NCT02575339终止1 期
An Open Label Randomized Phase I/II Trial of MLN0128 Compared to Sorafenib in Patients With Advanced or Metastatic Hepatocellular Carcinoma: Big Ten Cancer Research Consortium BTCRC-GI13-002
适应症
干预措施
相关药物
试验速览
- 阶段
- 1 期
- 状态
- 终止
- 发起方
- Kathy Miller
- 入组人数
- 11
- 试验地点
- 6
- 主要终点
- Phase I: Maximum Tolerated Dose (MTD) of MLN0128
研究概览
简要总结
This is an open label, multi-center, randomized phase I/II study of MLN0128 versus standard sorafenib. Eligible subjects in the phase I trial will receive MLN0128 in escalating doses. Eligible subjects in the phase II trial will be 1:1 randomized to either the MLN0128 arm or the sorafenib arm.
详细描述
OUTLINE: This is a multi-center trial.
The phase 1 dose escalation trial will evaluate MLN0128 in a standard 3+3 successive cohort design to identify the highest planned dose level. Phase II trial subjects will be 1:1 randomized to receive either MLN0128 (investigational arm) or sorafenib (control arm).
PHASE I DOSE ESCALATION INVESTIGATIONAL TREATMENT:
Cohort 1 (dose level +1) will consist of 3-6 evaluable patients who will receive MLN0128 15mg on day 1 of the 28-day cycle.
Cohort 2 (dose level +2) will consist of 3-6 evaluable patients who will receive MLN0128 20mg on day 1 of the 28-day cycle.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Male or female subjects 18 years or older at the time of informed consent.
- •Voluntary written consent must be signed before performance of any study related procedure not part of standard medical care, with the understanding that the subject may withdraw consent at any time without prejudice to future medical care.
- •Females of childbearing potential must agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 90 days after the last dose of study drug, or agree to completely abstain from heterosexual intercourse.
- •Females of childbearing potential must have a negative serum pregnancy test within 7 days prior to prior to registration for protocol therapy. NOTE: Female subjects are considered of childbearing potential unless they are surgically sterile (they have undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or they are naturally postmenopausal for at least 12 consecutive months.
- •Male subjects, even if surgically sterilized (i.e., status post-vasectomy), must agree to practice effective barrier contraception during the entire study treatment period and through 120 days after the last dose of study drug, or agree to completely abstain from heterosexual intercourse.
- •Subjects must have a diagnosis of measurable advanced or metastatic hepatocellular carcinoma (HCC). Advanced HCC is defined as disease not amenable to surgery, ablation, transplant, or embolic therapy.
- •Phase II subjects must be willing to provide a tissue biopsy prior to registration if archived HCC tumor tissue is not available for correlative studies.
- •For the phase I cohort, subjects with one prior systemic treatment are eligible.
- •Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or
- •Adequate organ function, as specified below, within 28 days before study registration:
- •Bone marrow reserve consistent with: absolute neutrophil count (ANC) ≥ 1.5 x 10^9/L; platelet count ≥ 50 x 10^9/L; hemoglobin ≥ 9 g/dL;
- •Hepatic: total bilirubin ≤ 2 x upper limit of normal (ULN), transaminases (aspartate aminotransferase/serum glutamic oxaloacetic transaminase-AST/SGOT and alanine aminotransferase/serum glutamic pyruvic transaminase-ALT/SGPT) ≤ 5 x ULN
- •Renal: creatinine clearance ≥50 mL/min based either on Cockcroft-Gault estimate or based on urine collection (12 or 24 hour);
- •Metabolic: Glycosylated hemoglobin (HbA1c) ≤7.0%, fasting serum glucose (≤ 130 mg/dL) and fasting triglycerides ≤ 300 mg/dL.
- •Ability to swallow oral medications.
- •Measurable disease according to RECIST v1.1 and obtained by imaging within 28 days prior to registration for protocol therapy.
- •Subjects who have a history of brain metastasis are eligible for the study provided all the following criteria are met:
- •Must have completed their treatment for brain metastasis
- •Must be asymptomatic
- •Must not have evidence of disease progression for ≥3 months or hemorrhage after treatment;
- •Must be off-treatment from dexamethasone for 4 weeks prior to study registration and
- •Must not have an ongoing requirement for dexamethasone or anti-epileptic drugs.
- •Prior locoregional liver directed therapy is allowed as long as treatment was at least 6 weeks prior to study registration, and clear progression is demonstrated by RECIST v1.1 criteria. Subject must have recovered from the acute toxic effects (≤ grade 1 CTCAE v4) of previous anti-cancer treatment prior to study enrollment; the only exception is that grade 2 neuropathy is permitted.
- •Prior radiation therapy is allowed to < 25% of the bone marrow, but is not permitted within 28 days prior to study registration.
- •Estimated life expectancy > 3 months as determined by the treating physician.
排除标准
- •Subjects meeting any of the following exclusion criteria are not to be enrolled in the study:
- •Female subjects who are both lactating and breastfeeding
- •Any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol.
- •Treatment with any investigational products within 28 days prior to study registration.
- •No prior systemic treatment is allowed, except for subjects in the phase I cohort who are permitted one prior systemic treatment.
- •Failed to recover from the reversible effects of prior anticancer therapies with the exception of alopecia and grade 2 neuropathy.
- •Have initiated treatment with bisphosphonates less than 30 days prior to study registration. Concurrent bisphosphonate use is only allowed if the bisphosphonate was initiated at least 30 days prior to study registration.
- •Manifestations of malabsorption due to prior gastrointestinal (GI) surgery, GI disease, or for an unknown reason that may alter the absorption of MLN
- •No condition that could affect the absorption of study drug, including any of the following:
- •Malabsorption syndrome
- •Disease significantly affecting gastrointestinal function
- •Bowel obstruction or sub-obstruction
- •History of any of the following within the last 6 months prior to study registration:
- •Ischemic myocardial event, including angina requiring therapy and artery revascularization procedures
- •Ischemic cerebrovascular event, including transient ischemic attack (TIA) and artery revascularization procedures
- •Requirement for inotropic support (excluding digoxin) or serious (uncontrolled) cardiac arrhythmia (including atrial flutter/fibrillation, ventricular fibrillation or ventricular tachycardia)
- •Placement of a pacemaker for control of rhythm
- •New York Heart Association (NYHA) Class III or IV heart failure
- •Pulmonary embolism
- •Significant active cardiovascular or pulmonary disease at the time of study registration, including:
- •Uncontrolled high blood pressure (i.e., systolic blood pressure >160 mm Hg, diastolic blood pressure > 95 mm Hg)
- •Pulmonary hypertension
- •Uncontrolled asthma or O2 saturation < 90% by ABG (Arterial Blood Gas) analysis or pulse oximetry on room air
- •Significant valvular disease; severe regurgitation or stenosis by imaging independent of symptom control with medical intervention, or history of valve replacement
- •Medically significant (symptomatic) bradycardia
- •History of arrhythmia requiring an implantable cardiac defibrillator
- •Baseline prolongation of the rate-corrected QT interval (QTc) (e.g., repeated demonstration of QTc interval > 480 milliseconds, or history of congenital long QT syndrome, or torsades de pointes)
- •Initiation of treatment with hematopoietic growth factors, transfusions of blood and blood products, or systemic corticosteroids (either IV or oral steroids, excluding inhalers) within 1 week prior to study registration (subjects already receiving erythropoietin on a chronic basis for ≥ 28 days are eligible).
- •Other clinically significant co-morbidities, such as uncontrolled pulmonary disease, active central nervous system disease, active infection, or any other condition that could compromise participation of the subject in the study.
- •Cirrhosis with Child-Pugh score > 7
- •Variceal bleeding within 1 month prior to study registration.
- •Refractory encephalopathy or ascites
- •Known HIV positivity
- •Hepatitis B surface antigen (HBsAg) positivity without active treatment. A subject found to be HBsAg positive should be on antiviral therapy for at least two weeks prior to study registration.
- •Treatment with strong inhibitors and/or inducers of cytochrome P450 (CYP) 3A4, CYP2C19 or CYP2C19 within 7 days prior to study registration.
- •Subjects requiring daily or chronic use of a proton pump inhibitor (PPI) and/or having taken a PPI within 7 days prior to study registration.
研究组 & 干预措施
Phase I MLN0128 Dose Escalation Study
Experimental
Subjects will receive MLN0128 orally on days 1, 8, 15 and 22 in successive cohorts.
Cohort 1 MLN0128 15mg each week (QW); Cohort 2 MLN0128 20mg QW; Cohort 3 MLN0128 30mg QW
干预措施: MLN0128 (Drug)
Phase II Arm A: MLN0128
Experimental
Subjects randomized to experimental arm will receive MLN0128 orally at the recommended phase II dose (RP2D) once weekly.
干预措施: MLN0128 (RP2D) (Drug)
Phase II Arm B: Sorafenib
Active Comparator
Subjects randomized to control arm will receive sorafenib 400mg by mouth (PO) twice a day (BID) daily.
干预措施: Sorafenib (Drug)
结局指标
主要结局
Phase I: Maximum Tolerated Dose (MTD) of MLN0128
时间窗: From start of treatment Day 1 (D1) until completion of two cycles of treatment (maximum 56 days)
The primary objective for phase I of this study is to determine the maximum tolerated dose (MTD) of MLN0128. Maximum Tolerated Dose is defined as the dose level at which fewer than 33% of subjects experience a dose limiting toxicity (DLT).
Phase II: Time to Progression (TTP)
时间窗: From date of randomization until the date of first documented progression or date of death from any cause, whichever occurs first, assessed up to 7 months (estimated).
The primary endpoint of Phase II of the study is to evaluate the time to progression, which is defined as the time from randomization until tumor progression as defined by RECIST v1.1.
次要结局
- Phase I: Overall Survival (OS) Rate(From date of registration until death from any cause, up to a maximum of 27 months)
- Phase I: Characterize Adverse Effects (AE)(From date of first dose until 30 days after the last treatment, assessed for estimated 7 cycles (est. 196 days))
- Phase I: Objective Response Rate (ORR)(Objective Response Rate is assessed at 16 weeks and 24 weeks from start of treatment cycle until Progressive disease is documented.)
- Phase I: Disease Control Rate (DCR)(Disease Control Rate is assessed at 16 weeks and 24 weeks from start of treatment cycle until Progressive disease is documented.)
- Phase II: Overall Survival (OS) Rate(From date of registration until death from any cause, up to a maximum of 24 months)
- Phase I: Time to Progression (TTP)(From date of randomization until the date of first documented progression or date of death from any cause, whichever occurs first, assessed up to 6 months (estimated).)
- Phase I: Progression-free Survival (PFS)(From date of randomization to tumor progression or death from any cause, up to a maximum of 6 months)
- Phase II: Progression Free Survival (PFS)(From date of randomization to tumor progression or death from any cause, up to a maximum of 24 months)
- Phase II: Characterize Adverse Effects (AE)(From date of first dose until 30 days after the last treatment, assessed for estimated 7 cycles (est. 196 days))
- Phase II: Radiographic Response Rate (RRR)(Radiographic Response Rate is assessed at 16 weeks and 24 weeks from start of treatment cycle until Progressive disease is documented.)
研究者
Kathy Miller
Sponsor-Investigator
Big Ten Cancer Research Consortium
研究点 (6)
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