A Phase I study to assess the systemic exposure efficacy and safety of 450mg ceritinib taken with a lowfat meal and 600mg ceritinib taken with a lowfat meal as compared with that of 750mg ceritinib taken in the fasted state in adult patients with ALK rearranged metastatic nonsmall cell lung cancer
- Conditions
- Health Condition 1: C399- Malignant neoplasm of lower respiratory tract, part unspecifiedHealth Condition 2: null- previously treated and treatment-naiveadult patients with metastatic ALK-positive NSCLC.
- Registration Number
- CTRI/2016/09/007234
- Lead Sponsor
- ovartis Healthcare Pvt Ltd
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Other (Terminated)
- Sex
- Not specified
- Target Recruitment
- 20
1. Histologically or cytologically confirmed diagnosis of stage IIIB and is not a candidate for definitive multimodality therapy or IV ALK positive NSCLC.
Eligible patients include those who are either previously treated with systemic anticancer therapy for advanced disease, either experimental or not, or treatment naive with the exception of neo adjuvant or adjuvant therapy excluding regimens containing an ALK inhibitor as depicted in the inclusion criterion No. 13. For AJCC stage groupings and TNM definitions, refer to NCI 2014 guidelines.
For patients previously treated with systemic anti-cancer therapy (including crizotinib), ALK-positive status can be determined locally by using the FDA approved Vysis ALK Break Apart FISH Probe Kit Abbott Molecular Inc. test and scoring algorithm including positivity criteria. Locally confirmed results of ALK positive status must be available prior to randomization. In instances where a local ALK positive result is not available as described above, a central test to confirm ALK positivity must be performed at a Novartis designated central laboratory using either archival tumor obtained at or since the time of diagnosis or a newly obtained tumor sample taken prior to randomization.
For patients who are treatment-naive, ALK-positivity must be determined prospectively at a Novartis central laboratory using the Ventana anti ALK D5F3 IHC test Ventana IHC prior to randomization. The Ventana IHC test must be performed on a biopsy obtained prior to randomization or on archival tumor obtained at or since the time of initial diagnosis.
Note Patients with clinically and neurologically stable central nervous system CNSmetastases who have not required increasing doses of steroids within the 2 weeks prior to study entry to manage CNS symptoms are eligible
2. Retired from protocol version 00
3. Age 18 years or older at the time of informed consent.
4. Patients who are previously treated may have received one prior treatment regimen with crizotinib. all other ALK inhibitors are excluded.
Patients previously treated with crizotinib must have discontinued treatment with crizotinib at least 1 week prior to the first dose of study drug
5. Patients who are previously treated may have received prior chemotherapy, biologic therapy, or other investigational agents. ALK inhibitors other than crizotinib are excluded.
Patients who have been treated with chemotherapy, biological therapy, or other investigational agents must have discontinued the treatment at least 2 weeks prior to starting study drug. In case last chemotherapy contains nitroso urea or mitomycin C, the treatment must be discontinued at least 6 weeks prior to the first dose of study drug.
6. Patients who have received prior chemotherapy, crizotinib, biologic therapy, or other investigational agents must have recovered from all toxicities related to prior anticancer therapies to grade less than 1 CTCAE v 4. 03 prior to starting study drug. Patients with grade less than 2 peripheral neuropathy or any grade of alopecia, nail changes, or skin changes are allowed to enter the study.
7. Patient must meet the following laboratory values at the screening visit:
Absolute Neutrophil Count greater than 1.5 x 10 raised to 9 per L
Platelets greater than 75 x 10 raised to 9 per L
Hemoglobin Hgb greater than 8 g per dL
Serum creatinine less than 1.5 mg per dL and or
Patients eligible for this study must not meet any of the following criteria
1.Prior treatment with an ALK inhibitor other than crizotinib.
2.Patients with known hypersensitivity to any of the excipients of ceritinib microcrystalline cellulose, mannitol, crospovidone, colloidal silicon dioxide and magnesium stearate.
3. History of carcinomatous meningitis.
4. Presence or history of a malignant disease other than an ALK positive advanced tumor that has been diagnosed and or required therapy within the past 3 years. Exceptions to this exclusion include the following completely resected basal cell and squamous cell skin cancers, and completely resected carcinoma in situ of any type.
5. Patient who has received thoracic radiotherapy to lung fields less than 4 weeks prior to starting the study treatment or patients who have not recovered from radiotherapy related toxicities.
For all other anatomic sites including radiotherapy to thoracic vertebrae and ribs radiotherapy less than 2 weeks prior to starting the study treatment or has not recovered from radiotherapy related toxicities. Palliative radiotherapy for bone lesions less than 2 weeks prior to starting study treatment is allowed.
6. Clinically significant, uncontrolled heart disease and or recent cardiac event within 6 months, such as
Unstable angina within 6 months prior to screening.
Myocardial infarction within 6 months prior to screening.
History of documented congestive heart failure New York Heart Association
functional classification III to IV.
Uncontrolled hypertension defined by a Systolic Blood Pressure SBP greater than 160 mm Hg andor Diastolic Blood Pressure DBP greater than 100 mm Hg, with or without antihypertensive medication. Initiation or adjustment of antihypertensive medication is allowed prior to screening.
Ventricular arrhythmias.
Supraventricular and nodal arrhythmias not controlled with medication.
Other cardiac arrhythmia not controlled with medication.
Corrected QT QTcF greater than 470 ms using Fridericias correction on the screening ECG as mean of triplicate ECGs. Patient has history of interstitial lung disease or interstitial pneumonitis, including clinically significant radiation pneumonitis i.e., affecting activities of daily living or
requiring therapeutic intervention.
8. Patient has other severe, acute, or chronic medical conditions including uncontrolled diabetes mellitus or psychiatric conditions or laboratory abnormalities that in the opinion of the investigator may increase the risk associated with study participation, or that may interfere with the interpretation of study results.
9. Patient has impairment of GI function or GI disease that may significantly alter the absorption of ceritinib e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea,or malabsorption syndrome.
10. Patient receiving treatment with medications that meet one of the following criteria and that cannot be discontinued at least 1 week prior to the start of treatment with ceritinib and for the duration of the study
Strong inhibitors or strong inducers of CYP3A4 or 5. Medications with a low therapeutic index that are primarily metabolized by CYP3A4 or 5 and or CYP2C9.
Medications with a known risk of prolonging the QT interval or inducing Torsades de Pointes.
11. Patient is currently receiving treatment with
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method To assess the steady state PK of 450 mg or 600 mg ceritinib <br/ ><br>taken daily with a lowfat meal as compared with that of 750 <br/ ><br>mg ceritinib taken daily in the fasted state in patients with <br/ ><br>metastatic ALK positive NSCLC <br/ ><br>Timepoint: Plasma concentration of ceritinib and PK parameters, <br/ ><br>including but not limited to AUClast, AUC0 24h, Cmax, Tmax, <br/ ><br>Tlast, Racc, and CLssF <br/ ><br>
- Secondary Outcome Measures
Name Time Method