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Study of Miransertib (MK-7075) in Participants With PIK3CA-related Overgrowth Spectrum and Proteus Syndrome (MOSAIC) (MK-7075-002) (MOSAIC)

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ClinicalTrials.gov Identifier: NCT03094832
Recruitment Status : Active, not recruiting
First Posted : March 29, 2017
Last Update Posted : March 23, 2021
Sponsor:
Collaborator:
Worldwide Clinical Trials
Information provided by (Responsible Party):
ArQule, Inc. (a wholly owned subsidiary of Merck Sharp and Dohme, a subsidiary of Merck & Co., Inc.)

Brief Summary:
This is an open label, Phase 1/2 study of oral miransertib (MK-7075) administered to participants at least 2 years of age with PIK3CA-related Overgrowth Spectrum (PROS) and Proteus Syndrome (PS) (MOSAIC).

Condition or disease Intervention/treatment Phase
PIK3CA-Related Overgrowth Spectrum (PROS)/Proteus Syndrome Drug: Miransertib Phase 1 Phase 2

Expanded Access : An investigational treatment associated with this study is available outside the clinical trial.   More info ...

Detailed Description:
The study consists of two parts: Part A and Part B. Part A was closed to enrollment under Amendment 6. As of Amendment 7, the endpoints for Part A and Part B have been combined to assess the safety and tolerability of miransertib in participants with PROS and PS. Previous efficacy and pharmacokinetic (PK) objectives and endpoints have been removed.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 85 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2 Study of ARQ 092 (Miransertib) in Subjects With PIK3CA-related Overgrowth Spectrum (PROS) and Proteus Syndrome (PS) (MOSAIC)
Actual Study Start Date : May 16, 2017
Estimated Primary Completion Date : March 30, 2022
Estimated Study Completion Date : March 30, 2025


Arm Intervention/treatment
Experimental: Part A: Miransertib PROS/PS
Participants with either PROS or PS receive miransertib orally at 15 mg/m^2 once daily (QD) for at least three 28-day cycles with an option to dose increase to 25 mg/m^2.
Drug: Miransertib
Miransertib capsules administered orally either 1 hour before or 2 hours after a meal
Other Names:
  • MK-7075
  • ARQ 092

Experimental: Part B: Miransertib PROS (Cohort 1)
Participants with PROS who have a measurable lesion by volumetric MRI receive miransertib orally at 15 mg/m^2 QD for at least three 28-day cycles with an option to dose increase to 25 mg/m^2. Treatment will continue for up to 48 cycles or until disease progression, unacceptable toxicity, or discontinuation.
Drug: Miransertib
Miransertib capsules administered orally either 1 hour before or 2 hours after a meal
Other Names:
  • MK-7075
  • ARQ 092

Experimental: Part B: Miransertib PS (Cohort 2)
Participants with PS who have a measurable lesion by standardized digital photography receive miransertib orally at 15 mg/m^2 QD for at least three 28-day cycles with an option to dose increase to 25 mg/m^2. Treatment will continue for up to 48 cycles or until disease progression, unacceptable toxicity, or discontinuation.
Drug: Miransertib
Miransertib capsules administered orally either 1 hour before or 2 hours after a meal
Other Names:
  • MK-7075
  • ARQ 092

Experimental: Part B: Miransertib PROS/PS (Cohort 3)
Participants with PROS or PS who do not meet all the eligibility criteria for Cohorts 1 or 2 receive miransertib orally at 15 mg/m^2 QD for at least three 28-day cycles with an option to dose increase to 25 mg/m^2. Treatment will continue for up to 48 cycles or until disease progression, unacceptable toxicity, or discontinuation.
Drug: Miransertib
Miransertib capsules administered orally either 1 hour before or 2 hours after a meal
Other Names:
  • MK-7075
  • ARQ 092

Experimental: Part B: Miransertib Compassionate Use/Expanded Access (Cohort 4)
Participants previously treated with miransertib or currently receiving miransertib under Compassionate Use/Expanded Access. Participants receive miransertib orally at 15 mg/m^2 QD for at least three 28-day cycles with an option to dose increase to 25 mg/m^2. Participants receiving miransertib at the time of enrollment under Compassionate Use/Expanded Access will continue with their current dose (not to exceed 25 mg/m^2). Treatment will continue for up to 48 cycles or until disease progression, unacceptable toxicity, or discontinuation.
Drug: Miransertib
Miransertib capsules administered orally either 1 hour before or 2 hours after a meal
Other Names:
  • MK-7075
  • ARQ 092




Primary Outcome Measures :
  1. Number of participants experiencing an Adverse Event (AE) [ Time Frame: Up to approximately 51 months ]
    An AE is defined as any untoward medical occurrence associated with the use of a drug in a participant, whether or not considered drug related. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal product and does not imply any judgment about causality.

  2. Number of participants discontinuing study treatment due to an Adverse Event (AE) [ Time Frame: Up to approximately 48 months ]
    An AE is defined as any untoward medical occurrence associated with the use of a drug in a participant, whether or not considered drug related. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal product and does not imply any judgment about causality.



Information from the National Library of Medicine

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Ages Eligible for Study:   2 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Part A

  • Signed informed consent and, when applicable, signed assent
  • Male or female participants ≥ 2 years old with BSA of ≥ 0.33 m2
  • Have a clinical diagnosis of PROS or PS with documented somatic PIK3CA or AKT1 mutations
  • Archival or fresh overgrowth tissue sample available to be shipped to Sponsor or designee
  • Have poor prognosis, significant morbidity, and/or progressive disease (e.g., worsening of the disease/increase in number or size of the overgrowth lesions in the last 12 months)
  • Have measurable disease (at least one overgrowth lesion that can be accurately measured in size by imaging and/or linear or circumference measure)
  • Adequate organ function based on screening laboratory values
  • If a female is of child-bearing potential, documentation of a negative pregnancy test is required prior to enrollment. Sexually active participants (male and female) must agree to use double-barrier contraceptive measures, oral contraception, or avoidance of intercourse while on study and for up to 90 days after ending treatment
  • Ability to complete the Quality of Life (QoL) questionnaires by the participant or his/her caregiver

Part B:

  • Signed consent form and when applicable, signed assent
  • Archival or fresh overgrowth tissue sample available to be shipped to Sponsor or designee
  • Except for Cohort 4, clinically progressive or worsening disease defined as an increase in number or size of the overgrowth lesion(s) in the last 6 months as assessed by the Investigator
  • Adequate organ function based on screening laboratory values
  • Male or female participants of child-producing potential must agree to use double-barrier contraceptive measures, oral contraception, or avoidance of intercourse during the study and for 90 days after the last dose of miransertib
  • Ability to complete the study questionnaires by the participant or his/her caregiver

Cohort 1 (PROS) specific criteria

  • Male or female participants ≥ 2 years and ≤30 years of age with BSA of ≥ 0.33 m2
  • Have clinical diagnosis of PROS per Diagnostic Criteria for PROS and documented somatic PIK3CA variant
  • Have at least one lesion that can be measured by study- standardized volumetric MRI (eligibility to be confirmed by blinded independent central imaging review

    - Cohort 2 (PS) specific criteria

  • Male or female participants ≥ 2 years and ≤18 years of age with BSA of ≥ 0.33 m2
  • Have clinical diagnosis of PS per Diagnostic Criteria for PS and documented somatic AKT1 variant
  • Have at least one plantar CCTN and pre-CCTN lesion that can be measured by standardized photography

    • Cohort 3 specific criteria: Male or female participants ≥2 years old with BSA of ≥ 0.33 m2 and who fail to meet the eligibility criteria for Cohorts 1 or 2
    • Cohort 4 (PROS or PS) specific criteria: participants previously treated with miransertib or currently receiving miransertib under Compassionate Use/Expanded Access. Participants should meet the age criterion by/on the date of the first dose, Cycle 1 Day 1

Exclusion Criteria

Part A:

  • History of Type 1 or 2 uncontrolled diabetes mellitus requiring regular medication (other than metformin or other oral hypoglycemic agents) or fasting glucose ≥ 160 mg/dL (if > 12 years old) and ≥ 180 mg/dL (if ≤ 12 years old) at the screening visit
  • History of significant cardiac disorders:

    • Myocardial infarction (MI) or congestive heart failure defined as Class II-IV per the New York Heart Association (NYHA) classification within 6 months of the first dose of miransertib (MI occurring > 6 months of the first dose of miransertib will be permitted)
    • Grade 2 (per NCI CTCAE version 4.03) or worse conduction defect (e.g., right or left bundle branch block); left ventricular ejection fraction (LVEF) < 50% assessed by echocardiogram/multigated acquisition (MUGA) scan
  • Major surgery, radiotherapy, or immunotherapy within four weeks of the first dose of miransertib
  • Any experimental systemic therapy for the purpose of treating PROS or PS (e.g., sirolimus, everolimus, high dose steroids) within two weeks of the first dose of miransertib, except for participants who were previously or are currently treated with miransertib under a Compassionate Use/Expanded Access program
  • Intolerance of or severe toxicity attributed to AKT inhibitors (e.g., miransertib, uprosertib, afuresertib, ipatasertib)
  • Concurrent severe uncontrolled illness not related to PROS or PS (ongoing or active infection, known human immunodeficiency virus (HIV) infection, malabsorption syndrome, psychiatric illness/substance abuse/social situation that would limit compliance with study requirements)
  • Pregnant or breastfeeding
  • Inability to comply with study evaluations or to follow drug administration guidelines

Part B

  • History of Type 1 diabetes mellitus or Type 2 uncontrolled diabetes mellitus requiring regular medication (other than metformin or other oral hypoglycemic agents) or fasting glucose ≥ 160 mg/dL (if > 12 years old) and ≥ 180 mg/dL (if ≤ 12 years old) at the screening visit
  • History of significant cardiac disorders:

    • Myocardial infarction (MI) or congestive heart failure defined as Class II-IV per the New York Heart Association (NYHA) classification within 6 months of the first dose of miransertib (MI occurring > 6 months of the first dose of miransertib will be permitted)
    • Grade 2 (per current version of National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE]) or worse conduction defect (e.g., right or left bundle branch block)
    • Major surgery or locoregional therapy within four weeks of the first dose of miransertib
  • Any experimental systemic therapy for the purposes of treating PROS or PS (e.g., sirolimus, everolimus, high dose steroids) within two weeks of the first dose of miransertib
  • Intolerance of or severe toxicity attributed to AKT inhibitors (e.g., miransertib, uprosertib, afuresertib, ipatasertib)
  • Concurrent severe uncontrolled illness not related to PROS or PS (e.g. ongoing or active infection, known HIV infection, malabsorption syndrome, psychiatric illness/substance abuse/social situation that would limit compliance with study requirements)
  • Pregnant or breastfeeding
  • Inability to comply with study evaluations or to follow drug administration guidelines

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): NCT03094832


Locations
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United States, Georgia
Children's Hospital of Atlanta ( Site 0107)
Atlanta, Georgia, United States, 30342
United States, Illinois
Ann & Robert H. Lurie Children's Hospital of Chicago ( Site 0101)
Chicago, Illinois, United States, 60611
United States, Massachusetts
Boston Children's Hospital ( Site 0089)
Boston, Massachusetts, United States, 02115
United States, Ohio
Cincinnati Children's Hospital Medical Center ( Site 0102)
Cincinnati, Ohio, United States, 45229
United States, Texas
Texas Children's Hospital ( Site 0104)
Houston, Texas, United States, 77030
United States, Washington
Seattle Childrens Hospital ( Site 0103)
Seattle, Washington, United States, 98105
Australia, New South Wales
Hunter Genetics ( Site 0201)
Waratah NSW, New South Wales, Australia, 2298
Italy
Ospedale Pediatrico Bambino Gesu ( Site 0087)
Rome, Roma, Italy, 00165
Universita di Catania ( Site 0088)
Catania, Italy, 95123
Fondazione Policlinico Universitario A. Gemelli ( Site 0052)
Roma, Italy, 00168
Spain
Hospital Sant Joan ( Site 0601)
Esplugues de Llobregat, Barcelona, Spain, 08950
Sponsors and Collaborators
ArQule, Inc. (a wholly owned subsidiary of Merck Sharp and Dohme, a subsidiary of Merck & Co., Inc.)
Worldwide Clinical Trials
Investigators
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Study Director: Medical Director Merck Sharp & Dohme Corp.
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: ArQule, Inc. (a wholly owned subsidiary of Merck Sharp and Dohme, a subsidiary of Merck & Co., Inc.)
ClinicalTrials.gov Identifier: NCT03094832    
Other Study ID Numbers: 7075-002
MOSAIC ( Other Identifier: ArQule )
ARQ 092-103 ( Other Identifier: ArQule )
2016-000558-37 ( EudraCT Number )
MK-7075-002 ( Other Identifier: Merck )
First Posted: March 29, 2017    Key Record Dates
Last Update Posted: March 23, 2021
Last Verified: March 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
URL: http://engagezone.msd.com/ds_documentation.php

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by ArQule, Inc. (a wholly owned subsidiary of Merck Sharp and Dohme, a subsidiary of Merck & Co., Inc.):
ARQ 092
ArQule
AKT
PIK3CA
Overgrowth
Congenital malformations
Miransertib
MOSAIC
Additional relevant MeSH terms:
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Proteus Infections
Proteus Syndrome
Syndrome
Disease
Pathologic Processes
Enterobacteriaceae Infections
Gram-Negative Bacterial Infections
Bacterial Infections
Hamartoma Syndrome, Multiple
Hamartoma
Neoplasms
Neoplasms, Multiple Primary
Bone Diseases, Developmental
Bone Diseases
Musculoskeletal Diseases
Limb Deformities, Congenital
Musculoskeletal Abnormalities
Abnormalities, Multiple
Congenital Abnormalities