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A Phase 1 Drug-Drug Interaction Study Between Brigatinib and the CYP3A Substrate, Midazolam, in Participants With ALK-Positive or ROS1-Positive Solid Tumors

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: NCT03420742
Recruitment Status : Completed
First Posted : February 5, 2018
Results First Posted : January 27, 2023
Last Update Posted : January 27, 2023
Sponsor:
Information provided by (Responsible Party):
Takeda

Brief Summary:
The purpose of this study is to characterize the effect of repeat-dose administration of brigatinib 180 milligram (mg) once daily (QD) on the single-dose pharmacokinetics (PK) of midazolam.

Condition or disease Intervention/treatment Phase
Carcinoma, Advanced ALK+ or ROS1+Non-Small-Cell Lung, Neoplasm, Advanced ALK+ or ROS1+Solid Tumors Drug: Midazolam Drug: Brigatinib Phase 1

Detailed Description:

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.

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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

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Drug Reactions

Arm Intervention/treatment
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.
Drug: Midazolam
Midazolam syrup.

Drug: Brigatinib
Brigatinib tablets.
Other Name: Alunbrig




Primary Outcome Measures :
  1. 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).

  2. 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).

  3. 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) ]


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:

  1. 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.
  2. Eastern cooperative Oncology Group (ECOG) performance status of 0 or 1.
  3. Have at least 1 target lesion per response evaluation criteria in solid tumors (RECIST) version 1.1.
  4. 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.
  5. Suitable venous access for study-required blood sampling (that is, including PK and laboratory safety tests).

Exclusion Criteria:

  1. Systemic treatment with strong or moderate cytochrome P450 3A (CYP3A) inhibitors or inducers within 14 days before enrollment.
  2. Prior therapy with brigatinib.
  3. Received prior ALK-inhibitor therapy within 7 days before the first dose of study drug.
  4. Treatment with any investigational systemic anticancer agents within 14 days or 5 half-lives, whichever is longer, before the first dose of study drug.
  5. 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.
  6. Received antineoplastic monoclonal antibodies within 30 days before the first dose of study drug.
  7. 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.
  8. Have current spinal cord compression (symptomatic or asymptomatic and detected by radiographic imaging). Patients with leptomeningeal disease and without cord compression are allowed.

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): NCT03420742


Locations
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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
Sponsors and Collaborators
Takeda
Investigators
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Study Director: Study Director Takeda
  Study Documents (Full-Text)

Documents provided by Takeda:
Study Protocol  [PDF] May 13, 2019
Statistical Analysis Plan  [PDF] November 19, 2020

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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/

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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 Takeda:
Drug therapy, brigatinib, lung cancer, ALK, ROS1
Additional relevant MeSH terms:
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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