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Thorough ECG (Electrocardiogram) and Drug Interaction Study With Anetumab Ravtansine and Itraconazole

Phase 1
Completed
Conditions
Medical Oncology
Interventions
Drug: Anetumab ravtansine (BAY94-9343)
Registration Number
NCT02824042
Lead Sponsor
Bayer
Brief Summary

Characterize the safety, tolerability, ECG effects, pharmacokinetics and immunogenicity of anetumab ravtansine given as single agent and after inhibition of CYP3A4 and P-gp by concomitant administration of itraconazole in subjects with mesothelin-expressing advanced solid cancers

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
63
Inclusion Criteria
  • Subjects must have histologically confirmed, locally advanced or metastatic solid cancers of the following histological types:

    1. predominantly epithelial (≥50% tumor component) pleural or peritoneal mesothelioma
    2. epithelial ovarian cancer (fallopian tube and primary peritoneal cancers are eligible)
    3. adenocarcinoma of the pancreas,
    4. triple-negative adenocarcinoma of the breast
    5. non-small-cell adenocarcinoma of the lung
    6. gastric cancer (including gastro-esophageal junction)
    7. colon cancer
    8. cholangiocarcinoma
    9. Thymic carcinoma
  • Subjects must have no standard therapy available, or have actively refused standard therapy

  • Subjects must provide samples of archival tumor tissue collected and submitted anytime during the study

  • Subjects must have a life expectancy of at least 12 weeks

  • Subjects must have ECOG (Eastern Cooperative Oncology Group) performance status of 0 or 1

  • Subjects must have adequate bone marrow, renal and hepatic function and coagulation

  • Subjects must have normal or clinically insignificant ECG at screening

  • Women of reproductive potential must have a negative serum pregnancy test obtained within 3 days before the start of anetumab ravtansine

  • Women of childbearing potential and fertile men must agree to use adequate contraception when sexually active. This applies from the time period between signing of the informed consent until at least 6 months after the last administration of the last study drug. Male patients with a female partner of childbearing potential must use a condom and ensure that an additional form of contraception is also used during treatment and until 6 months after last study drug administration.

Exclusion Criteria
  • Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study, except cervical carcinoma in situ, treated basal cell carcinoma, superficial noninvasive bladder tumors or any previous cancer curatively treated ≥ 3 years before the start of anetumab ravtansine

  • New or progressive brain or meningeal or spinal metastases

  • Corneal epitheliopathy or any eye disorder that may predispose the subjects to drug-induced corneal epitheliopathy, or may interfere with diagnosis of treatment-emergent corneal epitheliopathy at the ophthalmologist's or the investigator's discretion

  • History or current evidence of

    • biliary cirrhosis
    • malignant biliary obstruction unless the bile flow to the gastrointestinal tract is maintained by a fully operational biliary stent
    • CTCAE (Common Terminology Criteria for Adverse Events) Grade ≥2 bleeding disorder within 4 weeks before the start of anetumab ravtansine
    • uncontrolled cardiovascular disease or uncontrolled hypertension
    • Long QT Syndrome
    • HIV infection
    • Hepatitis B or C infection
  • Had a major surgery or significant trauma within 4 weeks before the start of anetumab ravtansine

  • Had solid organ or bone marrow transplantation

  • Have LVEF (left ventricular ejection fraction) <50% at screening

  • Have QTc >450 ms or heart rate ≥100 bpm or ≤45 bpm at screening

  • Poor CYP2D6 metabolizers based on the screening test for genetic polymorphisms in CYP2D6 metabolizing capacity

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Anetumab ravtansineAnetumab ravtansine (BAY94-9343)The evaluation of multiple ECG parameters and the drug-drug interaction (DDI) potential of anetumab ravtansine parameters when administered alone and together with itraconazole 100 mg oral capsules will be conducted in 2 sequential parts. On Cycle 1 Day 1, anetumab ravtansine will be given alone at a dose of 6.5 mg/kg in Part 1 and Part 2. On Cycle 2 Day 1, anetumab ravtansine will be given together with itraconazole at a dose of 0.6 mg/kg in Part 1, and at a dose of 6.5 mg/kg (planned) in Part 2.
Anetumab ravtansineItraconazoleThe evaluation of multiple ECG parameters and the drug-drug interaction (DDI) potential of anetumab ravtansine parameters when administered alone and together with itraconazole 100 mg oral capsules will be conducted in 2 sequential parts. On Cycle 1 Day 1, anetumab ravtansine will be given alone at a dose of 6.5 mg/kg in Part 1 and Part 2. On Cycle 2 Day 1, anetumab ravtansine will be given together with itraconazole at a dose of 0.6 mg/kg in Part 1, and at a dose of 6.5 mg/kg (planned) in Part 2.
Primary Outcome Measures
NameTimeMethod
PR interval durationUp to 2 months per patient

ECG evaluation

QT interval durationUp to 2 months per patient

ECG evaluation

Cycle 1+2 AUC (area under the plasma concentration vs. time curve from zero to infinity after single (first) dose) of BAY94-9343 analytesAt pre-dose, 0.5h, 1h, 1.5h, 2h, 3h, 5h, 8h, 10h, 24h, 48h, 168h, 336h, 480h and 504h after each dose during first 42 days of the study
Cycle 1+2 Cmax (maximum drug concentration in plasma after the first dose administration) of BAY94-9343 analytesAt pre-dose, 0.5h, 1h, 1.5h, 2h, 3h, 5h, 8h, 10h, 24h, 48h, 168h, 336h, 480h and 504h after each dose during first 42 days of the study
QTcF (QT interval, corrected for heart rate according to Fridericia's formula) interval durationUp to 2 months per patient

ECG evaluation

Cycle 1+2 AUC(0-tlast) (AUC from time zero to the last data point > LLOQ [lower limit of quantification]) of BAY94-9343 analytesAt pre-dose, 0.5h, 1h, 1.5h, 2h, 3h, 5h, 8h, 10h, 24h, 48h, 168h, 336h, 480h and 504h after each dose during first 42 days of the study
Abnormal T/U wavesUp to 2 months per patient

ECG evaluation

QRS interval durationUp to 2 months per patient

ECG evaluation

Heart rateUp to 2 months per patient

ECG evaluation

QTcP (QT interval, corrected for heart rate using a population-specific correction) interval durationUp to 2 months per patient

ECG evaluation

Secondary Outcome Measures
NameTimeMethod
Incidence of non-serious adverse eventsUp to 6 months per patient
Incidence of serious adverse eventsUp to 6 months per patient
Incidence of positive anti-drug antibody titerUp to 6 months per patient
Cycle 3 Cmax,md (Cmax after multiple-dose administration) of BAY94-9343 analytesAt pre-dose, 0.5h, 1h, 1.5h, 2h, 3h, 5h, 8h, 168h, 336h and 504h between 43rd and 64th days of the study
Cycle 3 AUC(0-tlast)md (AUC(0-tlast) after multiple-dose administration) of BAY94-9343 analytesAt pre-dose, 0.5h, 1h, 1.5h, 2h, 3h, 5h, 8h, 168h, 336h and 504h between 43rd and 64th days of the study
Incidence of neutralizing antibody titersUp to 6 months per patient

Trial Locations

Locations (18)

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Blacktown Cancer & Haematology Centre

🇦🇺

Blacktown, New South Wales, Australia

Centre Georges Francois Leclerc Dijon

🇫🇷

Dijon, France

Hôpital de la Timone - Marseille

🇫🇷

Marseille, France

Hôpital Henri Mondor

🇫🇷

Creteil, France

Fundacion Jimenez Diaz (Clinica de la Concepcion)

🇪🇸

Madrid, Spain

Ciutat Sanitària i Universitaria de la Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Virgen de la Victoria

🇪🇸

Málaga, Spain

UCLA-Santa Monica Medical Center

🇺🇸

Santa Monica, California, United States

University Hospitals Cleveland Medical Center

🇺🇸

Cleveland, Ohio, United States

Mary Crowley Medical Research Center

🇺🇸

Dallas, Texas, United States

Epworth HealthCare

🇦🇺

Richmond, Victoria, Australia

Henry Ford Health System

🇺🇸

Detroit, Michigan, United States

CU Saint-Luc/UZ St-Luc

🇧🇪

Bruxelles - Brussel, Belgium

UZ Gent

🇧🇪

Gent, Belgium

Nederlands Kanker Instituut

🇳🇱

Amsterdam, Netherlands

VUmc

🇳🇱

Amsterdam, Netherlands

Universitair Medisch Centrum St. Radboud

🇳🇱

Nijmegen, Netherlands

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