseline in Carbohydrate Antigen 19-9 (CA 19-9)
timeFrame: Month 6
measure: Change From Baseline in Carbohydrate Antigen 19-9 (CA 19-9)
timeFrame: Month 12
measure: Change From Baseline in Plasma Carbohydrate Antigen 19-9 (CA 19-9)
timeFrame: End of Study as defined up to 24 months
measure: Weight Change From Baseline
timeFrame: Month 6
measure: Weight Change From Baseline
timeFrame: Month 12
measure: Weight Change From Baseline
timeFrame: End of Study as defined up to 24 months
measure: Change From Baseline in Serum Albumin
timeFrame: Month 6
measure: Change From Baseline in Serum Albumin
timeFrame: Month 12
measure: Change From Baseline in Serum Albumin
timeFrame: End of Study as defined up to 24 months
Other outcomes:
Locations:
city: Gilbert
country: United States
facility: TerSera Investigational Site
state: Arizona
city: Fullerton
country: United States
facility: TerSera Investigational Site
state: California
city: Gainesville
country: United States
facility: TerSera Investigational Site
state: Florida
city: Tampa
country: United States
facility: TerSera Investigational Site
state: Florida
city: Chicago
country: United States
facility: TerSera Investigational Site
state: Illinois
city: Westwood
country: United States
facility: TerSera Investigational Site
state: Kansas
city: Lexington
country: United States
facility: TerSera Investigational Site
state: Kentucky
city: Boston
country: United States
facility: TerSera Investigational Site
state: Massachusetts
city: Grand Rapids
country: United States
facility: TerSera Investigational Site
state: Michigan
city: Buffalo
country: United States
facility: TerSera Investigational Site
state: New York
city: Lake Success
country: United States
facility: TerSera Investigational Site
state: New York
city: Charlotte
country: United States
facility: TerSera Investigational Site
state: North Carolina
city: Oklahoma City
country: United States
facility: TerSera Investigational Site
state: Oklahoma
city: San Antonio
country: United States
facility: TerSera Investigational Site
state: Texas
Study officials:
affiliation: Roswell Park Cancer Institute
name: Renuka Iyer, M.D.
role: STUDY_CHAIR
affiliation: H. Lee Moffitt Cancer Center and Research Institute
name: Richard Kim, M.D.
role: STUDY_CHAIR
References: