Study of the Pharmacokinetics and Safety of Carfilzomib in Patients With Advanced Malignancies and Hepatic Impairment
Solid Tumors, Hematologic Malignancies, Hepatic Impairment
About this trial
This is an interventional other trial for Solid Tumors
Eligibility Criteria
Key Inclusion Criteria:
- Relapsed or progressive advanced malignancies (solid tumors or hematologic malignancies)
- At least ≥ 2 prior treatment regimens for the underlying malignancy
- Confirmed advanced solid tumor or hematologic malignancy
- Measurable or evaluable disease
Clinical diagnosis of chronic hepatic impairment that is stable with no acute worsening of liver failure within one month prior to enrollment. Hepatic impairment will be assessed as per National Cancer Institute Organ Dysfunction Working Group Criteria (NCI-ODWG) schema and will fall into one of the following three categories:
- Cohort 2 (mild): Bilirubin > 1-1.5 × upper limit of the normal range (ULN) or aspartate aminotransferase (AST) > ULN, but bilirubin ≤ ULN
- Cohort 3 (moderate): ≥ 1.6-3 × ULN; any AST
- Cohort 4 (severe): Bilirubin > 3 × ULN; any AST
Exception to Inclusion Criterion #5 for Subjects with Normal Hepatic Function:
All subjects enrolled with normal hepatic function (N=10) must meet all inclusion criteria as outlined with the exception of Inclusion Criterion
#5, which should be substituted with the following criterion to be enrolled into the study:
- Cohort 1 (normal hepatic function): Bilirubin ≤ ULN; AST ≤ ULN
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
- Left ventricular ejection fraction (LVEF) ≥ 40%
- Adequate renal function (calculated creatinine clearance ≥ 30 mL/min)
- Active congestive heart failure (New York Heart Association [NYHA] Class III to IV), symptomatic ischemia, conduction abnormalities uncontrolled by conventional intervention or myocardial infarction within the protocol-specified period prior to enrollment
Key Exclusion Criteria:
- Subjects with symptomatic brain metastasis or central nervous system (CNS) disease
- Significant neurotoxicity (Grade 2 with pain or higher) at the time of enrolment
- Known human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infection (Exception: Subjects with chronic or cleared HBV and HCV infection and stable liver function tests [bilirubin, AST] will be allowed)
Sites / Locations
- Karmanos Cancer Institute
- Duke Cancer Institute
- Gabrail Cancer Center
- Tennessee Oncology, PLLC
- Evergreen Hematology and Oncology
- Institut Gustave Roussy
- University Medical Centre Utrecht
- Northern Ireland Cancer Trials Centre - Queen's University Belfast TriaIs Centre
- Beatson West of Scotland Cancer Centre
- Velindre Hospital
- Sir Bobby Robson Cancer Trials Research Centre
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Experimental
Normal Hepatic Function
Mild Hepatic Impairment
Moderate Hepatic Impairment
Severe Hepatic Impairment
Participants with normal hepatic function (bilirubin and aspartate aminotransferase (AST) ≤ the upper limit of normal (ULN)) received carfilzomib 20 mg/m² administered by intravenous (IV) infusion on days 1 and 2 of cycle 1, followed by a planned step-up to 27 mg/m² IV on days 8, 9, 15, and 16 of cycle 1. Participants who adequately tolerated dosing at 27 mg/m² in cycle 1 received carfilzomib 56 mg/m² IV on days 1, 2, 8, 9, 15, and 16 of cycle 2 and subsequent 28-day cycles until confirmed progressive disease (PD), unacceptable toxicity, withdrawal of consent, study closure, or death.
Participants with mild hepatic impairment (bilirubin > 1-1.5 x ULN or AST > ULN, but bilirubin ≤ ULN) received carfilzomib 20 mg/m² administered by intravenous (IV) infusion on days 1 and 2 of cycle 1, followed by a planned step-up to 27 mg/m² IV on days 8, 9, 15, and 16 of cycle 1. Participants who adequately tolerated dosing at 27 mg/m² in cycle 1 received carfilzomib 56 mg/m² IV on days 1, 2, 8, 9, 15, and 16 of cycle 2 and subsequent 28-day cycles until confirmed progressive disease (PD), unacceptable toxicity, withdrawal of consent, study closure, or death.
Participants with moderate hepatic impairment (bilirubin > 1.5-3 x ULN, any AST) received carfilzomib 20 mg/m² administered by intravenous (IV) infusion on days 1 and 2 of cycle 1, followed by a planned step-up to 27 mg/m² IV on days 8, 9, 15, and 16 of cycle 1. Participants who adequately tolerated dosing at 27 mg/m² in cycle 1 received carfilzomib 56 mg/m² IV on days 1, 2, 8, 9, 15, and 16 of cycle 2 and subsequent 28-day cycles until confirmed progressive disease (PD), unacceptable toxicity, withdrawal of consent, study closure, or death.
(Bilirubin > 3 × ULN; any AST) Participants with severe hepatic impairment (bilirubin > 3 x ULN; any AST) received carfilzomib 20 mg/m² administered by intravenous (IV) infusion on days 1 and 2 of cycle 1, followed by a planned step-up to 27 mg/m² IV on days 8, 9, 15, and 16 of cycle 1. Participants who adequately tolerated dosing at 27 mg/m² in cycle 1 received carfilzomib 56 mg/m² IV on days 1, 2, 8, 9, 15, and 16 of cycle 2 and subsequent 28-day cycles until confirmed progressive disease (PD), unacceptable toxicity, withdrawal of consent, study closure, or death.