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Phase I Dose Escalation Study of VS-5584 in Subjects With Advanced Non-Hematologic Malignancies or Lymphoma

Primary Purpose

Non Hematologic Cancers, Metastatic Cancer, Lymphoma

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
VS-5584
Sponsored by
Verastem, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non Hematologic Cancers focused on measuring PI3K Inhibitor, mTOR Inhibitor, Dual PI3K/mTOR Inhibitor, CSC, Cancer Stem Cells

Eligibility Criteria

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

Inclusion Criteria:

  1. Able to provide signed and dated informed consent prior to initiation of any study procedures.
  2. Age ≥ 18 years.
  3. Subjects must have a histopathologically confirmed diagnosis of an advanced non-hematologic malignancy or lymphoma or indolent NHL/CLL.
  4. Subjects must have no alternate therapy of proven benefit or have refused standard therapy.
  5. All clinically significant toxicities from prior chemotherapy must be ≤ Grade 1.
  6. ECOG performance status of 0 or 1, measured at screening and immediately before the start of treatment.
  7. Predicted life expectancy of ≥ 3 months.
  8. Fasting blood glucose of ≤ 140 mg/dL (7.8 mmol/L).
  9. Adequate renal function [creatinine ≤ 1.5x ULN (upper limit of normal)] or GFR of ≥ 60mL/min.
  10. Adequate hepatic function (total bilirubin ≤ 1.5x ULN for the institution; AST [aspartate transaminase] and ALT [alanine transaminase] ≤ 3x ULN).
  11. Adequate bone marrow function (hemoglobin ≥ 9.0 g/dL; platelets ≥ 75 x10^9 cells/L; absolute neutrophil count ≥ 1.0x10^9 cells/L).
  12. Corrected QT interval (QTc) < 470 ms (as calculated by the Fridericia correction formula).
  13. Negative pregnancy test for women of child-bearing potential.
  14. Men and women of child bearing potential must agree to use adequate birth control throughout their participation in the study and for 60 days following the last study treatment.
  15. Willing and able to participate in the trial and comply with all trial requirements.
  16. Subjects must have archival tumor tissue available for mutational analysis. A study specific biopsy can be performed if archival tissue is not available.
  17. Stable brain metastases either treated or being treated with a stable dose of steroids/ anticonvulsants, with no dose change within 28 days prior to the first dose of study drug, will be allowed.

Exclusion Criteria:

  1. Gastrointestinal (GI) condition which could interfere with the swallowing or absorption of study medication.
  2. Uncontrolled or severe concurrent medical condition including cardiovascular disease (e.g., myocardial infarct, unstable angina, New York Heart Association (NYHA) Class II or greater congestive heart failure, serious arrhythmias requiring medication for treatment, clinically significant pericardial disease, cardiac amyloidosis, transient ischemic attacks, CVA, coronary artery or other vascular stents).
  3. A past history of, or current uncontrolled hypertension. Blood pressure must be adequately controlled prior to dosing with VS-5584.
  4. Prior history of a hypertensive reaction to a kinase inhibitor
  5. History of upper gastrointestinal bleeding, ulceration, or perforation within 12 months prior to the first dose of study drug.
  6. Subjects with known infection with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) (testing not required).
  7. Subjects with known active Hepatitis A, B or C (testing not required).
  8. Subjects being actively treated for a secondary malignancy.
  9. Cancer-directed therapy (chemotherapy, radiotherapy, hormonal therapy with the exception of LHRH agonists for prostate cancer, biologic or immunotherapy, etc.) within 21 days of the first dose of study drug or 5 half-lives, whichever is shorter. Palliative radiotherapy is allowed prior to initiating treatment if associated toxicity resolved to ≤ Grade 1.
  10. Subjects currently taking medications known to be strong CYP3A4 inhibitors.
  11. Major surgery within 28 days prior to the first dose of study drug.
  12. Subjects with acute or chronic pancreatitis.
  13. Subjects with diabetes mellitus requiring insulin treatment or subjects with a HbA1C > 7.
  14. Use of an investigational drug within 28 days or 5 half-lives (whichever is shorter) prior to the first dose of study drug. A minimum of 14 days between termination of the investigational drug and administration of the study treatment is required. In addition, any drug-related toxicity except alopecia should have recovered to grade 1 or less.
  15. Women who are pregnant or breastfeeding.
  16. Any evidence of serious active infections.
  17. Uncontrolled intercurrent illness involving any other organ system or a social situation that would, in investigator's opinion, place the subject at unacceptable risk, limit compliance, or confound interpretation of safety or other results.

Sites / Locations

  • HonorHealth Research Institute
  • Cedars-Sinai Medical Center
  • Memorial Sloan Kettering Cancer Center
  • Tennessee Oncology
  • The Royal Marsden

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

VS-5584

Arm Description

Oral VS-5584 administered once daily on Day 1, 3, 5, 8, 10, 12, 15, 17 and 19 of each cycle

Outcomes

Primary Outcome Measures

Assess the safety and tolerability of VS-5584 in subjects with advanced non-hematologic malignancies or lymphoma
Serious Adverse events, Adverse events and their frequency, duration and severity, physical examination, laboratory parameters, vital signs and ECGs as determined based on CTCAE (Common Toxicity Criteria for Adverse Effects) V4.03. A Safety Monitoring Committee will review safety information.
Determine the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) and schedule of VS-5584 administered to subjects with advanced non-hematologic malignancies or lymphoma
The RP2D will be determined based on the MTD of VS-5584 as determined by number of participants with dose limiting toxicities related to VS-5584. Observations related to pharmacokinetics, pharmacodynamics, and any VS-5584 related toxicities may be included in the rationale supporting the RP2D and schedule and will not exceed the MTD.

Secondary Outcome Measures

Assess the pharmacokinetics of VS-5584
PK (pharmacokinetics) parameters, including but not limited to plasma concentration, clearance, AUC (Area Under Curve, 0-24 and 0-t), Cmax, Tmax, and T1/2

Full Information

First Posted
November 18, 2013
Last Updated
January 26, 2017
Sponsor
Verastem, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01991938
Brief Title
Phase I Dose Escalation Study of VS-5584 in Subjects With Advanced Non-Hematologic Malignancies or Lymphoma
Official Title
A Phase I Dose Escalation Study of VS-5584, a Dual PI3K/mTOR Inhibitor, in Subjects With Advanced Non-Hematologic Malignancies or Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Terminated
Why Stopped
Lack of recruitment and the company's decision to de-prioritize 5584 development
Study Start Date
November 2013 (undefined)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
December 2016 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase I, open-label, multicenter, dose-escalation trial of VS-5584, a PI3K/mTOR kinase inhibitor, in subjects with advanced non-hematologic malignancies or lymphoma. This clinical study is comprised of 2 sequential parts: Part 1 (Dose Escalation) and Part 2 (Expansion). The purpose of this study is to evaluate the safety (including the recommended Phase II dose), pharmacokinetics (the amount of VS-5584 in subject's blood) and the anti-cancer activity of VS-5584. Biomarkers (genes or proteins that may predict or show how subject's body may respond to VS-5584) will also be assessed in archival tumor tissue, tumor biopsies (in consenting subjects), and blood samples.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Hematologic Cancers, Metastatic Cancer, Lymphoma
Keywords
PI3K Inhibitor, mTOR Inhibitor, Dual PI3K/mTOR Inhibitor, CSC, Cancer Stem Cells

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
VS-5584
Arm Type
Experimental
Arm Description
Oral VS-5584 administered once daily on Day 1, 3, 5, 8, 10, 12, 15, 17 and 19 of each cycle
Intervention Type
Drug
Intervention Name(s)
VS-5584
Primary Outcome Measure Information:
Title
Assess the safety and tolerability of VS-5584 in subjects with advanced non-hematologic malignancies or lymphoma
Description
Serious Adverse events, Adverse events and their frequency, duration and severity, physical examination, laboratory parameters, vital signs and ECGs as determined based on CTCAE (Common Toxicity Criteria for Adverse Effects) V4.03. A Safety Monitoring Committee will review safety information.
Time Frame
From start of treatment to end of treatment, an expected average of 6 weeks
Title
Determine the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) and schedule of VS-5584 administered to subjects with advanced non-hematologic malignancies or lymphoma
Description
The RP2D will be determined based on the MTD of VS-5584 as determined by number of participants with dose limiting toxicities related to VS-5584. Observations related to pharmacokinetics, pharmacodynamics, and any VS-5584 related toxicities may be included in the rationale supporting the RP2D and schedule and will not exceed the MTD.
Time Frame
From start of treatment to end of Cycle 1 (21 day cycles)
Secondary Outcome Measure Information:
Title
Assess the pharmacokinetics of VS-5584
Description
PK (pharmacokinetics) parameters, including but not limited to plasma concentration, clearance, AUC (Area Under Curve, 0-24 and 0-t), Cmax, Tmax, and T1/2
Time Frame
Time points on Day 1, 2, 3, 17, 18
Other Pre-specified Outcome Measures:
Title
Evaluate the efficacy of VS-5584
Description
Response rate and progression-free survival as determined by Response Evaluation Criteria In Solid Tumors (RECIST), version 1.1 or by the Revised Response Criteria for Malignant Lymphoma
Time Frame
Every 6 weeks to end of treatment, expected average of 6 weeks
Title
Evaluate the time to new lesion
Time Frame
Expected average of 6 weeks from start of treatment to end of treatment
Title
Evaluate duration of response to VS-5584 compared with duration of response to prior therapy
Time Frame
Expected average of 6 weeks from start of treatment to end of treatment
Title
Examine the pharmacodynamic effect of VS-5584 on target proteins in platelet rich plasma and tumor biopsies
Description
Pharmacodynamic and predictive response biomarkers intended to demonstrate inhibition of the molecular target and determination of the mechanism of action will be assessed in archival tissue and tumor biopsies and platelet rich plasma samples.
Time Frame
Platelet rich plasma time points: Day 1, 2, 8, 17; Tumor biopsies time points: Screening, Day 22, and at the time of progression
Title
Examine if tumor genetic alterations and/or plasma biomarkers correlate with response to VS-5584 therapy
Description
Tumor genetic alterations and/or plasma biomarkers compared with response to VS-5584, as determined by Response Evaluation Criteria In Solid Tumors (RECIST), version 1.1 or Revised Response Criteria for Malignant Lymphoma
Time Frame
start of treatment to end of treatment, an expected average of 6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able to provide signed and dated informed consent prior to initiation of any study procedures. Age ≥ 18 years. Subjects must have a histopathologically confirmed diagnosis of an advanced non-hematologic malignancy or lymphoma or indolent NHL/CLL. Subjects must have no alternate therapy of proven benefit or have refused standard therapy. All clinically significant toxicities from prior chemotherapy must be ≤ Grade 1. ECOG performance status of 0 or 1, measured at screening and immediately before the start of treatment. Predicted life expectancy of ≥ 3 months. Fasting blood glucose of ≤ 140 mg/dL (7.8 mmol/L). Adequate renal function [creatinine ≤ 1.5x ULN (upper limit of normal)] or GFR of ≥ 60mL/min. Adequate hepatic function (total bilirubin ≤ 1.5x ULN for the institution; AST [aspartate transaminase] and ALT [alanine transaminase] ≤ 3x ULN). Adequate bone marrow function (hemoglobin ≥ 9.0 g/dL; platelets ≥ 75 x10^9 cells/L; absolute neutrophil count ≥ 1.0x10^9 cells/L). Corrected QT interval (QTc) < 470 ms (as calculated by the Fridericia correction formula). Negative pregnancy test for women of child-bearing potential. Men and women of child bearing potential must agree to use adequate birth control throughout their participation in the study and for 60 days following the last study treatment. Willing and able to participate in the trial and comply with all trial requirements. Subjects must have archival tumor tissue available for mutational analysis. A study specific biopsy can be performed if archival tissue is not available. Stable brain metastases either treated or being treated with a stable dose of steroids/ anticonvulsants, with no dose change within 28 days prior to the first dose of study drug, will be allowed. Exclusion Criteria: Gastrointestinal (GI) condition which could interfere with the swallowing or absorption of study medication. Uncontrolled or severe concurrent medical condition including cardiovascular disease (e.g., myocardial infarct, unstable angina, New York Heart Association (NYHA) Class II or greater congestive heart failure, serious arrhythmias requiring medication for treatment, clinically significant pericardial disease, cardiac amyloidosis, transient ischemic attacks, CVA, coronary artery or other vascular stents). A past history of, or current uncontrolled hypertension. Blood pressure must be adequately controlled prior to dosing with VS-5584. Prior history of a hypertensive reaction to a kinase inhibitor History of upper gastrointestinal bleeding, ulceration, or perforation within 12 months prior to the first dose of study drug. Subjects with known infection with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) (testing not required). Subjects with known active Hepatitis A, B or C (testing not required). Subjects being actively treated for a secondary malignancy. Cancer-directed therapy (chemotherapy, radiotherapy, hormonal therapy with the exception of LHRH agonists for prostate cancer, biologic or immunotherapy, etc.) within 21 days of the first dose of study drug or 5 half-lives, whichever is shorter. Palliative radiotherapy is allowed prior to initiating treatment if associated toxicity resolved to ≤ Grade 1. Subjects currently taking medications known to be strong CYP3A4 inhibitors. Major surgery within 28 days prior to the first dose of study drug. Subjects with acute or chronic pancreatitis. Subjects with diabetes mellitus requiring insulin treatment or subjects with a HbA1C > 7. Use of an investigational drug within 28 days or 5 half-lives (whichever is shorter) prior to the first dose of study drug. A minimum of 14 days between termination of the investigational drug and administration of the study treatment is required. In addition, any drug-related toxicity except alopecia should have recovered to grade 1 or less. Women who are pregnant or breastfeeding. Any evidence of serious active infections. Uncontrolled intercurrent illness involving any other organ system or a social situation that would, in investigator's opinion, place the subject at unacceptable risk, limit compliance, or confound interpretation of safety or other results.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hagop Youssoufian, MD
Organizational Affiliation
Verastem, Inc.
Official's Role
Study Chair
Facility Information:
Facility Name
HonorHealth Research Institute
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Tennessee Oncology
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
The Royal Marsden
City
Sutton
State/Province
London
ZIP/Postal Code
SM2 5PT
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase I Dose Escalation Study of VS-5584 in Subjects With Advanced Non-Hematologic Malignancies or Lymphoma

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