First-in-Human Study of the Safety, Tolerability, and Pharmacokinetic/Pharmacodynamic Profile of VX-984 in Combination With Chemotherapy

Phase 1

Completed

• Conditions: Advanced Solid Tumor
• Interventions: Drug: VX-984 120 mg + PLD 40 mg/m^2; Drug: VX-984 240 mg + PLD 40 mg/m^2; Drug: VX-984 480 mg + PLD 40 mg/m^2; Drug: VX-984 720 mg + PLD 40 mg/m^2

• Registration Number: NCT02644278
• Lead Sponsor: EMD Serono Research & Development Institute, Inc.

Brief Summary

The purpose of this study was to evaluate the safety and tolerability of VX-984 (M9831) administered alone and in combination with pegylated liposomal doxorubicin (PLD), and to determine the maximum tolerated dose (MTD) and preliminary evidence of efficacy of VX-984 in combination with PLD in participants with advanced solid tumors.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2015-12-10
• Study First Submitted QC: 2015-12-28
• Study First Posted: 2015-12-31
• Study Start: 2016-02-29
• Primary Completion: 2017-10-19
• Study Completion: 2017-10-19
• Status Verified: 2019-07
• Results First Submitted: 2019-07-29
• Results First Submitted QC: 2019-07-29
• Last Update Submitted: 2019-07-29
• Results First Posted: 2019-09-09
• Last Update Posted: 2019-09-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 15

Inclusion Criteria

• Participants (male and female for Part A and female for Part B) were at least 18 year of age.

• Part A Participants with histologically or cytologically confirmed malignant advanced solid tumors, who had progressed on at least 1 prior chemotherapy, and for whom either

  1. No standard care available
  2. PLD at the dose and schedule being used might be considered standard of care

• Part B

  1. Participants with histologically confirmed advanced primary endometrial cancer (locally advanced and incurable endometrial cancer that had been treated with surgery and/or radiation or is ineligible for such treatment), or recurrent or metastatic endometrial cancer, and
  2. Completed 1 line of chemotherapy treatment with a platinum-containing regimen in the advanced setting

• Measurable disease according to RECIST criteria (Version 1.1)

• Life expectancy of at least 12 weeks

• Hematological and biochemical indices within acceptable ranges shown at screening.

• Normal left ventricular ejection fraction on screening assessed by transthoracic echocardiogram or multiple gated acquisition (MUGA) scan

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Exclusion Criteria

• Previous radiotherapy (unless brachytherapy), endocrine therapy, chemotherapy, or exposure to investigational medicinal products during the 4 weeks (6 weeks for nitrosoureas and Mitomycin-C) or 4 drug half-lives before the planned administration of the first dose of study drug, whichever is greater. Previous immunotherapy during the 4 weeks before the planned administration of the first dose of study drug.

• For Part B only:

  1. Participants with uterine carcinosarcoma
  2. Prior anthracycline therapy
  3. More than 1 prior chemotherapy regimen (a participant was received first- line carboplatin and taxane and then received the same taxane second- line were considered to have had 1 prior chemotherapy regimen)

• Unresolved toxicity of Common Terminology Criteria for Adverse Events (CTCAE) Grade 2 or greater from previous anti-cancer therapy or radiotherapy

• History of spinal cord compression or brain metastases, unless asymptomatic, treated, stable, and not requiring treatment with steroids for at least 4 weeks before the planned administration of the first dose of study drug. Any history of leptomeningeal metastases.

• Female participants who was pregnant or lactating at Screening, or planned to become pregnant while on study or within 6 months after the last dose of study drug

• Female participants of childbearing potential were adhere to contraception guidelines as outlined in the protocol. Female participants were considered to be of nonchildbearing potential if they had undergone surgical hysterectomy or bilateral oophorectomy or had been amenorrheic for more than 2 years with a screening serum follicle-stimulating hormone (FSH) level within the laboratory's reference range for postmenopausal females

• Male participants with pregnant or lactating partners or partners who planned to become pregnant while on study or within 6 months after the planned administration of the last dose of study drug

• Major surgery ≤4 weeks before first dose of study drug, or incomplete recovery from a prior major surgical procedure

• Cardiac conditions

• Prior bone marrow transplant

• Extensive radiotherapy (to greater than 15% of bone marrow)

• Any other condition that in the investigator's opinion would not make the participant a good candidate for the clinical study,

• Part B: Current active malignancies of other types, with the exception of adequately treated cone-biopsied in situ carcinoma of the cervix uteri and basal or squamous cell carcinoma of the skin. Prior cancer in remission for 2 years or more would not be excluded.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
VX-984 120 mg + PLD 40 mg/m^2	VX-984 120 mg + PLD 40 mg/m^2	-
VX-984 240 mg + PLD 40 mg/m^2	VX-984 240 mg + PLD 40 mg/m^2	-
VX-984 480 mg + PLD 40 mg/m^2	VX-984 480 mg + PLD 40 mg/m^2	-
VX-984 720 mg + PLD 40 mg/m^2	VX-984 720 mg + PLD 40 mg/m^2	-

Primary Outcome Measures

Name	Time	Method
Part A: Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious TEAEs	Baseline up to 28 days after the last dose of study treatment, assessed up to 53.1 weeks	An adverse event (AE) was defined as any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not considered related to the study drug. A serious AE was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Treatment-Emergent adverse events (TEAEs) were defined as AEs that were reported or worsened on or after the start of study drug dosing through the 28-day Safety Follow-up visit. TEAEs included both Serious TEAEs and non-serious TEAEs.
Part A: Number of Participants With Toxicity Grade 3 or Higher in Laboratory Abnormalities	Baseline up to 28 days after the last dose of study treatment, assessed up to 53.1 weeks	The laboratory measurements included hematology and serum chemistry. It had been graded according to National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03 into Grade 1 (mild), Grade 2 (moderate), Grade 3 (severe), Grade 4 (Life-threatening) and Grade 5 = death. Participants with grade 3 or higher were reported.
Part A: Number of Participants With Clinical Significant Abnormalities in Electrocardiogram(ECG) Parameters	Baseline up to 28 days after the last dose of study treatment, assessed up to 53.1 weeks	ECG parameters included heart rate, pulse rate, QRS,QT, RR, QTcB and QTcF. Clinical significance was determined by the investigator. Number of participants with clinical significant abnormalities in ECG parameters reported here.
Part A: Number of Participants Who Experienced Dose Limiting Toxicity (DLT)	Cycle 1 (each cycle is 28 days)	DLT was defined using National cancer Institute Common Toxicity Criteria for Adverse Events Version 4.0 as any of the following toxicities: Grade 4 neutropenia for more than 7 days; Grade greater than or equal to (\>=) 3 febrile neutropenia; Grade 4 or Grade 3 thrombocytopenia with bleeding. Grade \>= 3 uncontrolled nausea/vomiting and/or diarrhea despite adequate and optimal treatment and Grade \>= 3 any non- hematological adverse event (AE), except the aforementioned gastrointestinal events and alopecia.
Part A: Maximum Tolerated Dose (MTD) of VX-984 in Combination With Pegylated Liposomal Doxorubicin (PLD)	Up to Cycle 1 Day 28 (each cycle is 28 days)	The MTD was defined as the combination dose associated with the highest probability that Dose limiting toxicity (DLT) events will occur in 16.6 percent to less than 33.3 percent participants as the combination dose that not exceeded the overdose criterion (more than 25 percent probability that DLT events occurred less than or equal to (\>=) 33 percent of participants. DLT was defined using National Cancer Institute Common Toxicity Criteria for Adverse Events Version 4.0.
Part A: Number of Participants With Clinical Significant Abnormalities in Vital Signs	Baseline up to 28 days after the last dose of study treatment, assessed up to 53.1 weeks	Vital signs assessment included blood pressure, pulse rate and body temperature. Clinical significance was determined by the investigator. Number of participants with clinical significant abnormalities in vital Signs reported here.
Part A: Number of Participants With Clinical Significant Abnormalities Echocardiograms	Baseline up to 28 days after the last dose of study treatment, assessed up to 53.1 weeks	Echocardiogram is a graphic outline of the heart's movement. Clinical significance was determined by the investigator. Number of participants with clinical significant abnormalities in Echocardiograms reported here.

Secondary Outcome Measures

Name	Time	Method
Part A: Maximum Observed Plasma Concentration (Cmax) of VX-984	Pre-dose and at 0.5, 1, 2, 4, 8, and 24 hours post-dose on Day -12 and Day 4 in Cycle 1; Pre-dose and at 0.5, 1, 2, 4 hours post-dose on Day 2 in Cycle 1 (each Cycle is of 28 days)	Pharmacokinetic PK parameter Cmax was obtained directly from the concentration versus time curve.
Part A: Time to Reach Maximum Plasma Concentration (Tmax) of VX-984	Pre-dose and at 0.5, 1, 2, 4, 8, and 24 hours post-dose on Day -12 and Day 4 in Cycle 1; Pre-dose and at 0.5, 1, 2, 4 hours post-dose on Day 2 in Cycle 1 (each Cycle is of 28 days)	Time to reach the maximum plasma concentration (Tmax) was obtained directly from the concentration versus time curve.
Part A: Time to Reach Maximum Plasma Concentration From Zero to 96 Hours Post Dose (tmax0-96h) of Pegylated Liposomal Doxorubicin	Pre-infusion and at 1, 2, 4, 6, 24, 72 and 96 hours after infusion in Cycle 1 (each Cycle is of 28 days)	Tmax is time to reach maximum observed plasma concentration obtained directly from the concentration versus time curve from zero to 96 hours post dose.
Part A: Number of Participants With Best Overall Response Evaluated by Response Criteria Evaluation (RECIST 1.1)	Up to 2 years	The best overall response was defined as the number of participants who had achieved complete response (CR) or partial response (PR) as the best overall response according to radiological assessments as adjudicated by the IRC from randomization until the first occurrence of progressive disease (PD). CR: Complete Response (CR) defined as disappearance of all target and non-target lesions and any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. Partial response (PR) defined as at least a 30% decrease in the sum of diameters of target lesions taking as reference the baseline sum diameters. PD defined as an increase of at least 20% in the sum of the diameters of target lesions, taking as reference the smallest sum of the diameters of target lesions recorded since treatment started.
Part A: Area Under Plasma Concentration (AUC) During a Dosing Interval of VX-984	Pre-dose and at 0.5, 1, 2, 4, 8, and 24 hours post-dose on Day -12 and Day 4 in Cycle 1; Pre-dose and at 0.5, 1, 2, 4 hours post-dose on Day 2 in Cycle 1 (each Cycle is of 28 days)	AUC is the area under the plasma concentration curve within 1 dosing interval.
Part A: Area Under the Plasma Concentration Curve From Time Zero to 96 Hours Post Dose AUC(0-96h) of Pegylated Liposomal Doxorubicin	Pre-infusion and at 1, 2, 4, 6, 24, 72 and 96 hours after infusion in Cycle 1 (each Cycle is of 28 days)	The AUC(0-96h) was estimated by determining the total area under the curve of the concentration versus curve extrapolated from 0 to 96 hours.
Part A: Maximum Observed Plasma Concentration (Cmax0-96h) From Time Zero to 96 Hours Post Dose of Pegylated Liposomal Doxorubicin	Pre-infusion and at 1, 2, 4, 6, 24, 72 and 96 hours after infusion in Cycle 1 (each Cycle is of 28 days)	Cmax is the maximum observed plasma concentration obtained directly from concentration versus time curve from zero to 96 hours
Part A: Minimum Observed Plasma Concentration During Dosing Interval (Cmin) of VX-984	Pre-dose and at 0.5, 1, 2, 4, 8, and 24 hours post-dose on Day -12 and Day 4 in Cycle 1; Pre-dose and at 0.5, 1, 2, 4 hours post-dose on Day 2 in Cycle 1 (each Cycle is of 28 days)	Cmin is minimum observed plasma concentration obtained directly from the concentration versus time curve.