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Trial record 4 of 9 for:    PIQUR

Study to Evaluate the Efficacy, Safety, Pharmacokinetics and Pharmacodynamic Effects of PQR309 in Glioblastoma Patients

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.
ClinicalTrials.gov Identifier: NCT02850744
Recruitment Status : Terminated
First Posted : August 1, 2016
Last Update Posted : October 19, 2018
Sponsor:
Collaborators:
University Hospital, Basel, Switzerland
University Hospital Inselspital, Berne
University Hospital, Zürich
Information provided by (Responsible Party):
PIQUR Therapeutics AG

Brief Summary:
PQR309 is an oral, dual pan-PI3K (phosphatidylinositol 3-kinase phosphoinositide 3-kinase) and mTOR (mammilian target of rapamycin) inhibitor that penetrates the blood-brain barrier at pharmacodynamically active concentrations. This study plans to evaluate PQR309 in treatment of patients with first progression of glioblastoma.

Condition or disease Intervention/treatment Phase
Glioblastoma Multiforme Drug: PQR309 Phase 2

Detailed Description:

Open-label, non-randomized, two-stage, multi-center study evaluating clinical efficacy, safety, pharmacokinetics and pharmacodynamic effects of PQR309 in patients with progressive glioblastoma during or after standard temozolomide chemoradiotherapy.

The first stage of the study will enroll a minimum of 18 patients with glioblastoma at first progression during or after temozolomide chemoradiotherapy or temozolomide only. Following the completion of recruitment of patients in the first stage of the study, the decision will be made by the study team (study investigators and the sponsor), based on the continuous evaluation of safety and efficacy data, whether to continue recruitment of patients in the second stage while awaiting the data analyses. 17 additional patients may be enrolled for the second stage of the study, for a minimum of 35 patients in total. All patients evaluable for the primary endpoint will be followed until disease progression or death.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 10 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Open-label, Non-randomized, Two-stage Study to Evaluate the Efficacy, Safety, Pharmacokinetics and Pharmacodynamic Effects of PQR309 in Patients With Progressive Glioblastoma
Study Start Date : July 2015
Actual Primary Completion Date : November 2017
Actual Study Completion Date : November 2017

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Single-arm
Open label, single arm including patients with progressive glioblastoma during or after temozolomide chemotherapy obtaining PQR309 80mg capsules.
Drug: PQR309
80mg capsules p.o. once daily and possibly Standard Treatment with temozolomide
Other Name: temozolomide




Primary Outcome Measures :
  1. Progression-free survival rate at 6 months (PFS6) based on RANO criteria [30]glioblastoma, using progression-free survival rate at 6 months (PFS6) based on RANO criteria [30] [ Time Frame: Change to base line of contrast MRI scans and incorporated clinical signs will be assessed on Day 1 of Cycle 1 and on Day 1 of every following cycle and at the end of treatment which can be up to 24 months after ]
    Non Surgical Cohort, Tumor response evaluation according to RANO criteria

  2. Progression-free survival rate at 6 months (PFS6) based on RANO criteria [30]glioblastoma, using progression-free survival rate at 6 months (PFS6) based on RANO criteria [30] [ Time Frame: Change to base line of contrast MRI scans and incorporated clinical signs will be assessed on Day1 pre-surgery, Day 4 post-surgery and 30 days after surgery and thereafter every 8 weeks (+/-7 days) until end of treatment up to 24mths ]
    Surgical Cohort, Tumor response evaluation according to RANO criteria


Secondary Outcome Measures :
  1. Number of Adverse Events and Serious Adverse Events as related to the study medication [ Time Frame: Cycle 1 on Day 1,2,8 and 15, on Cycle 2 and following cycles on Day 1 and 15 und 30 days after end of treatmen which can up to 24 months ]
    Non surgical cohort

  2. Number of Adverse Events and Serious Adverse Events as related to the study medication [ Time Frame: Assessment on Day 1,2 pre-surgery, Day3 surgery, Day4 post -surgery and 30 days after surgery, Cycle 2 on Day 1 and 15 and 30 days after end of treatment which can be up to 24 months ]
    Surgical cohort

  3. Changes in pulse rate [ Time Frame: Assessment on Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical Cohort

  4. Changes in pulse rate [ Time Frame: Assessment will during Cycle 1 on day 1,8,15, Cycle 2 day 1, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment and 30 days after last treatment ]
    Non-surgical cohort

  5. Changes in blood pressure [ Time Frame: Assessment on Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical cohort

  6. Changes in blood pressure [ Time Frame: Assessment will during Cycle 1 on day 1,8,15, Cycle 2 day 1, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment and 30 days after last treatment ]
    Non-surgical cohort

  7. Changes in body weight [ Time Frame: Assessment on Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical cohort

  8. Changes in body weight [ Time Frame: Assessment will during Cycle 1 on day 1,8,15, Cycle 2 day 1, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment and 30 days after last treatment ]
    Non-surgical cohort

  9. Changes in temperature [ Time Frame: Assessment on Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical Cohort

  10. Changes in temperature [ Time Frame: Assessment will during Cycle 1 on day 1,8,15, Cycle 2 day 1, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment and 30 days after last treatment ]
    Non-surgical cohort

  11. Changes in ECG [ Time Frame: Assessment on Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical Cohort

  12. Changes in ECG [ Time Frame: Assessment will during Cycle 1 on day 1,8,15, Cycle 2 day 1, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment and 30 days after last treatment ]
    Non-surgical cohort

  13. Physical examination according to Karnofsky Performance Status [ Time Frame: Assessment on Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical cohort

  14. Physical examination according to Karnofsky Performance Status [ Time Frame: Assessment will during Cycle 1 on day 1,8,15, Cycle 2 day 1, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment and 30 days after last treatment ]
    Non-surgical cohort

  15. Depression Test (PHQ-9) [ Time Frame: Assessment on Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical cohort

  16. Depression test PHQ-9 [ Time Frame: CAssessment will during Cycle 1 on day 1,8,15, Cycle 2 day 1, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment and 30 days after last treatment ]
    Non-surgical cohort

  17. Generalized Anxiety Disorder mood scale score (GAD7) [ Time Frame: Assessment on Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical Cohort

  18. Generalized Anxiety Disorder mood scale score (GAD) [ Time Frame: Cycle 1Assessment will during Cycle 1 on day 1,8,15, Cycle 2 day 1, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment and 30 days after last treatment ]
    Non-surgical cohort

  19. Changes in routine blood chemistry [ Time Frame: Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical cohort

  20. Changes in routine blood chemistry [ Time Frame: Cycle 1 on day 1,8,15, Cycle 2 day 1& 15, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment & 30 days after last treatment ]
    Non-surgical cohort

  21. Changes in hematology [ Time Frame: Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical cohort

  22. Changes in hematology [ Time Frame: Cycle 1 on day 1,8,15, Cycle 2 day 1& 15, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment & 30 days after last treatment ]
    Non-surgical cohort

  23. Changes of urinalysis [ Time Frame: Day1,2 pre-surgery, Day 3 surgery and Day 4 post-surgery and 30 days after surgery ]
    Surgical cohort

  24. Changes of urinalysis [ Time Frame: Cycle 1 on day 1,8,15, Cycle 2 day 1& 15, Cycle 3 und follow up cycles on day 1 up to 24 weeks, end of treatment & 30 days after last treatment ]
    Non-surgical cohort

  25. Change of Insulin/Glucose/C-Peptide [ Time Frame: Day 1: at pre-dose and 0.5, 1, 2, 4, 6, 8 hours post-dose (± 5 minutes) Day 2: at pre-dose (= 24 hour post first dose on Day 1) (± 5 minutes)& 3 - Pre-dose, and 1hr post dose. Day 4 - 24hr post last dose on Day 3 ]
    Surgical cohort

  26. Change of Insulin/Glucose/C-Peptide [ Time Frame: Cycle 1 Day 1 - Pre-dose, 1hr post dose. Day 2 - 24hr post-dose. Cycle 2 Day 1 - pre-dose. ]
    Non- surgical cohort

  27. Change of Haemostasis [ Time Frame: Cycle 1 Day 1 - Pre-dose, 1hr post dose. Day 2 - 24hr post-dose. Cycle 2 Day 1 - pre-dose. ]
    Non- surgical cohort

  28. Change of Haemostasis [ Time Frame: Cycle 1 Day 1 - Pre-dose, 1hr post dose. Day 2 - 24hr post-dose. Cycle 2 Day 1 pre-dose. ]
    Surgical cohort

  29. Determination of cmax [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the last dose ]
    Surgical cohort

  30. Determination of cmax [ Time Frame: Day 1: at pre-dose and 0.5, 1, 2, 4, 6, 8 hours post-dose; Day 2: at pre-dose (= 24 hour post first dose on Day 1), Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose, Day 4: at 24h after the last dose ]
    Surgical cohort

  31. Determination of AUC0-24 [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the last dose ]
    Non-surgical cohort

  32. Determination of AUC0-24 [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the ]
    Non-surgical cohort

  33. Determination of tmax [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the ]
    Non-surgical cohort

  34. Determination of AUClast [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the ]
    Non-surgical cohort

  35. Determination of tmax [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the last dose ]
    Surgical cohort

  36. Determination of AUClast [ Time Frame: Day 1: at pre-dose and 0.5, 1, 2, 4, 6, 8 hours post-dose; Day 2: at pre-dose (= 24 hour post first dose on Day 1), Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose, Day 4: at 24h after the last dose ]
    Surgical cohort

  37. Determination of AUC0-∞ [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the last dose ]
    Surgical cohort

  38. Determination of AUC0-∞ [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the ]
    Non-surgical cohort

  39. Determination of t½ [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the last dose ]
    Surgical cohort

  40. Determination of t½ [ Time Frame: Day 1: at pre-dose ,0.5, 1, 2, 4, 6, 8 hours post-dose ;Day 2: at pre-dose (= 24 hour post first dose on Day 1);Day 3:at pre-dose, 0.5h, 1.0h, 2h, 4h, 6h, 8h post-dose; Day 4: at 24h after the ]
    Non-surgical cohort

  41. Assessment of tumor concentration, [ Time Frame: On day of surgery (day 3) ]
    Surgical cohort only

  42. Assessment of PQR309 concentration in cerebrospinal fluid Day 3,pre-dose,0.5h, 1h, 2h, 4h, 6h, 8h post-dose Day 4 24h after the last dose given [ Time Frame: On day of surgery (day 3) ]
    Surgical cohort only

  43. Assessment of PQR309 Skin concentration [ Time Frame: On day of surgery (day 3) ]
    Surgical cohort only

  44. Overall Response Rate (ORR) including complete and partial Response based on RANO criteria [ Time Frame: Change to base line of contrast MRI scans and incorporated clinical signs will be assessed on Day 1 of Cycle 1 and on Day 1 of every following cycle and at the end of treatment which can be up to 24 months after ]
    Surgical and Non-surgical Cohort

  45. Duration of response (DOR) based on RANO criteria [ Time Frame: of contrast MRI scans and incorporated clinical signs will be assessed on Day 1 of Cycle 1 and on Day 1 of every following cycle and at the end of treatment which can be up to 24 months after ]
    Surgical and non-surgical cohort

  46. Progression-free survival at 3 months (PFS3) based on RANO criteria [ Time Frame: of contrast MRI scans and incorporated clinical signs will be assessed on Day 1 of Cycle 1 and on Day 1 of every following cycle and at the end of treatment which can be up to 24 months after ]
    Surgical and non surgical cohort



Information from the National Library of Medicine

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, Learn About Clinical Studies.


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

Inclusion Criteria:

  1. Patients with histologically confirmed glioblastoma at first progression following or during standard temozolomide chemoradiotherapy (TMZ/RTTMZ)
  2. older than 18 years of age
  3. Radiographic demonstration of disease progression by RANO criteria
  4. Only for patients of the surgical cohort:

    • Eligible for open resection of progressive tumor according to standard practice of the study center
    • Availability of adequate surgical tissue sample for the evaluation of concentration of PQR309 in the tumor and its PD effect
    • Patients treated with PQR309 after incomplete surgical resection may still have measurable disease according to RANO criteria and may therefore be evaluable for evaluation of response to treatment with PQR309 according to RANO criteria. The best response in patients treated with PQR309 after complete surgical resection is stable disease. All patients can be assessed for PFS6.
  5. Only for patients of the non-surgical cohort:

    - Presence of at least one lesion of bi-dimensionally measurable disease by MRI with a contrast-enhancing tumor of at least 1 cm (10 mm) in the longest diameter on baseline MRI is required for patients who do not undergo surgery at relapse. For patients who undergo surgery for recurrence but do not participate in the presurgical PQR309 dosing cohort, the same rules regarding response assessment as in the surgical cohort apply. All patients can be assessed for PFS6.

  6. Patient must have at least 1 formalin-fixed paraffin-embedded archival tumor tissue block representative of glioblastoma available from the first surgical resection of glioblastoma.
  7. One prior systemic therapy regimen: patients must have received at least one dose of TMZ in the first line therapy. More than 6 cycles and alternative dosing regiments of TMZ are allowed.
  8. If receiving corticosteroids, patients must have been on a stable or decreasing dose of corticosteroids and no more than 8 mg dexamethasone equivalent for ≥ 5 days prior to baseline MRI.
  9. Karnofsky Performance Score (KPS) >70%.
  10. More than 12 weeks from radiotherapy (RT)
  11. More than 4 weeks from last administration of TMZ
  12. More than 4 weeks from any investigational agent (at the judgment of the investigator and in agreement with lead investigator and PIQUR)
  13. Adequate hematological, liver and renal function defined as follows:

    Absolute neutrophil count (ANC) ≥1.5x109/l, platelets ≥ 100x109/l, hemoglobin ≥ 100g/L. Total bilirubin ≤ 1.5 times the upper limit of normal (ULN). Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times ULN Serum Creatinine ≤ 1.5 times ULN

  14. Able and willing to swallow and retain oral medication
  15. Female and male patients of reproductive potential must agree to use effective contraception from screening until 90 days after discontinuing study treatment*
  16. Willing and able to sign the informed consent and to comply with the protocol for the duration of the study

Exclusion Criteria:

  1. Second or later glioblastoma relapse
  2. Received more than one systemic treatment regimen for glioblastoma
  3. Patients receiving enzyme-inducing anti-epileptic drug (EIAED) within 7 days of the first dose of PQR309
  4. Patient is taking a drug with known risk to promote QT prolongation and Torsades de Pointes.
  5. Patient is currently using herbal preparations or medications. Patient should stop using herbal medications 7 days prior to the first dose of the study drug
  6. Patients with glioblastoma known to contain IDH1 or 2 mutation
  7. Other concomitant anti-tumor therapy as determined by the study team
  8. Prior treatment with intracerebral agents, e.g. prolifeprospan 20 with carmustine wafer
  9. Patients unable to undergo contrast-enhanced MRI
  10. Fasting glucose > 7.0 mmol/L or HbA1c > 6.4%.
  11. 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 (e.g. risk of doing harm to self or others), or patients with active severe personality disorders.
  12. Anxiety ≥CTC AE grade 3
  13. Patient has an uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, known HIV infection, chronic liver disease, chronic renal disease, pancreatitis, chronic pulmonary disease, active cardiac disease or cardiac dysfunction, interstitial lung disease, active autoimmune disease, uncontrolled diabetes, neuropsychiatric or social situations that would limit compliance with the study requirements
  14. Presence of gastrointestinal disease or any other condition that could interfere significantly with the absorption of the study drug.
  15. Concomitant treatment with medicinal products that increase the pH (reduce acidity) of the upper gastrointestinal tract, including, but not limited to, proton-pump inhibitors (e.g. omeprazole), H2-antagonists (e.g. ranitidine) and antacids. Patients may be enrolled in the study after a wash-out period sufficient to terminate their effect (See section 11.2.2.8).Women who are pregnant or breast feeding,
  16. Women able to conceive and unwilling to practice an effective method of birth control* from screening until 90 days after discontinuing study treatment (women of childbearing potential** must have a negative urine or serum pregnancy test within 7 days prior to first dose of PQR309

    • Adequate contraception is defined as surgical sterilization (e.g., bilateral tubal ligation, vasectomy), hormonal contraception (implantable, patch, oral), or double-barrier methods (any double combination of: IUD, male or female condom with spermicidal gel, diaphragm, sponge, cervical cap). Male patients must agree to use condoms as contraception method.

      • Child-bearing potential for the sake of this study is defined as sexually mature women who have not undergone a hysterectomy, have not been naturally postmenopausal for at least 12 consecutive months or have a serum FSH < 40 mIU/ml.

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): NCT02850744


Locations
Switzerland
University Hospital Zurich, Neurology
Zurich, Switzerland, 8091
Sponsors and Collaborators
PIQUR Therapeutics AG
University Hospital, Basel, Switzerland
University Hospital Inselspital, Berne
University Hospital, Zürich
Investigators
Principal Investigator: Michael Weller, Professor University Hospital Zurich, Neurology

Responsible Party: PIQUR Therapeutics AG
ClinicalTrials.gov Identifier: NCT02850744     History of Changes
Other Study ID Numbers: PQR309-004
First Posted: August 1, 2016    Key Record Dates
Last Update Posted: October 19, 2018
Last Verified: October 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Additional relevant MeSH terms:
Glioblastoma
Astrocytoma
Glioma
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Temozolomide
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents