Open-label, multicentre phase Ib/IIa study of AZD2014 administered with selumetinib. There are two parts to this study: a dose-escalation part in treatment-refractory advanced solid tumours and a subsequent separate expansion cohort part for TNBC, squamous cell lung cancers, non-squamous cell lung cancers with KRAS mutations and non-squamous cell lung cancers with wild-type KRAS
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
118
AZD2014 is a dual inhibitor of both mTORC1 (rapamycin-sensitive) and mTORC2 (rapamycin insensitive); compared to rapalogues, AZD2014 has a broader range of growth inhibitory activity in preclinical models based on a more profound mTORC1 inhibition and the additional inhibition of mTORC2. AZD2014 is currently in phase 2 studies in renal cell cancers and metastatic breast cancer.
Selumetinib (AZD6244, ARRY-142886) is an orally available, potent, selective, non-ATP competitive inhibitor of MEK1/MEK2 kinases. Selumetinib has demonstrated clinical efficacy in pre-treated KRAS-mutant NSCLC, leading to a significantly improved progression-free survival in combination with docetaxel compared to docetaxel alone.
University Hospitals Birmingham NHS Foundation Trust
Birmingham, United Kingdom
Barts Health NHS Trust
London, United Kingdom
University College London Hospitals NHS Foundation Trust
London, United Kingdom
Christie NHS Foundation Trust
Manchester, United Kingdom
Establish feasible dose levels and regimens of AZD2014 and selumetinib when given in combination by close observation of any dose limiting toxicities
Dose limiting toxicity is defined as occurrence of any of the following toxicities during the first 21 days of treatment: * Any grade \>3 non-haematological toxicity (excluding nausea, vomiting or diarrhoea) * Grade 3 nausea, vomiting or diarrhoea lasting \>48 hours despite supportive care or any Grade 4 hause, vomiting or diarrhoea * Grade 4 neutropenia lasting \>7days or febrile neutropenia * Grade 3 thrombocytopenia with bleeding or grade 4 thrombocytopenia * Inability to receive at least 75% of the planned doses due to unresolved toxicity * Any treatment delays for \>14 days due to unresolved toxicity NB: This primary outcome relates to the Phase Ib part of study.
Time frame: First 21 days of treatment.
Assess clinical activity, as measured by disease control rate, of AZD2014 in combination with selumetinib.
Disease control rate is defined as number of patients with complete or partial response or stable disease maintained \>12weeks (as assessed by the site radiologist and/or investigator, using RECIST 1.1) divided by the number of patients in the analysis. Patients without a post-baseline tumour assessment will be considered to have no disease control. NB: This primary outcome relates only to the Phase IIa part of this study
Time frame: Day 1 to > 12 weeks.
Single dose and/or multiple dose AZD2014 PK Tmax parameters will be used to determine the PK of AZD2014 when given in combination with selumetinib.
Time frame: Until Day 9
Single dose and/or multiple dose AZD2014 PK Cmax parameter will be used to determine the PK of AZD2014 when given in combination with selumetinib.
Time frame: Until Day 9
Single dose and/or multiple dose AZD2014 PK AUC parameters will be used to determine the PK of AZD2014 when given in combination with selumetinib.
Time frame: Until Day 9
Assess clinical activity of AZD2014 and Selumetinib, as measured by objective response rate.
Objective response, defined as a complete or partial response (as assessed by the site radiologist and/or investigator, using RECIST 1.1) divided by the number of patients of risk
Time frame: 12 weeks.
Assess clinical activity of AZD2014 and Selumetinib, as measured by change in tumour size.
Average change (%) in tumour size at 12 weeks compared to baseline, as assessed by RECIST 1.1; tumour size is defined as the sum of the diameters of the target lesion.
Time frame: 12 weeks.
To assess the safety and tolerability of AZD2014 when given in combination with selumetinib by the continuous assessment of Adverse Events.
i.e. Incidence of serious adverse events; Incidence of Grade 3 and 4 adverse events; Incidence of all adverse events of all grades; Adverse events leading to discontinuation of the study medication; Clinically significant changes in vital signs and clinical laboratory results during and following study drug administration; Clinically significant changes in ECG measurements
Time frame: A median time of 12 weeks.
Overall survival defined as the time from date of registration to the date of death due to any cause will be used to assess the efficacy of AZD2014 when given in combination with selumetinib.
Time frame: A median time of 12 weeks.
Duration of response will be used to assess of AZD2014 when given in combination with selumetinib.
Duration of response defined as the time from first documentation of CR or PR to disease progression (RECIST v1.1) or death from any cause, whichever occurs first.
Time frame: A median time of 12 weeks.
Single dose and/or multiple dose of AZD2014 and selumetinib PK Tmax parameters will be used to investigate the PK of Selumetinib when given in combination with AZD2014.
Time frame: Until Day 9
Single dose and/or multiple dose of AZD2014 and selumetinib PK Cmax parameters will be used to investigate the PK of Selumetinib when given in combination with AZD2014.
Time frame: Until Day 9
Single dose and/or multiple dose of AZD2014 and selumetinib PK AUC parameters will be used to investigate the PK of Selumetinib when given in combination with AZD2014.
Time frame: Until Day 9
Progression-free survival (PFS) will be used to assess the efficacy of AZD2014 when given in combination with selumetinib.
PFS defined as the time from the date of registration to the date of first documented tumour progression (RECISTv1.1) or death from any cause, whichever occurs first.
Time frame: A median time of 12 weeks.
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