Phase I/II Study With Galunisertib Combined With Capecitabine in Patients With Advanced Chemotherapy Resistant Colorectal Cancer With Peritoneal Metastases
This is a two-center open-label non-randomized proof of principle study consisting of a dose-finding part (phase I) and phase II study with Simon two-stage design investigating the anti-tumor activity of the combination of capecitabine and galunisertib in patients with colorectal cancer with peritoneal metastases.
• Histological or cytological proof of CRC with at least confirmed peritoneal metastases (presence of additional extraperitoneal metastases is allowed);
• Disease progression or relapse upon treatment for advanced CRC with fluoropyrimidine containing chemotherapy as single agent or in combination with other anti-cancer drugs, with no treatment options at time of inclusion (combinations with oxaliplatin, irinotecan, bevacizumab and cetuximab/panitumumab are allowed);
• Age ≥ 18 years;
• Able and willing to give written informed consent and informed consent form must have been signed before start of the trial;
• WHO performance status of ≤1;
• Able and willing to undergo blood sampling for PK analysis;
• Able and willing to undergo tumor biopsy before start, during treatment and at the end of treatment;
• Life expectancy \> 3 months allowing adequate follow up of toxicity and anti-tumor activity;
• Evaluable disease according to RECIST 1.1 criteria (measurable disease for the phase II part; evaluable disease is sufficient for the phase I part);
⁃ Minimal acceptable safety laboratory values
∙ ANC of ≥1.5 x 109/L
‣ Platelet count of ≥100 x 109/L
‣ Hepatic function as defined by serum bilirubin ≤ 1.5 x ULN, ALAT and ASAT ≤ 3.0 x ULN, or ALAT and ASAT \< 5 x ULN in patients with liver metastases
‣ Renal function as defined by serum creatinine ≤ 1.5 x ULN
‣ Creatinine clearance ≥ 50 ml/min (by Cockcroft-Gault formula or MDRD);
⁃ Negative pregnancy test (urine or serum) for female patients with childbearing potential.
⁃ Able and willing to swallow tablets.