Phase 1
Completed N=87
A Study of MLN8237, a Novel Aurora A Kinase Inhibitor, in Participants With Advanced Solid Tumors
Advanced Malignancies
Source: ClinicalTrials.gov NCT00500903 ↗
Enrolled (actual)
87
Serious AEs
31.0%
Results posted
Mar 2019
Primary outcomePrimary: Number of Participants With Dose-Limiting Toxicity (DLT) — 0; 0; 0; 0 participants
Summary
To determine the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of MLN8237 when given by mouth (PO) for a minimum of 7 and a maximum of 21 consecutive days, followed by a 14-day recovery period.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Dose-Limiting Toxicity (DLT) |
0; 0; 0; 0; 0; 1 | — |
| PRIMARY Maximum Tolerated Dose (MTD) of Alisertib |
50 | — |
| PRIMARY Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) |
65; 2; 20; 26; 0; 1 | — |
| SECONDARY Cmax: Maximum Observed Concentration for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
208.4; 279.1; 759.3; 1245.4; 1661.3; 2717.8 | — |
| SECONDARY Tmax: Time of First Occurrence of Cmax for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
2.000; 2.000; 1.500; 2.000; 2.000; 2.000 | — |
| SECONDARY AUCt: Area Under the Concentration-Time Curve From Time 0 to Time t for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
1682.4; 2525.8; 5772.1; 12045.4; 20958.1; 29460.7 | — |
| SECONDARY Terminal Half-Life (t1/2) for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
24.950; 35.150; 26.400; 18.155; 39.333; 13.427 | — |
| SECONDARY Accumulation Ratio (Rac) for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
1.753; 6.350; 2.037; 1.997; 1.535; 1.677 | — |
| SECONDARY Peak/Trough Ratio for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
4.107; 5.195; 5.430; 3.907; 3.850; 4.922 | — |
| SECONDARY CLss/F: Apparent Oral Clearance at Steady State for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
3.302; 1.817; 3.525; 3.511; 5.545; 4.348 | — |
| SECONDARY Ae: Amount of Alisertib Excreted in Urine Over the Collection Period for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
0.0; 0.0; 0.0; 4806.7; 18815.0; 13813.3 | — |
| SECONDARY CLr: Renal Clearance of Alisertib as Powder-in-Capsule (PIC) With Once Daily for 7 Days (QD7D) Dosing |
0.0012630; 0.0013860; 0.0009414; 0.0006710 | — |
| SECONDARY Cmax: Maximum Observed Concentration for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
778.7; 995.5; 808.9 | — |
| SECONDARY Tmax: Time of First Occurrence of Cmax for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
4.000; 2.000; 2.000 | — |
| SECONDARY AUCt: Area Under the Concentration--Time Curve From Time 0 to Time t for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
8061.6; 8634.0; 8978.0 | — |
| SECONDARY Terminal Half-Life for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
65.67 | — |
| SECONDARY Accumulation Ratio (Rac) for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
1.203; 1.133 | — |
| SECONDARY Peak/Trough Ratio for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
6.877; 5.073 | — |
| SECONDARY CLss/F: Apparent Oral Clearance at Steady State for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
6.030; 5.433 | — |
| SECONDARY Ae: Amount of Alisertib Excreted in Urine Over the Collection Period for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
800.0 | — |
| SECONDARY CLr: Renal Clearance of Alisertib as Powder-in-Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing |
0.0004930 | — |
| SECONDARY Cmax: Maximum Observed Concentration for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
898.2; 1725.9; 2237.0; 1343.3; 1722.0; 2598.3 | — |
| SECONDARY Tmax: Time of First Occurrence of Cmax for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
2.020; 2.285; 2.000; 2.000; 2.000; 2.000 | — |
| SECONDARY AUCt: Area Under the Concentration-time Curve From Time 0 to Time t for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
10058.0; 14686.6; 22114.8; 15131.7; 17168.2; 23197.2 | — |
| SECONDARY Terminal Half-Life (t1/2) for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
31.667; 23.650; 22.378 | — |
| SECONDARY Accumulation Ratio (Rac) for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
1.560; 1.230; 1.440; 1.560; 1.373; 1.335 | — |
| SECONDARY Peak/Trough Ratio for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
4.773; 7.543; 6.392; 3.637; 4.157; 5.570 | — |
| SECONDARY CLss/F: Apparent Oral Clearance at Steady State for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
3.181; 5.612; 5.825; 3.656; 4.984; 5.745 | — |
| SECONDARY Ae: Amount of Alisertib Excreted in Urine Over the Collection Period for Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
3047.7; 5766.7; 9391.4 | — |
| SECONDARY CLr: Renal Clearance of Alisertib as Powder-in-Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing |
0.0008640; 0.0012323; 0.0007865 | — |
| SECONDARY Cmax: Maximum Observed Concentration for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
1581.1; 1867.1; 3376.4; 3080.8 | — |
| SECONDARY Tmax: Time of First Occurrence of Cmax for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
2.000; 2.000; 2.015; 2.000 | — |
| SECONDARY AUCt: Area Under the Concentration-time Curve From Time 0 to Time t for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
11166.3; 13200.4; 32291.5; 27386.1 | — |
| SECONDARY Terminal Half-Life (t1/2) for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
20.215; 18.200 | — |
| SECONDARY Accumulation Ratio (Rac) for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
2.474; 2.543 | — |
| SECONDARY Peak/Trough Ratio for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
2.193; 1.890 | — |
| SECONDARY CLss/F: Apparent Oral Clearance at Steady State for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
2.984; 4.220 | — |
| SECONDARY Ae: Amount of Alisertib Excreted in Urine Over the Collection Period for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
13775.0; 8498.3 | — |
| SECONDARY CLr: Renal Clearance of Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 7 Days (BID7D) Dosing |
0.001; 0.001 | — |
| SECONDARY Cmax: Maximum Observed Concentration for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 14 Days (BID14D) Dosing |
1236.6; 2060.0 | — |
| SECONDARY Tmax: Time of First Occurrence of Cmax for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 14 Days (BID14D) Dosing |
3.00; 1.70 | — |
| SECONDARY AUCt: Area Under the Concentration-time Curve From Time 0 to Time t for Alisertib as Powder-in-Capsule (PIC) With Twice Daily for 14 Days (BID14D) Dosing |
9684.8 | — |
| SECONDARY AUCt: Area Under the Concentration-time Curve From Time 0 to Time t as Assessment of Relative Bioavailability for Alisertib as Enteric-coated Tablet (ECT) Versus PIC at Day 7 |
12700.0; 14190.7 | — |
| SECONDARY Cmax: Maximum Observed Concentration as Assessment of Relative Bioavailability for Alisertib as Enteric-coated Tablet (ECT) Versus PIC at Day 7 |
1666.1; 2027.9 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Mitotic Index With PIC Once Daily for 7 Days (QD7D) Dosing |
0.405; 0.614; 0.263; 0.168; 0.488; 0.261 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Apoptotic Index With PIC Once Daily for 7 Days (QD7D) Dosing |
0.010; -0.090; 0.042; 0.040; 0.121; 0.036 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Mitotic Index With PIC Once Daily for 14 Days (QD14D) Dosing |
0.134; 0.047 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Apoptotic Index With PIC Once Daily for 14 Days (QD14D) Dosing |
0.000; 0.000 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Mitotic Index With PIC Once Daily for 21 Days (QD21D) Dosing |
0.380; 0.405; 0.510; 0.021; 0.082; 0.289 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Apoptotic Index With PIC Once Daily for 21 Days (QD21D) Dosing |
0.122; 0.000; 0.000; 0.042; 0.042; 0.000 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Mitotic Index With PIC Twice Daily for 7 Days (BID7D) Dosing |
0.054; 0.364; 2.578; 1.435; 5.486 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Apoptotic Index With PIC Twice Daily for 7 Days (BID7D) Dosing |
-0.016; 0.020; 0.055; 0.080; 2.142 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Mitotic Index With PIC Twice Daily for 14 Days (BID14D) Dosing |
1.507 | — |
| SECONDARY Change From Baseline in Alisertib Skin Punch Biopsy as Measured by Apoptotic Index With PIC Twice Daily for 14 Days (BID14D) Dosing |
2.837 | — |
| SECONDARY Number of Participants With Polymorphisms in Gene Encoding Enzyme UGT1A1 |
38; 30; 9; 4; 2; 1 | — |
| SECONDARY Best Overall Response Based on Investigator Assessment |
1 | — |
| SECONDARY Duration Of Response (DOR) |
470 | — |
| SECONDARY Effect of Food on the Pharmacokinetics (PK) of Alisertib |
— | — |
Eligibility Criteria
Inclusion Criteria
- Histologically or cytologically confirmed metastatic and/or advanced solid tumors (including lymphomas) for which no effective standard treatment is available
- Aged 18 years or more
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Expected survival longer than 3 months from enrollment in the study
- Radiographically or clinically evaluable tumor; however, measurable disease as defined by (RECIST) criteria is not required for participation in this study
- Suitable venous access for the conduct of blood sampling for MLN8237 PK
- Recovered from the reversible effects of prior antineoplastic therapy (with the exception of alopecia and grade 1 neuropathy) with at least 4 weeks elapsed since the last exposure to cytotoxic chemotherapy or to radiotherapy and at least 6 weeks elapsed since exposure to nitrosoureas or mitomycin C. Participants treated with fully human monoclonal antibodies must not have received treatment with such antibodies for at least 6 weeks, and those treated with chimeric monoclonal antibodies must not have received treatment with such antibodies for at least 4 weeks. Participants treated with noncytotoxic small molecule drugs (eg, tyrosine kinase inhibitors, such as Tarceva®, and hormonal agents, such as Femara®) must not have received treatment with these drugs for at least 2 weeks before the first dose of MLN8237 is given.
- Male participants must use an appropriate method of barrier contraception (eg, condoms) and inform any sexual partners that they must also use a reliable method of contraception (eg, birth control pills) from the time of informed consent until 3 months after the last dose of study treatment.
- Female participants must be postmenopausal, surgically sterilized, or willing to use reliable methods of birth control (eg, a hormonal contraceptive, an intrauterine device, diaphragm with spermicide, or abstinence) and inform male sexual partners that they must also use a reliable method of contraception (eg, condoms) from the time of informed consent until 3 months after the last dose of study treatment.
- Willing and able to give written informed consent before the conduct of any study related procedure that is not part of normal medical care, and willing to comply with the protocol
Exclusion Criteria
- Pregnant or lactating
- Major surgery or serious infection within the 28 days preceding the first dose of study treatment
- Life-threatening illness or uncontrolled medical illness unrelated to cancer
- Ongoing nausea or vomiting of any severity
- > Grade 1 diarrhea
- Known gastrointestinal (GI) disease or GI procedure that could interfere with the oral absorption or tolerance of MLN8237. Examples include but are not limited to partial gastrectomy, history of small intestine surgery, and celiac disease.
- History of uncontrolled sleep apnea syndrome and other conditions that could result in excessive daytime sleepiness, such as severe chronic obstructive pulmonary disease.
- Difficulty swallowing capsules
- Inability to take nothing by mouth except for water and prescribed medications for 2 hours before and 1 hour after each dose of MLN8237
- Received more than 4 previous cytotoxic chemotherapeutic regimens including regimens used as adjuvant or neo-adjuvant therapies. There is no limit on the number of noncytotoxic therapies (eg, hormonal and immunologic) that participants may have received. Tyrosine kinase inhibitors (eg, Tarceva and Iressa®) are considered noncytotoxic compounds.
- Prior treatment with high-dose chemotherapy, defined as chemotherapy requiring the use of peripheral blood or bone marrow stem cell support for hematopoietic reconstitution
- Prior treatment with radiation therapy involving ≥25% of the hematopoietically active bone marrow
- Clinical and/or radiographic evidence of cerebral metastases. However, participants who have a history of central nervous system (CNS) metastasis but who have no radiographic or clinical evidence o
Data sourced from ClinicalTrials.gov (NCT00500903). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.