Clinical Trials /

A Phase I, Multi-center, Open Label, Drug-drug Interaction Study to Assess the Effect of Ceritinib on the Pharmacokinetics of Warfarin and Midazolam in Patients With ALK-positive Advanced Tumors

NCT02422589

Description:

The purpose of this study was to evaluate the potential inhibitory effects of ceritinib on the CYP3A4- and CYP2C9-mediated metabolism of the probe drugs midazolam and warfarin, respectively, when administered simultaneously as a cocktail. The results obtained from this drug interaction study would provide guidance that would enable an update to the ceritinib labeling and ouldl help guide recommendations for administration of co-medications in future clinical trials.

Related Conditions:
  • Malignant Solid Tumor
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Phase I, Multi-center, Open Label, Drug-drug Interaction Study to Assess the Effect of Ceritinib on the Pharmacokinetics of Warfarin and Midazolam in Patients With ALK-positive Advanced Tumors
  • Official Title: A Phase I, Multi-center, Open Label, Drug-drug Interaction Study to Assess the Effect of Ceritinib on the Pharmacokinetics of Warfarin and Midazolam Administered as a Two-drug Cocktail in Patients With ALK-positive Advanced Tumors Including Non-small Cell Lung Cancer (NSCLC)

Clinical Trial IDs

  • ORG STUDY ID: CLDK378A2103
  • SECONDARY ID: 2014-003741-95
  • NCT ID: NCT02422589

Conditions

  • ALK-positive Advanced Tumors

Interventions

DrugSynonymsArms
ceritinibCeritinib
warfarinCeritinib
midazolamCeritinib

Purpose

The purpose of this study was to evaluate the potential inhibitory effects of ceritinib on the CYP3A4- and CYP2C9-mediated metabolism of the probe drugs midazolam and warfarin, respectively, when administered simultaneously as a cocktail. The results obtained from this drug interaction study would provide guidance that would enable an update to the ceritinib labeling and ouldl help guide recommendations for administration of co-medications in future clinical trials.

Trial Arms

NameTypeDescriptionInterventions
CeritinibExperimental
  • ceritinib
  • warfarin
  • midazolam

Eligibility Criteria

        Inclusion Criteria:

        Histologically or cytologically confirmed diagnosis of stage IIIB (and is not a candidate
        for definitive multimodality therapy) or stage IV NSCLC demonstrated ALK-positive or an
        advanced tumor, other than NSCLC, that carries an ALK genetic alteration (mutation,
        translocation or amplification) and/or ALK overexpression that has progressed despite
        standard therapy, or for which no effective standard therapy exists.

          -  The test to confirm ALK-positivity may be performed in archival tumor (obtained at or
             since the time of diagnosis), or in a newly obtained tumor sample taken prior to the
             first day of study drug. Results confirming ALK-positive status must be available
             before initiating treatment with ceritinib.

          -  Patients who have received prior chemotherapy, other ALK inhibitors, biologic therapy,
             or other investigational agents, must have recovered from all toxicities related to
             prior anticancer therapies to grade ≤ 1 (CTCAE v 4.03) prior to starting study drug.
             Patients with grade ≤ 2 peripheral neuropathy or any grade of alopecia, nail changes
             or skin changes are allowed to enter the study.

          -  Patients who have been treated with chemotherapy, with biological therapy or other
             investigational agent must have discontinued the treatment at least 2 weeks (14 days)
             prior to starting the study drug on Study Day 1.In case last chemotherapy contained
             nitrosourea or mitomycin C, the treatment was discontinued at least 6 weeks prior to
             starting study drug.

          -  Patient has the ability to understand and provide signed informed consent.

        Exclusion Criteria:

          -  Patients with known hypersensitivity to any of the excipients of ceritinib
             (microcrystalline cellulose, mannitol, crospovidone, colloidal silicon dioxide and
             magnesium stearate), midazolam and warfarin as described in the local product
             information.

          -  History of carcinomatous meningitis.

          -  Presence or history of a malignant disease other than an ALK-positive advanced tumor
             that has been diagnosed and/or required therapy within the past 3 years. Exceptions to
             this exclusion include the following: completely resected basal cell and squamous cell
             skin cancers, and completely resected carcinoma in situ of any type.

          -  Clinically significant, uncontrolled heart disease and/or recent cardiac event (within
             6 months), such as:

          -  Unstable angina within 6 months prior to screening.

          -  Myocardial infarction within 6 months prior to screening.

          -  History of documented congestive heart failure (New York Heart Association functional
             classification III-IV).

          -  Uncontrolled hypertension defined by a Systolic Blood Pressure ≥ 160 mmHg and/or
             Diastolic Blood Pressure ≥ 100 mmHg, with or without antihypertensive medication.
             Initiation or adjustment of antihypertensive medication (s) was allowed prior to
             screening.

          -  Ventricular arrhythmias.

          -  Supraventricular and nodal arrhythmias not controlled with medication.

          -  Other cardiac arrhythmia not controlled with medication.

          -  Corrected QT (QTcF) > 470 ms using Fridericia's correction on the screening
             electrocardiogram (ECG) (as mean of triplicate ECGs).

          -  Uncontrolled hypertension defined by a Systolic Blood Pressure (SBP) ≥ 160 mmHg and/or
             Diastolic Blood Pressure (DBP) ≥ 100 mmHg, with or without anti-hypertensive
             medication.

          -  Patient has history of interstitial lung disease or interstitial pneumonitis,
             including clinically significant radiation pneumonitis (i.e., affecting activities of
             daily living or requiring therapeutic intervention).

        Other Protocol defined Inclusion/Exclusion may applied.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Phamacokinetics (PK) parameters of probe drugs and their metabolites in the absence or presence of ceritinib dosing, including but not limited to: AUCinf
Time Frame:Days 1,2,3,4,5,6,7,28,29,30,31,32,33,34 and once every 21 days until death or up to 24 months.
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Ctrough concentrations of ceritinib
Time Frame:Days 1,2,3,4,5,6,7,28,29,30,31,32,33,34 and once every 21 days until death or up to 24 months.
Safety Issue:
Description:
Measure:Number of participants with Adverse Events as a measure of safety and tolerability
Time Frame:Days 1,2,3,4,5,6,7,28,29,30,31,32,33,34 and once every 21 days until death or up to 24 months.
Safety Issue:
Description:This will be done by looking at the vital signs, lab values and ECG
Measure:Objective Response Rate (ORR)
Time Frame:Baseline, every 6 weeks until week 27
Safety Issue:
Description:Tumor evaluation will be determined locally by investigator per RECIST 1.1
Measure:Duration of Response (DOR)
Time Frame:Baseline, every 6 weeks until week27
Safety Issue:
Description:Tumor evaluation will be determined locally by investigatorper RECIST 1.1

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:Novartis Pharmaceuticals

Trial Keywords

  • ALK-positive advanced tumors
  • midazolam
  • warfarin
  • ceritinib
  • ALK
  • CYP3A-4
  • Drug drug intereaction

Last Updated

December 19, 2020