A randomized, open-label, two-way crossover clinical trial to evaluate the food effect on pharmacokinetics and safety of DHP107 in patients with advanced solid tumors: the FEEL study
Clinical Snapshot
PICO Framework
| P — Population | Patients with advanced solid tumors (n=25) |
| I — Intervention | DHP107 (oral paclitaxel formulation) 200 mg/m² twice daily administered with food |
| C — Comparator | DHP107 administered in fasted state |
| O — Outcomes | Primary: pharmacokinetic parameters (Cmax, AUC0-72, AUC0-inf); Secondary: safety and tolerability; Exploratory: efficacy |
Bottom Line
This well-designed crossover study demonstrates that DHP107, an oral paclitaxel formulation, exhibits no clinically significant food effect on pharmacokinetics in patients with advanced solid tumors. The geometric mean ratios for key pharmacokinetic parameters were close to 100% with confidence intervals meeting regulatory criteria for bioequivalence. This finding provides important clinical flexibility, allowing patients to take DHP107 with or without food without compromising drug exposure. The safety profile appeared consistent with known paclitaxel toxicities, with manageable gastrointestinal and hematologic adverse events. While the open-label design and small sample size limit the strength of conclusions, the crossover methodology appropriately controls for inter-patient variability in this pharmacokinetic study. These results support flexible dosing instructions that may improve patient adherence and quality of life during oral paclitaxel therapy.
Key Findings
P Value: Not reported
Effect Size: Geometric mean ratios (fed:fasted) for Cmax 101.00%, AUC0-72 102.92%, AUC0-inf 104.76%
Primary Outcome: No significant food effect on DHP107 pharmacokinetics
Nnt Or Sensitivity: All confidence intervals contained 100%, meeting regulatory criteria for no food effect
Confidence Interval: 95% CIs: 91.93-110.95%, 95.04-111.45%, 96.44-113.80% respectively
Clinical Application
High - allows flexible dosing with or without food, improving patient convenience and adherence Relevant for TGA submission data if DHP107 seeks Australian registration; supports flexible dosing recommendations consistent with RACGP medication adherence principles Patients with advanced solid tumors requiring oral paclitaxel therapy
Abstract
PURPOSE: The phase 1, randomized, open-label, two-way crossover FEEL study assessed the effect of food on the pharmacokinetics of DHP107, an oral paclitaxel with a novel lipid formulation designed to be systemically absorbed without Cremophor EL, in patients with advanced solid tumors. METHODS: Patients were randomized 1:1 to DHP107 (200 mg/m2 orally twice daily on Days 1, 8, 15 every 28 days for two cycles) treatment sequences: fasted-fed (first DHP107 dose administered after overnight fast; n = 13) and fed-fasted (first DHP107 dose administered after a high-fat meal; n = 12). The primary objective was to evaluate the effect of food on DHP107 pharmacokinetics. The secondary objective was DHP107 safety; efficacy was also assessed (both in all patients regardless of dosing sequence). RESULTS: Mean systemic exposures were similar for paclitaxel and its metabolites under fed and fasted conditions. Geometric mean ratios (fed:fasted) for paclitaxel were: maximum concentration (Cmax), 101.00% (95% CI 91.93-110.95%); area under the curve (AUC0-72), 102.92% (95% CI 95.04-111.45%); and AUC0-inf 104.76% (95% CI 96.44-113.80%), meeting criteria for no food effect. Common adverse events across the study period included diarrhea (fasted-fed 61.5%; fed-fasted 41.7%), vomiting (fasted-fed 30.8%; fed-fasted 8.3%), and neutropenia (fasted-fed 23.1%; fed-fasted 16.7%). Two fed-fasted patients (16.7%) had partial responses and six had stable disease (50.0%); seven fasted-fed patients had stable disease (53.8%). CONCLUSION: This study suggests that the pharmacokinetics of DHP107 are unaffected by food and DHP107 can be taken with or without food. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT04675528; 107CS-7.
References
- 1.Hitre, E., Láng, I., & Páll, D. (2026). A randomized, open-label, two-way crossover clinical trial to evaluate the food effect on pharmacokinetics and safety of DHP107 in patients with advanced solid tumors: the FEEL study. Cancer Chemotherapy and Pharmacology. https://doi.org/10.1200/jco.20.01399
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