Description:
This is an open-label, 3-arm, fixed-sequence study to evaluate the effect of single and
multiple oral doses of encorafenib in combination with binimetinib on the single oral dose
pharmacokinetics (PK) of cytochrome P450 (CYP) enzyme probe substrates using a probe
cocktail, on an organic anion-transporting polypeptide/breast cancer resistance protein
(OATP/BCRP) substrate using rosuvastatin and on a CYP2B6 substrate using bupropion. The
effect of multiple oral doses of the moderate cytochrome P450 (CYP) inhibitor modafinil on
encorafenib in combination with binimetinib will also be assessed. The study will have 2
treatment phases, a drug-drug interaction (DDI) phase followed by a post-DDI phase.
Title
- Brief Title: Pharmacokinetic Drug-drug Interaction Study of Encorafenib and Binimetinib on Probe Drugs in Patients With BRAF V600-mutant Melanoma or Other Advanced Solid Tumors
- Official Title: An Open-label Phase 1 Study to Evaluate Drug-Drug Interactions of Agents Co-Administered With Encorafenib and Binimetinib in Patients With BRAF V600-mutant Unresectable or Metastatic Melanoma or Other Advanced Solid Tumors
Clinical Trial IDs
- ORG STUDY ID:
ARRAY-818-103
- SECONDARY ID:
C4221003
- SECONDARY ID:
2019-001036-66
- NCT ID:
NCT03864042
Conditions
- Advanced Solid Tumors
- Metastatic Melanoma
Interventions
Drug | Synonyms | Arms |
---|
losartan | | Arm 1 - CYP Probe Cocktail |
dextromethorphan | | Arm 1 - CYP Probe Cocktail |
caffeine | | Arm 1 - CYP Probe Cocktail |
omeprazole | | Arm 1 - CYP Probe Cocktail |
midazolam | | Arm 1 - CYP Probe Cocktail |
rosuvastatin | | Arm 2 - Rosuvastatin and Bupropion |
bupropion immediate release (IR) | | Arm 2 - Rosuvastatin and Bupropion |
encorafenib | | Arm 1 - CYP Probe Cocktail |
binimetinib | | Arm 1 - CYP Probe Cocktail |
modafinil | | Arm 3 - Modafinil |
Purpose
This is an open-label, 3-arm, fixed-sequence study to evaluate the effect of single and
multiple oral doses of encorafenib in combination with binimetinib on the single oral dose
pharmacokinetics (PK) of cytochrome P450 (CYP) enzyme probe substrates using a probe
cocktail, on an organic anion-transporting polypeptide/breast cancer resistance protein
(OATP/BCRP) substrate using rosuvastatin and on a CYP2B6 substrate using bupropion. The
effect of multiple oral doses of the moderate cytochrome P450 (CYP) inhibitor modafinil on
encorafenib in combination with binimetinib will also be assessed. The study will have 2
treatment phases, a drug-drug interaction (DDI) phase followed by a post-DDI phase.
Trial Arms
Name | Type | Description | Interventions |
---|
Arm 1 - CYP Probe Cocktail | Experimental | Patients will receive a single oral dose of the CYP Probe Cocktail on Day -7, Day 1, and Day 14:
25 mg losartan oral tablet
30 mg dextromethorphan oral capsule
50 mg caffeine oral liquid
20 mg omeprazole oral capsule
2 mg midazolam oral syrup
encorafenib/binimetinib continuous daily dosing starting Day 1:
450 mg (6 x 75 mg) encorafenib oral capsules once daily (QD)
45 mg (3 x 15 mg) binimetinib oral tablet twice daily (BID)
All drugs will be taken within 10 minutes. | - losartan
- dextromethorphan
- caffeine
- omeprazole
- midazolam
- encorafenib
- binimetinib
|
Arm 2 - Rosuvastatin and Bupropion | Experimental | Patients will receive a single oral dose of rosuvastatin and bupropion once on Day -7, Day 1 and Day 14:
10 mg rosuvastatin oral tablet
75 mg bupropion immediate release (IR) oral tablet
encorafenib/binimetinib continuous daily dosing starting Day 1:
450 mg (6 x 75 mg) encorafenib oral capsules once daily (QD)
45 mg (3 x 15 mg) binimetinib oral tablet twice daily (BID)
All drugs will be taken within 10 minutes. | - rosuvastatin
- bupropion immediate release (IR)
- encorafenib
- binimetinib
|
Arm 3 - Modafinil | Experimental | Patients will begin encorafenib/binimetinib continuous daily dosing starting Day 1:
450 mg (6 x 75 mg) encorafenib oral capsules once daily (QD)
45 mg (3 x 15 mg) binimetinib oral tablet twice daily (BID)
then receive continuous treatment of modafinil on Day 15 through Day 21:
- 400 mg modafinil tablet once daily (QD) | - encorafenib
- binimetinib
- modafinil
|
Eligibility Criteria
Key Inclusion Criteria - Patients must meet all of the inclusion criteria to be eligible
for enrollment into the study:
- Histologically confirmed diagnosis of locally advanced, unresectable or metastatic
cutaneous melanoma or unknown primary melanoma American Joint Committee on Cancer
(AJCC) Stage IIIB, IIIC or IV; or other BRAF V600-mutant advanced solid tumors
- Presence of BRAF V600E and/or V600K mutation in tumor tissue prior to enrollment, as
determined using a local test;
- Evidence of measurable or non-measurable lesions
- Patient with unresectable locally advanced or metastatic melanoma who has received no
prior treatment or progressed on or after prior systemic therapy; Note: Prior therapy
with a BRAF proto-oncogene serine-threonine protein kinase (BRAF) inhibitor and/or a
mitogen-activated protein (MAP) kinase (MEK) inhibitor is permitted except in the
regimen immediately prior to study entry
- Patient with other (non-melanoma) BRAF V600E and/or V600K -mutant advanced solid
tumors who has progressed on standard therapy or for whom there are no available
standard therapies; Note: Prior therapy with a BRAF inhibitor and/or a MEK inhibitor
is permitted except in the regimen immediately prior to study entry
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1
- Adequate bone marrow, hepatic and renal function as specified in the protocol
- ARM 1 ONLY: Non-smoker who has not used nicotine containing products for at least 3
months prior to the first dose.
Key Exclusion Criteria - Patients meeting any of the following criteria are not eligible
for enrollment in the study:
- Symptomatic brain metastasis. Patients previously treated or untreated for these
conditions that are asymptomatic in the absence of corticosteroid and anti-epileptic
therapy are allowed. Brain metastases must be stable, with imaging (e.g., magnetic
resonance imaging [MRI] or computed tomography [CT] demonstrating no current evidence
of progressive brain metastases at screening);
- Symptomatic or untreated leptomeningeal disease;
- History or current evidence of retinal vein occlusion (RVO) or current risk factors
for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity
or hypercoagulability syndromes);
- Clinically significant cardiac disease
- Known hyper-coagulability risks other than malignancy (e.g., Factor V Leiden
syndrome);
- Thromboembolic event except catheter-related venous thrombosis ≤ 12 weeks prior to
starting study treatment.
- Discontinuation of prior BRAF and/or MEK inhibitor treatment due to left ventricular
dysfunction, pneumonitis/interstitial lung disease, or retinal vein occlusion;
- ARM 1 ONLY: Positive urine cotinine test at screening
- ARM 3 ONLY:
- History of psychosis, depression or mania;
- History of angioedema;
- History of mitral valve prolapse;
- History of left ventricular hypertrophy;
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Probe substrate peak plasma concentration (Cmax) in Arms 1 and 2 |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Metabolite ratio (MRAUC) for 1-OH midazolam/midazolam, paraxanthine/caffeine, 5-hydroxy omeprazole/omeprazole, hydroxybupropion/bupropion and LHY746/encorafenib |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | Metabolite ratio (MRCmax) for 1-OH midazolam/midazolam, paraxanthine/caffeine, 5-hydroxy omeprazole/omeprazole, hydroxybupropion/bupropion and LHY746/encorafenib |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | Metabolite ration (MRAe0-8) for E-3174/losartan and dextrorphan/dextromethorphan |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (time to reach Cmax [Tmax]) in plasma for midazolam, 1-OH midazolam, caffeine, paraxanthine, omeprazole, 5-hydroxy omeprazole, rosuvastatin, bupropion and hydroxybupropion |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (AUC from time zero extrapolated to infinity [AUCinf]) in plasma for midazolam, 1-OH midazolam, caffeine, paraxanthine, omeprazole, 5-hydroxy omeprazole, rosuvastatin, bupropion and hydroxybupropion |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (percent of AUC extrapolated [AUC%extrap]) in plasma for midazolam, 1-OH midazolam, caffeine, paraxanthine, omeprazole, 5-hydroxy omeprazole, rosuvastatin, bupropion and hydroxybupropion |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (apparent terminal elimination half-life [T1/2]) in plasma for midazolam, 1-OH midazolam, caffeine, paraxanthine, omeprazole, 5-hydroxy omeprazole, rosuvastatin, bupropion and hydroxybupropion |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (apparent terminal elimination rate constant [Kel]) in plasma for midazolam, 1-OH midazolam, caffeine, paraxanthine, omeprazole, 5-hydroxy omeprazole, rosuvastatin, bupropion and hydroxybupropion |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (apparent total body clearance after extravascular administration [CL/F]) in plasma for midazolam, 1-OH midazolam, caffeine, paraxanthine, omeprazole, 5-hydroxy omeprazole, rosuvastatin, bupropion and hydroxybupropion |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (apparent total volume of distribution after extravascular administration [Vz/F]) in plasma for midazolam, 1-OH midazolam, caffeine, paraxanthine, omeprazole, 5-hydroxy omeprazole, rosuvastatin, bupropion and hydroxybupropion |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (urine concentration [Curine]) for losartan, E-3174, dextromethorphan and dextrorphan |
Time Frame: | multiple timepoints over 8 hours post dose on Day-7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (quantity of urine excreted during each collection interval) for losartan, E-3174, dextromethorphan and dextrorphan |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (cumulative amount excreted in urine during each collection interval [CumA]e) for losartan, E-3174, dextromethorphan and dextrorphan |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (percentage of dose recovered in urine [Fe] %) for losartan, E-3174, dextromethorphan and dextrorphan |
Time Frame: | multiple timepoints over 8 hours post dose on Day -7, Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (Cmax) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (AUClast) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (Tmax) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (AUCinf,) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (AUC%extrap) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 in Arms 1 and 2 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (Kel) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 in Arms 1 and 2 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (T1/2) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 in Arms 1 and 2 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (CL/F) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 in Arms 1 and 2 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (Vz/F) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 1 and Day 14 in Arms 1 and 2 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (Cmax) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (AUClast) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (Tmax) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (AUCinf,) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (AUC%extrap) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (Kel) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (CL/F) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (T1/2) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | PK parameter (Vz/F) for encorafenib, LHY746, binimetinib and AR00426032 |
Time Frame: | multiple timepoints over 8 hours post dose on Day 15 and Day 21 in Arm 3 (Drug-Drug Interaction (DDI) phase) |
Safety Issue: | |
Description: | |
Measure: | Safety will be evaluated by monitoring adverse events (AEs) |
Time Frame: | From first dose of study intervention/treatment until the end of DDI phase (through 28 days) |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Pfizer |
Trial Keywords
Last Updated
June 15, 2021