E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with advanced solid tumours |
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E.1.1.1 | Medical condition in easily understood language |
Patients with advanced solid tumours |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10007050 |
E.1.2 | Term | Cancer |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To establish the maximum tolerated dose (MTD) and dose-limiting toxicities (DLT) of CTX-SPL9111 given intravenously (IV).
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E.2.2 | Secondary objectives of the trial |
- To characterise the safety and tolerability profile of CTX-SPL9111 in patients with advanced cancer - To characterise the pharmacokinetics (PK) of CTX-SPL9111 - To define a recommended dose for phase 2 studies of CTX-SPL9111 dosed IV - To explore preliminary anti-tumour efficacy |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Signed informed consent form. 2. At least 18 years old. 3. Patients with histologically or cytologically confirmed advanced or metastatic cancer for which no curative therapy exists and who, in the opinion of the investigator, could potentially benefit from treatment with taxanes. 4. Measurable or evaluable disease per RECIST version 1.1., Prostate Cancer Working Group 3 (PCWG3) consensus guidelines (i.e. prostate cancer patients with bone-only lesions) or Response Assessment in Neuro- Oncology working group consensus guidelines (RANO; patients with primary central nervous system malignancy). 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. 6. Life expectancy of greater than 12 weeks. 7. Reproductive inclusion criteria: a. If of childbearing potential, willing to use an effective form of contraception (see below) during chemotherapy treatment and for at least six months thereafter. Such methods include (if using hormonal contraception this method must be supplemented with a barrier method, preferably male condom): combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: - oral - intravaginal - transdermal progestogen-only hormonal contraception associated with inhibition of ovulation: - oral - implantable intrauterine device (IUD) intrauterine hormone-releasing system (IUS) bilateral tubal occlusion vasectomised partner true sexual abstinence when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods), declaration of abstinence for the duration of a trial, and withdrawal are not acceptable methods of contraception. b. Women must have a negative pregnancy test at study entry. c. Men who are truly sexually abstinent when this is in line with the preferred and usual lifestyle of the subject or vasectomized or willing to ensure that their female sexual partners use a highly-effective means of contraception (i.e. as outlined in Inclusion criterion 7.a.) for the duration of study therapy and 6 months afterwards. In addition, men must be willing to use a condom during sexual intercourse from the first dose of CTX-SPL9111 until 6 months after their final dose, so as to protect their partner from exposure to study drug.
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E.4 | Principal exclusion criteria |
1. Uncontrolled brain metastases or spinal cord compression. Patients who were treated with surgical resection or radiation therapy completing at least 4 weeks earlier are eligible if they are neurologically stable and have a follow-up MRI scan performed within the previous 4 weeks showing no tumour progression. 2. Inadequate bone marrow reserve as demonstrated by an absolute neutrophil count (ANC) < 1.5 × 109/L or platelet count < 100 × 109/L (cannot be post- transfusion) or haemoglobin < 10 g/dL (can be post-transfusion). 3. Serum bilirubin > upper limit of normal (ULN). 4. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level > 1.5 × ULN. 5. Serum creatinine > 1.5 × ULN; however, an exception can be made if the calculated (by the Cockcroft-Gault formula) or measured creatinine clearance is > 50 mL/min. 6. History of a bleeding diathesis. 7. Allergy to cabazitaxel, other components of study therapy or compounds of similar chemical composition. 8. Congenital long-QT syndrome. 9. Myocardial infarction within 6 months of enrolment, congestive heart failure of New York Heart Association class > II, unstable angina or unstable cardiac arrhythmias. 10. Other uncontrolled intercurrent illness, including active infection. 11. A history of infection with HIV or hepatitis B or C viruses. 12. Participation in a study of an investigational agent within 30 days prior to first study therapy. 13. Anti-tumour therapy (including chemotherapy, radiation therapy, targeted therapeutics or hormonal therapy) within the 30 days prior to first study therapy. Permitted exceptions are concurrent use of GnRH agonists/antagonists for prostate cancer and radiation to bone metastases completed > 14 days prior to first study therapy. 14. Cumulative dose of corticosteroid ≥ 150 mg prednisone (or equivalent doses of corticosteroids) within two weeks before the first IMP administration. 15. Unresolved toxicity from prior anti-tumour therapy, defined as toxicities (excluding alopecia) that have not resolved to < grade 2 as scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Exceptions may be allowed for stable toxicities after discussion with the investigator and sponsor. 16. Symptomatic grade 1 peripheral neuropathy. 17. Peripheral neuropathy of grade 2 or higher due to any cause. 18. Patients with diabetes with signs or symptoms of peripheral neuropathy or other end organ damage or those at a higher risk of peripheral neuropathy (eg: history of poor diabetes control or non-compliance with anti-diabetic medication). 19. Major surgery within 30 days of commencing first study therapy. 20. Pregnant or breast-feeding females. 21. Concurrent or planned treatment with strong inhibitors (e.g. ketoconazole, itraconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole) or inducers (e.g., phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital) of cytochrome P450 3A4/5. Concurrent or planned treatment with St John’s Wort. Concurrent or planned treatment with Organic Anion-Transporting- Polypeptide OATP1B1 substrates (e.g, statins, valsartan, repaglinide) should be avoided during CTX-SPL9111 treatment where possible. A 1-week washout period is necessary for patients already on these treatments. 22. Any concurrent condition which, in the Investigator's opinion, makes it undesirable for the subject to participate in this study or which would jeopardize compliance with the protocol. |
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E.5 End points |
E.5.1 | Primary end point(s) |
14.3 Endpoints 14.3.1 Safety endpoints Toxicity will be graded using the NCI CTCAE v4.03. Safety assessments will include medical review of AEs and the results of vital sign measurements, physical examinations, ECGs and clinical laboratory tests. 14.3.2 Pharmacokinetic Endpoints Plasma concentrations of free and total cabazitaxel versus time will be analysed using non- compartmental methods and a validated PK analysis program to generate the following PK parameters for each patient: Cmax: Maximum observed plasma concentration. Tmax: Time to maximum observed plasma concentration. AUC: Area under the concentration-time curve. t1/2: Apparent terminal half-life. 14.3.3 Efficacy Endpoints RECIST 1.1 criteria, PCWG3 criteria and RANO criteria will be used to classify tumour responses to CTX-SPL9111 into the following categories: (1) complete response; (2) partial response; (3) stable disease; or (4) progressive disease. The following efficacy variables will be derived: Objective Response Rate (ORR) based on RECIST 1.1 Progression Free Survival (PFS) which equals time from enrolment to progression or death whichever comes first Overall Survival (OS) which equals time from enrolment to death Duration of best overall response Duration of stable disease If progression or death are not observed then the time will be censored at the last tumour assessment for PFS, and the last observation for survival. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Please refer to the study protocol. |
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E.5.2 | Secondary end point(s) |
There are no secondary endpoints. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | Yes |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Last patient, last visit in the study. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 0 |