Clinical Trials /

LGX818 and MEK162 in Combination With a Third Agent (BKM120, LEE011, BGJ398 or INC280) in Advanced BRAF Melanoma

NCT02159066

Description:

The primary purpose of this study is to assess the anti-tumor activity of LGX818/MEK162 in combination with targeted agents after progression on LGX818/MEK162 combination therapy, as well as the safety and tolerability of the novel triple combinations.

Related Conditions:
  • Melanoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: LGX818 and MEK162 in Combination With a Third Agent (BKM120, LEE011, BGJ398 or INC280) in Advanced BRAF Melanoma
  • Official Title: The LOGIC 2 Trial A Phase II, Multi-center, Open-label Study of Sequential LGX818/MEK162 Combination Followed by a Rational Combination With Targeted Agents After Progression, to Overcome Resistance in Adult Patients With Locally Advanced or Metastatic BRAF V600 Melanoma

Clinical Trial IDs

  • ORG STUDY ID: CLGX818X2109
  • SECONDARY ID: C4221013
  • SECONDARY ID: 2013-004552-38
  • NCT ID: NCT02159066

Conditions

  • Melanoma

Interventions

DrugSynonymsArms
LGX818LGX818 + MEK162
MEK162LGX818 + MEK162
LEE011LGX818 + MEK162 + LEE011
BGJ398LGX818 + MEK162 + BGJ398
BKM120LGX818 + MEK162 + BKM120
INC280LGX818 + MEK162 + INC280

Purpose

The primary purpose of this study is to assess the anti-tumor activity of LGX818/MEK162 in combination with targeted agents after progression on LGX818/MEK162 combination therapy, as well as the safety and tolerability of the novel triple combinations.

Detailed Description

      This study consists of two parts: in Part I/Run-In, patients naïve to selective BRAF and MEK
      inhibitors will be treated with the LGX818/MEK162 combination until disease progression (as
      defined per RECIST v1.1). Based on the genetic analysis of a tumor biopsy obtained at that
      time, patients will enter Part II of the study for tailored combination treatment in one of
      four arms of LGX818/MEK162 + either BKM120, BGJ398, INC280 or LEE011 Patients with BRAF
      mutant melanoma treated by LGX818/MEK162 combination in other studies can be enrolled
      directly in Part II of CLGX818X2109 after relapse.

      Dose-escalations in the combination arms for which no MTD has been established will be based
      on the recommendations of a Bayesian logistic regression model guided by an escalation with
      overdose control criterion
    

Trial Arms

NameTypeDescriptionInterventions
LGX818 + MEK162Experimental
  • LGX818
  • MEK162
LGX818 + MEK162 + LEE011Experimental
  • LEE011
LGX818 + MEK162 + BGJ398Experimental
  • BGJ398
LGX818 + MEK162 + BKM120Experimental
  • BKM120
LGX818 + MEK162 + INC280Experimental
  • INC280

Eligibility Criteria

        INCLUSION CRITERIA:

          -  Age ≥ 18 years

          -  Histologically confirmed diagnosis of unresectable stage III or metastatic melanoma
             (stage IIIC to IV per American Joint Committee on Cancer [AJCC])

          -  Documented evidence of BRAF V600 mutation.

          -  Newly obtained tumor biopsy at baseline, and patient agrees to a mandatory biopsy at
             the time of progression, if not medically contraindicated.

          -  Evidence of measurable disease, as determined by RECIST v1.1.

        INCLUSION CRITERIA for triple combinations:

        Progressive disease following prior treatment with LGX818/MEK162 combination. PRINCIPAL
        EXCLUSION CRITERIA Symptomatic or untreated leptomeningeal disease.

          -  Symptomatic brain metastases. Patients previously treated or untreated for brain
             metastases that are asymptomatic in the absence of corticosteroid therapy or on a
             stable dose of steroids for four weeks are allowed to enroll. Brain metastases must be
             stable at least 4 weeks with verification by imaging (e.g. brain MRI completed at
             screening demonstrating no current evidence of progressive brain metastases). Patients
             are not permitted to receive enzyme inducing anti-epileptic drugs.

          -  Patients who have developed brain metastases during Part I of the study may continue
             to Part II upon discussion with Novartis Medical Monitor. The brain metastasis must be
             either asymptomatic or treated and stable for at least 4 weeks and on a stable or
             tapering dose of steroids for at least 2 weeks. Patients with brain metastasis are not
             eligible for the combination with LEE011.

          -  Known acute or chronic pancreatitis.

          -  History or current evidence of retinal vein occlusion (RVO) or current risk factors
             for RVO (e.g. uncontrolled glaucoma or ocular hypertension, history of hyperviscosity
             or hypercoagulability syndromes);

          -  Clinically significant cardiac disease including any of the following:

          -  CHF requiring treatment (NYH grade ≥ 2),

          -  LVEF < 50% as determined by MUGA scan or ECHO

          -  History or presence of clinically significant ventricular arrhythmias or atrial
             fibrillation

          -  Clinically significant resting bradycardia

          -  Unstable angina pectoris ≤ 3 months prior to starting study drug

          -  Acute Myocardial Infarction (AMI) ≤ 3 months prior to starting study drug,

          -  QTcF > 480 msec. Patients with any of the following laboratory values at

        Screening/baseline:

          -  Absolute neutrophil count (ANC) <1,500/mm3 [1.5 x 109/L]

          -  Platelets < 100,000/mm3 [100 x 109/L]

          -  Hemoglobin < 9.0 g/dL

          -  Serum creatinine >1.5 x ULN or calculated or directly measured CrCl < 50% LLN (lower
             limit of normal)

          -  Serum total bilirubin >1.5 x ULN

          -  AST/SGOT or ALT/SGPT > 2.5 x ULN, or > 5 x ULN if liver metastases are present

        Additional exclusion criteria for the triple combinations:

        LGX818/MEK162/BKM120:

          -  Patients with fasting glucose > 120 mg/dL or 6.7 mmol/L, and HbA1c > 8 %.

          -  Patient has any of the following mood disorders as judged by the

        Investigator or a Psychiatrist:

          -  Patient has a score ≥ 12 on the PHQ-9 questionnaire

          -  Patient has ≥ CTCAE grade 3 anxiety

        LGX818/MEK162/BGJ398:

          -  History and/or current evidence of significant ectopic mineralization/ calcification
             with the exception of calcified lymph nodes and asymptomatic vascular calcification.

          -  Current evidence of corneal disorder/ keratopathy incl. but not limited to bullous/
             band keratopathy, corneal abrasion, inflammation/ulceration, keratoconjunctivits etc.,
             confirmed by ophthalmologic examination

        LGX818/MEK162/LEE011:

          -  Patients with uncontrolled hypertension (please refer to WHO-ISHguidelines) are
             excluded from study.

          -  QTcF >450 ms for males and >470 ms for females Congenital long QT syndrome or family
             history of unexpected sudden cardiac death and/or hypokalemia CTCAE Grade ≥ 3 and
             magnesium levels below the clinically relevant lower limits at study entry

          -  Current evidence of brain metastasis or brain metastasis detected by mandatory CT/MRI
             at screening

          -  PT/INR or aPTT > 1.5xULN

        Other protocol-defined inclusion/exclusion criteria may apply.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall Response Rate (ORR) (Part II)
Time Frame:2 years
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Incidence of adverse events
Time Frame:2 years
Safety Issue:
Description:
Measure:Incidence rate of Dose Limiting Toxicities (DLTs)
Time Frame:2 years
Safety Issue:
Description:in Cycle 1 of Combination Part (Part II); cycle 1 = 21 days or 28 days
Measure:Plasma Pharmacokinetics (PK) parameters of LGX818 + MEK162 and triple combination partners
Time Frame:2 years
Safety Issue:
Description:AUCtau, ss; Cmax; Cmax, ss; Tmax; Tmax, ss; Ctrough; Clast, ss; T1/2, ss; CL,ss/F; Vz,ss/F
Measure:Overall Response Rate (ORR) (Part II)
Time Frame:2 years
Safety Issue:
Description:
Measure:Progression Free Survival (PFS)(Part I and II)
Time Frame:2 years
Safety Issue:
Description:
Measure:Duration Of Response (DOR) (Part I and II)
Time Frame:2 years
Safety Issue:
Description:
Measure:Overall Survival (OS) (Part II)
Time Frame:2 years
Safety Issue:
Description:
Measure:Molecular status
Time Frame:baseline, at progression with LGX818 + MEK162 combination treatment up to 2 years
Safety Issue:
Description:Molecular Status includes mutation, amplification, expression of markers relevant to the RAF/MEK/ERK and PI3K/AKT pathways
Measure:Time to Response (TTR) (Part I and II)
Time Frame:2 years
Safety Issue:
Description:
Measure:Disease Control Rate (DCR) (Part I and II)
Time Frame:2 years
Safety Issue:
Description:
Measure:Severity of adverse events
Time Frame:2 years
Safety Issue:
Description:

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:Pfizer

Trial Keywords

  • Melanoma

Last Updated

June 15, 2021