A Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Preliminary Anti-Tumor Activity of the Oral Anaplastic Lymphoma Kinase (ALK)/Epidermal Growth Factor Receptor (EGFR) Inhibitor Brigatinib (AP26113)
Lymphoma, Large-Cell, Anaplastic · Carcinoma, Non-Small-Cell Lung
Bottom Line
View on ClinicalTrials.gov: NCT01449461 ↗Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Brigatinib (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Ariad Pharmaceuticals
- Primary completion
- Nov 2015
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Recommended Phase 2 Dose (RP2D) of Brigatinib |
NA | — |
| PRIMARY Objective Response Rate (ORR) |
0; 53.8; 60.0; 76.0; 65.2; 25.0 | — |
| SECONDARY Number of Participants Who Had at Least One Treatment-Emergent Adverse Event (TEAE) |
6; 18; 18; 32; 48; 15 | — |
| SECONDARY Maximum Tolerated Dose (MTD) Assessed in Dose Escalation Phase of the Study |
NA | — |
| SECONDARY Number of Participants With Dose Limiting Toxicities (DLTs) Assessed in Dose Escalation Phase of the Study |
0; 0; 0; 0; 0; 1 | — |
| SECONDARY Cmax: Maximum Observed Plasma Concentration for Brigatinib at Cycle 1 Day 1 |
125.6; 406.3; 493; 793.7; 1185; 1515 | — |
| SECONDARY Cmax: Maximum Observed Plasma Concentration for Brigatinib at Cycle 2 Day 1 |
249.50; 491.67; 634.07; 942.30; 1694.3; 2280.0 | — |
| SECONDARY Tmax: Time to Reach the Maximum Observed Plasma Concentration (Cmax) for Brigatinib at Cycle 1 Day 1 |
3.9; 1.0; 2.0; 2.0; 2.0; 2.0 | — |
| SECONDARY Tmax: Time to Reach the Maximum Observed Plasma Concentration (Cmax) for Brigatinib at Cycle 2 Day 1 |
2.49; 1.00; 2.00; 3.00; 2.10; 2.00 | — |
| SECONDARY AUC(0-24): Area Under the Plasma Concentration-Time Curve From Time 0 to 24 Hours Post-dose for Brigatinib at Cycle 1 Day 1 |
1320.9; 3900; 5710.1; 9895.5; 13204; 16800 | — |
| SECONDARY AUC(0-24): Area Under the Plasma Concentration-Time Curve From Time 0 to 24 Hours Post-dose for Brigatinib at Cycle 2 Day 1 |
2689.0; 5069.0; 9142.1; 13888; 23478; 30117 | — |
| SECONDARY T1/2: Terminal Phase Elimination Half-life for Brigatinib at Cycle 2 Day 1 |
31.55; 30.93; 28.69; 25.52; 24.90; 21.77 | — |
| SECONDARY Best Overall Response |
0.0; 0.0; 0.0; 12.0; 8.7; 0.0 | — |
| SECONDARY Duration of Response |
11.1; 4.0; 14.8; 20.4; 29.7; 30.4 | — |
| SECONDARY Progression Free Survival (PFS) |
1.8; 12.6; 5.4; 11.0; 5.4; 5.4 | — |
| SECONDARY Overall Survival (OS) |
5.3; 11.6; 7.3; 17.9; 7.3; 8.3 | — |
| SECONDARY Intracranial Objective Response Rate |
100; 80; 42.9; 100; 16.7; 100 | — |
| SECONDARY Duration of Intracranial Response |
12.9; 5.0; 11.4; 29.2; 11.3 | — |
| SECONDARY Intracranial Progression Free Survival (PFS) |
36.8; 6.7; NA; 14.4; 7.3 | — |
Summary
Eligibility Criteria
Inclusion Criteria
General Eligibility Criteria
- All participants must have tumor tissue available for analysis. If sufficient tissue is not available, participants must undergo a biopsy to obtain adequate samples. For participants in expansion cohorts 2, 3 and 5, for whom failure of prior therapy is specified (crizotinib for cohorts 2 and 5, one epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) for cohort 3), tumor tissue must be available following failure of the prior therapy.
- Must have measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST).
- Male or female participants ≥ 18 years old.
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
- Minimum life expectancy of 3 months or more.
- Adequate renal and hepatic function.
- Adequate bone marrow function.
- Normal QT interval on screening electrocardiogram (ECG) evaluation.
- For females of childbearing potential, a negative pregnancy test must be documented prior to enrollment.
- Female participants who are of childbearing potential and fertile male participants must agree to use an effective form of contraception with their sexual partners throughout study participation.
- Signed and dated informed consent indicating that the participant has been informed of all pertinent aspects of the study.
- Willingness and ability to comply with scheduled visits and study procedures.
Cohort-specific Eligibility Criteria
PART 1: Dose Escalation Phase:
- Histologically confirmed advanced malignancies. All histologies except leukemia;
- Refractory to available therapies or for whom no standard or available curative treatments exist;
- Tumor tissue available for analysis.
PART 2: Expansion cohorts (5 additional cohorts):
- Expansion cohort 1: Non-small cell lung cancer (NSCLC) participants whose tumors exhibit anaplastic lymphoma kinase (ALK) rearrangements and who have not been treated with previous ALK inhibitors.
i. Histologically or cytologically confirmed NSCLC; ii. Tumor tissue available for analysis (see General Eligibility Criterion 1; iii. History of ALK rearrangement by fluorescence in situ hybridization (FISH); iv. No prior ALK inhibitor therapy; 2. Expansion cohort 2: NSCLC participants whose tumors exhibit ALK rearrangements and who are resistant to crizotinib: i. Histologically or cytologically confirmed NSCLC; ii. Tumor tissue available for analysis (see General Eligibility Criterion 1); iii. History of ALK rearrangement by FISH; iv. Resistant to crizotinib (and have not received any other prior ALK inhibitor therapy); 3. Expansion cohort 3: NSCLC participants whose tumors exhibit an epidermal growth factor receptor EGFR-T790M mutation and who are resistant to 1 prior EGFR TKI: i. Histologically or cytologically confirmed NSCLC ii. Previous treatment with only 1 EGFR TKI for which the last administration was within 30 days of the initiation of brigatinib; iii. Documented evidence of an EGFR-T790M mutation following disease progression on the most recent EGFR TKI therapy; iv. No intervening systemic therapy between cessation of the EGFR TKI and initiating brigatinib; v. Tumor tissue available for analysis (see General Eligibility Criterion 1). 4. Expansion cohort 4: Participants with any cancers with abnormalities in ALK or other brigatinib targets. Examples include, but are not limited to, anaplastic large cell lymphoma (ALCL), diffuse large-cell lymphoma (DLCL), inflammatory myofibroblastic tumors (IMT), and other cancers with ALK abnormalities, or tumors with ROS1 fusions: i. Histologically confirmed lymphomas and other cancers, with the exception of leukemias; ii. Tumor tissue available for analysis (see General Eligibility Criterion 1). 5. Expansion Cohort 5: NSCLC participants whose tumors exhibit ALK rearrangements and who have active, measurable brain metastases: i. Histologically or cytologically confirmed NSCLC: ii. Tumor tissue available for analysis (see General Eligibility
Data sourced from ClinicalTrials.gov (NCT01449461). 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.