This is a phase I, open-label, multicentre study of AZD8186 administered orally in patients with advanced castrate-resistant prostate cancer (CRPC), squamous non-small cell lung cancer (sqNSCLC), triple negative breast cancer (TNBC) and known PTEN-deficient/mutated or PIK3CB mutated/amplified advanced solid malignancies as monotherapy and in combination with abiraterone acetate or AZD2014.
This is a phase I, open-label, multicentre study of AZD8186 administered orally in patients with advanced castrate-resistant prostate cancer (CRPC), squamous non-small cell lung cancer (sqNSCLC), triple negative breast cancer (TNBC) and known PTEN-deficient/mutated or PIK3CB mutated/amplified advanced solid malignancies. The study design allows an escalation of dose with intensive safety monitoring to ensure the safety of the patients. There are 4 parts to this study: Part A, monotherapy dose escalation, Part B, monotherapy expansion cohort(s) in PTEN deficient patients at the monotherapy intended therapeutic dose(s) and schedule(s), Part C, AZD8186 added to abiraterone accetate (with prednisone) treatment - dose/ schedule finding followed by expansion phase in PTEN-deficient/mutated or PIK3CB mutated mCRPC and Part D, AZD8186 in combination with AZD2014 (a novel dual mTORC1/2 inibitor) dose/schedule finding followed by expansion phase in PTEN-deficient/mutated or PIK3CB mutated TNBC.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
147
The initial schedule will use intermittent dosing of AZD8186. Dose, frequency and schedule in subsequent cohorts may be modified in response to safety, tolerability, pharmacokinetic and preclinical data.
Part B will be at a dose(s) and schedule(s) at or below from Part A
Dose and schedule finding of AZD8186 added to approved labelled dose of abiraterone acetate (with prednisone).
Research Site
Boston, Massachusetts, United States
Research Site
Detroit, Michigan, United States
Research Site
New York, New York, United States
Safety and tolerability
Assess safety and tolerability of AZD8186 when given as monotherapy or in combination with abiraterone acetate (with prednisone) or with AZD2014 by measuring AEs, SAE (incl death), safety measures incl ECG, physical exam, pulse, blood pressure, weight, lab variables
Time frame: Routine safety assessments, throughout the period that patients receive AZD8186 up to 30 days following discont of last dose of study treatment.
Part A: The number of evaluable patients with dose limiting toxicities (DLTs).
Measure the number of evaluable patients with reported dose limiting toxicities (DLTs) at escalating dose levels and different intermittent and continuous dose schedules of AZD8186 monotherapy
Time frame: DLTs assessed during the first 21 days of multiple dosing.
Part A, B, C + D: Antitumor activity of AZD8186 monotherapy or in combination
Evaluation of tumour response using RECIST 1.1 or Prostate Cancer Clinical Trials Working Group (PCWG2) criteria for those patients with prostate cancer
Time frame: Every 12 weeks (non prostate patients) or every 6 weeks (prostate patients) from baseline up to disease progression or withdrawal of consent
Part A, B, C and D: Anti-tumour activity of AZD8186 monotherapy or in combination
Measurement of changes in circulating prostate-specific antigen (PSA) and circulating tumour cells (CTC) enumeration in pts with prostate cancer.
Time frame: PSA at Screening, Days 1, 8 & 15 then every 28 days, discontinuation of treatment (on average after 4 months), 30-day follow-up: CTC enumeration Days 1, 56 & 84, then every 12 weeks, at discontinuation (on average after 4 months).
Part A + B: Plasma concentrations of AZD8186 and pharmacokinetic parameters (Cmax, tmax, AUC, terminal rate constant, clearance, half life, volume of distribution and mean resistance time)
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Dose \& schedule finding of AZD8186 in combination with AZD2014
Combination AZD8186/ AZD2014 dose expansion at dose determined in Part D1
Dose expansion of AZD8186 at dose determined in Part C1 added to approved dose of abiraterone acetate (with prednisone)
Research Site
Seattle, Washington, United States
Research Site
Madison, Wisconsin, United States
Research Site
Toronto, Ontario, Canada
Research Site
Barcelona, Spain
Research Site
Barcelona, Spain
Research Site
Pozuelo de Alarcón, Spain
Research Site
Cambridge, United Kingdom
...and 3 more locations
Blood samples will be collected at multiple timepoints on 2 intense PK collection days, with sparse sampling on additional days.
Time frame: Prior to first dose and during first 28 days of treatment
Part A + B: 4 beta-hydroxy cholesterol concentration in blood samples.
Understanding of the CYP3A4 induction potential of AZD8186
Time frame: Blood samples will be collected from all patients for 4 beta-hydroxy cholesterol concentration measurements pre-dose day 1 and pre-morning dose day 22 in both Part A and B.
Part B: Obtaining a preliminary assessment of the antitumour activity of AZD8186 as monotherapy
Evaluation of proof of mechanism biomarkers in PTEN-deficient TNBC or mCRPC tumour tissue
Time frame: Paired tumour biopsies will be collected; one prior to treatment and the other during treatment (after at least 3 consecutive days of dosing 2-4 hours post-dose during 2nd week of trreatment)
Part B: Obtaining a preliminary assessment of AZD8186 drug effect in the tumour
Evaluation of pharmacodynamics biomarker changes in tumour tissue
Time frame: Paired tumour biopsies will be collected; one prior to treatment and the other during treatment (after at leat 3 consecutive days of dosing 2-4 hours post-dose in the second week of treatment)
Part A: Urine concentrations of AZD8186 and pharmacokinetic parameters (Cmax, tmax, AUC, terminal rate constant, clearance, half life, volume of distribution and mean residence time)
Evaluation of the pharmacokinetics of AZD8186
Time frame: Urine samples will collected at multiple time points: Day 1 (predose, 15min post dose, 30min post dose); Last dosing day during week 3 (predose and 15min post dose)
Part C: safety and tolerability assessed by dose limiting toxicity of AZD8186 with abiraterone acetate (and prednisone)
Dose limiting toxicity of AZD8186 when given at different doses and schedules in combination with abiraterone (with prednisone)
Time frame: DLTs assessed during the first 21 days of multiple dosing
Part C: pharmacokinetics of and exposure to AZD8186, its major metabolite M1, and abiraterone
Assess the impact of co-administration on pharmacokinetics of and exposure to AZD8186, its major metabolite M1, and abiraterone
Time frame: Blood samples will be collected at multiple timepoints on 2 intense PK collection days between screening and the end of the first 28 days of combination treatment.
Part C: steady state exposure to abiraterone
Measure the steady state exposure to abiraterone in the absence and presence of steady state AZD8186
Time frame: Blood samples will be collected at multiple timepoints on 2 intense PK collection days between screening and the end of the first 28 days of combination treatment.
Part C: steady state exposure of AZD8186 in combination with abiraterone acetate
Measure the steady state exposure of AZD8186 in combination with abiraterone acetate and compare to previous steady state exposures when administered as a monotherapy
Time frame: Blood samples will be collected at multiple timepoints on 2 intense PK collection days between screening and the end of the first 28 days of combination treatment.
Part D: Measure the dose limiting toxicity of AZD8186 in combination with AZD2014.
Safety and tolerability of the combination of AZD8186 and AZD2014
Time frame: DLTs assessed during the first 21 days of multiple dosing
Part D: Single dose and multiple dose pharmacokinetics of and assess exposure to AZD8186, its major metabolite M1, and AZD2014 when co-administered
Measure the pharmacokinetics of and exposure to AZD8186, its major metabolite M1, and AZD2014 when co-administered
Time frame: Blood samples will be collected at multiple timepoints on intense PK collection days for AZD8186 and AZD2014 monotherapy run-in, cycle 0 (single dose), day 9 (multiple dose)
Part D: Measure the exposure to AZD2014 following the last weekly dose of AZD2014 in the absence and presence of multiple dose AZD8186.
Assessment of exposure to AZD2014 in absence and presence of multiple dose AZD8186
Time frame: Blood samples will be collected at multiple timepoints on intense PK collection days for AZD8186 and AZD2014 monotherapy run-in, cycle 0 (single dose), Day 9 of treatment (multiple dose)
Part D: Measure the exposure on the 4th administred dose of AZD8186 in the absence and presence of multiple dose AZD2014
Assessment of exposure of AZD8186 in absence and presence of multiple dose AZD2014
Time frame: Blood samples will be collected at multiple timepoints on intense PK collection days for AZD8186 and AZD2014 monotherapy run-in, cycle 0 (single dose), day 9 (multiple dose)