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A Drug-Drug Interaction Study in Healthy Volunteers of the Effects of Tucatinib

Registration Number
NCT03723395
Lead Sponsor
Seagen Inc.
Brief Summary

This study is being done to look at how tucatinib could affect the way other drugs work. This study will look at healthy volunteers and how tucatinib affects their liver enzymes. Liver enzymes can change how drugs work in the body. There are 5 parts to this study. Parts A and C are looking at how the body breaks down tucatinib when there are lower levels of certain liver enzymes. Part B is looking at how the body breaks down tucatinib when there are high levels of certain liver and stomach enzymes. Parts D and E are looking at how tucatinib could change the levels of some liver and stomach enzymes in the body. This will help us know more about how tucatinib should be given to patients.

Detailed Description

This is a fixed-sequence, drug-drug interaction study of tucatinib conducted in 5 parts in healthy subjects. Part A will evaluate the effect of the strong CYP3A4 inhibitor itraconazole on the pharmacokinetics (PK) of tucatinib. Part B will evaluate the effect of rifampin, a strong inducer of CYP3A4 and CYP2C8, on the PK of tucatinib. Part C will evaluate the effect of the strong CYP2C8 inhibitor gemfibrozil on the PK of tucatinib. Part D will evaluate the effects of tucatinib on the PK of substrate probes of the metabolizing enzymes CYP2C8 (repaglinide), CYP2C9 (tolbutamide), and CYP3A4 (midazolam). Part E will evaluate the effect of tucatinib on the PK of a substrate probe of the transporter P-gp (digoxin). Parts A, B, C, D, and E of the study are independent of one another and do not need to be conducted in a particular order.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
116
Inclusion Criteria
  • Body mass index (BMI) between 18 and 32 kg/m^2
  • In good health, determined be no clinically significant findings from medical history, physical examination, and screening evaluations
  • Female subjects must be of nonchildbearing potential
  • Male subjects must agree to use contraception or must be surgically sterile for at least 90 days prior to enrollment
  • Able to understand and sign informed consent form
Exclusion Criteria
  • Any condition affecting drug absorption (including stomach or intestinal surgery)
  • Significant history of metabolic, allergic, dermatological, hepatic, renal, hematological, pulmonary, cardiovascular, gastrointestinal, neurological, respiratory, endocrine, or psychiatric disorder
  • History of hypersensitivity, intolerance, or allergy to any drug compounds, food, or other substance (unless approved by Investigator)
  • Participation in a clinical study involving an investigational drug within the past 30 days
  • Use or intend to any prescription medications within 28 days prior to check in
  • Use of tobacco- or nicotine-containing products within 28 days prior to check in
  • History of hyperbilirubinemia
  • History of alcoholism or drug abuse within 2 years
  • History of regular alcohol consumption exceeding 7 drinks/week for female subjects or 14 drinks/week for male subjects
  • Positive hepatitis panel and/or positive human immunodeficiency virus (HIV) test

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part DtolbutamideTucatinib plus Repaglinide plus Tolbutamide plus Midazolam
Part BtucatinibTucatinib plus Rifampin
Part DrepaglinideTucatinib plus Repaglinide plus Tolbutamide plus Midazolam
Part AtucatinibTucatinib plus Itraconazole
Part AitraconazoleTucatinib plus Itraconazole
Part BrifampinTucatinib plus Rifampin
Part CtucatinibTucatinib plus Gemfibrozil
Part CgemfibrozilTucatinib plus Gemfibrozil
Part DtucatinibTucatinib plus Repaglinide plus Tolbutamide plus Midazolam
Part DmidazolamTucatinib plus Repaglinide plus Tolbutamide plus Midazolam
Part EtucatinibTucatinib plus Digoxin
Part EdigoxinTucatinib plus Digoxin
Primary Outcome Measures
NameTimeMethod
Time of maximum observed concentrationUp to 22 days

PK parameters for tucatinib (Parts A, B, and C); repaglinide and its M4 metabolite (Part D), tolbutamide and its 4-hydroxytolbutamide metabolite (Part D), midazolam and its 1-hydroxymidazolam metabolite (Part D), and digoxin (Part E)

Apparent total clearanceUp to 22 days

PK parameters for tucatinib (Parts A, B, and C); repaglinide (Part D), tolbutamide (Part D), midazolam (Part D), and digoxin (Part E).

Area under the concentration-time curve (AUC) from time 0 to infinityUp to 22 days

PK parameters for tucatinib (Parts A, B, and C); repaglinide and its M4 metabolite (Part D), tolbutamide and its 4-hydroxytolbutamide metabolite (Part D), midazolam and its 1-hydroxymidazolam metabolite (Part D), and digoxin (Part E)

Apparent terminal elimination half-lifeUp to 22 days

PK parameters for tucatinib (Parts A, B, and C); repaglinide and its M4 metabolite (Part D), tolbutamide and its 4-hydroxytolbutamide metabolite (Part D), midazolam and its 1-hydroxymidazolam metabolite (Part D), and digoxin (Part E)

Apparent volume of distributionUp to 22 days

PK parameters for tucatinib (Parts A, B, and C); repaglinide (Part D), tolbutamide (Part D), midazolam (Part D), and digoxin (Part E).

Maximum observed concentrationUp to 22 days

PK parameters for tucatinib (Parts A, B, and C); repaglinide and its M4 metabolite (Part D), tolbutamide and its 4-hydroxytolbutamide metabolite (Part D), midazolam and its 1-hydroxymidazolam metabolite (Part D), and digoxin (Part E)

AUC from time 0 to the time of the last quantifiable concentrationUp to 22 days

PK parameters for tucatinib (Parts A, B, and C); repaglinide and its M4 metabolite (Part D), tolbutamide and its 4-hydroxytolbutamide metabolite (Part D), midazolam and its 1-hydroxymidazolam metabolite (Part D), and digoxin (Part E)

Percentage extrapolation in AUCUp to 22 days

PK parameters for tucatinib (Parts A, B, and C); repaglinide and its M4 metabolite (Part D), tolbutamide and its 4-hydroxytolbutamide metabolite (Part D), midazolam and its 1-hydroxymidazolam metabolite (Part D), and digoxin (Part E)

Metabolite-to-parent ratio based on AUCUp to 22 days

PK parameters for M4 metabolite, 4-hydroxytolbutamide metabolite, and 1-hydroxymidazolam metabolite (Part D only)

Secondary Outcome Measures
NameTimeMethod
Accumulation ratioUp to 15 days

PK parameters of tucatinib and ONT-993; Parts D and E only

Percentage extrapolation in AUCUp to 15 days

PK parameters of tucatinib and ONT-993; Parts D and E only

Maximum observed concentrationUp to 15 days

PK parameters of tucatinib and ONT-993; Parts D and E only

Apparent volume of distribution at steady stateUp to 15 days

PK parameter of tucatinib; Parts D and E only

Incidence of adverse events (AEs)Up to 58 days

Parts A, B, C, D, and E (all)

Time of maximum observed concentrationUp to 15 days

PK parameters of tucatinib and ONT-993; Parts D and E only

Apparent terminal elimination half-lifeUp to 15 days

PK parameters of tucatinib and ONT-993; Parts D and E only

Apparent total clearanceUp to 8 days

PK parameter of tucatinib; Parts D and E only

Apparent total clearance at steady stateUp to 15 days

PK parameter of tucatinib; Parts D and E only

Apparent volume of distributionUp to 8 days

PK parameter of tucatinib; Parts D and E only

Physical examinationsUp to 58 days

Incidence of AEs resulting from clinically significant findings in examination of general appearance, skin, thorax/lungs, cardiovascular system, and abdomen. Parts A, B, C, D, and E (all)

AUC within a dosing intervalUp to 15 days

PK parameters of tucatinib and ONT-993; Parts D and E only

Incidence of laboratory abnormalitiesUp to 58 days

Parts A, B, C, D, and E (all)

12-lead electrocardiogram (ECG) assessmentUp to 58 days

PR, RR, QRS, and QT interval. Parts A, B, C, D, and E (all)

Vital signs measurementsUp to 58 days

Heart rate. Parts A, B, C, D, and E (all)

AUC from time 0 to infinityUp to 8 days

PK parameters of tucatinib and ONT-993; Parts D and E only

AUC from time 0 to the time of the last quantifiable concentrationUp to 15 days

PK parameters of tucatinib and ONT-993; Parts D and E only

Metabolite-to-parent ratio based on AUCUp to 15 days

PK parameter of ONT-993; Parts D and E only

Trial Locations

Locations (1)

Covance Clinical Research Unit

🇺🇸

Dallas, Texas, United States

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