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Study of PX-866 and Vemurafenib in Patients With Advanced Melanoma

Primary Purpose

Advanced BRAF-mutant Cancers

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PX-866
vemurafenib
Sponsored by
Cascadian Therapeutics Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced BRAF-mutant Cancers focused on measuring PX-866, BRAF-mutant cancers, Advanced melanoma, BRAF inhibitor, Vemurafenib, Zelboraf, PI-3K inhibitor

Eligibility Criteria

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

Inclusion Criteria:

  • ≥ 18 years at time of consent
  • If a sexually active male or a sexually active female of child-bearing potential, agrees to use a highly effective form of contraception (including birth control pills, barrier device, or intrauterine device)from the time of consent 90 days following the last dose of study drug
  • If female of child-bearing potential, negative pregnancy test
  • For Phase 1: must have histologically or cytologically-confirmed advanced cancer that is BRAF mutation-positive (V600E or V600K) for which there is no remaining standard therapy with curative potential. Patients must have disease sites amenable to biopsy. For Phase 2: must have histologically or cytologically-confirmed BRAF mutation-positive (V600E or V600K) advanced (defined as unresectable Stage IIIC or IV) melanoma that has not been treated with a selective BRAF inhibitor
  • For Phase 1: must have measurable or non-measurable disease. For Phase 2: must have measurable disease per RECIST 1.1
  • For Phase 1: no restriction on number of prior therapy regimens. For Phase 2: the following restrictions on prior therapy apply: 1) must not have been treated with a selective BRAF inhibitor and must not have had more than 2 prior treatment regimens for advanced metastatic disease; 2) must have completed prior cytotoxic chemotherapy a minimum of 4 weeks prior to starting PX-866 and/or vemurafenib (except for BCNU and/or mitomycin C, which must have been completed a minimum of 6 weeks prior to starting therapy). Prior biologic therapy and localized radiation therapy must have been completed a minimum of 2 weeks prior to starting therapy.
  • All toxicities related to prior cancer therapies other than alopecia must have resolved to Grade 1 or less
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • In the opinion of the clinical investigator, life expectancy > 3 months
  • Adequate hematologic function
  • Adequate hepatic function
  • Serum creatinine < 2.0 mg/dL
  • Adequate cardiac function
  • Corrected QTc must be <480 milliseconds

Exclusion Criteria:

  • May not be receiving any other investigational agents
  • Active central nervous system (CNS) metastases are excluded. Patients with a history of CNS metastasis, who have been treated prior to enrollment, must be stable for eight weeks after completion of treatment. These patients must have undergone appropriate imaging studies and currently be on a stable, lowest possible dose of steroids
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to PX-866 or vemurafenib
  • Uncontrolled intercurrent illness including, but not limited to: ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Uncorrectable electrolyte abnormalities or long QT syndrome
  • Poorly controlled diabetes mellitus
  • Pregnant, breastfeeding, or planning to become pregnant
  • Known to be human immunodeficiency virus (HIV)-positive
  • Inability to swallow pills
  • Previous treatment with a phosphatidylinositol-3-kinase (PI-3K) inhibitor
  • Any other significant medical or psychiatric condition that in the opinion of the investigator renders the patient inadequate for participation

Sites / Locations

  • H. Lee Moffitt Cancer Center
  • New York University
  • University of Pennsylvania
  • University of Pittsburgh Cancer Institute
  • Vanderbilt-Ingram Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Phase 1 Dose Escalation of PX-866 + vemurafenib

Phase 2 Combination PX-866 + vemurafenib

Phase 2 Single-agent vemurafenib

Arm Description

PX-866 given with vemurafenib

PX-866 given with vemurafenib

vemurafenib given as a single agent

Outcomes

Primary Outcome Measures

Incidence and severity of adverse events (phase 1)
Progression-free survival (PFS) (phase 2)

Secondary Outcome Measures

Plasma concentrations of PX-866 and metabolites (phase 1)
Objective Response Rate (ORR)(phase 2)
Disease Control Rate (DCR)(phase 2)
Plasma concentrations of vemurafenib (phase 1)

Full Information

First Posted
June 6, 2012
Last Updated
May 14, 2018
Sponsor
Cascadian Therapeutics Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01616199
Brief Title
Study of PX-866 and Vemurafenib in Patients With Advanced Melanoma
Official Title
Phase 1/2 Study of PI-3K Inhibition With PX-866 Combined With Vemurafenib (BRAF Inhibitor) in Patients With BRAF-mutant Cancer Including Advanced Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2015
Overall Recruitment Status
Terminated
Why Stopped
slow accrual
Study Start Date
August 2012 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cascadian Therapeutics Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the phase 1 portion of the study is to determine the maximally tolerated dose (MTD) or recommended dose (RD) and the safety/tolerability of PX-866 in combination vemurafenib in patients with any advanced BRAF-mutant cancer. The purpose of the phase 2 portion of the study is to compare progression free survival (PFS), antitumor activity (response rate), disease control rate (DCR), and the safety and tolerability of PX-866 in combination with vemurafenib vs. vemurafenib alone in patients with advanced BRAF-mutant melanoma at the doses recommended from Phase 1.
Detailed Description
This is a Phase 1 / 2 open-label study of PX-866 given in combination with vemurafenib to patients with BRAF-mutant cancer, including advanced melanoma. Phase 1 will use a 3+3 dose escalation design to evaluate up to three dose levels of PX-866 in combination with up to two dose levels of vemurafenib in order to identify the maximal tolerated dose/recommended dose (MTD/RD) of both PX-866 and vemurafenib to be used in Phase 2. Vemurafenib will be administered orally twice per day on days 1-28 of all cycles except cycle 1, where vemurafenib will be administered on days 9-28 to allow for PK assessments). PX-866 will be administered once per day on days 1-28 of each cycle. Phase 2 will evaluate the antitumor activity and safety of PX-866 given to patients randomized 2:1 to receive combination with vemurafenib at the doses recommended from Phase 1 compared with vemurafenib alone administered at the approved dose orally BID. All treatments will be administered on a 28-day cycle. Patients randomized to receive single-agent vemurafenib may cross-over to receive the combination treatment at the time of progression. Patients will be evaluated for progression approximately every 8 weeks for the initial 24 weeks and every 12 weeks thereafter. All patients with stable disease (SD) or better, will receive repeat cycles until disease progression (PD), unacceptable toxicity, or withdrawal of consent.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced BRAF-mutant Cancers
Keywords
PX-866, BRAF-mutant cancers, Advanced melanoma, BRAF inhibitor, Vemurafenib, Zelboraf, PI-3K inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Phase 1 Dose Escalation of PX-866 + vemurafenib
Arm Type
Experimental
Arm Description
PX-866 given with vemurafenib
Arm Title
Phase 2 Combination PX-866 + vemurafenib
Arm Type
Experimental
Arm Description
PX-866 given with vemurafenib
Arm Title
Phase 2 Single-agent vemurafenib
Arm Type
Active Comparator
Arm Description
vemurafenib given as a single agent
Intervention Type
Drug
Intervention Name(s)
PX-866
Other Intervention Name(s)
PI-3K inhibitor
Intervention Description
Phase 1 dose escalation: PX-866 in combination administered orally every day in 28-day cycles until progression or unacceptable toxicity. Phase 2 combination: PX-866 and vemurafenib administered every day in 28 day cycles until progression or unacceptable toxicity. Phase 2 single-agent: vemurafenib administered orally at labeled dose every day in 28 day cycles until progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
vemurafenib
Other Intervention Name(s)
Zelboraf
Intervention Description
vemurafenib is a B-Raf enzyme inhibitor
Primary Outcome Measure Information:
Title
Incidence and severity of adverse events (phase 1)
Time Frame
28 days
Title
Progression-free survival (PFS) (phase 2)
Time Frame
56 days
Secondary Outcome Measure Information:
Title
Plasma concentrations of PX-866 and metabolites (phase 1)
Time Frame
44 days
Title
Objective Response Rate (ORR)(phase 2)
Time Frame
56 days
Title
Disease Control Rate (DCR)(phase 2)
Time Frame
56 Days
Title
Plasma concentrations of vemurafenib (phase 1)
Time Frame
44 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: ≥ 18 years at time of consent If a sexually active male or a sexually active female of child-bearing potential, agrees to use a highly effective form of contraception (including birth control pills, barrier device, or intrauterine device)from the time of consent 90 days following the last dose of study drug If female of child-bearing potential, negative pregnancy test For Phase 1: must have histologically or cytologically-confirmed advanced cancer that is BRAF mutation-positive (V600E or V600K) for which there is no remaining standard therapy with curative potential. Patients must have disease sites amenable to biopsy. For Phase 2: must have histologically or cytologically-confirmed BRAF mutation-positive (V600E or V600K) advanced (defined as unresectable Stage IIIC or IV) melanoma that has not been treated with a selective BRAF inhibitor For Phase 1: must have measurable or non-measurable disease. For Phase 2: must have measurable disease per RECIST 1.1 For Phase 1: no restriction on number of prior therapy regimens. For Phase 2: the following restrictions on prior therapy apply: 1) must not have been treated with a selective BRAF inhibitor and must not have had more than 2 prior treatment regimens for advanced metastatic disease; 2) must have completed prior cytotoxic chemotherapy a minimum of 4 weeks prior to starting PX-866 and/or vemurafenib (except for BCNU and/or mitomycin C, which must have been completed a minimum of 6 weeks prior to starting therapy). Prior biologic therapy and localized radiation therapy must have been completed a minimum of 2 weeks prior to starting therapy. All toxicities related to prior cancer therapies other than alopecia must have resolved to Grade 1 or less Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 In the opinion of the clinical investigator, life expectancy > 3 months Adequate hematologic function Adequate hepatic function Serum creatinine < 2.0 mg/dL Adequate cardiac function Corrected QTc must be <480 milliseconds Exclusion Criteria: May not be receiving any other investigational agents Active central nervous system (CNS) metastases are excluded. Patients with a history of CNS metastasis, who have been treated prior to enrollment, must be stable for eight weeks after completion of treatment. These patients must have undergone appropriate imaging studies and currently be on a stable, lowest possible dose of steroids History of allergic reactions attributed to compounds of similar chemical or biologic composition to PX-866 or vemurafenib Uncontrolled intercurrent illness including, but not limited to: ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Uncorrectable electrolyte abnormalities or long QT syndrome Poorly controlled diabetes mellitus Pregnant, breastfeeding, or planning to become pregnant Known to be human immunodeficiency virus (HIV)-positive Inability to swallow pills Previous treatment with a phosphatidylinositol-3-kinase (PI-3K) inhibitor Any other significant medical or psychiatric condition that in the opinion of the investigator renders the patient inadequate for participation
Facility Information:
Facility Name
H. Lee Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
New York University
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
University of Pittsburgh Cancer Institute
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Facility Name
Vanderbilt-Ingram Cancer Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States

12. IPD Sharing Statement

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Study of PX-866 and Vemurafenib in Patients With Advanced Melanoma

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