Clinical Trials /

A Study of Prexasertib (LY2606368), CHK1 Inhibitor, and LY3300054, PD-L1 Inhibitor, in Patients With Advanced Solid Tumors

NCT03495323

Description:

This research study is studying a combination of a targeted therapy and an immune therapy as a possible treatment. The drugs involved in this study are: - Prexasertib (LY2606368) - LY3300054

Related Conditions:
  • Malignant Solid Tumor
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Study of Prexasertib (LY2606368), CHK1 Inhibitor, and LY3300054, PD-L1 Inhibitor, in Patients With Advanced Solid Tumors
  • Official Title: A Phase I Combination Study of Prexasertib (LY2606368), CHK1 Inhibitor, and LY3300054, PD-L1 Inhibitor, in Patients With Advanced Solid Tumors

Clinical Trial IDs

  • ORG STUDY ID: 18-008
  • NCT ID: NCT03495323

Conditions

  • Cancer

Interventions

DrugSynonymsArms
LY3300054Prexasertib + LY3300054
PrexasertibPrexasertib + LY3300054

Purpose

This research study is studying a combination of a targeted therapy and an immune therapy as a possible treatment. The drugs involved in this study are: - Prexasertib (LY2606368) - LY3300054

Detailed Description

      This research study is a Phase I clinical trial, which tests the safety of an investigational
      drug and also tries to define the appropriate doses of the investigational drugs to use for
      further studies. "Investigational" means that the drugs are being studied.

      The FDA (the U.S. Food and Drug Administration) has not approved prexasertib or LY3300054 as
      a treatment for any disease.

      Prexasertib (LY2606368) is a checkpoint kinase 1 (CHK1) inhibitor that is being developed as
      a treatment for patients with advanced cancer. CHK1 inhibitors work by preventing the cancer
      cells from being able to repair damaged DNA (one of the building blocks of a cell) which then
      leads to cell death.

      A monoclonal antibody is a protein that is made in a laboratory that can target specific
      substances in the body. LY3300054 is a monoclonal antibody that targets programmed cell death
      ligand 1 (PD-L1). PD-L1 is a protein often produced by cancer cells or surrounding cells that
      stops white blood cells from attacking the cancer cells. The drug blocks the protein,
      allowing the immune system to recognize and attack the cancer cells.
    

Trial Arms

NameTypeDescriptionInterventions
Prexasertib + LY3300054ExperimentalPrexasertib is administered intravenously twice per cycle LY3300054 is administered intravenously twice per cycle
  • LY3300054
  • Prexasertib

Eligibility Criteria

        Inclusion Criteria:

          -  Written informed consent obtained prior to any study-specific procedures not
             considered part of routine medical care.

          -  Patients must have histologically confirmed solid tumor that is metastatic or
             unresectable, and there is no available therapy likely to convey clinical benefit

          -  Patients must have measurable disease by RECIST version 1.1. Measurable disease is
             defined as at least one dimension (longest diameter to be recorded for non-nodal
             lesions and short axis for nodal lesions) as ≥ 20mm (≥ 2cm) with conventional
             techniques or as ≥ 10mm (≥ 1cm) with spiral computed tomography (CT) scan, MRI, or
             calipers by clinical exam. See Section 11 for the evaluation of measurable disease.

          -  Patients must have recovered to eligibility levels from prior toxicity or adverse
             events as a result of previous treatment prior to entering the study (except
             alopecia).

          -  Age ≥18 years, as no dosing or adverse event data are currently available on the use
             of prexasertib in combination with LY3300054 in patients < 18 years of age, children
             are excluded from this study.

          -  ECOG performance status 0-1.

          -  Patients must have normal organ and marrow function as defined below:

               -  absolute neutrophil count ≥ 1,500/mcL

               -  platelets ≥ 100,000/mcL

               -  total bilirubin ≤ 1.5 × institutional upper limit of normal (ULN)

               -  AST(SGOT)/ALT(SGPT) ≤ 2.5 × institutional ULN

               -  creatinine ≤ 1.5 × institutional ULN OR

               -  creatinine clearance ≥ 60 mL/min by Cockcroft-Gault equation for participants
                  with creatinine levels above institutional normal.

               -  Free T4 within institutional normal limits

          -  The effects of prexasertib and LY3300054 on the developing human fetus are unknown.
             For this reason, women of childbearing potential and male patients with partners of
             childbearing potential must agree to use two highly effective forms of contraception
             (see Section 5.5.1) prior to study entry, for the duration of study participation, and
             for 6 months after completion of study. Men treated or enrolled on this protocol must
             also agree to use adequate contraception prior to the study, for the duration of study
             participation, and for 3 months after completion of prexasertib and LY3300054
             administration. Should a woman become pregnant or suspect she is pregnant while she or
             her partner is participating in this study, she should inform her treating physician
             immediately.

          -  Women of childbearing potential enrolling on study must have a negative serum
             pregnancy test prior to registration.

          -  Childbearing potential is defined as women who are not postmenopausal (defined as
             amenorrheic for ≥ 12 months following cessation of any exogenous hormonal treatments;
             LH and FSH levels in the postmenopausal range for women under 50; radiation-induced
             oophorectomy with last menses > 12 months prior; or chemotherapy-induced menopause
             with last menses > 12 months prior) or surgically sterile (bilateral oophorectomy or
             hysterectomy).

          -  Ability to understand and the willingness to sign a written informed consent document.
             Patients must be willing and able to comply with the protocol for the duration of the
             study including undergoing treatment and scheduled visits and examinations.

        Exclusion Criteria:

          -  Participants who have had chemotherapy, immune therapy, or radiotherapy within 3 weeks
             (6 weeks for nitrosoureas or mitomycin C; five-half lives for any investigational or
             FDA-approved kinase inhibitors) prior to entering the study. Patients who have
             received prior CHK1 inhibitor therapy are excluded. Exposure to prior PD-L1 antibody
             will be allowed as long as this was not the most recent treatment prior to enrollment.

          -  No prior radiation to > 25% of the marrow

          -  Must not have received more than 4 lines of cytotoxic chemotherapy. A line of therapy
             is defined as being preceded by disease progression. Discontinuation of a regimen
             without progression (for example, due to toxicity) or a switch of an agent within the
             same drug class (for example from cisplatin to carboplatin) will not be considered a
             new line of therapy. Similarly, maintenance therapy (continuation maintenance or
             switch maintenance) will not be considered a new line of treatment.

          -  Participants who are receiving any other investigational agents.

          -  Participants who have undergone major surgery within 14 days of starting the study
             treatment, or participants who have not recovered to baseline status from the effects
             of major surgery received more than 14 days prior.

          -  Participants with known brain metastases or carcinomatous meningitis are excluded from
             this clinical trial, with the exception of patients with brain metastatic disease that
             has previously been treated and remained stable on MRI ≥ 2 months prior to enrollment,
             without steroids or anti-epileptic medications. These patients may be enrolled at the
             discretion of the Principal Investigator.

          -  Uncontrolled intercurrent illness including, but not limited to, ongoing or active
             infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
             arrhythmia, uncontrolled seizures, myocardial infarction within the past 3 months,
             superior vena cava syndrome, unstable spinal cord compression (untreated and unstable
             for at least 28 days prior to study entry), or psychiatric illness/social situations
             that would limit compliance with study requirements.

          -  Participants must not have experienced a Grade ≥ 3 immune-related AE or an
             immune-related neurologic or ocular AE of any grade while receiving prior
             immunotherapy, or experienced a toxicity of any grade that led to permanent
             discontinuation of prior immunotherapy as a result of the toxicity. Participants with
             prior endocrine adverse events of Grade ≤ 2 are permitted to enroll if stably
             maintained on appropriate replacement therapy and are asymptomatic. In the setting of
             prior immune-related AE, participants must not have required the use of additional
             immunosuppressive agents other than corticosteroids for the management of the adverse
             event(s), not have experienced recurrence of the adverse event if re-challenged, and
             not currently requiring maintenance doses of > 10 mg of prednisone or equivalent per
             day at the time of enrollment.

          -  History of allergic reactions attributed to compounds of similar chemical or biologic
             composition to prexasertib or LY3300054.

          -  The effects of prexasertib and LY3300054 on the developing human fetus are unknown.
             For this reason, pregnant women are excluded from this study. Because there is an
             unknown but potential risk for adverse events in nursing infants secondary to
             treatment of the mother with prexasertib and LY3300054, breastfeeding women are also
             excluded.

          -  Known HIV-positive participants on combination antiretroviral therapy are ineligible
             because of the potential for pharmacokinetic interactions with prexasertib and
             LY3300054. In addition, these participants are at increased risk of lethal infections
             when treated with marrow-suppressive therapy such as prexasertib.

          -  Participants with known active or chronic infection with Hepatitis B or C.

          -  Consistent QTc > 470 msec on more than one screening ECG. Patients with a history of
             long QTc syndrome or personal or family history of ventricular arrhythmias will be
             excluded
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Dose Limiting Toxicity
Time Frame:2 years
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Pharmacokinetics of prexasertib and LY3300054
Time Frame:2 years
Safety Issue:
Description:Pharmacokinetic Sampling - Peak Plasma Concentration (Cmax)
Measure:Pharmacokinetics of prexasertib and LY3300054
Time Frame:2 years
Safety Issue:
Description:Pharmacokinetic Sampling - Area Under the Plasma Concentration versus Time Curve (AUC)
Measure:Changes in PD-L1 expression in paired pre- and on-treatment biopsies
Time Frame:2 years
Safety Issue:
Description:
Measure:H2AX expression levels in paired tumor biopsies as a consequence of treatment with prexasertib as proof-of-principle of target engagement
Time Frame:2 years
Safety Issue:
Description:
Measure:Changes in immune markers through analysis of T-cell subsets in paired tumor biopsies
Time Frame:2 years
Safety Issue:
Description:
Measure:Changes in cytokine profile in peripheral blood samples
Time Frame:2 years
Safety Issue:
Description:
Measure:Changes in immune markers through analysis of T-cell subsets in peripheral blood and tumor tissue
Time Frame:2 years
Safety Issue:
Description:
Measure:Differences in immune markers between responders and non-responders
Time Frame:2 years
Safety Issue:
Description:

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Dana-Farber Cancer Institute

Trial Keywords

  • Cancer Care

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