Combination Trial of Tipifarnib and Alpelisib in Adult Recurrent/ Metastatic Head and Neck Squamous Cell Carcinoma (R/M HNSCC)
Primary Purpose
HNSCC
Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Tipifarnib
Alpelisib
Sponsored by
About this trial
This is an interventional treatment trial for HNSCC focused on measuring HRAS, PIK3CA, PI3K, Tipifarnib, Alpelisib, R/M HNSCC (Recurrent/metastatic Head and Neck Squamous Cell Carcinoma), Head and Neck Cancer, SCCHN
Eligibility Criteria
Inclusion Criteria:
- At least 18 years of age.
- Histologically confirmed head and neck cancer of squamous histology not amenable to local therapy with curative intent (surgery or radiation therapy with or without chemotherapy).
- Documented treatment failure from at least 1 prior systemic therapy in the R/M setting, unless determined not appropriate.
- Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.
- Has a tumor that is dependent upon HRAS and/or PIK3CA.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
- Acceptable liver, renal, endocrine, and hematologic function.
- Must be able to swallow alpelisib whole tablet or oral suspension containing crushed tablets. Feeding tube may not be used for alpelisib administration.
- Other protocol defined inclusion criteria may apply.
Exclusion Criteria:
- Histologically confirmed salivary gland, thyroid, (primary) cutaneous squamous or nonsquamous histologies (eg, mucosal melanoma).
- Ongoing treatment with certain anticancer agents.
- Prior treatment (at least 1 full treatment cycle) with an FTI or PI3K, mTOR, or AKT inhibitor.
- Received treatment for unstable angina, myocardial infarction, and/or cerebro-vascular attack within the prior 6 months.
- Non-tolerable Grade 2, or ≥ Grade 3 neuropathy or evidence of unstable neurological symptoms within 4 weeks of Cycle 1 Day 1.
- Major surgery, other than diagnostic surgery, within 2 weeks prior to Cycle 1 Day 1, without complete recovery.
- Active, uncontrolled bacterial, viral, or fungal infections requiring systemic therapy.
- Participant with an established diagnosis of diabetes mellitus Type 1 or not controlled Type 2.
- Participant has impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of the trial drugs based on Investigator discretion.
- Participant has currently documented pneumonitis/interstitial lung disease.
- Participant has a history of severe cutaneous reaction, such as Stevens-Johnson Syndrome (SJS), Erythema Multiforme (EM), Toxic Epidermal Necrolysis (TEN), or Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).
- Other protocol defined exclusion criteria may apply.
Sites / Locations
- City of Hope Comprehensive Cancer CenterRecruiting
- Lake Nona DDU (Florida Cancer Specialists)Recruiting
- University of Maryland School of Medicine (Marlene and Stewart Greenebaum Comprehensive Cancer Center)Recruiting
- Johns Hopkins University School of Medicine (Sidney Kimmel Comprehensive Cancer Center)Recruiting
- Dana-Farber Cancer Institute (Head and Neck Cancer Treatment Center)Recruiting
- Washington University, School of MedicineRecruiting
- Memorial Sloan Kettering Cancer CenterRecruiting
- UPMC Hillman Cancer CenterRecruiting
- UT Southwestern Medical Center (Harold C. Simmons Comprehensive Cancer Center)Recruiting
- University of Texas MD Anderson Cancer CenterRecruiting
- University of Wisconsin Carbone Cancer CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
PIK3CA-dependent (Cohort 1)
HRAS-dependent (Cohort 2)
Arm Description
Adult participants with R/M HNSCC whose tumors harbor PI3KCA (activating) mutations and/or amplifications
Adult participants with R/M HNSCC whose tumors have increased HRAS dependency, defined as HRAS overexpression
Outcomes
Primary Outcome Measures
To determine the recommended dose and regimen and evaluate the safety and tolerability of the combination of tipifarnib and alpelisib
Rate of DLT per dose level and Descriptive statistics of adverse events per the NCI CTCAE v 5.0
Secondary Outcome Measures
Determine the Objective Response Rate (ORR)
Overall confirmed response rate (CR + PR) and Median duration of response
Disease control rate (DCR)
Disease control rate (CR + PR + SD), Median duration of disease control, Rate of SD, Median duration of SD
Cmax of tipifarnib and alpelisib when administered in combination
Peak drug concentration for single dose and multiple dose
Tmax of tipifarnib and alpelisib when administered in combination
Time to reach peak concentration following drug administration for single dose and multiple dose
AUC(0-last) of tipifarnib and alpelisib when administered in combination
Area under the concentration-time curve from time zero to time of last measurable concentration for single dose and multiple dose
AUC(tau) of tipifarnib and alpelisib when administered in combination
Area under the concentration-time curve during a dosage interval for single dose and multiple dose
AUC(0-infinity) of tipifarnib and alpelisib when administered in combination
Area under the concentration-time curve from time zero to infinity for single dose
CL/F of tipifarnib and alpelisib when administered in combination
Apparent total clearance of the drug after administration for single dose and multiple dose
Vd/F of tipifarnib and alpelisib when administered in combination
Apparent volume of distribution after administration for single dose and multiple dose
Half-life of tipifarnib and alpelisib when administered in combination
Time required for the amount of drug in the body to decrease by half for single dose and multiple dose
Accumulation ratio of tipifarnib and alpelisib when administered in combination
Ratio of accumulation of a drug after multiple doses compared to a single dose
Antitumor activity in terms of PFS and rate of PFS at 6 months
Median PFS and Proportion of participants alive and without progression at 6 months
Overall Survival (OS) and rate of OS at 12 months
Median OS and Proportion of participants alive at 12 months
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04997902
Brief Title
Combination Trial of Tipifarnib and Alpelisib in Adult Recurrent/ Metastatic Head and Neck Squamous Cell Carcinoma (R/M HNSCC)
Official Title
A Phase 1/2 Open-label, Biomarker-defined Cohort Trial to Evaluate the Safety, Determine the Recommended Combination Dosing, and Assess Early Antitumor Activity of Tipifarnib and Alpelisib for the Treatment of Adult Participants Who Have HRAS-overexpressing and/or PIK3CA-mutated and/or - Amplified Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 7, 2021 (Actual)
Primary Completion Date
September 2024 (Anticipated)
Study Completion Date
September 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kura Oncology, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
This phase 1/2 combination trial of tipifarnib, a farnesyltransferase inhibitor, and alpelisib, a PI3K inhibitor in participants with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) whose tumors overexpress the HRAS protein and/or are PIK3CA-mutated and/or PIK3CA-amplified.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HNSCC
Keywords
HRAS, PIK3CA, PI3K, Tipifarnib, Alpelisib, R/M HNSCC (Recurrent/metastatic Head and Neck Squamous Cell Carcinoma), Head and Neck Cancer, SCCHN
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
40 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
PIK3CA-dependent (Cohort 1)
Arm Type
Experimental
Arm Description
Adult participants with R/M HNSCC whose tumors harbor PI3KCA (activating) mutations and/or amplifications
Arm Title
HRAS-dependent (Cohort 2)
Arm Type
Experimental
Arm Description
Adult participants with R/M HNSCC whose tumors have increased HRAS dependency, defined as HRAS overexpression
Intervention Type
Drug
Intervention Name(s)
Tipifarnib
Intervention Description
Oral administration
Intervention Type
Drug
Intervention Name(s)
Alpelisib
Other Intervention Name(s)
BYL719
Intervention Description
Oral administration
Primary Outcome Measure Information:
Title
To determine the recommended dose and regimen and evaluate the safety and tolerability of the combination of tipifarnib and alpelisib
Description
Rate of DLT per dose level and Descriptive statistics of adverse events per the NCI CTCAE v 5.0
Time Frame
DLTs will be evaluated during the first 28 days (1 cycle) of combination therapy
Secondary Outcome Measure Information:
Title
Determine the Objective Response Rate (ORR)
Description
Overall confirmed response rate (CR + PR) and Median duration of response
Time Frame
Up to approximately 3 years
Title
Disease control rate (DCR)
Description
Disease control rate (CR + PR + SD), Median duration of disease control, Rate of SD, Median duration of SD
Time Frame
Up to approximately 3 years
Title
Cmax of tipifarnib and alpelisib when administered in combination
Description
Peak drug concentration for single dose and multiple dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
Tmax of tipifarnib and alpelisib when administered in combination
Description
Time to reach peak concentration following drug administration for single dose and multiple dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
AUC(0-last) of tipifarnib and alpelisib when administered in combination
Description
Area under the concentration-time curve from time zero to time of last measurable concentration for single dose and multiple dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
AUC(tau) of tipifarnib and alpelisib when administered in combination
Description
Area under the concentration-time curve during a dosage interval for single dose and multiple dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
AUC(0-infinity) of tipifarnib and alpelisib when administered in combination
Description
Area under the concentration-time curve from time zero to infinity for single dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
CL/F of tipifarnib and alpelisib when administered in combination
Description
Apparent total clearance of the drug after administration for single dose and multiple dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
Vd/F of tipifarnib and alpelisib when administered in combination
Description
Apparent volume of distribution after administration for single dose and multiple dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
Half-life of tipifarnib and alpelisib when administered in combination
Description
Time required for the amount of drug in the body to decrease by half for single dose and multiple dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
Accumulation ratio of tipifarnib and alpelisib when administered in combination
Description
Ratio of accumulation of a drug after multiple doses compared to a single dose
Time Frame
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
Title
Antitumor activity in terms of PFS and rate of PFS at 6 months
Description
Median PFS and Proportion of participants alive and without progression at 6 months
Time Frame
Up to approximately 3 years
Title
Overall Survival (OS) and rate of OS at 12 months
Description
Median OS and Proportion of participants alive at 12 months
Time Frame
Up to approximately 3 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
At least 18 years of age.
Histologically confirmed head and neck cancer of squamous histology not amenable to local therapy with curative intent (surgery or radiation therapy with or without chemotherapy).
Documented treatment failure from at least 1 prior systemic therapy in the R/M setting, unless determined not appropriate.
Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.
Has a tumor that is dependent upon HRAS and/or PIK3CA.
Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
Acceptable liver, renal, endocrine, and hematologic function.
Must be able to swallow alpelisib whole tablet or oral suspension containing crushed tablets. Feeding tube may not be used for alpelisib administration.
Other protocol defined inclusion criteria may apply.
Exclusion Criteria:
Histologically confirmed salivary gland, thyroid, (primary) cutaneous squamous or nonsquamous histologies (eg, mucosal melanoma).
Ongoing treatment with certain anticancer agents.
Prior treatment (at least 1 full treatment cycle) with an FTI or PI3K, mTOR, or AKT inhibitor.
Received treatment for unstable angina, myocardial infarction, and/or cerebro-vascular attack within the prior 6 months.
Non-tolerable Grade 2, or ≥ Grade 3 neuropathy or evidence of unstable neurological symptoms within 4 weeks of Cycle 1 Day 1.
Major surgery, other than diagnostic surgery, within 2 weeks prior to Cycle 1 Day 1, without complete recovery.
Active, uncontrolled bacterial, viral, or fungal infections requiring systemic therapy.
Participant with an established diagnosis of diabetes mellitus Type 1 or not controlled Type 2.
Participant has impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of the trial drugs based on Investigator discretion.
Participant has currently documented pneumonitis/interstitial lung disease.
Participant has a history of severe cutaneous reaction, such as Stevens-Johnson Syndrome (SJS), Erythema Multiforme (EM), Toxic Epidermal Necrolysis (TEN), or Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).
Other protocol defined exclusion criteria may apply.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Clinical Operations
Phone
617-588-3755
Email
KO-TIP-013@kuraoncology.com
Facility Information:
Facility Name
City of Hope Comprehensive Cancer Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Khaleda Khan
Email
kkhan@coh.org
First Name & Middle Initial & Last Name & Degree
Victoria M Villaflor, MD
Facility Name
Lake Nona DDU (Florida Cancer Specialists)
City
Orlando
State/Province
Florida
ZIP/Postal Code
32827
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cesar A Perez, MD
Phone
689-216-8500
Email
Cesar.PerezBatista@flcancer.com
First Name & Middle Initial & Last Name & Degree
Cesar A Perez, MD
Facility Name
University of Maryland School of Medicine (Marlene and Stewart Greenebaum Comprehensive Cancer Center)
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ranee Mehra, MD
Facility Name
Johns Hopkins University School of Medicine (Sidney Kimmel Comprehensive Cancer Center)
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tracey K Adams, RN, BA
First Name & Middle Initial & Last Name & Degree
Peggy Fitzpatrick, MSN
Email
mfitzpa7@jhmi.edu
First Name & Middle Initial & Last Name & Degree
Tanguy Y Seiwert, MD
Facility Name
Dana-Farber Cancer Institute (Head and Neck Cancer Treatment Center)
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Glenn J Hanna, MD
Phone
617-632-3090
First Name & Middle Initial & Last Name & Degree
Glenn J Hanna, MD
Facility Name
Washington University, School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jessica Ley, MD
Phone
314-747-8092
Email
jcley@wustl.edu
First Name & Middle Initial & Last Name & Degree
Douglas R Adkins, MD
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Susan Korte
Email
kortes@mskcc.org
First Name & Middle Initial & Last Name & Degree
Alan L Ho, MD, PhD
Facility Name
UPMC Hillman Cancer Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kasey Stragand, RN
Phone
412-647-9015
Email
stragandk2@upmc.edu
First Name & Middle Initial & Last Name & Degree
Dan P Zandberg, MD
Facility Name
UT Southwestern Medical Center (Harold C. Simmons Comprehensive Cancer Center)
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tiffany Thomas, BSN, RN
Email
tiffany.thomas@utsouthwestern.edu
First Name & Middle Initial & Last Name & Degree
Randall S Hughes, MD
Facility Name
University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jessie (Xiaoyan) Jia, MS RN OCN CCRP
Phone
(713) 792-9801
Email
xjia1@mdanderson.org
First Name & Middle Initial & Last Name & Degree
Maura L Gillison, MD, PhD
Facility Name
University of Wisconsin Carbone Cancer Center
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Justine Y Bruce, MD
Phone
608-261-1500
Email
lunggroup@uwcarbone.wisc.edu
First Name & Middle Initial & Last Name & Degree
Justine Y Bruce, MD
12. IPD Sharing Statement
Learn more about this trial
Combination Trial of Tipifarnib and Alpelisib in Adult Recurrent/ Metastatic Head and Neck Squamous Cell Carcinoma (R/M HNSCC)
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