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Phase 2 N=137 Treatment

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

Enrolled (actual)
137
Serious AEs
55.5%
Results posted
Jun 2017
Primary outcome: Primary: Recommended Phase 2 Dose (RP2D) of Brigatinib — NA mg

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

OutcomeResultp-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

The purpose of this study is 2-fold: initially, in the dose escalation phase, the goal is to determine the safety profile of orally administered brigatinib, including: the maximum tolerated dose (MTD), dose limiting toxicities (DLTs), recommended phase 2 dose (RP2D), and pharmacokinetic (PK) profile. Then, once the RP2D is established, an expansion phase will assess the preliminary anti-tumor activity of brigatinib, both in non-small cell lung cancer (NSCLC) with ALK gene rearrangement (including participants with active brain metastases) or mutated EGFR, and in other cancers with abnormal targets against which brigatinib is active.

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

View full record on ClinicalTrials.gov →

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.

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