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LBH589 Oral in Combination With Carboplatin and Paclitaxel in Advanced Solid Tumors

12 september 2011 bijgewerkt door: Southern Europe New Drug Organization

A Phase IB Study of the Histone Deacetylase Inhibitor Panobinostat (LBH589) Given Orally in Combination With Carboplatin and Paclitaxel in Patients With Advanced Solid Tumors

The purpose of this study is to determine the Maximum Tolerated Dose (MTD) of Panobinostat (LBH589) when administered in combination with Carboplatin and Paclitaxel in patients with advanced solid malignancies and to identify the Recommended Dose (RD) for a subsequent Phase II study.

Studie Overzicht

Gedetailleerde beschrijving

The combination of Carboplatin (C) and Paclitaxel (PTX) is considered standard treatment in patients with epithelial ovarian cancer and endometrial cancer, in USA and in those in whom anthracyclines are not recommended. In cervical cancer, where very often the renal function is impaired, C represents a convenient substitute of cisplatin in the combination with PTX; in NSCLC the C and PTX regimen is first choice therapy for outpatient treatment first or second line.

LBH is a histone deacetylase (HDAC) inhibitor available also for oral administration.

In combination with platinum agents LBH589 could improve efficacy on DNA by multiple non-exclusive mechanisms (by increasing drug access to chromosomal DNA, interfering with DNA repair, modulating the levels of pro antiapoptotic genes or proliferation/survival genes).

The inclusion of Paclitaxel in the combination of LBH589 and Carboplatin is supported by the results already available with the combination of the HDAC inhibitor Vorinostat (suberoylanilide hydroxamic acid) given orally with carboplatin (AUC 6 mg/ml.h) and paclitaxel (200 mg/m2) in a Phase I study in patients with solid tumors. The regimen proved to be feasible, well tolerated and was associated with promising antitumor activity in patients with NSCLC.

The mechanism of action, and the preliminary preclinical data, suggest that the combination of LBH589, Carboplatin and Paclitaxel could be feasible and worthy of clinical investigation.

Studietype

Ingrijpend

Inschrijving (Verwacht)

36

Fase

  • Fase 1

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Basel, Zwitserland, 4031
        • Huniversitätsspitals Basel
      • Bellinzona, Zwitserland, 6500
        • Istituto Oncologico della Svizzera Italiana
      • Lausanne, Zwitserland, 1011
        • Mèdecin Adjoint, ME - CePO, CHUV

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 75 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  1. Histological/cytological diagnosis of solid tumors in which treatment with Carboplatin and Paclitaxel is indicated, e.g. NSCLC, GY tumors, prostate cancer, unknown primary
  2. Progressive disease (also in terms of tumor markers only, like CA 125 for ovary and PSA for prostate).
  3. Age 18-75 years
  4. Prior chemotherapy of ≤ 1 line for advanced disease
  5. ECOG Performance Status < 2
  6. Life expectancy of at least 3 months
  7. The patient must be able to read, understand and provide written evidence of informed consent
  8. Female patients may not be pregnant or lactating and must be willing to practice contraception. The effects of LBH589 on the developing human fetus are unknown. For this reason, women of childbearing potential must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for the duration of study participation.
  9. Male patients that are not surgically sterile must be practicing a medically acceptable contraceptive regimen while on study treatment
  10. Adequate organ function as defined by the following:

    • ANC > 1500/µL
    • Platelets ≥ 100,000/µL
    • Haemoglobin ≥ 10 g/dl
    • Serum creatinine ≤ 1.5 x ULN or 24-hour creatinine clearance ≥ 60 ml/min
    • Magnesium, potassium and phosphorus ≥ the lower limit of normal or correctable with supplements
    • Aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) ≤ 2.5 x ULN or ≤ 5.0 x ULN if hepatic involvement is present
    • Serum bilirubin ≤ 1.5 x ULN
    • Alkaline phosphatase (ALP) ≤ 2.5 x ULN or ALP > 2.5 x UNL with liver fraction ≤ 2.5 x ULN

Exclusion Criteria:

  1. Other chemotherapy treatment < 4 weeks prior to enrolment
  2. Hypersensitivity or allergic reactions to platinum compounds or Carboplatin®; hypersensitivity or allergic reactions to Paclitaxel
  3. Radiotherapy involving > 30% of the active bone marrow
  4. Radiotherapy < 4 weeks prior to enrolment
  5. Pre-existing peripheral neuropathy ≥ grade 2
  6. Pre-existing CTCAE hearing loss or tinnitus ≥ grade 2
  7. Symptomatic pleural effusion
  8. Clinically significant third space fluid accumulation (e.g. ascites,..)
  9. Symptomatic brain metastasis or meningeal tumors
  10. Patients who have not recovered (> grade 1) from the following toxicities of previous regimens before enrolment: fatigue, mucositis, nausea/vomiting, diarrhea
  11. Concurrent enrolment, or previous enrolment within 30 days prior to registration in another investigational device or drug trial(s) or is receiving other investigational agent(s)
  12. Human immunodeficiency virus (HIV) infection
  13. History of bone marrow or major organ transplant
  14. Prior high dose treatment with PBSC support
  15. Impaired cardiac function, including any one of the followings:

    • Complete Left Bundle Branch Block or obligate use of a cardiac pacemaker or congenital long QT syndrome or history or presence of atrial or ventricular tachyarrhythmias or clinically significant resting bradycardia (< 50 beats per minute) or QTcF > 480 msec on screening ECG or Right Bundle Branch block + left anterior hemiblock (bifascicular block)
    • Angina pectoris or acute MI ≤ 3 months prior to starting study drug
    • Other clinically significant heart disease (e.g. congestive heart failure, uncontrolled hypertension, history of labile hypertension, or history of poor compliance with an antihypertensive regimen)
  16. Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral LBH589 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, malabsorption syndrome, or small bowel resection)
  17. Acute or chronic liver or renal disease
  18. Other concurrent severe and/or uncontrolled medical conditions (e.g., uncontrolled diabetes, active or uncontrolled infection, chronic obstructive or chronic restrictive pulmonary disease) that could cause unacceptable safety risks or compromise compliance with the protocol
  19. Concomitant use of CYP3A4/5 inhibitors or inducers where the treatment can not be discontinued or switched to a different medication prior to starting study drug (medications listed in Appendix 3). The medications listed in Appendix 3 have a relative risk of prolonging the QT interval or inducing Torsades de Pointes, but do not represent an exclusion criteria
  20. Treatment with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GMCSF) ≤ 2 weeks prior to starting study drug.
  21. Treatment with therapeutic doses of sodium warfarin (Coumarin ). Low doses of Coumarin (e.g., ≤ 2 mg/day) for line patency is allowable
  22. Patients who have received biologic therapy (excluding antiangiogenics) or immunotherapy ≤ 2 weeks prior to starting study treatment or who have not recovered from side effects of such therapy
  23. Patients who have undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  24. Unable or unwilling to comply with all study procedures
  25. Current history of alcohol or drug abuse

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Panobinostat (LBH589), Carboplatin and Paclitaxel
  1. Panobinostat (LBH589) p.o. on days 1,4,8 and 11 of each cycle (20mg-45mg).Carboplatin i.v.on day 1 at a total dose corresponding to a AUC of 5 µg/ml.h. Paclitaxel as 3 hour infusion on day 1 (135 mg/m2).
  2. Panobinostat (LBH589) p.o. on days 1, 4, 15 and 18 of each cycle (20mg-30mg).Carboplatin i.v. on day 8 at a total dose corresponding to a AUC of 5 µg/ml.h.Paclitaxel as a 3 hour infusion on day 8 (135mg/m2-175mg/m2).
  3. Once the MTD is achieved:Panobinostat (LBH589) p.o. on days 1 and 4 of each cycle(20mg-30 mg). Carboplatin i.v. on day 8 at a total dose corresponding to a AUC of 5 µg/ml.h.Paclitaxel as a 3 hour infusion on day 8 (135mg/m2-175 mg/m2).

The treatment will be repeated every three weeks until disease progression.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Maximum Tolerated Dose (MTD) Recommended Dose (RD)
Tijdsspanne: 3 weeks after the first drug administration (1 Cycle)
Number of Dose-Limiting Tocixities (DLTs)
3 weeks after the first drug administration (1 Cycle)

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Hints of antitumor activity
Tijdsspanne: from first drug administration until tumor progression (every 6 weeks)
objective tumor responses based on RECIST criteria
from first drug administration until tumor progression (every 6 weeks)
Biomarkers of HDAC
Tijdsspanne: Cycle 1 on day 1, 4, 8, 15 and Cycle 2 on day 1, 8.
acetylation of histones, H3, H4 and tubulin in PBMC
Cycle 1 on day 1, 4, 8, 15 and Cycle 2 on day 1, 8.
Safety and tolerability
Tijdsspanne: 4 weeks after last drug administration
AE types and frequency monitored by laboratory and instrumental assessments, and physical examination
4 weeks after last drug administration

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 juni 2008

Primaire voltooiing (Verwacht)

1 december 2011

Studie voltooiing (Verwacht)

1 maart 2012

Studieregistratiedata

Eerst ingediend

8 juli 2010

Eerst ingediend dat voldeed aan de QC-criteria

8 juli 2010

Eerst geplaatst (Schatting)

9 juli 2010

Updates van studierecords

Laatste update geplaatst (Schatting)

13 september 2011

Laatste update ingediend die voldeed aan QC-criteria

12 september 2011

Laatst geverifieerd

1 september 2011

Meer informatie

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Klinische onderzoeken op Geavanceerde solide tumoren

Klinische onderzoeken op Panobinostat (LBH589), Carboplatin and Paclitaxel

3
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