Description:
The study assessed the safety and the dose of the combination of INC280 and buparlisib
(BKM120), as well as the anti-tumor activity of the combination, in patients with recurrent
glioblastoma with PTEN mutations, homozygous deletion of PTEN or PTEN negative by IHC. In
addition, the anti-tumor activity of INC280 single agent should have been assessed in
patients with recurrent glioblastoma with c-Met alteration.
Title
- Brief Title: Safety and Efficacy of INC280 and Buparlisib (BKM120) in Patients With Recurrent Glioblastoma
- Official Title: A Phase Ib/II, Multi-center, Open-label Study of INC280 in Combination With Buparlisib in Patients With Recurrent Glioblastoma
Clinical Trial IDs
- ORG STUDY ID:
CINC280X2204
- SECONDARY ID:
2013-000699-14
- NCT ID:
NCT01870726
Conditions
- c-MET Inhibitor; PI3K Inhibitor, PTEN Mutations, Homozygous Del. of PTEN or PTEN Neg. by IHC, c-Met Ampli. by FISH, INC280, BKM120, Buparlisib; Recurrent GBM
Interventions
Drug | Synonyms | Arms |
---|
INC280 | | Phase II |
Buparlisib | BKM120 | Phase Ib |
Purpose
The study assessed the safety and the dose of the combination of INC280 and buparlisib
(BKM120), as well as the anti-tumor activity of the combination, in patients with recurrent
glioblastoma with PTEN mutations, homozygous deletion of PTEN or PTEN negative by IHC. In
addition, the anti-tumor activity of INC280 single agent should have been assessed in
patients with recurrent glioblastoma with c-Met alteration.
Detailed Description
This was a multi-center, open-label, phase Ib/II study. The aim of the phase Ib part was to
estimate the MTD and/or to identify the recommended phase II dose (RP2D) for the combination
of INC280 and buparlisib, followed by the phase II part to assess the clinical efficacy of
INC280 single agent and in combination with buparlisib (BKM120), and to further assess the
safety of the combination. In addition, a surgical arm should have started concurrently with
the phase II part, to determine the PK/PD profile of the study drug combination in patients
undergoing tumor resection for recurrent glioblastoma after 7 to 10-days treatment.
RP2D was not declared due to a lack of efficacy of the combination in the phase Ib stage, and
phase II was continued with INC280 monotherapy only.
Trial Arms
Name | Type | Description | Interventions |
---|
Phase Ib | Experimental | To estimate the safe dose of the combination INC280 and buparlisib | |
Phase II | Experimental | To estimate anti-tumor efficacy of INC280 single agent and in combination with buparlisib | |
Eligibility Criteria
Inclusion Criteria:
- ≥ 18 years of age.
- Histologically confirmed diagnosis of glioblastoma (after initial tumor resection or
biopsy) with radiographic evidence of recurrent tumor per RANO criteria.
- Phase Ib: Documented evidence of PTEN mutations, homozygous deletion of PTEN or PTEN
negative (H Score <10) by IHC confirmed by local or central assessment.
- Phase II: Documented evidence of c-Met amplification (GCN>5) (fusion transcripts or
mutant c-Met may be eligible after discussion with Novartis) or PTEN mutations,
homozygous deletion of PTEN or PTEN negative (H Score <10) by central assessment.
- Must have received the following treatment for glioblastoma:
•Prior treatment with radiotherapy and temozolomide; Note: A maximum of two prior
chemotherapy/antibody regimens (including bevacizumab or other direct VEFG/VEGFR
inhibitors) for recurrent disease are permitted.
- Representative archival tumor sample from glioblastoma (formalin-fixed paraffine
embedded tissue) must be available.
- ECOG performance status ≤ 2.
- Able to swallow and retain oral medication.
- Patients in the surgical arm only: patients with recurrent glioblastoma must be
eligible for surgical resection as deemed by the site Investigator.
Exclusion Criteria:
- Prior or current treatment with a c-MET inhibitor or HGF-targeting therapy
- Prior treatment with a PI3K and/or mTOR inhibitors for glioblastoma or for
pre-existing neoplasm transformed to glioblastoma (applicable for combination
treatment arm only)
- Received radiation (including therapeutic radioisotopes such as strontium 89) therapy
≤ 3 months prior to the first dose of study treatment and have not recovered from side
effects of such therapy (≤ Grade 1) prior to the first dose of study treatment, except
for alopecia.
- Receiving treatment with medications that are known strong inhibitors or inducers of
CYP3A, and cannot be discontinued 7 days prior to the start of the treatment and
during the course of the study.
- Receiving treatment with medications that are known CYP3A, CYP1A2, CYP2C8, CYP2C9 or
CYP2C19 substrates with narrow therapeutic index, and cannot be discontinued during
the course of the study.
- Receiving treatment with long acting proton pump inhibitors, and cannot be
discontinued 3 days prior to the start of INC280 treatment and during the course of
the study.
- Currently receiving warfarin or other coumadin-derived anticoagulants for treatment,
prophylaxis or otherwise.
- Currently receiving increasing or chronic treatment ( > 5 days) with corticosteroids
(e.g. dexamethasone > 4 mg/day or other corticosteroids equivalent dose) or another
immunosuppressive agent.
- History of acute or chronic pancreatitis or any risk factors that may increase the
risk of pancreatitis.
- Active cardiac disease or a history of cardiac dysfunction.
- Impairment of gastrointestinal (GI) function or GI disease that might significantly
alter the absorption of study drug
- Medically documented history of or active major depressive episode, bipolar disorder
(I or II), obsessive-compulsive disorder, schizophrenia, a history of suicidal attempt
or ideation, or homicidal ideation (e.g. risk of doing harm to self or others), or
patients with active severe personality disorders (defined according to DSM- IV).
- Anxiety ≥ CTCAE grade 3
- Any of the following baseline laboratory values:
- Hemoglobin < 9 g/dL
- Platelet count < 75 x 109/L
- Absolute neutrophil count (ANC) < 1.0 x 109/L
- INR > 1.5
- Serum lipase > normal limits for the institution
- Asymptomatic serum amylase > grade 2
- Potassium, magnesium, and calcium (corrected for albumin) > normal limits for the
institution
- Total bilirubin > 1.5 x ULN
- Serum creatinine >1.5 x ULN or creatinine clearance ≤ 45 mL/min
- Alanine aminotransferase (AST) or aspartate aminotransferase (ALT) > 3.0 x ULN
(or < 5.0 x ULN if liver metastases are present)
- Fasting plasma glucose > 120mg/dL or > 6.7 mmol/L
- HbA1c > 8%.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Number of Patients Reporting Dose Limiting Toxicities (DLTs) in Cycle 1 |
Time Frame: | Cycle 1, 28 days |
Safety Issue: | |
Description: | A DLT is defined as an adverse event or abnormal laboratory value where the relationship to study treatment cannot be ruled out, and is not primarily related to disease, disease progression, inter-current illness, or concomitant medications that occurs within the first cycle of treatment (28 days) with INC280 in combination with buparlisib and meets any of the pre-defined criteria. The maximum tolerated dose was identified as INC280 300 mg BID + buparlisib 80 mg QD. |
Secondary Outcome Measures
Measure: | Number of Participants With Adverse Events |
Time Frame: | throughout the duration of the trial, approximately 3 years from FPFV to LPLV |
Safety Issue: | |
Description: | To characterize the safety of INC280 single agent and in combination with buparlisib including type, frequency, severity of adverse events, serious adverse events, and dose interruptions and adjustments. Adverse events will be assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03, unless otherwise specified.
If CTCAE grading did not exist for an AE, the severity of mild, moderate, severe, and lifethreatening, corresponding to Grades 1 - 4, were used. CTCAE Grade 5 (death) was not used in this study but was collected as a seriousness criterion; rather, information about deaths was collected though a Death form. |
Measure: | Pharmacokinetic Profile of INC280 - AUCtau |
Time Frame: | Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1, approximately 6 months |
Safety Issue: | |
Description: | Plasma concentration profile of INC280 in combination with Buparlisib. AUCtau is the AUC from time zero to the end of dosing interval. |
Measure: | Pharmacokinetic Profile of INC280 - Cmax |
Time Frame: | Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1, approximately 6 months |
Safety Issue: | |
Description: | Plasma concentration profile of INC280 in combination with Buparlisib. Cmax is the Maximum (peak) observed drug concentration after dose administration. |
Measure: | Pharmacokinetic Profile of INC280 - Tmax |
Time Frame: | Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1, approximately 6 months |
Safety Issue: | |
Description: | Plasma concentration profile of INC280 in combination with Buparlisib. Tmax is the time to reach maximum (peak) observed concentration (Cmax) after dose administration |
Measure: | Pharmacokinetic Profile of INC280 - T1/2 |
Time Frame: | Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1, approximately 6 months |
Safety Issue: | |
Description: | Plasma concentration profile of INC280 in combination with Buparlisib. T1/2 is the terminal half life |
Measure: | Pharmacokinetic Profile of Buparlisib - AUCtau |
Time Frame: | Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1, approximately 6 months |
Safety Issue: | |
Description: | Plasma concentration profile of Buparlisib in combination with INC280. AUCtau is the AUC from time zero to the end of dosing interval. |
Measure: | Pharmacokinetic Profile of Buparlisib - Cmax |
Time Frame: | Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1, approximately 6 months |
Safety Issue: | |
Description: | Plasma concentration profile of INC280 in combination with Buparlisib. Cmax is the Maximum (peak) observed drug concentration after dose administration. |
Measure: | Pharmacokinetic Profile of Buparlisib - Tmax |
Time Frame: | Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1, approximately 6 months |
Safety Issue: | |
Description: | Plasma concentration profile of INC280 in combination with Buparlisib. Tmax is the time to reach maximum (peak) observed concentration (Cmax) after dose administration |
Measure: | Pharmacokinetic Profile of Buparlisib - T1/2 |
Time Frame: | Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1, approximately 6 months |
Safety Issue: | |
Description: | Plasma concentration profile of INC280 in combination with Buparlisib. T1/2 is the terminal half life |
Measure: | Best Overall Response (BOR) |
Time Frame: | throughout the duration of the trial - approximately 3 years (from FPFV to LPLV) |
Safety Issue: | |
Description: | Best Overall Response (BOR) observed in the study population of INC280 Single Agent and in Combination with Buparlisib. Responses will be assessed by the investigators following the RANO criteria with MRI or CT scans scheduled every 8 weeks.
Summary of the RANO response criteria: CR has no T1-Gd+ (enhancing lesion), stable or decrease T2/FLAIR (non-enhancing lesion), absence of new lesion, stable or improve in clinical status; PR has ≥50% decrease T1-Gd+ (enhancing lesion), stable or decrease T2/FLAIR (non-enhancing lesion), absence of new lesion, stable or improve in clinical status; SD has ≥50% decrease but <25% increase T1-Gd+ (enhancing lesion), stable or decrease T2/FLAIR (non-enhancing lesion), absence of new lesion, stable or improve in clinical status; PD has ≥25% increase in T1-Gd+ (enhancing lesion), increase T2/FLAIR (non-enhancing lesion), presence of new lesion, deterioration in clinical status. |
Measure: | Overall Survival (OS) |
Time Frame: | throughout the duration of the trial - approximately 3 years (FPFV to LPLV) |
Safety Issue: | |
Description: | Survival rate of patients from start of treatment to date of death due to any cause.
Patients did not reach the milestone for the survival data analysis (terminated early); as such no analysis was done. |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Terminated |
Lead Sponsor: | Novartis Pharmaceuticals |
Trial Keywords
- Glioblastoma multiforme (GBM), glioblastoma, Grade IV Astrocytoma, brain tumor, brain cancer, giant cell glioblastoma, gliosarcoma
Last Updated
May 30, 2018