Clinical Trials /

First-in-Human Dose Escalation Trial in Subjects With Advanced Malignancies

NCT01971515

Description:

This is a Phase 1, first-in-human, open-label, non-randomized, dose escalation, trial to explore the safety, tolerability, pharmacokinetic (PK), pharmacodynamic (PD) and clinical activity signals of MSC2363318A.

Related Conditions:
  • Malignant Solid Tumor
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: First-in-Human Dose Escalation Trial in Subjects With Advanced Malignancies
  • Official Title: A Phase I, First-in-Human, Dose Escalation Trial of MSC2363318A, a Dual p70S6K/Akt Inhibitor, in Subjects With Advanced Malignancies

Clinical Trial IDs

  • ORG STUDY ID: EMR100018-001
  • NCT ID: NCT01971515

Conditions

  • Solid Tumor

Interventions

DrugSynonymsArms
MSC2363318AM2698MSC2363318A
MSC2363318A plus TrastuzumabMSC2363318A plus Trastuzumab
MSC2363318A plus TamoxifenMSC2363318A plus Tamoxifen

Purpose

This is a Phase 1, first-in-human, open-label, non-randomized, dose escalation, trial to explore the safety, tolerability, pharmacokinetic (PK), pharmacodynamic (PD) and clinical activity signals of MSC2363318A.

Trial Arms

NameTypeDescriptionInterventions
MSC2363318AExperimental
  • MSC2363318A
MSC2363318A plus TrastuzumabExperimental
  • MSC2363318A plus Trastuzumab
MSC2363318A plus TamoxifenExperimental
  • MSC2363318A plus Tamoxifen

Eligibility Criteria

        Inclusion Criteria:

          -  Age greater than or equal to (>=)18 years

          -  Confirmed diagnosis of advanced malignancies that may be controlled with p70S6K or Akt
             inhibition based on already identified molecular alteration known to affect the PAM
             pathway, such as:: such as: such as: phosphate and tensin homolog (PTEN),
             phosphoinositide 3-Kinase catalytic subunit alpha isoform (PIK3CA), protein kinase B 1
             (Akt 1), Akt 3, mammalian target of rapamycin (mTOR), tumor sclerosis complex 1
             (TSC1), tumor sclerosis complex 2 (TSC2), in subjects who have received at least all
             treatment options considered to be standard therapy, unless some available treatment
             are not acceptable to the subject. For the dose escalation portion of the trial,
             subjects must have received the standard therapy unless intolerant or contraindicated.

               -  Part 2, Cohort 1: For subjects with only PAM pathway alterations, subjects must
                  have only PAM alterations, excluding Akt2 activating mutations or amplifications,
                  and no other genomic alterations.

               -  Part 2, Cohort 2: Histologically confirmed local laboratory testing
                  (immunohistochemistry 3+ staining and/or fluorescence in situ hybridization ratio
                  >= 2.0) HER2+ metastatic breast cancer subjects who are resistant to
                  trastuzumab-containing treatment and progressed on trastuzumab, pertuzumab, a
                  taxane, and/or trastuzumab emtansine. There is no limit regarding the number of
                  prior lines of therapy. Subjects may be enrolled regardless of whether or not
                  their tumor harbors a PAM pathway alteration (documentation of PAM pathway
                  alteration for this cohort is not required).

               -  Part 2, Cohort 3: Histologically and/or cytologically confirmed diagnosis of
                  breast cancer with hormone receptor-positive status (ER and/or PgR positive) and
                  HER2-negative status with prior exposure to tamoxifen and/or an aromatase
                  inhibitor and/or an aromatase inhibitor plus palbociclib. Prior treatment with
                  tamoxifen in the neoadjuvant setting is allowed but must have been discontinued
                  for at least 1 year prior to the first dose.

          -  Measurable disease using clinically appropriate criteria for the type of malignancy,
             RECIST version 1.1 for solid tumors and Cheson 2007 for lymphoma

          -  A tumor accessible for biopsies and consent to undergo tumor biopsies before and
             during MSC2363318A treatment. Subjects who do not have a tumor suitable for biopsy
             (such as, but not limited to, high procedural risk, inaccessible site for needle
             biopsy, etc.) but are otherwise eligible for this study may be considered for
             enrollment on a case-by-case basis after discussion with the Medical Monitor of the
             study

          -  Ability to read and understand the informed consent form and willingness and ability
             to give informed consent and demonstrate comprehension of the trial before undergoing
             any trial activities

          -  Negative blood pregnancy test at the screening visit for women of childbearing
             potential

          -  Willingness to avoid pregnancy and breast feeding beginning two weeks before the first
             MSC2363318A dose and ending three months after the last trial treatment. Male subjects
             with female partners of childbearing potential and female subjects of childbearing
             potential must use adequate contraception in the judgment of the Investigator, such as
             a two barrier method or a one barrier method with spermicide or intrauterine device
             during trial treatment dosing and for 3 months after the last dose of the study.

        Exclusion Criteria:

          -  Eastern Cooperative Oncology Group Performance Status >=2

          -  Previous therapy with:

               -  Chemotherapy, immunotherapy, biologic therapy, or any other anticancer therapy
                  within 2 weeks (or five elimination half lives for noncytotoxics, whichever is
                  shorter) of Day 1 of trial drug treatment (6 weeks for nitrosureas or mitomycin).
                  Subjects on therapy with trastuzumab (trastuzumab cohort) may continue with
                  trastuzumab during the screening phase of the study. Subjects on endocrine
                  therapy may continue with antihormonal therapy until Day 1 of the study.

               -  Any investigational agent within 3 weeks of Day 1 of trial drug treatment

               -  Extensive prior radiotherapy on more than 30 percent of bone marrow reserves, or
                  prior bone marrow/stem cell transplantation within 5 years from enrolment

               -  Palliative radiation therapy within 2 weeks of Day 1 of trial drug treatment

          -  Known tumor EGFR, KRAS, and/or Akt2 mutations or amplification

          -  Ongoing toxicity due to a prior therapy, unless returned to baseline or Grade 1. Grade
             2 toxicities (e.g., alopecia or peripheral neuropathy) that are not likely to increase
             the subject's safety risk while receiving trial treatment may be accepted after
             Sponsor approval.

          -  Major surgical intervention or participation in a therapeutic clinical trial within 28
             days from Day 1 of the first dose of MSC2363318A

          -  Bone marrow impairment, renal impairment, liver function abnormality and impaired
             cardiac function as defined in the protocol

          -  History of cerebral vascular accident or stroke within the previous 2 years

          -  Uncontrolled hypertension

          -  History of Grade 3 or 4 allergic reactions attributed to compounds of similar chemical
             or biologic composition as MSC2363318A

          -  Known symptomatic central nervous system (CNS) metastases

          -  History of difficulty swallowing, malabsorption or other chronic gastrointestinal
             disease or conditions that may hamper compliance and/or absorption of the
             investigational product

          -  Known human immunodeficiency virus, viral hepatitis, or tuberculosis positivity

          -  Legal incapacity or limited legal capacity

          -  Any other condition which, in the opinion of the Investigator, might impair the
             subject's tolerance of trial treatment, the safety of the individual subject or the
             outcome of the trial. (including but not limited to: history of major depressive
             episode, bipolar disorder, obsessive-compulsive disorder, schizophrenia, suicidal
             attempt or ideation, homicidal ideation, or >= Common Terminology Criteria for Adverse
             Events [CTCAE] Grade 3 anxiety)

          -  Immediate prior therapy with a PAM pathway inhibitor (i.e., the subject is excluded if
             the last treatment regimen, prior to MSC2363318A, was a PAM pathway inhibitor, or if
             the last PAM pathway inhibitor that the subject was treated with occured less than 2
             months prior to Day 1 of trial drug treatment).
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of dose limiting toxicities (DLTs) in Dose Escalation and Trastuzumab or Tamoxifen combination arms
Time Frame:Up to Day 21 of Cycle 1
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Observed Maximum Plasma Concentration (Cmax)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Time To Reach Maximum Plasma Concentration (Tmax)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Area Under Plasma Concentration Versus Time Curve From Time Zero to Last Sampling Time (AUC0-t)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Area Under the Plasma Concentration Versus Time Curve From Time Zero to Infinity (AUC0-inf)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Area Under Plasma Concentration Versus Time Curve Within One Dosing Interval (AUCtau)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Apparent Terminal Half-life ( t1/2)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Apparent Oral Clearance (CL/F)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Apparent Oral Clearance Steady State (CLss/F)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Apparent Volume of Distribution (Vz/F)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Apparent Volume of Distribution at Steady State (Vss/F)
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Factor to Assess the Increase of Drug Concentration in Plasma Until Steady State is Reached [Racc(AUC)]
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Factor to Assess the Maximal Increase of Drug Concentration in Plasma [Racc (Cmax)]
Time Frame:Days 1, 2, 8 and 15 of Cycle 1 and Days 1, 8 and 15 of Cycle 2, Cycle 3
Safety Issue:
Description:
Measure:Number of subjects with best overall response according to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v 1.1) or Cheson 2007
Time Frame:Evaluation were performed on Day 1 of every alternate cycle until tumor progression
Safety Issue:
Description:
Measure:Percentage of subjects with clinical benefit
Time Frame:Week 12
Safety Issue:
Description:Percentage of subjects with clinical benefit is defined as subjects with complete response (CR) or partial response (PR) at week 12, based on tumor assessment as determined by RECIST version 1.1 or Cheson 2007.
Measure:Disease control rate (DCR) for Cohort 2 only
Time Frame:Week 6
Safety Issue:
Description:
Measure:Progression-free survival (PFS) rate for Cohorts 2 and 3 only
Time Frame:up to 6 months
Safety Issue:
Description:

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:EMD Serono

Trial Keywords

  • MSC2363318A
  • Maximum tolerated dose
  • Dose limiting toxicities
  • Recommended phase 2 dose
  • M2698
  • Metastatic Breast Cancer
  • HER2+ Metastatic Breast Cancer
  • Hormone refractory ER/PR+ breast cancer
  • Tamoxifen
  • PAM Pathway Alteration(s)
  • PAM Pathway
  • Targeted Therapy
  • P70S6K
  • AKT Inhibition
  • PI3K Pathway
  • HER2+ Trastuzumab Resistance

Last Updated

September 19, 2018