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A Phase I Study of Nilontinib and Cetuximab in Patients With Solid Tumors

Primary Purpose

Colorectal Cancer, Head and Neck Cancer

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Nilotinib + Cetuximab
Sponsored by
Georgetown University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring metastatic Kras wildtype, squamous cell carcinoma, cetuximab, nilotinib

Eligibility Criteria

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

Inclusion Criteria:

  1. Recurrent and/or metastatic Kras wildtype colorectal cancer or squamous cell carcinoma of the head and neck
  2. Previous therapy:

    1. Patients must have progressed after standard therapy for metastatic/recurrent disease, including irinotecan and oxaliplatin-containing regimens for patients with CRC and platinum-containing regimens for patients with H&NSCC.
    2. Patients may have received cetuximab or panitumumab previously
  3. Ability to swallow medication tablets by mouth (which may include taking nilotinib mixed in apple sauce)
  4. At least one measurable lesion by RECIST criteria
  5. A tumor lesion that can be readily biopsied using a core needle via clinical exam or image-guidance.
  6. Over the age of 18 years and able to provide informed consent
  7. Adequate kidney, liver, and bone marrow function as follows:

    1. Hemoglobin >/= 8.0 gm/dL
    2. Absolute neutrophil count >/= 1500
    3. Platelet count >/= 100,000
    4. Creatinine within institutional normal limits or glomerular filtration rate > 60
    5. Total bilirubin f. AST and ALT
  8. Life expectancy of greater than 3 months
  9. ECOG performance status
  10. Normal left ventricular ejection fraction, defined as EF > 50%

Exclusion Criteria:

  1. Chemotherapy or surgery within 4 weeks prior to treatment start
  2. Radiation treatment within 3 weeks prior to treatment start
  3. Prior therapy with nilotinib, ponatinib, dasatinib, or imatinib
  4. Untreated brain metastases or neurologically unstable central nervous system metastases; CNS metastases will be considered stable if there is no new nor enlarging lesions for one month, and the patient remains off steroids and anti-epileptics for the same time period
  5. Any severe or uncontrolled medical condition or other condition that could affect participation in this study, including: unstable angina, uncontrolled hypertension, serious uncontrolled cardiac arrhythmia, uncontrolled infection, or myocardial infarction
  6. Diarrhea > Grade 1 at baseline
  7. Concomitant medication or herbal therapy known to inhibit CYP3A4
  8. Gastrointestinal tract disease resulting in the inability to take oral medication or a requirement for IV alimentation, prior surgical procedures affecting absorption, or active peptic ulcer disease
  9. Ongoing ventricular cardiac dysrhythmias of NCI CTCAE grade >/= 2
  10. Subjects with a history of serious ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation >/= 3 beats in a row)
  11. Serious cardiac arrhythmia requiring medication
  12. QTc interval > 500 msec
  13. Female patients who are pregnant or breast feeding, or adults who are of reproductive potential and are unwilling to refrain from conceiving a child during study treatment
  14. Patients unwilling or unable to comply with the protocol, or provide informed consent

Sites / Locations

  • Georgetown Lombardi Comprehensive Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Nilotinib + Cetuximab

Arm Description

All patients with receive Nilotinib BID for a 28-day cycle + Cetuximab 400 mg/m2 on day 1 dose then 250 mg/m2 weekly

Outcomes

Primary Outcome Measures

Maximum tolerated dose
The dose at which </= 1 out of 6 subjects experiences a dose limiting toxicity

Secondary Outcome Measures

Full Information

First Posted
June 4, 2013
Last Updated
February 6, 2019
Sponsor
Georgetown University
Collaborators
Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT01871311
Brief Title
A Phase I Study of Nilontinib and Cetuximab in Patients With Solid Tumors
Official Title
A Phase I Study of the BCR-ABL Tyrosine Kinase Inhibitor Nilontinib and Cetuximab in Patients With Solid Tumors That Can be Treated With Cetuximab
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Terminated
Why Stopped
Primary investigator left the institution.
Study Start Date
May 2014 (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
Georgetown University
Collaborators
Novartis

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the recommended Phase II dose of nilotinib when used in combination with cetuximab in the treatment of patients with recurrent and/or metastatic Kras wildtype colorectal cancer or squamous cell carcinoma of the head and neck.
Detailed Description
ABL1 has been suggested to play a key role in the resistance mechanism to anti EGFR therapy in cancer. Therefore, this study aims to evaluate the safety and possible effect of targeting both EGFR using cetuximab along with ABL1 using nilotinib. Correlative studies assess the changes in tumor proteome in response to therapy and magnitude of ADCC as a marker of antibody activity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer, Head and Neck Cancer
Keywords
metastatic Kras wildtype, squamous cell carcinoma, cetuximab, nilotinib

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Nilotinib + Cetuximab
Arm Type
Experimental
Arm Description
All patients with receive Nilotinib BID for a 28-day cycle + Cetuximab 400 mg/m2 on day 1 dose then 250 mg/m2 weekly
Intervention Type
Drug
Intervention Name(s)
Nilotinib + Cetuximab
Intervention Description
Nilotinib BID for a 28-day cycle + Cetuximab 400 mg/m2 on day 1 dose then 250 mg/m2 weekly Three dose levels for nilotinib: Dose level -1 200-mg daily Dose level 1 200-mg BID Dose level 2 300-mg BID Cycle duration will be 4 weeks, with weekly evaluation of toxicity. Assessment of tumor progression will occur every 2 cycles. Subjects will be treated until disease progression or cessation due to intolerable toxicity.
Primary Outcome Measure Information:
Title
Maximum tolerated dose
Description
The dose at which </= 1 out of 6 subjects experiences a dose limiting toxicity
Time Frame
18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Recurrent and/or metastatic Kras wildtype colorectal cancer or squamous cell carcinoma of the head and neck Previous therapy: Patients must have progressed after standard therapy for metastatic/recurrent disease, including irinotecan and oxaliplatin-containing regimens for patients with CRC and platinum-containing regimens for patients with H&NSCC. Patients may have received cetuximab or panitumumab previously Ability to swallow medication tablets by mouth (which may include taking nilotinib mixed in apple sauce) At least one measurable lesion by RECIST criteria A tumor lesion that can be readily biopsied using a core needle via clinical exam or image-guidance. Over the age of 18 years and able to provide informed consent Adequate kidney, liver, and bone marrow function as follows: Hemoglobin >/= 8.0 gm/dL Absolute neutrophil count >/= 1500 Platelet count >/= 100,000 Creatinine within institutional normal limits or glomerular filtration rate > 60 Total bilirubin f. AST and ALT Life expectancy of greater than 3 months ECOG performance status Normal left ventricular ejection fraction, defined as EF > 50% Exclusion Criteria: Chemotherapy or surgery within 4 weeks prior to treatment start Radiation treatment within 3 weeks prior to treatment start Prior therapy with nilotinib, ponatinib, dasatinib, or imatinib Untreated brain metastases or neurologically unstable central nervous system metastases; CNS metastases will be considered stable if there is no new nor enlarging lesions for one month, and the patient remains off steroids and anti-epileptics for the same time period Any severe or uncontrolled medical condition or other condition that could affect participation in this study, including: unstable angina, uncontrolled hypertension, serious uncontrolled cardiac arrhythmia, uncontrolled infection, or myocardial infarction Diarrhea > Grade 1 at baseline Concomitant medication or herbal therapy known to inhibit CYP3A4 Gastrointestinal tract disease resulting in the inability to take oral medication or a requirement for IV alimentation, prior surgical procedures affecting absorption, or active peptic ulcer disease Ongoing ventricular cardiac dysrhythmias of NCI CTCAE grade >/= 2 Subjects with a history of serious ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation >/= 3 beats in a row) Serious cardiac arrhythmia requiring medication QTc interval > 500 msec Female patients who are pregnant or breast feeding, or adults who are of reproductive potential and are unwilling to refrain from conceiving a child during study treatment Patients unwilling or unable to comply with the protocol, or provide informed consent
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ann W Gramza, MD
Organizational Affiliation
Georgetown University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Georgetown Lombardi Comprehensive Cancer Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase I Study of Nilontinib and Cetuximab in Patients With Solid Tumors

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