Clinical Trials /

The BURAN Study of Buparlisib in Patients With Recurrent or Metastatic HNSCC

NCT04338399

Description:

The BURAN study is a randomized, open-label phase III study to assess the treatment effect of once-daily buparlisib in combination with weekly paclitaxel compared to weekly paclitaxel alone in patients with refractory, recurrent, or metastatic head and neck squamous cell carcinoma (HNSCC) that have progressed after prior platinum-based therapy with or without prior anti PD 1/anti PD L1 therapy.

Related Conditions:
  • Head and Neck Squamous Cell Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: The BURAN Study of Buparlisib in Patients With Recurrent or Metastatic HNSCC
  • Official Title: The BURAN Study of Buparlisib (AN2025) In Combination With Paclitaxel Compared to Paclitaxel Alone, in Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

Clinical Trial IDs

  • ORG STUDY ID: AN2025H0301
  • NCT ID: NCT04338399

Conditions

  • Head and Neck Cancer

Interventions

DrugSynonymsArms
Buparlisib & PaclitaxelAN2025Buparlisib & Weekly Paclitaxel

Purpose

The BURAN study is a randomized, open-label phase III study to assess the treatment effect of once-daily buparlisib in combination with weekly paclitaxel compared to weekly paclitaxel alone in patients with refractory, recurrent, or metastatic head and neck squamous cell carcinoma (HNSCC) that have progressed after prior platinum-based therapy with or without prior anti PD 1/anti PD L1 therapy.

Detailed Description

      This study is to assess the impact on overall survival of the combination of Buparlisib and
      paclitaxel compared to paclitaxel alone in patients who have failed cisplatin based treatment
      or cisplatin based treatment and anti-PD1 based treatment.
    

Trial Arms

NameTypeDescriptionInterventions
Buparlisib & Weekly PaclitaxelExperimentalDrug: Patients will receive 100 mg (2 x 50 mg) buparlisib hard gel capsule administered orally, once daily starting on Day 1 of Treatment Cycle 1, Drug: Paclitaxel (80 mg/m2) administered intravenously (IV) on Days 1, 8, and 15 of a 21-day treatment cycle. Treatment will continue until disease progression, unacceptable toxicity, death or discontinuation for any other reason.
  • Buparlisib & Paclitaxel
Weekly PaclitaxelActive ComparatorPatients will receive weekly paclitaxel (80 mg/m2) administered intravenously (IV) on Days 1, 8, and 15 of a 21-day treatment cycle. Treatment will continue until disease progression, unacceptable toxicity, death or discontinuation for any other reason.
  • Buparlisib & Paclitaxel

Eligibility Criteria

        Inclusion Criteria:

          1. Aged ≥18 years old.

          2. Able to provide informed consent obtained before any trial related activities and
             according to local guidelines.

          3. Patient has histologically and/or cytologically-confirmed HNSCC.

          4. Patient has archival or new tumor tissue for the analysis of biomarkers. One tumor
             block (preferred) or a minimum of 12 (15 recommended) unstained slides to be provided.
             Enrollment in the study is contingent on confirmation of an adequate amount of tumor
             tissue. Patients progressing following treatment with an anti PD 1/anti PD L1 therapy
             are encouraged to have a new tumor biopsy for biomarker analysis (optional).

          5. Patient has either:

               1. refractory disease defined as progression or recurrence within six months after
                  the last dose of platinum based chemotherapy in combination with radiation
                  therapy for locally advanced disease given with a curative intent or

               2. disease progression after platinum based chemotherapy for recurrent or metastatic
                  disease or

               3. recurrent or metastatic disease after platinum based chemotherapy and anti PD
                  1/anti PD L1 treatment (defined as progression after one month from the last dose
                  of anti PD 1/anti PD L1 therapy). Pretreatment with cetuximab as part of
                  chemoradiation, first-line therapy or maintenance is allowed.

          6. Patient has received no more than two prior lines of treatment for HNSCC.

          7. Patient has measurable disease as determined per RECIST version 1.1. If the only site
             of measurable disease is a previously irradiated lesion, documented progression of
             disease and a four-week period since radiotherapy completion is required.

          8. Patient has adequate bone marrow function and organ function as shown by the
             following:

               1. Absolute neutrophil count (ANC) ≥1.5 x 109/L.

               2. Hemoglobin ≥9 g/dL (which may be reached by transfusion).

               3. Platelets ≥100 x 109/L (which may be reached by transfusion).

               4. International normalized ratio (INR) ≤1.5.

               5. Calcium (corrected for serum albumin) within normal limits (WNL) or ≤ grade 1
                  severity according to NCI-CTCAE version 5.0 if judged clinically not significant
                  by the Investigator. Patients concomitantly taking bisphosphonates or denosumab
                  for calcium correction are eligible.

               6. Alanine aminotransferase (AST) and aspartate aminotransferase (ALT) ≤1.5 x upper
                  limit of normal (ULN) or <3.0 x ULN if liver metastases are present.

               7. Total serum bilirubin ≤ ULN or ≤1.5 x ULN if liver metastases are present; or
                  total bilirubin ≤3.0 x ULN with direct bilirubin below or within normal range in
                  patients with well documented Gilbert's Syndrome. Gilbert's syndrome is defined
                  as presence of episodes of unconjugated hyperbilirubinemia with normal results
                  from cells blood count (including normal reticulocyte count and blood smear),
                  normal liver function test results, and absence of other contributing disease
                  processes at the time of diagnosis.

               8. Serum creatinine ≤1.5 x ULN or calculated or directly measured creatinine
                  clearance (CrCL) >30 mL/min.

               9. Haemoglobin A1c (glycosylated hemoglobin; HbA1c) ≤8%.

          9. Patient has Eastern Cooperative Oncology Group (ECOG) performance status ≤1.

         10. Patient is able to swallow and retain oral medication. Patients able to swallow oral
             medication but mostly self-nourished through gastric or jejunal feeding tube are
             eligible.

         11. Patients must apply highly effective contraception during and throughout the study, as
             well after the final dose of study treatment

        Exclusion Criteria:

        Patients meeting any of the following criteria will not be eligible for participation in
        the study:

          1. Patient has received previous treatment with any protein kinase B (PKB/AKT), mammalian
             target of rapamycin (mTOR) inhibitors, or phosphatidylinositol 3 kinase (PI3K) pathway
             inhibitors.

          2. Patient received treatment with a taxane as part of prior treatment for metastatic
             disease.

          3. Patient has only received anti-PD 1/anti PD L1 monotherapy for HNSCC.

          4. Patient has symptomatic central nervous system (CNS) metastases. Patients with
             asymptomatic CNS metastases may participate in this study. Patient must have completed
             any prior local treatment for CNS metastases ≥28 days prior to the start of study
             treatment (including radiotherapy) and must be on a stable low dose of corticosteroid
             therapy. Radiosurgery must have been completed at least 14 days prior to start of
             study treatment.

          5. Patient has received wide field radiotherapy ≤4 weeks or limited field radiation for
             palliation ≤2 weeks prior to starting study treatment or who have not recovered to
             grade 1 or better from related side effects of such therapy (except alopecia).

          6. Patient has grade ≥2 neuropathy, colitis, pneumonitis, elevated HbA1C, and
             uncontrolled endocrinopathies (e.g., hypothyroidism) from previous treatment.

          7. Patient has had major surgery within 14 days prior to starting study treatment or has
             not recovered from major side effects.

          8. Patient is currently receiving increasing or chronic treatment (>5 days) with
             corticosteroids or another immunosuppressive agent. The following uses of
             corticosteroids are permitted: single doses; standard premedication for paclitaxel,
             topical applications (e.g., rash), inhaled sprays (e.g., obstructive airways
             diseases), eye drops, or local injections (e.g., intra-articular), or <10 mg
             prednisolone or equivalent.

          9. Patient is being treated at start of study treatment with any of the following drugs:

               1. Drugs known to be strong inhibitors or inducers of isoenzyme cytochrome P450 3A4
                  (CYP3A4) including herbal medications.

               2. Drugs with a known risk of inducing Torsades de Pointes. Note: The patient must
                  have discontinued strong inducers for at least one week and must have
                  discontinued strong inhibitors before the treatment is initiated. Switching to a
                  different medication prior to starting study treatment is allowed.

         10. Patient is currently receiving warfarin or other coumarin-derived anti-coagulant, for
             treatment, prophylaxis, or otherwise. Therapy with heparin, low molecular weight
             heparin (LMWH), fondaparinux or new oral anticoagulants (NOACs) is allowed.

         11. Patient has a known hypersensitivity and/or contraindication to paclitaxel, standard
             premedication for paclitaxel, or other products containing Cremophor®.

         12. Patient has other concurrent severe and/or uncontrolled medical conditions that would,
             in the Investigator's judgment, contraindicate patient participation in the clinical
             study (e.g., active or uncontrolled severe infection, chronic active hepatitis,
             immunocompromised, acute or chronic pancreatitis, uncontrolled high blood pressure,
             interstitial lung disease, etc).

         13. Patient has a known history of human immunodeficiency virus (HIV) infection (testing
             not mandatory).

         14. Patient has any of the following cardiac abnormalities:

               1. Symptomatic congestive heart failure.

               2. History of documented congestive heart failure (New York Heart Association
                  functional classification III-IV) or documented cardiomyopathy.

               3. Left ventricular ejection fraction (LVEF) <50% as determined by multiple gated
                  acquisition (MUGA) scan or echocardiogram (ECHO).

               4. Myocardial infarction ≤six months prior to enrollment.

               5. Unstable angina pectoris.

               6. Serious uncontrolled cardiac arrhythmia.

               7. Symptomatic pericarditis.

               8. QT interval corrected according to the formula of Fridericia (QTcF) >450 msec for
                  males and >470 msec for females, on the screening electrocardiogram (ECG).

               9. Currently receiving treatment with medication that has a known risk to prolong
                  the QT interval or inducing Torsades de Pointes, and the treatment cannot be
                  discontinued or switched to a different medication prior to starting study
                  treatment.

         15. Patient has impairment of gastrointestinal (GI) function or GI disease that may
             significantly alter the absorption of study treatment (e.g., ulcerative diseases,
             uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel
             resection).

         16. Patient has a medically documented history of or active major depressive episode,
             bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia, a history of
             suicidal attempt or ideation, or homicidal ideation (e.g., risk of doing harm to self
             or others), or active severe personality disorders (defined according to the
             Diagnostic and Statistical Manual of Mental Disorders Fifth Edition [DSM-V]) are not
             eligible. Note: For patients with psychotropic treatments ongoing at baseline, the
             dose and the schedule should not be modified within the previous six weeks prior to
             start of study treatment.

         17. Patient has other prior or concurrent malignancy except for the following: adequately
             treated basal cell or squamous cell skin cancer, or other adequately treated in situ
             cancer, early gastric or GI cancer resected completely by endoscopy procedures or any
             other cancer from which the patient has been disease free for ≥3years.

         18. Patient has a history of non-compliance to any medical regimen or inability to grant
             consent.

         19. Patient is concurrently using other approved or investigational cancer agent.

         20. Patient is pregnant or nursing (lactating). Patients with elevated human chorionic
             gonadotrophin (hCG) at baseline that is judged to be related to the tumor are eligible
             if hCG levels do not show the expected doubling when repeated five to seven days
             later, or pregnancy has been ruled out by vaginal ultrasound.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall Survival (OS)
Time Frame:Overall survival will be measured from time of randomization until death from any cause. The analysis will occur when all patients have been randomized and followed for 12 months.
Safety Issue:
Description:To assess the OS of buparlisib in combination with paclitaxel compared to paclitaxel alone in patients with recurrent or metastatic HNSCC

Secondary Outcome Measures

Measure:Progression free survival
Time Frame:PFS will be assessed up to 24 months after all patients are randomized
Safety Issue:
Description:Defined as the time from randomization date until tumor progression or death from any cause.
Measure:Overall Response Rate
Time Frame:ORR will be assessed for all patients 6 months after randomization is complete.
Safety Issue:
Description:Defined at the proportion of patients with a complete or partial response
Measure:Health Related Quality of Life (QoL): Time to Definitive deterioration of Quality of Life as assessed by EORTC C30 questionnaire
Time Frame:Assessments will be made from randomization until treatment discontinuation
Safety Issue:
Description:A summary of EORTC-QLQ-C30 scores by time window. Time to deterioration is the number of days between the date of randomization and the date of the assessment when definitive deterioration is seen. Definitive deterioration is defined as a decrease in the sub scale score by at least 10% compared with baseline.
Measure:Safety and Tolerability of Buparlisib in combination with Paclitaxel compared with Paclitaxel alone as Measured by Number of Participants Experiencing Adverse Events (AEs).
Time Frame:From screening until 4 weeks following treatment discontinuation
Safety Issue:
Description:Treatment Emergent Adverse Events AEs will be assessed according to the NCI-CTCAE version 5.0 for severity and will be recorded and classified on the basis of MedDRA terminology. Anxiety score change from baseline taken at time of screening (General Anxiety Disorder 7 item scale) until end of treatment. Depression score change from baseline taken at time of screening (Patient Health Questionnaire 9) until end of treatment.
Measure:Pharmacokinetics of Buparlisib: plasma concentration-time profile of Buparlisib during 15 days of treatment
Time Frame:Day 0 to Day 15 sparse sampling
Safety Issue:
Description:For Sparse PK sampling, blood samples will be collected on Treatment Cycle 1, Days 1, 8, and 15 at pre-dose, 1 (± 0.25), 2 ± (0.25) and 6 ± (0.5) hours post-dose. PK sampling will be collected only for those patients randomized to the buparlisib in combination with paclitaxel arm and pharmacokinetic profile of Buparlisib combined with paclitaxel in the study population will be compared with a simulated population PK model.

Details

Phase:Phase 3
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Adlai Nortye Biopharma Co., Ltd.

Trial Keywords

  • Buparlisib

Last Updated

January 7, 2021