Clinical Trials /

Selumetinib Paediatric NF1 Japan Study

NCT04495127

Description:

This is a phase I open label study designed to evaluate the safety, tolerability, PK and efficacy of selumetinib in Japanese paediatric patients with neurofibromatosis type 1 and inoperable and symptomatic plexiform neurofibroma.

Related Conditions:
  • Plexiform Neurofibroma
Recruiting Status:

Active, not recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Selumetinib Paediatric NF1 Japan Study
  • Official Title: A Phase 1 Open Label Study to Assess the Safety, Tolerability, Pharmacokinetics and Efficacy of Selumetinib, a Selective Mitogen Activated Protein Kinase Kinase (MEK) 1 Inhibitor, in Japanese Paediatric Subjects With Neurofibromatosis Type 1 (NF1) and Inoperable and Symptomatic Plexiform Neurofibromas (PN)

Clinical Trial IDs

  • ORG STUDY ID: D1346C00013
  • NCT ID: NCT04495127

Conditions

  • Neurofibromatosis Type 1

Interventions

DrugSynonymsArms
SelumetinibSelumetinib

Purpose

This is a phase I open label study designed to evaluate the safety, tolerability, PK and efficacy of selumetinib in Japanese paediatric patients with neurofibromatosis type 1 and inoperable and symptomatic plexiform neurofibroma.

Trial Arms

NameTypeDescriptionInterventions
SelumetinibExperimental
  • Selumetinib

Eligibility Criteria

        Key Inclusion Criteria:

          -  Three years of age or older, and less than or equal to 18 years of age at the time of
             obtaining informed consent. BSA greater than or equal to 0.55 m2, and able to swallow
             the whole study drug (capsules) without entire contents unpacked from the capsules.

          -  NF1 and inoperable and symptomatic PN who have PN-related morbidities (symptom and/or
             complications), as judged by the investigator.

          -  Inoperable PN is defined as PN that cannot be surgically completely removed without
             risk for substantial morbidity due to encasement of, or close proximity to, vital
             structures, invasiveness, or high vascularity of the PN.

          -  A PN is defined as a neurofibroma that has grown along the length of a nerve and may
             involve multiple fascicles and branches. A spinal PN involves two or more levels with
             connection between the levels or extending laterally along the nerve.

          -  In addition to PN, subjects must have at least 1 other diagnostic criterion for NF1 as
             follows:

               1. Six or more café-au-lait macules >5 mm in greatest diameter in pre-pubertal
                  individuals and >15 mm in greatest diameter in post-pubertal individuals.

               2. Freckling in the axillary or inguinal regions.

               3. Optic glioma.

               4. Two or more Lisch nodules (iris hamartomas).

               5. A distinctive osseous lesion such as sphenoid dysplasia or tibial pseudarthrosis.

               6. A first-degree relative with NF1.

          -  At least one measurable typical or nodular PN in principle, defined as a lesion of at
             least 3 cm measured in one dimension.

          -  Adequate organ/haematological function

        Key Exclusion Criteria:

          -  Evidence of malignant peripheral nerve sheath tumour.

          -  Prior malignancy (except for adequately treated basal cell or squamous cell skin
             cancer, in situ cervical cancer, low grade optic pathway gliomas associated with NF1
             which does not require systemic treatment or other cancer from which the subject had
             been disease free for ≥2 years or which would not have limited survival to <2 years)
             or other cancer requiring treatment with chemotherapy or radiation therapy.

          -  Clinically significant cardiovascular disease

          -  Known history of human immunodeficiency virus, serologic status reflecting active
             hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, or any uncontrolled
             active systemic infection

          -  Subjects with clinically significant ophthalmological findings/conditions

          -  Inability to undergo MRI and/or contraindication for MRI (i.e. prosthesis or
             orthopaedic or dental braces that would interfere with volumetric analysis of target
             PN on MRI).

          -  Have refractory nausea and vomiting, chronic gastrointestinal diseases (e.g.
             inflammatory bowel disease), or significant bowel resection that would adversely
             affect the absorption/bioavailability of the orally administered study medication.

          -  Receiving supplementation with vitamin E greater than 100% of the daily recommended
             dose.

          -  Receiving herbal supplements or medications known to be strong inhibitors or inducers
             of the cytochrome P450 (CYP) 3A4 enzymes unless such products can be safely
             discontinued at least 14 days before the first dose of study medication.
      
Maximum Eligible Age:18 Years
Minimum Eligible Age:3 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Safety and tolerability in terms of adverse events
Time Frame:From obtaining the first informed consent until 30 days after the last dose (Selumetinib). Expected duration is approximately 2 years.
Safety Issue:
Description:Number of subjects with adverse events as a measure of safety and tolerability including changes in vital signs, electrocardiograms, safety laboratory parameters, echocardiogram and ophthalmologic assessment.

Secondary Outcome Measures

Measure:Maximum plasma concentration (Cmax)
Time Frame:From obtaining the first informed consent until 30 days after the last dose (Selumetinib). Expected duration is approximately two years.
Safety Issue:
Description:Pharmacokinetics (PK) parameters will be derived using standard non-compartmental methods.
Measure:Area under the plasma concentration-time curve (AUC)
Time Frame:From obtaining the first informed consent until 30 days after the last dose (Selumetinib). Expected duration is approximately two years.
Safety Issue:
Description:Pharmacokinetics (PK) parameters will be derived using standard non-compartmental methods.
Measure:Overall response rate
Time Frame:Assessed at every 4 cycles until drug permanently discontinued. Expected duration is approximately 2 years. Each cycle is 28 days.
Safety Issue:
Description:Defined as the proportion of subjects who achieve a response by independent central review per Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) criteria.
Measure:Duration of response
Time Frame:Assessed at every 4 cycles until drug permanently discontinued. Expected duration is approximately 2 years. Each cycle is 28 days.
Safety Issue:
Description:Defined as the time from the date of the first documented response (which is subsequently confirmed) until the date of documented progression or death in the absence of disease progression, as determined by independent central review per REiNS criteria.
Measure:Clinical Global Impression of Change (CGIC)
Time Frame:Assessed at every 2 cycles for the first year and every 4 cycles until drug permanently discontinued. Expected duration is approximately 2 years. Each cycle is 28 days.
Safety Issue:
Description:Comprehensive evaluation will be performed by investigator on the changes of PN related morbidities (symptoms and/or complications), and relevant findings including imaging studies and physical exams from baseline.
Measure:Total scale score of Paediatric Quality of Life Inventory (PedsQL; self- and parent-reported)
Time Frame:Assessed at every 4 cycles until drug permanently discontinued. Expected duration is approximately 2 years. Each cycle is 28 days.
Safety Issue:
Description:Scale scores are computed as the sum of the items divided by the number of items answered (this accounts for missing data). A Total Scale Score will also be derived as the sum of all the items divided by the number of items answered on all the scales.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:AstraZeneca

Last Updated

June 28, 2021