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Phase Ib/II Study of Buparlisib Plus Carboplatin or Lomustine in Patients With Recurrent Glioblastoma Multiforme

Primary Purpose

Recurrent Glioblastoma Multiforme

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
buparlisib
carboplatin
lomustine
placebo
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Glioblastoma Multiforme focused on measuring BKM120, Recurrent glioblastoma multiforme, rGBM, buparlisib

Eligibility Criteria

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

Inclusion Criteria:

  • Patient is an adult ≥ 18 years old at the time of informed consent.
  • Patient has histologically confirmed diagnosis of GBM with documented recurrence after first line treatment including radiotherapy and TMZ (SoC), not suitable for curative surgery or re-irradiation.
  • Patient has at least one measurable and/or non-measurable lesion as per RANO criteria
  • Patient has recovered (to Grade ≤1) from all clinically significant toxicities related to prior antineoplastic therapies.
  • Patient has Karnofsky performance status (KPS) ≥70%.
  • Patient has adequate organ and bone marrow functions:

    • Absolute Neutrophils Count (ANC) ≥ 1.5 x 109/L
    • Platelets ≥ 100 x 109/L (in case of transfusion stable for ≥14 days prior to treatment start)
    • Hemoglobin ≥ 9.0 g/dL (in case of transfusion stable for ≥14 days prior to treatment start)
    • INR ≤ 1,5
    • Serum Creatinine ≤ 1.5 x ULN, or Creatinine Clearance > 45mL/min
    • Potassium and calcium (corrected for albumin), sodium and magnesium within institutional normal limits
    • Serum Bilirubin ≤ ULN, AST and ALT ≤ ULN
    • HbA1c ≤ 8%
    • Fasting plasma glucose (FPG) ≤ 120 mg/dL or ≤ 6.7 mmol/L
  • Patient has tumor tissues available (archival or fresh).

Exclusion Criteria:

  • Patient has received previous treatment with PI3K inhibitors, lomustine or carboplatin.
  • Patient has received previous antineoplastic treatment for recurrent GBM (e.g. VEGF inhibitors, cytotoxic agents).
  • Patient has received more than one line of cytotoxic chemotherapy
  • Patient has concurrent use of anti-neoplastic agents including investigational therapy
  • Patient is currently receiving warfarin or other coumarin derived anti-coagulant, for treatment, prophylaxis or otherwise. Therapy with heparin, low molecular weight heparin (LMWH), or fondaparinux is allowed.
  • Patient is currently receiving treatment with drugs known to be moderate or strong inhibitors or inducers of isoenzyme CYP3A. The patient must have discontinued strong inducers for at least one week and must have discontinued strong inhibitors before the treatment is initiated. Switching to a different medication prior to randomization is allowed.
  • Patient is currently receiving an enzyme-inducing anti-epileptic drug (EIAED). The patient must have discontinued EIAED therapy for at least two weeks prior to starting study drug.

Other protocol-defined Inclusion/exclusion criteria may apply.

Sites / Locations

  • Barrow Neurological Insitute St. Joseph's Hospital
  • Highlands Oncology Group
  • Northwestern University
  • Dana Farber Cancer Institute
  • MD Anderson Cancer Center/University of Texas
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Experimental

Arm Label

Lomustine+ buparlisib (Phase Ib)

carboplatin+ buparlisib (Phase Ib)

lomustine+ buparlisib (Phase II)

lumustine + placebo (Phase II)

carboplatin+ buparlisib (Phase II)

Arm Description

Outcomes

Primary Outcome Measures

Number of Total Dose-limiting Toxicity (DLT) during Dose Escalation part to determine Maximum Tolerated Dose (MTD) [Phase Ib]
Maximum Tolerated Dose (MTD) is defined as the highest BKM120 dosage that does not cause medically unacceptable Dose Limiting Toxicities (DLTs) in more than 35% of the treated patients during the first cycle of treatment. DLT is defined as treatment-related toxicity occurring during the phase Ib cycle 1 and meeting specific protocol-predefined criteria. The information will be integrated in a Bayesian logistic regression model with overdose control to estimate the MTD.
12 week Progression Free Survival (PFS) rate (Phase II- Carboplatin combination)
12-week Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 12 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 12 weeks of observation are counted as "failure".
Progression Free Survival (PFS) [phase II lomustine combinations]
Progression Free Survival (PFS) is defined as the time from date of randomization to the date of the event, which is the first radiologically documented disease progression [per local investigator assessment according to Response Assessment in Neuro-Oncology (RANO) criteria] or death due to any cause.

Secondary Outcome Measures

Frequency and severity of Adverse Events (AEs) [Phase Ib, Phase II, all treatment arms]
The incidence of Adverse Events (AEs) summarized by system organ class and or preferred term, severity (based on Common Terminology Criteria for Adverse Events (CTCAE) grades version 4), type of AE, relation to study treatment.
Overall Response Rate (ORR) as per Response Assessment in Neuro-Oncology (RANO) [Phase Ib , both combinations]
Overall response rate (ORR) is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR), based on the investigator assessment as per Response Assessment in Neuro-Oncology (RANO) criteria.
Progression Free Survival (PFS) [Phase Ib- both combinations]
Progression Free Survival (PFS) is defined as time from date of treatment start to the date of the event, which is the first radiologically documented disease progression or death due to any cause per local investigator assessment.
Overall response rate (ORR) [Phae II, carboplatin combination]
Overall response rate (ORR) is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR), based on the investigator assessment as per Response Assessment in Neuro-Oncology (RANO) criteria.
Progression Free Survival (PFS) [Phase II, carboplatin combination]
Progression Free Survival (PFS) is defined as time from date of treatment start to the date of the event, which is the first radiologically documented disease progression or death due to any cause per local investigator assessment.
24 week Progression Free Survival (PFS) rate (Phase II carboplatin combination)
24 weeks Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 24 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 24 weeks of observation are counted as "failure".
Overall Survival (OS) (Phase II Carboplatin combination)
Overall survival (OS) is defined as the time from the date of randomization for buparlisib + lomustine / placebo + lomustine Phase II, or the time from the first study drug intake for buparlisib + carboplatin Phase II, to the date of death due to any cause.
Overall Response Rate (ORR) (Phase II Lomustine combinations)
Overall response rate (ORR) is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR), based on the investigator assessment as per Response Assessment in Neuro-Oncology (RANO) criteria.
12 week Progression Free Survival (PFS) rate (Phase II- lomustine combinations)
12-week Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 12 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 12 weeks of observation are counted as "failure".
24 week Progression Free Survival (PFS) rate (Phase II- lomustine combinations)
24 weeks Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 24 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 24 weeks of observation are counted as "failure".
Overall survival (OS) [Phase II lomustine combinations]
Overall survival (OS) is defined as the time from the date of randomization for buparlisib + lomustine / placebo + lomustine Phase II, or the time from the first study drug intake for buparlisib + carboplatin Phase II, to the date of death due to any cause.

Full Information

First Posted
August 20, 2013
Last Updated
December 6, 2020
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01934361
Brief Title
Phase Ib/II Study of Buparlisib Plus Carboplatin or Lomustine in Patients With Recurrent Glioblastoma Multiforme
Official Title
Phase Ib/II Multicenter Study of Buparlisib Plus Carboplatin or Lomustine in Patients With Recurrent Glioblastoma Multiforme
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
February 28, 2014 (Actual)
Primary Completion Date
July 7, 2016 (Actual)
Study Completion Date
July 7, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

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
This is a multi-center, phase Ib/ II study (two parts) with patients that had recurrent glioblastoma multiforme. The first part (phase Ib) was to investigate the maximum tolerated dose/Recommended phase ll dose (MTD/RP2D) of once daily buparlisib in combination with every-three-week carboplatin or buparlisib once daily in combination with every-six-week lomustine (CCNU) using a Bayesian model. Once MTD/ RP2D is established in either of the 2 arms, the corresponding phase II portion of the study was to start. Phase II was to assess the treatment effect of buparlisib in combination with carboplatin in terms of Progression Free Survival (PFS) and was to compare the treatment effect of buparlisib with lomustine versus lomustine plus placebo in terms of PFS. A preliminary assessment for both combinations (buparlisib plus carboplatin or lomustine) demonstrated that there was not enough antitumor activity compared to historical data with single agent carboplatin or lomustine. Based on the overall safety profile, and preliminary anti-tumor activity observed in this study, Novartis decided that no additional patients would be enrolled into this study. As a consequence, the Phase II part of the study was not conducted.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Glioblastoma Multiforme
Keywords
BKM120, Recurrent glioblastoma multiforme, rGBM, buparlisib

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
35 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lomustine+ buparlisib (Phase Ib)
Arm Type
Experimental
Arm Title
carboplatin+ buparlisib (Phase Ib)
Arm Type
Experimental
Arm Title
lomustine+ buparlisib (Phase II)
Arm Type
Experimental
Arm Title
lumustine + placebo (Phase II)
Arm Type
Placebo Comparator
Arm Title
carboplatin+ buparlisib (Phase II)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
buparlisib
Intervention Description
Buparlisib administered orally on a continuous daily schedule. Buparlisib is manufactured as 10mg and 50mg hard gelatin capsules.
Intervention Type
Drug
Intervention Name(s)
carboplatin
Intervention Description
Carboplatin intravenous infusion will be administered at a dose of AUC 5 in a 21 day cycle (every 3 weeks).
Intervention Type
Drug
Intervention Name(s)
lomustine
Intervention Description
Lomustine will be administered as a single oral dose of 100 mg/m² every 6 weeks in a 42 day cycles.
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
Placebo will be administered orally on a continuous QD dosing schedule for cycles of 42 days. Buparlisib matching placebo is manufactured as 10 mg and 50 mg hard gelatin capsules.
Primary Outcome Measure Information:
Title
Number of Total Dose-limiting Toxicity (DLT) during Dose Escalation part to determine Maximum Tolerated Dose (MTD) [Phase Ib]
Description
Maximum Tolerated Dose (MTD) is defined as the highest BKM120 dosage that does not cause medically unacceptable Dose Limiting Toxicities (DLTs) in more than 35% of the treated patients during the first cycle of treatment. DLT is defined as treatment-related toxicity occurring during the phase Ib cycle 1 and meeting specific protocol-predefined criteria. The information will be integrated in a Bayesian logistic regression model with overdose control to estimate the MTD.
Time Frame
Cycle 1 (21 days carboplatin combination or 42 days lomustine combination )
Title
12 week Progression Free Survival (PFS) rate (Phase II- Carboplatin combination)
Description
12-week Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 12 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 12 weeks of observation are counted as "failure".
Time Frame
12 weeks
Title
Progression Free Survival (PFS) [phase II lomustine combinations]
Description
Progression Free Survival (PFS) is defined as the time from date of randomization to the date of the event, which is the first radiologically documented disease progression [per local investigator assessment according to Response Assessment in Neuro-Oncology (RANO) criteria] or death due to any cause.
Time Frame
Randomization until date of the event (expected average 3 months).
Secondary Outcome Measure Information:
Title
Frequency and severity of Adverse Events (AEs) [Phase Ib, Phase II, all treatment arms]
Description
The incidence of Adverse Events (AEs) summarized by system organ class and or preferred term, severity (based on Common Terminology Criteria for Adverse Events (CTCAE) grades version 4), type of AE, relation to study treatment.
Time Frame
Until 30 days after treatment discontinuation
Title
Overall Response Rate (ORR) as per Response Assessment in Neuro-Oncology (RANO) [Phase Ib , both combinations]
Description
Overall response rate (ORR) is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR), based on the investigator assessment as per Response Assessment in Neuro-Oncology (RANO) criteria.
Time Frame
Baseline, every 6 weeks from treatment start until disease progression or until start of another antineoplastic treatment or death which ever occurs first up to 1 year
Title
Progression Free Survival (PFS) [Phase Ib- both combinations]
Description
Progression Free Survival (PFS) is defined as time from date of treatment start to the date of the event, which is the first radiologically documented disease progression or death due to any cause per local investigator assessment.
Time Frame
Time from treatment start to the date of the event (expected average 3 months)
Title
Overall response rate (ORR) [Phae II, carboplatin combination]
Description
Overall response rate (ORR) is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR), based on the investigator assessment as per Response Assessment in Neuro-Oncology (RANO) criteria.
Time Frame
Baseline, every 6 weeks from treatment start until disease progression or until start of another antineoplastic treatment or death which ever occurs first up to 1 year
Title
Progression Free Survival (PFS) [Phase II, carboplatin combination]
Description
Progression Free Survival (PFS) is defined as time from date of treatment start to the date of the event, which is the first radiologically documented disease progression or death due to any cause per local investigator assessment.
Time Frame
Time from treatment start to the date of the event (Expected average: 3 months)
Title
24 week Progression Free Survival (PFS) rate (Phase II carboplatin combination)
Description
24 weeks Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 24 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 24 weeks of observation are counted as "failure".
Time Frame
24 weeks
Title
Overall Survival (OS) (Phase II Carboplatin combination)
Description
Overall survival (OS) is defined as the time from the date of randomization for buparlisib + lomustine / placebo + lomustine Phase II, or the time from the first study drug intake for buparlisib + carboplatin Phase II, to the date of death due to any cause.
Time Frame
12 months
Title
Overall Response Rate (ORR) (Phase II Lomustine combinations)
Description
Overall response rate (ORR) is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR), based on the investigator assessment as per Response Assessment in Neuro-Oncology (RANO) criteria.
Time Frame
Baseline, every 6 weeks from treatment start until disease progression or until start of another antineoplastic treatment or death which ever occurs first up to 1 year
Title
12 week Progression Free Survival (PFS) rate (Phase II- lomustine combinations)
Description
12-week Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 12 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 12 weeks of observation are counted as "failure".
Time Frame
12 weeks
Title
24 week Progression Free Survival (PFS) rate (Phase II- lomustine combinations)
Description
24 weeks Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 24 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 24 weeks of observation are counted as "failure".
Time Frame
24 weeks
Title
Overall survival (OS) [Phase II lomustine combinations]
Description
Overall survival (OS) is defined as the time from the date of randomization for buparlisib + lomustine / placebo + lomustine Phase II, or the time from the first study drug intake for buparlisib + carboplatin Phase II, to the date of death due to any cause.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is an adult ≥ 18 years old at the time of informed consent. Patient has histologically confirmed diagnosis of GBM with documented recurrence after first line treatment including radiotherapy and TMZ (SoC), not suitable for curative surgery or re-irradiation. Patient has at least one measurable and/or non-measurable lesion as per RANO criteria Patient has recovered (to Grade ≤1) from all clinically significant toxicities related to prior antineoplastic therapies. Patient has Karnofsky performance status (KPS) ≥70%. Patient has adequate organ and bone marrow functions: Absolute Neutrophils Count (ANC) ≥ 1.5 x 109/L Platelets ≥ 100 x 109/L (in case of transfusion stable for ≥14 days prior to treatment start) Hemoglobin ≥ 9.0 g/dL (in case of transfusion stable for ≥14 days prior to treatment start) INR ≤ 1,5 Serum Creatinine ≤ 1.5 x ULN, or Creatinine Clearance > 45mL/min Potassium and calcium (corrected for albumin), sodium and magnesium within institutional normal limits Serum Bilirubin ≤ ULN, AST and ALT ≤ ULN HbA1c ≤ 8% Fasting plasma glucose (FPG) ≤ 120 mg/dL or ≤ 6.7 mmol/L Patient has tumor tissues available (archival or fresh). Exclusion Criteria: Patient has received previous treatment with PI3K inhibitors, lomustine or carboplatin. Patient has received previous antineoplastic treatment for recurrent GBM (e.g. VEGF inhibitors, cytotoxic agents). Patient has received more than one line of cytotoxic chemotherapy Patient has concurrent use of anti-neoplastic agents including investigational therapy Patient is currently receiving warfarin or other coumarin derived anti-coagulant, for treatment, prophylaxis or otherwise. Therapy with heparin, low molecular weight heparin (LMWH), or fondaparinux is allowed. Patient is currently receiving treatment with drugs known to be moderate or strong inhibitors or inducers of isoenzyme CYP3A. The patient must have discontinued strong inducers for at least one week and must have discontinued strong inhibitors before the treatment is initiated. Switching to a different medication prior to randomization is allowed. Patient is currently receiving an enzyme-inducing anti-epileptic drug (EIAED). The patient must have discontinued EIAED therapy for at least two weeks prior to starting study drug. Other protocol-defined Inclusion/exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Barrow Neurological Insitute St. Joseph's Hospital
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
Highlands Oncology Group
City
Fayetteville
State/Province
Arkansas
ZIP/Postal Code
72703
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
MD Anderson Cancer Center/University of Texas
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Novartis Investigative Site
City
Heidelberg
State/Province
Victoria
ZIP/Postal Code
3084
Country
Australia
Facility Name
Novartis Investigative Site
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3050
Country
Australia
Facility Name
Novartis Investigative Site
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
Novartis Investigative Site
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1Z6
Country
Canada
Facility Name
Novartis Investigative Site
City
Marseille Cedex 05
ZIP/Postal Code
13885
Country
France
Facility Name
Novartis Investigative Site
City
Paris Cedex 13
ZIP/Postal Code
75651
Country
France
Facility Name
Novartis Investigative Site
City
Saint Herblain cedex
ZIP/Postal Code
44805
Country
France
Facility Name
Novartis Investigative Site
City
Barcelona
State/Province
Catalunya
ZIP/Postal Code
08036
Country
Spain
Facility Name
Novartis Investigative Site
City
Hospitalet de LLobregat
State/Province
Catalunya
ZIP/Postal Code
08907
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32665311
Citation
Rosenthal M, Clement PM, Campone M, Gil-Gil MJ, DeGroot J, Chinot O, Idbaih A, Gan H, Raizer J, Wen PY, Pineda E, Donnet V, Mills D, El-Hashimy M, Mason W. Buparlisib plus carboplatin or lomustine in patients with recurrent glioblastoma: a phase Ib/II, open-label, multicentre, randomised study. ESMO Open. 2020 Jul;5(4):e000672. doi: 10.1136/esmoopen-2020-000672.
Results Reference
derived
Links:
URL
https://www.novctrd.com/ctrdweb/trialresult/trialresults/pdf?trialResultId=16410
Description
Results for CBMK120E2102 can be found on the Novartis Clinical Trial Results Website

Learn more about this trial

Phase Ib/II Study of Buparlisib Plus Carboplatin or Lomustine in Patients With Recurrent Glioblastoma Multiforme

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