- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03838692
Ponatinib in Advanced or Metastatic Medullary Thyroid Cancer
A Study of Ponatinib in Advanced or Metastatic Medullary Thyroid Cancer (MTC)
Study Overview
Detailed Description
Ponatinib is an investigational agent that blocks abnormal cancer proteins and therefore harms cancer cells. It was recently approved by the Food and Drug Administration for leukemia treatment, but is not approved for medullary thyroid cancer treatment. Early studies, however, have shown that medullary thyroid tumors respond to ponatinib. These studies were done in the laboratory and not performed on humans. This is a study designed for patients with medullary thyroid cancer. Treatment will consist of a drug called ponatinib which is a pill that taken once each day and continue throughout the duration of the study. The purpose of the study is to:
- Determine if this treatment will be effective in decreasing the amount of cancer and, if it does, to determine how long the response will last.
- Determine the side effects that may occur with this treatment.
- To analyze genetic mutations in tumors to help us understand how tumors grow and how these drugs interact with the mechanisms within the tumor.
Ponatinib has been given to many patients with leukemia and is now approved by the United States Food and Drug Administration for treatment of certain types of leukemia. This study will seek to determine if ponatinib can bring benefit to patients with medullary thyroid cancer.
Study Type
Phase
- Phase 2
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosis of localized or metastatic unresectable MTC.
- Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as ≥20 mm with conventional techniques or as ≥10 mm with spiral computerized tomography (CT) scan.
- The last dose of previous therapy targeting RET kinase must be given at least 4 weeks - Previous treatment with cytotoxic chemotherapy, immunotherapy, or radiotherapy are permitted, if the last dose was given at least 4 weeks prior to the first dose of ponatinib
- Patient must have failed (progressed on or been intolerant of) prior treatment with cabozantinib or vandetanib.
- Age ≥18 years old
- Eastern Cooperative Oncology Group (ECOG) performance status ≤2
- Normal organ and marrow function as defined below:
Negative pregnancy test for women of childbearing potential or male patients, even if surgically sterilized (i.e., status post-vasectomy), who:
- Agree to practice effective barrier contraception during the entire study treatment period and through 4 months after the last dose of study drug, or
- Agree to completely abstain from heterosexual intercourse
- Normal QT interval corrected on screening electrocardiogram (ECG) evaluation, defined as the corrected QT interval by Fredericia (QTcF) of ≤450 ms.
- Ability to understand and the willingness to sign a written informed consent document and follow the guidelines of the clinical protocol including visits for treatment and follow up
- Life expectancy of greater than 12 weeks
- Available archival tissue or willingness to undergo fresh biopsy if no archival tissue is available.
Exclusion Criteria:
- Patients who are receiving any other investigational agent.
- Patients with brain metastases or spinal cord compression unless they completed radiation therapy ≥4 weeks prior to the first dose of ponatinib and are stable without steroids or anti-convulsant therapy for ≥10 days.
- Patients who cannot discontinue medications that are known to be associated with Torsades de Pointes. These medications are listed in Attachment 3
- Uncontrolled hypertension (systolic blood pressure >150 or diastolic blood pressure >100
- Significant or active cardiovascular disease within 6 months prior to enrollment
- A history of pancreatitis or alcohol abuse
- Uncontrolled hypertriglyceridemia (>450 mg/dL)
- Major surgery (with the exception of minor surgical procedures, such as catheter placement or tumor biopsy) within 28 days prior to the first dose of ponatinib
- Ongoing or active infection including known history of human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C (HCV). Testing for these viruses is not required in the absence of a history of infection.
- Suffer from any condition or illness that, in the opinion of the investigator, would compromise patient safety or interfere with the evaluation of the safety of the study drug
- Evidence of a bleeding diathesis that cannot be corrected with standard therapy or factor replacement
- Presence of another primary malignancy within the past 2 years (except for non-melanoma skin cancer or cervical cancer in situ. Prior prostate cancer is also permitted if prostate-specific antigen (PSA) is now undetectable)
- Pregnant or lactating
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to investigational agent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Ponatinib Arm
Ponatinib tablets will be taken by mouth, continuously, once daily at a dose of 30 mg.
A cycle of ponatinib is defined as 28 consecutive days starting with the first day of the treatment cycle.
Treatment can be taken with water, with or without food, at approximately the same time each day.
|
A daily oral dose at 30 mg.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Objective Response Rate (ORR)
Time Frame: 24 months
|
ORR is defined as the proportion of the subjects in the analysis population who have a complete response (CR) or partial response (PR).
Responses are based on assessments per RECIST.
|
24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression-Free Survival (PFS)
Time Frame: 24 months
|
PFS is defined as the time from the first day of trial treatment to the first documented disease progression per the Kaplan-Meier curve.
|
24 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total Number of Adverse Reactions
Time Frame: 24 months
|
Testing safety and toxicity assessed using CTCAE criteria
|
24 months
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Adenocarcinoma
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Endocrine System Diseases
- Endocrine Gland Neoplasms
- Head and Neck Neoplasms
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroendocrine Tumors
- Thyroid Diseases
- Thyroid Neoplasms
- Carcinoma, Neuroendocrine
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Protein Kinase Inhibitors
- Ponatinib
Other Study ID Numbers
- AAAR5196
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Medullary Thyroid Cancer
-
University Medical Center GroningenRecruitingMedullary Thyroid Cancer | Thyroid Cancer, Medullary | Medullary Thyroid Carcinoma | Thyroid Carcinoma, MedullaryNetherlands
-
Genzyme, a Sanofi CompanyCompletedMetastatic Medullary Thyroid CancerBelgium
-
University of WashingtonNational Cancer Institute (NCI)CompletedRecurrent Thyroid Cancer | Thyroid Gland Medullary Carcinoma | Stage IVA Follicular Thyroid Cancer | Stage IVA Papillary Thyroid Cancer | Stage IVB Follicular Thyroid Cancer | Stage IVB Papillary Thyroid Cancer | Stage IVC Follicular Thyroid Cancer | Stage IVC Papillary Thyroid CancerUnited States
-
National Cancer Institute (NCI)CompletedInsular Thyroid Cancer | Recurrent Thyroid Cancer | Stage II Follicular Thyroid Cancer | Stage II Papillary Thyroid Cancer | Stage IV Follicular Thyroid Cancer | Stage IV Papillary Thyroid Cancer | Thyroid Gland Medullary CarcinomaUnited States
-
Fondazione Policlinico Universitario Agostino Gemelli...RecruitingThyroid Neoplasms | Thyroid Cancer, Papillary | Thyroid Cancer, Follicular | Thyroid Carcinoma | Thyroid Cancer | Anaplastic Thyroid Cancer | Thyroid Medullary CarcinomaItaly
-
National Cancer Institute (NCI)CompletedRecurrent Thyroid Cancer | Stage IV Follicular Thyroid Cancer | Stage IV Papillary Thyroid Cancer | Thyroid Gland Medullary CarcinomaUnited States
-
University of PennsylvaniaCompletedMetastatic Medullary Thyroid Cancer | Metastatic Differentiated Thyroid Cancer | Metastatic Anaplastic Thyroid Cancer | Metastatic Poorly Differentiated Thyroid CancerUnited States
-
Chia Tai Tianqing Pharmaceutical Group Co., Ltd.RecruitingMedullary Thyroid CancerChina
-
National Institute of Diabetes and Digestive and...RecruitingNon-Medullary Thyroid CancerUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)RecruitingAdvanced Thyroid Gland Medullary Carcinoma | Stage III Thyroid Gland Medullary Carcinoma AJCC v8 | Stage IV Thyroid Gland Medullary Carcinoma AJCC v8 | Stage IVA Thyroid Gland Medullary Carcinoma AJCC v8 | Stage IVB Thyroid Gland Medullary Carcinoma AJCC v8 | Stage IVC Thyroid Gland Medullary...United States
Clinical Trials on Ponatinib
-
Associazione Italiana Pazienti Leucemia Mieloide...Not yet recruitingChronic Myeloid Leukemia (CML)Italy
-
Ariad PharmaceuticalsCompletedChronic Myeloid Leukemia (CML) | Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia (Ph+ ALL)Japan
-
Dana-Farber Cancer InstituteCompleted
-
Dana-Farber Cancer InstituteTerminatedNon-Small Cell Lung Cancer, Head and Neck CancerUnited States
-
Memorial Sloan Kettering Cancer CenterCompletedNon Small Cell Lung Cancer | KRAS Gene MutationUnited States
-
Ariad PharmaceuticalsTerminatedChronic Phase Chronic Myeloid LeukemiaBelgium
-
Sebastian BauerHannover Medical School; University Hospital Tuebingen; Universitätsmedizin Mannheim and other collaboratorsUnknownGIST, Malignant | KIT Gene Mutation | KIT Exon 13 MutationGermany
-
Ariad PharmaceuticalsApproved for marketingChronic Myeloid Leukemia (CML) | Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia (Ph+ ALL)United States
-
Versailles HospitalActive, not recruiting
-
Ariad PharmaceuticalsTerminatedChronic Myeloid LeukemiaUnited States, Australia, Austria, Belgium, Canada, Czech Republic, Finland, France, Germany, Hong Kong, Italy, Korea, Republic of, Netherlands, New Zealand, Poland, Portugal, Puerto Rico, Singapore, Slovakia, Spain, Sweden, Switz... and more