Phase 1 Pharmacokinetics Study of Oral IXAZOMIB in Patients With Advanced Nonhematologic Malignancies or Lymphoma

This study is currently recruiting participants. (see Contacts and Locations)
Verified June 2014 by Millennium Pharmaceuticals, Inc.
Sponsor:
Information provided by (Responsible Party):
Millennium Pharmaceuticals, Inc.
ClinicalTrials.gov Identifier:
NCT01454076
First received: October 13, 2011
Last updated: June 24, 2014
Last verified: June 2014
  Purpose

This is an open-label, multicenter, sequential, 5-arm, phase 1 study of oral IXAZOMIB designed to assess drug-drug interaction with ketoconazole (Arm 1), the relative bioavailability of 2 capsule formulations of IXAZOMIB (Arm 2), food effect (Arm 3), drug-drug interaction with rifampin (Arm 4), and drug-drug interaction with clarithromycin (Arm 5) in patients with advanced nonhematologic malignancies or lymphoma.


Condition Intervention Phase
Nonhematologic Malignancies
Lymphoma
Drug: IXAZOMIB Capsule B formulation
Drug: IXAZOMIB Capsule A formulation
Drug: ketoconazole
Drug: rifampin
Drug: Drug: clarithromycin
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase 1 Study of Oral IXAZOMIB (MLN9708) to Assess Relative Bioavailability, Food Effect, Drug-Drug Interaction With Ketoconazole, Clarithromycin or Rifampin; and Safety and Tolerability in Patients With Advanced Nonhematologic Malignancies or Lymphoma

Resource links provided by NLM:


Further study details as provided by Millennium Pharmaceuticals, Inc.:

Primary Outcome Measures:
  • Arm 1: Ratio of geometric mean Cmax and AUC0-tlast of IXAZOMIB administered as Capsule B formulation with ketoconazole versus when administered as a single agent and 90% confidence intervals (CI) [ Time Frame: Cycle 1: Days 1-28 ] [ Designated as safety issue: No ]
    Arm 1: Effect of ketoconazole on the single-dose pharmacokinetics of IXAZOMIB administered as Capsule B formulation

  • Arm 2: Ratio of geometric mean Cmax and AUC0-tlast of Capsule B formulation versus Capsule A formulation and 90% CI [ Time Frame: Cycle 1: Days 1-28 ] [ Designated as safety issue: No ]
    Arm 2: Relative bioavailability of a Capsule B formulation of IXAZOMIB in reference to Capsule A formulation

  • Arm 3: Capsule B formulation ratio of geometric mean Cmax and AUC0-tlast of IXAZOMIB administered as Capsule B formulation with food versus without food and 90% CI [ Time Frame: Cycle 1: Days 1-28 ] [ Designated as safety issue: No ]
    Arm 3: Effect of food on the single-dose pharmacokinetics of IXAZOMIB administered as Capsule B formulation

  • Arm 4: Ratio of geometric mean Cmax and AUC0-tlast of IXAZOMIB administered as Capsule B with rifampin versus when administered as a single agent and 90% confidence intervals (CI) [ Time Frame: Cycle 1: Days 1-21 ] [ Designated as safety issue: No ]
    Arm 4: To characterize the effect of rifampin on the single-dose pharmacokinetics of IXAZOMIB administered as Capsule B formulation

  • • Arm 5: Ratio of geometric mean Cmax and AUC0-tlast of IXAZOMIB administered as Capsule B with clarithromycin versus when administered as a single agent and 90% confidence intervals (CI) [ Time Frame: Cycle 1: Days 1-21 ] [ Designated as safety issue: No ]
    Arm 5: To characterize the effect of clarithromycin on the single-dose pharmacokinetics of IXAZOMIB administered as Capsule B formulation


Secondary Outcome Measures:
  • Adverse events, serious adverse events, assessments of clinical laboratory values, and vital sign measurements [ Time Frame: From the time informed consent is signed through 30 days after the last dose of study drug, approximately 13 months ] [ Designated as safety issue: Yes ]
    Safety and tolerability of IXAZOMIB

  • Measures of disease response according to standard criteria [ Time Frame: Q2 cycles for first 4 cycles, then Q3 cycles, approximately 13 months ] [ Designated as safety issue: No ]

Estimated Enrollment: 125
Study Start Date: November 2011
Estimated Study Completion Date: October 2015
Estimated Primary Completion Date: October 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1 (ketoconazole drug-drug interaction study)
Patients receive a single 2.5-mg oral dose of IXAZOMIBCapsule B formulation on Day 1 and Day 15 during Cycle 1. Patients receive concomitant oral ketoconazole, a strong CYP3A inhibitor, at a dose of 400-mg once daily on Days 12 through 25 during Cycle 1.
Drug: IXAZOMIB Capsule B formulation

Applicable to all Arms:

After completion of Cycle 1, patients receive a 4.0- mg dose of IXAZOMIB Capsule B formulation on Days 1, 8, and 15 of a 28-day schedule; however, starting with Cycle 4 and beyond patients will have the option of escalating to the 5.3-mg dose at the discretion of the investigator and the Millennium clinician.

The maximum duration of treatment is 12 months after completion of Cycle 1 (13 months in total) unless it is determined that a patient would derive benefit from continued therapy beyond 12 cycles.

Drug: ketoconazole
Experimental: Arm 2 (relative bioavailability study)
Patients receive a single oral dose of IXAZOMIB Capsule A or Capsule B formulation on Day 1, followed by a single dose of 4.0-mg of the alternate formulation (Capsule B formulation or A) on Day 15 of a 28-days pharmacokinetic cycle.
Drug: IXAZOMIB Capsule B formulation

Applicable to all Arms:

After completion of Cycle 1, patients receive a 4.0- mg dose of IXAZOMIB Capsule B formulation on Days 1, 8, and 15 of a 28-day schedule; however, starting with Cycle 4 and beyond patients will have the option of escalating to the 5.3-mg dose at the discretion of the investigator and the Millennium clinician.

The maximum duration of treatment is 12 months after completion of Cycle 1 (13 months in total) unless it is determined that a patient would derive benefit from continued therapy beyond 12 cycles.

Drug: IXAZOMIB Capsule A formulation
Experimental: Arm 3 (food effect study)
Patients receive a single 4.0-mg oral dose of IXAZOMIB as Capsule B formulation with or without a standard high-fat breakfast on Day (D) 1 of Cycle (C) 1, followed by administration under the alternate food intake condition on D 15 of C 1. Fasted treatment: D 1 or 15 dose administered with ~ 8-oz of water following an overnight fast, including no medications, of ~10 hrs. Fed treatment: following an overnight fast, including no medications, of ~10 hrs, patients start breakfast 30 min prior to the administration of the D 1 or 15 dose. IXAZOMIB is administered 30 min after the start of the meal with ~8-oz of water. In both treatments, no food is allowed for at least 4 hrs postdose of the D 1 or 15 dose. Water is allowed except for 1 hr before and after drug administration.
Drug: IXAZOMIB Capsule B formulation

Applicable to all Arms:

After completion of Cycle 1, patients receive a 4.0- mg dose of IXAZOMIB Capsule B formulation on Days 1, 8, and 15 of a 28-day schedule; however, starting with Cycle 4 and beyond patients will have the option of escalating to the 5.3-mg dose at the discretion of the investigator and the Millennium clinician.

The maximum duration of treatment is 12 months after completion of Cycle 1 (13 months in total) unless it is determined that a patient would derive benefit from continued therapy beyond 12 cycles.

Experimental: Arm 4 (rifampin drug-drug interaction study)
Patients receive a single 4.0-mg oral dose of IXAZOMIB Capsule B formulation on Day 1 and Day 15 during Cycle 1, the 21-day PK cycle. Patients receive concomitant oral rifampin, a strong CYP3A inducer, at a dose of 600 mg once daily on Days 8 through 21 during Cycle 1.
Drug: IXAZOMIB Capsule B formulation

Applicable to all Arms:

After completion of Cycle 1, patients receive a 4.0- mg dose of IXAZOMIB Capsule B formulation on Days 1, 8, and 15 of a 28-day schedule; however, starting with Cycle 4 and beyond patients will have the option of escalating to the 5.3-mg dose at the discretion of the investigator and the Millennium clinician.

The maximum duration of treatment is 12 months after completion of Cycle 1 (13 months in total) unless it is determined that a patient would derive benefit from continued therapy beyond 12 cycles.

Drug: rifampin
Experimental: Arm 5 (clarithromycin drug-drug interaction study)
Patients receive a single 4.0-mg oral dose of IXAZOMIB Capsule B formulation on Day 6 during Cycle 1, the 21-day PK cycle. Patients receive concomitant oral clarithromycin, a strong CYP3A inhibitor, at a dose of 500 mg twice daily on Days 1 through 16 during Cycle 1.
Drug: IXAZOMIB Capsule B formulation

Applicable to all Arms:

After completion of Cycle 1, patients receive a 4.0- mg dose of IXAZOMIB Capsule B formulation on Days 1, 8, and 15 of a 28-day schedule; however, starting with Cycle 4 and beyond patients will have the option of escalating to the 5.3-mg dose at the discretion of the investigator and the Millennium clinician.

The maximum duration of treatment is 12 months after completion of Cycle 1 (13 months in total) unless it is determined that a patient would derive benefit from continued therapy beyond 12 cycles.

Drug: Drug: clarithromycin

  Eligibility

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

Inclusion Criteria:

  • Male or female patients 18 years or older
  • Patients must have a diagnosis of histologically or cytologically confirmed metastatic and/or advanced solid tumor malignancy or lymphoma for which no effective standard treatment is available
  • Female patients who are postmenopausal at least 1 year, OR surgically sterile, OR if of childbearing potential, agree to practice 2 effective methods of contraception, at the same time from the time of signing the consent form through 90 days after the last dose of study drug, or agree to practice true abstinence
  • Male patients, even if surgically sterilized, agree to practice effective barrier contraception during the entire study treatment period and through 90 days after the last dose of study drug OR agree to practice true abstinence
  • Voluntary written informed consent
  • Clinical laboratory values as specified in protocol
  • Suitable venous access
  • Recovered (ie, < Grade 1 toxicity or patient's baseline status) from the reversible effects of prior anticancer therapy

Exclusion Criteria:

  • Peripheral neuropathy > Grade 2 on clinical examination
  • Systemic treatment with strong inhibitors of CYP1A2, strong inhibitors of CYP3A, or strong CYP3A inducers or use of ginkgo biloba or St. John's wort within 14 days before the first dose of IXAZOMIB
  • Patient has symptomatic brain metastasis. Patients with brain metastases must: have stable neurologic status following surgery or radiation for at least 2 weeks after completion of the definitive therapy; AND be without neurologic dysfunction that would confound the evaluation of neurologic and other adverse events
  • Female patients who are pregnant or lactating
  • Serious illness that could interfere with protocol completion
  • Autologous stem cell transplant within 6 months before Day 1 of Cycle 1, or prior allogeneic stem cell transplant at any time
  • Prior treatment with rituximab or other unconjugated any antibody treatment within 42 days (21 days if there is clear evidence of progressive disease or immediate treatment is mandated)
  • Ongoing treatment with corticosteroids
  • Radiotherapy within 21 days before the first dose of study drug
  • Major surgery within 14 days before the first dose of study drug
  • Infection requiring systemic antibiotic therapy or other serious infection within 14 days prior to first dose of study drug
  • Life-threatening illness unrelated to cancer
  • Known human immunodeficiency virus (HIV) positive, hepatitis B surface antigen-positive, or suspected hepatitis C infection
  • Diagnosis or treatment of another malignancy within 2 years preceding first dose, OR previously diagnosed with another malignancy and have any evidence of residual disease. Patients with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection
  • Evidence of uncontrolled cardiovascular conditions
  • QTc > 500 milliseconds on a 12-lead electrocardiogram (ECG)
  • Known gastrointestinal disease or procedure that could interfere with the oral absorption or tolerance of IXAZOMIB including difficulty swallowing capsules; diarrhea > Grade 1 despite supportive therapy
  • Patients with gastric achlorhydria
  • Patients who have used any nicotine containing products within 14 days before the first dose of study drug (Arm 1, Arm 4, and Arm 5)
  • Treatment with any investigational products or systemic antineoplastic therapies within 21 days before the first dose of IXAZOMIB
  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: NCT01454076

Contacts
Contact: For an updated listing of recruitment sites contact: Millennium Medical and Drug Information Center 1-877-674-3784 medical@mlnm.com

Locations
United States, California
San Diego Pacific Oncology & Hematology Assoc Inc. Recruiting
San Diego, California, United States, 92024
UCLA Hematology-Oncology Santa Monica Withdrawn
Santa Monica, California, United States, 90404
United States, Indiana
IUPUI Recruiting
Indianapolis, Indiana, United States, 46202
United States, Texas
Mary Crowley Cancer Research Centers Recruiting
Dallas, Texas, United States, 75201
United States, Utah
University of Utah Recruiting
Salt Lake City, Utah, United States, 84112
Sponsors and Collaborators
Millennium Pharmaceuticals, Inc.
Investigators
Study Director: Medical Monitor Millennium Pharmaceuticals, Inc.
  More Information

No publications provided

Responsible Party: Millennium Pharmaceuticals, Inc.
ClinicalTrials.gov Identifier: NCT01454076     History of Changes
Other Study ID Numbers: C16009
Study First Received: October 13, 2011
Last Updated: June 24, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by Millennium Pharmaceuticals, Inc.:
Cmax: maximum plasma concentration
AUC0-tlast: time zero to the time of the last quantifiable concentration

Additional relevant MeSH terms:
Neoplasms
Lymphoma
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Rifampin
Clarithromycin
Ketoconazole
Antibiotics, Antitubercular
Anti-Bacterial Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions
Antitubercular Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Leprostatic Agents
Nucleic Acid Synthesis Inhibitors
Protein Synthesis Inhibitors
Antifungal Agents
14-alpha Demethylase Inhibitors

ClinicalTrials.gov processed this record on September 22, 2014