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A Study Of Crizotinib Plus VEGF Inhibitor Combinations In Patients With Advanced Solid Tumors.

Primary Purpose

Carcinoma, Renal Cell, Glioblastoma, Carcinoma, Hepatocellular

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Crizotinib plus VEGF inhibitor combinations
Crizotinib plus axitinib
Crizotinib plus sunitinib
Crizotinib plus axitinib
Crizotinib plus sunitinib
Crizotinib plus bevacizumab
Crizotinib plus sorafenib
Sponsored by
Pfizer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Renal Cell focused on measuring Phase 1b, crizotinib, sunitinib, axitinib, sorafenib, bevacizumab, cMET inhibitor, VEGF inhibitor, crizotinib combination

Eligibility Criteria

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

Inclusion Criteria:

  • Dose Escalation Population: Histological or cytological diagnosis of advanced/metastatic solid tumor that is resistant to standard therapy or for which no standard therapy is available. Lesions may be measurable or non measurable.
  • Expansion Population 1: Patients with histologically confirmed metastatic renal cell cancer with no prior systemic therapy directed at the malignant tumor.
  • Expansion Population 2: Patients with histologically confirmed metastatic renal cell cancer whose prior systemic therapy directed at the malignant tumor was single agent VEGF inhibitor and who now have acquired resistance to this treatment. Resistance is defined as progression following an initial response (complete or partial), or stable disease for at least 6 months on single agent VEGF inhibitor.
  • Expansion Population 3: Patients with histologically confirmed glioblastoma whose disease has failed on previous therapy, and which must have included treatment with external beam radiation and temozolomide chemotherapy, and who now have radiographically recurrent or progressive disease.
  • Expansion Population 4: Patients with histologically confirmed advanced-stage (unresectable or metastatic) hepatocellular carcinoma who have not received previous systemic therapy directed at the malignant tumor will be eligible to receive crizotinib plus sorafenib, should this combination be tested. Eligibility criteria also include normal hepatic function or Child-Pugh hepatic function class A.

Exclusion Criteria:

  • Patients with hemorrhagic brain metastases or with known symptomatic brain metastases requiring steroids.
  • Major surgery within 4 weeks of starting study treatment.
  • Radiation therapy within 2 weeks of starting study treatment.
  • Hypertension that cannot be controlled with medications (>150/90 mmHg despite optimal medical therapy).
  • For glioblastoma patients: Prior treatment of glioblastoma with Gliadel wafers, stereotactic radiation, or brachytherapy unless there is pathological or definitive radiological evidence (PET scan or perfusion MRI) of recurrent tumor or unless there is new enhancement outside of the radiation field. History of Grade 2 or greater acute intracranial hemorrhage. Radiation therapy (RT) for glioblastoma within 3 months unless there is either: a) histopathologic confirmation of recurrent tumor, or b) new enhancement on MRI outside of the RT treatment field.Concomitant treatment with therapeutic doses of anticoagulants (low dose warfarin (Coumadin) up to 2 mg PO daily for deep vein thrombosis prophylaxis is allowed).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    Dose Escalation

    Expansion Population 1

    Expansion Population 2

    Expansion Population 3

    Expansion Population 4

    Arm Description

    Histological or cytological diagnosis of advanced/metastatic solid tumor that is resistant to standard therapy or for which no standard therapy is available.

    Patients with histologically confirmed metastatic renal cell cancer with no prior systemic therapy directed at the malignant tumor.

    Patients with histologically confirmed metastatic renal cell cancer whose prior systemic therapy directed at the malignant tumor was single agent VEGF inhibitor and who now have acquired resistance to this treatment.

    Patients with histologically confirmed glioblastoma whose disease has failed on previous therapy, and which must have included treatment with external beam radiation and temozolomide chemotherapy, and who now have radiographically recurrent or progressive disease.

    Patients with histologically confirmed advanced-stage (unresectable or metastatic) hepatocellular carcinoma who have not received previous systemic therapy directed at the malignant tumor will be eligible to receive crizotinib plus sorafenib, should this combination be tested.

    Outcomes

    Primary Outcome Measures

    Dose Limiting Toxicities (DLTs).

    Secondary Outcome Measures

    Duration of Response (DR)
    Progression free survival (PFS)
    Area under the plasma concentration versus time curve (AUC) of crizotinib and each VEGF inhibitor
    Best overall response, as assessed using the Response Evaluation Criteria in Solid Tumor (RECIST) version 1.1 or , in the case of GBM (glioblastoma multiforme , RANO (Response Assessment in Neuro-Oncology) criteria.
    Overall survival (OS) up to 12 months
    Pre- and post-dose levels of soluble peripheral blood biomarkers.
    Tumor tissue biomarkers.
    6-month progression free survival proportion (PFS6) for glioblastoma patients
    Peak plasma concentration (Cmax) of crizotinib and each VEGF inhibitor

    Full Information

    First Posted
    September 23, 2011
    Last Updated
    December 19, 2011
    Sponsor
    Pfizer
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01441388
    Brief Title
    A Study Of Crizotinib Plus VEGF Inhibitor Combinations In Patients With Advanced Solid Tumors.
    Official Title
    A Phase 1B, Open-Label, Dose Escalation Study To Evaluate Safety, Pharmacokinetics And Pharmacodynamics Of Crizotinib (PF-02341066) Plus VEGF Inhibitor Combinations In Patients With Advanced Solid Tumors.
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 2011
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Business/Operational issues
    Study Start Date
    December 2011 (undefined)
    Primary Completion Date
    November 2013 (Anticipated)
    Study Completion Date
    November 2013 (Anticipated)

    3. Sponsor/Collaborators

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

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Despite the success of anti-angiogenic therapy in multiple treatment settings, a fraction of patients are refractory to vascular endothelial growth factor (VEGF) inhibitor treatment while the majority of patients will eventually develop evasive resistance and exhibit disease progression while on therapy. It is proposed that mesenchymal-epithelial transition factor (c-MET) and its ligand hepatocyte growth factor (HGF or scatter factor) contribute significantly to VEGF inhibitor resistance such that combining a c-MET inhibitor with a VEGF inhibitor will provide additional clinical activity compared to VEGF inhibitor alone. This hypothesis will be tested using the cMET/ALK inhibitor, crizotinib, in combination with individual VEGF inhibitors. Three combinations will be prioritized, namely crizotinib plus axitinib, crizotinib plus sunitinib and crizotinib plus bevacizumab, with a fourth combination, crizotinib plus sorafenib to be tested only if crizotinib does not combine with either axitinib and/or sunitinib.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Carcinoma, Renal Cell, Glioblastoma, Carcinoma, Hepatocellular
    Keywords
    Phase 1b, crizotinib, sunitinib, axitinib, sorafenib, bevacizumab, cMET inhibitor, VEGF inhibitor, crizotinib combination

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Dose Escalation
    Arm Type
    Experimental
    Arm Description
    Histological or cytological diagnosis of advanced/metastatic solid tumor that is resistant to standard therapy or for which no standard therapy is available.
    Arm Title
    Expansion Population 1
    Arm Type
    Experimental
    Arm Description
    Patients with histologically confirmed metastatic renal cell cancer with no prior systemic therapy directed at the malignant tumor.
    Arm Title
    Expansion Population 2
    Arm Type
    Experimental
    Arm Description
    Patients with histologically confirmed metastatic renal cell cancer whose prior systemic therapy directed at the malignant tumor was single agent VEGF inhibitor and who now have acquired resistance to this treatment.
    Arm Title
    Expansion Population 3
    Arm Type
    Experimental
    Arm Description
    Patients with histologically confirmed glioblastoma whose disease has failed on previous therapy, and which must have included treatment with external beam radiation and temozolomide chemotherapy, and who now have radiographically recurrent or progressive disease.
    Arm Title
    Expansion Population 4
    Arm Type
    Experimental
    Arm Description
    Patients with histologically confirmed advanced-stage (unresectable or metastatic) hepatocellular carcinoma who have not received previous systemic therapy directed at the malignant tumor will be eligible to receive crizotinib plus sorafenib, should this combination be tested.
    Intervention Type
    Drug
    Intervention Name(s)
    Crizotinib plus VEGF inhibitor combinations
    Intervention Description
    Three combinations will be prioritized, namely crizotinib plus axitinib, crizotinib plus sunitinib and crizotinib plus bevacizumab, with a fourth combination, crizotinib plus sorafenib to be tested only if crizotinib does not combine with either axitinib and/or sunitinib. All study drugs are tablets or capsules except for bevacizumab which is parenteral (intravenous). Dosage, frequency and duration to be determined.
    Intervention Type
    Drug
    Intervention Name(s)
    Crizotinib plus axitinib
    Intervention Description
    Study drugs are tablets or capsules; dosage, frequency and duration to be determined.
    Intervention Type
    Drug
    Intervention Name(s)
    Crizotinib plus sunitinib
    Intervention Description
    Study drugs are tablets or capsules; dosage, frequency and duration to be determined.
    Intervention Type
    Drug
    Intervention Name(s)
    Crizotinib plus axitinib
    Intervention Description
    Study drugs are tablets or capsules; dosage, frequency and duration to be determined.
    Intervention Type
    Drug
    Intervention Name(s)
    Crizotinib plus sunitinib
    Intervention Description
    Study drugs are tablets or capsules; dosage, frequency and duration to be determined.
    Intervention Type
    Drug
    Intervention Name(s)
    Crizotinib plus bevacizumab
    Intervention Description
    Study drugs are tablets or capsules except for bevacizumab which is parenteral (intravenous). Dosage, frequency and duration to be determined.
    Intervention Type
    Drug
    Intervention Name(s)
    Crizotinib plus sorafenib
    Intervention Description
    Study drugs are tablets or capsules; dosage, frequency and duration to be determined.
    Primary Outcome Measure Information:
    Title
    Dose Limiting Toxicities (DLTs).
    Time Frame
    12 months
    Secondary Outcome Measure Information:
    Title
    Duration of Response (DR)
    Time Frame
    24 months
    Title
    Progression free survival (PFS)
    Time Frame
    24 months
    Title
    Area under the plasma concentration versus time curve (AUC) of crizotinib and each VEGF inhibitor
    Time Frame
    24 months
    Title
    Best overall response, as assessed using the Response Evaluation Criteria in Solid Tumor (RECIST) version 1.1 or , in the case of GBM (glioblastoma multiforme , RANO (Response Assessment in Neuro-Oncology) criteria.
    Time Frame
    24 months
    Title
    Overall survival (OS) up to 12 months
    Time Frame
    24 months
    Title
    Pre- and post-dose levels of soluble peripheral blood biomarkers.
    Time Frame
    24 months
    Title
    Tumor tissue biomarkers.
    Time Frame
    18 months
    Title
    6-month progression free survival proportion (PFS6) for glioblastoma patients
    Time Frame
    24 months
    Title
    Peak plasma concentration (Cmax) of crizotinib and each VEGF inhibitor
    Time Frame
    24 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Dose Escalation Population: Histological or cytological diagnosis of advanced/metastatic solid tumor that is resistant to standard therapy or for which no standard therapy is available. Lesions may be measurable or non measurable. Expansion Population 1: Patients with histologically confirmed metastatic renal cell cancer with no prior systemic therapy directed at the malignant tumor. Expansion Population 2: Patients with histologically confirmed metastatic renal cell cancer whose prior systemic therapy directed at the malignant tumor was single agent VEGF inhibitor and who now have acquired resistance to this treatment. Resistance is defined as progression following an initial response (complete or partial), or stable disease for at least 6 months on single agent VEGF inhibitor. Expansion Population 3: Patients with histologically confirmed glioblastoma whose disease has failed on previous therapy, and which must have included treatment with external beam radiation and temozolomide chemotherapy, and who now have radiographically recurrent or progressive disease. Expansion Population 4: Patients with histologically confirmed advanced-stage (unresectable or metastatic) hepatocellular carcinoma who have not received previous systemic therapy directed at the malignant tumor will be eligible to receive crizotinib plus sorafenib, should this combination be tested. Eligibility criteria also include normal hepatic function or Child-Pugh hepatic function class A. Exclusion Criteria: Patients with hemorrhagic brain metastases or with known symptomatic brain metastases requiring steroids. Major surgery within 4 weeks of starting study treatment. Radiation therapy within 2 weeks of starting study treatment. Hypertension that cannot be controlled with medications (>150/90 mmHg despite optimal medical therapy). For glioblastoma patients: Prior treatment of glioblastoma with Gliadel wafers, stereotactic radiation, or brachytherapy unless there is pathological or definitive radiological evidence (PET scan or perfusion MRI) of recurrent tumor or unless there is new enhancement outside of the radiation field. History of Grade 2 or greater acute intracranial hemorrhage. Radiation therapy (RT) for glioblastoma within 3 months unless there is either: a) histopathologic confirmation of recurrent tumor, or b) new enhancement on MRI outside of the RT treatment field.Concomitant treatment with therapeutic doses of anticoagulants (low dose warfarin (Coumadin) up to 2 mg PO daily for deep vein thrombosis prophylaxis is allowed).
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Pfizer CT.gov Call Center
    Organizational Affiliation
    Pfizer
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Links:
    URL
    https://trialinfoemail.pfizer.com/pages/landing.aspx?StudyID=A8081030&StudyName=A%20Study%20Of%20Crizotinib%20Plus%20VEGF%20Inhibitor%20Combinations%20In%20Patients%20With%20Advanced%20Solid%20Tumors.
    Description
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    A Study Of Crizotinib Plus VEGF Inhibitor Combinations In Patients With Advanced Solid Tumors.

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