Clinical Trials /

A Study to Assess the Effects of Itraconazole, Rifampicin, and Omeprazole on Pharmacokinetics of Adavosertib

NCT04959266

Description:

This is a Phase 1, open-label, non-randomised, 3-arm (A, B, and C), drug-drug interaction study in patients with advanced solid tumours.

Related Conditions:
  • Malignant Solid Tumor
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Study to Assess the Effects of Itraconazole, Rifampicin, and Omeprazole on Pharmacokinetics of Adavosertib
  • Official Title: A Phase I, Open-label, Non-randomised Study to Assess the Effect of Itraconazole (a CYP3A4 Inhibitor), Rifampicin (a CYP3A4 Inducer), and Omeprazole (a Proton Pump Inhibitor) on the Pharmacokinetics of a Single Oral Dose of Adavosertib in Patients With Advanced Solid Tumours

Clinical Trial IDs

  • ORG STUDY ID: D601HC00006
  • NCT ID: NCT04959266

Conditions

  • Advanced Solid Tumours

Interventions

DrugSynonymsArms
AdavosertibArm A
ItraconazoleArm A
RifampicinArm B
OmeprazoleArm C

Purpose

This is a Phase 1, open-label, non-randomised, 3-arm (A, B, and C), drug-drug interaction study in patients with advanced solid tumours.

Detailed Description

      The study will include 3 arms consisting of a screening period of up to 28 days (Day -28 to
      Day -1), an intervention period (12 days for arm A, 17 days for arm B, and 12 days for arm
      C), and a follow-up end of treatment [EOT] visit (within 3 days after a 4-day washout period
      relative to the last dose of adavosertib).

      Arm A of this study follows a non-randomised, open-label, 2-intervention design. Patients
      will receive the following 2 study interventions: a single oral dose of adavosertib alone,
      and a single oral dose of adavosertib administered concomitantly with itraconazole.

      Arm B of this study follows a non-randomised, open-label, 2-intervention design. Patients
      will receive the following 2 study interventions: a single oral dose of adavosertib alone,
      and a single oral dose of adavosertib administered concomitantly with rifampicin.

      Arm C of this study follows a non-randomised, open-label, 2-intervention design. Patients
      will receive the following 2 study interventions: a single oral dose of adavosertib alone,
      and a single oral dose of adavosertib administered concomitantly with omeprazole.
    

Trial Arms

NameTypeDescriptionInterventions
Arm AExperimentalPatients will receive a single oral dose of adavosertib alone, and a single oral dose of adavosertib concomitantly with itraconazole.
  • Adavosertib
  • Itraconazole
Arm BExperimentalPatients will receive a single oral dose of adavosertib alone, and a single oral dose of adavosertib concomitantly with rifampicin.
  • Adavosertib
  • Rifampicin
Arm CExperimentalPatients will receive a single oral dose of adavosertib alone, and a single oral dose of adavosertib concomitantly with omeprazole.
  • Adavosertib
  • Omeprazole

Eligibility Criteria

        Inclusion Criteria:

          1. Histologically or cytologically documented, locally advanced or metastatic solid
             tumour, excluding lymphoma, for which standard therapy does not exist or has proven
             ineffective or intolerable.

          2. Eastern Cooperative Oncology Group performance status score of 0 or 1.

          3. Predicted life expectancy ≥ 12 weeks.

          4. Patients must have normal organ and marrow function at baseline, within 7 days prior
             to study drug administration.

          5. Males and females of childbearing potential who agree to use contraceptive measures
             must be consistent with clinical study protocol.

        Exclusion Criteria:

          1. Persistent toxicities (Common Terminology Criteria for Adverse Events [CTCAE] Grade >
             2) caused by previous anticancer therapy, excluding alopecia and CTCAE Grade 2
             peripheral neuropathy.

          2. Refractory nausea and vomiting, chronic gastrointestinal disease, inability to swallow
             the formulated product, or previous significant bowel resection that would preclude
             adequate absorption, distribution, metabolism, or excretion of adavosertib,
             itraconazole, rifampicin, and omeprazole.

          3. Any significant cardiac diseases currently or within the last 6 months such as: (a)
             unstable angina pectoris (b) acute myocardial infarction, congestive heart failure (c)
             conduction abnormality not controlled with pacemaker or medication (d) significant
             ventricular or supraventricular arrhythmias.

          4. Any of the following:

               1. History or current evidence of congenital long QT syndrome;

               2. concomitant medications known to prolong QT interval or history of
                  medicationrelated QT prolongation.

          5. Known to have tested positive for human immunodeficiency virus or active tuberculosis
             infection.

          6. Known active hepatitis infection, positive hepatitis C antibody, hepatitis B virus
             surface antigen or hepatitis B virus core antibody, at screening.

          7. Any evidence of diseases (such as severe or uncontrolled systemic diseases, including
             uncontrolled hypertension, renal transplant, active infections, and active bleeding
             diseases) which prohibit participating in the study.

          8. Spinal cord compression or brain metastases unless asymptomatic, stable, and not
             requiring steroids for at least 4 weeks prior to start of study intervention.

          9. Receipt of live virus and live bacterial vaccines whilst the patient is receiving the
             study intervention and during the 30-day follow-up period. Inactivated flu vaccines
             are permitted.

         10. Use of an anti-cancer treatment drug ≤ 21 days (≤ 6 weeks for nitroureas or mitomycin
             C) or use of an investigational product within 5 half-lives prior to the first dose of
             adavosertib.

         11. Patient uses drugs that are sensitive to CYP3A4 substrates or CYP3A4 substrates with a
             narrow therapeutic index, or are moderate to strong inhibitors/inducers of CYP3A4
             which cannot be discontinued 2 weeks or 5 halflives (whichever is longer) prior to Day
             1 of dosing.

         12. Patients with a known hypersensitivity to adavosertib, itraconazole, rifampicin, and
             omeprazole or any of the excipients of the product.

         13. Currently pregnant (confirmed with positive pregnancy test) or breast-feeding.
      
Maximum Eligible Age:130 Years
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Ratios of geometric means of Cmax (maximum observed plasma concentration) when administered in combination with itraconazole/rifampicin/omeprazole relative to adavosertib alone
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of the effect of itraconazole (arm A)/rifampicin (arm B)/omeprazole (arm C) on the Cmax of adavosertib following oral dosing in patients with advanced solid tumours.

Secondary Outcome Measures

Measure:Summary of Adavosertib plasma concentrations with time
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of pharmacokinetics (PK) for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of Cmax
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of Cmax for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of AUCinf
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of AUCinf for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of AUClast
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of AUClast for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of tmax (Time to reach maximum observed concentration following drug administration)
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of tmax for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of λz (Terminal elimination rate constant)
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of λz for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of t½λz (Half-life associated with terminal slope (λz) of a semi-logarithmic concentration-time curve)
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of t½λz for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of CL/F (Apparent total body clearance of drug from plasma after extravascular administration)
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of CL/F for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of Vss/F (Volume of distribution (apparent) at steady state following extravascular administration)
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of Vss/F for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of Vz/F (Apparent volume of distribution during the terminal phase after extravascular administration)
Time Frame:Arm A: Days 1-4 and 9-12; Arm B: Days 1-4 and 14-17; Arm C: Days 1-4 and 9-12
Safety Issue:
Description:Assessment of Vz/F for adavosertib when administered alone and in combination with itraconazole (arm A) /rifampicin (arm B) /omeprazole (arm C).
Measure:Descriptive statistics of Ctrough (Observed lowest drug concentration reached before the next dose is administered)
Time Frame:Arm A: Days 9-11; Arm B: Days 14-17; Arm C: Day 9
Safety Issue:
Description:Assessment of Ctrough for itraconazole, rifampicin and omeprazole when administered in combination with adavosertib.
Measure:Number of patients with serious and non-serious adverse events
Time Frame:From screening to end of study [within 30 (±7) days of last adavosertib dose]
Safety Issue:
Description:Assessment of the safety and tolerability of adavosertib when dosed with itraconazole (arm A), rifampicin (arm B), and omeprazole (arm C).

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:AstraZeneca

Trial Keywords

  • Proton Pump Inhibitor
  • Cytochrome P450 3A4 Inhibitor
  • Cytochrome P450 3A4 Inducer
  • Pharmacokinetics

Last Updated

August 3, 2021