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A Drug-drug Interaction Study of Avapritinib and Midazolam

Primary Purpose

Gastrointestinal Stromal Tumors, GIST, Non-resectable Advanced Solid Tumors

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Avapritinib
midazolam
Sponsored by
Blueprint Medicines Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Gastrointestinal Stromal Tumors focused on measuring Avapritinib, Midazolam, GIST, BLU-285, KIT, IDH-mutant astrocytoma, IDH-mutant oligodendroglioma, glioblastoma, H3K27-altered diffuse midline glioma, H3G34-mutant diffuse hemispheric glioma, midline glioma

Eligibility Criteria

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

Inclusion Criteria:

  1. Must be ≥18 years of age at the time of signing the informed consent
  2. Confirmed diagnosis of

    • metastatic or unresectable KIT mutant GIST that has recurred or progressed after at least 4 lines of prior systemic SOC therapy or the Investigator has determined that treatment with SOC therapy is not appropriate for patients who failed at least 2 lines of prior SOC

    OR

    ---Non-resectable advance solid tumor with KIT mutation with progression following standard of care treatment.

    OR

    ---Confirmed diagnosis of recurrent or unresectable CNS tumors including :IDH-mutant astrocytoma, IDH-mutant oligodendroglioma, glioblastoma, H3K27-altered diffuse midline glioma, H3G34-mutant diffuse hemispheric glioma, midline glioma (with unknown H3K27 mutation status) that has failed prior radiation or systemic SOC therapy.

  3. Must be able to swallow an oral medication
  4. Must have Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
  5. Patient agrees to use contraception consistent with local regulations
  6. Must provide signed informed consent to participate in the study

Exclusion Criteria:

  1. Patients with GIST that harbors a known PDGFRA mutation
  2. Known hypersensitivity to avapritinib, midazolam, or any of their excipients
  3. Have received previous therapy with avapritinib
  4. Have any of the following laboratory abnormalities before the first dose of study drug:

    • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) >3 × upper limit of normal (ULN) if no hepatic metastases are present; >5 × ULN if hepatic metastases are present
    • Total bilirubin >1.5 × ULN; >3 × ULN in the presence of Gilbert's Disease
    • Estimated (Cockcroft-Gault formula) or measured creatinine clearance <60 mL/min
    • Platelet count <100 × 10^9/liter (L)
    • Absolute neutrophil count (ANC) <1.0 × 10^9/L
    • Hemoglobin <9 grams per deciliter (g/dL). Transfusion and erythropoietin may be used to reach at least 9 g/dL but must have been administered at least 2 weeks before the first dose of the study drug.
  5. Require therapy with a concomitant medication that is a strong and moderate CYP3A4 inhibitors or inducers
  6. Consumption of any nutrients known to modulate CYP3A4 enzymes activity (eg, grapefruit or grapefruit juice, pomelo juice, star fruit, or Seville [blood] orange and derivative products, cruciferous vegetables [eg, broccoli, cauliflower, cabbage, brussel sprouts]) within 14 days before screening and during the study until the end of the Main Treatment Period
  7. Have received a prior anticancer drug less than 5 half-lives or 14 days (whichever is shorter) before screening
  8. Have had a major surgical procedure within 14 days of the first dose of study drug or have significant traumatic injury within 28 days before screening
  9. Have history of a cerebrovascular accident or transient ischemic attacks within 1 year before screening
  10. Have known risk of intracranial bleeding, such as a brain aneurysm or history of subdural or subarachnoid bleeding
  11. Have corrected QT interval using Fridericia's formula (QTcF) >450 msec
  12. Have clinically significant, uncontrolled, cardiovascular disease, including congestive heart failure Grades 2, 3, or 4 according to the New York Heart Association classification, myocardial infarction, or unstable angina within the previous 6 months, or uncontrolled hypertension
  13. Have experienced any hemorrhage or bleeding event National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0 Grade ≥3 within 4 weeks before screening. Exceptions are patients with primary CNS tumors who are eligible if the Grade ≥3 bleeding event was in the CNS and it occurred 2 weeks or more prior to the first dose of avapritinib.
  14. Patients who have a symptomatic nonhealing wound, ulcer, GI perforation, or bone fracture
  15. Have received organ or allogenic bone marrow or peripheral blood stem cell transplant
  16. Have known diagnosis of human immunodeficiency virus infection or active viral hepatitis; viral testing is not required
  17. History of alcohol consumption exceeding 2 standard drinks per day on average (1 standard drink = 14 grams of alcohol). Alcohol consumption will be prohibited 48 hours before screening and throughout the entire the Main Treatment Period
  18. Use of tobacco- or nicotine-containing products within 3 months of enrollment
  19. Is a female patient who is unwilling, if not postmenopausal or surgically sterile, to abstain from sexual intercourse or employ highly effective contraception from the time of informed consent and for until at least 6 weeks after the last dose of study drug. Males who are unwilling, if not surgically sterile, to abstain from sexual intercourse or employ highly effective contraception from the time of informed consent and for at least 6 weeks after the last dose of study drug.
  20. Is a female patient who is pregnant, as documented by a serum beta human chorionic gonadotropin (β-hCG) pregnancy test consistent with pregnancy obtained within 7 days before the first dose of study drug. Patients with β-hCG values that are within the range for pregnancy but are not pregnant (false positives) may be enrolled with written consent of the Sponsor after pregnancy has been ruled out. Females of nonchildbearing potential (postmenopausal for more than 12 months, bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) do not require a serum β-hCG test.
  21. Female who is breastfeeding
  22. Have a prior or ongoing clinically significant illness, medical condition, surgical history, physical finding, or laboratory abnormality that, in the Investigator's opinion, could affect the safety of the patient, alter the absorption, distribution, metabolism or excretion of the study drugs, or impair the assessment of study results.

Sites / Locations

  • Mayo Clinic FloridaRecruiting
  • University of MichiganRecruiting
  • Thomas Jefferson University, Sidney Kimmel Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Participants with metastatic, unresectable GIST, non-CNS solid tumors, or CNS tumors

Arm Description

Participants will receive 5 mg of midazolam orally on Day 1 and Day 17. Participants will receive avapritinib 300 mg daily, orally on starting on Day 3. Participants with CNS tumors will receive avapritinib 300 mg daily orally, until Day 56.

Outcomes

Primary Outcome Measures

maximum plasma concentration (Cmax) of midazolam
time of maximum plasma concentration (tmax) of midazolam
area under the plasma concentration-time curve (AUC) of midazolam

Secondary Outcome Measures

Number of adverse events (AEs), serious AEs (SAEs),
Cmax at steady state (Cmax, ss) of avapritinib
Cmax at steady state (Cmax, ss) of metabolite
area under the plasma concentration-time curve at steady state (AUC,ss) of avapritinib
area under the plasma concentration-time curve at steady state (AUC,ss) of metabolite

Full Information

First Posted
May 27, 2021
Last Updated
March 9, 2023
Sponsor
Blueprint Medicines Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT04908176
Brief Title
A Drug-drug Interaction Study of Avapritinib and Midazolam
Official Title
A Drug-drug Interaction Study to Investigate the Effect of Avapritinib on the Pharmacokinetics of Midazolam in Patients With Unresectable or Metastatic Gastrointestinal Stromal Tumors (GIST) and Other Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 24, 2022 (Actual)
Primary Completion Date
November 30, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Blueprint Medicines Corporation

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 investigate the effect of multiple dosing of avapritinib on the pharmacokinetics (PK) of midazolam in adult patients with metastatic or unresectable gastrointestinal stromal tumors (GIST), recurrent gliomas, or other KIT mutant tumors.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastrointestinal Stromal Tumors, GIST, Non-resectable Advanced Solid Tumors, Recurrent or Unresectable Central Nervous System (CNS) Tumors
Keywords
Avapritinib, Midazolam, GIST, BLU-285, KIT, IDH-mutant astrocytoma, IDH-mutant oligodendroglioma, glioblastoma, H3K27-altered diffuse midline glioma, H3G34-mutant diffuse hemispheric glioma, midline glioma

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Participants with metastatic, unresectable GIST, non-CNS solid tumors, or CNS tumors
Arm Type
Experimental
Arm Description
Participants will receive 5 mg of midazolam orally on Day 1 and Day 17. Participants will receive avapritinib 300 mg daily, orally on starting on Day 3. Participants with CNS tumors will receive avapritinib 300 mg daily orally, until Day 56.
Intervention Type
Drug
Intervention Name(s)
Avapritinib
Other Intervention Name(s)
BLU-285
Intervention Description
avapritinib tablets
Intervention Type
Drug
Intervention Name(s)
midazolam
Intervention Description
midazolam syrup
Primary Outcome Measure Information:
Title
maximum plasma concentration (Cmax) of midazolam
Time Frame
Day 1 and Day 18
Title
time of maximum plasma concentration (tmax) of midazolam
Time Frame
Day 1 and Day 18
Title
area under the plasma concentration-time curve (AUC) of midazolam
Time Frame
Day 1 and Day 18
Secondary Outcome Measure Information:
Title
Number of adverse events (AEs), serious AEs (SAEs),
Time Frame
up to approximately 2 months
Title
Cmax at steady state (Cmax, ss) of avapritinib
Time Frame
Day 18
Title
Cmax at steady state (Cmax, ss) of metabolite
Time Frame
Day 18
Title
area under the plasma concentration-time curve at steady state (AUC,ss) of avapritinib
Time Frame
Day 18
Title
area under the plasma concentration-time curve at steady state (AUC,ss) of metabolite
Time Frame
Day 18

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must be ≥18 years of age at the time of signing the informed consent Confirmed diagnosis of metastatic or unresectable KIT mutant GIST that has recurred or progressed after at least 4 lines of prior systemic SOC therapy or the Investigator has determined that treatment with SOC therapy is not appropriate for patients who failed at least 2 lines of prior SOC OR ---Non-resectable advance solid tumor with KIT mutation with progression following standard of care treatment. OR ---Confirmed diagnosis of recurrent or unresectable CNS tumors including :IDH-mutant astrocytoma, IDH-mutant oligodendroglioma, glioblastoma, H3K27-altered diffuse midline glioma, H3G34-mutant diffuse hemispheric glioma, midline glioma (with unknown H3K27 mutation status) that has failed prior radiation or systemic SOC therapy. Must be able to swallow an oral medication Must have Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 Patient agrees to use contraception consistent with local regulations Must provide signed informed consent to participate in the study Exclusion Criteria: Patients with GIST that harbors a known PDGFRA mutation Known hypersensitivity to avapritinib, midazolam, or any of their excipients Have received previous therapy with avapritinib Have any of the following laboratory abnormalities before the first dose of study drug: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) >3 × upper limit of normal (ULN) if no hepatic metastases are present; >5 × ULN if hepatic metastases are present Total bilirubin >1.5 × ULN; >3 × ULN in the presence of Gilbert's Disease Estimated (Cockcroft-Gault formula) or measured creatinine clearance <60 mL/min Platelet count <100 × 10^9/liter (L) Absolute neutrophil count (ANC) <1.0 × 10^9/L Hemoglobin <9 grams per deciliter (g/dL). Transfusion and erythropoietin may be used to reach at least 9 g/dL but must have been administered at least 2 weeks before the first dose of the study drug. Require therapy with a concomitant medication that is a strong and moderate CYP3A4 inhibitors or inducers Consumption of any nutrients known to modulate CYP3A4 enzymes activity (eg, grapefruit or grapefruit juice, pomelo juice, star fruit, or Seville [blood] orange and derivative products, cruciferous vegetables [eg, broccoli, cauliflower, cabbage, brussel sprouts]) within 14 days before screening and during the study until the end of the Main Treatment Period Have received a prior anticancer drug less than 5 half-lives or 14 days (whichever is shorter) before screening Have had a major surgical procedure within 14 days of the first dose of study drug or have significant traumatic injury within 28 days before screening Have history of a cerebrovascular accident or transient ischemic attacks within 1 year before screening Have known risk of intracranial bleeding, such as a brain aneurysm or history of subdural or subarachnoid bleeding Have corrected QT interval using Fridericia's formula (QTcF) >450 msec Have clinically significant, uncontrolled, cardiovascular disease, including congestive heart failure Grades 2, 3, or 4 according to the New York Heart Association classification, myocardial infarction, or unstable angina within the previous 6 months, or uncontrolled hypertension Have experienced any hemorrhage or bleeding event National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0 Grade ≥3 within 4 weeks before screening. Exceptions are patients with primary CNS tumors who are eligible if the Grade ≥3 bleeding event was in the CNS and it occurred 2 weeks or more prior to the first dose of avapritinib. Patients who have a symptomatic nonhealing wound, ulcer, GI perforation, or bone fracture Have received organ or allogenic bone marrow or peripheral blood stem cell transplant Have known diagnosis of human immunodeficiency virus infection or active viral hepatitis; viral testing is not required History of alcohol consumption exceeding 2 standard drinks per day on average (1 standard drink = 14 grams of alcohol). Alcohol consumption will be prohibited 48 hours before screening and throughout the entire the Main Treatment Period Use of tobacco- or nicotine-containing products within 3 months of enrollment Is a female patient who is unwilling, if not postmenopausal or surgically sterile, to abstain from sexual intercourse or employ highly effective contraception from the time of informed consent and for until at least 6 weeks after the last dose of study drug. Males who are unwilling, if not surgically sterile, to abstain from sexual intercourse or employ highly effective contraception from the time of informed consent and for at least 6 weeks after the last dose of study drug. Is a female patient who is pregnant, as documented by a serum beta human chorionic gonadotropin (β-hCG) pregnancy test consistent with pregnancy obtained within 7 days before the first dose of study drug. Patients with β-hCG values that are within the range for pregnancy but are not pregnant (false positives) may be enrolled with written consent of the Sponsor after pregnancy has been ruled out. Females of nonchildbearing potential (postmenopausal for more than 12 months, bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) do not require a serum β-hCG test. Female who is breastfeeding Have a prior or ongoing clinically significant illness, medical condition, surgical history, physical finding, or laboratory abnormality that, in the Investigator's opinion, could affect the safety of the patient, alter the absorption, distribution, metabolism or excretion of the study drugs, or impair the assessment of study results.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Blueprint Medicines
Phone
617-714-6707
Email
medinfo@blueprintmedicines.com
Facility Information:
Facility Name
Mayo Clinic Florida
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Steven Attia, D.O.
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48103
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Denise Leung, MD
Facility Name
Thomas Jefferson University, Sidney Kimmel Cancer Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Iyad Alnahhas, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Drug-drug Interaction Study of Avapritinib and Midazolam

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