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Study With LDE225 in Combination With Docetaxel in Triple Negative (TN) Advanced Breast Cancer (ABC) Patients (EDALINE)

This study is ongoing, but not recruiting participants.
Sponsor:
ClinicalTrials.gov Identifier:
NCT02027376
First Posted: January 6, 2014
Last Update Posted: October 12, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborator:
Novartis
Information provided by (Responsible Party):
Spanish Breast Cancer Research Group
  Purpose

This is a single-arm, open-label, phase Ib study. In this trial, patients with Triple Negative (TN) Advanced Breast Cancer (ABC) will be treated with increasing doses of LDE225 and docetaxel to determine the MTD (Maximum Tolerated Dose), DLT (Dose Limiting Toxicity) and RP2D (Recommended Phase II Dose) of the combination.

Eligible patients with hormonal receptors negative and HER2 negative ABC will be included and treated with docetaxel intravenously in every three weeks cycles. LDE225 will be administered orally at three dose levels 400, 600 and 800mg QD (a -1 dose level is included just in case dose de-escalation is needed). Treatment will be repeated on day 1 of a 21-day cycle until radiographic or symptomatic progression, unacceptable toxicity or withdraws informed consent.

The investigators propose to develop a phase Ib trial with the combination of docetaxel with LDE225 in TN ABC patients to define the safety, tolerability and RP2D, as well as to have some information about the efficacy of the combination.

Primary Objective:

To determine the MTD and RP2D of LDE225 administered orally in combination with docetaxel in TN ABC patients.

Primary End-point:

To determine the incidence rate of DLT within the first two cycles of LDE225 in combination with docetaxel at each dose level.

Secondary Objectives:

  • To determine the safety and tolerability of LDE225 given in combination with docetaxel.
  • To characterize the effects of LDE225 in combination with docetaxel on QTc intervals and their correlation with systemic drug exposure.
  • To evaluate the efficacy of the combination of docetaxel with LDE225 in TN ABC patients.
  • To evaluate the Pharmacokinetics (PK) of the combination of docetaxel with LDE225.

Secondary End-points:

  • Safety will be assessed by standard clinical and laboratory tests (hematology, serum chemistry). Adverse events grade will be defined by the NCI CTCAE v4.0.
  • Changes in QT/QTc from baseline ECG values and correlation with systemic drug exposure.
  • The efficacy endpoints are Time To Progression (TTP) and Objective Response Rate (ORR). TTP is measured from the initiation of treatment till disease progression and ORR is defined by RECIST 1.1 criteria as complete response rate + partial response rate.
  • The PK will determine whether LDE225 influences the pharmacology of docetaxel. Blood samples will be taken at the times defined in the protocol.

Exploratory Objectives:

  • To study potential predictive biomarkers of efficacy by evaluating activation of Hh signaling pathway and related pathways.
  • To analyze the pharmacodynamic (PD) treatment effects on the expression of Smo related biomarkers and Hg target genes in correlative samples.
  • To correlate biomarker, PD and PK findings with efficacy and toxicity data.

Exploratory End-points:

  • Hh gene expression signature associated to pathway activation (at least Shh, Smo, Ptch1, Ptch2, Gli1, Gli2), analyzed in tumor samples.
  • Changes in Smo related pathway biomarkers (at least Gli1) in skin and blood correlative samples.
  • Pharmacodynamic and biomarker analysis results will be correlated with PK findings, efficacy and toxicity data.

Demographics and Baseline Characteristics:

Standard descriptive statistics, such as the mean, median, range and proportion, will be used to summarize the patient sample and to estimate parameters of interest. Ninety-five percent confidence intervals will be provided for estimates of interest wherever possible.

Safety Analyses:

Adverse events data and serious adverse events will be reported in frequency tables (overall and by intensity). The safety analysis will be performed in the population that has received at least one dose of the drugs.

Efficacy Analyses:

Response will be analyzed in patients with measurable disease that have received at least one dose of the drugs.

TTP will be evaluated in all patients that have received at least one dose of the drugs.

Study population:

Patient with hormonal receptors negative and HER2 negative ABC.


Condition Intervention Phase
Advanced Breast Cancer Drug: LDE225 Drug: Docetaxel Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase Ib Dose Escalation, Open Label, Multicenter Study Evaluating LDE225 in Combination With Docetaxel in Triple Negative (TN) Advanced Breast Cancer (ABC) Patients "EDALINE"

Resource links provided by NLM:


Further study details as provided by Spanish Breast Cancer Research Group:

Primary Outcome Measures:
  • To determine the incidence rate of DLT within the first two cycles of LDE225 in combination with docetaxel at each dose level. [ Time Frame: 42 months ]

Secondary Outcome Measures:
  • • Safety will be assessed by standard clinical and laboratory tests (hematology, serum chemistry). Adverse events grade will be defined by the NCI CTCAE v4.0. [ Time Frame: 42 months ]
  • • Changes in QT/QTc from baseline ECG values and correlation with systemic drug exposure. [ Time Frame: 42 months ]
  • Time To Progression (TTP) [ Time Frame: 42 months ]
  • • Pharmacokinetics (PK) study of the combination of docetaxel with LDE225 [ Time Frame: 42 months ]
    PK sampling of LDE225 on Day 1 of each cycle until Cycle 5 will be analyzed and also PK sampling of Docetaxel on Day 1 of Cycle 1, and Day 1 of Cycle 2 will be analyzed. AUC and Cmax will be measured.

  • Objective Response Rate (ORR) [ Time Frame: 42 months ]

Estimated Enrollment: 18
Study Start Date: May 2014
Estimated Study Completion Date: May 2017
Estimated Primary Completion Date: May 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: LDE225 in combination with docetaxel
Eligible patients will be included and treated with docetaxel intravenously (75mg/m2)in every three weeks cycles and LDE225 will be administered orally at three dose levels 400, 600 and 800mg QD. Treatment will be repeated on day 1 of a 21-day cycle until radiographic or symptomatic progression, unacceptable toxicity or withdraws informed consent.
Drug: LDE225 Drug: Docetaxel

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. The patient is capable to understand and comply with the protocol and has signed the informed consent document.
  2. Females with histologically confirmed advanced breast cancer.
  3. TN breast cancer by local laboratory determination. HR negative defined as < 1% positive cells by IHC for both ER and PgR, and HER2 negative defined as ISH negative or IHC 0 or 1+ in the absence of ISH (Note: patients with IHC 2+ must have an ISH determination in order to confirm the HER2 negativity.
  4. Measurable or non-measurable disease according to RECIST 1.1 criteria.
  5. Patient is at least 18 years of age.
  6. World Health Organization (WHO) Performance Status ≤ 1.
  7. Life expectancy ≥ 12 weeks.
  8. Common laboratory values within normal range (…)
  9. A negative serum pregnancy test ≤ 72 hours before starting study treatment for pre-menopausal women and for women < 1 year from the last menstruation date.

Exclusion Criteria:

  1. Have received more than 3 prior chemotherapy regimens for ABC.
  2. Patients with untreated brain metastases. However, a patient with CNS metastases may participate in this trial if > 4 weeks from therapy completion (incl. radiation and/or surgery), is clinically stable with respect to the tumor at the time of study entry and is not receiving corticosteroid therapy.
  3. Patients with acute or chronic liver or renal disease or pancreatitis.
  4. Patients with a second primary malignancy that is clinically detectable at the time of consideration for study enrollment.
  5. Patients unable to swallow tablets.
  6. History of a positive HIV test (HIV testing is not mandatory).
  7. History of a positive Hepatitis B surface antigen (HBsAg) or Hepatitis C test result (Hepatitis B or C testing is not mandatory).
  8. Impairment of gastrointestinal (GI) function or GI disease (e.g. ulcerative disease, uncontrolled nausea, vomiting, grade ≥ 2 diarrhea, malabsorption syndrome or small bowel resection).
  9. Peripheral vascular disease requiring active therapy or having had surgery < 12 months prior to starting study drug.
  10. Impaired cardiac function or clinically significant heart disease (…)

    • A past medical history of clinically significant ECG abnormalities or a family history of prolonged QT-interval syndrome
    • Other clinically significant heart disease (e.g. congestive heart failure, uncontrolled hypertension, history of labile hypertension, or history of poor compliance with an antihypertensive regimen)
  11. Patients who are receiving treatment with medications that are known to be strong inhibitors or inducers of CYP3A4/5 (listed in Protocol Attachment 3) or drugs metabolized by CYP2B6 or CYP2C9 (listed in Protocol Attachment 3) that cannot be discontinued prior to study entry and for the duration of the study. Medications that are strong CYP3A4/5 inhibitors should be discontinued for at least 2 days, and strong CYP3A4/5 inducers for at least 1 week prior to initiating LDE225 dosing.
  12. Patients who have received chemotherapy within a period of time that is < the cycle length used for that treatment (e.g. < 3 weeks for fluorouracil, doxorubicine, epirubucine) prior to starting study drug or who have not recovered from the side effects of such therapy.
  13. Patients who have received biologic therapy (e.g. antibodies) ≤ 4 weeks prior to starting study drug or who have not recovered from the side effects of such therapy.
  14. Patients who have been treated with a small molecule therapeutic ≤ 5 t1/2 or ≤ 4 weeks (whichever is shorter) prior to starting study drug or who have not recovered from the side effects of such therapy.
  15. Patients who have received any other investigational agents ≤ 5 t1/2 or ≤ 4 weeks (whichever is shorter) prior to starting study drug or who have not recovered from the side effects of such therapy.
  16. Patients who have received wide field radiotherapy (including therapeutic radioisotopes such as strontium 89) ≤ 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 are currently receiving treatment with therapeutic doses of warfarin sodium (Coumadin) who cannot discontinue this treatment at least 5 days prior to starting study drug.
  18. Patients who are currently receiving immunosuppressive treatment and in whom the treatment cannot be discontinued prior to starting study drug, except in the case of patients with basal cell carcinoma (BCC). Immunosuppressive treatment should be discontinued for at least 1 week prior to initiating LDE225 dosing.

  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02027376


Locations
Spain
A Coruña, Spain, 15006
Madrid, Spain, 28007
Madrid, Spain, 28040
Málaga, Spain, 29010
Sevilla, Spain, 41071
Sponsors and Collaborators
Spanish Breast Cancer Research Group
Novartis
Investigators
Study Chair: Miguel Martin, MD, PhD GEICAM (Spanish Breast Cancer Research Group)
  More Information

Additional Information:
Responsible Party: Spanish Breast Cancer Research Group
ClinicalTrials.gov Identifier: NCT02027376     History of Changes
Other Study ID Numbers: GEICAM/2012-12
2013-001750-96 ( EudraCT Number )
First Submitted: November 12, 2013
First Posted: January 6, 2014
Last Update Posted: October 12, 2017
Last Verified: November 2015

Keywords provided by Spanish Breast Cancer Research Group:
Advanced Breast Cancer
LDE225
Triple Negative
Hormonal Receptor negative
Her2 negative

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Docetaxel
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action