Phase II Open-Label Multi-Cohort Study Evaluating CPI-613 (Devimistat) in Combination With Hydroxychloroquine and 5-fluorouracil or Gemcitabine in Patients With Advanced Chemorefractory Colorectal, Pancreatic, or Other Solid Cancers

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Investigational drug late phase More information Active drug More information Moderate burden on patient More information

Trial Details

Sponsor: Northwestern University (other)

Phase: 2

Start date: March 8, 2023

Planned enrollment: 94

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Trial ID: NCT05733000
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More trial details at ClinicalTrials.gov More info

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Goal: To estimate the overall response rate (ORR) of CPI-613 (devimistat) in combination with hydroxychloroquine and either 5-fluorouracil or gemcitabine in patients with advanced solid tumors that are refractory to standard chemotherapy, and to further characterize progression-free survival, overall survival, duration of response, and safety.

Patients: The trial is enrolling adults (age ≥18) with histologically confirmed advanced or metastatic solid tumors, specifically colorectal, pancreatic, biliary, gastroesophageal, urothelial, ovarian, or non-small cell lung adenocarcinoma, who have progressed on or are intolerant to standard therapies. Eligible patients must have measurable disease by RECIST 1.1, ECOG performance status 0-1 (occasionally 2 with approval), and meet standard laboratory criteria.

Design: This is a phase II, open-label, non-randomized, multi-cohort study. Patients are assigned to disease-specific cohorts according to tumor histology and receive specified combinations of investigational and standard chemotherapies.

Treatments: Treatment includes CPI-613 (devimistat) in combination with hydroxychloroquine and either 5-fluorouracil (5-FU) or gemcitabine depending on cancer type. Devimistat is a lipoic acid analogue that inhibits key mitochondrial enzymes (pyruvate dehydrogenase and α-ketoglutarate dehydrogenase) in the TCA cycle, disrupting tumor energy metabolism and inducing cell death. Previous trials in pancreatic and biliary cancers show devimistat is generally well tolerated but has not significantly improved survival in pancreatic cancer; in biliary tract cancer, it showed encouraging response rates when combined with gemcitabine and cisplatin. Hydroxychloroquine may modulate tumor immunity and autophagy, while 5-FU and gemcitabine are standard chemotherapy agents interfering with nucleic acid synthesis.

Outcomes: Primary outcome is overall response rate (ORR) by RECIST 1.1. Secondary outcomes include progression-free survival (PFS), overall survival (OS), duration of response (DOR), and safety/tolerability as assessed by CTCAE v5.0. Exploratory molecular and metabolic evaluations will be performed on blood samples from selected patients.

Burden on patient: Patient burden is moderate. Treatment involves regular intravenous infusions and oral agents, with standard imaging (CT or MRI) for response assessment. Blood sampling is required throughout the study, with additional biospecimen collection in some cohorts for exploratory biomarker analysis. No protocol-mandated tumor biopsies or intensive pharmacokinetic sampling are specified. Overall, the burden is somewhat higher than standard-of-care chemotherapy due to combination investigational therapy and research blood draws but remains acceptable for patients with advanced refractory disease.

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Northwestern University

Chicago, Illinois, 60611, United States

[email protected] / 312-695-6929

Status: Recruiting

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