Neoplasms

All Conditions

Digestive System Diseases

Carcinoma

Carcinoma, Hepatocellular

Liver Neoplasms

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Adenocarcinoma

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Liver Diseases

Hematinics

All Drugs and Chemicals

Antineoplastic Agents

Liver Extracts

Sorafenib

Protein Kinase Inhibitors

Enzyme Inhibitors

Phase I Study treatment will be started as monotherapy with DKN-01 for up to 8 weeks or until unacceptable toxicity occurs. The study will be continued as combination therapy of DKN-01 and sorafenib until objective disease progression (PD) or unacceptable toxicity occurs. The dose of DKN-01 for cohort 1 will be 300 mg , depending on the results of the safety assessment. Phase II The dose of DKN-01 will be the recommended phase II dose (RP2D) determined from Part A. Study treatment will be started as monotherapy with DKN-01 until objective disease progression (PD1) or unacceptable toxicity occurs. After PD1, study treatment will be continued as combination therapy of DKN-01 and sorafenib until disease progression (PD2) or unacceptable toxicity occurs.

Phase I Study treatment will be started as monotherapy with DKN-01 for up to 8 weeks or until unacceptable toxicity occurs. The study will be continued as combination therapy of DKN-01 and sorafenib until objective disease progression (PD) or unacceptable toxicity occurs. The dose of DKN-01 for cohort 2 will be 600 mg or 150 mg, depending on the results of the safety assessment. Phase II The dose of DKN-01 will be the recommended phase II dose (RP2D) determined from Part A. Study treatment will be started as monotherapy with DKN-01 until objective disease progression (PD1) or unacceptable toxicity occurs. After PD1, study treatment will be continued as combination therapy of DKN-01 and sorafenib until disease progression (PD2) or unacceptable toxicity occurs.

DKN-01 will be administered intravenous (IV) over a minimum of 30 minutes and up to a maximum of 2 hours given on days 1 and 15 of each 28 day cycle.

DKN-01 300 mg

DKN-01 600 mg

For combination with DKN-01, sorafenib will be administrated according to standard clinical practice. Part A: After 8 weeks monotherapy with DKN-01, the study will be continued as combination therapy of DKN-01 and sorafenib until objective disease progression (PD) or unacceptable toxicity occurs. Part B:After PD1, study treatment will be continued as combination therapy of DKN-01 and sorafenib until disease progression (PD2) or unacceptable toxicity occurs.

Jens U Marquardt, Dr med

Markus Möhler, Dr.med

Dirk-Thomas Waldschmidt, Dr. med

Henning Wege, PD Dr.

Arndt Vogel, Prof Dr med

Jens Marquardt, Professor

Jens U Marquardt, Dr.med.

Andreas Teufel, Professor

This clinical trial is a prospective, open label, single arm oncological phase I/II trial in patients with hepatocellular carcinoma and WNT signaling alterations. The trial consists of two parts: Part A is a phase I study investigating the safety of DKN-01 administered as mono- as well as combination therapy with sorafenib in a 2 step dose escalation.Part B is a phase II study to investigate the anti-tumor activity and safety of DKN-01 in patients with advanced HCC. DKN-01 is administered at the recommend phase II dose (RP2D) for monotherapy and at the recommend phase II dose for combination therapy established in Part A.

Part A is a phase I study investigating the safety of DKN-01 administered as mono- as well as combination therapy with sorafenib in a 2 step dose escalation. Up to 20 patients with advanced HCC will be included in Part A. Tumor assessment will be performed every 8 weeks.The first 10 patients (cohort 1) will start with IV infusion of 300 mg DKN-01 on day 1 and 15 (monotherapy for 28 days). DLTs will be determined. After cycle 2 of monotherapy patients of cohort 1 will continue with combination of 300 mg DKN-01 IV on day 1 and 15 and sorafenib (recommended dose 800 mg per day or at discretion of the investigator) until disease progression. After 2 cycles of combination therapy and prior to the start of the next cohort DLTs will be determined. Part B is a phase II study to investigate the anti-tumor activity and safety of DKN-01 in patients with advanced HCC. DKN-01 is administered at the recommend phase II dose (RP2D) for monotherapy and at the recommend phase II dose for combination therapy established in Part A. Depending on the tolerability, the doses may be different for monotherapy and for combination therapy. Up to 50 additional patients with advanced HCC may be enrolled in Part B. Every 8 weeks tumor assessment will be performed. If progression of disease (PD1) is observed with DKN-01 monotherapy, patients will continue on study receiving DKN-01 at the recommend phase II dose for combination therapy.

DKN-01 Inhibition in Advanced Liver Cancer

A Phase I/II Multicenter, Open-label Study of DKN-01 to Investigate the Anti-tumor Activity and Safety of DKN-01 in Patients With Hepatocellular Carcinoma and WNT Signaling Alterations

Absolute and relative incidences of treatment-emergent adverse events.

The TTP2 is defined as the time from the first DKN-01 intake until PD2. Tumor progression is assessed by mRECIST criteria (modified Response Evaluation Criteria in Solid Tumors).

Serum DKN-01 levels to characterize the pharmacokinetics of DKN-01 when administered at the dose of 300 mg and 600 mg as monotherapy and in combination with sorafenib

Overall survival is defined as the time from first DKN-01 intake until death from any cause, assessed up to 2 years

Progression free survival (PFS1, PFS2) is defined as the time from first DKN-

01 intake until death or PD1 or PD2 respectively whichever comes first, assessed up to 2 years

DCR (CR, PR or SD), binary measurement (CR, PR or SD) after 2, 4 and 6 months will be analyzed by absolute and relative frequencies.

Duration of disease control is defined as the time from the first to the last occurrence of disease control (CR, PR, or SD), assessed up to 2 years

Absolute and relative incidences of treatment-emergent adverse events as assessed by NCI CTCAE v5.0

Leap Therapeutics, Inc.

Johannes Gutenberg University Mainz

Jun. Prof. Dr. J. U. Marquardt

Colonic Neoplasms

Colorectal Neoplasms

Intestinal Neoplasms

Colonic Diseases

Intestinal Diseases

Platelet Aggregation Inhibitors

Herbal and Botanical

Resveratrol

Antioxidants

Protective Agents

Grape

Cola

GM-CSF administration to all subjects in addition to chemotherapy treatment.

Patients were randomly assigned to one of four dose cohorts: plant-derived resveratrol tablets (purchased through the Life Extension Foundation, Scottsdale, AZ) at a dose of 80 mg/day, plant-derived resveratrol tablets at a dose of 20 mg/day, Grape Powder (GP) dissolved in water and taken orally (supplied by the California Table Grape Commission) at a dose of 120 g/day, and GP at a dose of 80 g/day.

Randall Holcombe, MD

Resveratrol is purported to possess cancer preventive activity, especially for colon cancer, though its mechanisms of action are not well defined. Resveratrol is found in the skin of grapes and has anti-oxidative and pro-apoptotic effects on cancer cell lines in vitro. The main dietary sources of resveratrol are grapes, grape products, and red wine, and small amounts may be found in mulberries. A prior report and compelling preliminary data from our laboratory suggest that resveratrol modulates Wnt signaling, a signaling pathway which is activated in over 85% of colon cancers. In this proposal, studies were performed to define the actions of resveratrol on the Wnt signaling pathway in a clinical trial in which patients with colon cancer received treatment with Resveratrol, and correlative laboratory studies examined its effects directly on colon cancer and normal colonic mucosa. These studies provided data on the mechanisms of resveratrol action and provided a foundation for future prevention trials, correlative studies and therapeutic clinical research with this agent.

Patients will be treated with a two-week course of resveratrol. The initiation of the treatment will be approximately 14 days before standard of care surgical resection of tumor. Resveratrol will be ingested as 20 mg pills or in the form of freeze-dried grape extract which is prepared by the California Table Grape Commission used under GMP guidelines for human consumption.

The first two patients receiving resveratrol will be treated at a dose of 20 mg/day, the third and fourth patients at a dose of 80 mg/day, and the fifth and sixth patients with a dose of 160 mg/day. All patients receiving grape extract will receive 125 mg/day that will have to be mixed with one 8 oz glass of water. There will be no dose adjustments. If a patient has any side effects which are attributed to the resveratrol, it will be discontinued.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
DKN-01 Inhibition in Advanced Liver Cancer	NCT03645980	Hepatocellular ...	DKN-01 300 mg DKN-01 600 mg Sorafenib	18 Years -	Johannes Gutenberg University Mainz
Resveratrol for Patients With Colon Cancer	NCT00256334	Colon Cancer Cancer	Resveratrol	18 Years -	University of California, Irvine
DKN-01 Inhibition in Advanced Liver Cancer	NCT03645980	Hepatocellular ...	DKN-01 300 mg DKN-01 600 mg Sorafenib	18 Years -	Johannes Gutenberg University Mainz

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