1733tip - a pilot study of oral paclitaxel (oraxol) in ...€¦ · study schema • we are...

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This is a single-arm, multi-centre, pilot study (up to 25 evaluable patients) Major inclusion criteria: eligible subject must have (i) cutaneous angiosarcoma that is not amenable to curative intent surgery; (ii) have not received taxanes for treatment of angiosarcoma; (iii) without metastases outside of local lymph node involvement; (iv) have not received wide-field radiotherapy to the pelvis ≤3 or limited-field radiation for palliation ≤3 months prior to oral paclitaxel with encequidar administration; (v) no active bleeding or bleeding diathesis requiring transfusions; (vi) known active viral or nonviral hepatitis or cirrhosis. Treatment period: Oral paclitaxel (205mg/m 2 ) with encequidar (15 mg) to be administered once daily for 3 consecutive days every week from Weeks 1 through 25 Extension period: From week 26, patients without disease progression are eligible to receive further treatment until study withdrawal criteria are met Tumour response measured by RECIST v1.1 at specified timepoints and safety assessments Primary objective is to determine the response rate (RR) within 6 months of initiation of treatment. Secondary objectives include: (i) safety and tolerability; (ii) PFS; (iii) OS; (iv) duration of- and (v) time to-best response. 1733TiP - A Pilot Study of Oral Paclitaxel (ORAXOL) in Subjects With Cutaneous Angiosarcomas (KX-ORAX-010) Herbert H Loong 1 , Robert Mennel 2 , Michael Wagner 3 , Teresa Tse 1 , Yat-ming Lau 1 , Candy Yuen 1 , Roxanne Moore 3 , Tom Wei-Wu Chen 6 , Chueh-Chuan Yen 7 , Robin L Jones 8 , Min-Fun Rudolf Kwan 4 , David Cutler 4 , Doug Kramer 4 , Wing Kai Chan 4 , Vinod Ravi 5 1 Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, 2 Texas Oncology, Dallas, TX, USA, 3 University of Washington Seattle Cancer Alliance, Seattle, WA, USA, 4 Athenex Inc. Buffalo, NY, USA, 5 The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 6 National Taiwan University Hospital, Taipei, Taiwan 7 Taipei Veterans General Hospital, Taipei, Taiwan, 8 Royal Marsden and Institute of Cancer Research, UK Angiosarcomas are rare, aggressive and heterogeneous tumours accounting for approximately 2% of all soft tissue sarcomas. Only limited treatment options for advanced disease exist with poor outcomes (5-year survival rates 30 50%). Phase II trial and retrospective studies have shown that intravenous (IV) paclitaxel 1- 3 has efficacy in angiosarcomas. IV paclitaxel is associated with treatment-limited toxicities including peripheral neuropathy and hypersensitivity-type reactions due to the presence of Cremophor EL in the formulation. Paclitaxel has poor oral absorption due to active excretion by P- glycoprotein (P-gp) pump in intestinal cells. Encequidar (HM30181A) is a novel oral inhibitor of intestinal P-gp, which when administered with oral paclitaxel, enables the oral administration and systemic exposure of of paclitaxel 4 . A clinical pharmacokinetic (PK) study showed that oral paclitaxel (205mg/m 2 ) plus encequidar (15 mg) administered for 3 consecutive days per week can produce a paclitaxel exposure (AUC) similar to that of 80 mg/m 2 IV paclitaxel per week in cancer patients. Oral paclitaxel with encequidar was granted Orphan Drug Designation by the U.S. FDA for the treatment of angiosarcomas in 2018. BACKGROUND METHODS Case example 1 References: (1) Penel et al. J Clin Oncol 2008; 26(32): 52695274; (2) Schlemmer et al. Eur J Cancer 2008; 44(16): 24332436; (3) Byeon et al. Clin Sarcoma Res 2016; 6(1): 8 (4) Journal of Clinical Oncology 2019 37:15_suppl, 3032-3032 Clinicaltrials.gov NCT03544567 STUDY SCHEMA We are currently recruiting patients on a multi-centre pilot study to investigate the efficacy, safety, and tolerability of oral paclitaxel with encequidar in patients with cutaneous angiosarcoma who have not been previously treated with taxanes. The first patient started dosing in December 2018 APD-0150-01-10/19

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Page 1: 1733TiP - A Pilot Study of Oral Paclitaxel (ORAXOL) in ...€¦ · STUDY SCHEMA • We are currently recruiting patients on a multi-centre pilot study to investigate the efficacy,

• This is a single-arm, multi-centre, pilot study (up to 25 evaluable

patients)

• Major inclusion criteria: eligible subject must have (i) cutaneous

angiosarcoma that is not amenable to curative intent surgery; (ii)

have not received taxanes for treatment of angiosarcoma; (iii)

without metastases outside of local lymph node involvement; (iv)

have not received wide-field radiotherapy to the pelvis ≤3 or

limited-field radiation for palliation ≤3 months prior to oral

paclitaxel with encequidar administration; (v) no active bleeding

or bleeding diathesis requiring transfusions; (vi) known active

viral or nonviral hepatitis or cirrhosis.

• Treatment period: Oral paclitaxel (205mg/m2) with encequidar

(15 mg) to be administered once daily for 3 consecutive days

every week from Weeks 1 through 25

• Extension period: From week 26, patients without disease

progression are eligible to receive further treatment until study

withdrawal criteria are met

• Tumour response measured by RECIST v1.1 at specified

timepoints and safety assessments

• Primary objective is to determine the response rate (RR) within 6

months of initiation of treatment.

• Secondary objectives include: (i) safety and tolerability; (ii) PFS;

(iii) OS; (iv) duration of- and (v) time to-best response.

1733TiP - A Pilot Study of Oral Paclitaxel (ORAXOL) in Subjects With

Cutaneous Angiosarcomas (KX-ORAX-010)

Herbert H Loong1, Robert Mennel2, Michael Wagner3, Teresa Tse1, Yat-ming Lau1, Candy Yuen1, Roxanne Moore3, Tom Wei-Wu Chen6, Chueh-Chuan Yen7, Robin L Jones8, Min-Fun

Rudolf Kwan4, David Cutler 4, Doug Kramer 4, Wing Kai Chan4, Vinod Ravi5

1Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, 2Texas Oncology, Dallas, TX, USA, 3University of Washington Seattle Cancer Alliance, Seattle, WA, USA, 4Athenex Inc. Buffalo, NY, USA, 5The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 6National Taiwan University Hospital, Taipei, Taiwan 7Taipei Veterans General Hospital, Taipei, Taiwan, 8Royal Marsden and Institute of Cancer Research, UK

• Angiosarcomas are rare, aggressive and heterogeneous tumoursaccounting for approximately 2% of all soft tissue sarcomas. Onlylimited treatment options for advanced disease exist with pooroutcomes (5-year survival rates 30 – 50%). Phase II trial andretrospective studies have shown that intravenous (IV) paclitaxel 1-

3 has efficacy in angiosarcomas.

• IV paclitaxel is associated with treatment-limited toxicities includingperipheral neuropathy and hypersensitivity-type reactions due tothe presence of Cremophor EL in the formulation.

• Paclitaxel has poor oral absorption due to active excretion by P-glycoprotein (P-gp) pump in intestinal cells. Encequidar(HM30181A) is a novel oral inhibitor of intestinal P-gp, which whenadministered with oral paclitaxel, enables the oral administrationand systemic exposure of of paclitaxel4.

• A clinical pharmacokinetic (PK) study showed that oral paclitaxel(205mg/m2) plus encequidar (15 mg) administered for 3consecutive days per week can produce a paclitaxel exposure(AUC) similar to that of 80 mg/m2 IV paclitaxel per week in cancerpatients.

• Oral paclitaxel with encequidar was granted Orphan DrugDesignation by the U.S. FDA for the treatment of angiosarcomas in2018.

BACKGROUND

METHODS

Case example 1

References: (1) Penel et al. J Clin Oncol 2008; 26(32): 5269–5274; (2) Schlemmer et al. Eur J Cancer 2008; 44(16): 2433–2436; (3) Byeon et al. Clin Sarcoma Res 2016; 6(1): 8 (4) Journal of Clinical Oncology 2019 37:15_suppl, 3032-3032 Clinicaltrials.gov NCT03544567

STUDY SCHEMA

• We are currently recruiting patients on a multi-centre pilot study to

investigate the efficacy, safety, and tolerability of oral paclitaxel

with encequidar in patients with cutaneous angiosarcoma who

have not been previously treated with taxanes.

• The first patient started dosing in December 2018

APD-0150-01-10/19