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Phase Ib Study to Determine MTD of AZD1775 Monotherapy in Patients With Locally Advanced or Metastatic Solid Tumours.

Primary Purpose

Locally Advanced Solid Tumours, Metastatic Solid Tumours, Ovarian Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AZD1775
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Locally Advanced Solid Tumours focused on measuring AZD1775, Metastatic solid tumors, Ovarian cancer

Eligibility Criteria

18 Years - 130 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Prior palliative radiation completed ≥ 7 days prior to the start of AZD1775 and recovered from any acute adverse effects.
  2. ECOG PS score 0 or 1.
  3. Baseline laboratory values:

    • ANC ≥1500/μL
    • Hemoglobin (HgB) ≥9 g/dL
    • Platelets ≥100,000/μL
    • ALT and AST ≤3 x ULN or ≤5 x ULN if known hepatic metastases.
    • Serum bilirubin WNL or ≤1.5 x ULN in patients with liver metastases; or total bilirubin ≤3.0 x ULN with direct bilirubin WNL in patients with well documented Gilbert's Syndrome.
    • Serum creatinine ≤1.5 x ULN, or measured creatinine clearance ≥45 mL/min.
  4. Females who are not of child-bearing potential and fertile females of child-bearing potential who agree to use adequate contraceptive measures, who are not breastfeeding, and who have a negative serum or urine pregnancy test within 3 days prior to, and on the day of starting study treatment.
  5. Males willing to use at least one medically acceptable form of contraception for duration of study and for 3 months after treatment stops.
  6. Predicted life expectancy ≥12 wks.
  7. Age ≥18
  8. Histologically or cytologically documented locally advanced or metastatic solid tumour, excluding lymphoma, for which standard therapy does not exist or has proven ineffective or intolerable.
  9. Measurable or non-measurable disease according to RECIST v1.1.

Exclusion Criteria:

  1. Use of a treatment drug 21 days or 5 half-lives (whichever is shorter) prior to AZD1775. For drugs for which 5 half-lives is ≤21 days, a minimum of 10 days between termination of the prior treatment and administration of AZD1775 treatment is required.
  2. Use of an investigational drug during the past 30 days or 5 half-lives (whichever is longer) prior to first dose of study treatment.
  3. Major surgical procedures ≤28 days of beginning study treatment, or minor surgical procedures ≤7 days.
  4. Grade >1 toxicity from prior therapy (except alopecia or anorexia).
  5. Inability to swallow oral medications.
  6. Palliative radiation therapy completed ≤7 days prior to start of study drug.
  7. Known malignant CNS disease other than neurologically stable, treated brain metastases.
  8. Rx or non-Rx drugs or products known to be sensitive to CYP3A4 substrates or CYP3A4 substrates with a narrow therapeutic index, or to be moderate to strong inhibitors/inducers of CYP3A4 which cannot be discontinued 2 weeks prior to dosing and withheld until 2 weeks after the last dose of study drug.
  9. Patients should stop using herbal medications 7 days prior to first dose of study treatment.
  10. Any of the following cardiac diseases currently or within the last 6 months as defined by New York Heart Association (NYHA) ≥ Class 2.

    • Unstable angina pectoris
    • Congestive heart failure
    • Acute myocardial infarction
    • Conduction abnormality not controlled with pacemaker or medication
    • Significant ventricular or supraventricular arrhythmias (patients with chronic rate-controlled atrial fibrillation in the absence of other cardiac abnormalities are eligible)
  11. History of Torsades de pointes unless all risk factors that contributed to Torsades have been corrected.

11. Mean resting QTc interval >470 msec (as calculated per institutional standards) at study entry obtained from 3 ECGs within 5 minutes or congenital long QT syndrome.

12. Pregnant or lactating. 13. Serious active infection at the time of study entry, or another serious underlying medical condition that would impair the ability of the patient to receive study treatment.

14. Presence of other active invasive cancers. 15. Psychological, familial, sociological, or geographical conditions that do not permit compliance with protocol.

Sites / Locations

  • Research Site
  • Research Site
  • Research Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AZD1775

Arm Description

This is a single-arm study in which all patients will receive AZD1775 orally. Patients will continue to receive treatment with AZD1775 until disease progression, intolerable toxicity, or discontinuation criteria are met.

Outcomes

Primary Outcome Measures

The incidence of dose-limiting toxicities (DLTs) associated with AZD1775 monotherapy administered once daily (QD) in 14 day cycles (5 days on, followed by 9 days rest) in patients with locally advanced or metastatic solid tumours.
The MTD will be determined through dose-escalation using a 3+3 cohort design. If less than one-third of evaluable patients in a given cohort (0 of 3 patients or 1 of 6 patients) experiences a DLT; escalation may proceed to the next higher dose level. If one of the first 3 patients enrolled in a given cohort experiences a dose-limiting toxicity (DLT), at least 3 additional patents will be enrolled in that cohort. If a DLT is observed in one-third or more of patients, the dose at which this occurs will be considered not tolerated and the MTD will have been exceeded. The highest dose level(s) at which less than one-third of patients (0 of 3 patients or 1 of 6 patients) experiences a DLT will be declared the MTD.
The incidence of dose-limiting toxicities (DLTs) associated with AZD1775 monotherapy administered once daily (QD) in 21-day cycles (5 days on, followed by 2 days rest) in patients with locally advanced or metastatic solid tumours.
The MTD will be determined through dose-escalation using a 3+3 cohort design. If less than one-third of evaluable patients in a given cohort (0 of 3 patients or 1 of 6 patients) experiences a DLT; escalation may proceed to the next higher dose level. If one of the first 3 patients enrolled in a given cohort experiences a dose-limiting toxicity (DLT), at least 3 additional patents will be enrolled in that cohort. If a DLT is observed in one-third or more of patients, the dose at which this occurs will be considered not tolerated and the MTD will have been exceeded. The highest dose level(s) at which less than one-third of patients (0 of 3 patients or 1 of 6 patients) experiences a DLT will be declared the MTD.
The incidence of dose-limiting toxicities (DLTs) associated with AZD1775 monotherapy administered twice daily (BID) in 14-day cycles (5 days on, followed by 9 days rest) in patients with locally advanced or metastatic solid tumours.
The MTD will be determined through dose-escalation using a 3+3 cohort design. If less than one-third of evaluable patients in a given cohort (0 of 3 patients or 1 of 6 patients) experiences a DLT; escalation may proceed to the next higher dose level. If one of the first 3 patients enrolled in a given cohort experiences a dose-limiting toxicity (DLT), at least 3 additional patents will be enrolled in that cohort. If a DLT is observed in one-third or more of patients, the dose at which this occurs will be considered not tolerated and the MTD will have been exceeded. The highest dose level(s) at which less than one-third of patients (0 of 3 patients or 1 of 6 patients) experiences a DLT will be declared the MTD.

Secondary Outcome Measures

Plasma concentration of AZD1775 in fasted condition
Blood samples for determination of AZD1775 concentration will be collected during dose escalation and dose expansion.
Plasma concentration of AZD1775 when dosed with a high fat meal.
Blood samples for determination of AZD1775 concentration will be collected during dose escalation and dose expansion.
The incidence of treatment-emergent adverse events (TEAEs) in patients with locally advanced or metastatic solid tumours.
Treatment-emergent adverse events will be assessed by physical examinations, ECOG performance status, complete blood count (CBC) with differential and platelets, clinical chemistry and haematology, triplicate 12-lead ECG, changes in vital signs, and patient reported symptoms.
Best objective response (OR) to treatment will be assessed by dose level cohort according to RECIST v1.1 in patients with locally advanced or metastatic solid tumours.
RECIST v1.1 criteria will be used to assess response to treatment. Tumour imaging studies will be repeated every 4 cycles (8 weeks) to assess response until objective disease progression as defined by RECIST v1.1 or withdrawal from study. Categorisation of objective tumour response assessment will be based on the RECIST v1.1 criteria of response: Complete Response (CR), Partial Response (PR), Stable Disease (SD) and Progressive Disease (PD). Target lesion progression will be calculated in comparison to when the tumour burden was at a minimum. In the absence of progression, tumour response will be calculated in comparison to the baseline tumour measurements obtained before starting treatment.
The incidence of QTc interval abnormalities in patients with locally advanced or metastatic solid tumours.

Full Information

First Posted
November 17, 2015
Last Updated
June 30, 2023
Sponsor
AstraZeneca
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1. Study Identification

Unique Protocol Identification Number
NCT02610075
Brief Title
Phase Ib Study to Determine MTD of AZD1775 Monotherapy in Patients With Locally Advanced or Metastatic Solid Tumours.
Official Title
A Phase Ib Study to Determine the Maximum Tolerated Dose (MTD) of AZD1775 Monotherapy in Patients With Locally Advanced or Metastatic Solid Tumours.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
December 1, 2015 (Actual)
Primary Completion Date
April 26, 2018 (Actual)
Study Completion Date
April 26, 2018 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This Phase Ib study will identify the Maximum Tolerated Dose (MTD) of AZD1775 monotherapy when administered orally once daily (QD) or two times per day (BID) on Days 1 to 5 followed by 9 days of rest in 14-day cycles, or QD on a 5/2 dosing schedule (5 days on, followed by 2 days rest) in 21-day cycles in patients with locally advanced or metastatic solid tumours. Alternative treatment schedules may be explored if preliminary data suggest these would be more appropriate. The effect of food on single dose PK of AZD1775 will be assessed in 12 patients. In this sub-study, patients will receive a single oral dose of AZD1775 with 240 mL of water, once in the fasted state and once following a high-fat meal.
Detailed Description
This study will attempt to determine the Maximum Tolerated Dose (MTD)/Recommended Phase 2 Dose (RP2D) of AZD1775 monotherapy when administered orally once daily (QD) or two times per day (BID) on Days 1 to 5 followed by 9 days of rest in 14-day cycles, or QD on a 5/2 dosing schedule (5 days on, followed by 2 days rest) in 21-day cycles in patients with locally advanced or metastatic solid tumours. Both the QD 5/9 and 5/2 dosing schedules will run in parallel. An evaluation will be made after the second QD cohort has been completed to determine whether to proceed with one or both dosing schedules. The AZD1775 MTD will be determined through dose-escalation using a 3+3 cohort design. If less than one-third of evaluable patients in a given cohort (0 of 3 patients or 1 of 6 patients) experiences a Dose-Limiting Toxicity (DLT); escalation may proceed to the next higher dose level. If one of the first 3 patients enrolled in a given cohort experiences a DLT, 3 additional patents will be enrolled in that cohort. If a DLT is observed in one-third or more of patients, the dose at which this occurs will be considered not tolerated and the MTD will have been exceeded. The highest dose level(s) at which less than one-third of patients (0 of 3 patients or 1 of 6 patients) experiences a DLT will be declared the MTD. Up to 6 patients will be enrolled in each cohort. Dose escalation will continue until identification of the MTD or Sponsor termination of the study. A maximum of 10 dose escalations are anticipated in the determination of MTD. Approximately 6 subjects may be added to replace non-evaluable patients. Therefore, a total of 66 patients are expected to be treated. Dose-limiting toxicities will be evaluated during Cycles 1 and 2 of treatment. If appropriate the DLT observation period can be expanded by up to 2 weeks in case of treatment delay due to study drug-related adverse events. Toxicity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.03. Patients must complete Cycle 1 and Cycle 2 safety evaluations which will conclude on Cycle 3 Day 1, and must receive at least 80% of the planned dose to be considered evaluable. Patients receiving less than 80% of Cycle 1 and Cycle 2 dose (28 days) will be replaced unless they experienced a confirmed DLT. The patient population used to determine the MTD will consist of patients who have met the minimum safety evaluation requirements of the study, and/or who have experienced a DLT in Cycle 1 or Cycle 2. Minimum safety requirements will be met if during Cycle 1 and Cycle 2 of treatment the patient receives a minimum of 80% of treatment doses of AZD1775, completes the safety evaluations, and is observed for at least 28 days. Patients who do not meet these minimum safety evaluation and treatment requirements and whom do not experience a DLT will be replaced. Patients will be allowed to continue treatment with AZD1775 until evidence of disease progression, unacceptable toxicity, or other discontinuation criterion has occurred.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Locally Advanced Solid Tumours, Metastatic Solid Tumours, Ovarian Cancer
Keywords
AZD1775, Metastatic solid tumors, Ovarian cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
AZD1775
Arm Type
Experimental
Arm Description
This is a single-arm study in which all patients will receive AZD1775 orally. Patients will continue to receive treatment with AZD1775 until disease progression, intolerable toxicity, or discontinuation criteria are met.
Intervention Type
Drug
Intervention Name(s)
AZD1775
Intervention Description
All patients will receive intervention with AZD1775 orally. Patients will continue to receive treatment with AZD1775 until disease progression, intolerable toxicity, or discontinuation criteria are met.
Primary Outcome Measure Information:
Title
The incidence of dose-limiting toxicities (DLTs) associated with AZD1775 monotherapy administered once daily (QD) in 14 day cycles (5 days on, followed by 9 days rest) in patients with locally advanced or metastatic solid tumours.
Description
The MTD will be determined through dose-escalation using a 3+3 cohort design. If less than one-third of evaluable patients in a given cohort (0 of 3 patients or 1 of 6 patients) experiences a DLT; escalation may proceed to the next higher dose level. If one of the first 3 patients enrolled in a given cohort experiences a dose-limiting toxicity (DLT), at least 3 additional patents will be enrolled in that cohort. If a DLT is observed in one-third or more of patients, the dose at which this occurs will be considered not tolerated and the MTD will have been exceeded. The highest dose level(s) at which less than one-third of patients (0 of 3 patients or 1 of 6 patients) experiences a DLT will be declared the MTD.
Time Frame
Dose-limiting toxicities will be evaluated during the first 2 cycles (28 days) of AZD1775 monotherapy treatment.
Title
The incidence of dose-limiting toxicities (DLTs) associated with AZD1775 monotherapy administered once daily (QD) in 21-day cycles (5 days on, followed by 2 days rest) in patients with locally advanced or metastatic solid tumours.
Description
The MTD will be determined through dose-escalation using a 3+3 cohort design. If less than one-third of evaluable patients in a given cohort (0 of 3 patients or 1 of 6 patients) experiences a DLT; escalation may proceed to the next higher dose level. If one of the first 3 patients enrolled in a given cohort experiences a dose-limiting toxicity (DLT), at least 3 additional patents will be enrolled in that cohort. If a DLT is observed in one-third or more of patients, the dose at which this occurs will be considered not tolerated and the MTD will have been exceeded. The highest dose level(s) at which less than one-third of patients (0 of 3 patients or 1 of 6 patients) experiences a DLT will be declared the MTD.
Time Frame
Dose-limiting toxicities will be evaluated during the first cycle (21 days) of AZD1775 monotherapy treatment.
Title
The incidence of dose-limiting toxicities (DLTs) associated with AZD1775 monotherapy administered twice daily (BID) in 14-day cycles (5 days on, followed by 9 days rest) in patients with locally advanced or metastatic solid tumours.
Description
The MTD will be determined through dose-escalation using a 3+3 cohort design. If less than one-third of evaluable patients in a given cohort (0 of 3 patients or 1 of 6 patients) experiences a DLT; escalation may proceed to the next higher dose level. If one of the first 3 patients enrolled in a given cohort experiences a dose-limiting toxicity (DLT), at least 3 additional patents will be enrolled in that cohort. If a DLT is observed in one-third or more of patients, the dose at which this occurs will be considered not tolerated and the MTD will have been exceeded. The highest dose level(s) at which less than one-third of patients (0 of 3 patients or 1 of 6 patients) experiences a DLT will be declared the MTD.
Time Frame
Dose-limiting toxicities will be evaluated during the first 2 cycles (28 days) of AZD1775 monotherapy treatment.
Secondary Outcome Measure Information:
Title
Plasma concentration of AZD1775 in fasted condition
Description
Blood samples for determination of AZD1775 concentration will be collected during dose escalation and dose expansion.
Time Frame
Samples for AZD1775 PK analysis (fasted) will be taken on Cycle 1 Day 1 predose & 2 hr postdose, Cycle 1, Day 5 pre-dose & 1, 2, 4, 6, 8, & 10 hr post-dose. Samples will also be collected on Cycle 5, Day 3, 4, or 5 pre-dose & pre-dose every 3-5 Cycles.
Title
Plasma concentration of AZD1775 when dosed with a high fat meal.
Description
Blood samples for determination of AZD1775 concentration will be collected during dose escalation and dose expansion.
Time Frame
Samples for AZD1775 PK food effect analysis will be taken 4 hours after dosing on Cycle 2 Day 1. Subjects will fast for 10 hours prior to dose and for 4 hours post-dose except for the high-fat meal 30 minutes post-dose.
Title
The incidence of treatment-emergent adverse events (TEAEs) in patients with locally advanced or metastatic solid tumours.
Description
Treatment-emergent adverse events will be assessed by physical examinations, ECOG performance status, complete blood count (CBC) with differential and platelets, clinical chemistry and haematology, triplicate 12-lead ECG, changes in vital signs, and patient reported symptoms.
Time Frame
6 months
Title
Best objective response (OR) to treatment will be assessed by dose level cohort according to RECIST v1.1 in patients with locally advanced or metastatic solid tumours.
Description
RECIST v1.1 criteria will be used to assess response to treatment. Tumour imaging studies will be repeated every 4 cycles (8 weeks) to assess response until objective disease progression as defined by RECIST v1.1 or withdrawal from study. Categorisation of objective tumour response assessment will be based on the RECIST v1.1 criteria of response: Complete Response (CR), Partial Response (PR), Stable Disease (SD) and Progressive Disease (PD). Target lesion progression will be calculated in comparison to when the tumour burden was at a minimum. In the absence of progression, tumour response will be calculated in comparison to the baseline tumour measurements obtained before starting treatment.
Time Frame
8 weeks
Title
The incidence of QTc interval abnormalities in patients with locally advanced or metastatic solid tumours.
Time Frame
28 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
130 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Prior palliative radiation completed ≥ 7 days prior to the start of AZD1775 and recovered from any acute adverse effects. ECOG PS score 0 or 1. Baseline laboratory values: ANC ≥1500/μL Hemoglobin (HgB) ≥9 g/dL Platelets ≥100,000/μL ALT and AST ≤3 x ULN or ≤5 x ULN if known hepatic metastases. Serum bilirubin WNL or ≤1.5 x ULN in patients with liver metastases; or total bilirubin ≤3.0 x ULN with direct bilirubin WNL in patients with well documented Gilbert's Syndrome. Serum creatinine ≤1.5 x ULN, or measured creatinine clearance ≥45 mL/min. Females who are not of child-bearing potential and fertile females of child-bearing potential who agree to use adequate contraceptive measures, who are not breastfeeding, and who have a negative serum or urine pregnancy test within 3 days prior to, and on the day of starting study treatment. Males willing to use at least one medically acceptable form of contraception for duration of study and for 3 months after treatment stops. Predicted life expectancy ≥12 wks. Age ≥18 Histologically or cytologically documented locally advanced or metastatic solid tumour, excluding lymphoma, for which standard therapy does not exist or has proven ineffective or intolerable. Measurable or non-measurable disease according to RECIST v1.1. Exclusion Criteria: Use of a treatment drug 21 days or 5 half-lives (whichever is shorter) prior to AZD1775. For drugs for which 5 half-lives is ≤21 days, a minimum of 10 days between termination of the prior treatment and administration of AZD1775 treatment is required. Use of an investigational drug during the past 30 days or 5 half-lives (whichever is longer) prior to first dose of study treatment. Major surgical procedures ≤28 days of beginning study treatment, or minor surgical procedures ≤7 days. Grade >1 toxicity from prior therapy (except alopecia or anorexia). Inability to swallow oral medications. Palliative radiation therapy completed ≤7 days prior to start of study drug. Known malignant CNS disease other than neurologically stable, treated brain metastases. Rx or non-Rx drugs or products known to be sensitive to CYP3A4 substrates or CYP3A4 substrates with a narrow therapeutic index, or to be moderate to strong inhibitors/inducers of CYP3A4 which cannot be discontinued 2 weeks prior to dosing and withheld until 2 weeks after the last dose of study drug. Patients should stop using herbal medications 7 days prior to first dose of study treatment. Any of the following cardiac diseases currently or within the last 6 months as defined by New York Heart Association (NYHA) ≥ Class 2. Unstable angina pectoris Congestive heart failure Acute myocardial infarction Conduction abnormality not controlled with pacemaker or medication Significant ventricular or supraventricular arrhythmias (patients with chronic rate-controlled atrial fibrillation in the absence of other cardiac abnormalities are eligible) History of Torsades de pointes unless all risk factors that contributed to Torsades have been corrected. 11. Mean resting QTc interval >470 msec (as calculated per institutional standards) at study entry obtained from 3 ECGs within 5 minutes or congenital long QT syndrome. 12. Pregnant or lactating. 13. Serious active infection at the time of study entry, or another serious underlying medical condition that would impair the ability of the patient to receive study treatment. 14. Presence of other active invasive cancers. 15. Psychological, familial, sociological, or geographical conditions that do not permit compliance with protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gerald Falchook, MD
Organizational Affiliation
Sarah Cannon Research Institute HealthOne, Denver, CO
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research Site
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States
Facility Name
Research Site
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Facility Name
Research Site
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
32705
Country
United States

12. IPD Sharing Statement

Links:
URL
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Phase Ib Study to Determine MTD of AZD1775 Monotherapy in Patients With Locally Advanced or Metastatic Solid Tumours.

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