This open-label, 2-part Phase I/ randomized Phase II multi-center study is conducted to evaluate the safety, tolerability, pharmacokinetics (PK), and clinical activity of afuresertib in combination with carfilzomib versus carfilzomib alone, in subjects with relapsed/refractory MM. Part 1 will evaluate 2 dose levels (125 milligrams \[mg\] and 150 mg of afuresertib) in 16 subjects (approximately 8 in each parallel arm) to determine an optimal dose of afuresertib for administration in combination with carfilzomib in Part 2. If neither of these dose levels are tolerated, an additional dose level of 100mg of afursertib in combination with carfilzomib may be explored in approximately 8 additional subjects. Part 2 was to investigate the safety, and clinical activity of the combination of afuresertib with carfilzomib (determined in Part 1) compared to carfilzomib alone, in approximately 100 subjects (50 in each parallel arm), however the study was terminated after the discontinuation of the single subject following the transition of the afuresertib development program from GSK to Novartis. The reason for the study termination is that the protocol defined study treatment was no longer aligned with the evolving standard of care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
1
Afuresertib will be dosed orally in morning, and will be sourced as opaque, white, size 4, 25 mg capsule and size 1, 100 mg capsules.
Intravenous (IV) Carfilzomib will be sourced in the US from commercial stock. It will be a single-use 60 mg vial as a sterile, white to off-white lyophilized cake or powder
Novartis Investigative Site
Cary, North Carolina, United States
Part1: Number of participants with adverse events (AEs) as a measure of safety
AEs and serious adverse events (SAEs) will be collected from the screening until the follow-up visit
Time frame: Until 4 weeks after the last subject's last dose (LSLD) (Approximately assessed up to 4 years)
Part1: Safety assessed by monitoring the changes in vital signs
Vital signs assessments included temperature, systolic and diastolic blood pressure, temperature and pulse rate measurements
Time frame: Until 4 weeks after the LSLD (Approximately assessed up to 4 years)
Part1: Safety assessed by monitoring the changes in laboratory parameters
Clinical laboratory parameters will include hematology and clinical chemistry
Time frame: Until 4 weeks after the LSLD (Approximately assessed up to 4 years)
Part1: Safety assessed by monitoring the changes in electrocardiograms (ECG)
Single 12-lead ECGs will be obtained over a brief recording period at the start of each cycle
Time frame: Until 4 weeks after the LSLD (Approximately assessed up to 4 years)
Part 2: Progression Free Survivial (PFS)
PFS defined as the interval between the date of randomization and the earliest date of disease progression as assessed by investigator or death due to any cause
Time frame: Until 12 months of follow-up after the LSLD (Approximately assessed up to 6 years)
Part 1: Composite of PK parameters of afuresertib and carfilzomib alone or in combination with each other will be assessed following multiple afuresertib doses and following a single dose of carfilzomib
Peripheral blood will be collected to evaluate PK parameters for Afuresertib (e.g., area under the plasma drug concentration-time curve \[AUC\], maximum observed plasma drug concentration \[Cmax\]) and carfilzomib (e.g., AUC, Cmax)
Time frame: Afuresertib (Cycle 1[C1], any Day[D] between 21-28 and C2 D1): 30 min predose; Carfilzomib (C1 D1 and C2 D1): 30 min predose; end of dosing; post dosing time-points for both treatments: 5 min, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10-12, 14-22, 24 hours (hr)
Part 1: Afuresertib concentrations
Afuresertib concentrations will be assessed in peripheral blood using a sparse sampling strategy
Time frame: C1 D15: predose; 1 to 3 hr and 4 to 6 hr post-dose. C2 D1 and any cycle where disease assessments are obtained: pre-treatment and right before subject leaves clinic for the day (C2 and every 3rd cycle; approximately (approx) assessed up to 4 years)
Part1: Overall response rate (ORR)
ORR is defined as the percentage of subjects with a confirmed stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR), as assessed by investigator using the 2011 recommendations in the International Myeloma Workshop Consensus (IMWC) Panel 1
Time frame: Until 12 months of follow-up after the LSLD (Approximately assessed up to 6 years)
Part1: PFS
PFS is defined as the interval between the date of first dose and the earliest date of disease progression as assessed by investigator or death due to any cause
Time frame: Until 12 months of follow-up after the LSLD (Approximately assessed up to 6 years
Part1: Overall survival (OS)
OS is defined as the time until death due to any cause. Subjects will be followed for up to a maximum of 12 months following the LSLD. Subjects who are alive at 12 months following the LSLD will be censored for OS
Time frame: Until 12 months of follow-up after the LSLD (Approximately assessed up to 8 years
Part1: Duration of response (DOR)
DOR defined for those subjects that achieve ORR as the time from first documented evidence of sCR, CR, VGPR, or PR until first documented disease progression or death
Time frame: Until 12 months of follow-up after the LSLD (Approximately assessed up to 6 years)
Part 2: ORR
ORR defined as the percentage of subjects with a confirmed sCR, CR, VGPR or PR, as assessed by investigator using the 2011 recommendations in the IMWC Panel 1
Time frame: Until 12 months of follow-up after LSLD (Approximately assessed up to 6 years)
Part 2: OS
OS is defined as the time until death due to any cause. Subjects will be followed for up to a maximum of 12 months following the LSLD. Subjects who are alive at 12 months following the LSLD will be censored for OS
Time frame: Until 12 months of follow-up after the LSLD (Approximately assessed up to 8 years
Part 2: DOR
DOR defined for those subjects that achieve ORR as the time from first documented evidence of sCR, CR, VGPR, or PR until first documented disease progression or death
Time frame: Until 12 months of follow-up after LSLD (Approximately assessed up to 6 years)
Part 2: Number of participants with adverse events (AEs) as a measure of safety
AEs and SAEs will be collected from the screening until the follow-up visit
Time frame: Until 4 weeks after the LSLD (Approximately assessed up to 4 years
Part 2: Safety assessed by monitoring the changes in vital signs
Vital signs assessments included temperature, systolic and diastolic blood pressure, temperature and pulse rate measurements
Time frame: Until 4 weeks after the LSLD (Approximately assessed up to 4 years
Part 2: Safety assessed by monitoring the changes in laboratory parameters
Clinical laboratory parameters will include hematology and clinical chemistry
Time frame: Until 4 weeks after the LSLD (Approximately assessed up to 4 years
Part 2: Safety assessed by monitoring the changes in ECG
Single 12-lead ECGs will be obtained over a brief recording period at the start of each cycle.
Time frame: Until 4 weeks after the LSLD (Approximately assessed up to 4 years
Part 2: Afuresertib concentrations
Afuresertib concentrations will be assessed in peripheral blood using a sparse sampling strategy
Time frame: C1 D1: predose; 1-3 hr post-dose. C1 D15: predose; 1-3 hr and 4-6 hr post-dose. C2 D1 and any cycle where assessments are obtained: pre-treatment and right before subject leaves clinic for the day (C2 and every 3rd cycle; approx assessed up to 4 years)
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