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Phase I-II Study With Tumor Molecular Pharmacodynamic (MPD) Evaluation and Pharmacokinetics of PD-0332991 in Patients Suffering Metastatic Melanoma (OPTIMUM)

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: NCT02202200
Recruitment Status : Unknown
Verified April 2016 by Assistance Publique - Hôpitaux de Paris.
Recruitment status was:  Recruiting
First Posted : July 28, 2014
Last Update Posted : April 18, 2016
Sponsor:
Information provided by (Responsible Party):
Assistance Publique - Hôpitaux de Paris

Study Description
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Brief Summary:

An open label multicentre, phase I-II study with tumour molecular pharmacodynamics (MPD) evaluation and pharmacokinetics of PD-0332991 added to vemurafenib in patients suffering metastatic melanoma with BR.

The main objective is to establish the Maximum Tolerated Dose (MTD) of PD-0332991 when added to standard vemurafenib therapy (960 mg BID). The estimated MTD is defined as the dose of PD-0332991 combined with vemurafenib that will be associated with a prespecified proportion of patients experiencing a Dose-Limiting Toxicity (DLT), ie, 1/3.


Condition or disease Intervention/treatment Phase
Melanoma BRAF V600E/K Mutated CDNKN2A Loss Defined Drug: PD- 0332991 Phase 1 Phase 2

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 40 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open Label Multicenter, Phase I-II Study With Tumor Molecular Pharmacodynamic (MPD) Evaluation and Pharmacokinetics of PD-0332991 in Patients Suffering Metastatic Melanoma With BRAFv600 Mutated and CDKN2A Loss and Expression of Rb and Treated by Vemurafenib
Study Start Date : May 2014
Estimated Primary Completion Date : November 2016
Estimated Study Completion Date : August 2018

Resource links provided by the National Library of Medicine

MedlinePlus Genetics related topics: Melanoma
MedlinePlus related topics: Melanoma
Drug Information available for: Palbociclib

Arms and Interventions
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Arm Intervention/treatment
Experimental: PD-0332991 Drug: PD- 0332991

PD-0332991 Inhibitor of cyclin-dependant kinase (CDK) 8 schedules will be evaluated PD-0332991 PO QD either at 25 mg, 50 mg, 75 mg, 100 mg, 125 mg, 150 mg, 175 mg and 200 mg

All patients will receive vemurafenib as background therapy ,bid at 720mg bid for the first group (during the first 2 cycle then 960 mg bid if good tolerance) and 960mg bid for all other patients


Outcome Measures
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Primary Outcome Measures :
  1. Occurrence within the first 2 cycles of treatment of a DLT [ Time Frame: 42 Days ]

    DLTs, serious adverse events and adverse events leading to treatment discontinuations will be determined as follows:

    • Any grade 3 or more non-haematological toxicity excluding:
    • Grade 3 asymptomatic increase in liver function tests (AST, ALT, ALP) reversible within 7 days for subjects without liver involvement, or grade 4 for subjects with liver involvement.
    • Grade 3 vomiting if it is encountered despite adequate and optimal therapy (e.g. 5HT3 antagonists and corticosteroids).
    • Grade 3 diarrhoeas if encountered despite adequate and optimal anti diarrhoea therapy.
    • Confirmed grade 3 QTc prolongation (QTc >500 msec) that persists after correction of other possible causes such as electrolyte imbalance
    • Grade 4 hyperlipidemia if it is encountered despite adequate and optimal therapy.
    • Any grade 4 neutropenia of > 5 days duration, or febrile neutropenia lasting for more than 1 day.
    • Grade 4 thrombocytopenia > 1 day, or grade 3 with bleeding.


Secondary Outcome Measures :
  1. Efficacy [ Time Frame: 42 Days ]
    Occurrence of clinical benefit (defined as Complete Response (CR), Partial Response (PR) or stable disease (SD)) and progressive disease based on the best overall response which depends on the tumour evaluations assessed using RECIST at the end of each 2 cycles.

  2. 1 year survival rate [ Time Frame: 1 year ]
    survival

  3. Tolerance [ Time Frame: 6 months ]
    Occurrence of clinically significant changes in a laboratory parameter and/or vital signs judged to be related to the trial medication within the first 6 months.


Other Outcome Measures:
  1. Pharmacodynamic [ Time Frame: 42 days ]
    • Changes from baseline of ANC and platelet levels
    • Efficiency on the cell-cycle machinery and proliferation (tumor sample)
    • Induction of senescence: will be evaluated using the senescence β-Galactosidase assay (Cell Signaling Technology)
    • Induction of apoptosis: will be performed using TUNEL staining with the ApopTag Peroxidase In Situ Apoptosis Detection Kit (Millipore).


Eligibility Criteria
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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.


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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:

  • Age > 18 years
  • Stage IV or un-resectable stage III melanoma
  • Presence of BRAF V600E/K mutation and CDNKN2A loss and expression of Rb using immunohistochemistry in a recent metastatic sample (< 6 months)
  • A previous exposure to BRAF inhibitor or combination of BRAF and MEK inhibitors therapy is allowed unless it has been stopped more than 3 months before study enrolment(This will defined the two strata of the trial)
  • No previous therapy by MEK inhibitor unless associated with BRAF inhibitors
  • No previous therapy with the AKT/PI3K pathway inhibitor
  • Patients should have a tumour available for repeated biopsies for pharmacodynamics evaluation
  • Life expectancy of > 3 months
  • ECOG performance status <2
  • Signed informed consent
  • Patient with health insurance coverage
  • No patient under guardianship or curators

Exclusion Criteria:

  • Inadequate hepatic function defined as serum bilirubin>25 μmol/l, transaminases > 3.0 times the upper limit of normal (ULN) or 5ULN in cases of liver metastases;
  • Inadequate bone marrow function defined as absolute neutrophil count<1500/mcl, platelets<150000/mcl and haemoglobin<8g/dL
  • Inadequate renal function with serum creatinine>2.0mg/dl) and /or creatinine clearance< 60 ml/min
  • Untreated brain metastases : Patients with brain metastases will be eligible if they have completed treatment 1 months prior to the start of study medication, have discontinued corticosteroid treatment for these metastases for at least 5 days, and are neurologically asymptomatic
  • Myocardial infarct or unstable angina within the past 6 months
  • Concomitant take of drugs known to be strong inhibitor or inducers of CYP314
  • HIV positive.
  • Chemotherapy, immunotherapy within 4 weeks
  • Drugs interfering with PD-0332991 and vemurafenib metabolism
  • Malabsorption syndrome or other condition that would interfere with enteral absorption
  • Congenital long QT syndrome or screening QTc > 470 msec
  • Need for chronic corticosteroid therapy of ≥10 mg of prednisone per day
Contacts and Locations
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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): NCT02202200


Locations
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France
Saint-Louis Hospital Recruiting
Paris, France, 75010
Contact: Celeste Lebbe, MDPHD    +33 1 42 49 49 49    celeste.lebbe@sls.aphp.fr   
Principal Investigator: celeste lebbe, MD-PHD         
Sponsors and Collaborators
Assistance Publique - Hôpitaux de Paris
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Assistance Publique - Hôpitaux de Paris
ClinicalTrials.gov Identifier: NCT02202200    
Other Study ID Numbers: D20121106
First Posted: July 28, 2014    Key Record Dates
Last Update Posted: April 18, 2016
Last Verified: April 2016
Keywords provided by Assistance Publique - Hôpitaux de Paris:
Melanoma
BRAF mutated
Additional relevant MeSH terms:
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Melanoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
 Nevi and Melanomas
Palbociclib
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action