Clinical Trials /

A Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics, and Anti-Cancer Activity of Trametinib in Combination With Palbociclib in Subjects With Solid Tumors

NCT02065063

Description:

This is a dose-escalation, Phase I/II, open-label, three-part study. Part 1 is designed to determine the recommended dose and schedule for the orally administered MEK inhibitor trametinib, given together with the CDK4/6 inhibitor palbociclib in subjects with solid tumors. Multiple dose levels of each inhibitor will be tested to determine the recommended dose and schedule. Part 2 will evaluate the effect of the combination on tumor biomarkers safety, and anti-cancer activity in subjects with cutaneous melanoma that do not have a change at BRAFV600. Approximately 100-200 subjects will be enrolled. All subjects will receive trametinib and/or palbociclib until disease progression, death, consent withdrawal or unacceptable adverse event (AE). Data was only collected and analyzed for the Phase I component of the study, the Phase II component of the study was terminated without data collection

Related Conditions:
  • Malignant Solid Tumor
  • Melanoma
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics, and Anti-Cancer Activity of Trametinib in Combination With Palbociclib in Subjects With Solid Tumors
  • Official Title: A Dose-Escalation, Phase I/II, Open-Label, Three-Part Study of the MEK Inhibitor, Trametinib, Combined With the CDK4/6 Inhibitor, Palbociclib, To Investigate the Safety, Pharmacokinetics, Pharmacodynamics, and Anti-Cancer Activity in Subjects With Solid Tumors

Clinical Trial IDs

  • ORG STUDY ID: 200344
  • NCT ID: NCT02065063

Conditions

  • Cancer

Interventions

DrugSynonymsArms
TrametinibPart 1
PalbociclibPart 1

Purpose

This is a dose-escalation, Phase I/II, open-label, three-part study. Part 1 is designed to determine the recommended dose and schedule for the orally administered MEK inhibitor trametinib, given together with the CDK4/6 inhibitor palbociclib in subjects with solid tumors. Multiple dose levels of each inhibitor will be tested to determine the recommended dose and schedule. Part 2 will evaluate the effect of the combination on tumor biomarkers safety, and anti-cancer activity in subjects with cutaneous melanoma that do not have a change at BRAFV600. Approximately 100-200 subjects will be enrolled. All subjects will receive trametinib and/or palbociclib until disease progression, death, consent withdrawal or unacceptable adverse event (AE). Data was only collected and analyzed for the Phase I component of the study, the Phase II component of the study was terminated without data collection

Trial Arms

NameTypeDescriptionInterventions
Part 1ExperimentalPart 1 is a dose finding phase in which subjects will be initially administered 75 milligram (mg) of palbociclib (21 days on/7 days off) and 1.5 mg of trametinib (once daily continuous dosing) in each 28-day cycle. Dose escalations will continue based on predefined parameters until the RCR is identified. The RCR will not exceed the maximum tolerated dose (MTD).
  • Trametinib
  • Palbociclib
Part 2ExperimentalOnce the MTD and schedule have been determined, two expansion cohorts of up to 20 subjects each will be enrolled. The cohorts will enroll subjects with BRAF-WT (wild type) cutaneous melanoma that are either NRAS-WT or NRAS-MUT (mutated). Subjects will be dosed at or below the RCR to determine the inhibition of selected tumor biomarkers at each dose level.
  • Trametinib
  • Palbociclib
Part 3ExperimentalPart 3 will be a randomized Phase II study in which subjects will be administered the RCR as previously identified. Part 3 will be initiated only if an RCR is identified, and sufficient anticancer activity is observed in Parts 1 and 2.
  • Trametinib
  • Palbociclib

Eligibility Criteria

        Inclusion Criteria:

          -  Inclusion Criteria for Part 1 and Part 2

          -  Subjects >=18 years old.

          -  Signed written informed consent.

          -  All prior anti-cancer treatment-related toxicities (except alopecia and laboratory
             values as listed in the protocol) must be <=grade 1 according to the Common
             Terminology Criteria for Adverse Events version 4 (CTCAE version 4.0) at the time of
             randomization.

          -  Able to swallow and retain oral medication and must not have any clinically
             significant gastrointestinal abnormalities that may alter absorption such as
             malabsorption syndrome or major resection of the stomach or bowels.

          -  Women of childbearing potential must have a negative serum pregnancy test within 7
             days of first dose of study treatment and agree to use effective contraception as
             defined in the protocol.

          -  Men with a female partner of childbearing potential must have either had a prior
             vasectomy or agree to use effective contraception as described in the protocol.

          -  An Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

          -  Adequate baseline organ function as defined in the protocol.

          -  Other Inclusion criteria for Part 1

          -  Histologically or cytologically confirmed diagnosis of solid tumor malignancy that is
             not responsive to standard therapies or for which there is no approved or curative
             therapy.

          -  Subjects with cutaneous melanoma must provide either a fresh or archived tumor sample
             for genetic analysis including determination of or confirmation of BRAF and NRAS
             genetic status based on local laboratory results. To ensure prompt delivery of tumor
             samples, tissue shipment tracking information must be provided before administration
             of study treatment can be initiated.

          -  Other Inclusion criteria for Part 2

          -  Measurable disease (i.e., present with at least one measurable lesion per RECIST,
             version 1.1).

          -  Histologically or cytologically confirmed diagnosis of advanced or metastatic
             cutaneous melanoma that is determined to be BRAFV600 wild type and either NRAS wild
             type or NRAS mutation type. Note: Subjects with a melanoma of unknown primary origin
             may be allowed to enrol if all other types of melanoma (e.g., uveal, mucosal, or
             acral) can be reasonably ruled out.

          -  Must provide either a fresh or archived tumor sample for genetic analysis.

          -  Accessible tumor for biopsy and willingness to provide pre-dose tumor biopsies on Days
             1 and Day 15.

          -  Inclusion Criteria for Part 3

          -  The inclusion criteria for Part 3 will be based on emerging data from Parts 1 and 2
             and will be specified in an amendment.

        Exclusion Criteria:

          -  Prior treatment with a MEK inhibitor or a CDK4/6 inhibitor.

          -  BRAFV600 mutation positive.

          -  For Part 1, subjects may have had any number of prior systemic anti-cancer treatments,
             but may not have received more than 2 schedules of myeloablative chemotherapy. For
             Parts 2 and 3, more than two prior systemic anti-cancer treatment (chemotherapy,
             immunotherapy, biologic therapy, vaccine therapy, or investigational treatment) for
             Stage IIIC (unresectable) or Stage IV (metastatic) melanoma are not permitted. Prior
             systemic treatment in the adjuvant setting is allowed. (Note: Ipilimumab treatment
             must end at least 8 weeks prior to Study Day 1 (Parts 1 and 2) or randomization (Part
             3.)

          -  Any major surgery, extensive radiotherapy, chemotherapy with delayed toxicity,
             biologic therapy, or immunotherapy within 21 days prior to Study Day 1 (Parts 1 and 2)
             or randomization (Part 3), or daily or weekly chemotherapy without the potential for
             delayed toxicity within 14 days prior to Study Day 1 (Parts 1 and 2) or randomization
             (Part 3).

          -  Taken an investigational drug within 28 days or 5 half-lives (minimum 14 days),
             whichever is shorter, prior to Study Day 1 (Parts 1 and 2) or randomization (Part 3).

          -  Current use of a prohibited medication as described in the protocol.

          -  History of another malignancy (Part 3 only). Exception: Subjects who have been
             disease-free for 3 years, or subjects with a history of completely resected,
             non-melanoma skin cancer, or subjects with indolent second malignancies are eligible.
             T1a melanoma and melanoma in situ are permitted. Consult GlaxoSmithKline (GSK) Medical
             Monitor if unsure whether second malignancies meet requirements specified above.

          -  Any serious or unstable pre-existing medical conditions (aside from malignancy
             exceptions specified above), psychiatric disorders, or other conditions that could
             interfere with the subject's safety, obtaining informed consent, or compliance with
             study procedures.

          -  Known Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), or Hepatitis C
             Virus (HCV) infection (subjects with laboratory evidence of cleared HBV and HCV
             infection will be permitted).

          -  History of leptomeningeal disease or spinal cord compression secondary to metastasis.

          -  Brain metastasis, unless previously treated with surgery or stereotactic radiosurgery
             and the disease has been confirmed stable (i.e., no increase in lesion size, and
             stable or decreased doses of corticosteroids) for at least 6 weeks with two
             consecutive scans prior to Study Day 1 (Parts 1 and 2) or randomization (Part 3).
             (Enzyme inducing anticonvulsants are not allowed while subjects are on study
             treatment. Prior whole-brain radiation as adjuvant treatment is allowed.)

          -  A history or evidence of cardiovascular risk including any of the following: A QT
             interval corrected for heart rate using the Fridericia's formula (QTcF) >=480
             millisecond (msec); A history or evidence of current clinically significant
             uncontrolled arrhythmias; Exception: Subjects with atrial fibrillation controlled for
             >30 days prior to Study Day 1 (Parts 1 and 2) or randomization (Part 3); History of
             acute coronary syndromes (including myocardial infarction and unstable angina),
             coronary angioplasty, or stenting within 6 months prior to Study Day 1 (Parts 1 and 2)
             or randomization (Part 3); A history or evidence of current >=Class II congestive
             heart failure as defined by the New York Heart Association (NYHA) guidelines;
             Treatment refractory hypertension defined as a blood pressure of systolic>140
             millimeters of mercury (mmHg) and/or diastolic >90 mmHg which cannot be controlled by
             anti-hypertensive therapy; Patients with intra-cardiac defibrillators or permanent
             pacemakers; Known cardiac metastases.

          -  A history or current evidence/risk of Retinal Vein Occlusion (RVO) or Central Serous
             Retinopathy (CSR) including: History of RVO or CSR, or predisposing factors to RVO or
             CSR (e.g. uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease
             such as hypertension, diabetes mellitus, or history of hyperviscosity or
             hypercoagulability syndromes); or Visible retinal pathology as assessed by ophthalmic
             examination that is considered a risk factor for RVO or CSR such as: Evidence of new
             optic disc cupping; Evidence of new visual field defects; Intraocular pressure >21
             mmHg as measured by tonography.

          -  Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs
             chemically related to the study treatments, their excipients, and/or dimethyl
             sulfoxide (DMSO).

          -  History of interstitial lung disease or pneumonitis.

          -  Females who are nursing.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Part 1: Change from baseline in vital signs
Time Frame:Up to 36 months
Safety Issue:
Description:Vital sign measurements will include systolic and diastolic blood pressure, temperature, respiration rate and pulse rate

Secondary Outcome Measures

Measure:Part 1: GSK1120212 and PD-0332991 PK parameters following repeat-dose administration of trametinib and palbociclib
Time Frame:Cycle 1 Day 15 (pre-dose, and 1, 2, 4, 6, 8, and 10 hours post dose) and Cycle 2 Day 15 (pre-dose)
Safety Issue:
Description:The following PK parameters will be calculated: Area under the concentration-time curve over the dosing interval (AUC[0-tau]), minimum observed concentration (Cmin), pre-dose (trough) concentration at the end of the dosing interval (Ctau), maximum observed concentration (Cmax), time of occurrence of Cmax (tmax), and terminal phase half-life (t1/2) (if data permits)
Measure:Part 1 and Part 2: Number of subjects with response rate
Time Frame:Up to 36 months for part 1 and 24 months for part 2
Safety Issue:
Description:Subjects whose disease responds (either complete response [CR] or partial response [PR]), using RECIST Version 1.1 (up to approximately 100 subjects)
Measure:Part 1 and Part 2 : Number of subjects with Duration of response (DOR)
Time Frame:Up to 36 months for part 1 and 24 months for part 2
Safety Issue:
Description:up to approximately 100 subjects
Measure:Part 1 and Part 2: Number of subjects with Progression-free survival (PFS)
Time Frame:Up to 36 months for part 1 and 24 months for part 2
Safety Issue:
Description:up to approximately 100 subjects
Measure:Part 2 : Change from baseline in vital signs
Time Frame:Up to 24 months
Safety Issue:
Description:Vital sign measurements will include systolic and diastolic blood pressure, temperature, respiration rate and pulse rate
Measure:Part 2: Change from baseline in physical examination findings
Time Frame:Up to 24 months
Safety Issue:
Description:A complete physical examination will include assessments of the head, eyes, ears, nose, throat, skin, thyroid, neurological, lungs, cardiovascular, abdomen (liver and spleen), lymph nodes and extremities
Measure:Part 2: Change from baseline in 12-lead electrocardiograms (ECG) assessment
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Part 2: Change from baseline in echocardiogram (ECHO) or Multi Gated Acquisition (MUGA) scans assessment
Time Frame:Up to 24 months
Safety Issue:
Description:An ECHO (preferred) or a MUGA scan will be performed at baseline to assess cardiac ejection fraction and cardiac valve morphology for the purpose of study eligibility
Measure:Part 2 : Change from baseline in chemistry and hematology laboratory values
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Part 2 : Number of subjects with adverse events (AEs)
Time Frame:From the time the first dose of study treatment is administered until 30 days following discontinuation of study treatment
Safety Issue:
Description:up to 40 subjects
Measure:Part 2: Composite of pharmacokinetic (PK) parameters following trametinib and palbociclib administration
Time Frame:Cycle 1 Day 15
Safety Issue:
Description:PK parameters will include: Cmax, tmax, AUC(0-t), CL/F, Cmin. Blood samples of approximately 2 mL for trametinib and 2 mL for palbociclib (4 mL total) will be collected for PK analysis (up to 40 subjects)

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:GlaxoSmithKline

Trial Keywords

  • MEK inhibitor
  • PD-0332991
  • CDK4/6 inhibitor
  • palbociclib
  • NRAS wild type
  • cutaneous melanoma
  • GSK1120212
  • trametinib
  • NRAS mutant
  • BRAFV600 wild type

Last Updated

June 1, 2018