Phase 1
N=40
Phase I Study of LDK378 in Pediatric, Malignancies With a Genetic Alteration in Anaplastic Lymphoma Kinase (ALK)
ALK-activated Tumors
Bottom Line
View on ClinicalTrials.gov: NCT01742286 ↗Enrolled (actual)
40
Serious AEs
48.2%
Results posted
Jun 2020
Primary outcome: Primary: Incidence Rate of Dose Limiting Toxicities (DLTs) Occurring During First Cycle of Treatment — 0; 0; 0; 1 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 1
- Interventions
- Ceritinib (Drug)
- Age
- Pediatric · 0+ yrs
- Sex
- All
- Sponsor
- Novartis Pharmaceuticals
- Primary completion
- Apr 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Incidence Rate of Dose Limiting Toxicities (DLTs) Occurring During First Cycle of Treatment |
0; 0; 0; 1; 0; 1 | — |
| SECONDARY Summary of Best Overall Response by Overall Response Rate (ORR) Per Investigator Assessment |
20.0; 70.0; 75.0; 14.3 | — |
| SECONDARY Duration of Response (DoR) Per Investigator Assessment |
15.0; NA; NA; NA | — |
| SECONDARY Progression Free Survival (PFS) Based on Investigator Assessment |
2.4; NA; NA; 1.9 | — |
| SECONDARY Plasma Concentration Time Profiles by Treatment Group in Escalation Phase |
0.0; 0.0; 0.0; 0.0; 0.0; 0.0 | — |
| SECONDARY Plasma Concentration Time Profiles by Treatment Group in Expansion Phase |
0.0; 0.0; 1190; 529; 627; 798 | — |
| SECONDARY Pharmacokinetics (PK) Parameters: AUC0 - 24h & AUClast in Cycle 1 Day 1 - Dose Escalation Phase (Single Dose) |
3920; 5220; 8750; 5720; 7272; 4730 | — |
| SECONDARY Pharmacokinetics (PK) Parameters: AUC0 - 24h & AUClast in Cycle 2 Day 1 - Dose Escalation Phase (Single Dose) |
8160; 16900; 21000; 25300; 2100; 30500 | — |
| SECONDARY Pharmacokinetics (PK) Parameters: AUC0 - 24h & AUClast in Cycle 2 Day 1 - Dose Expansion Phase (Multiple Dose) |
15900; 24100; 16100 | — |
| SECONDARY PK Parameter: Cmax in Cycle 1 Day 1 - Dose Escalation Phase (Single Dose) |
258; 270; 537; 265; 251; 341 | — |
| SECONDARY PK Parameter: Cmax in Cycle 2 Day 1 - Dose Escalation Phase (Single Dose) |
427; 870; 1020; 1300; 300; 674 | — |
| SECONDARY PK Parameter: Cmax in Cycle 2 Day 1 - Dose Expansion Phase (Multiple Dose) |
1220; 890 | — |
| SECONDARY PK Parameter: Tmax in Cycle 1 Day 1 - Dose Escalation Phase (Single Dose) |
4.20; 4.25; 4.30; 6.10; 6.10; 6.00 | — |
| SECONDARY PK Parameter: Tmax in Cycle 2 Day 1 - Dose Escalation Phase (Single Dose) |
6.00; 5.10; 4.00; 3.95; 5.90; 6.00 | — |
| SECONDARY PK Parameter: Tmax in Cycle 2 Day 1 - Dose Expansion Phase (Multiple Dose) |
6.20; 5.90 | — |
| SECONDARY PK Parameter: Racc in Dose Escalation Phase Cycle 2 Day 1 |
1.93; 5.50; 2.56; 6.86; 0.533; 3.41 | — |
Summary
The purpose of this study was to estimate the maximum tolerated dose and/or recommended dose for expansion of LDK378 as a single agent, assess safety, tolerability and anti-tumor activity and characterize single and multiple-dose pharmacokinetics when administered orally to pediatric patients with ALK-activated tumors, with and without food.
Eligibility Criteria
Inclusion Criteria
- Diagnosed with a locally advanced or metastatic malignancy that has progressed despite standard therapy, or for which no effective standard therapy exists
- Age ≥ 12 months and 12 years of age; Lansky score ≥ 50% for patients ≤ 12 years of age.
Exclusion criteria
- Symptomatic central nervous system (CNS) metastases who are neurologically unstable or require increasing doses of steroids or local CNS-directed therapy (such as radiotherapy, surgery or intrathecal chemotherapy) to control their CNS disease
- Inadequate end organ function as defined by specified laboratory values
- Body surface area (BSA) < 0.35 m2
- Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of LDK378 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, or malabsorption syndrome)
- Use of medications that are known to be strong inhibitors or inducers of CYP3A4/5 that cannot be discontinued at least 1 week prior to start of treatment with LDK378 and for the duration of the study
- Use of medications that are mainly metabolized by CYP3A4/5 or CYP2C9 that cannot be discontinued at least 1 week prior to start of treatment with LDK378 and for the duration of the study
- History of interstitial lung disease or interstitial pneumonitis, including clinically significant radiation pneumonitis
- History of pancreatitis or history of increased amylase or lipase that was due to pancreatic disease.
- Medications with a known risk of prolongation of QT interval
Data sourced from ClinicalTrials.gov (NCT01742286). 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.