The purposes of this study are to evaluate the safety and tolerability of sapanisertib (MLN0128) milled active pharmaceutical ingredient (API) capsules administered both as a single agent and in combination with paclitaxel, to characterize the effect of a high-fat meal on the pharmacokinetics (PK) of sapanisertib milled API capsules, and to characterize the PK of sapanisertib milled API capsules when administered on an empty stomach approximately 24 hours after paclitaxel infusion.
The drug being tested in this study is called sapanisertib (MLN0128). Sapanisertib is being tested to assess its safety and tolerability when administered alone or in combination with paclitaxel in people who have nonhematologic malignancies. Sapanisertib is also being tested to characterize its PK properties (how is processed by the body) when administered with a high-fat meal compared to on an empty stomach. This study will look at side effects and lab results in people who take sapanisertib with or without paclitaxel. This open label study enrolled 61 patients. Participants receiving only sapanisertib will participate in a 6-day PK Run-In Period where sapanisertib 4 mg capsules are administered under fasted conditions on Days 1 and 4, and with a high-fat breakfast on Day 3. The main treatment period will begin within 14 days from Day 6 of the PK Run-In Period. In the main treatment period participants will receive sapanisertib 4 mg daily in a 28-day Cycle for up to 12 cycles. Participants in the treatment arm receiving sapanisertib and paclitaxel will not have a PK Run-In Period and will receive sapanisertib 6 mg daily on Days 2-4, 9-11, 16-18, and 23-25 in a 28-day Cycle for up to 12 cycles and paclitaxel 80 mg/m\^2 intravenously (IV) on Days 1, 8, and 15 in 28-day Cycle, for up to 12 cycles. The dose of sapanisertib may be modified based on safety and tolerability during each 28-day cycle in either treatment arm. This multi-centre trial will be conducted in the United States. The overall time to participate in this study is up to 15 months. Participants in the sapanisertib only arm will make up to 32 visits to the clinic and participants in the sapanisertib and paclitaxel arm will make up to 26 visits to the clinic. All participants will make a final visit to the clinic 30 days after the last dose of study drug for a follow-up assessment.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
61
Sapanisertib capsules
Paclitaxel injection
Unnamed facility
Scottsdale, Arizona, United States
Unnamed facility
Sarasota, Florida, United States
Unnamed facility
Oklahoma City, Oklahoma, United States
Unnamed facility
Germantown, Tennessee, United States
Unnamed facility
Nashville, Tennessee, United States
Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
An 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. An AE can therefore be any unfavorable and unintended sign (example, a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A TEAE is defined as an adverse event with an onset that occurs after receiving study drug. An SAE is defined as an untoward medical occurrence, significant hazard, contraindication, side effect or precaution that at any dose: 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.
Time frame: From Day 1, Cycle 1 through 30 days after the last dose of study drug (up to 15 months)
Geometric Mean Ratio of Cmax: Maximum Observed Plasma Concentration of Sapanisertib Milled Active Pharmaceutical Ingredient (API) Capsules Under Fasted and Fed Conditions
Time frame: Days 3 and 5 predose and at multiple time points (up to 24 hours) post-dose
Geometric Mean Ratio of AUC(0-last): Area Under the Plasma Concentration Curve From Time Zero to the Time of the Last Quantifiable Concentration of Sapanisertib Milled API Capsules Under Fasted and Fed Conditions
Time frame: Days 3 and 5 predose and at multiple time points (up to 24 hours) post-dose
Geometric Mean Ratio of AUC(0-inf): Area Under the Plasma Concentration-Time Curve From Time 0 to Infinity for Sapanisertib Milled API Capsules Under Fasted and Fed Conditions
Time frame: Days 3 and 5 predose and at multiple time points (up to 24 hours) post-dose
Cmax: Maximum Observed Plasma Concentration of Sapanisertib Milled API Capsules Under Fasted Conditions Approximately 24 Hours After Paclitaxel Infusion
Time frame: Cycle 1, Day 2 pre-dose and at multiple time points (up to 8 hours) post-dose
Tmax: Time to Reach the Maximum Plasma Concentration of Sapanisertib Milled API Capsules Under Fasted Conditions Approximately 24 Hours After Paclitaxel Infusion
Time frame: Cycle 1, Day 2 pre-dose and at multiple time points (up to 8 hours) post-dose
AUC(0-8): Area Under the Plasma Concentration Curve From Time Zero to 8 Hours Post-dose for Sapanisertib Milled API Capsules Under Fasted Conditions Approximately 24 Hours After Paclitaxel Infusion
Time frame: Cycle 1, Day 2 pre-dose and at multiple time points (up to 8 hours) post-dose
Geometric Mean Ratio of Cmax: Maximum Observed Plasma Concentration of Sapanisertib Milled Versus Unmilled API Capsules Under Fasted Conditions
Time frame: Days 1 and 3 pre-dose and at multiple time points (up to 24 hours) post-dose
Geometric Mean Ratio of AUC(0-last): Area Under the Plasma Concentration Curve From Time Zero to the Time of the Last Quantifiable Concentration for Sapanisertib Milled Versus Unmilled API Capsules Under Fasted Conditions
Time frame: Days 1 and 3 pre-dose and at multiple time points (up to 24 hours) post-dose
AUC(0-inf): Area Under the Plasma Concentration-Time Curve From Time 0 to Infinity for Sapanisertib Milled Versus Unmilled API Capsules Under Fasted Conditions
Time frame: Days 1 and 3 pre-dose and at multiple time points (up to 24 hours) post-dose
Overall Response Rate Based on Response Evaluation Criteria in Solid Tumors (RECIST)
ORR is defined as the percentage of participants with complete response (CR) or partial response (PR) using Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1. CR: Disappearance of all target lesions, non-target lesions, no new lesions, and normalization of tumor marker level. PR: At least a 30% decrease in the sum of diameters of target lesions, no progression in non-target lesion, and no new lesions.
Time frame: Baseline then every 2 cycles beginning at Cycle 3, Day 1, until disease progression, death or end of study (Up to 14 months)
Progression Free Survival (PFS)
PFS is defined as the time from the date of first study drug administration to the date of first documented PD or death due to any cause. PD was based on response evaluation criteria in solid tumors (RECIST V1.1), defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
Time frame: Baseline then every 2 cycles beginning at Cycle 3, Day 1, until disease progression, death or end of study (Up to 14 months)
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Clinical Benefit Response (CBR)
CBR is defined as the percentage of participants with complete response (CR) or partial response (PR) or stable disease (SD) using Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1. CR: Disappearance of all target lesions, non-target lesions, no new lesions, and normalization of tumor marker level. PR: At least a 30% decrease in the sum of diameters of target lesions, no progression in non-target lesion, and no new lesions. SD is neither shrinkage by greater than or equal to 30% of the sum of the longest diameter of target lesions or the increase of lesions by greater than or equal to 20% of the sum of the longest diameter of target lesions.
Time frame: Baseline then every 2 cycles beginning at Cycle 3, Day 1, until disease progression, death or end of study (Up to 14 months)
Change From Baseline in Tumor Volume/Size
Changes in tumor size and volume will be determined by measurements from computed tomography (CT) and magnetic resonance imaging (MRI) scans.
Time frame: From Cycle 1 Day -14 to 14 months