Testing the Addition of an Anti-Cancer Drug, ZEN003694, to the Usual Chemotherapy Treatment (Capecitabine) for Metastatic or Unresectable Cancers
Phase I Trial of ZEN003694 (ZEN-3694) in Combination With Capecitabine in Patients With Solid Tumors
Who can join
As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.
- Age
- 18 Years and older
- Sex
- All sexes
- Healthy volunteers
- Not accepted
- Compensation
- Not stated
Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.
What to expect
No one can promise a trial will help you personally — that is what the research is trying to find out.
What participation involves
- Time periods mentioned: 12 months
- Procedures mentioned: Blood draws, MRI scans, CT scans, Biopsies
Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.
Show the study's own words
- "Patients undergo computed tomography (CT) or magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, and collection of blood samples throughout the trial."
- "Patients may also undergo biopsies during screening and while on the study."
- "After completion of study treatment, patients are followed up for safety 30 days after the last dose, and then every 3 months for 12 months."
- Compensation
- Not stated
- Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
- Participants are monitored closely by the research team throughout the study.
- Some participants may receive access to an investigational treatment, which is still being studied.
- Your participation helps researchers learn whether this approach could help future patients.
About this study
In plain language
This early study tests the safety, side effects, and best dose of ZEN003694 when added to capecitabine, a usual chemotherapy drug. It is for adults whose cancer has spread or cannot be removed by surgery and has gotten worse after standard treatment.
This phase I trial tests the safety, side effects, and best dose of ZEN003694 in combination with the usual treatment with capecitabine in treating patients with cancer that has spread from where it first started (primary site) to other places in the body (metastatic) or cannot be removed by surgery (unresectable) and that it has progressed on previous standard treatment. ZEN003694 is an inhibitor of a family of proteins called the bromodomain and extra-terminal (BET). It may prevent the growth of tumor cells that over produce BET protein. Capecitabine is in a class of medications called antimetabolites. It is taken up by cancer cells and breaks down into fluorouracil, a substance that kills cancer cells. Giving ZEN003694 in combination with capecitabine may be safe in treating patients with metastatic or unresectable solid tumors.
Compensation is read from the study's own description and may be missing — always confirm with the study team.
Eligibility
Who can join
- Be age 18 or older, with cancer confirmed by a tissue test that can be measured.
- Have cancer that has spread or cannot be removed by surgery and has worsened after standard treatment that included fluorouracil (5-FU) or capecitabine. The dose-expansion part is only for people with colon or rectal cancer.
- Have stored tumor tissue available. People with colon or rectal cancer in the dose-finding part must agree to a biopsy (a tissue sample) before treatment. The dose-expansion part requires biopsies before and during treatment.
- Be able to do most self-care and meet the study's heart health, blood count, liver, and kidney test limits.
- Wait the required time after your last cancer drug treatment before starting study drugs.
- If you have HIV or hepatitis B or C, meet the study's treatment and virus-control rules. Treated cancer in the brain must show no further growth on scans.
- Agree to use birth control before and during treatment and for 6 months after finishing the study drugs, if required.
- Be able to understand and sign a consent form, or have a legally authorized person give consent for you.
Who can't join
- Past treatment with a BET inhibitor, the type of drug ZEN003694 is; inability to tolerate the planned capecitabine dose; or an allergy to drugs like those used in this study.
- Use of certain blood thinners, other experimental drugs, or medicines that interfere with the study drugs. Some HIV and hepatitis treatments may interfere.
- Stomach or bowel problems that make it hard to take or absorb pills, or known DPD deficiency (lack of an enzyme that breaks down certain cancer drugs).
- Tumors in more than 30% of the liver, or cancer spread through the lining of the belly.
- Untreated or uncontrolled disease in the brain or spinal cord, or another severe illness.
- Side effects from past cancer treatment that are still more than mild, except hair loss and some nerve damage.
- Unable or unwilling to follow study rules or return for follow-up visits.
- Pregnancy. Breastfeeding must stop if you receive ZEN003694.
Simplified for readability. The official criteria below are what the study team uses.
Official eligibility criteria
Inclusion Criteria: * Dose Escalation additional criteria: Patients must have histologically confirmed cancer that is metastatic or unresectable and must have progressed on standard therapies which would have included fluorouracil (5-FU) or capecitabine * Dose Escalation additional criteria specifically for colorectal cancer (CRC) patients: Willingness and ability to undergo a pre-treatment biopsy * Dose Expansion additional criteria: Patients must have histologically confirmed CRC that is metastatic or unresectable and must have progressed on standard therapies which would have included 5-FU or capecitabine * Dose Expansion additional criteria: Willingness and ability to undergo pre- and on- treatment biopsies * Patients must have measurable disease * Age \>= 18 years. Because no dosing or adverse event data are currently available on the use of ZEN003694 (ZEN-3694) in combination with capecitabine in patients \< 18 years of age, children are excluded from this study * Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 (Karnofsky \>= 60%) * Availability of archival tumor tissue at the time of patient enrollment for molecular profiling studies * Prior to study dosing, previous systemic therapy must have been completed for at least five half-lives or 2 weeks, whichever is shorter * Absolute neutrophil count \>= 1,000/mcL * Platelets \>= 100,000/mcL * Total bilirubin =\< 1.5 institutional upper limit of normal (ULN) * Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 3 x institutional ULN * Glomerular filtration rate (GFR) \>= 50 mL/min/1.73 m\^2 * Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial * For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated * Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load * Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of progression * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial * Patients should be New York Heart Association Functional Classification of class 2B or better * The effects of ZEN003694 (ZEN-3694) and capecitabine on the developing human fetus are unknown. For this reason and because BET inhibitors as well as other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Women of child-bearing potential and men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 6 months after completion of ZEN003694 (ZEN-3694) and capecitabine administration * Ability to understand and the willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants Exclusion Criteria: * Previous treatment with BET inhibitors * History of inability to tolerate capecitabine at the projected treatment dose on this trial * Use of oral Factor Xa inhibitors (i.e., rivaroxaban, apixaban, betrixaban, edoxaban otamixaban, letaxaban, eribaxaban) and Factor IIa inhibitors (i.e., dabigatran). Low molecular weight heparin is allowed * Treatment for HIV, hepatitis B or hepatitis C only if this interferes with the current treatment (e.g. through drug-drug interactions) * Gastrointestinal pathology or history that adversely impacts the ability to take or absorb oral medication * Hepatic tumor burden \> 30% or peritoneal carcinomatosis * Untreated/uncontrolled central nervous system (CNS) disease * Known dihydropyrimidine dehydrogenase (DPD) deficiency * Severe intercurrent illness or comorbidity * Inability to comply with the protocol and/or not willing or who will not be available for follow-up assessments * Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities \> grade 1) with the exception of alopecia and neuropathy up to and including grade 2 * Patients who are receiving any other investigational agents * History of allergic reactions attributed to compounds of similar chemical or biologic composition to ZEN003694 (ZEN-3694) or other agents used in study * Patients receiving any medications or substances that are strong inhibitors or inducers of CYP3A4 are ineligible. Strong inhibitors of CYP3A4 must be discontinued at least 7 days, and inducers 14 days prior to the first dose of ZEN003694 and capecitabine. Substrates of CYP1A2 with narrow therapeutic window must be avoided while taking ZEN003694 * Pregnant women are excluded from this study because ZEN003694 (ZEN-3694) is an agent with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ZEN003694 (ZEN-3694), breastfeeding should be discontinued if the mother is treated with ZEN003694 (ZEN-3694). These potential risks may also apply to other agents used in this study
Study sites (22)
CA
- UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care · Irvine, CA 92612Site Public Contact · Study contact · 877-827-8839 · ucstudy@uci.eduFa-Chyi Lee · Principal investigatorMore trials in Irvine
- UC Irvine Health/Chao Family Comprehensive Cancer Center · Orange, CA 92868Site Public Contact · Study contact · 877-827-8839 · ucstudy@uci.eduFa-Chyi Lee · Principal investigatorMore trials in Orange
FL
- UF Health Cancer Institute - Gainesville · Gainesville, FL 32610Site Public Contact · Study contact · 352-273-8010 · cancer-center@ufl.eduThomas J. George · Principal investigatorMore trials in Gainesville
IL
- Memorial Hospital East · Shiloh, IL 62269More trials in Shiloh
KS
- University of Kansas Clinical Research Center · Fairway, KS 66205Site Public Contact · Study contact · 913-588-3671 · KUCC_Navigation@kumc.eduJoaquina C. Baranda · Principal investigatorMore trials in Fairway
- University of Kansas Cancer Center · Kansas City, KS 66160Site Public Contact · Study contact · 913-588-3671 · KUCC_Navigation@kumc.eduJoaquina C. Baranda · Principal investigatorMore trials in Kansas City
- University of Kansas Hospital-Westwood Cancer Center · Westwood, KS 66205Site Public Contact · Study contact · 913-588-3671 · KUCC_Navigation@kumc.eduJoaquina C. Baranda · Principal investigatorMore trials in Westwood
MO
- Siteman Cancer Center at Saint Peters Hospital · City of Saint Peters, MO 63376More trials in City of Saint Peters
- Siteman Cancer Center at West County Hospital · Creve Coeur, MO 63141More trials in Creve Coeur
- Washington University School of Medicine · St Louis, MO 63110More trials in St Louis
- Siteman Cancer Center-South County · St Louis, MO 63129More trials in St Louis
- Siteman Cancer Center at Christian Hospital · St Louis, MO 63136More trials in St Louis
NY
- NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center · New York, NY 10032More trials in New York
- Montefiore Medical Center-Einstein Campus · The Bronx, NY 10461Site Public Contact · Study contact · 718-379-6866 · eskwak@montefiore.orgChaoyuan Kuang · Principal investigatorMore trials in The Bronx
- Montefiore Medical Center-Weiler Hospital · The Bronx, NY 10461Site Public Contact · Study contact · 718-379-6866 · eskwak@montefiore.orgChaoyuan Kuang · Principal investigatorMore trials in The Bronx
- Montefiore Medical Center - Moses Campus · The Bronx, NY 10467Site Public Contact · Study contact · 718-379-6866 · eskwak@montefiore.orgChaoyuan Kuang · Principal investigatorMore trials in The Bronx
OH
- University of Cincinnati Cancer Center-UC Medical Center · Cincinnati, OH 45219Site Public Contact · Study contact · 513-584-7698 · cancer@uchealth.comDavendra P. Sohal · Principal investigatorMore trials in Cincinnati
- University of Cincinnati Cancer Center-West Chester · West Chester, OH 45069Site Public Contact · Study contact · 513-584-7698 · cancer@uchealth.comDavendra P. Sohal · Principal investigatorMore trials in West Chester
OK
- University of Oklahoma Health Sciences Center · Oklahoma City, OK 73104Site Public Contact · Study contact · 405-271-8777 · ou-clinical-trials@ouhsc.eduSusanna V. Ulahannan · Principal investigatorMore trials in Oklahoma City
PA
- UPMC Hillman Cancer Center · Pittsburgh, PA 15232Site Public Contact · Study contact · 412-647-8073Anwaar Saeed · Principal investigatorMore trials in Pittsburgh
TN
- Vanderbilt Breast Center at One Hundred Oaks · Nashville, TN 37204Site Public Contact · Study contact · 800-811-8480Thatcher R. Heumann · Principal investigatorMore trials in Nashville
- Vanderbilt University/Ingram Cancer Center · Nashville, TN 37232Site Public Contact · Study contact · 800-811-8480Thatcher R. Heumann · Principal investigatorMore trials in Nashville