C00-C75
Conditions
Interventions
Group 1: Each treatment cycle is 3 weeks (14 days of S-1 treatment and 7 days recovery). Patients will be assigned to 2 cohorts sequentially.
Cohort 1: S-1 20 mg/m2/dose BID
Oxaliplatin 130 mg/m2 and
Sponsors
Disphar International B.V.
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Has given written informed consent. 2. Is =18 years of age. 3. Has advanced or metastatic solid tumor(s) for which no established curative therapy exists. 4. May have received any number of prior therapies for advanced or metastatic disease. 5. Is able to take medications orally. 6. Has ECOG performance status 0 or 1 on Cycle 1, Day 1. 7. Has a life expectancy of at least 3 months. 8. Left ventricular ejection fraction (LVEF) = the lower limit of normal (LLN) for the institution. 9. Serum troponin T and creatine phosphokinase (CPK)-MB values = upper limit of Normal (ULN) for the institution. 10. Has adequate organ function as defined by the following criteria: a. Aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) =2.5 x ULN; if liver function abnormalities are due to underlying liver metastasis, AST (SGOT) and ALT (SGPT) =5 x ULN. b. Total serum bilirubin of =1.5 x ULN. c. Absolute neutrophil count of =1,500/mm3 (ie, =1.5 x 109/L by International Units [IU]) (excluding measurements obtained within 7 days after administration of G-CSF). d. Platelet count =100,000/mm3 (IU: =100 x 109/L) (excluding measurements obtained within 7 days after transfusion). e. Hemoglobin value of =9.0 g/dL (excluding measurements obtained within 7 days after transfusion). f. Creatinine clearance =60 mL/min based on calculated creatinine clearance (Cockcroft- Gault32 formula) or 24-hour urine collection. g. Is willing and able to comply with scheduled visits, treatment plan, lab tests and other study procedures.
Exclusion criteria
Exclusion criteria: 1. Has had treatment with any of the following within the specified time frame prior to study drug administration: a. Major surgery within prior 4 weeks (the surgical incision should be fully healed prior to study drug administration). b. Radiotherapy within prior 4 weeks. c. >25% of marrow-bearing bone radiated. d. Any chemotherapy within prior 3 weeks. e. Previously received oxaliplatin or S-1. f. Previously received epirubicin with cumulative dose >350 mg/m2 (patients who have received epirubicin with cumulative dose =350 mg/m2 as adjuvant therapy are allowed to enroll). g. Extensive prior exposure to other anthracycline or anthracenedione agents (ie, prior cumulative doxorubicin exposure of =450 mg/m2 or prior mitoxantrone exposure of >100 mg/m2) h. Received trastuzumab (cardiotoxic agent) within prior 24 weeks. i. Any investigational agent received either concurrently or within the last 30 days. j. Current enrollment in another interventional clinical study. 2. Has a serious illness or medical condition(s) including, but not limited to, the following: a. Known brain metastasis or leptomeningeal metastasis. b. Known acute systemic infection. c. Myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack, pulmonary embolism, or deep vein thrombosis within the last 12 months. d. Symptomatic congestive heart failure (New York Heart Association [NYHA] class III or IV e. Ongoing cardiac dysrhythmias (=Grade 2), atrial fibrillation (any grade), or prolongation of QTc interval (>450 msec for males; >470 msec for females). f. Hypertensive crisis or severe hypertension that is not controlled. g. Chronic nausea, vomiting, or diarrhea considered to be clinically significant in the opinion of the Investigator. h. =Grade 1 peripheral neuropathy. i. Recent hemoptysis, coagulopathy and other bleeding disorders considered by the Investigator to be clinically significant. j. Known nephrotic syndrome (proteinuria >2 g/24 hours). k. Known clinically significant interstitial lung disease or pulmonary fibrosis. l. Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS)-related illness. m. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the Investigator would make the patient inappropriate for entry into this study. 3. Is receiving concomitant treatment with the following drugs that may interact with S-1: a. Sorivudine, brivudine, uracil, eniluracil, cimetidine, folinate/folinic acid, and dipyridamole (may enhance S-1 activity). b. Nitroimidazoles, including metronidazole and misonidazole (may enhance S-1 activity) c. Methotrexate (may enhance S-1 activity) d. Clozapine (may increase risk and severity of hematologic toxicity with S-1) e. Allopurinol (may diminish S-1 activity). f. Phenytoin (S-1 may enhance phenytoin activity). g. Flucytosine, a fluorinated pyrimidine antifungal agent (may enhance S-1 activity). 4. Is receiving concomitant treatment with the following drugs that may interaction with epirubicin: a. Cimetidine (may increase the area under the plasma concentrationtime curve [AUC] of epirubicin). b. Dexverapamil (may alter the pharmacokinetics of epirubicin). c. Quinine (may accelera
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To investigate the safety and determine the maximum tolerated dose (MTD) of S-1, either 20 mg/m2 or 25 mg/m2, when combined with epirubicin 50 mg/m2 and oxaliplatin 130 mg/m2 in patients with advanced or metastatic solid tumors. Standard safety monitoring and grading using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03 will be used. | — |
Secondary
| Measure | Time frame |
|---|---|
| To document any antitumor activity observed with S-1 administered in this combination treatment regimen. Tumor assessments will be performed throughout the study period and analyzed using Response Evaluation Criteria in Solid Tumors (RECIST) criteria (Version 1.1, 2009). Computed tomography (CT) scans will be performed at the end of every 3 cycles. | — |
Countries
Germany
Contacts
Public ContactMarkus Möhler
Universtätsmedizin der Johannes Gutenberg-Universität Mainz. I. Med Klinik und Poliklinik Gastrointestinale Onkologie
Outcome results
None listed