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A Drug-Drug Interaction Study of the Effects of XL184 (Cabozantinib) on Rosiglitazone in Subjects With Solid Tumors

Primary Purpose

Papillary Thyroid Cancer, Follicular Thyroid Cancer, Huerthle Cell Thyroid Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
rosiglitazone
XL184
Sponsored by
Exelixis
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Papillary Thyroid Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of a solid tumor that is metastatic or unresectable and is refractory to or progressed (or relapsed) following standard therapies, or a disease for which no standard therapy exists. Initial enrollment will be limited to differentiated thyroid cancer and renal cell carcinoma. Additional criteria will apply.
  • One lesion that is not within a previously radiated field and is measurable on computerized tomography (CT), magnetic resonance imaging (MRI) scan.
  • Body mass index (BMI) between 18 and 33 kg/m2.
  • Karnofsky Performance Status (≥ 70).
  • Adequate organ and marrow function.
  • Able to reside in the clinic for two one-day confinement periods in their entirety.
  • The subject is willing to refrain from consuming CYP-interacting foods including Seville orange-containing products, grapefruit-containing products, and star fruit-containing products, from 72 hours prior to first dose through the Day 23 Discharge.

Exclusion Criteria:

  • Restrictions regarding certain prior treatments will apply.
  • The subject has experienced clinically-significant hematemesis or hemoptysis of > 2.5 ml of red blood within 28 days prior to the first dose of study treatment, or other signs indicative of pulmonary hemorrhage within 28 days prior to the first dose of study treatment.
  • Not recovered from toxicity due to all prior therapies (ie, return to pre-therapy baseline or Grade ≤ 1).
  • Primary brain tumor or brain metastases or spinal cord compression, unless completed radiation therapy ≥ 28 days prior to study. treatment or had surgical resection and is stable without steroid and without anti-convulsant treatment for ≥ 10 days.
  • Prothrombin time/International Normalized Ratio (PT/INR) or partial thromboplastin time (PTT) at screening ≥ 1.5 times the laboratory upper limit of normal.
  • Uncontrolled, significant intercurrent illness.
  • Inherited bleeding diathesis or coagulopathy with the risk of bleeding.
  • Pregnancy or breastfeeding.
  • Human immunodeficiency virus (HIV), Hepatitis B, or Hepatitis C.
  • Allergy or hypersensitivity to components of either of the study treatment (XL184 and rosiglitazone) formulations.
  • History of any medical or surgical conditions (eg, stomach or intestinal surgery or resection) that would potentially interfere with or alter the gastrointestinal (GI) absorption, distribution, metabolism, or excretion of the study drug (exceptions: appendectomy, hernia repair, and/or cholecystectomy will be allowed).
  • History of, or clinical evidence of, pancreatic injury or pancreatitis, including but not limited to having amylase or lipase levels outside of normal limits.
  • Hepatic impaired, ie, with a Child-Pugh score of B or C.
  • The subject is being treated with drug(s) that are known to be either extensively metabolized by CYP2C8 (for example rosiglitazone), or inhibitors of either CYP2C8 or CYP3A4, or inducers of CYP3A isozymes.
  • The subject has used any prohibited prescription medications or products prior to the first Check-in, or is unable or unwilling to forgo the use of such products from the first Check-in through the Day 23 Discharge, unless deemed acceptable by the investigator.
  • Poor peripheral venous access.
  • The subject is receiving warfarin (or other coumarin derivatives) at study entry and unable to switch to low molecular weight heparin.
  • The subject is receiving dialysis.

Sites / Locations

  • City of Hope Comprehensive Cancer Center
  • Dana Farber Cancer Institute
  • Montefiore Medical Center
  • Hospital of the University of Pennsylvania
  • The University of Texas M.D. Anderson Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

All subjects

Arm Description

All subjects will receive daily XL184, and two single doses of rosiglitazone, 3 weeks apart

Outcomes

Primary Outcome Measures

Pharmacokinetics of XL184 and rosiglitazone
To evaluate the effect of multiple daily doses of XL184 on single dose PK of rosiglitazone

Secondary Outcome Measures

Safety and tolerability of repeated administration of XL184
To evaluate safety and tolerability of daily oral administration of XL184 and two single doses of rosiglitazone
Pharmacokinetics of XL184 after co-administration of rosiglitazone
To evaluate the plasma PK of XL184 after a single dose of rosiglitazone

Full Information

First Posted
March 22, 2010
Last Updated
September 17, 2013
Sponsor
Exelixis
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1. Study Identification

Unique Protocol Identification Number
NCT01100619
Brief Title
A Drug-Drug Interaction Study of the Effects of XL184 (Cabozantinib) on Rosiglitazone in Subjects With Solid Tumors
Official Title
A Phase 1 Drug-Drug Interaction Study of the Effects of XL184 on the Pharmacokinetics of a Single Oral Dose of Rosiglitazone in Subjects With Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2013
Overall Recruitment Status
Completed
Study Start Date
April 2010 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Exelixis

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of this clinical study is to determine whether the inhibition of cytochrome P450 (CYP) isozyme CYP2C8 by XL184 observed in in vitro preclinical studies translates into the potential for clinically significant drug-drug interactions in humans. The study will measure the effect of once daily dosing of XL184 on the pharmacokinetics (PK) of rosiglitazone. The PK of XL184 when combined with rosiglitazone will be evaluated as well. A specific objective of this study is to determine whether the interaction between XL184 and a drug such as rosiglitazone is sufficiently large enough to necessitate a dosage adjustment when used in combination with XL184, or whether the interaction would require additional therapeutic monitoring. Rosiglitazone, commonly known as Avandia, is a prescription medicine approved by the FDA used to treat adults with Type 2 (adult-onset or non-insulin dependent) diabetes mellitus (high blood sugar). In this study, subjects will only take 2 doses of rosiglitazone. There is no intention of therapy as a result of taking rosiglitazone in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Papillary Thyroid Cancer, Follicular Thyroid Cancer, Huerthle Cell Thyroid Cancer, Renal Cell Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
All subjects
Arm Type
Experimental
Arm Description
All subjects will receive daily XL184, and two single doses of rosiglitazone, 3 weeks apart
Intervention Type
Drug
Intervention Name(s)
rosiglitazone
Other Intervention Name(s)
Avandia
Intervention Description
one 4 mg dose as a tablet followed by a second 4 mg dose 3 weeks later
Intervention Type
Drug
Intervention Name(s)
XL184
Intervention Description
dosed with capsules daily
Primary Outcome Measure Information:
Title
Pharmacokinetics of XL184 and rosiglitazone
Description
To evaluate the effect of multiple daily doses of XL184 on single dose PK of rosiglitazone
Time Frame
at weekly or twice-weekly visits for the first 4 weeks
Secondary Outcome Measure Information:
Title
Safety and tolerability of repeated administration of XL184
Description
To evaluate safety and tolerability of daily oral administration of XL184 and two single doses of rosiglitazone
Time Frame
at weekly or twice-weekly visits, then every 4 weeks
Title
Pharmacokinetics of XL184 after co-administration of rosiglitazone
Description
To evaluate the plasma PK of XL184 after a single dose of rosiglitazone
Time Frame
at weekly or twice-weekly visits for 4 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of a solid tumor that is metastatic or unresectable and is refractory to or progressed (or relapsed) following standard therapies, or a disease for which no standard therapy exists. Initial enrollment will be limited to differentiated thyroid cancer and renal cell carcinoma. Additional criteria will apply. One lesion that is not within a previously radiated field and is measurable on computerized tomography (CT), magnetic resonance imaging (MRI) scan. Body mass index (BMI) between 18 and 33 kg/m2. Karnofsky Performance Status (≥ 70). Adequate organ and marrow function. Able to reside in the clinic for two one-day confinement periods in their entirety. The subject is willing to refrain from consuming CYP-interacting foods including Seville orange-containing products, grapefruit-containing products, and star fruit-containing products, from 72 hours prior to first dose through the Day 23 Discharge. Exclusion Criteria: Restrictions regarding certain prior treatments will apply. The subject has experienced clinically-significant hematemesis or hemoptysis of > 2.5 ml of red blood within 28 days prior to the first dose of study treatment, or other signs indicative of pulmonary hemorrhage within 28 days prior to the first dose of study treatment. Not recovered from toxicity due to all prior therapies (ie, return to pre-therapy baseline or Grade ≤ 1). Primary brain tumor or brain metastases or spinal cord compression, unless completed radiation therapy ≥ 28 days prior to study. treatment or had surgical resection and is stable without steroid and without anti-convulsant treatment for ≥ 10 days. Prothrombin time/International Normalized Ratio (PT/INR) or partial thromboplastin time (PTT) at screening ≥ 1.5 times the laboratory upper limit of normal. Uncontrolled, significant intercurrent illness. Inherited bleeding diathesis or coagulopathy with the risk of bleeding. Pregnancy or breastfeeding. Human immunodeficiency virus (HIV), Hepatitis B, or Hepatitis C. Allergy or hypersensitivity to components of either of the study treatment (XL184 and rosiglitazone) formulations. History of any medical or surgical conditions (eg, stomach or intestinal surgery or resection) that would potentially interfere with or alter the gastrointestinal (GI) absorption, distribution, metabolism, or excretion of the study drug (exceptions: appendectomy, hernia repair, and/or cholecystectomy will be allowed). History of, or clinical evidence of, pancreatic injury or pancreatitis, including but not limited to having amylase or lipase levels outside of normal limits. Hepatic impaired, ie, with a Child-Pugh score of B or C. The subject is being treated with drug(s) that are known to be either extensively metabolized by CYP2C8 (for example rosiglitazone), or inhibitors of either CYP2C8 or CYP3A4, or inducers of CYP3A isozymes. The subject has used any prohibited prescription medications or products prior to the first Check-in, or is unable or unwilling to forgo the use of such products from the first Check-in through the Day 23 Discharge, unless deemed acceptable by the investigator. Poor peripheral venous access. The subject is receiving warfarin (or other coumarin derivatives) at study entry and unable to switch to low molecular weight heparin. The subject is receiving dialysis.
Facility Information:
Facility Name
City of Hope Comprehensive Cancer Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10466
Country
United States
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
The University of Texas M.D. Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77230
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
24827131
Citation
Choueiri TK, Pal SK, McDermott DF, Morrissey S, Ferguson KC, Holland J, Kaelin WG, Dutcher JP. A phase I study of cabozantinib (XL184) in patients with renal cell cancer. Ann Oncol. 2014 Aug;25(8):1603-8. doi: 10.1093/annonc/mdu184. Epub 2014 May 14.
Results Reference
derived

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A Drug-Drug Interaction Study of the Effects of XL184 (Cabozantinib) on Rosiglitazone in Subjects With Solid Tumors

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