ARRAY 818-103: A Sequential 2-arm, Open-label Phase 1 Study to Evaluate the Effects of Encorafenib in Combination with Binimetinib on the Pharmacokinetics of Losartan, Midazolam, Caffeine, Omeprazole, and Dextromethorphan Administered in a Cocktail Approach and on the Pharmacokinetics of Rosuvastatin in Patients with BRAF V600-mutant Unresectable or Metastatic Melanoma or Other Advanced Solid Tumors
Principal Investigator: Arek Dudek, MD, PhD
Study Sponsor: ARRAY Pharmaceuticals, Inc.
Location: Regions Cancer Care Center (Regions Hospital)
Phase of Study: Phase 1
Purpose of Study: To assess the effect of encorafenib and binimetinib (the study drugs) on the activity of other common drugs. This study will also look at the safety and how you tolerate the study drugs when administered with the other common drugs. These other common drugs are approved by the FDA and include losartan (a drug used to treat high blood pressure), dextromethorphan (a drug used to treat coughs), caffeine (about the same amount as a cup of coffee), omeprazole (a drug used to treat upset stomach), midazolam (a drug used as a sedative), and rosuvastatin (a drug used to treat high cholesterol).
The study drugs are investigational study drugs, meaning that they have not been approved by the United States Food and Drug Administration (FDA).
– Male or female patient, age ≥ 18 years;
– Histologically confirmed diagnosis of locally advanced, unresectable or metastatic cutaneous melanoma or unknown primary melanoma AJCC Stage IIIB, IIIC or IV; or other BRAF V600-mutant advanced solid tumors;
– Presence of BRAF V600E and/or V600K mutation in tumor tissue prior to enrollment, as determined locally using an approved test;
– Evidence of measurable or non-measurable lesions as detected by radiological or photographic methods according to guidelines based on RECIST v. 1.1;
– Patient with unresectable locally advanced or metastatic melanoma who has received no prior treatment or progressed on or after prior systemic therapy. Note: Prior therapy with a BRAF inhibitor (e.g., vemurafenib,dabrafenib, encorafenib and XL281/BMS-908662) and/or a MEK inhibitor (e.g., trametinib, binimetinib, selumetinib, cobimetinib and refametinib) is permitted except in the regimen immediately prior to study entry. Progression during prior BRAF/MEK inhibitor treatment is not required;
– Patient with other (non-melanoma) BRAF V600-mutant advanced solid tumors who has progressed on standard therapy or for whom there are no available standard therapies. Note: Prior therapy with a BRAF inhibitor and/or a MEK inhibitor is permitted except in the regimen immediately prior to study entry.
– Symptomatic brain metastasis. Patients previously treated or untreated for these conditions who are asymptomatic in the absence of corticosteroid and anti-epileptic therapy are allowed. Brain metastases must be stable, with imaging (MRI or CT) demonstrating no current evidence of progressive brain metastases at screening;
– History of reaction to any of the study medications being used in this trial;
– Use, within 2 weeks prior to the start of treatment (Day -14) and through DDI phase (Day 28), of any herbal medications/supplements or any medications or foods that are strong inhibitors or inducers of CYP3A4/5, strong inhibitors of UGT1A1 and substrates of CYP3A4, CYP2C9, CYP1A2, CYP2C19, CYP2D6, BCRP, P-glycoprotein (P-gp), organic anion transporters 1 and 3 (OAT1, OAT3), organic anion transporter 2 (OCT2), OATP1B1 and OATP1B3.
– Consumption of grapefruit, pomegranates, star fruits, Seville oranges or products containing the juice of each starting from Day -14 and through the DDI phase (Day 28), due to potential CYP3A4 interaction with the study drugs. Orange juice is allowed;
– Symptomatic or untreated leptomeningeal disease;
Lisa Wahowske, RN, BSN, OCN
ASTELLAS 8951-CL-0301 (Spotlight)
Principal Investigator: Daniel Anderson, MD
Study sponsor: Astellas
Location: Frauenshuh Cancer Center
Phase of Study: Phase 3
Purpose of study: A study to assess the efficacy of IMAB362 plus mFOLFOX6 compared with placebo plus mFOLFOX6 as first-line treatment of subjects with Claudin (CLDN) 18.2 positive, HER2-negative, locally advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma (Spotlight).
Waivers to the inclusion criteria will NOT be allowed.
– Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written informed consent and privacy language as per national regulations (e.g., HIPAA Authorization for US sites) must be obtained from the subject or legally authorized representative (if applicable) prior to any study-related procedures.
– Subject is considered an adult (e.g., ≥ 18 years of age in the US) according to local regulation at the time of signing the informed consent.
– Subject agrees not to participate in another interventional study while on study treatment.
– A female subject is eligible to participate if she is not pregnant (negative serum pregnancy test at screening; female subjects with elevated serum beta human chorionic gonadotropin (βhCG) and a demonstrated non-pregnant status through additional testing are eligible) and at least 1 of the following conditions applies:
a. Not a woman of childbearing potential (WOCBP) as defined in Appendix 12.3 Contraception Requirements OR
b. WOCBP who agrees to follow the contraceptive guidance as defined in Appendix 12.3 Contraception Requirements throughout the treatment period and for at least 6 months after the final study drug administration.
– Female subject must agree not to breastfeed starting at Screening and throughout the study period, and for 6 months after the final study treatment administration.
– Female subject must not donate ova starting at Screening and throughout the study period, and for 6 months after the final study drug administration.
– A sexually active male subject with female partner(s) who are of childbearing potential must agree to use contraception as detailed in Appendix 12.3 Contraception Requirements during the treatment period and for at least 6 months after the final study drug administration.
– Male subject must not donate sperm starting at Screening and throughout the study period and for 6 months after the final study drug administration.
– Male subject with a pregnant or breastfeeding partner(s) must agree to remain abstinent or use a condom for the duration of the pregnancy or for the time partner is breastfeeding throughout the study period and for 6 months after the final study drug administration.
Disease Specific Criteria:
– Subject has histologically confirmed diagnosis of Gastric or GEJ adenocarcinoma.
– Subject has radiologically confirmed locally advanced unresectable or metastatic disease within 28 days prior to the first dose of study treatment.
– Subject has measurable disease according to RECIST 1.1 within 28 days prior to the first dose of study treatment. For subjects with only 1 measurable lesion and prior radiotherapy, the lesion must be outside the field of prior radiotherapy or must have documented progression following radiation therapy.
– Subject’s tumor expresses CLDN18.2 in ≥ 75% of tumor cells demonstrating moderate to strong membranous staining as determined by central IHC testing.
– Subject has a HER2-Negative tumor as determined by local or central testing on a gastric or GEJ tumor specimen.
Physical or Laboratory Findings
– Subject has ECOG performance status 0 to 1.
– Subject has predicted life expectancy 12 weeks in the opinion of the investigator.
– Subject must meet all of the following criteria based on the centrally analyzed laboratory tests within 14 days prior to the first dose of study treatment. In case of multiple laboratory data within this period, the most recent data should be used to determine eligibility.
a. Hemoglobin (Hgb) ≥ 9 g/dL. NOTE: subject must not have received any growth factor or blood transfusions within 14 days prior to the hematology values obtained at screening. Subjects requiring transfusions to meet eligibility criteria are not eligible.
b. Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
c. Platelets ≥ 100 x 109/L
d. Albumin ≥ 2.5 g/dL
e. Total bilirubin < 1.5 x upper limit of normal (ULN)
f. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN without liver metastases (or ≤ 5 x ULN if liver metastases are present)
g. Estimated creatinine clearance ≥ 30 mL/min
h. PT/international normalized ratio (INR) and PTT ≤ 1.5 x ULN (except for subjects receiving anticoagulation therapy)
Waivers to the exclusion criteria will NOT be allowed.
Subject who meets any of the following exclusion criteria prior to enrollment is not eligible for enrollment:
Prohibited Treatment or Therapies
– Subject has received prior systemic chemotherapy for locally advanced unresectable or metastatic gastric or GEJ adenocarcinoma. However, subject may have received either neo-adjuvant or adjuvant chemotherapy as long as it was completed at least 6 months prior to the first dose of study treatment. Subject may have received treatment with herbal medications that have known antitumor activity > 28 days prior to first dose of study treatment.
– Subject has received radiotherapy for locally advanced unresectable or metastatic gastric or GEJ adenocarcinoma unless the radiotherapy was completed >28 days prior to start of study treatment. Subject who received palliative radiotherapy to peripheral bone metastases ≥14 days prior to start of study treatment and has recovered from all acute toxicities is allowed.
– Subject has received systemic immunosuppressive therapy, including systemic corticosteroids within 14 days prior to first dose of study treatment. Subjects using a physiologic replacement dose of hydrocortisone or its equivalent (defined as up to 30 mg per day of hydrocortisone or up to 10 mg per day of prednisone) or a single dose of systemic corticosteroids are allowed.
– Subject has received other investigational agents or devices within 28 days prior to first dose of study treatment.
Medical History or Concurrent Disease
– Subject has prior severe allergic reaction or intolerance to known ingredients of zolbetuximab or other monoclonal antibodies, including humanized or chimeric antibodies.
– Subject has known immediate or delayed hypersensitivity, intolerance or contraindication to any component of study treatment.
– Subject has prior severe allergic reaction or intolerance to any component of mFOLFOX6.
– Subject has known dihydropyrimidine dehydrogenase (DPD) deficiency. (NOTE: Screening for DPD deficiency should be conducted per local requirements.)
– Subject has gastric outlet syndrome or persistent/recurrent vomiting.
– Subject with recent gastric bleeding or symptomatic subjects with proven gastric ulcers that would exclude the subject from participation per investigator judgment.
– Subject has a known history of a positive test for human immunodeficiency virus (HIV) infection or known active hepatitis B (positive HBs Ag) or C infection. For subjects who are negative for HBs Ag, but HBc Ab positive, an HB DNA test will be performed and if positive the subject will be excluded. Subjects with positive serology but negative HCV RNA test results are eligible.
– Subject has an active autoimmune disease that has required systemic treatment within the past 2 years.
– Subject has active infection requiring systemic therapy that has not completely resolved within 14 days prior to start of study treatment.
– Subject has significant cardiovascular disease, including any of the following:
a. Congestive heart failure (defined as New York Heart Association Class III or IV), myocardial infarction, unstable angina, coronary angioplasty, stenting, coronary artery bypass graft, cerebrovascular accident or hypertensive crisis within 6 months prior to administration of first dose of study drug.
b. History of clinically significant ventricular arrhythmias (i.e., sustained ventricular tachycardia, ventricular fibrillation or Torsades de Pointes)
c. QTc interval > 450 msec for male subjects; QTc interval > 470 msec for female subjects
d. History or family history of congenital long QT syndrome
e. Cardiac arrhythmias requiring anti-arrhythmic medications (Subject with rate controlled atrial fibrillation for > 1 month prior to first dose of study drugs are eligible)
– Subject has known active central nervous system metastases and/or carcinomatous meningitis.
– Subject has known peripheral sensory neuropathy > Grade 1 unless the absence of deep tendon reflexes is the sole neurological abnormality.
– Subject has had a major surgical procedure 28 days prior to the start of study treatment.
a. Subject is without complete recovery from a major surgical procedure 14 days prior to the first dose of study treatment.
– Subject has psychiatric illness or social situations that would preclude study compliance, per investigator judgment.
– Subject has another malignancy for which treatment is required per investigator’s clinical judgment.
– Subject has any concurrent disease, infection or comorbid condition that interferes with the ability of the subject to participate in the study, which places the subject at undue risk or complicates the interpretation of data in the opinion of the investigator.
TAK 981-1002: An Open Label, Dose-Escalation, Phase 1 Study to Evaluate the Safety, Tolerability, and Pharmacokinetics, of TAK-981 in Adult Patients with Metastatic Solid Tumors or Lympho-mas (TAK 981-1002)
Principal Investigator: Arkadiusz Dudek, PhD, MD
Study Sponsor: Takeda Pharmaceuticals
Location: Regions Cancer Care Center
Phase of Study: Phase 1
Purpose of Study: The purpose of this study is to evaluate safety, tolerability and to identify the most appropriate dose of TAK-981 as treatment for patients with cancer. In addition, this study will also serve to obtain information on the amount of study drug in your blood after taking single and/or multiple doses of the study drug.
The main purposes of this study are:
– To determine if TAK-981 is safe in patients with cancer.
– To select the dose for future studies.
– To measure the amount of TAK-981 in your blood.
– To assess the anti-tumor effect of TAK-981.
– To assess how the research drug reaches its target protein (called SUMO activating enzyme). Small Ubiquitin-like
Modifier (or SUMO) proteins are proteins that attach and detach from other proteins. This happens in normal and
tumor cells to modify their function. SUMOylation is the process of adding these SUMO proteins to other proteins.
The process of SUMOylation allows growth of tumor cells, and prevents the immune system from attacking the
tumor. TAK-981 reduces SUMOylation, allowing the immune system to attack the tumor cells.
– To obtain information on how your body reacts to the study drug by looking at biomarkers. Biomarkers are
measurable substances that can be found in different tissues of your body like the blood, skin and the tumor.
– To determine if the amount of TAK-981 in your blood has any impact on your ECG results (heart function test).
TAK-981 is an investigational drug that has not yet been studied in humans. It has not been approved by the FDA (U.S. Food and Drug Administration) or other regulatory authorities for use by the general public. TAK-981 will be investigated in adult patients with metastatic solid tumors or lymphomas for which standard curative treatment or life-prolonging treatment does not exist, is no longer effective or if it cannot be tolerated or is not indicated for you.
– Adult male of female patients >/= 18 years old.
– Eastern Cooperative Group (ECOG) performance status of 0 to 1.
– Patients with histologically confirmed advanced (local regionally recurrent not amenable to curative therapy) or metastatic solid tumors that have no standard therapeutic option with a proven clinical benefit, are intolerant or have refused them, OR
– Patients with relapsed/refractory lymphoma not amenable to therapies with proven clinical benefit or who are intolerant or who refuse them. Patients with low-grade lymphomas such as follicular lymphoma, small lymphocytic lymphoma, lymphoplasmacytoid lymphoma, and marginal zone lymphomas may not need to exhaust all available therapy.
– Adequate bone marrow reserve and renal and hepatic function.
– Treatment with systemic anticancer treatments or investigational products within 14 days before the first dose of study drug or 5 half-lives, whichever is shorter. Patients should have recovered from previous treatment toxicity to Grade 1, baseline (except alopecia and peripheral neuropathy), or the toxicity is considered established as a sequela.
– History of uncontrolled brain metastasis. Patients with brain metastases are allowed if they are previously treated with surgery, whole-brain radiation, or stereotactic radiosurgery and the patients is receiving a corticosteroid dose ≤10 mg/day of prednisone equivalent at the time of receiving the first dose of TAK-981. For asymptomatic patients, screening brain imaging is not required.
– Patient has received extended field radiotherapy ≤4 weeks before the start of treatment (≤2 weeks for limited field radiation for palliation), and who has not recovered to grade 1 or better from related side effects of such therapy (except for alopecia).
– Patient is receiving any live vaccine (eg, varicella, pneumococcus) within 4 weeks of initiation of study treatment.
– History of any of the following ≤6 months before first dose: congestive heart failure New York Heart Association Grade III or IV, unstable angina, myocardial infarction, unstable symptomatic ischemic heart disease, uncontrolled hypertension despite appropriate medical therapy, ongoing symptomatic cardiac arrhythmias of >Grade 2, pulmonary embolism, or symptomatic cerebrovascular events, or any other serious cardiac condition (eg, pericardial effusion or restrictive cardiomyopathy). Chronic atrial fibrillation on stable anticoagulant therapy is allowed.
Lisa Wahowske, RN, BSN, OCN