This trial is active, not recruiting.

Condition advanced biliary tract carcinoma
Treatments gemcitabine, cisplatin, mek162
Phase phase 1/phase 2
Target MEK
Sponsor Memorial Sloan Kettering Cancer Center
Collaborator Array BioPharma
Start date April 2013
End date April 2017
Trial size 42 participants
Trial identifier NCT01828034, 13-004


The purpose of this study is to test an investigational combination of drugs for bile duct or gallbladder cancers. Gemcitabine and cisplatin are two forms of chemotherapy commonly used in combination to treat bile duct and gallbladder cancers. The investigators are looking to improve treatment results. They will attempt to do so by adding the drug MEK162 to the treatment plan. MEK162 acts by blocking a protein called MEK 1/2 which helps cancer cells grow and divide. This study will help answer the question of whether MEK162 is a helpful drug in patients with bile duct or gallbladder cancers when given with gemcitabine and cisplatin.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Endpoint classification safety/efficacy study
Intervention model single group assignment
Masking open label
Primary purpose treatment
Phase I component of the study, a classic 3+3 cohort dose escalation scheme will be used to identify the MTD of MEK162 when administered with gemcitabine at dose 800 mg/m2 and cisplatin given at dose 20 mg/m2 week 2 & 3 of a 3 week cycle. The final cohort will receive gemcitabine 1000mg/m2 and cisplatin 20mg/m2 week 2 and 3 of a 3 week cycle in combination with MEK162 at the MTD as determined above. In the phase II part of the study, patients will receive MEK162 at the MTD dose plus gemcitabine and cisplatin at the dose level determined acceptable in the phase I portion. In the phase II part of the study, patients will receive MEK162 at 45mg BID plus gemcitabine (800 mg/m2) and cisplatin (20 mg/m2) as determined by the phase I portion.

Primary Outcomes

MTD of MEK162 - Phase I
time frame: 1 year
six-month progression free survival - phase II
time frame: 6 months
objective response rate - phase II
time frame: 1 year

Secondary Outcomes

median PFS
time frame: 1 year
median overall survival
time frame: 1 year
safety/toxicity profile
time frame: 2 years

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - Histologically / cytologically verified, non-resectable, recurrent, or metastatic biliary tract carcinoma including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma and gallbladder carcinoma. Combined cholangiocarcinoma and hepatocellular carcinoma is allowed. - Patients must have measurable disease by RECIST 1.1 - KPS ≥ 80% - Age ≥ 18 years - Adequate bone marrow function defined as: Hb ≥ 8 g/dl, ANC ≥ 1.5 K/mcL, Platelets ≥ 100 K/mcL - Adequate renal function defined as serum creatinine < 1.6 mg/dl and/or measured creatinine clearance from 24-hour urine collection of ≥ 60 ml/min - Adequate hepatic function defined as total bilirubin ≤ 2 mg/dl, ALT/AST ≤ 5 x ULN. - Patients with biliary obstruction can join if bilirubin corrects to required limit after adequate biliary drainage. Adequate cardiac function defined as ejection fraction ≥ 45% as determined by transthoracic echocardiogram or MUGA - Patients who have received prior local therapy, including but not limited to embolization, chemoembolization, radiofrequency ablation, radiation therapy, are eligible provided that measurable disease falls outside the treatment field or within the field but has shown an increase of ≥ 20% in the size. Prior local therapy must be completed at least 4 weeks prior to the baseline scan - Women of childbearing potential must have a negative pregnancy test within 7 days prior to study treatment - Men and women of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 3 months thereafter. - Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: - Any previous chemotherapy, biologic therapy, or investigational agent, except for adjuvant therapy as single agents and/or as radio-sensitizing agents limited to 5-fluorouracil and gemcitabine. Patient must have completed adjuvant therapy no less than six months prior to accrual. - Evidence of another active cancer that may influence patient outcome as determined by the Principal Investigator (PI) or co-Principal Investigator (co-PI), except for nonmelanoma skin carcinoma, melanoma in-situ, in-situ carcinoma of the cervix curatively treated, treated superficial bladder cancer, and adenocarcinoma of the prostate that has been surgically treated with a post-treatment PSA that is non-detectable. - Known brain metastases or primary central nervous system tumors with seizures that are not well controlled with standard medical therapy. - Uncontrolled intercurrent illness including, but not limited to psychiatric illness/social situations that would limit compliance with study requirements. - Known HIV positive patient - Significant cardiovascular disease including congestive heart failure (New York Heart Association Class II or higher) or active angina pectoris. - History of a myocardial infarction within 6 months. - History of a stroke or transient ischemic attack within 6 months. - Clinically significant peripheral vascular disease. - Major surgical procedure within 4 weeks. - Uncontrolled infection. - Known or suspected allergy to gemcitabine or cisplatin - Pregnant (positive pregnancy test) - Breast-feeding should be discontinued if a nursing mother is to be treated on clinical trial. - Any condition that impairs patient's ability to swallow whole pills - Malabsorption problem that may limit or inhibit the absorption of MEK 162 - Patients with a history or current known evidence of central serous retinopathy (CSR), retinal vein occlusion (RVO) or ophthalmopathy at baseline that would be considered a risk factor for CSR or RVO. - History of any organ or bone marrow transplant.

Additional Information

Official title A Phase I/II Study of First Line Gemcitabine, Cisplatin and MEK162 in Advanced Biliary Tract Carcinoma
Principal investigator Maeve Lowery, MD
Trial information was received from ClinicalTrials.gov and was last updated in October 2016.
Information provided to ClinicalTrials.gov by Memorial Sloan Kettering Cancer Center.