Description:
This is an open-label, multi-center Phase 1/2 study of oral LOXO-292 in pediatric
participants with an activating rearranged during transfection (RET) alteration and an
advanced solid or primary CNS tumor.
Title
- Brief Title: A Study of Oral LOXO-292 (Selpercatinib) in Pediatric Participants With Advanced Solid or Primary Central Nervous System (CNS) Tumors
- Official Title: A Phase 1/2 Study of the Oral RET Inhibitor LOXO 292 in Pediatric Patients With Advanced RET-Altered Solid or Primary Central Nervous System Tumors
Clinical Trial IDs
- ORG STUDY ID:
17493
- SECONDARY ID:
J2G-OX-JZJJ
- SECONDARY ID:
LOXO-RET-18036
- SECONDARY ID:
2019-000212-28
- NCT ID:
NCT03899792
Conditions
- Medullary Thyroid Cancer
- Infantile Myofibromatosis
- Infantile Fibrosarcoma
- Papillary Thyroid Cancer
- Soft Tissue Sarcoma
Interventions
Drug | Synonyms | Arms |
---|
LOXO-292 | Selpercatinib, LY3527723 | LOXO-292 |
Purpose
This is an open-label, multi-center Phase 1/2 study of oral LOXO-292 in pediatric
participants with an activating rearranged during transfection (RET) alteration and an
advanced solid or primary CNS tumor.
Detailed Description
This study includes 2 parts: phase 1 (dose escalation) and phase 2 (dose expansion). In phase
1, participants will be enrolled using a rolling 6 dose escalation scheme. The starting dose
of LOXO-292 is equivalent to the adult recommended phase 2 dose of 160 milligrams (mg) twice
a day (BID). Once the maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D) is
identified, participants will be enrolled to one of four phase 2 dose expansion cohorts
depending on tumor histology and tumor genotype. Cycle length will be 28 days.
Trial Arms
Name | Type | Description | Interventions |
---|
LOXO-292 | Experimental | Phase 1- Dose Escalation and determination of MTD; multiple dose levels of LOXO-292 to be evaluated; Phase 2 - The MTD/recommended dose from Phase 1 | |
Eligibility Criteria
Inclusion Criteria:
- Advanced or metastatic solid or primary CNS tumor which has failed standard of care
therapies
- Evidence of an activating RET gene alteration in the tumor and/or blood
- Measurable or non-measurable disease
- Karnofsky (participants 16 years and older) or Lansky (participants younger than 16)
performance score of at least 50
- Participant with primary CNS tumors or cerebral metastases must be neurologically
stable for 7 days prior and must not have required increasing doses of steroids within
the last 7 days
- Adequate hematologic, hepatic and renal function.
- Ability to receive study drug therapy orally or via gastric access
- Willingness of men and women of reproductive potential to observe conventional and
effective birth control
Exclusion Criteria:
- Major surgery within two weeks prior to planned start of LOXO-292
- Clinically significant, uncontrolled cardiac, cardiovascular disease or history of
myocardial infarction within 6 months prior to planned start of LOXO-292
- Active uncontrolled systemic bacterial, viral, fungal or parasitic infection
- Clinically significant active malabsorption syndrome
- Pregnancy or lactation
- Uncontrolled symptomatic hyperthyroidism or hypothyroidism (i.e. the participant
required a modification to current thyroid medication in the 7 days before start of
LOXO-292)
- Uncontrolled symptomatic hypercalcemia or hypocalcemia
- Known hypersensitivity to any of the components of the investigational agent, LOXO-292
or Ora-Sweet® SF and OraPlus®, for participants who will receive LOXO-292 suspension
- Prior treatment with a selective RET inhibitor(s) (including investigational selective
RET inhibitor[s])
Maximum Eligible Age: | 21 Years |
Minimum Eligible Age: | 6 Months |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | To Determine the Safety of Oral LOXO-292 in Pediatric Participants with Advanced Solid Tumors: Dose Limiting Toxicities (DLTs) |
Time Frame: | During the first 28-day cycle of LOXO-292 treatment |
Safety Issue: | |
Description: | For Phase 1 |
Secondary Outcome Measures
Measure: | Plasma Concentrations of LOXO-292 |
Time Frame: | Days 1 and 8 of Cycle 1, Day 1 of Cycle 3 and Day 8 after Intra-participant Dose Escalation (each cycle is 28 days) |
Safety Issue: | |
Description: | Phase 1 |
Measure: | Area Under the Concentration-Time Curve from 0 to 24 hours (AUC0-24) of LOXO-292 |
Time Frame: | Days 1 and 8 of Cycle 1, Day 1 of Cycle 3 and Day 8 after Intra-participant Dose Escalation (each cycle is 28 days) |
Safety Issue: | |
Description: | Phase 1 and Phase 2 |
Measure: | Maximum Concentration (Cmax) of LOXO-292 |
Time Frame: | Days 1 and 8 of Cycle 1, Day 1 of Cycle 3 and Day 8 after Intra-participant Dose Escalation (each cycle is 28 days) |
Safety Issue: | |
Description: | Phase 1 and Phase 2 |
Measure: | Time to Maximum Concentration (Tmax) of LOXO-292 |
Time Frame: | Days 1 and 8 of Cycle 1, Day 1 of Cycle 3 and Day 8 after Intra-participant Dose Escalation (each cycle is 28 days) |
Safety Issue: | |
Description: | Phase 1 and Phase 2 |
Measure: | Recommended LOXO-292 Dose for Phase 2 (MTD) |
Time Frame: | Cycle 1 (28 days) |
Safety Issue: | |
Description: | For Phase 1 |
Measure: | To Assess the Preliminary Anti-Tumor Activity of LOXO-292 in Pediatric Participants with Tumors Harboring an Activating RET Alteration as Determined by ORR Based on RECIST v1.1 |
Time Frame: | Baseline to Progressive Disease or Death due to any cause (Estimated up to 12 months) |
Safety Issue: | |
Description: | For Phase 1 |
Measure: | Changes from Baseline in Pain Measures as Measured by Wong Baker Faces scales. Wong-Baker Faces Pain Scale includes pictures of facial expressions with correlating scores of 0 being 'no hurt' and 10 being 'hurts worst'. |
Time Frame: | Up to 24 months |
Safety Issue: | |
Description: | For Phase 1 |
Measure: | Changes from Baseline in Health Related Quality of Life Measures as Measured by Pediatric Quality of Life (PedsQoL) Inventory Core. PedsQoL includes a list of problems with scores of 0 being 'never a problem' and 4 being 'almost always a problem'. |
Time Frame: | Up to 24 months |
Safety Issue: | |
Description: | For Phase 1 |
Measure: | Objective Response Rate as Assessed by RECIST v1.1, as Assessed by Investigator |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, and 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Objective Response Rate as Assessed by RANO, as Assessed by Investigator |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, and 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Duration of Response (DOR) as Assessed by Investigator |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, and 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Duration of Response (DOR) as Assessed by the IRC |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, and 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Progression Free Survival (PFS) as Assessed by Investigator |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, and 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | PFS as Assessed by IRC |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, and 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Overall survival (OS) |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, and 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Clinical Benefit Rate (by Investigator) |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Clinical Benefit Rate (by IRC) |
Time Frame: | Approximately every 8 weeks for one year, then every 12 weeks, 7 days after the last dose (for up to 2 years) in participants who have not progressed. |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Frequency of Adverse Events (AEs) |
Time Frame: | From the time of informed consent, for approximately 24 months (or earlier if the participants discontinues from the study), and through Safety Follow-up (28 days after the last dose) |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | To Evaluate the Concordance of Prior Molecular that Detected a RET Alteration within the Participant's Tumor with Diagnostic Tests Being Evaluated by Sponsor |
Time Frame: | 6 months |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Phase 2: Post-Operative Stage on Participants Treated with LOXO-292 |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | Tumor stage is described according to the Tumor, Node, Metastasis (TNM)Classification of malignant tumors of the Union for International Cancer Control (UICC) |
Measure: | Phase 2: Surgical Margin Status in Participants Treated with LOXO-292 |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | Tumor margins after surgery are classified into four groups using the International Cancer Control (UICC)-R classification and the Intergroup Rhabdomyosarcoma Staging (IRS) systems: 1) Complete tumor resection with histologically free margins, 2) Macroscopic resection but invaded margins on histology, 3)Macroscopic residual tumor and 4) Distant metastatic tumor. |
Measure: | Descriptive Analysis of Pretreatment Surgical Plan |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | For Phase 2 |
Measure: | Descriptive Analysis of Post-Treatment Plans |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | For Phase 2 |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Loxo Oncology, Inc. |
Trial Keywords
- Loxo
- LOXO-292
- KIF5B-RET
- M918T
- CCDC6-RET
- RET-PTC1
- NCOA4-RET
- RET-PTC
- RET-PTC3
- RET-PTC4
- PRKAR1A-RET
- RET-PTC2
- GOLGA5-RET
- RET-PTC5
- ERC1-RET
- KTN1-RET
- RET-PTC8
- HOOK3-RET
- PCM1-RET
- TRIM24-RET
- RET-PTC6
- TRIM27-RET
- TRIM33-RET
- RET-PTC7
- AKAP13-RET
- FKBP15-RET
- SPECC1L-RET
- TBL1XR1-RET
- BCR-RET
- FGRF1OP-RET
- RFG8-RET
- RET-PTC9
- ACBD5-RET
- MYH13-RET
- CUX1-RET
- KIAA1468-RET
- FRMD4A-RET
- SQSTM1-RET
- AFAP1L2-RET
- PPFIBP2-RET
- EML4-RET
- PARD3-RET
- G533C
- C609F
- C609G
- C609R
- C609S
- C609Y
- C611F
- C611G
- C611S
- C611Y
- C611W
- C618F
- C618R
- C618S
- C620F
- C620R
- C620S
- C630R
- C630Y
- D631Y
- C634F
- C634G
- C634R
- C634S
- C634W
- C634Y
- K666E
- E768D
- L790F
- V804L
- V804M
- A883F
- S891A
- R912P
- CLIP1-RET
- Y806C
- RET fusion
- RET alteration
- RET mutation
- RET rearrangement
- RET translocation
- Neoplasms by Site
- Neoplasms
- Non-Small Cell Lung Cancer
- Lung Neoplasms
- Carcinoma, Non-Small-Cell Lung
- Cancer of Lung
- Cancer of the Lung
- Lung Cancer
- Neoplasms, Lung
- Neoplasms, Pulmonary
- Pulmonary Cancer
- Pulmonary Neoplasms
- Respiratory Tract Neoplasms
- Lung Diseases
- Respiratory Tract Diseases
- Carcinoma, Bronchogenic
- Bronchial Neoplasms
- Medullary Thyroid Cancer
- Papillary Thyroid Cancer
- Thyroid Diseases
- Thyroid Neoplasms
- Cancer of the Thyroid
- Cancer of Thyroid
- Neoplasms, Thyroid
- Thyroid Adenoma
- Thyroid Cancer
- Thyroid Carcinoma
- Endocrine System Diseases
- Endocrine Gland Neoplasms
- Head and Neck Neoplasms
- Thoracic Neoplasms
- CNS tumor
- Primary CNS tumor
- Colonic Neoplasms
- Cancer of Colon
- Cancer of the Colon
- Colon Cancer
- Colon Neoplasms
- Colonic Cancer
- Neoplasms, Colonic
- Malignant tumor of Breast
- Mammary Cancer
- Mammary Carcinoma, Human
- Mammary Neoplasm, Human
- Neoplasms, Breast
- Tumors, Breast
- Human Mammary Carcinoma
- Malignant Neoplasm of Breast
- Breast Carcinoma
- Breast Tumors
- Cancer of the Breast
- Breast Neoplasms
- Breast Cancer
- RET Inhibitor
- MTC
- NSCLC
- Soft tissue sarcoma
- Infantile Myofibromatosis
- Infantile Fibrosarcoma
Last Updated
August 18, 2021