Dose Escalation Study of MLN0128 in Combination With Paclitaxel, With/Without Trastuzumab, in Subjects With Advanced Solid Malignancies

Millennium Pharmaceuticals, Inc.68 enrolled

Overview

This is a Phase I, open label, dose escalation study of oral administration of MLN0128 in combination with paclitaxel, with/without trastuzumab, in participants with advanced solid malignancies.

This is a Phase I, open-label study consisting of a dose escalation phase in advanced solid malignancies to determine the maximum tolerated dose (MTD) of oral administration of MLN0128 in 1 or more dosing schedules, combined with paclitaxel on Days 1, 8 and 15 of each cycle, followed by an expansion phase for further safety and preliminary efficacy. Once the MTD is determined for each of the dosing schedules evaluated, a dose and schedule will be selected for the expansion phase, which may enroll participants into 2 arms in parallel: * Arm A will consist of HER2- unknown cancer participants receiving MLN0128+paclitaxel * Arm B will consist of HER2+ cancer participants receiving MLN0128+paclitaxel plus weekly trastuzumab

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Advanced Solid Malignancies Hematologic Malignancies

Interventions

MLN0128DRUG

MLN0128 capsules

paclitaxelDRUG

paclitaxel intravenous infusion

trastuzumabDRUG

trastuzumab intravenous infusion

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Voluntary written consent * Locally advanced or metastatic solid tumors with the exception of primary brain tumor, and have failed or are not eligible for standard of care therapy * Eastern Cooperative Oncology Group (ECOG) performance status 0-1 * Ability to swallow oral medications * For women of child-bearing potential, negative serum or urine pregnancy test within 14 days prior to the first study drug administration and use of physician-approved method of birth control from 30 days prior to 30 days following the last study drug administration * Male participants must be surgically sterile or must agree to use physician-approved contraception during the study and for 30 days following the last study drug administration * Clinical laboratory values as specified in the protocol * For expansion phase (Arm A) - HER2-/unknown participants will be enrolled * For expansion phase (Arm B) - HER2+ cancer participants will be enrolled Exclusion Criteria: * Diagnosis of primary brain tumor * Have received prior cancer or other investigational therapy within 2 weeks prior to the first administration of study drug * Known impaired cardiac function or clinically significant cardiac disease * Known treatment with systemic corticosteroid within one week prior to the first administration of study drug * Diabetes mellitus * Human immunodeficiency virus (HIV) infection * Known active cardiovascular disease condition as specified in protocol * Pregnancy (positive serum or urine pregnancy test) or breast feeding * Malabsorption due to prior gastrointestinal (GI) surgery, GI disease * Other clinically significant co-morbidities Please note that there are additional inclusion and exclusion criteria. The study center will determine if you meet all of the criteria. Site personnel will explain the trial in detail and answer any question you may have if you do qualify for the study. You can then decide whether or not you wish to participate. If you do not qualify for the trial, site personnel will explain the reasons

Locations (3)

Unnamed facility

Fort Myers, Florida, United States

Unnamed facility

Oklahoma City, Oklahoma, United States

Unnamed facility

Nashville, Tennessee, United States

Outcomes

Primary Outcomes

Dose Escalation Phase: Maximum Tolerated Dose (MTD)

MTD is the highest dose level at which the participants tolerate treatment without dose-limiting toxicities during the first cycle (28 days) of therapy.

Time frame: Cycle 1: Days 1 to 28

Dose Escalation Phase: Number of Participants With at Least 1 Dose Limiting Toxicity (DLT)

DLT was defined as any of the following occurring during Cycle 1 (Days 1-28) and attributable to MLN0128P: Grade ≥ 3 nonhematologic toxicity; Grade 3 thrombocytopenia with hemorrhage; Grade 4 neutropenia lasting \> 7 days in the absence of growth factor support; Grade 4 neutropenia of any duration associated with fever 38.5 degrees C and/or infection; Any other Grade 4 hematologic toxicity; Inability to administer at least 75 % of doses of MLN0128 within Cycle 1 due to drug-related toxicity; Any clinically significant occurrence which the investigators and sponsor agree would place participants at undue safety risk; Participants who experienced an adverse event (AE) that met the definition for a DLT.

Time frame: Cycle 1: Days 1 to 28

Objective Response Rate (ORR)

ORR was defined as the percentage of participants with Complete Response (CR) and Partial Response (PR) based on Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). Each cycle was a 28 day cycle. CR was defined as the disappearance of all target lesions and for non-target lesions, the disappearance of all non-target lesions and normalization of tumor marker level. PR was defined of at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD and for non-target lesions.

Time frame: At screening and thereafter every 2 cycles of treatment until disease progression (Up to 65.8 weeks)

Percentage of Participants With Treatment Emergent Adverse Events (AEs), Serious Adverse Events(SAEs), AEs Resulting in Discontinuation of MLN0128 and Fatal AEs Within 30 Days of Last Dose of Study Drug

An Adverse Event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug. A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant.

Data from ClinicalTrials.gov

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Secondary Outcomes

Cmax: Maximum Observed Plasma Concentration for MLN0128

Participants in the 6 mg QD×3d QW and 9 mg QD×3d QW were dosed with MLN0128 in conjunction with paclitaxel during Cycle 1 and Cycle 2 when PK was collected. Participants in the 7 mg QD×3d QW cohorts were dosed with paclitaxel during Cycle 1, but were subsequently switched to MLN0128 being dosed 24 hours after paclitaxel infusion Cycle 2 (i e, C2D2). In all the other dosing cohorts, MLN0128 was dosed 24 hours after paclitaxel infusion. Cycle 1: Data was collected at Day 1 for the 6, 7 and 9 mg QD×3d QW arms and at Day 2 for the 8 and 10 mg QD×3d QW, 7 mg QD×5d QW, 30 and 40 mg QW arms. Cycle 2: Data was collected at Day 1 for the 6 and 9 mg QD×3d QW arms and at Day 2 for the 7,8 and 10 mg QD×3d QW, 7 mg QD×5d QW, 30 and 40 mg QW arms.