A Phase Ib/II Study of LEE011 in Combination With MEK162 in Patients With NRAS Mutant Melanoma

This study is not yet open for participant recruitment.
Verified January 2013 by Novartis
Sponsor:
Information provided by (Responsible Party):
Novartis ( Novartis Pharmaceuticals )
ClinicalTrials.gov Identifier:
NCT01781572
First received: January 24, 2013
Last updated: January 30, 2013
Last verified: January 2013
  Purpose

In the phase Ib, the primary purpose is to establish the maximum tolerated dose (MTD)(s)/recommended phase ll dose (RP2D) of the LEE011 and MEK162 orally administered combination. Once the MTD(s)/RP2D have been determined, the PhII part will begin in order to assess antitumor activity of LEE011and MEK162 orally administered combination.


Condition Intervention Phase
Locally Advanced or Metastatic NRAS Mutant Melanoma
Drug: LEE011 and MEK162
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase Ib/II, Multicenter, Open Label, Study of LEE011 in Combination With MEK162 in Adult Patients With NRAS Mutant Melanoma

Resource links provided by NLM:


Further study details as provided by Novartis:

Primary Outcome Measures:
  • Incidence of dose limiting toxicities (Phase Ib) [ Time Frame: first 28 days of treatment ] [ Designated as safety issue: Yes ]
    To estimate the maximum tolerate doses (MTDs) and/or identify the RP2D and schedule of LEE011 and MEK162 combination.

  • Objective response rate (ORR) (phase II) [ Time Frame: Baseline, every 2-4 months ] [ Designated as safety issue: Yes ]
    ORR is the proportion of patients with best overall response of complete response (CR) or partial response (PR) by month 2 assessed according to RECIST 1.1 criteria. ORR is done to describe the anti-tumor activity of LEE011 and MEK162 combination.


Secondary Outcome Measures:
  • Plasma concentration-time profile (AUCtau) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profile (AUCtau,ss) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profile (Cmin,ss) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profiles of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    Evaluation of PK parameters, including but not limited to AUCtau, AUCtau,ss, Cmin,ss, Cmax, Cmax,ss ,Tmax, Tmax,ss, accumulation ratio (Racc), and T1/2,acc, CL/F in cycle 1-6. (Phase Ib).

  • Plasma concentration-time profile (Cmax) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profile (Cmax,ss) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profile (Tmax) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profile (Tmax,ss) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profile (accumulation ration, Racc) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profile (T1/2, acc) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Plasma concentration-time profile (CL/F) of LEE011 and MEK162 (phase Ib) [ Time Frame: up to 24 weeks ] [ Designated as safety issue: Yes ]
    To Characterize the PK profiles of LEE011 and MEK162 as well as any other significant metabolites identified (Phase Ib).

  • Incidence of adverse drug reactions [ Time Frame: Approximatley 12 months after FPFV ] [ Designated as safety issue: Yes ]
    Safety and tolerability will be characterized through the incidence and severity of adverse drug reactions, serious adverse drug reactions, changes in hematology and chemistry values, vital signs, electrocardiograms (ECGs), dose interruptions, dose reduction and dose intensity.

  • Duration of Response (DoR) - Phase ll [ Time Frame: Approximatley 12 months after the FPFV ] [ Designated as safety issue: Yes ]
    To assess clinical safety as per RECIST 1.1. Evaluation will occur continuously throughout the trial until progression, or death due to underlying cancer.

  • Time to Progression (TTP) - Phase ll [ Time Frame: Approximately 12 months after the FPFV ] [ Designated as safety issue: Yes ]
    To assess clinical safety as per RECIST 1.1. Evaluation will occur continuously throughout the trial until progression, or death due to underlying cancer.

  • Progression Free Survival (PFS) - Phase ll [ Time Frame: Approximatley 12 months after the FPFV ] [ Designated as safety issue: Yes ]
    To assess clinical safety as per RECIST 1.1. Evaluation will occur continuously throughout the trial until progression, or death due to underlying cancer.

  • Overall Survival (OS) - Phase ll [ Time Frame: Approximately 12 months after the FPFV ] [ Designated as safety issue: Yes ]
    To assess clinical safety as per RECIST 1.1. Evaluation will occur continuously throughout the trial until progression, or death due to underlying cancer.

  • Best Overall Response (BOR) - Phase ll [ Time Frame: Approximately 12 months after the FPFV ] [ Designated as safety issue: Yes ]
    To assess clinical safety according to RECIST 1.1. Evaluation will occur continuously throughout the trial until progression, or death due to underlying cancer.


Estimated Enrollment: 58
Study Start Date: April 2013
Estimated Study Completion Date: April 2015
Estimated Primary Completion Date: April 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Phase Ib
Phase Ib is the dose escalation part where successive cohorts of 3-6 newly enrolled patients receiving various dose pairs considering the recommendation from an adaptive BLRM incorporating the EWOC principle until MTD(s)/RP2D is defined. Patients with either measurable or evaluable disease will be eligible. At least 15 patients will be treated during the Phase Ib part. Approximately 18 are expected. The objective of the phase Ib part of the study is to estimate the MTD(s) and/or to identify the RP2D and schedule of LEE011 and MEK162 in combination.
Drug: LEE011 and MEK162
MEK162 will be administered at 45 mg twice daily on a continuous dosing schedule. There is no planned escalation of this dose although a lower dose of 30 mg BID may be explored if the combination is not tolerated with the starting dose of LEE011. Oral LEE011 will be administered once daily for 21 days followed by a 1 week break (28-day cycle) at a starting dose of 200 mg/QD. At the time of the MTD(s) declaration for this schedule if safety and PK data from the on-going adult phase 1 study indicates a continuous dosing regimen may be more appropriate, this regimen will be evaluated in this study in one or more separate cohorts to establish MTD(s) for that schedule. For the purpose of scheduling and evaluations a treatment cycle is defined as 28 days.
Experimental: Phase II
The Phase II part will begin once the MTD(s)/RP2D have been determined in the Phase Ib in order to assess antitumor activity of the LEE011and MEK162 combination. Data from enrolled patients will also be used to better characterize the safety, tolerability and PK profile of the two agents. Patients enrolled in the Phase II part of the study are required to have measurable disease. Approximately 40 patients will be treated in this part.
Drug: LEE011 and MEK162
Study treatment doses in the phase II will be declared after the MTD/RP2D has been determined in the phase Ib. LEE011 will be administered orally, once daily for 21 days followed by a 1 week break and MEK162 will be administered twice daily in a continuous dosing schedule. For the purpose of scheduling assessments and establishing the MTD/RP2D, a cycle is defined as 28 days in length.

  Eligibility

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

Inclusion Criteria:

  • Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 2
  • Patients enrolled into phase Ib may be enrolled with evaluable disease only. Patients enrolled into the phase II expansion must have at least one measurable lesion as defined by RECIST 1.1 criteria.
  • Patients must have adequate organ function, as defined by the following parameters:

    1. Bone marrow:

      • Absolute Neutrophil Count (ANC) ≥ 1.5 x 109/L
      • Hemoglobin (Hgb) ≥ 9 g/dL
      • Platelets ≥ 75 x 109/L without transfusions within 21 days before 1st treatment
    2. Serum creatinine ≤1.5 ULN
    3. Serum total bilirubin ≤ 1.5 x upper limit of normal (ULN)
    4. Aspartate Aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and ALT (SGPT) ≤ 3 x ULN, except in patients with tumor involvement of the liver who must have AST and ALT ≤ 5 x ULN

Exclusion Criteria:

  • Symptomatic brain metastases. Patients previously treated or untreated for brain metastases that are asymptomatic in the absence of corticosteroid therapy are allowed to enroll. Brain metastases must be stable for at least 2 weeks after completion of the definitive therapy with verification by imaging (e.g. brain MRI completed at screening demonstrating no current evidence of progressive brain metastases).
  • Impaired cardiac function or clinically significant cardiac diseases, including any of the following:

    1. Left ventricular ejection fraction (LVEF) < 50% as determined by multiple gated acquisition scan (MUGA) or echocardiogram (ECHO)
    2. Congenital long QT syndrome or family history of unexpected sudden cardiac death
    3. QTc corrected with Frederica's or Bazett's formula (QTcF) >450 ms for males and >470 ms for females on screening ECG
    4. Any other clinically significant heart disease such as angina pectoris, resting bradycardia, left bundle branch block, ventricular tachyarrhythmia, unstable atrial fibrillation, branch block or hemi block, acute myocardial infarction or any heart disease that requires the use of a cardiac pacemaker or implantable cardioverter defibrillator
  • Patients who are currently receiving treatment with agents that are known to cause QTc prolongation in humans. See investigators brochure for a complete list of agents that are known to cause QTc prolongation in humans.
  • Patients who are currently receiving treatment with agents that are metabolized predominantly through CYP3A4 and that have a narrow therapeutic window.
  • Patients with concurrent severe and/or uncontrolled concurrent medical conditions that could compromise participation in the study (e.g., uncontrolled hypertension and/or diabetes mellitus, clinically significant pulmonary disease, clinically significant neurological disorder, active or uncontrolled infection)
  • Current evidence of retinal disease; history of CSR, RVO or ophthalmology as assessed by ophthalmologic examination at baseline that would be considered a risk factor for CSR/RVO (e.g., optic disc cupping, visual field defects, IOP > 21 mm Hg)

Other protocol related inclusion/exclusion criteria may apply.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01781572

Contacts
Contact: Novartis Pharmaceuticals 1-888-669-6682
Contact: Novartis Pharmaceuticals

Locations
United States, New York
Memorial Sloan Kettering Cancer Center Dept Oncology Not yet recruiting
New York, New York, United States, 10021
Contact: Gerry O'Neill     646-888-4339     oneillg@mskcc.org    
Principal Investigator: Gary K. Schwartz            
Australia, New South Wales
Novartis Investigative Site Not yet recruiting
North Sydney, New South Wales, Australia, 2060
Novartis Investigative Site Not yet recruiting
Westmead, New South Wales, Australia, 2145
Australia, Victoria
Novartis Investigative Site Not yet recruiting
Melbourne, Victoria, Australia, 3002
Sponsors and Collaborators
Novartis Pharmaceuticals
Investigators
Study Director: Novartis Pharmaceuticals Novartis Pharmaceuticals
  More Information

No publications provided

Responsible Party: Novartis ( Novartis Pharmaceuticals )
ClinicalTrials.gov Identifier: NCT01781572     History of Changes
Other Study ID Numbers: CMEK162X2114
Study First Received: January 24, 2013
Last Updated: January 30, 2013
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Melanoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
Nevi and Melanomas

ClinicalTrials.gov processed this record on June 18, 2013