A Phase I, Multicenter Study to Assess the Safety, Tolerability, and Pharmacokinetics of Ascending Doses of AZD1390 in Combination With Radiation Therapy in Patients With Glioblastoma Multiforme and Brain Metastases From Solid Tumors
Summary
This study will test an investigational drug called AZD1390 in combination with radiation therapy for the treatment of brain tumors. This is the first time AZD1390 is being given to patients. This study will test safety, tolerability and PK (how the drug is absorbed, distributed and eliminated) of ascending doses of AZD1390 in combination with distinct regimens of radiation therapy
Detailed description
This first time-in patients (FTIP), open-label, multicentre study of AZD1390 will be conducted in the United States, the United Kingdom and Japan. It consists of three treatment arms: Arm A, B, C. The Japan dose confirmation part (Japan part) is a sub-study of Arm A. Sites from Japan will only participate in the Japan part. This Phase 1 study will assess safety and tolerability of AZD1390 in combination with radiation therapy (RT) in brain malignancies. The combination cohorts have been designed to assess escalating cumulative doses of AZD1390 in settings with 3 different radiation treatment regimens: * Arm A: 35 Gy over 2 weeks with intensity-modulated radiation therapy (IMRT) in patients with recurrent Glioblastoma Multiforme (GBM). Arm A will also include the food effect cohort * Arms B: 30 Gy over two weeks with whole brain radiation therapy (WBRT)/ partial brain radiation therapy (PBRT) in patients with brain metastases. \*\*Arm B has now closed to recruitment\*\* * Arm C: 60 Gy over 6 weeks (IMRT) in patients with primary GBM Each arm provides standard of care RT for the disease setting indicated with the experimental agent being administered in dose escalating cohorts.
Arms & interventions
- RadiationRadiation Therapy
35 Gy of Intensity-modulated radiation therapy (IMRT) administered at daily fractions of 3.5 Gy over 10 fractions (2 weeks)
- DrugAZD1390
AZD1390 Administered in 3 Cycles depending on arm: Cycle 0: 1 dose prior to Radiation Therapy. Cycle 1: 2 weeks Intermittent or continuous dosing during Radiation Therapy. Cycle 2: 2 weeks adjuvant treatment after Radiation Therapy. For optional food effect assessment in Arm A, 2 doses prior to RT under both fed and fasted conditions. Note: the food effect assessment is currently open to recruitment. Arm A includes the Japan part following the same dosing administration.
- RadiationRadiation Therapy
30 Gy of whole brain radiation therapy (WBRT) or partial brain radiation therapy (PBRT) administered at daily fractions of 3 Gy over 10 fractions (2 weeks).
- RadiationRadiation Therapy
60 Gy of intensity- modulated radiation therapy (IMRT) administered at daily fractions of 2 Gy over 30 fractions (6 weeks)
- DrugAZD1390
AZD1390 administered in 1 Cycle. AZD1390 administration concomitantly with RT (2 weeks). Cycle 1 also contains an additional 5 days (post completion of RT with AZD1390 administration). Arm is Closed.
- DrugAZD1390
AZD1390 Administered in 3 Cycles depending on arm: Cycle 0: 1 dose prior to Radiation Therapy. Cycle 1: 6 weeks Intermittent or continuous dosing during Radiation Therapy. Cycle 2: 2 weeks adjuvant treatment after Radiation Therapy. Arm is closed.
Outcome measures
Primary
Incidence of dose-limiting toxicities (DLTs)
DLTs will be used to calculate the maximum tolerated dose (MTD). In each arm, the MTD of AZD1390 is the highest dose at which the predicted probability of a DLT is less than 25% in that specific RT setting
Time frame: From the start of treatment until the end of the DLT period (approximately 6 weeks for Arm A, 3 weeks for Arm B and 10 weeks for Arm C)
Incidence of adverse events (AEs) and serious adverse events (SAEs)
For each adverse event CTCAE grade and causality (related to AZD1390 or radiotherapy) will be collected.
Time frame: From the start of treatment until the end of the study (approximately 9 months after the last patient has started treatment)
Secondary
Event free survival (EFS) for Arms A and C only
Time frame: From the start of treatment until the patient is off study (approximately 9 months after the last patient has started treatment)
Objective response rate defined by RANO criteria for Arms A and C only
Time frame: Every 8 weeks starting from 4 weeks after RT until the end of the study (approximately 9 months after the last patient has started treatment)
Objective response rate defined by RANO-BM criteria for Arm B only. **Arm B has now closed to recruitment**
Time frame: From screening until the patient is off study, approximately 8 weeks
Objective response rate defined by RECIST 1.1 criteria for Arm B only. **Arm B has now closed to recruitment**
Time frame: From screening until the patient is off study, approximately 8 weeks
Maximum Observed Plasma Concentration (Cmax) of AZD1390
Time frame: At predefined intervals throughout the AZD1390 treatment period (approximately 5 weeks for Arm A, 2 weeks for Arm B and 9 weeks for Arm C)
Time to observed Cmax (Tmax) for AZD1390
Time frame: At predefined intervals throughout the AZD1390 treatment period (approximately 5 weeks for Arm A, 2 weeks for Arm B and 9 weeks for Arm C)
Area under the plasma concentration-time curve (AUC) for AZD1390
Time frame: At predefined intervals throughout the AZD1390 treatment period (approximately 5 weeks for Arm A, 2 weeks for Arm B and 9 weeks for Arm C)
Overall survival for Arms A and C only
Time frame: From start of treatment until the patient dies, withdraws or the end of study is reached (approximately 9 months after the last patient has started treatment)
Assessment of the food effect of AZD1390 at the MTD for Arm A (if conducted)
Time frame: At two predefined intervals during cycle 0 (at least 5 days apart)
Eligibility criteria
Study locations (5)
Research Site
Boston, Massachusetts, 02114
Research Site
Boston, Massachusetts, 02215
Research Site
New York, New York, 10065
Research Site
Pittsburgh, Pennsylvania, 15232
Research Site
Richmond, Virginia, 23298