A Phase I Study of BKM120 and Everolimus in Advanced Solid Malignancies

This study is currently recruiting participants. (see Contacts and Locations)
Verified May 2014 by Emory University
Sponsor:
Collaborator:
Novartis Pharmaceuticals
Information provided by (Responsible Party):
Taofeek K. Owonikoko, Emory University
ClinicalTrials.gov Identifier:
NCT01470209
First received: October 25, 2011
Last updated: May 19, 2014
Last verified: May 2014
  Purpose

This study will assess the safety of combining two agents (Everolimus and BKM120) for the treatment of advanced cancer arising from solid organ in patients who are no longer benefiting from or unable to withstand standard treatment of these conditions.


Condition Intervention Phase
Solid Tumors
Drug: BKM120
Drug: Everolimus
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Study of BKM120 and Everolimus in Advanced Solid Malignancies

Resource links provided by NLM:


Further study details as provided by Emory University:

Primary Outcome Measures:
  • Dose limiting toxicity [ Time Frame: during the first cycle of treatment; approximately 4 weeks ] [ Designated as safety issue: Yes ]

    i. Grade 4 hematologic toxicity (excluding anemia) lasting more than 7 days

    ii. Grade 3 anemia lasting more than 7 days or requiring blood transfusion

    iii. Grade 4 anemia

    iv. Grade ≥3 febrile neutropenia of any duration

    v. Grade ≥3 nausea and or vomiting lasting more than 72 hours in spite of standard supportive therapy

    vi. Grade ≥3 non-hematologic toxicity (excluding alopecia).



Secondary Outcome Measures:
  • Clinical Benefit Rate [ Time Frame: During the entire duration of therapy estimated to be an average of 6 months for each patient ] [ Designated as safety issue: No ]
    Sum of Complete response, Partial response and Stable disease


Estimated Enrollment: 53
Study Start Date: January 2012
Estimated Study Completion Date: February 2016
Estimated Primary Completion Date: January 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Combination of BKM120 and everolimus Drug: BKM120
BKM120 (20mg to 100mg) The study drug BKM120 will be self-administered (by the patients themselves). The investigator will instruct the patient to take the study drug exactly as specified in the protocol. BKM120 will be administered on a continuous once daily dosing schedule. Patients should be instructed to take the dose of BKM120 daily in the morning, one hour after a light breakfast (morning meal) at approximately the same time each day. BKM120 should be taken with a glass of water and consumed over as short a time as possible. Patients should swallow the capsules as a whole and not chew them. Patients should continue to fast for 2 hours after the administration of each BKM120 dose.
Drug: Everolimus
RAD001 will be self-administered (by the patients themselves). The investigator will instruct the patient to take the study drug exactly as specified in the protocol. RAD001 will be administered orally as once daily dose of 5mg or 10 mg (based on the dose cohort) continuously from study day 1 until progression of disease or unacceptable toxicity. Patients will be instructed to take RAD001 in the morning, at the same time each day.
Other Name: RAD001

Detailed Description:

The purpose of this study is to study the combination of two anticancer drugs, everolimus and BKM120 in patients whose cancer is no longer responding to standard treatment or patients who are unable to tolerate the standard treatment for their cancer. The investigators seek to establish the safety of taking these two medications together and to determine the appropriate doses of the two drugs when given together as well as identify potential side effects when the drugs are administered together.

Another purpose of this study is to determine the effectiveness and side effects of the combination of RAD001 and BKM120 by looking at the patient's response to the treatment. The investigators want to find out what effects, good or bad, the drugs have on the patient's cancer.

This study will also look at specific biomarkers in the patient's blood and in the tumor tissue which are involved in the growth of tumor cells and determine if the levels of these biomarkers are related to the patient's response to treatment or development of side effects.

Everolimus, also known by the brand name, Afinitor, is a biologic drug approved by the Food and Drug Administration (FDA) for the treatment of kidney cancer. It works by preventing cancer cell from multiplying and it also renders them easily susceptible to death.

BKM120 is a new study drug that is being tested for its ability to treat cancer. However, it has not yet been approved by the FDA for the treatment of any specific cancer type.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Histologic or cytologic confirmation of a solid malignancy with established intolerance or refractoriness to standard therapies
  2. Age ≥ 18 years
  3. ECOG performance status £ 2 (see appendix A for details)
  4. Patients must have at least one site of measurable disease (per RECIST 1.1 criteria)
  5. Life expectancy in the estimation of the investigator of ≥ 12 weeks
  6. Adequate organ function including:

    1. Bone marrow function as shown by: ANC ≥ 1.5 x 109/L, Platelets ≥ 100 x 109/L, Hb >9 g/dL
    2. Electrolytes: Total calcium (corrected for serum albumin) within normal limits (ongoing requirement for bisphosphonate to control malignant hypercalcemia is not allowed but prophylactic use of bisphosphonate to prevent skeletal complication of bone metastasis is allowed); Magnesium ≥ the lower limit of normal
    3. Liver function: AST/SGOT and ALT/SGPT ≤ 2.5 x Upper Limit of Normal (ULN) or ≤ 5.0 x ULN if liver metastases are present; Serum bilirubin ≤ 1.5 x ULN
    4. Renal function: serum creatinine ≤ 1.5 x ULN or 24-hour clearance ≥ 50 mL/min or calculated GFR of 60cc/ml using the formula of Cockroft and Gault.
  7. Serum amylase ≤ ULN
  8. Serum lipase ≤ ULN
  9. Fasting plasma glucose ≤ 140 mg/dL (7.8 mmol/L)
  10. Negative serum pregnancy test within 48 hours before starting study treatment in women with childbearing potential
  11. Ability and willingness to participate in the informed consent process and signing a copy of the informed consent form

Exclusion Criteria:

  1. Patients who have received prior treatment with a P13K inhibitor or RAD001 (if discontinued for toxicity).
  2. Patients with a known hypersensitivity to BKM120, RAD001 (including other rapalogs) or their excipient
  3. Patients with untreated symptomatic brain metastases are excluded. However, patients with metastatic CNS tumors may participate in this trial, if the patient is > 4 weeks from therapy completion (including radiation and/or surgery), is clinically stable at the time of study entry and is not receiving corticosteroid therapy for the brain mets
  4. Patients with acute or chronic liver, renal disease or pancreatitis
  5. Patients with the following mood disorders as judged by the Investigator or a psychiatrist, or as result of patient's mood assessment questionnaire:

    1. medically documented history of or active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia, a history of suicidal attempt or ideation, or homicidal ideation (immediate risk of doing harm to others)
    2. ≥ CTCAE grade 3 anxiety Note: The psychiatric judgment overrules the mood assessment questionnaire result or the investigators judgment.
  6. Any of the following concurrent severe and/or uncontrolled medical conditions which could compromise participation in the study:

    • ST depression or elevation of ≥ 1.5 mm in 2 or more leads
    • Congenital long QT syndrome
    • History or presence of ventricular arrhythmias or atrial fibrillation
    • Clinically significant resting bradycardia (< 50 beats per minutes)
    • QTc > 480 msec on screening ECG
    • Complete left bundle branch block
    • Right bundle branch block + left anterior hemiblock (bifascicular block)
    • Unstable angina pectoris ≤ 6 months prior to starting study drug
    • Acute myocardial infarction ≤ 6 months prior to starting study drug
    • Other clinically significant heart disease such as congestive heart failure requiring treatment (NYHA Class III or IV) or uncontrolled hypertension (please refer to WHO-ISH guidelines)
  7. Active diarrhea ≥ CTCAE grade 2
  8. Patients with clinical manifestation of uncontrolled diabetes mellitus (i.e. treated and/or with clinical signs) or steroid-induced diabetes mellitus
  9. Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g., active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol
  10. Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of BKM120 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection). Patients with unresolved diarrhea will be excluded as previously indicated
  11. Patients who have been treated with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GM-CSF) ≤ 2 weeks prior to starting study drug. Erythropoietin or darbepoetin therapy, if initiated at least 2 weeks prior to enrollment, may be continued
  12. Patients who are currently receiving treatment with medication that has the potential 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
  13. Patients who have received corticosteroids ≤ 2 weeks prior to starting study drug. Topical and systemic corticosteroids should not be administered with BKM120
  14. Patients who have received chemotherapy or targeted anticancer therapy ≤ 4 weeks (6 weeks for nitrosourea, antibodies or mitomycin-C) prior to starting study drug or who have not recovered from side effects of such therapy
  15. Patients who have received any continuous or intermittent small molecule therapeutics (excluding monoclonal antibodies) ≤ 5 effective half lives prior to starting study drug or who have not recovered from side effects of such therapy
  16. Patients who have received wide field radiotherapy ≤ 4 weeks or limited field radiation for palliation ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  17. Patients who have undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  18. Patients who are currently taking therapeutic doses of warfarin sodium or any other coumadin-derivative anticoagulant.
  19. Women who are pregnant or breast feeding or adults of reproductive potential not employing an effective method of birth control. Double barrier contraceptives must be used through the trial by both sexes. Oral, implantable, or injectable contraceptives may be affected by cytochrome P450 interactions, and are therefore not considered effective for this study. Women of child-bearing potential, defined as sexually mature women who have not undergone a hysterectomy or who have not been naturally postmenopausal for at least 12 consecutive months (i.e., who has had menses any time in the preceding 12 consecutive months), must have a negative serum pregnancy test ≤ 48 hours prior to initiating treatment
  20. Liver disease such as cirrhosis or severe hepatic impairment (Child-Pugh class C). Note: A detailed assessment of Hepatitis B/C medical history and risk factors must be done at screening for all patients. HBV DNA and HCV RNA PCR testing are required at screening for all patients with a positive medical history based on risk factors and/or confirmation of prior HBV/HCV infection.
  21. Known diagnosis of human immunodeficiency virus (HIV) infection
  22. History of another malignancy within 3 years, except cured basal cell carcinoma of the skin, treated DCIS, cured early stage prostate cancer without detectable PSA or excised carcinoma in situ of the cervix
  23. Patients should not receive immunization with attenuated live vaccines during study period or within 1 week of study entry. Close contact with those who have received attenuated live vaccines should be avoided during treatment with everolimus. Examples of live vaccines include intranasal influenza, measles, mumps, rubella, oral polio, BCG, yellow fever, varicella and TY21a typhoid vaccines.
  24. Patients taking medications known to be strong CYP3A inhibitors (Table 4.18).
  25. Patient is unable or unwilling to abide by the study protocol or cooperate fully with the investigator.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01470209

Contacts
Contact: Taofeek Owonikoko, MD, PhD 1-888-946-7447 towonik@emory.edu

Locations
United States, Georgia
Taofeek Owonikoko, MD, PhD Recruiting
Atlanta, Georgia, United States, 30322
Sponsors and Collaborators
Emory University
Novartis Pharmaceuticals
Investigators
Principal Investigator: Taofeek Owonikoko, MD, PhD Emory University Winship Cancer Institute
  More Information

Additional Information:
No publications provided

Responsible Party: Taofeek K. Owonikoko, Assistant Professor and Principal Investigator, Emory University
ClinicalTrials.gov Identifier: NCT01470209     History of Changes
Other Study ID Numbers: IRB00048549, WCI1925-10
Study First Received: October 25, 2011
Last Updated: May 19, 2014
Health Authority: United States: Institutional Review Board
United States: Food and Drug Administration

Keywords provided by Emory University:
lung cancer
breast cancer
colon cancer
kidney cancer
melanoma
thyroid cancer
rectal cancer

Additional relevant MeSH terms:
Everolimus
Sirolimus
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Antibiotics, Antineoplastic
Antineoplastic Agents
Therapeutic Uses
Antifungal Agents
Anti-Infective Agents
Anti-Bacterial Agents

ClinicalTrials.gov processed this record on July 26, 2014