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Mass Balance, Pharmacokinetics and Metabolism Study of Alisertib

Primary Purpose

Advanced Solid Tumors, Lymphoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
[^14C]-alisertib
alisertib
Sponsored by
Millennium Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Solid Tumors focused on measuring Drug Therapy

Eligibility Criteria

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

Inclusion Criteria:

Each participants must meet all of the following inclusion criteria to be enrolled in the study:

  • 18 years or older.
  • Histologically or cytologically confirmed metastatic and/or advanced solid tumors or lymphomas for which standard curative or life-prolonging treatment does not exist, or is no longer effective or tolerable.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
  • Expected survival longer than 3 months from enrollment in the study.
  • Radiographically or clinically evaluable tumor.
  • Suitable venous access for the conduct of blood sampling.
  • Recovered from the reversible effects of prior antineoplastic treatment (with the exception of alopecia and Grade 1 neuropathy).
  • Female participants who are postmenopausal for at least 1 year OR are surgically sterile OR if of childbearing potential, agree to practice 2 effective methods of contraception at the same time.
  • Male participants who agree to practice effective barrier contraception during the entire study and through 4 months after the last dose of study drug OR agree to abstain from heterosexual intercourse.

Exclusion Criteria:

Participants meeting any of the following exclusion criteria are not to be enrolled in the study:

  • Female participants who are lactating or have a positive serum pregnancy test.
  • Treatment with any investigational products or systemic antineoplastic treatment within 21 days before the first dose of alisertib.
  • Medical conditions requiring daily, chronic, or regular use of proton pump inhibitors(PPIs) within 7 days preceding the first dose of alisertib, or H2-receptor antagonists within 24 hours preceding the first dose of alisertib.
  • Participants requiring systemic anticoagulation (excluding low-dose aspirin, or low-dose anticoagulation to maintain patency of venous access devices). Low molecular weight heparin, administered as preventive treatment, is allowed if the participant has tolerated treatment with a stable dose and schedule without bleeding complications for more than 1 month.
  • Major surgery within the 14 days preceding the first dose of alisertib.
  • Infection requiring systemic intravenous (IV) antibiotic therapy within 14 days preceding the first dose of study drug, or other severe infection.
  • Life-threatening or uncontrolled medical illness unrelated to cancer.
  • Ongoing nausea or vomiting that is Grade 2 or worse in intensity.
  • Diarrhea that is Grade 2 or worse in intensity or use of an antimotility agent to control diarrhea to an intensity of Grade 1 or lower level.
  • Known GI disease or GI procedures that could interfere with the oral absorption, excretion, or tolerance of alisertib.
  • History of urinary and/or fecal incontinence.
  • History of uncontrolled sleep apnea syndrome and other conditions that could result in excessive daytime sleepiness such as severe chronic obstructive pulmonary disease.
  • Inability to swallow tablets, or inability or unwillingness to avoid taking anything by mouth except for water and prescribed medications for 2 hours before and 1 hour after the first dose of alisertib.
  • Inadequate bone marrow or other organ function as specified in study protocol.
  • Any cardiovascular condition specified in the study protocol.
  • Known or suspected human immunodeficiency virus (HIV) positive or hepatitis B surface antigen-positive status, or known or suspected active hepatitis C infection.
  • Inability to comply with study visits and procedures including required inpatient confinement (approximately 11-17 days).

Please note that there are additional exclusion criteria. The study center will determine if you meet all of the criteria.

Sites / Locations

  • Comprehensive Clinical Development

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Alisertib

Arm Description

Part A: [^14C]-alisertib 35 mg, oral solution containing 80 - 100 microcuries (μCi) of total radioactivity (1.19 - 1.48 mCi/mmol), orally, single dose on Day 1. Part B: Alisertib 50 mg, enteric coated tablets, orally, twice daily for 7 days, followed by 14-day washout period in 21-day cycles until disease progression or unacceptable treatment-related toxicity (Up to 3 Cycles).

Outcomes

Primary Outcome Measures

Cmax: Maximum Observed Plasma Concentration for Alisertib and Drug-Related Material Following a Single Dose of [^14C]-Alisertib Oral Solution
Tmax: Time of First Occurrence of Cmax for Alisertib and Drug-Related Material in Plasma Following a Single Dose of [^14C]-Alisertib Oral Solution
AUClast: Area Under the Concentration-Time Curve From Time 0 to Time of the Last Quantifiable Plasma Concentration for Alisertib and Drug-Related Material Following a Single Dose of [^14C]-Alisertib Oral Solution
AUC∞: Area Under the Concentration-Time Curve From Time 0 to Infinity, Calculated Using the Observed Value of the Last Quantifiable Plasma Concentration for Alisertib and Drug-Related Material Following a Single Dose of [^14C]-Alisertib Oral Solution
T1/2: Terminal Half Life for Alisertib and Drug-Related Material in Plasma Following a Single Dose of [^14C]-Alisertib Oral Solution
CL/F: Apparent Clearance After Extravascular Administration, Calculated Using the Observed Value of the Last Quantifiable Plasma Concentration for Alisertib Following a Single Dose of [^14C]-Alisertib Oral Solution
Ratio of Whole Blood Total Radioactivity (TRA) Cmax to Plasma TRA Cmax
Ratio of Alisertib Plasma Cmax to Drug-Related Material TRA Plasma Cmax
Ratio of Whole Blood TRA AUClast to Plasma TRA AUClast
Ratio of Alisertib Plasma AUClast to Drug-Related Material TRA Plasma AUClast
Ratio of Whole Blood TRA AUC∞ to Plasma TRA AUC∞
Ratio of Alisertib Plasma AUC∞ to Drug-Related Material TRA Plasma AUC∞
Fe: Fraction of Administered Dose of [^14C]-Alisertib Excreted in Urine
Fe: Fraction of Administered Dose of [^14C]-Alisertib Excreted in Feces
Ae: Amount of [^14C]-Alisertib Excreted in Urine
Ae: Amount of [^14C]-Alisertib Excreted in Feces
Percent of Total Radioactivity (TRA) in Urine and Feces
Fe: Fraction of Administered Dose of Alisertib Excreted in Urine
Ae: Amount of Alisertib Excretion in Urine
Renal Clearance (CLR) of Alisertib

Secondary Outcome Measures

Percentage of Alisertib Metabolites in Plasma Following a Single Dose of [^14C]-Alisertib Oral Solution
Total radioactive peak distributions of metabolites in 0 to 192 hours pooled plasma samples from participants.
Percentage of Alisertib Metabolites in Urine Following a Single Dose of [^14C]-Alisertib Oral Solution
Total radioactive peak distributions of metabolites in 0 to 192 hours pooled urine samples from participants.
Percentage of Alisertib Metabolites in Feces Following a Single Dose of [^14C]-Alisertib Oral Solution
Total radioactive peak distributions of metabolites in 0 to 192 hours pooled fecal samples from participants.
Number of Participants With Treatment-Emergent Adverse Events and Serious Adverse Events
An Adverse Event (AE) was defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. A Serious Adverse Event (SAE) was defined as any AE at any dose that: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in a persistent or significant disability/incapacity or resulted in congenital anomaly/birth defect. A treatment-emergent adverse event is defined as an adverse event with an onset that occurs after receiving study drug.
Number of Participants With Clinically Significant Changes or Abnormalities in Clinical Laboratory Values Reported as AEs
An abnormal laboratory was assessed to be an AE if the value lead to discontinuation or delay in treatment, dose modification, therapeutic intervention, or was considered by the investigator to be a clinically significant change from Baseline.
Number of Participants With Clinically Significant Changes or Abnormalities in Vital Sign Measurements
Vital signs included body temperature, heart rate, and sitting blood pressure. The investigator determined if the changes were clinically significant.

Full Information

First Posted
October 17, 2012
Last Updated
February 20, 2018
Sponsor
Millennium Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01714947
Brief Title
Mass Balance, Pharmacokinetics and Metabolism Study of Alisertib
Official Title
Mass Balance, Pharmacokinetics, and Metabolism of [^14C]-Alisertib in Patients With Advanced Solid Tumors or Lymphomas
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
January 24, 2013 (Actual)
Primary Completion Date
April 4, 2013 (Actual)
Study Completion Date
June 14, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Millennium Pharmaceuticals, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the mass balance (i.e. cumulative excretion of total radioactivity [TRA] in urine and feces) of alisertib and pharmacokinetic (PK) of alisertib in plasma and urine, and of TRA in plasma and whole blood.
Detailed Description
The drug being tested in this study is called alisertib (MLN8237). Alisertib is being tested to treat participants who have advanced solid tumors or lymphomas. This study looked at mass balance, pharmacokinetics (PK), metabolism, elimination and safety of alisertib. The study enrolled 3 patients. The study consisted of 2 parts: Part A and Part B. Participants received: [^14C]-alisertib 35 mg in Part A alisertib 50 mg in Part B Participants were asked to take a single dose of [^14C]-alisertib oral solution containing 80-100 μCi of total radioactivity (1.19-1.48 mCi/mmol) in Part A and alisertib 50 mg, orally, twice daily for 7 days in 21-day cycles until disease progression or unacceptable toxicity in Part B. This single center trial was conducted in United States. The overall time to participate in this study was up to 117 days. Participants remained confined to clinic in Part A and made multiple visits to the clinic in Part B. Participants were contacted 30 days after last dose of alisertib in Part A (if not continuing in Part B), or were contacted by telephone or a final visit 30 days after receiving their last dose of alisertib in Part B for a follow-up assessment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Tumors, Lymphoma
Keywords
Drug Therapy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Alisertib
Arm Type
Experimental
Arm Description
Part A: [^14C]-alisertib 35 mg, oral solution containing 80 - 100 microcuries (μCi) of total radioactivity (1.19 - 1.48 mCi/mmol), orally, single dose on Day 1. Part B: Alisertib 50 mg, enteric coated tablets, orally, twice daily for 7 days, followed by 14-day washout period in 21-day cycles until disease progression or unacceptable treatment-related toxicity (Up to 3 Cycles).
Intervention Type
Drug
Intervention Name(s)
[^14C]-alisertib
Other Intervention Name(s)
MLN8237
Intervention Description
[^14C]-alisertib oral solution
Intervention Type
Drug
Intervention Name(s)
alisertib
Other Intervention Name(s)
MLN8237
Intervention Description
Alisertib enteric coated tablets
Primary Outcome Measure Information:
Title
Cmax: Maximum Observed Plasma Concentration for Alisertib and Drug-Related Material Following a Single Dose of [^14C]-Alisertib Oral Solution
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Tmax: Time of First Occurrence of Cmax for Alisertib and Drug-Related Material in Plasma Following a Single Dose of [^14C]-Alisertib Oral Solution
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
AUClast: Area Under the Concentration-Time Curve From Time 0 to Time of the Last Quantifiable Plasma Concentration for Alisertib and Drug-Related Material Following a Single Dose of [^14C]-Alisertib Oral Solution
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
AUC∞: Area Under the Concentration-Time Curve From Time 0 to Infinity, Calculated Using the Observed Value of the Last Quantifiable Plasma Concentration for Alisertib and Drug-Related Material Following a Single Dose of [^14C]-Alisertib Oral Solution
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
T1/2: Terminal Half Life for Alisertib and Drug-Related Material in Plasma Following a Single Dose of [^14C]-Alisertib Oral Solution
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
CL/F: Apparent Clearance After Extravascular Administration, Calculated Using the Observed Value of the Last Quantifiable Plasma Concentration for Alisertib Following a Single Dose of [^14C]-Alisertib Oral Solution
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ratio of Whole Blood Total Radioactivity (TRA) Cmax to Plasma TRA Cmax
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ratio of Alisertib Plasma Cmax to Drug-Related Material TRA Plasma Cmax
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ratio of Whole Blood TRA AUClast to Plasma TRA AUClast
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ratio of Alisertib Plasma AUClast to Drug-Related Material TRA Plasma AUClast
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ratio of Whole Blood TRA AUC∞ to Plasma TRA AUC∞
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ratio of Alisertib Plasma AUC∞ to Drug-Related Material TRA Plasma AUC∞
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Fe: Fraction of Administered Dose of [^14C]-Alisertib Excreted in Urine
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Fe: Fraction of Administered Dose of [^14C]-Alisertib Excreted in Feces
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ae: Amount of [^14C]-Alisertib Excreted in Urine
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ae: Amount of [^14C]-Alisertib Excreted in Feces
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Percent of Total Radioactivity (TRA) in Urine and Feces
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Fe: Fraction of Administered Dose of Alisertib Excreted in Urine
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Ae: Amount of Alisertib Excretion in Urine
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Title
Renal Clearance (CLR) of Alisertib
Time Frame
Predose and multiple timepoints post-dose (up to 240 hours)
Secondary Outcome Measure Information:
Title
Percentage of Alisertib Metabolites in Plasma Following a Single Dose of [^14C]-Alisertib Oral Solution
Description
Total radioactive peak distributions of metabolites in 0 to 192 hours pooled plasma samples from participants.
Time Frame
Predose and multiple timepoints post-dose (0 to 192 hours)
Title
Percentage of Alisertib Metabolites in Urine Following a Single Dose of [^14C]-Alisertib Oral Solution
Description
Total radioactive peak distributions of metabolites in 0 to 192 hours pooled urine samples from participants.
Time Frame
Predose and multiple timepoints post-dose (0 to 192 hours)
Title
Percentage of Alisertib Metabolites in Feces Following a Single Dose of [^14C]-Alisertib Oral Solution
Description
Total radioactive peak distributions of metabolites in 0 to 192 hours pooled fecal samples from participants.
Time Frame
Predose and multiple timepoints post-dose (0 to 192 hours)
Title
Number of Participants With Treatment-Emergent Adverse Events and Serious Adverse Events
Description
An Adverse Event (AE) was defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. A Serious Adverse Event (SAE) was defined as any AE at any dose that: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in a persistent or significant disability/incapacity or resulted in congenital anomaly/birth defect. A treatment-emergent adverse event is defined as an adverse event with an onset that occurs after receiving study drug.
Time Frame
From first dose of study drug through 30 days after the last dose of study drug (Up to 117 days)
Title
Number of Participants With Clinically Significant Changes or Abnormalities in Clinical Laboratory Values Reported as AEs
Description
An abnormal laboratory was assessed to be an AE if the value lead to discontinuation or delay in treatment, dose modification, therapeutic intervention, or was considered by the investigator to be a clinically significant change from Baseline.
Time Frame
Part A: Day 1 and End of Study (EOS) Day 31 if not continuing to Part B, Part B: Days 8 and 15 of each cycle and EOS (Up to 117 days)
Title
Number of Participants With Clinically Significant Changes or Abnormalities in Vital Sign Measurements
Description
Vital signs included body temperature, heart rate, and sitting blood pressure. The investigator determined if the changes were clinically significant.
Time Frame
Part A: Day 1 and EOS (Day 31 if not continuing to Part B), Part B: Day 1 of each cycle and EOS (Up to 117 days)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Each participants must meet all of the following inclusion criteria to be enrolled in the study: 18 years or older. Histologically or cytologically confirmed metastatic and/or advanced solid tumors or lymphomas for which standard curative or life-prolonging treatment does not exist, or is no longer effective or tolerable. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1. Expected survival longer than 3 months from enrollment in the study. Radiographically or clinically evaluable tumor. Suitable venous access for the conduct of blood sampling. Recovered from the reversible effects of prior antineoplastic treatment (with the exception of alopecia and Grade 1 neuropathy). Female participants who are postmenopausal for at least 1 year OR are surgically sterile OR if of childbearing potential, agree to practice 2 effective methods of contraception at the same time. Male participants who agree to practice effective barrier contraception during the entire study and through 4 months after the last dose of study drug OR agree to abstain from heterosexual intercourse. Exclusion Criteria: Participants meeting any of the following exclusion criteria are not to be enrolled in the study: Female participants who are lactating or have a positive serum pregnancy test. Treatment with any investigational products or systemic antineoplastic treatment within 21 days before the first dose of alisertib. Medical conditions requiring daily, chronic, or regular use of proton pump inhibitors(PPIs) within 7 days preceding the first dose of alisertib, or H2-receptor antagonists within 24 hours preceding the first dose of alisertib. Participants requiring systemic anticoagulation (excluding low-dose aspirin, or low-dose anticoagulation to maintain patency of venous access devices). Low molecular weight heparin, administered as preventive treatment, is allowed if the participant has tolerated treatment with a stable dose and schedule without bleeding complications for more than 1 month. Major surgery within the 14 days preceding the first dose of alisertib. Infection requiring systemic intravenous (IV) antibiotic therapy within 14 days preceding the first dose of study drug, or other severe infection. Life-threatening or uncontrolled medical illness unrelated to cancer. Ongoing nausea or vomiting that is Grade 2 or worse in intensity. Diarrhea that is Grade 2 or worse in intensity or use of an antimotility agent to control diarrhea to an intensity of Grade 1 or lower level. Known GI disease or GI procedures that could interfere with the oral absorption, excretion, or tolerance of alisertib. History of urinary and/or fecal incontinence. History of uncontrolled sleep apnea syndrome and other conditions that could result in excessive daytime sleepiness such as severe chronic obstructive pulmonary disease. Inability to swallow tablets, or inability or unwillingness to avoid taking anything by mouth except for water and prescribed medications for 2 hours before and 1 hour after the first dose of alisertib. Inadequate bone marrow or other organ function as specified in study protocol. Any cardiovascular condition specified in the study protocol. Known or suspected human immunodeficiency virus (HIV) positive or hepatitis B surface antigen-positive status, or known or suspected active hepatitis C infection. Inability to comply with study visits and procedures including required inpatient confinement (approximately 11-17 days). Please note that there are additional exclusion criteria. The study center will determine if you meet all of the criteria.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director Clinical Science
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
Facility Name
Comprehensive Clinical Development
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98418
Country
United States

12. IPD Sharing Statement

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Mass Balance, Pharmacokinetics and Metabolism Study of Alisertib

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