A Phase 1 Study of MLN8237, an Aurora A Kinase Inhibitor, in Patients With Advanced Solid Tumors Including Castration-Resistant Prostate Cancer Receiving a Standard Docetaxel Regimen
Inclusion Criteria:
Each patient must meet all of the following inclusion criteria to be enrolled in the
study:
- 18 years or older
- Histologically or cytologically confirmed advanced tumors and candidates for
docetaxel treatment
- Measurable or evaluable disease is required. Patients must have clinical evidence of
progressive disease or persistent disease
- Patients with castration-resistant prostate cancer (CRPC) are required to have
- Pathologically confirmed adenocarcinoma of the prostate
- Evidence of metastatic disease on bone scan or other imaging. Patients with PSA
elevation as the only manifestation of disease are not eligible.
- Progressive disease after at least 1 hormonal treatment with documented
testosterone levels less than 50 ng/dl
- Concurrent use of an agent for testosterone suppression (e.g., LHRH agonist) is
required if the patient has not been surgically castrated
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Recovered to less than or equal to Grade 1 toxicity (CTCAE), to patient's baseline
status (except alopecia) or deemed irreversible from the effects of prior cancer
therapy and must have evidence of progressive or persistent disease
- Adequate bone marrow, liver and renal function
- Any use of opiates must be stable for at least 2 weeks prior to study entry
- Female patients who are postmenopausal for at least 1 year OR are surgically sterile
OR if of childbearing potential, agree to practice 2 effective methods of
contraception at the same time
- Male patients who agree to practice effective barrier contraception during the entire
study and through 6 months after the last dose of study drug OR agree to abstain from
heterosexual intercourse
- Voluntary written consent
- Willing to comply with scheduled visits, treatment plan, laboratory tests and other
trial procedures
- Suitable venous access for blood sampling
Exclusion Criteria:
Patients meeting any of the following exclusion criteria are not to be enrolled in the
study:
- Female patients who are lactating or pregnant
- Antineoplastic therapy or any experimental therapy within 21 days before the first
dose of MLN8237
- Prior or current investigational therapies within 4 weeks before the first dose of
MLN8237
- Concurrent investigational treatment of treatment with any investigational products
within 28 days before the first dose of MLN8237
- Radiotherapy to greater than 40% of bone marrow or any radiotherapy (except
localized, small field radiation) within 4 weeks prior to enrollment, unless reviewed
and approved by the medical monitor
- Nitrosoureas or mitomycin-C within 6 weeks before the first dose of MLN8237.
- Autologous stem cell transplant within 3 months before the first dose of MLN8237, or
prior allogeneic stem cell transplant at any time.
- Use of enzyme-inducing antiepileptic drugs such as phenytoin, carbamazepine or
phenobarbital, or rifampin, rifabutin, rifapentine or St. John's wort within 14 days
prior to the first dose of MLN8237
- For CRPC patients:
- Radiotherapy or antiandrogen therapy for prostate cancer within 4 weeks prior to
enrollment
- Prior treatment with antineoplastic chemotherapy or radioisotopes for advanced
prostate cancer
- Use of products known to affect PSA levels within 4 weeks of enrollment
- Major surgery within 4 weeks of study enrollment
- Uncontrolled high blood pressure
- Patients with abnormal gastric or bowel function or who require continuous treatment
with antacids or proton pump inhibitors
- Patients receiving chronic steroid therapy other than the following: low dose steroid
for the control of nausea and vomiting, topical steroid, inhaled steroid or use of
dexamethasone
- Known severe hypersensitivity to docetaxel or other drugs formulated in polysorbate
80
- Comorbid condition or unresolved toxicity that would preclude administration of
docetaxel
- Prior history of Grade 2 or greater neurotoxicity or any toxicity that has not
resolved to Grade 1 or below
- Symptomatic brain or other CNS metastasis
- Diagnosis or treatment of another malignancy within 2 years preceding first dose of
study drug except nonmelanoma skin cancer or in situ malignancy completely resected
- Known history of human immunodeficiency virus (HIV) infection, hepatitis B, or
hepatitis C
- Patients requiring full systemic anticoagulation
- Prior allogeneic bone marrow or other organ transplant
- Active infection requiring systemic therapy within 14 days preceding first dose, or
other serious infection
- History of hemorrhagic or thrombotic cerebrovascular event in the past 12 months
- Serious medical or psychiatric illness that could interfere with protocol completion
- Inability to swallow oral medication
- Prior treatment with more than 3 myelosuppressive cytotoxic chemotherapy regimens
- Prior treatment with more than 1 prior taxane-containing regimen