Description:
The purpose of this study is to evaluate the safety, tolerability, and efficacy of single
agent ibrutinib or the combination treatments of ibrutinib with everolimus, paclitaxel,
docetaxel, pembrolizumab or cetuximab in selected advanced gastrointestinal and genitourinary
tumors.
Title
- Brief Title: A Study to Evaluate Ibrutinib Combination Therapy in Patients With Selected Gastrointestinal and Genitourinary Tumors
- Official Title: A Phase 1b/2 Study of Ibrutinib Combination Therapy in Selected Advanced Gastrointestinal And Genitourinary Tumors
Clinical Trial IDs
- ORG STUDY ID:
PCYC-1128-CA
- NCT ID:
NCT02599324
Conditions
- Metastatic Renal Cell Carcinoma
- Advanced Urothelial Carcinoma
- Advanced Gastric Adenocarcinoma
- Metastatic Colorectal Adenocarcinoma
Interventions
Drug | Synonyms | Arms |
---|
Ibrutinib | | Colorectal Adenocarcinoma - Enrollment Closed |
Everolimus | | Renal Cell Carcinoma - Enrollment Closed |
Docetaxel | | Gastric Adenocarcinoma - Enrollment Closed |
Paclitaxel | | Urothelial Carcinoma - Enrollment Closed |
Cetuximab | | Colorectal Adenocarcinoma - Enrollment Closed |
Pembrolizumab | | Urothelial Carcinoma with Pembrolizumab - Enrollment Closed |
Purpose
The purpose of this study is to evaluate the safety, tolerability, and efficacy of single
agent ibrutinib or the combination treatments of ibrutinib with everolimus, paclitaxel,
docetaxel, pembrolizumab or cetuximab in selected advanced gastrointestinal and genitourinary
tumors.
Trial Arms
Name | Type | Description | Interventions |
---|
Renal Cell Carcinoma - Enrollment Closed | Experimental | Phase 1b: Patients will receive ibrutinib at various dose levels in combination with everolimus to determine the Recommended Phase 2 Dose (RP2D) of ibrutinib.
Phase 2: Patients will receive ibrutinib at the RP2D determined in Phase 1b in combination with everolimus. | |
Urothelial Carcinoma - Enrollment Closed | Experimental | Phase 1b: Patients will receive ibrutinib at various dose levels in combination with paclitaxel to determine the RP2D of ibrutinib.
Phase 2: Subjects will receive paclitaxel at the RP2D determined in Phase 1b in combination with paclitaxel. | |
Gastric Adenocarcinoma - Enrollment Closed | Experimental | Phase 1b: Patients will receive ibrutinib at various dose levels in combination with docetaxel to determine the RP2D of ibrutinib.
Phase 2: Subjects will receive docetaxel at the RP2D determined in Phase 1b in combination with docetaxel. | |
Colorectal Adenocarcinoma - Enrollment Closed | Experimental | Phase 1b: Patients will receive ibrutinib at various dose levels in combination with cetuximab to determine RP2D of ibrutinib.
Phase 2: Subjects will receive ibrutinib at the RP2D determined in Phase 1b in combination with cetuximab. | |
Urothelial Carcinoma Ibrutinib- Enrollment Closed | Experimental | Phase 1b: Patients will receive ibrutinib at various dose levels to determine the RP2D of ibrutinib Phase 2: Subjects will receive ibrutinib at the RP2D determined in Phase 1b. | |
Urothelial Carcinoma with Pembrolizumab - Enrollment Closed | Experimental | Phase 1b: Patients will receive ibrutinib at various dose levels in combination with pembrolizumab to determine the RP2D of ibrutinib Phase 2: Subjects will receive ibrutinib at the RP2D determined in Phase 1b in combination with pembrolizumab. | |
Eligibility Criteria
Inclusion Criteria:
- RCC (clear cell), urothelial carcinoma (UC) (transitional cell), gastric or
gastro-esophageal junctional (GEJ) adenocarcinoma, or K-RAS or N-RAS wild-type EGFR
expressing CRC
- For cohort 1 RCC: minimum of 1 and maximum of 4 prior regimens, one or more of which
must have included a VEGF-TKI
- For UC cohort 2: minimum of 1 and maximum of 2 prior regimens, one of which must have
included a platinum-based regimen
- For UC cohort 5: Minimum of 1 and maximum of 2 prior regimens, one of which must have
included a checkpoint inhibitor.
- For UC cohort 6:
- Locally advanced or mUC who are not eligible for cisplatin chemo with a PDL-1
score (CPS) of ≥ 10 without prior treatment.
- Locally advanced or mUC who have progressed on platinum chemo or within 12 months
of neo- or adjuvant therapy with a platinum chemotherapy. A minimum of 1 and
maximum of 2 prior therapies.
- For cohort 3 gastric or GEJ adenocarcinoma: minimum of 1 and maximum of 3 prior
regimens one of which must have included a fluoropyrimidine regimen
- For cohort 4 CRC: minimum of 2 and maximum of 4 prior regimens, which must have
included both an irinotecan and an oxaliplatin based regimen unless unable to tolerate
irinotecan chemotherapy
Laboratory:
- Adequate hematologic function:
- Absolute neutrophil count ≥1500 cells/mm3 (1.5 x 109/L)
- Platelet count >80,000 cells/mm3 (80 x 109/L) for cohort 1 (RCC)
- Platelet counts >100,000 cells/mm3 (100 x 109/L) for all UC cohorts
- Hemoglobin ≥8.0 g/dL. for cohort 1 (RCC),all UC cohorts, and cohort 3 (GC)
- Hemoglobin ≥9.0 g/dL for cohort 4 (CRC)
- Adequate hepatic and renal function defined as:
- Serum aspartate transaminase (AST) and/or alanine transaminase (ALT) ≤5.0 x upper
- limit of normal (ULN) if liver metastases, or ≤3 x ULN without liver metastases
- Alkaline phosphatase <3.0 x ULN or ≤5.0 x ULN if liver or bone metastases present
- Bilirubin ≤1.5 x ULN (unless bilirubin rise is due to Gilbert's syndrome or of
non-hepatic
- origin, such as hemolysis) with the exception of subjects in the GC cohort where
- docetaxel is administered, these subjects must have bilirubin within normal
limits (WNL)
- Estimated Creatinine Clearance ≥30 mL/min (Cockcroft-Gault)
Exclusion Criteria
- Prior treatment with:
- Everolimus or temsirolimus (RCC cohort 1)
- Any taxane (UC cohort of ibrutinib + paclitaxel) (cohort 2)
- Checkpoint inhibitors (UC cohort 6)
- Any taxane (GC cohort 3)
- Cetuximab or panitumumab (CRC cohort 4)
- For all Cohorts:
- Concomitant use of warfarin or other Vitamin K antagonists
- History of stroke or intracranial hemorrhage within 6 months prior to enrollment
- Major surgery within 4 weeks of first dose of study drug
- Requires treatment with strong CYP3A inhibitors known bleeding disorders or
hemophilia
- UC cohort 6 only:
- Subjects who have an active, known or suspected autoimmune disease.
- Evidence of clinically significant interstitial lung disease or active,
noninfectious pneumonitis.
- Non-steroid immunosuppressive medications within 14 days before the first dose of
ibrutinib and pembrolizumab.
- Subjects in whom prior anti PD-1 / anti-PD-L1 therapy was intolerable and
required discontinuation of treatment.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Phase 1b: To determine the recommended Phase 2 dose (RP2D) of ibrutinib |
Time Frame: | Approximately 6 months after evaluation |
Safety Issue: | |
Description: | Evaluated by the number of dose-limiting toxicities (DLT) graded using the NCI CTCAE v 4.03 |
Secondary Outcome Measures
Measure: | To assess the safety and tolerability of ibrutinib combination or single agent |
Time Frame: | Approximately 12 months |
Safety Issue: | |
Description: | Safety and tolerability of ibrutinib combination or single agent as measured by frequency and type of adverse events graded using NCI CTCAE v4.03 |
Measure: | To assess the disease control rate (DCR). |
Time Frame: | Approximately 12 months |
Safety Issue: | |
Description: | Defined by the proportion of subjects with a best response of complete response (CR), partial response (PR), stable disease (greater than or equal to 6 weeks) by investigator assessment, per RECIST 1.1 |
Measure: | Phase 2: To assess the duration of response (DOR) |
Time Frame: | Approximately 12 months |
Safety Issue: | |
Description: | Defined for responders as duration of time from initial response (CR or PR by investigator assessment) to first documentation of disease progression or death from any cause, whichever occurs first. |
Measure: | Phase 2: To assess the median overall survival (OS) |
Time Frame: | Approximately 24 months |
Safety Issue: | |
Description: | Defined as the time from first dose of study drug to death due to any cause. |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Pharmacyclics LLC. |
Last Updated
January 5, 2021