Advanced Solid Tumors
Conditions
Keywords
Phase 1 dose escalation dose finding pharmacokinetic and pharmacodynamic study
Brief summary
This is the first study using PF-03758309, an oral compound, in patients with advanced solid tumors. In this study different doses of PF-03758309 will be administered to different groups of patients. The study will assess the compound's safety, the blood levels of PF-03758309 during the treatment and the effect of the compound on the tumor cells.
Detailed description
The study was prematurely terminated on 26Jul2011 due to the undesirable PK characteristics of PF-03758309 and the lack of an observed dose-response relationship. There were no safety concerns that contributed to the study termination.
Interventions
Oral PF-03758309 will be administered in capsules (once or twice daily) until toxicity, progressive disease, or patient refusal to continue on therapy. The starting dose is 1 mg once daily.
Sponsors
Study design
Eligibility
Inclusion criteria
* Advanced/metastatic solid tumor that is resistant to standard therapy or for which no standard therapy is available. * ECOG (Eastern Cooperative Oncology Group) Performance Status (PS) must be 0 or 1. * Adequate bone marrow, liver and kidney function.
Exclusion criteria
* Patients with known brain metastases. * Previous high dose chemotherapy requiring stem cell rescue. * Prior irradiation to \>25% of the bone marrow. * Active bacterial, fungal or viral infection including hepatitis B (HBV), hepatitis C (HCV). * Current active treatment in another clinical study. * Pregnancy or breast feeding. * Active inflammatory gastrointestinal disease, chronic diarrhea (unless related to underlying malignancy or prior related treatment) or history of abdominal fistula, gastrointestinal perforation, peptic ulcer disease, or intra-abdominal abscess within 6 months prior to study enrollment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | Baseline (up to 30 days prior to first study drug administration) till 28 days after the last treatment administration (end of Cycle 1 [28 days]) | DLT includes: Grade (GR) 4 neutropenia (NP) that persisted for \>7 consecutive days; Febrile NP; GR3 NP infection; GR4 thrombocytopenia (TP); GR3 TP with bleeding; Any other GR\>=3 toxicity not classified under Common Terminology Criteria for Adverse Events (CTCAE) blood or bone marrow (exception of nausea, vomiting, or diarrhea in subjects who received optimal treatment with antiemetics or anti-diarrheals); Failure to recover to an adequate condition to recommence study treatment after a 2-week delay; Failure to receive \>= 80% of planned PF-03758309 dose due to study drug related toxicity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Tumor Progression (TTP) | Baseline until the date of first documented progression or discontinuation from the study due to any cause, assessed every 2 months until when the last participant was discontinued due to disease progression in Month 27 of the study | Time in weeks from start of study treatment to first documentation of objective tumor progression or death due to cancer, whichever comes first. TTP was calculated as (first event date minus the date of first dose of study medication plus 1) divided by 7. Tumor progression was determined from oncologic assessment data (where data meet the criteria for progressive disease \[PD\]) |
| Duration of Response | Baseline until the date of first documented progression or discontinuation from the study due to any cause, assessed every 2 months until when the last participant was discontinued due to disease progression in Month 27 of the study | Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cancer. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cancer minus the date of the first CR or PR that was subsequently confirmed plus 1) divided by 7. DR was calculated for the subgroup of participants with a confirmed objective tumor response. |
| Maximum Observed Plasma Concentration (Cmax) | predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, on Cycle 1 Day 8 and Cycle 2-4 Day 1 at pre-dose and 2 hours post morning dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose | — |
| Time to Reach Maximum Observed Plasma Concentration (Tmax) | predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, on Cycle 1 Day 8 and Cycle 2-4 Day 1 at pre-dose and 2 hours post morning dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose | — |
| Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast) | predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, on Cycle 1 Day 8 and Cycle 2-4 Day 1 at pre-dose and 2 hours post morning dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose | Area under the plasma concentration time-curve from zero to the last measured concentration (AUClast) |
| Number of Participants With Objective Response | Baseline until the date of first documented progression or discontinuation from the study due to any cause, assessed every 2 months until when the last participant was discontinued due to disease progression in Month 27 of the study | Number of participants with objective response based on assessment of confirmed complete response (CR) or confirmed partial response (PR) according to RECIST. Confirmed CR defined as disappearance of all target lesions. Confirmed PR defined as ≥30% decrease in sum of the longest dimensions (LD) of the target lesions taking as a reference the baseline sum LD according to RECIST. Confirmed responses are those that persist on repeat imaging study ≥4 weeks after initial documentation of response. |
| Minimum Observed Plasma Trough Concentration (Cmin) | predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose | — |
| Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau) | predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose | — |
| PAK (p21 Activated Kinase)-Related Pathway Molecule Expression Modulation by PF-03758309 in Tumor and Surrogate Tissue | Screening, 0, 2, 4, and 72 hours post dose Cycle 2 Day 8. A 6th sample of hair follicle could be requested at 6 or 8 hours post-dose if necessary. For fresh tumor tissue, baseline and between Day 8 and 22 of Cycle 1 in participants with accessible tumors | — |
| Baseline Tumor Expression of PAK-related Pathway Molecules and Other Known Biomarkers | Baseline | — |
| Area Under the Concentration-Time Curve From Time 0 to 12 Hours Post Morning Dose [AUC(0-12)] | pre-dose and 12 hours post morning dose | — |
Countries
Australia, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| PF-03758309 Participants who received: 1 mg QD, 1 mg BID, 2 mg BID, 10 mg BID, 20 mg BID, 40 mg BID, 50 mg BID and 60 mg BID | 35 |
| Total | 35 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 | FG006 | FG007 |
|---|---|---|---|---|---|---|---|---|---|
| Overall Study | Adverse Event | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 2 |
| Overall Study | Objective progression or relapse | 3 | 3 | 2 | 3 | 3 | 3 | 3 | 5 |
| Overall Study | Other | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 2 |
| Overall Study | Protocol Violation | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 |
| Overall Study | Withdrawal by Subject | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
Baseline characteristics
| Characteristic | PF-03758309 |
|---|---|
| Age, Customized 18 - 44 years | 6 participants |
| Age, Customized <18 years | 0 participants |
| Age, Customized 45 - 64 years | 15 participants |
| Age, Customized >=65 years | 14 participants |
| Sex: Female, Male Female | 17 Participants |
| Sex: Female, Male Male | 18 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk |
|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 3 / 3 | 3 / 3 | 3 / 3 | 3 / 3 | 5 / 5 | 3 / 3 | 5 / 5 | 10 / 10 |
| serious Total, serious adverse events | 0 / 3 | 0 / 3 | 0 / 3 | 0 / 3 | 1 / 5 | 0 / 3 | 1 / 5 | 2 / 10 |
Outcome results
Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT)
DLT includes: Grade (GR) 4 neutropenia (NP) that persisted for \>7 consecutive days; Febrile NP; GR3 NP infection; GR4 thrombocytopenia (TP); GR3 TP with bleeding; Any other GR\>=3 toxicity not classified under Common Terminology Criteria for Adverse Events (CTCAE) blood or bone marrow (exception of nausea, vomiting, or diarrhea in subjects who received optimal treatment with antiemetics or anti-diarrheals); Failure to recover to an adequate condition to recommence study treatment after a 2-week delay; Failure to receive \>= 80% of planned PF-03758309 dose due to study drug related toxicity
Time frame: Baseline (up to 30 days prior to first study drug administration) till 28 days after the last treatment administration (end of Cycle 1 [28 days])
Population: Safety analysis set: All participants enrolled in the study that received at least 1 dose of PF-03758309 (including the lead in dose).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| PF-03758309, 1 mg QD | Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | 0 participants |
| PF-03758309, 1 mg BID | Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | 0 participants |
| PF-03758309, 2 mg BID | Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | 0 participants |
| PF-03758309, 10 mg BID | Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | 0 participants |
| PF-03758309, 20 mg BID | Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | 0 participants |
| PF-03758309, 40 mg BID | Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | 0 participants |
| PF-03758309, 50 mg BID | Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | 1 participants |
| PF-03758309, 60 mg BID | Number of Participants With Cycle 1 Dose-limiting Toxicities (DLT) | 2 participants |
Area Under the Concentration-Time Curve From Time 0 to 12 Hours Post Morning Dose [AUC(0-12)]
Time frame: pre-dose and 12 hours post morning dose
Population: Data not analyzed due to early termination of the study.
Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau)
Time frame: predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose
Population: Data not analyzed due to early termination of the study.
Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast)
Area under the plasma concentration time-curve from zero to the last measured concentration (AUClast)
Time frame: predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, on Cycle 1 Day 8 and Cycle 2-4 Day 1 at pre-dose and 2 hours post morning dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose
Population: Data not analyzed due to early termination of the study.
Baseline Tumor Expression of PAK-related Pathway Molecules and Other Known Biomarkers
Time frame: Baseline
Population: Data not analyzed due to early study termination.
Duration of Response
Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cancer. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cancer minus the date of the first CR or PR that was subsequently confirmed plus 1) divided by 7. DR was calculated for the subgroup of participants with a confirmed objective tumor response.
Time frame: Baseline until the date of first documented progression or discontinuation from the study due to any cause, assessed every 2 months until when the last participant was discontinued due to disease progression in Month 27 of the study
Population: Data not analyzed due to early termination of the study.
Maximum Observed Plasma Concentration (Cmax)
Time frame: predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, on Cycle 1 Day 8 and Cycle 2-4 Day 1 at pre-dose and 2 hours post morning dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose
Population: Data not analyzed due to early termination of the study.
Minimum Observed Plasma Trough Concentration (Cmin)
Time frame: predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose
Population: Data not analyzed due to early termination of the study.
Number of Participants With Objective Response
Number of participants with objective response based on assessment of confirmed complete response (CR) or confirmed partial response (PR) according to RECIST. Confirmed CR defined as disappearance of all target lesions. Confirmed PR defined as ≥30% decrease in sum of the longest dimensions (LD) of the target lesions taking as a reference the baseline sum LD according to RECIST. Confirmed responses are those that persist on repeat imaging study ≥4 weeks after initial documentation of response.
Time frame: Baseline until the date of first documented progression or discontinuation from the study due to any cause, assessed every 2 months until when the last participant was discontinued due to disease progression in Month 27 of the study
Population: Per protocol analysis set: all participants who have received a minimum of 1 cycle of study treatment (at least 80% of planned dose), had baseline assessments and at least 1 on-study tumor assessment were considered evaluable for response.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| PF-03758309, 1 mg QD | Number of Participants With Objective Response | confirmed complete response (CR) | 0 participants |
| PF-03758309, 1 mg QD | Number of Participants With Objective Response | confirmed partial response (PR) | 0 participants |
| PF-03758309, 1 mg BID | Number of Participants With Objective Response | confirmed complete response (CR) | 0 participants |
| PF-03758309, 1 mg BID | Number of Participants With Objective Response | confirmed partial response (PR) | 0 participants |
| PF-03758309, 2 mg BID | Number of Participants With Objective Response | confirmed complete response (CR) | 0 participants |
| PF-03758309, 2 mg BID | Number of Participants With Objective Response | confirmed partial response (PR) | 0 participants |
| PF-03758309, 10 mg BID | Number of Participants With Objective Response | confirmed complete response (CR) | 0 participants |
| PF-03758309, 10 mg BID | Number of Participants With Objective Response | confirmed partial response (PR) | 0 participants |
| PF-03758309, 20 mg BID | Number of Participants With Objective Response | confirmed complete response (CR) | 0 participants |
| PF-03758309, 20 mg BID | Number of Participants With Objective Response | confirmed partial response (PR) | 0 participants |
| PF-03758309, 40 mg BID | Number of Participants With Objective Response | confirmed complete response (CR) | 0 participants |
| PF-03758309, 40 mg BID | Number of Participants With Objective Response | confirmed partial response (PR) | 0 participants |
| PF-03758309, 50 mg BID | Number of Participants With Objective Response | confirmed partial response (PR) | 0 participants |
| PF-03758309, 50 mg BID | Number of Participants With Objective Response | confirmed complete response (CR) | 0 participants |
| PF-03758309, 60 mg BID | Number of Participants With Objective Response | confirmed complete response (CR) | 0 participants |
| PF-03758309, 60 mg BID | Number of Participants With Objective Response | confirmed partial response (PR) | 0 participants |
PAK (p21 Activated Kinase)-Related Pathway Molecule Expression Modulation by PF-03758309 in Tumor and Surrogate Tissue
Time frame: Screening, 0, 2, 4, and 72 hours post dose Cycle 2 Day 8. A 6th sample of hair follicle could be requested at 6 or 8 hours post-dose if necessary. For fresh tumor tissue, baseline and between Day 8 and 22 of Cycle 1 in participants with accessible tumors
Population: Data not analyzed due to early study termination.
Time to Reach Maximum Observed Plasma Concentration (Tmax)
Time frame: predose, 0.5, 1, 2, 3, 5, 8, 10, 24 and 48 hours post dose, on Cycle 1 Day 8 and Cycle 2-4 Day 1 at pre-dose and 2 hours post morning dose, and on Cycle 1 Day 15 at predose, 0.5, 1, 2, 3, 5, 8 and 10 hours post morning dose
Population: Data not analyzed due to early termination of the study.
Time to Tumor Progression (TTP)
Time in weeks from start of study treatment to first documentation of objective tumor progression or death due to cancer, whichever comes first. TTP was calculated as (first event date minus the date of first dose of study medication plus 1) divided by 7. Tumor progression was determined from oncologic assessment data (where data meet the criteria for progressive disease \[PD\])
Time frame: Baseline until the date of first documented progression or discontinuation from the study due to any cause, assessed every 2 months until when the last participant was discontinued due to disease progression in Month 27 of the study
Population: Data not analyzed due to early termination of the study.