search
Back to results

MLN0128 in Recurrent/Metastatic Merkel Cell Carcinoma

Primary Purpose

Merkel Cell Carcinoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
MLN0128
Sponsored by
Dana-Farber Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Merkel Cell Carcinoma focused on measuring recurrent merkel cell carcinoma, metastatic merkel cell carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Metastatic or recurrent MCC confirmed by histology
  • Participants must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as > 20 mm with conventional techniques or as > 10 mm with spiral CT scan (see section 10 for the evaluation of measureable disease). Tumors within a previously irradiated field will be designated as "non-target" lesions unless progression is documented
  • Age 18 years or older
  • ECOG performance status ≤ 2
  • Participants must have normal organ and marrow function
  • Female patients who:

    • Are postmenopausal for at least 1 year before the screening visit

      --- OR

    • Are surgically sterile --- OR
  • If they are of childbearing potential, agree to practice 2 effective methods of contraception, at the same time
  • Male patients, even if surgically sterilized (ie, status post-vasectomy), who:

    • Agree to practice effective barrier contraception during the entire study treatment period and through 90 days after the last dose of study drug, or
    • Agree to completely abstain from heterosexual intercourse
    • Treatment with strong CYP2C19, CYP3A4, and CYP2C9 inhibitors and/or inducers
    • Tissue for correlative studies must be available (paraffinized or frozen)
    • Ability to swallow oral medications and maintain an empty stomach state for 2 hours prior to the MLN0128 dose and for 1 hour following administration
    • Ability to understand and the willingness to sign a written informed consent

Exclusion Criteria:

  • Participants who have had chemotherapy or radiotherapy within 2 weeks prior to entering the study
  • The subject has active brain metastases or epidural disease
  • Participants who are receiving any other investigational agents within 14 days before the first dose of study drug
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations
  • Female patients who are both lactating and breastfeeding or have a positive serum pregnancy test during the screening period or a positive urine pregnancy test on Day 1 before first dose of study drug
  • Manifestations of malabsorption due to prior gastrointestinal (GI) surgery, GI disease, or for an unknown reason that may alter the absorption of MLN0128
  • Poorly controlled diabetes mellitus
  • History of any of the following within the last 6 months prior to study entry:

    • Ischemic myocardial event
    • Ischemic cerebrovascular event
    • Requirement for inotropic support (excluding digoxin) or serious (uncontrolled) cardiac arrhythmia
    • Placement of a pacemaker for control of rhythm
    • New York Heart Association (NYHA) Class III or IV heart failure
    • Pulmonary embolism
  • Significant active cardiovascular or pulmonary disease at the time of study entry, including:

    • Uncontrolled high blood pressure
    • Pulmonary hypertension
    • Uncontrolled asthma
    • Significant valvular disease; severe regurgitation or stenosis
    • Medically significant (symptomatic) bradycardia
    • History of arrhythmia requiring an implantable cardiac defibrillator
    • Baseline prolongation of the rate-corrected QT interval (QTc)
  • Initiation of treatment with hematopoietic growth factors, transfusions of blood and blood products, or systemic corticosteroids

Sites / Locations

  • Dana Farber Cancer Institute

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Dose Level 1: MLN01283 3 mg (Phase 1)

Dose Level 2: MLN01283 4 mg (Phase 1)

Dose Level 3: MLN01283 5 mg (Phase 1)

MLN01283 RP2D (Phase 2)

Arm Description

Phase 1 dose level 1 participants receive MLN01283 3 mg orally once daily of a 28 day cycle. Participants are treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.

Phase 1 dose level 2 participants receive MLN01283 4 mg orally once daily of a 28 day cycle. Participants are treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.

Phase 1 dose level 3 participants receive MLN01283 5 mg orally once daily of a 28 day cycle. Participants are treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.

Phase 2 participants receive MLN01283 at the recommended phase 2 dose (RP2D) orally once daily of a 28 day cycle. Participants are treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.

Outcomes

Primary Outcome Measures

MLN01283 Maximum Tolerated Dose (MTD) [Phase I]
The MLN01283 MTD is determined by the number of participants who experience a dose limiting toxicity (DLT). See subsequent primary outcome measure for the DLT definition. The MTD is defined as the highest dose at which fewer than one-third of patients experience a DLT. If no DLTs are observed, the MTD is not reached but the highest dose received may be the Recommended Phase II Dose (RP2D).
Dose Limiting Toxicity (DLT) [Phase I]
A DLT was defined as an adverse event (AE) assessed as unrelated to disease, disease progression, inter-current illness, or concomitant medications meets any of the following criteria including but not limited to: grade (G) 4-5 AEs, G3 thrombocytopenia, neutropenia, AST, ALT, serum creatinine or total bilirubin 2 to 3 x upper limit normal (ULN), aymptomatic amylase and/or lipase lasting >7 consecutive days; febrile neutropenia; G3 cardiac, hyperglycemia, mood alteration; G2 pancreatitis; G2 hyperglycemia unresolved within 14 days; G2 mood alteration unresolved in 14 days despite medical treatment; Dose interruption >21 days due to G2 dematologic; one grade level increase neurotoxicity.

Secondary Outcome Measures

Full Information

First Posted
July 28, 2015
Last Updated
December 3, 2020
Sponsor
Dana-Farber Cancer Institute
Collaborators
Millennium Pharmaceuticals, Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT02514824
Brief Title
MLN0128 in Recurrent/Metastatic Merkel Cell Carcinoma
Official Title
MLN0128 in Recurrent/Metastatic Merkel Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
October 2015 (Actual)
Primary Completion Date
April 2017 (Actual)
Study Completion Date
June 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dana-Farber Cancer Institute
Collaborators
Millennium Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This research study is studying a targeted therapy as a possible treatment for merkel cell carcinoma. - The name of the study intervention involved in this study is: MLN0128.
Detailed Description
This is a phase I/II clinical trial. A phase I clinical trial tests the safety of an investigational intervention and also tries to define the appropriate dose of the investigational intervention to use for further studies. "Investigational" means that the intervention is being studied. The FDA (the U.S. Food and Drug Administration) has not approved MLN0128 as a treatment for any disease. MLN0128 may prevent tumor cells from dividing and growing by selectively and potently inhibiting a chemical, mTOR kinase, which regulates cell growth and survival. Patients with merkel cell carcinoma have been observed to sometimes carry genetic alterations in their tumor cells which may make the cancer more sensitive to inhibition by MLN0128. In this research study,the investigators are studying the usefulness of MLN0128 in merkel cell carcinoma cases.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Merkel Cell Carcinoma
Keywords
recurrent merkel cell carcinoma, metastatic merkel cell carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose Level 1: MLN01283 3 mg (Phase 1)
Arm Type
Experimental
Arm Description
Phase 1 dose level 1 participants receive MLN01283 3 mg orally once daily of a 28 day cycle. Participants are treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.
Arm Title
Dose Level 2: MLN01283 4 mg (Phase 1)
Arm Type
Experimental
Arm Description
Phase 1 dose level 2 participants receive MLN01283 4 mg orally once daily of a 28 day cycle. Participants are treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.
Arm Title
Dose Level 3: MLN01283 5 mg (Phase 1)
Arm Type
Experimental
Arm Description
Phase 1 dose level 3 participants receive MLN01283 5 mg orally once daily of a 28 day cycle. Participants are treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.
Arm Title
MLN01283 RP2D (Phase 2)
Arm Type
Experimental
Arm Description
Phase 2 participants receive MLN01283 at the recommended phase 2 dose (RP2D) orally once daily of a 28 day cycle. Participants are treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.
Intervention Type
Drug
Intervention Name(s)
MLN0128
Other Intervention Name(s)
INK128
Intervention Description
Investigational mTOR kinase inhibitor
Primary Outcome Measure Information:
Title
MLN01283 Maximum Tolerated Dose (MTD) [Phase I]
Description
The MLN01283 MTD is determined by the number of participants who experience a dose limiting toxicity (DLT). See subsequent primary outcome measure for the DLT definition. The MTD is defined as the highest dose at which fewer than one-third of patients experience a DLT. If no DLTs are observed, the MTD is not reached but the highest dose received may be the Recommended Phase II Dose (RP2D).
Time Frame
The observation period for DLT evaluation was the first 28 days (cycle 1) of treatment.
Title
Dose Limiting Toxicity (DLT) [Phase I]
Description
A DLT was defined as an adverse event (AE) assessed as unrelated to disease, disease progression, inter-current illness, or concomitant medications meets any of the following criteria including but not limited to: grade (G) 4-5 AEs, G3 thrombocytopenia, neutropenia, AST, ALT, serum creatinine or total bilirubin 2 to 3 x upper limit normal (ULN), aymptomatic amylase and/or lipase lasting >7 consecutive days; febrile neutropenia; G3 cardiac, hyperglycemia, mood alteration; G2 pancreatitis; G2 hyperglycemia unresolved within 14 days; G2 mood alteration unresolved in 14 days despite medical treatment; Dose interruption >21 days due to G2 dematologic; one grade level increase neurotoxicity.
Time Frame
The observation period for DLT evaluation was the first 28 days (cycle 1) of treatment.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Metastatic or recurrent MCC confirmed by histology Participants must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as > 20 mm with conventional techniques or as > 10 mm with spiral CT scan (see section 10 for the evaluation of measureable disease). Tumors within a previously irradiated field will be designated as "non-target" lesions unless progression is documented Age 18 years or older ECOG performance status ≤ 2 Participants must have normal organ and marrow function Female patients who: Are postmenopausal for at least 1 year before the screening visit --- OR Are surgically sterile --- OR If they are of childbearing potential, agree to practice 2 effective methods of contraception, at the same time Male patients, even if surgically sterilized (ie, status post-vasectomy), who: Agree to practice effective barrier contraception during the entire study treatment period and through 90 days after the last dose of study drug, or Agree to completely abstain from heterosexual intercourse Treatment with strong CYP2C19, CYP3A4, and CYP2C9 inhibitors and/or inducers Tissue for correlative studies must be available (paraffinized or frozen) Ability to swallow oral medications and maintain an empty stomach state for 2 hours prior to the MLN0128 dose and for 1 hour following administration Ability to understand and the willingness to sign a written informed consent Exclusion Criteria: Participants who have had chemotherapy or radiotherapy within 2 weeks prior to entering the study The subject has active brain metastases or epidural disease Participants who are receiving any other investigational agents within 14 days before the first dose of study drug Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations Female patients who are both lactating and breastfeeding or have a positive serum pregnancy test during the screening period or a positive urine pregnancy test on Day 1 before first dose of study drug Manifestations of malabsorption due to prior gastrointestinal (GI) surgery, GI disease, or for an unknown reason that may alter the absorption of MLN0128 Poorly controlled diabetes mellitus History of any of the following within the last 6 months prior to study entry: Ischemic myocardial event Ischemic cerebrovascular event Requirement for inotropic support (excluding digoxin) or serious (uncontrolled) cardiac arrhythmia Placement of a pacemaker for control of rhythm New York Heart Association (NYHA) Class III or IV heart failure Pulmonary embolism Significant active cardiovascular or pulmonary disease at the time of study entry, including: Uncontrolled high blood pressure Pulmonary hypertension Uncontrolled asthma Significant valvular disease; severe regurgitation or stenosis Medically significant (symptomatic) bradycardia History of arrhythmia requiring an implantable cardiac defibrillator Baseline prolongation of the rate-corrected QT interval (QTc) Initiation of treatment with hematopoietic growth factors, transfusions of blood and blood products, or systemic corticosteroids
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Haddad, MD
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Individual participant data (IPD) will not be shared. Cumulative data will be posted here and published.

Learn more about this trial

MLN0128 in Recurrent/Metastatic Merkel Cell Carcinoma

We'll reach out to this number within 24 hrs