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Testing the Use of Nilotinib and Paclitaxel as a Treatment for Patients With Prior Taxane Treatment, A ComboMATCH Treatment Trial

Phase 2
Active, not recruiting
Conditions
Metastatic Malignant Solid Neoplasm
Refractory Malignant Solid Neoplasm
Interventions
Procedure: Biopsy Procedure
Procedure: Biospecimen Collection
Procedure: Computed Tomography
Procedure: Magnetic Resonance Imaging
Registration Number
NCT05554341
Lead Sponsor
National Cancer Institute (NCI)
Brief Summary

This phase II ComboMATCH treatment trial evaluates nilotinib with paclitaxel for the treatment of patients with solid cancers that are growing, spreading, or getting worse (progressive) and that have previously been treated with taxane therapies. Nilotinib is in a class of medications called kinase inhibitors. It works by binding to and blocking the action of a protein called ABL, which signals tumor cells to multiply. This helps slow or stop the proliferation of tumor cells. Paclitaxel is a drug that blocks cell growth by stopping cell division and it may kill tumor cells. Giving nilotinib with paclitaxel may be effective at treating patients with progressive solid cancers that have previously been treated with taxane therapies.

Detailed Description

PRIMARY OBJECTIVE:

I. To evaluate the proportion of patients with taxane-refractory advanced malignancies who have objective responses (OR) to treatment with nilotinib hydrochloride monohydrate (nilotinib) and paclitaxel.

SECONDARY OBJECTIVE:

I. Collect tissue and provide it to the ComboMATCH registration protocol to assess concordance between the diagnostic tumor mutation profile generated by the designated laboratories, the pre-treatment biopsy mutation profile, and the pre-treatment circulating tumor deoxyribonucleic acid (ctDNA) mutation profile from plasma, as described in ComboMATCH registration protocol. For this treatment substudy, the outcome objective will be to report the proportion of cases providing sufficient tissue for that integrated scientific activity in the ComboMATCH registration protocol.

EXPLORATORY OBJECTIVES:

I. To evaluate progression free survival (PFS) at 6 months on study agents. II. To identify genomic and transcriptomic determinants of response and resistance in tumor biopsy specimens and cell-free deoxyribonucleic acid (DNA).

OUTLINE:

Patients receive nilotinib hydrochloride monohydrate orally (PO) twice daily (BID) on days 1-28 and paclitaxel intravenously (IV) over 1 hour on days 1, 8, and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo computed tomography (CT) or magnetic resonance imaging (MRI) throughout the study. Patients also undergo collection of blood samples and tumor biopsy on study.

After completion of study treatment, patients are followed until disease progression, and for survival for 3 years from registration.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Patient must be enrolled on the ComboMATCH registration protocol (EAY191) at the time of registration to the EAY191-E4 study

  • Patient must be >= 18 years of age

  • Patient must not have any of the following mutations (as determined by the ComboMATCH registration protocol), which are known to confer sensitivity or resistance to nilotinib monotherapy:

    • KIT: W557R, V559D, V559A, L576P, and K642E
    • PDGFR-alpha: D842V
  • Patient must have disease that can be safely biopsied and agree to a pre-treatment biopsy or have archival tissue available from within 12 months prior to the date of registration on the ComboMATCH registration trial (EAY191)

    • NOTE: The current actionable mutation of interest (aMOI)/actionable alteration list for this treatment trial can be found on the Cancer Trials Support Unit (CTSU) website
    • NOTE: Novel/dynamic aMOI can be submitted for review per the process described in the ComboMATCH registration protocol
  • Patient must be willing to provide blood samples for research purposes

  • Patient must have had at least one prior line of therapy in the metastatic setting

  • Patient must have previously undergone taxane therapy (in the metastatic setting)

    • Patients who previously responded to prior taxane therapy must have received their last dose of taxane therapy within 6 months prior to EAY191-E4 registration and have had no other intervening treatment prior to EAY191-E4 registration
    • Patients who did not respond to prior taxane therapy are eligible regardless of the time elapsed since the prior taxane therapy or any other intervening therapies
  • Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2

  • Patient must not have had platinum-resistant epithelial serous ovarian cancer

  • Patients must not have neuropathy >= grade 2 within 14 days of registration/randomization

  • Patient must have documented QT interval with Fridericia's correction (QTcF) of =< 450 msec within 8 days prior to EAY191-E4 registration. Patients with a QTcF interval of >= 450 msec at registration or patients with congenital long QT syndrome are not eligible

  • Patient must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used

    • All patients of childbearing potential must have a blood test or urine study within 14 days prior to registration to rule out pregnancy
    • A patient of childbearing potential is defined as anyone, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
  • Patient must not expect to conceive or father children by using accepted and effective method(s) of contraception or by abstaining from sexual intercourse for the duration of their participation in the study and for at least 3 months after the last dose of study drug

  • Patients must have progressive disease

  • Absolute neutrophil count (ANC) >= 1,500/mcL

  • Platelets >= 100,000/mcL

  • Total bilirubin =< 1.5 x institutional upper limit of normal (ULN) (with the exception of those with Gilbert syndrome, who must have total bilirubin =< 3 x institutional ULN)

  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 3 institutional upper limit of normal; < 5.0 x ULN in patients with liver metastases

  • Creatinine clearance > 60 mL/min/1.73 m^2 for patients with creatinine levels > 1.5 mg/dL

  • Patient must have the ability to swallow medications

  • Patient must have completed any prior therapy ≥ 4 weeks or ≥ 5 half-lives of the prior agent (whichever is shorter) prior to enrollment on protocol. Prior definitive radiation should have been completed ≥ 4 weeks prior to enrollment; prior palliative radiation should have been completed ≥ 2 weeks prior to enrollment. Patients must be ≥ 2 weeks since any investigational agent administered as part of a phase 0 study (where a sub-therapeutic dose of drug is administered) and should have recovered to grade 1 or baseline from any toxicities

  • Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of progression for ≥ 1 month after treatment of the brain metastases

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment (nilotinib hydrochloride monohydrate, paclitaxel)Biopsy ProcedurePatients receive nilotinib hydrochloride monohydrate PO BID on days 1-28 and paclitaxel IV over 1 hour on days 1, 8, and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI throughout the study. Patients also undergo collection of blood samples and tumor biopsy on study.
Treatment (nilotinib hydrochloride monohydrate, paclitaxel)Magnetic Resonance ImagingPatients receive nilotinib hydrochloride monohydrate PO BID on days 1-28 and paclitaxel IV over 1 hour on days 1, 8, and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI throughout the study. Patients also undergo collection of blood samples and tumor biopsy on study.
Treatment (nilotinib hydrochloride monohydrate, paclitaxel)PaclitaxelPatients receive nilotinib hydrochloride monohydrate PO BID on days 1-28 and paclitaxel IV over 1 hour on days 1, 8, and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI throughout the study. Patients also undergo collection of blood samples and tumor biopsy on study.
Treatment (nilotinib hydrochloride monohydrate, paclitaxel)Biospecimen CollectionPatients receive nilotinib hydrochloride monohydrate PO BID on days 1-28 and paclitaxel IV over 1 hour on days 1, 8, and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI throughout the study. Patients also undergo collection of blood samples and tumor biopsy on study.
Treatment (nilotinib hydrochloride monohydrate, paclitaxel)Computed TomographyPatients receive nilotinib hydrochloride monohydrate PO BID on days 1-28 and paclitaxel IV over 1 hour on days 1, 8, and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI throughout the study. Patients also undergo collection of blood samples and tumor biopsy on study.
Treatment (nilotinib hydrochloride monohydrate, paclitaxel)Nilotinib Hydrochloride MonohydratePatients receive nilotinib hydrochloride monohydrate PO BID on days 1-28 and paclitaxel IV over 1 hour on days 1, 8, and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI throughout the study. Patients also undergo collection of blood samples and tumor biopsy on study.
Primary Outcome Measures
NameTimeMethod
Best objective responseUp to 3 years

Evaluated using Response Evaluation Criteria in Solid Tumors version 1.1. 90% two-sided confidence intervals will be used for reporting estimated rates.

Progression free survivalFrom registration to documented disease progression or death from any cause, assessed up to 3 years

Distribution will be estimated using the method of Kaplan and Meier.

Overall survivalFrom registration to death from any cause, assessed up to 3 years

Distribution will be estimated using the method of Kaplan and Meier.

Incidence of adverse eventsUp to 3 years

Will be determined using the National Cancer Institute's Common Terminology Criteria for Adverse Events. Exact binomial confidence intervals will be used for adverse event rates.

Secondary Outcome Measures
NameTimeMethod
Concordance of diagnostic tumor mutation profile, pre-treatment tumor biopsy mutation profile, and pre-treatment circulating tumor deoxyribonucleic acid (ctDNA) profileUp to 3 years

Whole-exome sequencing, ribonucleic acid sequencing, and ctDNA sequencing will be performed on mandatory tissue biopsies and/or blood specimens.

Trial Locations

Locations (126)

Carle at The Riverfront

🇺🇸

Danville, Illinois, United States

Cancer Care Specialists of Illinois - Decatur

🇺🇸

Decatur, Illinois, United States

Decatur Memorial Hospital

🇺🇸

Decatur, Illinois, United States

Illinois CancerCare-Dixon

🇺🇸

Dixon, Illinois, United States

Crossroads Cancer Center

🇺🇸

Effingham, Illinois, United States

Advocate Sherman Hospital

🇺🇸

Elgin, Illinois, United States

Illinois CancerCare-Eureka

🇺🇸

Eureka, Illinois, United States

Illinois CancerCare-Galesburg

🇺🇸

Galesburg, Illinois, United States

University of Alabama at Birmingham Cancer Center

🇺🇸

Birmingham, Alabama, United States

Kingman Regional Medical Center

🇺🇸

Kingman, Arizona, United States

Stanford Cancer Institute Palo Alto

🇺🇸

Palo Alto, California, United States

Presbyterian Intercommunity Hospital

🇺🇸

Whittier, California, United States

UCHealth University of Colorado Hospital

🇺🇸

Aurora, Colorado, United States

UM Sylvester Comprehensive Cancer Center at Aventura

🇺🇸

Aventura, Florida, United States

UM Sylvester Comprehensive Cancer Center at Coral Gables

🇺🇸

Coral Gables, Florida, United States

UM Sylvester Comprehensive Cancer Center at Deerfield Beach

🇺🇸

Deerfield Beach, Florida, United States

University of Miami Miller School of Medicine-Sylvester Cancer Center

🇺🇸

Miami, Florida, United States

UM Sylvester Comprehensive Cancer Center at Kendall

🇺🇸

Miami, Florida, United States

UM Sylvester Comprehensive Cancer Center at Plantation

🇺🇸

Plantation, Florida, United States

Saint Alphonsus Cancer Care Center-Boise

🇺🇸

Boise, Idaho, United States

Saint Alphonsus Cancer Care Center-Caldwell

🇺🇸

Caldwell, Idaho, United States

Kootenai Health - Coeur d'Alene

🇺🇸

Coeur d'Alene, Idaho, United States

Saint Alphonsus Cancer Care Center-Nampa

🇺🇸

Nampa, Idaho, United States

Kootenai Clinic Cancer Services - Post Falls

🇺🇸

Post Falls, Idaho, United States

Kootenai Clinic Cancer Services - Sandpoint

🇺🇸

Sandpoint, Idaho, United States

Advocate Good Shepherd Hospital

🇺🇸

Barrington, Illinois, United States

Illinois CancerCare-Bloomington

🇺🇸

Bloomington, Illinois, United States

Illinois CancerCare-Canton

🇺🇸

Canton, Illinois, United States

Illinois CancerCare-Carthage

🇺🇸

Carthage, Illinois, United States

Centralia Oncology Clinic

🇺🇸

Centralia, Illinois, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

John H Stroger Jr Hospital of Cook County

🇺🇸

Chicago, Illinois, United States

Advocate Illinois Masonic Medical Center

🇺🇸

Chicago, Illinois, United States

AMG Crystal Lake - Oncology

🇺🇸

Crystal Lake, Illinois, United States

Advocate Good Samaritan Hospital

🇺🇸

Downers Grove, Illinois, United States

Carle Physician Group-Effingham

🇺🇸

Effingham, Illinois, United States

Advocate South Suburban Hospital

🇺🇸

Hazel Crest, Illinois, United States

Illinois CancerCare-Kewanee Clinic

🇺🇸

Kewanee, Illinois, United States

AMG Libertyville - Oncology

🇺🇸

Libertyville, Illinois, United States

Condell Memorial Hospital

🇺🇸

Libertyville, Illinois, United States

Illinois CancerCare-Macomb

🇺🇸

Macomb, Illinois, United States

Carle Physician Group-Mattoon/Charleston

🇺🇸

Mattoon, Illinois, United States

Cancer Care Center of O'Fallon

🇺🇸

O'Fallon, Illinois, United States

Advocate Christ Medical Center

🇺🇸

Oak Lawn, Illinois, United States

Illinois CancerCare-Ottawa Clinic

🇺🇸

Ottawa, Illinois, United States

Advocate Lutheran General Hospital

🇺🇸

Park Ridge, Illinois, United States

Illinois CancerCare-Pekin

🇺🇸

Pekin, Illinois, United States

Illinois CancerCare-Peoria

🇺🇸

Peoria, Illinois, United States

Illinois CancerCare-Peru

🇺🇸

Peru, Illinois, United States

Illinois CancerCare-Princeton

🇺🇸

Princeton, Illinois, United States

Southern Illinois University School of Medicine

🇺🇸

Springfield, Illinois, United States

Springfield Clinic

🇺🇸

Springfield, Illinois, United States

Springfield Memorial Hospital

🇺🇸

Springfield, Illinois, United States

Carle Cancer Center

🇺🇸

Urbana, Illinois, United States

Illinois CancerCare - Washington

🇺🇸

Washington, Illinois, United States

UI Health Care Mission Cancer and Blood - Des Moines Clinic

🇺🇸

Des Moines, Iowa, United States

University of Kentucky/Markey Cancer Center

🇺🇸

Lexington, Kentucky, United States

Ochsner Medical Center Jefferson

🇺🇸

New Orleans, Louisiana, United States

Lafayette Family Cancer Center-EMMC

🇺🇸

Brewer, Maine, United States

National Institutes of Health Clinical Center

🇺🇸

Bethesda, Maryland, United States

Trinity Health Saint Joseph Mercy Hospital Ann Arbor

🇺🇸

Ann Arbor, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology - Brighton

🇺🇸

Brighton, Michigan, United States

Trinity Health Medical Center - Brighton

🇺🇸

Brighton, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology - Canton

🇺🇸

Canton, Michigan, United States

Trinity Health Medical Center - Canton

🇺🇸

Canton, Michigan, United States

Chelsea Hospital

🇺🇸

Chelsea, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital

🇺🇸

Chelsea, Michigan, United States

Cancer Hematology Centers - Flint

🇺🇸

Flint, Michigan, United States

Genesee Hematology Oncology PC

🇺🇸

Flint, Michigan, United States

Genesys Hurley Cancer Institute

🇺🇸

Flint, Michigan, United States

Hurley Medical Center

🇺🇸

Flint, Michigan, United States

University of Michigan Health - Sparrow Lansing

🇺🇸

Lansing, Michigan, United States

Trinity Health Saint Mary Mercy Livonia Hospital

🇺🇸

Livonia, Michigan, United States

Henry Ford Saint John Hospital - Macomb Medical

🇺🇸

Macomb, Michigan, United States

Huron Gastroenterology PC

🇺🇸

Ypsilanti, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus

🇺🇸

Ypsilanti, Michigan, United States

Sanford Joe Lueken Cancer Center

🇺🇸

Bemidji, Minnesota, United States

Saint Francis Medical Center

🇺🇸

Cape Girardeau, Missouri, United States

Parkland Health Center - Farmington

🇺🇸

Farmington, Missouri, United States

Missouri Baptist Medical Center

🇺🇸

Saint Louis, Missouri, United States

Sainte Genevieve County Memorial Hospital

🇺🇸

Sainte Genevieve, Missouri, United States

Missouri Baptist Sullivan Hospital

🇺🇸

Sullivan, Missouri, United States

BJC Outpatient Center at Sunset Hills

🇺🇸

Sunset Hills, Missouri, United States

Community Hospital of Anaconda

🇺🇸

Anaconda, Montana, United States

Billings Clinic Cancer Center

🇺🇸

Billings, Montana, United States

Bozeman Health Deaconess Hospital

🇺🇸

Bozeman, Montana, United States

Benefis Sletten Cancer Institute

🇺🇸

Great Falls, Montana, United States

Logan Health Medical Center

🇺🇸

Kalispell, Montana, United States

Community Medical Center

🇺🇸

Missoula, Montana, United States

OptumCare Cancer Care at Seven Hills

🇺🇸

Henderson, Nevada, United States

OptumCare Cancer Care at Charleston

🇺🇸

Las Vegas, Nevada, United States

OptumCare Cancer Care at Fort Apache

🇺🇸

Las Vegas, Nevada, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Mount Sinai Hospital

🇺🇸

New York, New York, United States

Sanford Bismarck Medical Center

🇺🇸

Bismarck, North Dakota, United States

Sanford Broadway Medical Center

🇺🇸

Fargo, North Dakota, United States

Sanford Roger Maris Cancer Center

🇺🇸

Fargo, North Dakota, United States

Dayton Physician LLC - Englewood

🇺🇸

Dayton, Ohio, United States

Kettering Medical Center

🇺🇸

Kettering, Ohio, United States

Toledo Clinic Cancer Centers-Toledo

🇺🇸

Toledo, Ohio, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Saint Alphonsus Cancer Care Center-Ontario

🇺🇸

Ontario, Oregon, United States

Providence Portland Medical Center

🇺🇸

Portland, Oregon, United States

Providence Saint Vincent Medical Center

🇺🇸

Portland, Oregon, United States

Sanford Cancer Center Oncology Clinic

🇺🇸

Sioux Falls, South Dakota, United States

Sanford USD Medical Center - Sioux Falls

🇺🇸

Sioux Falls, South Dakota, United States

M D Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Swedish Cancer Institute-Edmonds

🇺🇸

Edmonds, Washington, United States

Swedish Cancer Institute-Issaquah

🇺🇸

Issaquah, Washington, United States

Valley Medical Center

🇺🇸

Renton, Washington, United States

Swedish Medical Center-First Hill

🇺🇸

Seattle, Washington, United States

North Star Lodge Cancer Center at Yakima Valley Memorial Hospital

🇺🇸

Yakima, Washington, United States

ThedaCare Regional Cancer Center

🇺🇸

Appleton, Wisconsin, United States

Aurora Cancer Care-Grafton

🇺🇸

Grafton, Wisconsin, United States

Aurora BayCare Medical Center

🇺🇸

Green Bay, Wisconsin, United States

Gundersen Lutheran Medical Center

🇺🇸

La Crosse, Wisconsin, United States

University of Wisconsin Carbone Cancer Center - University Hospital

🇺🇸

Madison, Wisconsin, United States

Aurora Bay Area Medical Group-Marinette

🇺🇸

Marinette, Wisconsin, United States

Aurora Saint Luke's Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

Aurora Sinai Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

Vince Lombardi Cancer Clinic - Oshkosh

🇺🇸

Oshkosh, Wisconsin, United States

Vince Lombardi Cancer Clinic-Sheboygan

🇺🇸

Sheboygan, Wisconsin, United States

Aurora Medical Center in Summit

🇺🇸

Summit, Wisconsin, United States

Vince Lombardi Cancer Clinic-Two Rivers

🇺🇸

Two Rivers, Wisconsin, United States

Aurora Cancer Care-Milwaukee West

🇺🇸

Wauwatosa, Wisconsin, United States

Aurora West Allis Medical Center

🇺🇸

West Allis, Wisconsin, United States

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