A Phase 1 Drug-Drug Interaction Study Between Brigatinib and the CYP3A Substrate, Midazolam, in Participants With ALK-Positive or ROS1-Positive Solid Tumors
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ClinicalTrials.gov Identifier: NCT03420742 |
Recruitment Status :
Completed
First Posted : February 5, 2018
Results First Posted : January 27, 2023
Last Update Posted : January 27, 2023
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Condition or disease | Intervention/treatment | Phase |
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Carcinoma, Advanced ALK+ or ROS1+Non-Small-Cell Lung, Neoplasm, Advanced ALK+ or ROS1+Solid Tumors | Drug: Midazolam Drug: Brigatinib | Phase 1 |
The study will enroll approximately 20 participants to achieve approximately 15 PK-evaluable participants for assessment. This study will consist of 2 parts: Part A of the study will evaluate the effect of repeat-dose administration of brigatinib on the single-dose PK of midazolam. Part B of the study is exploratory and will allow participants to continue brigatinib until disease progression (PD). All participants will receive study drug via the oral route. Participants will be assigned to: Midazolam 3 mg + Brigatinib 90 mg.
The overall time to participate in this study is 26 months. Participants will have a 28-day PK cycle in Part A and a maximum of 23 cycles in Part B, and a 30-day follow-up period after end of treatment.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 24 participants |
Allocation: | N/A |
Intervention Model: | Sequential Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Other |
Official Title: | A Phase 1 Drug-Drug Interaction Study Between Brigatinib and the CYP3A Substrate Midazolam in Patients With ALK-Positive or ROS1-Positive Solid Tumors |
Actual Study Start Date : | June 26, 2019 |
Actual Primary Completion Date : | March 24, 2020 |
Actual Study Completion Date : | April 29, 2021 |

Arm | Intervention/treatment |
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Experimental: Midazolam 3 mg + Brigatinib 90 mg
Midazolam 3 mg, orally, once on Day 1, followed by brigatinib 90 mg, orally, once daily on Days 2 to 8, further followed by brigatinib 180 mg, orally, once daily on Days 9 to 28 in Part A Cycle 1 (28 days treatment cycle). Participants escalating to brigatinib 180 mg once daily will also receive midazolam 3 mg, orally, once on Day 21 of Part A Cycle 1. After completion of Part A, participants will continue into Part B. Participants in Part B will receive brigatinib up to 180 mg (or at the highest tolerated dose in Part A), orally, once daily in a 28 day treatment cycle, up to a maximum of 23 cycles or until progression of disease, unacceptable toxicity, or another discontinuation criterion is met.
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Drug: Midazolam
Midazolam syrup. Drug: Brigatinib Brigatinib tablets.
Other Name: Alunbrig |
- Part A, AUC∞: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for Midazolam [ Time Frame: Cycle 1, Days 1 (Midazolam alone) and 21 (Midazolam + Brigatinib): pre-dose and at multiple timepoints (up to 24 hours) post-dose (Cycle length is 28 days) ]The statistical analysis was calculated via a mixed-effects analysis of variance (ANOVA) fitting terms for treatment (midazolam with or without brigatinib coadministration).
- Part A, Cmax: Maximum Observed Plasma Concentration for Midazolam [ Time Frame: Cycle 1, Days 1 (Midazolam alone) and 21 (Midazolam + Brigatinib): pre-dose and at multiple timepoints (up to 24 hours) post-dose (Cycle length is 28 days) ]The statistical analysis was calculated via a mixed-effects ANOVA fitting terms for treatment (midazolam with or without brigatinib coadministration).
- Part A, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for Midazolam [ Time Frame: Cycle 1, Days 1 (Midazolam alone) and 21 (Midazolam + Brigatinib): pre-dose and at multiple timepoints (up to 24 hours) post-dose (Cycle length is 28 days) ]

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 |
Inclusion Criteria:
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Locally advanced or metastatic solid tumors who meet 1 of the following 4 criteria:
- With locally advanced or metastatic ALK-positive NSCLC who have progressed on or are intolerant to treatment with at least 1 other ALK inhibitor.
- With ALK-positive nonlung solid tumors that are locally advanced or metastatic and for whom no standard, nonexperimental therapy is available.
- With locally advanced or metastatic ROS1-positive NSCLC who have progressed on crizotinib therapy or are intolerant to crizotinib, or
- With ROS1-positive nonlung solid tumors that are locally advanced or metastatic and for whom no standard, nonexperimental therapy is available.
- Eastern cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Have at least 1 target lesion per response evaluation criteria in solid tumors (RECIST) version 1.1.
- Have recovered from toxicities related to prior anticancer therapy to National Cancer Institute common terminology criteria for adverse events (NCI CTCAE) version 4.03 Grade less than or equal to (<=) 1.
- Suitable venous access for study-required blood sampling (that is, including PK and laboratory safety tests).
Exclusion Criteria:
- Systemic treatment with strong or moderate cytochrome P450 3A (CYP3A) inhibitors or inducers within 14 days before enrollment.
- Prior therapy with brigatinib.
- Received prior ALK-inhibitor therapy within 7 days before the first dose of study drug.
- Treatment with any investigational systemic anticancer agents within 14 days or 5 half-lives, whichever is longer, before the first dose of study drug.
- Received chemotherapy or radiation therapy within 14 days before the first dose of study drug, except for stereotactic radiosurgery (SRS) or stereotactic body radiation therapy.
- Received antineoplastic monoclonal antibodies within 30 days before the first dose of study drug.
- Had major surgery within 30 days before the first dose of study drug. Minor surgical procedures, such as catheter placement or minimally invasive biopsies, are allowed.
- Have current spinal cord compression (symptomatic or asymptomatic and detected by radiographic imaging). Patients with leptomeningeal disease and without cord compression are allowed.

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): NCT03420742
France | |
Groupe Hospitalier Bichat-Claude Bernard - Hopital Bichat | |
Paris, Ile-de-france, France, 75018 | |
Hopital de la Timone | |
Marseille, Provence Alpes COTE D'azur, France, 13005 | |
Italy | |
Centro di Riferimento Oncologico di Aviano | |
Aviano, Pordenone, Italy, 33081 | |
Policlinico Sant'Orsola Malpighi | |
Bologna, Italy, 40138 | |
Ospedale San Raffaele | |
Milano, Italy, 20132 | |
Istituto Europeo di Oncologia | |
Milano, Italy, 20141 | |
Azienda Ospedaliero Universitaria di Parma | |
Parma, Italy, 43126 | |
Ospedale Santa Maria delle Croci | |
Ravenna, Italy, 48121 | |
Netherlands | |
Netherlands Cancer Institute | |
Amsterdam, Noord-holland, Netherlands, 1066 CX | |
Spain | |
Hospital Universitario Dexeus | |
Barcelona, Spain, 8028 | |
Hospital Universitari Vall d'Hebron | |
Barcelona, Spain, 8035 | |
Hospital Universitario Ramon Y Cajal | |
Madrid, Spain, 28034 | |
Hospital Universitario Fundacion Jimenez Diaz | |
Madrid, Spain, 28040 | |
HM Centro Integral Oncologico Clara Campal | |
Madrid, Spain, 28050 |
Study Director: | Study Director | Takeda |
Documents provided by Takeda:
Responsible Party: | Takeda |
ClinicalTrials.gov Identifier: | NCT03420742 |
Other Study ID Numbers: |
Brigatinib-1001 U1111-1203-0166 ( Other Identifier: WHO ) 2018-001624-19 ( EudraCT Number ) |
First Posted: | February 5, 2018 Key Record Dates |
Results First Posted: | January 27, 2023 |
Last Update Posted: | January 27, 2023 |
Last Verified: | April 2022 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement. |
Supporting Materials: |
Study Protocol Statistical Analysis Plan (SAP) Informed Consent Form (ICF) Clinical Study Report (CSR) |
Access Criteria: | IPD from eligible studies will be shared with qualified researchers according to the criteria and process described on https://vivli.org/ourmember/takeda/ For approved requests, the researchers will be provided access to anonymized data (to respect patient privacy in line with applicable laws and regulations) and with information necessary to address the research objectives under the terms of a data sharing agreement. |
URL: | https://vivli.org/ourmember/takeda/ |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Drug therapy, brigatinib, lung cancer, ALK, ROS1 |
Neoplasms Midazolam Adjuvants, Anesthesia Hypnotics and Sedatives Central Nervous System Depressants Physiological Effects of Drugs Anti-Anxiety Agents Tranquilizing Agents |
Psychotropic Drugs Anesthetics, Intravenous Anesthetics, General Anesthetics GABA Modulators GABA Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action |