A Study of PDR001 in Combination With LCL161, Everolimus or Panobinostat
- Conditions
- Colorectal Cancer, Non-small Cell Lung Carcinoma (Adenocarcinoma), Triple Negative Breast Cancer, Renal Cell Carcinoma
- Interventions
- Registration Number
- NCT02890069
- Lead Sponsor
- Novartis Pharmaceuticals
- Brief Summary
The purpose of this study was to combine the PDR001 checkpoint inhibitor with several agents with immunomodulatory activity to identify the doses and schedule for combination therapy and to preliminarily assess the safety, tolerability, pharmacological and clinical activity of these combinations.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 298
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Written informed consent prior to any procedure
-
Patients with advanced/metastatic cancer, with measurable disease as determined by RECIST version 1.1, who have progressed despite standard therapy or are intolerant to SOC, or for whom no standard therapy exists. Patients must fit into one of the following groups:
• CRC •NSCLC • TNBC• RCC
-
ECOG ≤ 2
-
Patient must have a site of disease for biopsy, and be a candidate for tumor biopsy according to the institution's guidelines. Patient must be willing to undergo a new tumor biopsy at screening, and again during therapy on this study.
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Prior therapy with PD-1/PDL-1 inhibitors is allowed provided any toxicity attributed to prior PD-1- or PD-L1-directed therapy did not lead to discontinuation of therapy.
- Presence of symptomatic central nervous system (CNS) metastases, or CNS metastases that require local CNS-directed therapy within prior 2 weeks.
- Patients with known hypersensitivity to any of the components of an investigational treatment will be excluded from participation in the corresponding arm but are eligible for participation in other study arm; Patients that have a history of hypersensitivity to rapamycin derivatives will be excluded from participation in the everolimus arm
- History of or current drug-induced interstitial lung disease or pneumonitis grade ≥2
- Out of range lab values as defined in protocol
- Impaired cardiac function or clinically significant cardiac disease
- Active, known or suspected autoimmune disease
- Human Immunodeficiency Virus (HIV), or active Hepatitis C (HCV) virus. Escalation: active Hepatitis B (HBV); Expansion: Patients with Chronic HBV currently on medication will not be excluded.
- Impairment of gastrointestinal (GI) function
- Malignant disease, other than that being treated in this study
- Systemic anti-cancer therapy within 2 weeks of the first dose of study treatment. For cytotoxic agents that have major delayed toxicity and washout period is 6 weeks; prior immunotherapy - washout is 4 weeks
- Active infection requiring systemic antibiotic therapy.
- Patients requiring chronic treatment with systemic steroid therapy, other than replacement dose steroids or treatment with low, stable dose of steroid (<10 mg/day prednisone or equivalent) for stable CNS metastatic disease.
- Patients receiving systemic treatment with any immunosuppressive medication.
- Major surgery within 2 weeks of the first dose of study treatment
- Radiotherapy within 2 weeks of the first dose of study drug
- Participation in an interventional, investigational study within 2 weeks of the first dose of study treatment.
- Presence of ≥ CTCAE grade 2 toxicity (except alopecia, peripheral neuropathy and ototoxicity, which are excluded if ≥ CTCAE grade 3) due to prior therapy.
- Use of hematopoietic colony stimulating growth factors </= 3 weeks prior to first dose
Additional exclusion criteria for PDR001/LCL161
- Patients requiring medications metabolized through CYP3A4/5 and have a narrow therapeutic index or medications that are CYP3A4 substrates that cause QT prolongation
- Patients requiring treatment with strong CYP2C8 inhibitors
Additional exclusion criteria for PDR001/Everolimus
- Patients requiring treatment with moderate CYP3A4 inhibitors
- Patients requiring treatment with a strong CYP3A4 inhibitor or inducer
Additional exclusion criteria for PDR001/Panobinostat-
- Patient who received DAC inhibitors
- Patient needing valproic acid during the study or within 5 days prior to first dose
- Patients requiring medications that are sensitive CYP2D6 substrates areCYP2D6 substrates with a narrow therapeutic index or are anti-arrhythmic drugs/drugs with QT-prolongation risks
- Patients requiring a strong inhibitor or inducer of CYP3A4
- Clinically significant, uncontrolled heart disease and/or recent cardiac event within 6 months prior to study
- Unresolved diarrhea ≥ CTCAE grade 2 or a medical condition associated with chronic diarrhea
- Taking medications with QT prolongation risk or interval or inducing Torsade de pointes
Additional exclusion criteria for PDR001/QBM076-
- Patients requiring medications that are strong inducers or strong inhibitors of CYP3A4
- Patients requiring medications with narrow therapeutic index CYP3A4 substrates
- Women using any form of hormonal contraception (oral, injected, implanted, transdermal) will be excluded (unless they are willing to switch to another effective form of contraception under their physician's guidance)
Additional exclusion criteria for PDR001/HDM201-
- Prior treatment with compounds with the same mode of action as proposed for HDM201, i.e. an inhibition of the interaction of TP53 with HDM2, e.g. RG7112 or CGM097
- Patients who require the following treatments moderate to strong CYP3A4 inhibitors; any substrates of CYP3A4/5 with a narrow therapeutic index
- Moderate to strong CYP3A4 inducers
- Patients having out of range values for:
Absolute neutrophil count (ANC) <1500/µL; Platelets < 100 000/µL
Other protocol-defined inclusion exclusion criteria may apply.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description CRC - PDR001 + LCL161 PDR001 Enrollment to this combination arm is closed to further enrollment. CRC - PDR001 + LCL161 LCL161 Enrollment to this combination arm is closed to further enrollment. NSCLC - PDR001 + LCL161 PDR001 Enrollment to this combination arm is closed to further enrollment. NSCLC - PDR001 + LCL161 LCL161 Enrollment to this combination arm is closed to further enrollment. TNBC - PDR001 + LCL161 PDR001 Enrollment to this combination arm is closed to further enrollment. TNBC - PDR001 + LCL161 LCL161 Enrollment to this combination arm is closed to further enrollment. CRC - PDR001+ Everolimus PDR001 Enrollment to this combination arm is closed to further enrollment. CRC - PDR001+ Everolimus Everolimus Enrollment to this combination arm is closed to further enrollment. NSCLC - PDR001+ Everolimus PDR001 Enrollment to this combination arm is closed to further enrollment. NSCLC - PDR001+ Everolimus Everolimus Enrollment to this combination arm is closed to further enrollment. TNBC - PDR001+ Everolimus PDR001 Enrollment to this combination arm is closed to further enrollment. TNBC - PDR001+ Everolimus Everolimus Enrollment to this combination arm is closed to further enrollment. CRC - PDR001 + Panobinostat PDR001 Enrollment to this combination arm is closed to further enrollment. CRC - PDR001 + Panobinostat Panobinostat Enrollment to this combination arm is closed to further enrollment. NSCLC - PDR001 + Panobinostat PDR001 Enrollment to this combination arm is closed to further enrollment. TNBC - PDR001 + Panobinostat PDR001 Enrollment to this combination arm is closed to further enrollment. TNBC - PDR001 + Panobinostat Panobinostat Enrollment to this combination arm is closed to further enrollment. CRC - PDR001 + QBM076 QBM076 Enrollment to this combination arm is closed to further enrollment. TNBC - PDR001 + QBM076 QBM076 Enrollment to this combination arm is closed to further enrollment. NSCLC- PDR001 + QBM076 QBM076 Enrollment to this combination arm is closed to further enrollment. CRC - PDR001 + HDM201 HDM201 Dose escalation completed, expansion arm. RCC - PDR001 + HDM201 HDM201 Dose escalation completed, expansion arm. NSCLC - PDR001 + Panobinostat Panobinostat Enrollment to this combination arm is closed to further enrollment.
- Primary Outcome Measures
Name Time Method Frequency and severity of treatment-emergent adverse events (AEs) and serious adverse events (SAEs) 6 years Through study completion, an average of 6 months
Changes between baseline and post-baseline laboratory parameters and vital signs 6 years Through study completion, an average of 6 months
Dose intensities 6 years Through study completion, an average of 6 months
Phase 1: Incidence of dose limiting toxicities (DLTs) 5.5 years During the first two cycles Cycle = 28 days
Frequency of dose interruptions and reductions 5.5 years Through study completion, an average of 6 months
- Secondary Outcome Measures
Name Time Method Progression free survival (PFS) per irRC 6 years Maximum and minimum serum concentration of PDR001 (Cmax and Cmin) 6 years Cycle 1 through cycle 6 in treatment period 1 and 2, an average of 6 months
Area under the concentration-time curve calculated to the last concentration point (AUClast) for PDR001, as applicable 6 years Cycle 1 through cycle 6 in treatment period 1 and 2, an average of 6 months
Time to reach max concentration (Tmax) for Panobinostat 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Maximum and minimum Plasma concentrations of QBM076 (Cmax and Cmin) 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Changes from baseline in ECG parameters in patients recieving PDR001 in combination with Panobinostat 6 years Baseline and end of treatment, an average of 6 months
Best overall response (BOR) 6 years per RECIST v1.1
Time to reach max concentration (Tmax) for PDR001 6 years Presence of anti-PDR001 antibodies 6 years Progression free survival (PFS) 6 years per RECIST v1.1
Treatment Free Survival (TFS) 6 years Maximum and minimum plasma concentrations of LCL161 (Cmax and Cmin) 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Maximum and minimum Plasma concentrations of everolimus (Cmax and Cmin) 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Maximum and minimum plasma concentrations of panobinostat (Cmax and Cmin) 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Area under the concentration-time curve calculated to the last concentration point (AUClast) for Panobinostat, as applicable 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Area under the concentration-time curve calculated to the last concentration point (AUClast) for LCL161, as applicable 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Time to reach max concentration (Tmax) for LCL161 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Concentration of anti-PDR001 antibodies 6 years Cycle 1 through cycle 6 in treatment period 1 and 2, an average of 6 months
Area under the concentration-time curve calculated to the last concentration point (AUClast) for Everolimus, as applicable 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Area under the concentration-time curve calculated to the last concentration point (AUClast) for QBM076, as applicable 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Time to reach max concentration (Tmax) for Everolimus 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Maximum and minimum Plasma concentrations of HDM201 (Cmax and Cmin) 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Time to reach max concentration (Tmax) for HDM201 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Time to reach max concentration (Tmax) for QBM076 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Area under the concentration-time curve calculated to the last concentration point (AUClast) for HDM201, as applicable 6 years Cycle 1 through cycle 6 in treatment period 1, an average of 6 months
Trial Locations
- Locations (10)
Huntsman Cancer Institute
🇺🇸Salt Lake City, Utah, United States
Novartis Investigative Site
🇬🇧Oxford, United Kingdom
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
UT Health San Antonio Mays Cancer Center
🇺🇸San Antonio, Texas, United States
Washington University Medical School SC
🇺🇸Saint Louis, Missouri, United States
The Regents of the University of Michigan
🇺🇸Ann Arbor, Michigan, United States
UCLA Santa Monica Hematology / Oncology SC
🇺🇸Santa Monica, California, United States
Sidney Kimmel Comprehensive Cancer Center
🇺🇸Baltimore, Maryland, United States
Seattle Cancer Care Alliance
🇺🇸Seattle, Washington, United States
University of Texas MD Anderson Cancer Center
🇺🇸Houston, Texas, United States