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(NAVIGATOR) Study of BLU-285 in Patients With Gastrointestinal Stromal Tumors (GIST) and Other Relapsed and Refractory Solid Tumors

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ClinicalTrials.gov Identifier: NCT02508532
Recruitment Status : Completed
First Posted : July 27, 2015
Results First Posted : June 22, 2021
Last Update Posted : July 2, 2021
Sponsor:
Information provided by (Responsible Party):
Blueprint Medicines Corporation

Brief Summary:
This is a Phase 1, open-label, first-in-human (FIH) study designed to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) and antineoplastic activity of avapritinib (formerly BLU-285), administered orally (PO), in adult patients with unresectable GIST or other relapsed or refractory solid tumors. The study consists of 2 parts, a dose-escalation part (Part 1) and an expansion part (Part 2).

Condition or disease Intervention/treatment Phase
Gastrointestinal Stromal Tumors (GIST) Other Relapsed or Refractory Solid Tumors Drug: Avapritinib Phase 1

Expanded Access : An investigational treatment associated with this study has been approved for sale to the public.   More info ...

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 250 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Intervention Model Description: Dose Escalation and Dose Expansion
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1 Study of BLU-285 in Patients With Gastrointestinal Stromal Tumors (GIST) and Other Relapsed and Refractory Solid Tumors
Actual Study Start Date : August 2015
Actual Primary Completion Date : March 6, 2020
Actual Study Completion Date : June 3, 2021


Arm Intervention/treatment
Experimental: Part 1 Avapritinib (formerly BLU-285) 30 mg QD

Part 1: Patients received a starting dose of 30 mg QD for 28 days and they were assessed for dose limiting toxicities (DLT). If no DTLs were observed the dose escalation continued.

Patients received avapritinib in continuous 28 day cycles until discontinuation.

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285

Experimental: Part 1 Avapritinib (formerly BLU-285) 60 mg QD

Part 1: Patients received a starting dose of 60 mg QD for 28 days and they were assessed for dose limiting toxicities (DLT). If no DTLs were observed the dose escalation continued.

Patients received avapritinib in continuous 28 day cycles until discontinuation.

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285

Experimental: Part 1 Avapritinib (formerly BLU-285) 90 mg QD

Part 1: Patients received a starting dose of 90 mg QD for 28 days and they were assessed for dose limiting toxicities (DLT). If no DTLs were observed the dose escalation continued.

Patients received avapritinib in continuous 28 day cycles until discontinuation.

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285

Experimental: Part 1 Avapritinib (formerly BLU-285) 135 mg QD

Part 1: Patients received a starting dose of 135 mg QD for 28 days and they were assessed for dose limiting toxicities (DLT). If no DTLs were observed the dose escalation continued.

Patients received avapritinib in continuous 28 day cycles until discontinuation.

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285

Experimental: Part 1 Avapritinib (formerly BLU-285) 200 mg QD

Part 1: Patients received a starting dose of 200 mg QD for 28 days and they were assessed for dose limiting toxicities (DLT). If no DTLs were observed the dose escalation continued.

Patients received avapritinib in continuous 28 day cycles until discontinuation. .

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285

Experimental: Part 1 Avapritinib (formerly BLU-285) 300 mg QD

Part 1: Patients received a starting dose of 300 mg QD for 28 days and they were assessed for dose limiting toxicities (DLT). If no DTLs were observed the dose escalation continued.

Patients received avapritinib in continuous 28 day cycles until discontinuation. Patients that received at least one dose of avapritinib were included in the Part 2 analysis.

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285

Experimental: Part 1 Avapritinib (formerly BLU-285) 400 mg QD

Part 1: Patients received a starting dose of 400 mg QD for 28 days and they were assessed for dose limiting toxicities (DLT). If no DTLs were observed the dose escalation continued.

Patients received avapritinib in continuous 28 day cycles until discontinuation.

Patients that received at least one dose of avapritinib were included in the Part 2 analysis.

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285

Experimental: Part 1 Avapritinib (formerly BLU-285) 600 mg QD

Part 1: Patients received a starting dose of 600 mg QD for 28 days and they were assessed for dose limiting toxicities (DLT). If no DTLs were observed the dose escalation continued.

Patients received avapritinib in continuous 28 day cycles until discontinuation.

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285

Experimental: Part 1 and Part 2 Avapritinib (formerly BLU-285) 300 mg or 400 mg QD

Part 1 and Part 2: Patients enrolled in Part 1 and Part 2 at a starting dose of 300 or 400 mg QD were included in the Part1/Part 2 safety and efficacy analysis.

Patients received avapritinib in continuous 28 day cycles until discontinuation.

Drug: Avapritinib
avapritinib tablets
Other Name: BLU-285




Primary Outcome Measures :
  1. Part 1: Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D) of Avapritinib [ Time Frame: Cycle 1 (28 days) of treatment ]
    Patients with event(s) of dose-limiting toxicity

  2. Parts 1 and 2: Number of Patients With Adverse Events (AE) and Serious Adverse Events (SAE) [ Time Frame: AEs were collected from the start of study drug until 30 days after the last dose, SAEs were collected from the date of the informed consent signature until 30 days after the last dose of study drug, up to 5 years ]
    The overall safety profile of the drug was assessed by reviewing the number of patients with AEs, SAEs and other events. There was no formal statistical analysis. Safety assessments continued for the duration of treatment.

  3. Part 2: Objective Response Rate (ORR) Determined by Central Radiology Assessment Per mRECIST, Version 1.1 [ Time Frame: Tumor assessments were performed at screening, Cycle 3 Day 1, then every 2 cycles through Cycle 13, then every 3 cycles thereafter up to approximately 4 years. Each cycle is 28 days. ]
    To evaluate objective response rate (ORR) determined by central radiology assessment per mRECIST, version 1.1 in patients with advanced GIST treated with avapritinib. A complete response per modified Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) is defined as complete disappearance of all target lesions. A partial response is defined as at least 30% decrease in the sum of diameters of target lesions taking as reference the baseline sum of diameters. Overall Response (OR) = CR + PR


Secondary Outcome Measures :
  1. Maximum Plasma Drug Concentration (Cmax) [ Time Frame: Cycle 1 Day 1 ]
    Maximum plasma drug concentration (Cmax) following a single dose of avapritinib

  2. Time to Maximum Plasma Drug Concentration (Tmax) [ Time Frame: Cycle 1 Day 1 ]
    Cycle 1 Day 1 PK time to maximum plasma drug concentration (Tmax)

  3. Plasma Drug Concentration at 24 Hours Postdose Prior to the Next Daily Dose (C24) [ Time Frame: Cycle 1 Day 1 ]
    Plasma drug concentration at 24 hours postdose prior to the next daily dose (C24) following a single dose of avapritinib

  4. Area Under the Plasma Concentration-time Curve From Time 0 to 24 Hours (AUC 0-24) [ Time Frame: Cycle 1 Day 1 ]
    Area under the plasma concentration-time curve from time 0 to 24 hours (AUC 0-24) following a single dose of avapritinib

  5. Apparent Oral Clearance Unadjusted for Bioavailability (CL/F) [ Time Frame: Cycle 1 Day 1 ]
    Apparent oral clearance unadjusted for bioavailability (CL/F) following a single dose of avapritinib

  6. Apparent Volume of Distribution, Unadjusted for Bioavailability (Vz/F) [ Time Frame: Cycle 1 Day 1 ]
    Apparent volume of distribution, unadjusted for bioavailability (Vz/F) following a single dose of avapritinib

  7. Terminal Elimination Half-life (t1/2) [ Time Frame: Cycle 1 Day 1 ]
    Terminal elimination half-life (t1/2) following a single dose of avapritinib

  8. Maximum Plasma Drug Concentration (Cmax) at Steady State [ Time Frame: Cycle 1 Day 15 ]
    Maximum plasma drug concentration (Cmax) at steady state following 15 days of QD dosing

  9. Time of Maximal Concentration (Tmax) at Steady State [ Time Frame: Cycle 1 Day 15 ]
    Time of maximal concentration (Tmax) at steady state following 15 days of QD dosing

  10. Plasma Drug Concentration at 24 Hours Postdose Prior to the Next Daily Dose at Steady State (C24,ss) [ Time Frame: Cycle 1 Day 15 ]
    Plasma Drug Concentration at 24 Hours Postdose Prior to the Next Daily Dose at steady state (C24,ss) following 15 days of QD dosing

  11. Area Under the Plasma Concentration-time Curve Over the Dosing Interval at Steady Sate (AUC0-τ,ss) (τ=24 h) [ Time Frame: Cycle 1 Day 15 ]
    Area under the plasma concentration-time curve over the dosing interval at steady sate (AUC0-τ,ss) (τ=24 h) following 15 days of QD dosing

  12. Progression-free Survival Per mRECIST Version 1.1 [ Time Frame: Tumor assessments were performed at screening, Cycle 3 Day 1, then every 2 cycles through Cycle 13, then every 3 cycles thereafter up to approximately 4 years. Each cycle is 28 days. ]
    Progression-free survival is defined as the time in months from the start of treatment to the date of first documented progression or death due to any cause. Progression-free survival determined by central radiological assessment per modified Response Evaluation Criteria in Solid Tumors (mRECIST), version 1.1 in patients with advanced GIST. A progressively growing tumor must meet the following criteria: a) the target lesions must be greater or equal to 2cm in size and be a new GIST active lesion or b) the target lesions must be expanding on at least 2 sequential imaging studies.

  13. Apparent Oral Clearance at Steady State, Unadjusted for Bioavailability (CLss/F) [ Time Frame: Cycle 1 Day 15 ]
    Apparent oral clearance at steady state, unadjusted for bioavailability (CLss/F) following 15 days of QD dosing

  14. Clinical Benefit Rate Determined by Central Radiology Assessment Per mRECIST, Version 1.1 [ Time Frame: Tumor assessments were performed at screening, Cycle 3 Day 1, then every 2 cycles through Cycle 13, then every 3 cycles thereafter up to approximately 4 years. Each cycle is 28 days. ]
    Percent of patients with a complete response, partial response or stable disease lasting more than 16 weeks. A complete response per modified Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) is defined as complete disappearance of all target lesions. A partial response is defined as at least 30% decrease in the sum of diameters of target lesions taking as reference the baseline sum of diameters. Stable disease is defined as a tumor that does not meet the criteria for progression or for response. A progressively growing tumor must meet the following criteria: a) the target lesions must be greater or equal to 2cm in size and be a new GIST active lesion or b) the target lesions must be expanding on at least 2 sequential imaging studies.

  15. Response Rate Determined by Central Radiology Assessment Per Choi Criteria [ Time Frame: Tumor assessments were performed at screening, Cycle 3 Day 1, then every 2 cycles through Cycle 13, then every 3 cycles thereafter up to approximately 4 years. Each cycle is 28 days. ]
    A complete response is defined as complete disappearance of all target lesions. A partial response is ≥10% decrease tumor size at computed tomography (CT) or ≥15% decrease in tumor attenuation at computed tomography (CT) and no new lesions. The response rate is defined as complete response plus partial response.

  16. Duration of Response Determined by Central Radiology Assessment Per mRECIST, Version 1.1 [ Time Frame: Tumor assessments were performed at screening, Cycle 3 Day 1, then every 2 cycles through Cycle 13, then every 3 cycles thereafter up to approximately 4 years. Each cycle is 28 days. ]

    Duration from time to first documented CR/PR to date of first documented disease progression or death.

    A complete response per modified Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) is defined as complete disappearance of all target lesions. A partial response is defined as at least 30% decrease in the sum of diameters of target lesions taking as reference the baseline sum of diameters. Overall Response (OR) = CR + PR


  17. Median PFS on Last Prior Anti-cancer Therapy [ Time Frame: Historical data collected at enrollment, all available data on prior therapy was collected ]
    Progression Free Survival (PFS) is defined as the time in months from the start of treatment to the date of first documented disease progression or death due to any cause, which ever occurs first. PFS on last prior anti-cancer therapy is defined as the time in months from the start of last prior anti-cancer therapy to progression on that therapy.

  18. Change From Baseline in Levels of KIT and PDGFRα Mutant Allele Fractions in Peripheral Blood [ Time Frame: Baseline and End of treatment ]
    Change of mutant allele fraction (MAF) summarizes the largest fold change. Change from baseline only displayed for patients with pre and post treatment MAF measurements. A positive number represents an increase in MAF. Data is only provided for patients that had both a baseline measurement and an end of treatment measurement.

  19. KIT, PDGFRA, and Other Cancer-relevant Mutations Present in Tumor Tissue at Baseline and EOT [ Time Frame: Baseline and end of treatment ]
    Change in mutations in tumor tissue at baseline and end of treatment (EOT). EOT tumor biopsies were optional and there were no EOT samples collected.



Information from the National Library of Medicine

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, Learn About Clinical Studies.


Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • For Part 1: Histologically- or cytologically-confirmed diagnosis of unresectable GIST or another advanced solid tumor. Patients with unresectable GIST must have disease that has progressed following imatinib and at least 1 of the following: sunitinib, regorafenib, sorafenib, dasatinib, pazopanib or an experimental kinase-inhibitor agent, or disease with a D842 mutation in the PDGFRα gene. Patients with an advanced solid tumor other than GIST must have relapsed or refractory disease without an available effective therapy.

OR For Part 2:

  • Group 1: Patients must have a confirmed diagnosis of unresectable GIST that has progressed following imatinib and at least 1 of the following: sunitinib, regorafenib, sorafenib, dasatinib, pazopanib, or an experimental kinase-inhibitor agent, and the patient does not have a D842V mutation in PDGFRα.
  • Group 2: Patients must have a confirmed diagnosis of unresectable GIST with a D842V mutation in the PDGFRα gene. The PDGFRα mutation will be identified by local or central assessment, either in an archival tissue sample or a new tumor biopsy obtained prior to treatment with avapritinib.
  • Group 3: Patients must have a confirmed diagnosis of unresectable GIST that has progressed and/or patients must have experienced intolerance to imatinib and not received additional kinase-inhibitor therapy. Patients must not have a known D842V mutation in PDGFRα.
  • Groups 1, 2 and 3: At least 1 measurable lesion defined by mRECIST 1.1 for patients with GIST.
  • Groups 1 and 2: A tumor sample (archival tissue or a new tumor biopsy) has been submitted for mutational testing.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-2

Exclusion Criteria:

  • QT interval corrected using Fridericia's formula (QTcF) >450 milliseconds
  • Platelet count <90,000/mL
  • Absolute neutrophil count <1000/mL
  • Hemoglobin <9 g/dL
  • Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >3 x the upper limit of normal (ULN) if no hepatic metastases are present; >5 × ULN if hepatic metastases are present
  • Total bilirubin >1.5 × ULN; >3 × ULN with direct bilirubin, >1.5 × ULN in the presence of Gilbert's Disease
  • Estimated (Cockroft-Gault formula) or measured creatinine clearance <40 mL/min Brain malignancy or metastases to the brain
  • History of a seizure disorder or requirement for anti-seizure medication
  • Group 3: Patients known to be KIT wild type.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02508532


Locations
Show Show 19 study locations
Sponsors and Collaborators
Blueprint Medicines Corporation
  Study Documents (Full-Text)

Documents provided by Blueprint Medicines Corporation:
Study Protocol  [PDF] February 28, 2018
Statistical Analysis Plan  [PDF] October 26, 2018

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Layout table for additonal information
Responsible Party: Blueprint Medicines Corporation
ClinicalTrials.gov Identifier: NCT02508532    
Other Study ID Numbers: BLU-285-1101
First Posted: July 27, 2015    Key Record Dates
Results First Posted: June 22, 2021
Last Update Posted: July 2, 2021
Last Verified: July 2021
Keywords provided by Blueprint Medicines Corporation:
cancer gist
gastrointestinal stromal tumor
gist cancer
2L GIST
GIST second line
GIST gleevec
GIST imatinib
Second-line GIST clinical trial
BLU-285
BLU 285
BLUE-285
BLUE 285
Avapritinib
GIST imatinib relapse
GIST gleevec relapse
GIST KIT
GIST relapse
GIST refractory
GIST imatinib intolerance
GIST TKI treatment
GIST tyrosine kinase inhibitor treatment
GIST TKI
GIST tyrosine kinase inhibitor
Advanced GIST
GIST mutations
GIST treatments
Blueprint GIST
Relapsed GIST clinical trial
Refractory GIST clinical trial
KIT-mutant GIST
Additional relevant MeSH terms:
Layout table for MeSH terms
Neoplasms
Gastrointestinal Stromal Tumors
Neoplasms, Connective Tissue
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Gastrointestinal Neoplasms
Digestive System Neoplasms
Digestive System Diseases
Gastrointestinal Diseases