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.
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
Interventions
Drug | Synonyms | Arms |
---|
LGX818 | | LGX818 + MEK162 |
MEK162 | | LGX818 + MEK162 |
LEE011 | | LGX818 + MEK162 + LEE011 |
BGJ398 | | LGX818 + MEK162 + BGJ398 |
BKM120 | | LGX818 + MEK162 + BKM120 |
INC280 | | LGX818 + 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
Name | Type | Description | Interventions |
---|
LGX818 + MEK162 | Experimental | | |
LGX818 + MEK162 + LEE011 | Experimental | | |
LGX818 + MEK162 + BGJ398 | Experimental | | |
LGX818 + MEK162 + BKM120 | Experimental | | |
LGX818 + MEK162 + INC280 | Experimental | | |
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
Last Updated
June 15, 2021