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A Open-Label, Multiple Ascending Dose Study of DS-3078a, an Oral TORC1/2 Kinase Inhibitor, in Subjects With Advanced Solid Tumors or Lymphomas

Primary Purpose

Advanced Solid Tumor, Lymphoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
DS-3078a
Sponsored by
Daiichi Sankyo, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Solid Tumor focused on measuring endometrial, prostate, breast, gastric, cervical, ovarian, neuroendocrine cancers, soft-tissue sarcoma, squamous cell NSCLC, renal cell carcinoma, non-Hodgkin lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  • A pathologically or cytologically documented advanced solid tumor or lymphoma that has relapsed from or is refractory to standard treatment or for which no standard treatment is available.
  • Men or women >=18 years old.
  • Eastern Cooperative Oncology Group (ECOG) performance status =<1
  • Have adequate bone marrow function, defined as:

    • Platelet count >=100 x 10^9/L for solid tumors and >=75 x 10^9/L for lymphomas,
    • Hemoglobin level >=9.0 g/dL, and ANC >=1.5 x 10^9/L for solid tumors and >=1.0 x 10^9/L for lymphomas.
  • Have adequate renal function, defined as:

Creatinine clearance >=60 mL/min, or creatinine =<1.5 x ULN.

  • Have adequate hepatic function, defined as:

    • AST/ALT levels =<3 x ULN (=<5 x ULN if liver metastases are present) and
    • Bilirubin =<1.5 x ULN.
  • Have adequate blood clotting function, defined as prothrombin time and activated partial thromboplastin time =<1.5 x ULN.
  • Subjects must be fully informed about their illness and the investigational nature of the study protocol (including foreseeable risks and possible side effects) and must sign and date an Institutional Review Board/Ethics Committee-approved informed consent form (including Health Insurance Portability and Accountability Act authorization, if applicable) before performance of any study specific procedures or tests.

For Part 2

  • A pathologically or cytologically documented advanced solid tumor or non-Hodgkin lymphoma, with measurable disease based on RECIST 1.1 or revised IWG criteria, that is refractory to standard treatment. The solid tumor types that will be included in the study are of the following kinds in which the mTOR signaling is frequently activated: endometrial, prostate, breast, gastric, cervical,ovarian, or neuroendocrine cancers, soft-tissue sarcoma, squamous cell NSCLC,renal cell carcinoma or other tumor types approved by the Sponsor.
  • Agree to undergo pre- and post-treatment tumor biopsies.

Exclusion Criteria:

  • History of primary central nervous system malignancies
  • Gastrointestinal diseases that could affect the absorption of DS-3078a in the opinion of the Investigator
  • Subjects with a fasting glucose >126 mg/dL (>7 mmol/L)
  • History of diabetes mellitus (type 1 or 2) or glycosylated hemoglobin >7.0% at screening
  • Positive test for hepatitis B surface antigen or hepatitis C antibody
  • Recipient of live vaccine within 1 month of or during study drug treatment
  • Use of chronic systemic corticosteroids (use of nasal or inhaled steroids is permitted)
  • Subjects requiring daily supplemental oxygen
  • Recipient of an allogenic stem cell or bone marrow transplant
  • Presence of a concomitant medical condition that would increase the risk of toxicity, in the opinion of the Investigator or Sponsor
  • Clinically active brain metastases, defined as untreated and symptomatic, or requiring therapy with steroids or anticonvulsants to control associated symptoms.
  • Has unresolved toxicities from previous anticancer therapy, defined as toxicities (other than alopecia) not yet resolved to NCI-CTCAE v4 grade =<1 or baseline.
  • Systemic treatment with anticancer therapy, antibody-based therapy, retinoid therapy, or hormonal therapy within 3 weeks before study drug treatment; or treatment with nitrosoureas or mitomycin C within 6 weeks before study drug treatment; or treatment with small-molecule targeted agents within 2 weeks or 5 half-lives before study drug treatment, whichever is longer.
  • Therapeutic radiation or major surgery within 4 weeks before study drug treatment or palliative radiation therapy within 2 weeks before study drug treatment
  • Participation in a clinical study within 3 weeks (2 weeks or 5 half-lives, whichever is longer, for small-molecule targeted agents) before study drug treatment, or current participation in other investigational procedures
  • Concomitant treatment with strong inhibitors or inducers of cytochrome P450 3A4 and P glycoprotein
  • Less than 1 week since using systemically acting drugs that increase gastric pH, such as H2-blockers and proton pump inhibitors. Antacids should be avoided within 48 hours of the first dose of DS 3078a
  • Prolongation of corrected QT interval by Fridericia's method (QTcF) at rest, where the mean QTcF interval is >450 msec based on triplicate electrocardiogram (ECG)
  • Pregnant or breastfeeding
  • Substance abuse or medical, psychological, or social conditions that, in the opinion of the Investigator, may interfere with the subject's participation in the clinical study or evaluation of the clinical study results

For Part 2

  • Subjects who have had prior treatment with an mTOR catalytic site inhibitor or dual PI3K/mTOR inhibitor (including, but not limited to, OSI-027, INK128, ADZ8055,AZD2014, WYE12513, PP242, BEZ-235, DS-7423, XL765, GDC-0980, SF1126, GSK2126458, PF4691502, and PF05212384) will be disqualified from entering the study.

Sites / Locations

  • South Texas Accelerated Research Therapeutics

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

DS-3078a

Arm Description

Part 1 - Dose escalation of DS-3078a to determine the maximum tolerated dose (MTD) will be guided by the modified continuous reassessment method (mCRM) using a Bayesian logistic regression model (BLRM) following escalation with overdose control (EWOC) principle. Before starting mCRM, initial dose escalation will proceed following an accelerated titration in which single subjects will be enrolled into sequential dose levels with a dose increment of up to 100% from the previous dose. Upon completion of Part 1 with established MTD and tentative recommended phase 2 dose (RP2D), the Dose Expansion (Part 2) will begin with the intention of further assessing the safety and tolerability of DS-3078a, confirming the RP2D, determining the Pharmacodynamic response in tumor samples, and evaluating preliminary efficacy of DS-3078a in subjects.

Outcomes

Primary Outcome Measures

Maximum tolerated dose
To determine the maximum tolerated dose (MTD) and tentative recommended Phase 2 dose (RP2D) of DS 3078a

Secondary Outcome Measures

determine the Cmax profile of DS 3078a
determine the Cmax (maximum concentration) of DS-3078a administered under fed and unfed conditions
effect on glucose metabolism
determine the effect of DS-3078a on glucose metabolism by measuring serum glucose and C peptide
assess pharmacodynamic effects tumor glucose uptake
assess the pharmacodynamic effects of DS 3078a by determining tumor glucose uptake using (18F) fluorodeoxyglucose positron emission tomography (FDG-PET)
assess tumor response
assess tumor response to DS-3078a in subjects with advanced non-Hodgkin lymphomas or advanced solid tumor types in which the mammalian target of rapamycin (mTOR) signaling pathway is frequently activated
assess pharmacodynamic effects v-akt murine thymoma viral oncogene
assess the pharmacodynamic effects of DS 3078a by measuring v-akt murine thymoma viral oncogene homolog 1 (Akt) phosphorylation in platelet rich plasma (PRP)
determine the AUC of DS 3078a
determine the Area under the concentration versus time curve (AUC) of DS-3078a administered under fed and unfed conditions
determine the Tmax of DS 3078a
determine the time of maximum concentyration (Tmax) of DS-3078a administered under fed and unfed conditions
determine the terminal half-life of DS 3078a
determine the terminal half-life (T1/2) of DS-3078a administered under fed and unfed conditions

Full Information

First Posted
April 26, 2012
Last Updated
February 8, 2019
Sponsor
Daiichi Sankyo, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01588678
Brief Title
A Open-Label, Multiple Ascending Dose Study of DS-3078a, an Oral TORC1/2 Kinase Inhibitor, in Subjects With Advanced Solid Tumors or Lymphomas
Official Title
A Phase 1, Open-Label, Multiple Ascending Dose Study of DS-3078a, an Oral TORC1/2 Kinase Inhibitor, in Subjects With Advanced Solid Tumors or Lymphomas
Study Type
Interventional

2. Study Status

Record Verification Date
April 2015
Overall Recruitment Status
Completed
Study Start Date
April 2012 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
June 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Daiichi Sankyo, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
DS-3078a will be evaluated as a single agent in subjects with advanced solid tumor malignancies or lymphomas refractory to standard treatment or for which no standard treatment is available.
Detailed Description
This is a Phase 1, open-label study of DS-3078a to assess safety and tolerability, identify the maximum tolerated dose (MTD) and tentative recommended phase 2 dose (RP2D), and assess pharmacokinetic and pharmacodynamic properties in subjects with advanced solid tumor malignancies or lymphomas. The study will include 2 parts: Dose Escalation and Dose Expansion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Tumor, Lymphoma
Keywords
endometrial, prostate, breast, gastric, cervical, ovarian, neuroendocrine cancers, soft-tissue sarcoma, squamous cell NSCLC, renal cell carcinoma, non-Hodgkin lymphoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
DS-3078a
Arm Type
Experimental
Arm Description
Part 1 - Dose escalation of DS-3078a to determine the maximum tolerated dose (MTD) will be guided by the modified continuous reassessment method (mCRM) using a Bayesian logistic regression model (BLRM) following escalation with overdose control (EWOC) principle. Before starting mCRM, initial dose escalation will proceed following an accelerated titration in which single subjects will be enrolled into sequential dose levels with a dose increment of up to 100% from the previous dose. Upon completion of Part 1 with established MTD and tentative recommended phase 2 dose (RP2D), the Dose Expansion (Part 2) will begin with the intention of further assessing the safety and tolerability of DS-3078a, confirming the RP2D, determining the Pharmacodynamic response in tumor samples, and evaluating preliminary efficacy of DS-3078a in subjects.
Intervention Type
Drug
Intervention Name(s)
DS-3078a
Intervention Description
DS-3078a will be administered as oral capsules once daily and will be supplied in 5, 20, 50, and 150 mg capsules.
Primary Outcome Measure Information:
Title
Maximum tolerated dose
Description
To determine the maximum tolerated dose (MTD) and tentative recommended Phase 2 dose (RP2D) of DS 3078a
Time Frame
3 years
Secondary Outcome Measure Information:
Title
determine the Cmax profile of DS 3078a
Description
determine the Cmax (maximum concentration) of DS-3078a administered under fed and unfed conditions
Time Frame
3 years
Title
effect on glucose metabolism
Description
determine the effect of DS-3078a on glucose metabolism by measuring serum glucose and C peptide
Time Frame
3 years
Title
assess pharmacodynamic effects tumor glucose uptake
Description
assess the pharmacodynamic effects of DS 3078a by determining tumor glucose uptake using (18F) fluorodeoxyglucose positron emission tomography (FDG-PET)
Time Frame
3 years
Title
assess tumor response
Description
assess tumor response to DS-3078a in subjects with advanced non-Hodgkin lymphomas or advanced solid tumor types in which the mammalian target of rapamycin (mTOR) signaling pathway is frequently activated
Time Frame
3 years
Title
assess pharmacodynamic effects v-akt murine thymoma viral oncogene
Description
assess the pharmacodynamic effects of DS 3078a by measuring v-akt murine thymoma viral oncogene homolog 1 (Akt) phosphorylation in platelet rich plasma (PRP)
Time Frame
3 years
Title
determine the AUC of DS 3078a
Description
determine the Area under the concentration versus time curve (AUC) of DS-3078a administered under fed and unfed conditions
Time Frame
3 years
Title
determine the Tmax of DS 3078a
Description
determine the time of maximum concentyration (Tmax) of DS-3078a administered under fed and unfed conditions
Time Frame
3 years
Title
determine the terminal half-life of DS 3078a
Description
determine the terminal half-life (T1/2) of DS-3078a administered under fed and unfed conditions
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A pathologically or cytologically documented advanced solid tumor or lymphoma that has relapsed from or is refractory to standard treatment or for which no standard treatment is available. Men or women >=18 years old. Eastern Cooperative Oncology Group (ECOG) performance status =<1 Have adequate bone marrow function, defined as: Platelet count >=100 x 10^9/L for solid tumors and >=75 x 10^9/L for lymphomas, Hemoglobin level >=9.0 g/dL, and ANC >=1.5 x 10^9/L for solid tumors and >=1.0 x 10^9/L for lymphomas. Have adequate renal function, defined as: Creatinine clearance >=60 mL/min, or creatinine =<1.5 x ULN. Have adequate hepatic function, defined as: AST/ALT levels =<3 x ULN (=<5 x ULN if liver metastases are present) and Bilirubin =<1.5 x ULN. Have adequate blood clotting function, defined as prothrombin time and activated partial thromboplastin time =<1.5 x ULN. Subjects must be fully informed about their illness and the investigational nature of the study protocol (including foreseeable risks and possible side effects) and must sign and date an Institutional Review Board/Ethics Committee-approved informed consent form (including Health Insurance Portability and Accountability Act authorization, if applicable) before performance of any study specific procedures or tests. For Part 2 A pathologically or cytologically documented advanced solid tumor or non-Hodgkin lymphoma, with measurable disease based on RECIST 1.1 or revised IWG criteria, that is refractory to standard treatment. The solid tumor types that will be included in the study are of the following kinds in which the mTOR signaling is frequently activated: endometrial, prostate, breast, gastric, cervical,ovarian, or neuroendocrine cancers, soft-tissue sarcoma, squamous cell NSCLC,renal cell carcinoma or other tumor types approved by the Sponsor. Agree to undergo pre- and post-treatment tumor biopsies. Exclusion Criteria: History of primary central nervous system malignancies Gastrointestinal diseases that could affect the absorption of DS-3078a in the opinion of the Investigator Subjects with a fasting glucose >126 mg/dL (>7 mmol/L) History of diabetes mellitus (type 1 or 2) or glycosylated hemoglobin >7.0% at screening Positive test for hepatitis B surface antigen or hepatitis C antibody Recipient of live vaccine within 1 month of or during study drug treatment Use of chronic systemic corticosteroids (use of nasal or inhaled steroids is permitted) Subjects requiring daily supplemental oxygen Recipient of an allogenic stem cell or bone marrow transplant Presence of a concomitant medical condition that would increase the risk of toxicity, in the opinion of the Investigator or Sponsor Clinically active brain metastases, defined as untreated and symptomatic, or requiring therapy with steroids or anticonvulsants to control associated symptoms. Has unresolved toxicities from previous anticancer therapy, defined as toxicities (other than alopecia) not yet resolved to NCI-CTCAE v4 grade =<1 or baseline. Systemic treatment with anticancer therapy, antibody-based therapy, retinoid therapy, or hormonal therapy within 3 weeks before study drug treatment; or treatment with nitrosoureas or mitomycin C within 6 weeks before study drug treatment; or treatment with small-molecule targeted agents within 2 weeks or 5 half-lives before study drug treatment, whichever is longer. Therapeutic radiation or major surgery within 4 weeks before study drug treatment or palliative radiation therapy within 2 weeks before study drug treatment Participation in a clinical study within 3 weeks (2 weeks or 5 half-lives, whichever is longer, for small-molecule targeted agents) before study drug treatment, or current participation in other investigational procedures Concomitant treatment with strong inhibitors or inducers of cytochrome P450 3A4 and P glycoprotein Less than 1 week since using systemically acting drugs that increase gastric pH, such as H2-blockers and proton pump inhibitors. Antacids should be avoided within 48 hours of the first dose of DS 3078a Prolongation of corrected QT interval by Fridericia's method (QTcF) at rest, where the mean QTcF interval is >450 msec based on triplicate electrocardiogram (ECG) Pregnant or breastfeeding Substance abuse or medical, psychological, or social conditions that, in the opinion of the Investigator, may interfere with the subject's participation in the clinical study or evaluation of the clinical study results For Part 2 Subjects who have had prior treatment with an mTOR catalytic site inhibitor or dual PI3K/mTOR inhibitor (including, but not limited to, OSI-027, INK128, ADZ8055,AZD2014, WYE12513, PP242, BEZ-235, DS-7423, XL765, GDC-0980, SF1126, GSK2126458, PF4691502, and PF05212384) will be disqualified from entering the study.
Facility Information:
Facility Name
South Texas Accelerated Research Therapeutics
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified individual participant data (IPD) and applicable supporting clinical trial documents may be available upon request at https://vivli.org/. In cases where clinical trial data and supporting documents are provided pursuant to our company policies and procedures, Daiichi Sankyo will continue to protect the privacy of our clinical trial participants. Details on data sharing criteria and the procedure for requesting access can be found at this web address: https://vivli.org/ourmember/daiichi-sankyo/
IPD Sharing Time Frame
Studies for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
IPD Sharing Access Criteria
Formal request from qualified scientific and medical researchers on IPD and clinical study documents from clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.
IPD Sharing URL
https://vivli.org/ourmember/daiichi-sankyo/

Learn more about this trial

A Open-Label, Multiple Ascending Dose Study of DS-3078a, an Oral TORC1/2 Kinase Inhibitor, in Subjects With Advanced Solid Tumors or Lymphomas

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