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Safety, Pharmacokinetics and Efficacy of GDC-0084 in Newly-diagnosed Glioblastoma Multiforme

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ClinicalTrials.gov Identifier: NCT03522298
Recruitment Status : Recruiting
First Posted : May 11, 2018
Last Update Posted : September 13, 2018
Sponsor:
Information provided by (Responsible Party):
Kazia Therapeutics Limited

Brief Summary:

This protocol has a 2-part design:

The phase 2a study component is an open-label, multicenter, phase 2a dose-escalation and expansion study to assess the safety, tolerability, recommended phase 2 dose (RP2D), pharmacokinetics (PK) and clinical activity of GDC-0084 in patients with newly-diagnosed glioblastoma multiforme (GBM) with unmethylated MGMT promoter status as adjuvant therapy following surgical resection and initial chemoradiation with temozolomide (TMZ). The phase 2a study is fully detailed in this submission.

The phase 2b study component comprises an evaluation of clinical activity of GDC-0084 compared to TMZ in as adjuvant therapy following surgical resection and initial chemoradiation with TMZ and will be initiated following the determination of RP2D in the phase 2a study (Part 1). The phase 2b component will be will be further detailed in an amendment to this submission.


Condition or disease Intervention/treatment Phase
Glioblastoma, Adult Drug: GDC-0084 Phase 2

  Show Detailed Description

Study Type : Interventional
Estimated Enrollment : 66 participants
Intervention Model: Single Group Assignment
Intervention Model Description: The phase 2a study comprises an open-label, multicenter, phase 2a dose-escalation and expansion study to assess the safety, tolerability, RP2D, PK and clinical activity of GDC 0084 in patients with newly-diagnosed GBM with unmethylated MGMT promoter status as adjuvant therapy following surgical resection and initial chemoradiation with TMZ.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 2 Study to Evaluate the Safety, Pharmacokinetics, and Efficacy of the PI3K/mTOR Inhibitor GDC-0084 Administered to Patients With Glioblastoma Multiforme Characterized by Unmethylated O6-methylguanine-methyltransferase Promoter Status Following Surgical Resection and Standard Concomitant Chemoradiation Therapy With Temozolomide
Actual Study Start Date : May 15, 2018
Estimated Primary Completion Date : March 30, 2020
Estimated Study Completion Date : December 30, 2020

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Dose Escalation and Expansion Cohorts

This is an open-label study.

Patients in Stage 1 will be enrolled and sequentially assigned to a dose cohort.

The initial cohort will receive an oral dose of 60 mg GDC-0084 QD (4 x 15 mg capsules). Patients of future dose cohorts will receive GDC-0084 at increasing levels with 15 mg steps until a dose-limiting toxicity occurs (DLT) occurs. The dose level where <1/3 of the patients exhibit a DLT will be determined the Maximum Tolerated Dose (MTD).

Dose escalation will occur for three separate dose schedules including QD, every other day (QOD) and 3 times a week on consecutive days (3 days on/4 days off), i.e. an MTD will be established for three different dose schedules.

In stage 2, the expansion phase, patients will receive doses of oral GDC-0084 at the MTD established for each of the three dosing schedules until disease progression or an unacceptable toxicity, whichever occurs first.

Patients will be randomized in a 1:1:1 ratio to one of the three dose schedules.

Drug: GDC-0084
Patients will be dosed orally with GDC-0084 capsules (15-mg each) at the dose and schedule to which they are assigned.




Primary Outcome Measures :
  1. Dose limiting toxicities (DLTs) [ Time Frame: 12 months ]
    The recommended Phase 2 dose and schedule. DLTs according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 4.03.


Secondary Outcome Measures :
  1. Incidence of treatment-emergent adverse events (TEAEs) [ Time Frame: 24 months ]
    TEAEs defined as any AE occurring or worsening on/after the first study drug dose and within 28 days after the last dose date. AEs will be coded according to the Medical Dictionary for Regulatory Activities (MedDRA).

  2. Incidence of serious adverse events (SAEs) [ Time Frame: 24 months ]
    AEs will be coded according to the Medical Dictionary for Regulatory Activities (MedDRA).

  3. Incidence of treatment-emergent Grade 3/4 clinical laboratory abnormalities. [ Time Frame: 24 months ]
    Clinical laboratory values will be graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 4.03, for applicable tests.

  4. Change in electrocardiogram (ECG) parameter QTc. [ Time Frame: 24 months ]
    The number and percentage of patients with an increase of QTc to a value ≥ 500 msec or a change from baseline of at least 60 msec will be presented overall and by visit.

  5. Change in left ventricular ejection fraction (LVEF). [ Time Frame: 24 months ]
    The number and percentage of patients with a drop in LVEF to a value of ≤ 45% from baseline will be presented overall and by visit.

  6. Progression-free survival interval using RANO Criteria. [ Time Frame: 24 months ]
  7. Overall survival using RANO Criteria. [ Time Frame: 24 months ]

Other Outcome Measures:
  1. Pharmacokinetics of GDC-0084 as area under the curve from time 0 to last measurable time point (AUC0-last) and/or area under the curve from time 0 to infinity (AUC0-inf). [ Time Frame: 24 months ]
  2. Pharmacokinetics of GDC-0084 as maximum (Cmax) and minimum concentration (Cmin). [ Time Frame: 24 months ]
  3. Pharmacokinetics of GDC-0084 as time to reach Cmax (Tmax). [ Time Frame: 24 months ]
  4. Pharmacokinetics of GDC-0084 as half-life. [ Time Frame: 24 months ]
  5. Change in FDG-PET uptake in tumor and normal brain tissue in response to GDC-0084 in patients with measurable disease. [ Time Frame: 24 months ]
  6. Disease control rate measured as the proportion of patients achieving a confirmed best overall response (BOR) of complete response (CR), partial response (PR), or stable disease (SD) according to RANO criteria. [ Time Frame: 24 months ]


Information from the National Library of Medicine

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

Inclusion Criteria:

Patients must meet all the following inclusion criteria to be eligible for enrollment into the study:

  1. Age ≥ 18 years;
  2. Life expectancy > 12 weeks;
  3. Present with histologically confirmed intracranial (supratentorial) unmethylated MGMT promotor status GBM (WHO Grade lV astrocytoma) with a MGMT status that has been confirmed by validated PCR or validated alternate genomic analysis;
  4. Have undergone maximal surgical resection of their tumor and within 6 weeks of surgery received initial treatment with XRT/TMZ which consisted of XRT by external beam to a partial brain field in daily fractions of 2.0 Gray (Gy), to a planned total dose to the tumor of 60.0 Gy, in conjunction with TMZ oral QD 75 mg/m2 in accordance with the Stupp regimen;
  5. Must have measurable disease, according to RANO criteria for inclusion in the expansion cohort. Patients with non-measurable disease can be included in the dose-escalation cohorts;
  6. KPS ≥ 70;
  7. Cranial magnetic resonance imaging (MRI) must have been performed within 7 days prior to or on the day of the Randomization/Week 1 Visit;
  8. Stable or decreasing corticosteroid dose within 7 days prior to the first dose;
  9. Adequate bone marrow/hematological function within 7 days prior to Day 1;
  10. Adequate liver and renal function within 14 days prior to Day 1;
  11. International normalized ratio (INR) or prothrombin time (PT) (secs) and activated partial thromboplastin time (aPTT) within 7 days prior to randomization:
  12. Patients must be willing to forego other drug therapy against the tumor while enrolled in the study.

Exclusion Criteria:

  1. Previous radiotherapy to the brain or cytotoxic drug therapy (including Gliadel® wafers) in addition to the required postoperative radiation plus TMZ, non-cytotoxic drug therapy, or experimental drug therapy directed against the brain tumor prior to this regimen, will be excluded. Patients may have received or be receiving corticosteroids, analgesics, and other drugs to treat symptoms or prevent complications but the dose must be stable at treatment start. NOTE: 5 aminolevulinic acid-mediated photodynamic therapy administered prior to surgery to aid in optimal surgical resection is not considered a chemotherapy agent;
  2. Any prior or anticipated concomitant treatment involving a medical device (such as Optune®) applying tumor treating fields (TTF);
  3. QT interval time of ≥ 470 msec;
  4. Undetermined/indeterminate MGMT status;
  5. Diabetic patients; prediabetic patients treated with metformin;
  6. Use of any CYP3A4 inducing or inhibiting agents;
  7. Significant medical illnesses;
  8. Women who are pregnant or who are lactating;
  9. Diagnosed with infratentorial GBM, a tumor outside of brain or gliomatosis cerebri;
  10. Evidence of recent hemorrhage on postoperative MRI of the brain;
  11. Any previous malignancy; except for adequately controlled limited basal cell carcinoma of the skin, squamous carcinoma of the skin or carcinoma in situ of the cervix, or one which has been absent for ≥3 years;

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): NCT03522298


Contacts
Contact: Jeremy Simpson, PhD +612 9472 4101 jeremy.simpson@kaziatherapeutics.com
Contact: James Garner, MD +612 9472 4101 james.garner@kaziatherapeutics.com

Locations
United States, California
University of California Los Angeles - Jonsson Comprehensive Cancer Center Recruiting
Los Angeles, California, United States, 90095
Contact: Emese Filka       efilka@mednet.ucla.edu   
Principal Investigator: Timothy Cloughesy, MD         
United States, Colorado
University of Colorado Cancer Center Recruiting
Aurora, Colorado, United States, 80045
Contact: Rachel Freedman       Rachel.Freedman@ucdenver.edu   
Principal Investigator: Denise Damek, MD         
United States, Massachusetts
Dana Farber Cancer Institute Recruiting
Boston, Massachusetts, United States, 02115
Contact: Swati Samtani       Swati_Samtani@dfci.harvard.edu   
Principal Investigator: Patrick Wen, MD         
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02115
Contact: Edwin Nunez       Enunez2@mgh.harvard.edu   
Principal Investigator: Elizabeth Gerstner, MD         
United States, New Jersey
John Theurer Cancer Center at Hackensack University Medical Center Recruiting
Hackensack, New Jersey, United States, 07601
Contact: Lori Cappello    551-996-5098    Lori.Cappello@HackensackMeridian.org   
Principal Investigator: Samual A Goldlust, MD         
United States, Oklahoma
University of Oklahoma Health Sciences Center (Stephenson Cancer Center) Recruiting
Oklahoma City, Oklahoma, United States, 73104
Contact: Julie Schreiner         
Contact       Julie-Schreiner@ouhsc.edu   
Principal Investigator: James Battiste, MD         
United States, Texas
MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: Kathy Hunter    713-745-5769    kuhunter@mdanderson.org   
Principal Investigator: John de Groot, MD         
Sponsors and Collaborators
Kazia Therapeutics Limited
Investigators
Study Director: James Garner, MD Kazia Therapeutics Limited

Responsible Party: Kazia Therapeutics Limited
ClinicalTrials.gov Identifier: NCT03522298     History of Changes
Other Study ID Numbers: NVGN-0084-201
First Posted: May 11, 2018    Key Record Dates
Last Update Posted: September 13, 2018
Last Verified: September 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Kazia Therapeutics Limited:
newly diagnosed
unmethylated O6 methylguanine-methyltransferase (MGMT) promoter status

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