Clinical Trials /

Vismodegib and FAK Inhibitor GSK2256098 in Treating Patients With Progressive Meningiomas

NCT02523014

Description:

This phase II trial studies how well vismodegib and focal adhesion kinase (FAK) inhibitor GSK2256098 work in treating patients with meningioma that is growing, spreading, or getting worse. Vismodegib and FAK inhibitor GSK2256098 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Related Conditions:
  • Meningioma
Recruiting Status:

Suspended

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Vismodegib and FAK Inhibitor GSK2256098 in Treating Patients With Progressive Meningiomas
  • Official Title: Phase II Trial of SMO/AKT/NF2 Inhibitors in Progressive Meningiomas With SMO/AKT/NF2 Mutations

Clinical Trial IDs

  • ORG STUDY ID: A071401
  • SECONDARY ID: NCI-2015-00546
  • NCT ID: NCT02523014

Conditions

  • Intracranial Meningioma
  • Recurrent Meningioma
  • NF2 Gene Mutation

Interventions

DrugSynonymsArms
vismodegibArm A - vismodegib
GSK2256098Arm B - GSK2256098

Purpose

This phase II trial studies how well vismodegib and focal adhesion kinase (FAK) inhibitor GSK2256098 work in treating patients with meningioma that is growing, spreading, or getting worse. Vismodegib and FAK inhibitor GSK2256098 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Detailed Description

      PRIMARY OBJECTIVES:

      I. To determine the activity of a smoothened, frizzled class receptor (SMO) and PTCH1
      inhibitor in patients with meningiomas harboring SMO mutations as measured by 6-month
      progression free survival (PFS) and response rate.

      II. To determine the activity of a FAK inhibitor in patients with meningiomas harboring
      neurofibromin 2 (NF2) mutations as measured by 6-month PFS and response rate.

      SECONDARY OBJECTIVES:

      I. To determine overall survival and progression-free survival of SMO and FAK inhibitors in
      patients with meningioma.

      II. To determine adverse event rates of SMO and FAK inhibitors in patients with meningioma.

      III. To determine the activity of SMO and FAK inhibitor as measured by response rate by
      central radiology review.

      TERTIARY OBJECTIVES:

      I. To evaluate genetic biomarkers in meningioma. II. To evaluate dynamic contrast enhanced
      magnetic resonance imaging (MRI) during treatment with SMO and FAK inhibitors for meningioma.

      III. To evaluate volumetric response by central radiology review.

      OUTLINE: Patients are assigned to 1 of 2 treatment arms based on their mutation status.

      ARM A (SMO/PTCH1 mutation): Patients receive vismodegib orally (PO) once daily (QD). Courses
      repeat every 28 days in the absence of disease progression or unacceptable toxicity.

      ARM B (NF2 mutation): Patients receive FAK inhibitor GSK2256098 PO twice daily (BID). Courses
      repeat every 28 days in the absence of disease progression or unacceptable toxicity.

      After completion of study treatment, patients are followed up every 6 months for a maximum of
      5 years from registration.
    

Trial Arms

NameTypeDescriptionInterventions
Arm A - vismodegibExperimentalPatients receive vismodegib PO QD. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
  • vismodegib
Arm B - GSK2256098ExperimentalPatients receive FAK inhibitor GSK2256098 PO BID. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
  • GSK2256098

Eligibility Criteria

        -  Documentation of disease:

               -  Histologic documentation: histologically proven intracranial meningioma as
                  documented by central pathology review

               -  Molecular documentation: presence of SMO, PTCH1 or NF2 mutation in tumor sample
                  as documented by central laboratory

               -  Progressive OR residual disease, as defined by the following:

                    -  Residual measurable disease: residual measurable disease immediately after
                       surgery without requirement for progression; for grade I disease,
                       progression pre-operatively needs to be documented, with an increase in size
                       of the measurable primary lesion on imaging by 25% or more (bidirectional
                       area); the change must occur between scans separated by no more than 12
                       months; residual measurable disease will be defined by bidimensionally
                       measurable lesions with clearly defined margins by MRI scans, with a minimum
                       diameter of 10 mm in both dimensions

                    -  Progressive measurable disease: progression defined as an increase in size
                       of the measurable primary lesion on imaging by 25% or more (bidirectional
                       area); the change must occur between scans separated by no more than 12
                       months

                    -  Post radiation patients: patients with measurable and progressive meningioma
                       who have received radiation are potentially eligible, but need to show
                       evidence of progressive disease after completion of radiation; at least 24
                       weeks must have elapsed from completion of radiation to registration

          -  Measurable disease: measurable disease is defined by a bidimensionally measurable main
             lesion on MRI or computed tomography (CT) images (MRI preferred) with clearly defined
             margins; multifocal disease is allowed

          -  Prior treatment

               -  Prior medical therapy is allowed but not required

               -  No limit on number of prior therapies

               -  No chemotherapy, other investigational agents within 28 days of study treatment

               -  No other concurrent investigational agents or other meningioma-directed therapy
                  (chemotherapy, radiation) while on study

               -  For patients treated with external beam radiation, interstitial brachytherapy or
                  radiosurgery, an interval > 24 weeks must have elapsed from completion of
                  radiation therapy to registration

               -  Steroid dosing stable for at least 4 days

               -  Recovered to Common Terminology Criteria for Adverse Events (CTCAE) grade 1 or
                  less toxicity from other agents with exception of alopecia and fatigue

               -  No craniotomy within 28 days of registration

          -  Not pregnant and not nursing:

             * A female of childbearing potential is a sexually mature female who: 1) has not
             undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally
             postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in
             the preceding 12 consecutive months)

          -  Eastern Cooperative Oncology Group (ECOG) performance status =< 2

          -  Patient history:

               -  Patients with history of neurofibromatosis (NF) may have other stable central
                  nervous system (CNS) tumors (schwannoma, acoustic neuroma or ependymoma) if
                  lesions have been stable for 6 months

               -  No metastatic meningiomas (as defined by extracranial meningiomas) allowed

               -  No history of allergic reactions attributed to compounds of similar or biologic
                  composition to assigned study drug

               -  No known active hepatitis B or C

               -  No current Child Pugh class B or C liver disease

               -  No uncontrolled gastric ulcer disease (grade 3 gastric ulcer disease within 28
                  days of registration)

               -  No uncontrolled diabetes defined as a known diabetic with hemoglobin A1C (HBA1C)
                  > 7.5 OR fasting glucose > 140

               -  No uncontrolled hypertension defined as blood pressure (BP) > 140/90

               -  No abdominal fistula, gastrointestinal (GI) perforation, or intra-abdominal
                  abscess within 28 days prior to registration

          -  Concomitant medications:

               -  Chronic concomitant treatment with strong inhibitors of cytochrome P450, family
                  3, subfamily A, polypeptide 4 (CYP3A4) inhibitors must discontinue the drug for
                  14 days prior to registration on the study for patients with NF2 mutation
                  enrolled to GSK2256098

               -  Chronic concomitant treatment with strong CYP3A4 inducers is not allowed;
                  patients must discontinue the drug 14 days prior to the start of study treatment
                  for patients with NF2 mutation enrolled to GSK2256098

          -  Absolute neutrophil count (ANC) >= 1,500/mm^3

          -  Platelet count >= 100,000/mm^3

          -  Creatinine OR =< 1.5 mg/dl x upper limit of normal (ULN) OR calculated (calc.)
             creatinine clearance > 45 mL/min

          -  Urine protein:creatinine ratio (UPC) =< 45 mg/mmol; ONLY APPLICABLE for patients with
             NF2 mutation (GSK2256098)

          -  Total bilirubin =< 1.5 x upper limit of normal (ULN); except in case of Gilbert's
             disease

          -  Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 x upper limit
             of normal (ULN)

          -  Fasting triglyceride =< 200 mg/dL; ONLY APPLICABLE for patients with NF2 mutation
             (GSK2256098)

          -  Fasting cholesterol =< 240 mg/dL; ONLY APPLICABLE for patients with NF2 mutation
             (GSK2256098)

          -  Corrected QC interval calculated using Fridericia's formula (QTcF) =< 500 msec; ONLY
             APPLICABLE for patients with NF2 mutation (GSK2256098)
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Progression free survival (PFS)
Time Frame:At 6 months
Safety Issue:
Description:Point estimates and 95% binomial confidence intervals will be generated for the six month PFS rate within each cohort of each treatment arm. Kaplan-Meier curves will be generated for PFS for each cohort within each treatment arm.

Secondary Outcome Measures

Measure:Overall survival (OS)
Time Frame:Up to 2 years
Safety Issue:
Description:OS will be summarized for each cohort within each treatment group with Kaplan-Meier curves and estimates.
Measure:Incidence of adverse events according to National Cancer Institute CTCAE version 4.0
Time Frame:Up to 4 weeks after completion of study treatment
Safety Issue:
Description:Adverse events (AEs) will be summarized for each treatment group. They will be summarized as the number and frequency of each event. In addition the AEs will be summarized as the number and frequency of patients who experience any AE, AEs of grade 3+, and AEs of grade 4+.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Suspended
Lead Sponsor:Alliance for Clinical Trials in Oncology

Last Updated

August 17, 2021