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Safety and Efficacy of RO4929097 in Combination With Temsirolimus: A Pharmacokinetic and Pharmacodynamic Phase I Study in Patients With Advanced Solid Tumours With an Expansion of Cohort With Patients With Recurrent/Metastatic Endometrial and Renal Cell Cancers


Phase 1
18 Years
N/A
Open (Enrolling)
Both
Endometrial Papillary Serous Carcinoma, Recurrent Endometrial Carcinoma, Recurrent Renal Cell Cancer, Stage III Endometrial Carcinoma, Stage III Renal Cell Cancer, Stage IV Endometrial Carcinoma, Stage IV Renal Cell Cancer, Unspecified Adult Solid Tumor, Protocol Specific

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Trial Information

Safety and Efficacy of RO4929097 in Combination With Temsirolimus: A Pharmacokinetic and Pharmacodynamic Phase I Study in Patients With Advanced Solid Tumours With an Expansion of Cohort With Patients With Recurrent/Metastatic Endometrial and Renal Cell Cancers


PRIMARY OBJECTIVES:

I. To determine the recommended phase II dose (RP2D) and safety profile of temsirolimus in
combination with RO4929097 (gamma-secretase/Notch signalling pathway inhibitor RO4929097) in
patients with advanced solid tumors.

SECONDARY OBJECTIVES:

I. To obtain pharmacokinetic (PK) profiles for both drugs when administered in combination
in order to quantify the expected interactive effects in PK between these two agents.

II. To evaluate pharmacodynamic (PD) effects of both drugs when administered in combination,
with the goal of identifying potential predictive and PD markers that need further
exploration and validation in future trials.

OUTLINE: This is a multicenter, dose-escalation study.

Patients receive temsirolimus IV over 30 minutes on day -6 (course 1 only). Patients then
receive temsirolimus IV or orally (PO) on days 1, 8, and 15 and gamma-secretase/Notch
signalling pathway inhibitor RO4929097 PO once daily on days 1-3, 8-10, and 15-17. Courses
repeat every 21 days in the absence of disease progression or unacceptable toxicity. Blood
and tumor tissue samples may be collected periodically for pharmacokinetic and correlative
analyses.

After completion of study treatment, patients are followed up for 4 weeks.


Inclusion Criteria:



- Meets one of the following sets of criteria:

- Dose-escalation group:

- Histologically and/or cytologically confirmed solid malignancy

- Metastatic or unresectable disease

- Disease for which standard curative or palliative measures do not exist or
are no longer effective

- Expansion group:

- Histologically and/or cytologically confirmed endometrial (endometrioid,
uterine papillary serious carcinoma, or carcinosarcoma) or renal cell
cancer

- Metastatic or unresectable disease

- Disease for which standard curative or palliative measures do not exist or
are no longer effective

- Measurable or non-measurable disease

- Measurable disease is defined as ≥ 1 lesion that can be accurately measured in ≥
1 dimension (longest diameter to be recorded) as ≥ 20 mm with conventional
techniques or as ≥ 10 mm with spiral CT scan

- No known brain metastases

- ECOG performance status (PS) 0-1 (Karnofsky PS 70-100%)

- Life expectancy > 12 weeks

- Leukocytes ≥ 3,000/mm^3

- ANC ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Hemoglobin ≥ 90 g/L (or ≥ 9 g/dL)

- Total bilirubin normal

- AST/ALT ≤ 2.5 times upper limit of normal

- Serum creatinine normal OR creatine clearance ≥ 60 mL/min

- Fasting cholesterol ≤ 350 mg/dL (9.0 mmol/L)

- Fasting triglycerides ≤ 400 mg/dL (4.56 mmol/L)

- No uncontrolled hypocalcemia, hypomagnesemia, hyponatremia, hypophosphatemia or
hypokalemia defined as less than the lower limit of normal for the institution,
despite adequate electrolyte supplementation

- Note: it is acceptable to use corrected calcium when interpreting calcium levels

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use two effective forms of contraception (i.e., barrier
contraception and one other method of contraception) for ≥ 4 weeks before, during,
and for ≥ 12 months after completion of study therapy

- Able to swallow medication

- No malabsorption syndrome or other condition that would interfere with intestinal
absorption

- No diarrhea ≥ grade 2 that is not under control with standard anti-diarrhea
medications

- No uncontrolled concurrent illness including, but not limited to, any of the
following:

- Ongoing or active infection

- Symptomatic congestive heart failure

- Unstable anginal pectoris

- Cardiac arrhythmia other than chronic, stable atrial fibrillation

- Psychiatric illness or social situations that would limit compliance with study
medications

- QTc ≤ 450 msec in males and a QTc ≤ 470 msec in females, as measured by ECG using
Bazett formula

- No history of risk factors for QT interval prolongation including, but not limited
to, a family or personal history of any of the following:

- Long QT syndrome

- Torsades de pointes

- Recurrent syncope without known etiology

- Sudden unexpected death

- No pre-existing significant pulmonary infiltrates of unknown origin

- No serologic positivity for hepatitis A, B, or C or history of liver disease or other
forms of hepatitis or cirrhosis

- No HIV-positive patients on combination antiretroviral therapy

- No history of allergic reactions attributed to compounds of similar chemical or
biologic composition to gamma-secretase inhibitor RO4929097 or temsirolimus

- Female patients may not donate ova during or after study treatment

- Male patients may not donate sperm during and for ≥ 12 months after completion of
study treatment

- Patients may not donate blood during and for ≥ 12 months after completion of study
treatment

- Any number of prior therapies allowed

- Recovered from side effects of previous systemic anticancer therapy to < CTCAE grade
2 toxicity (except alopecia)

- Concurrent leuteinizing hormone-releasing hormone agonist allowed in patients with
castration-resistant prostate cancer

- No prior gamma-secretase inhibitor or any inhibitor of the PI3K/Akt/mTOR pathway

- At least 4 weeks since prior radiotherapy or systemic therapy (6 weeks for
carmustine, nitrosoureas, or mitomycin C)

- Exceptions may be made for low-dose, non-myelosuppressive radiotherapy for
symptomatic palliation

- No other concurrent investigational agents

- No concurrent medications with narrow therapeutic indices that are metabolized by
cytochrome P450 (CYP450), including warfarin sodium (Coumadin®)

- No concurrent medications that are strong inducers, inhibitors, or substrates of
CYP3A4

- No antiarrhythmics or other concurrent medications with known potential to prolong QT
interval

- No concurrent food that may interfere with the metabolism of gamma-secretase
inhibitor RO4929097, including grapefruit or grapefruit juice

- No other concurrent anticancer agents or therapies

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Recommended phase II dose defined as the dose level at which less than or equal to 1 of 6 patients experienced DLT assessed using NCI CTCAE version 4.0

Outcome Time Frame:

21 days

Safety Issue:

Yes

Principal Investigator

Amit Oza

Investigator Role:

Principal Investigator

Investigator Affiliation:

University Health Network-Princess Margaret Hospital

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2011-02529

NCT ID:

NCT01198184

Start Date:

August 2010

Completion Date:

Related Keywords:

  • Endometrial Papillary Serous Carcinoma
  • Recurrent Endometrial Carcinoma
  • Recurrent Renal Cell Cancer
  • Stage III Endometrial Carcinoma
  • Stage III Renal Cell Cancer
  • Stage IV Endometrial Carcinoma
  • Stage IV Renal Cell Cancer
  • Unspecified Adult Solid Tumor, Protocol Specific
  • Carcinoma
  • Carcinoma, Renal Cell
  • Cystadenocarcinoma, Serous
  • Adenoma
  • Neoplasms
  • Endometrial Neoplasms

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