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Study of Safety and Efficacy of Ribociclib and Trametinib in Patients With Metastatic or Advanced Solid Tumors

Primary Purpose

Solid Tumors for Phase Ib, Pancreatic Cancer for Phase II, Colorectal Cancer for Phase II

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
ribociclib
Trametinib
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Tumors for Phase Ib focused on measuring Trametinib, Ribociclib, LEE011, TMT212, advanced solid tumors, pancreatic cancer, KRAS-mutant colorectal cancer, colorectal cancer, advanced pancreatic cancer, metastatic pancreatic cancer

Eligibility Criteria

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

Inclusion Criteria (All):

  • Written informed consent must
  • Patient has histologically and/or cytologically confirmed malignancies:

Phase I:

• Patients with advanced or metastatic solid tumors who have failed at least one prior line of systemic antineoplastic therapy in the advanced setting without a standard of care treatment option available;

Phase II:

  • Advanced or metastatic pancreatic adenocarcinoma who have failed at least one prior systemic antineoplastic therapies in the advanced setting
  • Advanced or metastatic KRAS-mutant CRC who have failed at least two prior systemic antineoplastic therapies in the advanced setting without a standard of care treatment option available. Testing for KRAS mutation in patients with CRC using locally approved diagnostic kit will be used for eligibility.
  • Phase II only: patient must have measurable disease
  • Patient has an ECOG performance status 0 or 1.
  • Patient has adequate bone marrow and organ function
  • Patient must have specified laboratory values within normal limits or corrected to within normal limits with supplements before the first dose of study medication on Cycle 1 Day 1:
  • Standard 12-lead ECG values defined

Exclusion Criteria:

Phase II only:

• Patient has received prior treatment with a MEK inhibitor or a CDK4/6 inhibitor.

Phase I and Phase II:

  • Patient with a known hypersensitivity to the study drugs or any of the excipients of ribociclib or trametinib.
  • Patient is concurrently using other anti-cancer therapy.
  • Patient has received radiotherapy ≤ 4 weeks or limited field radiation for palliation ≤ 2 weeks prior to Cycle 1 Day 1
  • Patient has received local therapy to liver ≤ 3 months of C1D1
  • History of liver disease as follow:
  • Cirrhosis
  • Autoimmune hepatitis
  • Active viral hepatitis
  • Portal hypertension
  • Drug induced liver steatosis
  • Prior systemic anti-cancer treatment within 28 days prior to Cycle 1 Day 1
  • Prior therapy with anthracyclines at cumulative doses of 450 mg/ m2 or more for doxorubicin or 900 mg/m2 or more for epirubicin.
  • Patient is currently receiving warfarin or other coumadin derived anti-coagulant
  • Patient has a history of deep venin thrombosis or pulmonary embolism within 6 months of screening.
  • Patient has a concurrent malignancy or malignancy within 3 years prior to Cycle 1 Day 1, with the exception of adequately treated basal or squamous cell carcinoma or curatively resected cervical cancer.
  • Patients with central nervous system (CNS) involvement
  • Patient has impairment of GI function or GI disease that may significantly alter the absorption of the study drugs
  • History of interstitial lung disease or pneumonitis.
  • Clinically significant, uncontrolled heart disease and/or cardiac repolarization abnormality
  • Patient is currently receiving any strong inducers or inhibitors of CYP3A4/5 and/or Substances that have a narrow therapeutic window and are predominantly metabolized through CYP3A4/5 and cannot be discontinued 7 days prior to Cycle 1 Day 1:
  • Patient is currently receiving or has received systemic corticosteroids ≤ 2 weeks prior to starting study drug, or who have not fully recovered from side effects of such treatment.
  • History of retinal vein occlusion (RVO)

Other protocol-defined inclusion/exclusion criteria may apply.

Sites / Locations

  • Highlands Oncology Group
  • City of Hope National Medical Center
  • Yale University School of Medicine
  • University of Miami Sylvester Comp Cancer Ctr
  • Dana Farber Cancer Center
  • UT MD Anderson Cancer Center
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Advanced or metastatic solid tumors

Arm Description

Patients in the Phase I portion of the study who have advanced or metastatic solid tumors

Outcomes

Primary Outcome Measures

Incidence of dose limiting toxicities (DLTs)
Phase Ib part: The primary variable is the incidence of DLTs during the first 21 days of therapy. Estimation of the MTD of the combination treatment will be based upon the estimation of the probability of DLT during the first 21 days of therapy for patients in the DDS.
Objective Response Rate (ORR)
Phase II part: The primary variable used to evaluate the efficacy of the ribociclib and trametinib combination is the ORR, defined as the proportion of patients with a best overall confirmed CR or PR, as assessed per RECIST 1.1 by investigator assessment.

Secondary Outcome Measures

Duration of response (DOR)
Phase II part: Among patients with a confirmed response (PR or CR) per RECIST 1.1, DOR is defined as the time from first documented response (PR or CR) to the date of first documented disease progression or death due to any cause. The distribution function of DOR will be estimated using the Kaplan-Meier method. The median DOR along with 95% CI will be presented by treatment arm.
Time to response
Phase II part: Time to overall response of CR or PR (TTR) is defined as the time from start of study drug to first documented response (CR or PR, which must be confirmed subsequently) for patients with a confirmed CR or PR. TTR will be summarized by treatment arm, using descriptive statistics.
Disease control rate
Phase II part: Disease control rate (DCR) is defined as the proportion of patients with best overall response of CR, PR, or SD per RECIST 1.1. DCR will be estimated and the binomial exact 95% CI will be provided by arm.
Progression disease rate
Phase Ib part: Progression disease rate defined as the proportion of patients with a progression disease as assessed per RECIST 1.1 by investigator assessment.
Progression free survival
Phase Ib and phase II parts: Progression-free survival (PFS) is defined as the time from the date of the first dose of study drug to the date of first documented disease progression per RECIST 1.1 or death due to any cause.
overall survival
Phase Ib and phase II parts: Overall survival (OS) is defined as the time from the date of first dose of study drug to the date of death due to any cause.

Full Information

First Posted
March 4, 2016
Last Updated
December 17, 2020
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02703571
Brief Title
Study of Safety and Efficacy of Ribociclib and Trametinib in Patients With Metastatic or Advanced Solid Tumors
Official Title
A Phase I/II Study of Safety and Efficacy of Ribociclib (LEE011) in Combination With Trametinib (TMT212) in Patients With Metastatic or Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Terminated
Why Stopped
Company decision
Study Start Date
June 29, 2016 (Actual)
Primary Completion Date
September 24, 2019 (Actual)
Study Completion Date
September 24, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

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
Phase Ib dose escalation in advanced solid tumors to identify dose for Phase II dose expansion in advanced or metastatic pancreatic cancer and KRAS-mutant colorectal cancer. Open-label, nonrandomized.
Detailed Description
Upon careful review of all available efficacy and safety data from the study phase Ib part, Novartis decided to not start the study phase II part. This decision was in no means triggered by an unfavorable safety profile of the combination. The observed safety profile of the combination represents contributions of the individual safety profile of trametinib and ribociclib. No new safety signals were observed. The study was closed early in line with protocol Section 4.4.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Tumors for Phase Ib, Pancreatic Cancer for Phase II, Colorectal Cancer for Phase II
Keywords
Trametinib, Ribociclib, LEE011, TMT212, advanced solid tumors, pancreatic cancer, KRAS-mutant colorectal cancer, colorectal cancer, advanced pancreatic cancer, metastatic pancreatic cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
single group for phase 1b parallel group for phase 2
Masking
None (Open Label)
Allocation
N/A
Enrollment
95 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Advanced or metastatic solid tumors
Arm Type
Experimental
Arm Description
Patients in the Phase I portion of the study who have advanced or metastatic solid tumors
Intervention Type
Drug
Intervention Name(s)
ribociclib
Other Intervention Name(s)
LEE011
Intervention Description
Combination treatment with LEE and TMT
Intervention Type
Drug
Intervention Name(s)
Trametinib
Other Intervention Name(s)
TMT212
Intervention Description
Combination treatment with LEE and TMT
Primary Outcome Measure Information:
Title
Incidence of dose limiting toxicities (DLTs)
Description
Phase Ib part: The primary variable is the incidence of DLTs during the first 21 days of therapy. Estimation of the MTD of the combination treatment will be based upon the estimation of the probability of DLT during the first 21 days of therapy for patients in the DDS.
Time Frame
21-day cycle one of treatment
Title
Objective Response Rate (ORR)
Description
Phase II part: The primary variable used to evaluate the efficacy of the ribociclib and trametinib combination is the ORR, defined as the proportion of patients with a best overall confirmed CR or PR, as assessed per RECIST 1.1 by investigator assessment.
Time Frame
Until progression of disease up to 1 year
Secondary Outcome Measure Information:
Title
Duration of response (DOR)
Description
Phase II part: Among patients with a confirmed response (PR or CR) per RECIST 1.1, DOR is defined as the time from first documented response (PR or CR) to the date of first documented disease progression or death due to any cause. The distribution function of DOR will be estimated using the Kaplan-Meier method. The median DOR along with 95% CI will be presented by treatment arm.
Time Frame
Until progression of disease up to 1 year
Title
Time to response
Description
Phase II part: Time to overall response of CR or PR (TTR) is defined as the time from start of study drug to first documented response (CR or PR, which must be confirmed subsequently) for patients with a confirmed CR or PR. TTR will be summarized by treatment arm, using descriptive statistics.
Time Frame
Until progression of disease up to 1 year
Title
Disease control rate
Description
Phase II part: Disease control rate (DCR) is defined as the proportion of patients with best overall response of CR, PR, or SD per RECIST 1.1. DCR will be estimated and the binomial exact 95% CI will be provided by arm.
Time Frame
Until progression of disease up to 1 year
Title
Progression disease rate
Description
Phase Ib part: Progression disease rate defined as the proportion of patients with a progression disease as assessed per RECIST 1.1 by investigator assessment.
Time Frame
Until progression of disease up to 1 year
Title
Progression free survival
Description
Phase Ib and phase II parts: Progression-free survival (PFS) is defined as the time from the date of the first dose of study drug to the date of first documented disease progression per RECIST 1.1 or death due to any cause.
Time Frame
Until progression of disease up to 1 year
Title
overall survival
Description
Phase Ib and phase II parts: Overall survival (OS) is defined as the time from the date of first dose of study drug to the date of death due to any cause.
Time Frame
Until death up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria (All): Written informed consent must Patient has histologically and/or cytologically confirmed malignancies: Phase I: • Patients with advanced or metastatic solid tumors who have failed at least one prior line of systemic antineoplastic therapy in the advanced setting without a standard of care treatment option available; Phase II: Advanced or metastatic pancreatic adenocarcinoma who have failed at least one prior systemic antineoplastic therapies in the advanced setting Advanced or metastatic KRAS-mutant CRC who have failed at least two prior systemic antineoplastic therapies in the advanced setting without a standard of care treatment option available. Testing for KRAS mutation in patients with CRC using locally approved diagnostic kit will be used for eligibility. Phase II only: patient must have measurable disease Patient has an ECOG performance status 0 or 1. Patient has adequate bone marrow and organ function Patient must have specified laboratory values within normal limits or corrected to within normal limits with supplements before the first dose of study medication on Cycle 1 Day 1: Standard 12-lead ECG values defined Exclusion Criteria: Phase II only: • Patient has received prior treatment with a MEK inhibitor or a CDK4/6 inhibitor. Phase I and Phase II: Patient with a known hypersensitivity to the study drugs or any of the excipients of ribociclib or trametinib. Patient is concurrently using other anti-cancer therapy. Patient has received radiotherapy ≤ 4 weeks or limited field radiation for palliation ≤ 2 weeks prior to Cycle 1 Day 1 Patient has received local therapy to liver ≤ 3 months of C1D1 History of liver disease as follow: Cirrhosis Autoimmune hepatitis Active viral hepatitis Portal hypertension Drug induced liver steatosis Prior systemic anti-cancer treatment within 28 days prior to Cycle 1 Day 1 Prior therapy with anthracyclines at cumulative doses of 450 mg/ m2 or more for doxorubicin or 900 mg/m2 or more for epirubicin. Patient is currently receiving warfarin or other coumadin derived anti-coagulant Patient has a history of deep venin thrombosis or pulmonary embolism within 6 months of screening. Patient has a concurrent malignancy or malignancy within 3 years prior to Cycle 1 Day 1, with the exception of adequately treated basal or squamous cell carcinoma or curatively resected cervical cancer. Patients with central nervous system (CNS) involvement Patient has impairment of GI function or GI disease that may significantly alter the absorption of the study drugs History of interstitial lung disease or pneumonitis. Clinically significant, uncontrolled heart disease and/or cardiac repolarization abnormality Patient is currently receiving any strong inducers or inhibitors of CYP3A4/5 and/or Substances that have a narrow therapeutic window and are predominantly metabolized through CYP3A4/5 and cannot be discontinued 7 days prior to Cycle 1 Day 1: Patient is currently receiving or has received systemic corticosteroids ≤ 2 weeks prior to starting study drug, or who have not fully recovered from side effects of such treatment. History of retinal vein occlusion (RVO) Other protocol-defined inclusion/exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Highlands Oncology Group
City
Fayetteville
State/Province
Arkansas
ZIP/Postal Code
72703
Country
United States
Facility Name
City of Hope National Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Yale University School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520
Country
United States
Facility Name
University of Miami Sylvester Comp Cancer Ctr
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Dana Farber Cancer Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
UT MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Novartis Investigative Site
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3000
Country
Australia
Facility Name
Novartis Investigative Site
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
Novartis Investigative Site
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 1Z2
Country
Canada
Facility Name
Novartis Investigative Site
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 4E6
Country
Canada
Facility Name
Novartis Investigative Site
City
Koeln
ZIP/Postal Code
50937
Country
Germany
Facility Name
Novartis Investigative Site
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
Novartis Investigative Site
City
Amsterdam
ZIP/Postal Code
1066 CX
Country
Netherlands
Facility Name
Novartis Investigative Site
City
Utrecht
ZIP/Postal Code
3584 CX
Country
Netherlands
Facility Name
Novartis Investigative Site
City
Barcelona
State/Province
Catalunya
ZIP/Postal Code
08035
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Links:
URL
https://www.novctrd.com/ctrdweb/trialresult/trialresults/pdf?trialResultId=17721
Description
Results for CTMT212X2106 from the Novartis Clinical Trials Website

Learn more about this trial

Study of Safety and Efficacy of Ribociclib and Trametinib in Patients With Metastatic or Advanced Solid Tumors

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