A Phase Ib/II Study of AEB071 and MEK162 in Adult Patients With Metastatic Uveal Melanoma

Phase 1

Terminated

Conditions: Uveal Melanoma

Interventions: Drug: AEB071
Drug: MEK162

Registration Number: NCT01801358

Lead Sponsor: Array Biopharma, now a wholly owned subsidiary of Pfizer

Brief Summary: A phase Ib dose-escalation study of the AEB071 and MEK162 combination in adult patients with confirmed metastatic uveal melanoma. Cohorts of 3-6 patients will be assessed for dose limiting toxicities (DLTs) during Cycle 1 until the maximum tolerated dose (MTD) of the combination therapy is determined. The MTD or Phase 2 Recommended Dose (P2RD) will be used in a Phase II part of the study, which will enrol 55 patients each into two randomized groups: the combination therapy or MEK162 alone. The Phase II part will continue until proof of concept is established. Patients will continue treatment as long as clinical benefit is seen and no limiting adverse toxicity is observed

Detailed Description: Due to halted enrollment, the Phase II part of the study was not conducted. The Sponsor decided to permanently stop recruitment for the study prior to MTD determination.

Remaining patients on treatment with binimetinib and sotrastaurin who were considered by the Investigator to be benefiting from their treatment could have continued treatment and were to be followed up as per protocol. No patients were ongoing as of the data cut-off date. After the last patient last visit (LPLV) was declared, the study was terminated.

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 38

Inclusion Criteria

Written informed consent
Male and female patients aged 18 years or older
A history of uveal (ocular) melanoma with biopsy-confirmed metastatic disease
Consent to providing 3 tumor biopsy samples throughout the course of the study
Presence of measurable disease
A WHO performance status of less than or equal to 1

Exclusion Criteria

Presence of CNS lesions (stable lesions may be acceptable)
Previous or concurrent malignancy, other than basal cell or squamous cell carcinoma of the skin: in situ carcinoma of the cervix, without evidence of recurrence for at least 3 years; a primary malignancy completely resected and no evidence of recurrence for at least 3 years
Adverse event from prior chemotherapy, radiotherapy or surgery that has not recovered to CTCAE v4.03 Grade 1 or less, except for alopecia/sensory peripheral neuropathy, which must be less than Grade 2
History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO
Impaired cardiac function or clinically significant cardiac disease
Impaired GI function or disease that could interfere with the absorption of AEB071 and/or MEK162
Treatment with medicines or herbal supplements that are known inhibitors or inducers of CYP3A4/5 and cannot be withdrawn prior to study treatment
Females of child-bearing potential who are unwilling or unable to use highly effective means of contraception
Males who are unwilling or unable to use a condom during sexual intercourse
Prior exposure to a MEK or PKC inhibitor Other inclusion/exclusion criteria apply

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Arm A	MEK162	AEB071 and MEK162 combined
Arm B	MEK162	MEK162 alone
Arm A	AEB071	AEB071 and MEK162 combined

Primary Outcome Measures

Name	Time	Method
Phase Ib: Incidence of Dose Limiting Toxicities (DLT) During the First Cycle	Cycle 1 (up to 28 days)	A DLT is defined as an adverse event or abnormal laboratory value as defined in the protocol that is assessed as unrelated to disease, disease progression, inter-current illness, or concomitant medications that occurs within the first 28 days of treatment with AEB071 and MEK162.
Phase II: Progression Free Survival (PFS)	From first dose of Cycle 1, Day 1 (C1D1) to time to progression (up to 18 months from Last Patient First Visit)	The time from date of randomization to the date of event defined as the first documented progression or death due to any cause. Due to an enrollment halt, the Phase II part of the study was not conducted. The sponsor decided to permanently stop recruitment for the study prior to MTD determination.

Secondary Outcome Measures

Name	Time	Method
Phase Ib/II: The Number of Subjects Experiencing At Least One Serious Adverse Event (SAE)	From first dose of Cycle 1, Day 1 (C1D1) to time to progression (up to 18 months from Last Patient First Visit)	Serious adverse event (SAE) is defined as one of the following: * Is fatal or life-threatening * Results in persistent or significant disability/incapacity * Constitutes a congenital anomaly/birth defect * Is medically significant * Requires inpatient hospitalization or prolongation of existing hospitalization * Note that hospitalizations for the following reasons should not be reported as serious adverse events: * Routine treatment or monitoring of the studied indication, not associated with any deterioration in condition * Elective or pre-planned treatment for a pre-existing condition that is unrelated to metastatic uveal melanoma and has not worsened since signing the informed consent * Social reasons and respite care in the absence of any deterioration in the patient's general condition
Phase Ib: PK Parameters for AEB071 - AUC0-8hr (Cycle 1; Day 1)	Cycle 1 (Day 1)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase Ib: PK Parameters for AEB071 - AUC0-8hr (Cycle 1; Day 15)	Cycle 1 (Day 15)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase lb: PK Parameters for MEK162 - Cmax (Cycle 1; Day 1)	Cycle 1 (Day 1)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase lb: PK Parameters for MEK162 - Tmax (Cycle 1; Day 15)	Cycle 1 (Day 15)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase lb: PK Parameters for AEB071 - Cmax (Cycle 1; Day 1)	Cycle 1 (Day 1)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase lb: PK Parameters for MEK162 - Cmax (Cycle 1; Day 15)	Cycle 1 (Day 15)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase Ib/II: The Number of Subjects Experiencing At Least One Adverse Event (AE)	From first dose of Cycle 1, Day 1 (C1D1) to time to progression (up to 18 months from Last Patient First Visit)	An adverse event is defined as the appearance of (or worsening of any pre-existing) undesirable sign(s), symptom(s), or medical condition(s) that occur after patient's signed informed consent has been obtained.
Phase Ib: Assessment of The Preliminary Anti-tumor Activity - Duration of Response (DOR)	Cycle 1 (up to 28 days)	Assessment of the preliminary anti-tumor activity of AEB071 and MEK162 in combination. Duration of Response (DOR) is not reported, since there were no responses of Complete Response (CR) or Partial Response (PR) at any time during the study.
Phase II: Evaluation of Preliminary Anti-tumor Activity - Overall Response Rate (CR+PR)	From first dose of Cycle 1, Day 1 (C1D1) to time to progression (up to 18 months from Last Patient First Visit)	Evaluation of the preliminary anti-tumor activity at the RP2D for AEB071 and MEK162 and at 45 mg BID for MEK162 alone. Overall response rate (ORR) is the proportion of patients with a best overall response of Complete Response (CR) or Partial Response (PR). This is also referred to as 'Objective response rate' in some protocols or publications. Due to an enrollment halt, the Phase II part of the study was not conducted.
Phase II: Evaluation of Preliminary Anti-tumor Activity - Overall Survival (OS)	From first dose of Cycle 1, Day 1 (C1D1) to time to progression (up to 18 months from Last Patient First Visit)	Evaluation of the preliminary anti-tumor activity at the RP2D for AEB071 and MEK162 and at 45 mg BID for MEK162 alone. Overall survival (OS) is defined as the time from date of randomization/start of treatment to date of death due to any cause. Due to an enrollment halt, the Phase II part of the study was not conducted.
Phase lb: PK Parameters for AEB071 - Tmax (Cycle 1; Day 15)	Cycle 1 (Day 15)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase Ib: Assessment of The Preliminary Anti-tumor Activity - Best Overall Response (BOR)	Cycle 1 (up to 28 days)	Assessment of the preliminary anti-tumor activity of AEB071 and MEK162 in combination. The best overall response is the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for PD the smallest measurements recorded since the treatment started). In general, the patient's best response assignment will depend on the achievement of both measurement and confirmation criteria.
Phase Ib: Assessment of The Preliminary Anti-tumor Activity - Progression Free Survival (PFS)	Cycle 1 (up to 28 days)	Assessment of the preliminary anti-tumor activity of AEB071 and MEK162 in combination. PFS is the time from date of randomization/start of treatment to the date of event defined as the first documented progression or death due to any cause.
Phase II: Evaluation of Preliminary Anti-tumor Activity - Best Overall Response (BOR)	From first dose of Cycle 1, Day 1 (C1D1) to time to progression (up to 18 months from Last Patient First Visit)	Evaluation of the preliminary anti-tumor activity at the RP2D for AEB071 and MEK162 and at 45 mg BID for MEK162 alone. The best overall response is the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for Progressive Disease (PD) the smallest measurements recorded since the treatment started). In general, the patient's best response assignment will depend on the achievement of both measurement and confirmation criteria. Due to an enrollment halt, the Phase II part of the study was not conducted.
Phase II: Evaluation of Preliminary Anti-tumor Activity - Duration of Response (DOR)	From first dose of Cycle 1, Day 1 (C1D1) to time to progression (up to 18 months from Last Patient First Visit)	Evaluation of the preliminary anti-tumor activity at the RP2D for AEB071 and MEK162 and at 45 mg BID for MEK162 alone. Duration of Response is not reported, due to the enrollment halt, which occurred prior to Phase II of the study.
Phase lb: PK Parameters for AEB071 - Tmax (Cycle 1; Day 1)	Cycle 1 (Day 1)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase lb: PK Parameters for AEB071 - Cmax (Cycle 1; Day 15)	Cycle 1 (Day 15)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase Ib: PK Parameters for MEK162 - AUC0-8hr (Cycle 1; Day 1)	Cycle 1 (Day 1)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase lb: PK Parameters for MEK162 - Tmax (Cycle 1; Day 1)	Cycle 1 (Day 1)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.
Phase Ib: PK Parameters for MEK162 - AUC0-8hr (Cycle 1; Day 15)	Cycle 1 (Day 15)	Blood samples were collected from all patients during Cycle 1 (Days 1 and 15) for pharmacokinetic profiling. On Days 8 and 22 of Cycle 1, trough samples were collected. Additionally, pre-dose samples were collected on Day 1 of Cycle 2 through Cycle 6.

Trial Locations

Locations (3): Memorial Sloan Kettering Cancer Center Dept of Onc..
🇺🇸
New York, New York, United States
Pfizer Investigative Site
🇬🇧
London, United Kingdom
Dana Farber Cancer Institute Dept. Onc
🇺🇸
Boston, Massachusetts, United States