BKM120 + Carboplatin + Paclitaxel for Patients With Advanced Solid Tumors

This study is currently recruiting participants. (see Contacts and Locations)
Verified June 2014 by Memorial Sloan-Kettering Cancer Center
Sponsor:
Collaborators:
Novartis Pharmaceuticals
Sai Life Sciences
Information provided by (Responsible Party):
Memorial Sloan-Kettering Cancer Center
ClinicalTrials.gov Identifier:
NCT01297452
First received: February 15, 2011
Last updated: June 9, 2014
Last verified: June 2014
  Purpose

The purpose of this study is to find out the good and bad effects that occur when BKM120 is added to standard chemotherapy with carboplatin and paclitaxel.


Condition Intervention Phase
Solid Tumors
Drug: BKM120 days 1 - 21 plus paclitaxel + carboplatin
Drug: BKM120 (days 1 - 28, ) plus paclitaxel + carboplatin
Drug: BKM120 (days 1-21) + paclitaxel (day 1) + carboplatin (day 1)
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Study of BKM120 + Carboplatin + Paclitaxel for Patients With Advanced Solid Tumors

Resource links provided by NLM:


Further study details as provided by Memorial Sloan-Kettering Cancer Center:

Primary Outcome Measures:
  • To establish the phase II recommended dose of daily oral BKM120 [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
    for patients with advanced solid tumors, BKM120 in combination with two different schedules of paclitaxel and carboplatin.

  • EXPANSION COHORT:To evaluate the safety and tolerability of daily oral BKM120 (100 mg) + paclitaxel (200 mg/m2) + carboplatin (AUC 6), both given intravenously (IV) on day 1 of a 21-day cycle, with pegfilgrastim support [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To describe the safety of BKM120 combined with paclitaxel and carboplatin, [ Time Frame: weekly clinic visits during Cycle 1, on Day 1 of subsequent cycles, ] [ Designated as safety issue: Yes ]
    Patients will be evaluated by MD at weekly clinic visits during Cycle 1, on Day 1 of subsequent cycles, and will have additional evaluations if clinically indicated. Toxicities will be assessed according to NCI common toxicity criteria (CTC) version 4.0

  • To determine the pharmacokinetic profile of daily BKM120. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    when given in combination with carboplatin and paclitaxel. The area under the curve (AUC0→∞), half-life (t½), and maximum concentration (Cmax) for BKM120 will be determined by noncompartmental analysis.

  • To describe and tabulate the radiographic response rate of BKM120 in combination with carboplatin and paclitaxel, [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    there is insufficient sample size to support a formal analysis of response rate. As such, radiographic response data will be tabulated and presented in descriptive form.

  • Correlative Tissue Studies [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    we will calculate the proportion of cases with positive staining of PTEN along with a 95% confidence interval, using the Clopper and Pearson method for exact small sample inference. For Sequenom Analysis, we will calculate the proportion of cases that are positive for each mutation


Estimated Enrollment: 36
Study Start Date: February 2011
Estimated Study Completion Date: February 2015
Estimated Primary Completion Date: February 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: BKM120 days 1 - 21 plus paclitaxel + carboplatin
This will be a single institution phase I study. The primary objectives are to determine the maximum tolerated dose of BKM120 administered with paclitaxel + carboplatin on both a 21-day cycle with growth factor support (Group 1)
Drug: BKM120 days 1 - 21 plus paclitaxel + carboplatin
Patients will receive oral daily BKM120 (days 1 - 21, per dose escalation scheme) plus paclitaxel (175 mg/m2 intravenously, day 1) + carboplatin (AUC 5 intravenously, day 1)on a 21-day cycle. Pegfilgrastim (6 mg/subcutaneously) will be administered on day 2 of each cycle.
Experimental: BKM120 (days 1 - 28, ) plus paclitaxel + carboplatin
This will be a single institution phase I study. The primary objectives are to determine the maximum tolerated dose of BKM120 administered + paclitaxel with carboplatin on a 28-day cycle with growth factor support and a 28-day cycle (Group 2).
Drug: BKM120 (days 1 - 28, ) plus paclitaxel + carboplatin
Patients will receive oral daily BKM120 (days 1 - 28, per dose escalation scheme) plus paclitaxel (80 mg/m2 intravenously, days 1, 8 and 15) + carboplatin (AUC 5 intravenously, day 1) on a 28-day cycle.
Experimental: BKM120 (days 1-21) + paclitaxel (day 1) + carboplatin (day 1)
BKM120 100 mg (days 1 - 21, per dose escalation scheme) plus paclitaxel (200 mg/m2 intravenously, day 1) + carboplatin (AUC 6 intravenously, day 1) on a 21-day cycle. After enrollment to Groups 1 and 2 has been completed and all patients in Group 1 and 2 have completed the DLT monitoring period, up to 6 additional patients will be enrolled in this EXPANSION COHORT.
Drug: BKM120 (days 1-21) + paclitaxel (day 1) + carboplatin (day 1)
BKM120 100 mg (days 1 - 21, per dose escalation scheme) plus paclitaxel (200 mg/m2 intravenously, day 1) + carboplatin (AUC 6 intravenously, day 1) on a 21-day cycle. After enrollment to Groups 1 and 2 has been completed and all patients in Group 1 and 2 have completed the DLT monitoring period, up to 6 additional patients will be enrolled in this EXPANSION COHORT.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Pathologically confirmed recurrent or metastatic advanced solid tumor, for which there is no curative-intent treatment option. Pathology confirmation must be performed at MSKCC.
  • Age ≥ 18 years
  • ECOG performance status ≤ 1
  • Life expectancy of ≥ 12 weeks
  • Adequate bone marrow function as shown by: ANC ≥ 1.5 x 109/L, Platelets ≥ 100 x 109/L, Hemoglobin > 9 g/dL
  • Total calcium (corrected for serum albumin) within normal limits (biphosphonate use for malignant hypercalcemia control is not allowed)
  • Magnesium ≥ the lower limit of normal
  • Adequate liver function.
  • Serum bilirubin must be within the upper limit of normal. (ULN). AST and ALT and Alkaline Phosphatase must be within the range allowing for eligibility. In determining eligibility the more abnormal of the two values (AST or ALT) should be used.
  • Serum creatinine ≤ 1.5 x ULN or 24-hour clearance ≥ 55 mL/min
  • Serum amylase ≤ ULN
  • Serum lipase ≤ ULN
  • Fasting plasma glucose ≤ 140 mg/dL (7.8 mmol/L)
  • Negative serum pregnancy test within 14 days before starting study treatment in women with childbearing potential
  • Ability to swallow oral medication

Exclusion Criteria:

  • Patients who have received prior treatment with a P13K inhibitor.
  • Patients with a known hypersensitivity to BKM120 or to its excipients
  • Patients with untreated brain metastases are excluded. However, patients with metastatic CNS tumors may participate in this trial, if the patient is > 4 weeks from therapy completion (incl. radiation and/or surgery), is clinically stable at the time of study entry and is not receiving corticosteroid therapy
  • Patients with acute or chronic liver, renal disease or pancreatitis
  • Patients with the following mood disorders as judged by the Investigator or a psychiatrist, or as result of patient's mood assessment questionnaire:

    • medically documented history of or active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia, a history of suicidal attempt or ideation, or homicidal ideation (immediate risk of doing harm to others)

      *≥ CTCAE grade 3 anxiety

    • At screening, mood rating scores of ≥ 10 on PHQ-9 and/or ≥ 15 on GAD-7, unless overruled by psychiatrist's assessment Note: The psychiatric judgment overrules the mood assessment questionnaire result/investigators judgment. If mood rating scores do not meet eligibility criteria and/or the investigator deems that a patient has mood disorder that renders the patient ineligible, that patient may not be registered to the study unless there is a subsequent psychiatric clinic consultation in which the psychiatrist overrules the mood assessment questionnaire result/investigator judgment.
  • Patients with diarrhea ≥ CTCAE grade 2
  • Any of the following concurrent severe and/or uncontrolled medical conditions which could compromise participation in the study:
  • ST depression or elevation of ≥ 1.5 mm in 2 or more leads
  • Congenital long QT syndrome
  • History or presence of sustained ventricular arrhythmias or atrial fibrillation
  • Clinically significant resting bradycardia (< 50 beats per minutes) QTc > 480 msec on screening ECG
  • Complete left bundle branch block
  • Right bundle branch block + left anterior hemiblock (bifascicular block)
  • Unstable angina pectoris ≤ 6 months prior to starting study drug
  • Acute myocardial infarction ≤ 6 months prior to starting study drug
  • Other clinically significant heart disease such as congestive heart failure requiring treatment (NYHA Class III or IV) or uncontrolled hypertension (please refer to WHO-ISH guidelines)
  • Patients with uncontrolled diabetes mellitus
  • Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g., active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of BKM120 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection). Patients with unresolved diarrhea will be excluded as previously indicated
  • Patients who have been treated with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GM-CSF) ≤ 2 weeks prior to starting study drug. Erythropoietin or darbepoetin therapy, if initiated at least 2 weeks prior to enrollment, may be continued
  • Patients who are currently receiving treatment with QT prolonging medication with a known risk to induce Torsades de Pointes and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug. Please refer to Appendix E for a list of prohibited drugs.
  • Patient is currently being treated with drugs known to be moderate and strong inhibitors or inducers of isoenzyme CYP3A, and the treatment cannot be discontinued or switched to a different medication prior to starting study drug. Please refer to Appendix B for a list of prohibited CYP 3A4 inhibitors and inducers.
  • Patients who have received systemic corticosteroids ≤ 2 weeks prior to starting study drug. Systemic corticosteroids should not be administered with BKM120 (Usage of steroids as premedications and anti-emetics for paclitaxel and carboplatin, per MSKCC guidelines, is allowed). Steroids given as part of pre-medications for imaging studies are not exclusionary.).
  • Patients who have received chemotherapy or targeted anticancer therapy ≤ 4 weeks (6 weeks for nitrosourea, antibodies or mitomycin-C) prior to starting study drug or who have not recovered from side effects of such therapy (except alopecia)
  • Patients who have received any continuous or intermittent small molecule therapeutics (excluding monoclonal antibodies) ≤ 5 effective half lives prior to starting study drug or who have not recovered from side effects of such therapy (except alopecia)
  • Patients who have received radiotherapy within ≤ 4 weeks prior to registration
  • Patients who have undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  • Patients who are currently taking therapeutic doses of warfarin sodium or any other coumadin-derivative anticoagulant.
  • Patient is currently being treated with olanzapine and/or other drugs known to be moderate and strong inhibitors or inducers of isoenzyme CYP3A, and the treatment cannot be discontinued or switched to a different medication prior to starting study drug.
  • Women who are pregnant or breast feeding or adults of reproductive potential not employing an effective method of birth control. Double barrier contraceptives must be used through the trial by both sexes. Oral, implantable, or injectable contraceptives may be affected by cytochrome P450 interactions, and are therefore not considered effective for this study.
  • Known diagnosis of human immunodeficiency virus (HIV) infection
  • History of another malignancy within 3 years, except cured basal cell carcinoma of the skin or excised carcinoma in situ of the cervix
  • Patient is unable or unwilling to abide by the study protocol or cooperate fully with the investigator
  • More than 2 prior cytotoxic chemotherapy regimens for recurrent or metastatic disease
  • Patients with multifocal peripheral sensory alterations or paresthesias (including tingling) interfering with function, per patient report (example: activities of daily living).
  • Patients receiving other investigational therapies
  • Patients receiving herbal preparations/medications
  • Patients with any prior history of whole pelvic radiation therapy (WPRT)
  • EXPANSION COHORT ONLY: More than one prior cytotoxic chemotherapy regimen (in the setting of recurrent and/or metastatic disease (cytotoxic chemotherapy given as part of neo-adjuvant therapy, adjuvant therapy, or concurrent chemoradiation for curative intent is not included in this exclusion item).
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01297452

Contacts
Contact: Matthew Fury, MD 646-888-4233
Contact: David Hyman, MD 646-888-4544

Locations
United States, New York
Memorial Sloan Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: Matthew Fury, MD, PhD    646-888-4233      
Contact: David Hyman, MD    646-888-4544      
Principal Investigator: Matthew Fury, MD, PhD         
Sponsors and Collaborators
Memorial Sloan-Kettering Cancer Center
Novartis Pharmaceuticals
Sai Life Sciences
Investigators
Principal Investigator: Matthew Fury, MD Memorial Sloan-Kettering Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: Memorial Sloan-Kettering Cancer Center
ClinicalTrials.gov Identifier: NCT01297452     History of Changes
Other Study ID Numbers: 10-192
Study First Received: February 15, 2011
Last Updated: June 9, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by Memorial Sloan-Kettering Cancer Center:
BKM120
CARBOPLATIN
TAXOL (PACLITAXEL)
Chemotherapy
10-192

Additional relevant MeSH terms:
Neoplasms
Carboplatin
Paclitaxel
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Phytogenic

ClinicalTrials.gov processed this record on July 26, 2014