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Phase Ib Study of BKM120 With Cisplatin and XRT in High Risk Locally Advanced Squamous Cell Cancer of Head and Neck

Primary Purpose

Carcinoma, Squamous Cell of Head and Neck, HPV Positive Oropharyngeal Squamous Cell Carcinoma, Hypopharyngeal Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
BKM120
Cisplatin
Intensity-modulated radiotherapy (IMRT)
Sponsored by
Dana-Farber Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Squamous Cell of Head and Neck focused on measuring Carcinoma, Squamous Cell of Head and Neck, Human Papillomavirus Positive Oropharyngeal Carcinoma, Hypopharyngeal Cancer, Early Invasive Cervical Squamous Cell Carcinoma, Carcinoma of Larynx, Cancer of Nasopharynx

Eligibility Criteria

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

Inclusion Criteria:

  • Stage III/IV, locally advanced, biopsy proven squamous cell cancer of the head and neck that undergo chemoradiation as their primary treatment with curative intent.
  • Oropharynx (HPV positive and HPV negative), hypopharynx, larynx primaries, nasopharynx as well as those with documented SCC of the cervical lymph nodes, with unknown primaries.
  • >10 pack years of tobacco use
  • Age ≥ 18 years
  • ECOG performance status ≤ 2
  • At least one site of measurable disease
  • Adequate bone marrow function as shown by: ANC > 1.5 x 109/L, Platelets >100 x 109/L, Hb >9 g/dL
  • Total calcium (corrected for serum albumin) within normal limits
  • Magnesium ≥ the lower limit of normal
  • Potassium within normal limits for the institution.
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) within normal range
  • Serum bilirubin within normal range (or ≤ 1.5 x ULN if liver metastases are present; or total bilirubin ≤ 3.0 x ULN with direct bilirubin within normal range in patients with well documented Gilbert Syndrome)
  • Serum creatinine ≤ 1.5 x ULN or 24-hour clearance ≥ 50 mL/min
  • Serum amylase ≤ ULN
  • Serum lipase ≤ ULN
  • Fasting plasma glucose ≤ 120 mg/dL (6.7 mmol/L)
  • Signed informed consent
  • INR ≤ 2

Exclusion Criteria:

  • Distant metastatic disease
  • Less than or equal to 10 pack years of tobacco history
  • Received prior chemotherapy
  • Received prior radiation to the head and neck or adjacent anatomical site
  • Received prior treatment with a P13K inhibitor.
  • Known hypersensitivity to BKM120 or to its excipients
  • Acute or chronic liver, renal disease or pancreatitis
  • Mood disorders ≥ CTCAE grade 3
  • Diarrhea ≥ CTCAE grade 2
  • Active cardiac disease
  • History of cardiac dysfunction including any of the following:
  • Patient has poorly
  • Impairment of gastrointestinal (GI) function
  • Currently receiving treatment with medication with a known risk to prolong the QT interval or inducing Torsades de Pointes and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug.
  • Chronic treatment with steroids or another immunosuppressive agent.
  • Herbal medications and certain fruits within 7 days prior to starting study drug.
  • Currently treated with drugs known to be moderate and strong inhibitors or inducers of isoenzyme CYP3A, and the treatment cannot be discontinued or switched to a different medication prior to starting study drug. Please refer to Appendix B for a list of prohibited inhibitors and inducers of CYP3A (Please note that co-treatment with weak inhibitors of CYP3A is allowed).
  • Undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy.
  • Currently taking therapeutic doses of warfarin sodium or any other coumadin-derivative anticoagulant.
  • Women who are pregnant or breast feeding or adults of reproductive potential not employing an effective method of birth control.
  • Known diagnosis of human immunodeficiency virus (HIV) infection
  • History of another malignancy within 3 years, except cured basal cell carcinoma of the skin or excised carcinoma in situ of the cervix

Sites / Locations

  • Dana-Farber Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

BKM120

Arm Description

Participants will be enrolled in cohorts of 3- 6 per dose level. Once the MTD is reached, an additional 10 patients will be treated at that dose level and an amendment will be submitted to declare the dose. BKM120 will start 2 weeks prior to first dose of cisplatin and radiation start. During the study, BKM120 will be administered orally daily for 45 days. Starting dose 40 mg. Cisplatin: Starting Dose 30 mg/m2, given IV, weekly on days: (1, 8, 15, 22, 29, 36 and 43). Radiotherapy: All participants will receive daily radiotherapy with intensity-modulated radiotherapy (IMRT) for 7 weeks.

Outcomes

Primary Outcome Measures

Determine Maximum Tolerated Dose (MTD) of BKM120/cisplatin combination with radiation therapy
Determine Maximum Tolerated Dose (MTD) of BKM120/cisplatin in combination with radiation therapy in patients with locally advanced squamous cell cancer of the head and neck.

Secondary Outcome Measures

Overall Response Rate
Time to Progression
Survival
Mood alteration from BKM120
Activity of BKM120 as single agent in sequential biopsies

Full Information

First Posted
April 1, 2014
Last Updated
January 24, 2022
Sponsor
Dana-Farber Cancer Institute
Collaborators
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02113878
Brief Title
Phase Ib Study of BKM120 With Cisplatin and XRT in High Risk Locally Advanced Squamous Cell Cancer of Head and Neck
Official Title
A Phase Ib Study of BKM120 With Weekly Cisplatin and Radiotherapy in High Risk Locally Advanced Squamous Cell Cancer of the Head and Neck
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
September 29, 2014 (Actual)
Primary Completion Date
December 6, 2019 (Actual)
Study Completion Date
January 1, 2022 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This research study is evaluating a drug called buparlisib (BKM120) as a possible treatment for locally advanced head and neck squamous cell cancer.
Detailed Description
This phase Ib study is combining standard chemoradiotherapy with weekly cisplatin and BKM120 to assess tolerability of this combination in high risk patients with locally advanced Squamous Cell Carcinoma of the Head and Neck (SCCHN). The investigators will also obtain preliminary information about the efficacy of this treatment. The participant will receive the study drug buparlisib once daily, by mouth, for 45 days. The participant will be given a study drug-dosing diary for each cycle. It will include special instructions for taking the study drug at home. The investigators are looking for the highest dose of the study drug that can be administered safely without severe or unmanageable side effects, not everyone who participates in this research study will receive the same dose of the study drug. The dose given will depend on the number of participants who have been enrolled in the study before and how well they have tolerated their doses. All participants will receive weekly cisplatin injection. Cisplatin will be given intra-venously (IV) on days: (1, 8, 15, 22, 29, 36 and 43) at DFCI. All participants will receive daily radiotherapy with intensity-modulated radiotherapy (IMRT) for 7 weeks, delivered at DFCI. IMRT is a type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles. This type of radiation therapy reduces the damage to healthy tissue near the tumor. The investigators would like to keep track of the participant's medical condition. Follow-up will continue every 4 to 12 weeks after the end of treatment for the first year and at the investigator's discretion thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Squamous Cell of Head and Neck, HPV Positive Oropharyngeal Squamous Cell Carcinoma, Hypopharyngeal Cancer, Early Invasive Cervical Squamous Cell Carcinoma, Carcinoma of Larynx, Cancer of Nasopharynx
Keywords
Carcinoma, Squamous Cell of Head and Neck, Human Papillomavirus Positive Oropharyngeal Carcinoma, Hypopharyngeal Cancer, Early Invasive Cervical Squamous Cell Carcinoma, Carcinoma of Larynx, Cancer of Nasopharynx

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
BKM120
Arm Type
Experimental
Arm Description
Participants will be enrolled in cohorts of 3- 6 per dose level. Once the MTD is reached, an additional 10 patients will be treated at that dose level and an amendment will be submitted to declare the dose. BKM120 will start 2 weeks prior to first dose of cisplatin and radiation start. During the study, BKM120 will be administered orally daily for 45 days. Starting dose 40 mg. Cisplatin: Starting Dose 30 mg/m2, given IV, weekly on days: (1, 8, 15, 22, 29, 36 and 43). Radiotherapy: All participants will receive daily radiotherapy with intensity-modulated radiotherapy (IMRT) for 7 weeks.
Intervention Type
Drug
Intervention Name(s)
BKM120
Other Intervention Name(s)
Buparlisib
Intervention Description
BKM120 is a potent and highly specific oral pan-class I PI3K inhibitor.
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
Platinol-AQ, Platinol
Intervention Description
Cisplatin is a chemotherapy drug
Intervention Type
Radiation
Intervention Name(s)
Intensity-modulated radiotherapy (IMRT)
Other Intervention Name(s)
IMRT
Intervention Description
IMRT is the medical use of ionizing radiation, generally as part of cancer treatment to control or kill malignant cells
Primary Outcome Measure Information:
Title
Determine Maximum Tolerated Dose (MTD) of BKM120/cisplatin combination with radiation therapy
Description
Determine Maximum Tolerated Dose (MTD) of BKM120/cisplatin in combination with radiation therapy in patients with locally advanced squamous cell cancer of the head and neck.
Time Frame
2 Years
Secondary Outcome Measure Information:
Title
Overall Response Rate
Time Frame
2 Years
Title
Time to Progression
Time Frame
2 Years
Title
Survival
Time Frame
2 years
Title
Mood alteration from BKM120
Time Frame
2 Years
Title
Activity of BKM120 as single agent in sequential biopsies
Time Frame
2 Years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Stage III/IV, locally advanced, biopsy proven squamous cell cancer of the head and neck that undergo chemoradiation as their primary treatment with curative intent. Oropharynx (HPV positive and HPV negative), hypopharynx, larynx primaries, nasopharynx as well as those with documented SCC of the cervical lymph nodes, with unknown primaries. >10 pack years of tobacco use Age ≥ 18 years ECOG performance status ≤ 2 At least one site of measurable disease Adequate bone marrow function as shown by: ANC > 1.5 x 109/L, Platelets >100 x 109/L, Hb >9 g/dL Total calcium (corrected for serum albumin) within normal limits Magnesium ≥ the lower limit of normal Potassium within normal limits for the institution. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) within normal range Serum bilirubin within normal range (or ≤ 1.5 x ULN if liver metastases are present; or total bilirubin ≤ 3.0 x ULN with direct bilirubin within normal range in patients with well documented Gilbert Syndrome) Serum creatinine ≤ 1.5 x ULN or 24-hour clearance ≥ 50 mL/min Serum amylase ≤ ULN Serum lipase ≤ ULN Fasting plasma glucose ≤ 120 mg/dL (6.7 mmol/L) Signed informed consent INR ≤ 2 Exclusion Criteria: Distant metastatic disease Less than or equal to 10 pack years of tobacco history Received prior chemotherapy Received prior radiation to the head and neck or adjacent anatomical site Received prior treatment with a P13K inhibitor. Known hypersensitivity to BKM120 or to its excipients Acute or chronic liver, renal disease or pancreatitis Mood disorders ≥ CTCAE grade 3 Diarrhea ≥ CTCAE grade 2 Active cardiac disease History of cardiac dysfunction including any of the following: Patient has poorly Impairment of gastrointestinal (GI) function Currently receiving treatment with medication with a known risk to prolong the QT interval or inducing Torsades de Pointes and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug. Chronic treatment with steroids or another immunosuppressive agent. Herbal medications and certain fruits within 7 days prior to starting study drug. Currently treated with drugs known to be moderate and strong inhibitors or inducers of isoenzyme CYP3A, and the treatment cannot be discontinued or switched to a different medication prior to starting study drug. Please refer to Appendix B for a list of prohibited inhibitors and inducers of CYP3A (Please note that co-treatment with weak inhibitors of CYP3A is allowed). Undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy. Currently taking therapeutic doses of warfarin sodium or any other coumadin-derivative anticoagulant. Women who are pregnant or breast feeding or adults of reproductive potential not employing an effective method of birth control. Known diagnosis of human immunodeficiency virus (HIV) infection History of another malignancy within 3 years, except cured basal cell carcinoma of the skin or excised carcinoma in situ of the cervix
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Glenn J. Hanna, MD
Organizational Affiliation
Brigham and Women's Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
There are no plans to share the IPD. Cumulative data will be published however.
Citations:
PubMed Identifier
33004905
Citation
Glorieux M, Dok R, Nuyts S. The influence of PI3K inhibition on the radiotherapy response of head and neck cancer cells. Sci Rep. 2020 Oct 1;10(1):16208. doi: 10.1038/s41598-020-73249-z.
Results Reference
derived

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Phase Ib Study of BKM120 With Cisplatin and XRT in High Risk Locally Advanced Squamous Cell Cancer of Head and Neck

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