Description:
This is a phase 1 study in advanced cancer patients with varied hepatic fucntions to evaluate
the potential effect of hepatic impairment on pharmacokinetics and safety of lorlatinib and
provide dose recommendation for patients with hepatic impairment if possible.
Title
- Brief Title: Hepatic Impairment Study for Lorlatinib in Cancer Patients
- Official Title: A PHASE 1 STUDY TO EVALUATE THE EFFECT OF HEPATIC IMPAIRMENT ON THE PHARMACOKINETICS AND SAFETY OF LORLATINIB IN ADVANCED CANCER PATIENTS
Clinical Trial IDs
- ORG STUDY ID:
B7461009
- SECONDARY ID:
lorlatinib HEPATIC IMPAIRMENT
- SECONDARY ID:
HEPATIC IMPAIRMENT
- NCT ID:
NCT03726333
Conditions
Interventions
Drug | Synonyms | Arms |
---|
lorlatinib | | Group A1 Normal hepatic function |
lorlatinib | | Group A2 Normal hepatic function |
lorlatinib | | Group B mild hepatic impairment |
lorlatinib | | Group C moderate hepatic impairment |
lorlatinib | | Group D severe hepatic impairment |
Purpose
This is a phase 1 study in advanced cancer patients with varied hepatic fucntions to evaluate
the potential effect of hepatic impairment on pharmacokinetics and safety of lorlatinib and
provide dose recommendation for patients with hepatic impairment if possible.
Detailed Description
This will be a Phase 1, open label, multi center, multiple dose, non randomized, Phase 1
clinical trial of lorlatinib in advanced cancer patients with varying degrees of hepatic
impairment and necessary age , weight , and gender matched prospect normal hepatic function
patients. This study is intended to evaluate the potential effect of hepatic impairments on
the PK and safety of lorlatinib after daily administration of lorlatinib and to provide
dosing recommendation for patients with varied degree of hepatic impairment if possible.
Patients in the study will be assigned to different groups (A1, normal liver function,
control for group B; A2, normal liver function, control for group C; B, mild hepatic
impairment; C, moderate hepatic impairment; D, severe hepatic impairment) according to their
liver function. The enrollment of approximately 76 advanced cancer patients is anticipated in
this study in order to have 8 PK-evaluable patients in each of Groups A1, A2, B and C, and 6
PK-evaluable patients in Group D for final statistical analysis. Evaluable patients are those
who complete the planned PK sample collection on Cycle 2 Day 1 and have no lorlatinib dose
modification until completion of Cycle 2 Day 1 PK evaluation. Patients who are not evaluable
for PK will be replaced. Each patient will be treated with repeated oral once daily doses of
lorlatinib in 21-day cycles until disease progression, patient refusal, or unacceptable
toxicity occurs. The dose schedule may be modified as necessary for individual patients
according to tolerability.
Trial Arms
Name | Type | Description | Interventions |
---|
Group A1 Normal hepatic function | Active Comparator | continued daily administration of lorlatinib in patients with normal hepatic function | |
Group A2 Normal hepatic function | Active Comparator | continued daily administration of lorlatinib in patients with normal hepatic function | |
Group B mild hepatic impairment | Experimental | continued daily administration of lorlatinib in patients with mild hepatic imapirment | |
Group C moderate hepatic impairment | Experimental | continued daily administration of lorlatinib in patients with moderate hepatic impairment | |
Group D severe hepatic impairment | Experimental | continued daily administration of lorlatinib in patients with severe hepatic impairment | |
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed solid malignancy or lymphoma that is
metastatic or unresectable, and for which standard curative or palliative measures do
not exist, or are no longer effective;
- Biliary obstruction with a biliary drain or stent;
- Neurologically stable gliomas and brain metastases;
- ECOG performance status of 0, 1, or 2;
- adequate bone marrow function;
- adequate pancreatic function;
- adequate renal function;
- female patients with negative pregnancy test
Exclusion Criteria:
- untreated esophageal varices; uncontrolled ascites;
- episodes of hepatic encephalopathy within the last 4 weeks;
- spinal cord compression; major surgery within 4 weeks prior to enrollment;
- radiation therapy within 2 weeks prior to enrollment;
- last anti-cancer treatment within 2 weeks prior to screening;
- previous high-dose chemotherapy requiring stem cell rescue;
- prior to irradiation to >25% of the bone marrow;
- gastrointestinal abnormalities;
- known prior or suspected hypersensitivity to lorlatinib or lorlatinib tablet;
- clinically significant bacterial, fungal or viral infections for non-liver cancer
patients;
- clinically significant cardiovascular disease;
- uncontrolled hypertension; acute pancreatitis with predisposing characteristics;
- history of grade 3 or 4 interstitial fibrosis or interstitial lung disease;
- active hemoelysis or evidence of biliary sepsis;
- prior major gastrointestinal surgery;
- concurrent use of known strong CYP3A inhibitors, inducers and P-gp substrates with a
narrow therapeutic index;
- concurrent use of CYP3A substrates with narrow therapeutic indices;
- prior treatment with lorlatinib; active bleeding disorder
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Plasma lorlatinib AUC24 at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | area under plasma concentration-time curve from time 0 to dosing interval of 24 hours (AUC24) at steady state on cycle 2 day 1 |
Secondary Outcome Measures
Measure: | Plasma lorlatinib AUClast after single dose |
Time Frame: | cycle 1 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | area under plasma concentration-time curve from time 0 to the time of the last quantifiable concentration (AUClast) after single dose on cycle 1 day 1. |
Measure: | Plasma lorlatinib Tlast after single dose |
Time Frame: | cycle 1 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | the time of the last quantifiable concentration (Tlast) after single dose on cycle 1 day 1. |
Measure: | Plasma lorlatinib Tmax after single dose |
Time Frame: | cycle 1 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | the time to Cmax after single dose on cycle 1 day 1. |
Measure: | Plasma lorlatinib Cmin at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | observed minimal plasma concentration at steady state on cycle 2 day 1. |
Measure: | Plasma lorlatinib AUClast at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | area under plasma concentration-time curve from time 0 to the time of the last quantifiable concentration (AUClast) at steady state on cycle 2 day 1. |
Measure: | Plasma lorlatinib Tlast at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | the time of the last quantifiable concentration (Tlast) at steady state on cycle 2 day 1. |
Measure: | lorlatinib CL/F at steadys state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | lorlatinib apparent clearance at steady state on cycle 2 day 1 |
Measure: | plasma lorlatinib metabolite AUC24 at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | area under plasma concentration-time curve from time 0 to dosing interval of 24 hours (AUC24) at steady state on cycle 2 day 1 |
Measure: | Plasma lorlatinib metabolite AUClast after single dose |
Time Frame: | cycle 1 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | area under plasma concentration-time curve from time 0 to the time of the last quantifiable concentration (AUClast) after single dose on cycle 1 day 1. |
Measure: | Plasma lorlatinib metabolite AUClast at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | area under plasma concentration-time curve from time 0 to the time of the last quantifiable concentration (AUClast) at steady state on cycle 2 day 1. |
Measure: | Plasma lorlatinib metabolite Cmax at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | observed maximal plasma concentration at steady state on cycle 2 day 1. |
Measure: | Plasma lorlatinib metabolite Cmax after single dose |
Time Frame: | cycle 1 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | observed maximal plasma concentration after single dose on cycle 1 day 1. |
Measure: | Plasma lorlatinib metabolite Tmax after single dose |
Time Frame: | cycle 1 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | the time to Cmax after single dose on cycle 1 day 1. |
Measure: | Plasma lorlatinib metabolite Tmax at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | the time to Cmax at steady state on cycle 2 day 1. |
Measure: | Plasma lorlatinib metabolite Tlast after single dose |
Time Frame: | cycle 1 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | the time of the last quantifiable concentration (Tlast) after single dose on cycle 1 day 1. |
Measure: | Plasma lorlatinib metabolite Tlast at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | the time of the last quantifiable concentration (Tlast) at steady state on cycle 2 day 1. |
Measure: | MRAUC24 at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | metabolite ratio of lorlatinib metabolite for AUC24 at steady state on cycle 2 day 1 |
Measure: | MRAUClast at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | metabolite ratio of lorlatinib metabolite for AUClast at steady state on cycle 2 day 1 |
Measure: | MRCmax at steady state |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | metabolite ratio of lorlatinib metabolite for Cmax at steady state on cycle 2 day 1 |
Measure: | MRAUClast after single dose |
Time Frame: | cycle 2 day 1 up to 24 hours post lorlatinib dose (each cycle is 21 days) |
Safety Issue: | |
Description: | metabolite ratio of lorlatinib metabolite for AUClast after single dose on cycle 1 day 1 |
Measure: | number of patients experienced treatment emergent adverse event assessed by investigator |
Time Frame: | until at least 28 days after the last lorlatinib dose |
Safety Issue: | |
Description: | Type, incidence, severity, seriousness, and relationship to study medications of adverse events (AE) and any laboratory abnormalities |
Measure: | ORR |
Time Frame: | baseline up to approximately 1 year |
Safety Issue: | |
Description: | objective response rate (ORR) is defined as the percent of patients with complete response (CR) or partial response (PR) based on investigator evaluation, according to RECIST v1.1 relative to the response-evaluable population |
Measure: | DR |
Time Frame: | baseline up to approximately 1 year |
Safety Issue: | |
Description: | Duration of response (DR) will be measured from the date that an objective tumor response (CR or PR) is first documented (whichever occurs first) to date of objective tumor progression or death due to any cause, whichever occurs first |
Measure: | number of patients experienced treatment related adverse event assessed by investigator |
Time Frame: | until at least 28 days after the last lorlatinib dose |
Safety Issue: | |
Description: | Type, incidence, severity, seriousness, and relationship to study medications of adverse events (AE) and any laboratory abnormalities |
Measure: | number of patients experienced treatment emergent serious adverse event assessed by investigator |
Time Frame: | until at least 28 days after the last lorlatinib dose |
Safety Issue: | |
Description: | Type, incidence, severity, seriousness, and relationship to study medications of adverse events (AE) and any laboratory abnormalities |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Pfizer |
Trial Keywords
- hepatic impairment
- lorlatinib
- cancer
- pharmacokinetic
Last Updated
August 18, 2021