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Phase 1 Completed N=37 Treatment

Dose-finding Study of GSK2636771 When Administered in Combination With Enzalutamide in Male Subjects With Metastatic Castration-Resistant Prostate Cancer

Neoplasms
Source: ClinicalTrials.gov NCT02215096 ↗
Enrolled (actual)
37
Serious AEs
9.6%
Results posted
Oct 2020
Primary outcomePrimary: Number of Participants With Non-serious Adverse Events (Non-SAEs) and Serious Adverse Events (SAEs) During run-in Period — 11; 1 Participants

Summary

This Phase I, open-label, dose-finding, multicenter study is designed to determine the recommended Phase II dose (RP2D) for the combination of an orally administered Phosphatidylinositol-4,5-bisphosphate 3-kinase beta (PI3K-beta) inhibitor (GSK2636771) with enzalutamide. Subjects with phosphatase and tensin homolog (PTEN)-deficient metastatic castration-resistant prostate cancer (mCRPC) who are receiving a stable dose of enzalutamide with a recently demonstrated progression (either by RECIST [Response Evaluation Criteria In Solid Tumors] version 1.1, prostate-specific antigen [PSA] progression, and/or progression in bone) per the Prostate Cancer Working Group 2 (PCWG2) criteria will be enrolled. Eligible subjects will be enrolled in the Dose-Escalation Phase to determine the maximum tolerated dose (MTD) of the combination therapy using a modified 3+3 dose escalation procedure. The safety, pharmacokinetics (PK) and clinical efficacy will also be assessed to guide the selection of the RP2D. The starting dose will be GSK2636771 300 mg once daily in combination with the recommended dose (160 milligram [mg] once daily) of oral enzalutamide. Once the RP2D has been established, additional subjects will be enrolled in the Dose Expansion Phase to further evaluate the safety, PK and preliminary clinical activity. Safety assessments will be performed throughout the study including physical examinations, vital signs, clinical laboratory tests, 12 lead electrocardiograms and monitoring of adverse events. Blood samples will be collected for pharmacokinetic analysis. Subjects will continue treatment until an unacceptable toxicity, disease progression, withdrawal of consent or death occurs. A post-treatment follow-up visit will be performed within 30 days of the last dose of study treatment. Xtandi is a registered trademark of Astellas Pharma Inc

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants With Non-serious Adverse Events (Non-SAEs) and Serious Adverse Events (SAEs) During run-in Period
11; 1
PRIMARY
Number of Participants With Non-SAEs and SAEs During Combination Treatment Period
11; 11; 12; 2; 2; 2
PRIMARY
Number of Participant With Dose-limiting Toxicities (DLT) During Combination Treatment Period
1; 0; 2; 2
PRIMARY
Percent Change From Baseline in Hematology Parameters During Combination Treatment Period: Basophils, Eosinophils, Hematocrit, Hemoglobin, Lymphocytes, MCH, MCV, Monocytes, Total Neutrophils, Platelet Count, WBC Count
20.000; 0.000; 30.000; 33.330; 0.000; 27.500
PRIMARY
Percent Change From Baseline in Hematology Parameters During Combination Treatment Period: International Normalized Ratio (INR), Prothrombin Time (PT), Partial Thromboplastin Time (PTT)
-9.266; 1.230; 0.287; 11.110; 114.626; -0.677
PRIMARY
Percent Change From Baseline in Chemistry Parameters in Combination Treatment Period:ALT, Albumin, ALP, AST, Calcium, CO2, Chloride, Creatinine, Direct Bilirubin, Glucose, Lactate Dehydrogenase, Magnesium, Potassium, Sodium, Total Bilirubin, Total Protein
19.283; 42.860; 24.745; 26.454; 37.503; 35.715
PRIMARY
Percent Change From Baseline in Chemistry Parameters During Combination Treatment Period: Blood Urea Nitrogen (BUN), Uric Acid
-10.227; 18.180; -5.741; -7.622; 1.848; 236.360
PRIMARY
Percent Change From Baseline in Urine Concentration of Calcium, Creatinine Concentration, Magnesium, Phosphate, Protein During Combination Treatment Period
-65.187; -17.766; -46.473; -54.754; -95.740; 1.833
PRIMARY
Number of Participants With Abnormal Clinically Significant Electrocardiogram (ECG) Findings During Combination Treatment Period
0; 0; 0; 0; 0; 1
PRIMARY
Number of Participants With Worst Case Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) Results by Maximum Grade Increase Post-Baseline Relative to Baseline During Combination Treatment Period
8; 6; 5; 1; 3; 1
PRIMARY
Number of Participants With Worst Case Post-Baseline Results for Heart Rate During Combination Treatment Period
2; 2; 6; 1; 8; 7
PRIMARY
Number of Participants With Worst Case Post-Baseline Results for Body Temperature During Combination Treatment Period
0; 0; 0; 0; 11; 10
PRIMARY
Non-progressive Disease (Non-PD) Rate at Week 12 According to Prostate Cancer Working Group 2 (PCWG2) Criteria in GSK2636771 200mg/Enzalutamide 160mg - Overall Arm
50
SECONDARY
Prostate-specific Antigen Decrease From Baseline >=50% (PSA50) Response Rate at 12 Weeks During Combination Treatment Period
9; 9; 8; 50
SECONDARY
Objective Response Rate (ORR) During Combination Treatment Period
0; 0; 0; 0; 9; 0
SECONDARY
Time to PSA Progression According to PCWG2 Criteria During Combination Treatment Period
19.1; 14.6; 11.4; 11.9
SECONDARY
Time to Radiological Progression According to PCWG2 Criteria During Combination Treatment Period
38.1; 23.1; 21.9; 38.9
SECONDARY
Radiological Progression Free Survival (rPFS) Per PCWG2 Criteria During Combination Treatment Period
38.1; 23.1; 21.9; 38.9
SECONDARY
Plasma Concentration of GSK2636771 in GSK2636771/Enzalutamide Expansion Cohort in Combination Treatment Period
4035.000; 4758.333; 7124.286; 9565.714; 14600.000; 13400.000
SECONDARY
Plasma Concentration of GSK2636771 in GSK2636771/Enzalutamide Escalation Cohorts in Combination Treatment Period
6720.000; 5142.500; 0.000; 8059.250; 5008.333; 292.000
SECONDARY
Plasma Concentration of Enzalutamide in GSK2636771/Enzalutamide Escalation Cohorts in Combination Treatment Period
12.131; 12.134; 14.178; 13.545; 14.771; 14.829
SECONDARY
Plasma Concentration of Enzalutamide in GSK2636771/Enzalutamide Expansion Cohort in Combination Treatment Period
11.735; 14.793; 13.274; 12.886; 13.800; 13.300
SECONDARY
Plasma Concentration of N-desmethyl Enzalutamide in GSK2636771/Enzalutamide Escalation Cohorts in Combination Treatment Period
13.057; 12.583; 13.257; 12.208; 12.736; 11.350
SECONDARY
Plasma Concentration of N-desmethyl Enzalutamide in GSK2636771/Enzalutamide Expansion Cohort in Combination Treatment Period
11.623; 12.476; 12.069; 11.861; 11.850; 11.135

Eligibility Criteria

Inclusion Criteria

  • Signed written informed consent provided
  • Males >=18 years of age (at the time consent is obtained)
  • Histologically or cytologically confirmed diagnosis of prostate adenocarcinoma, surgically castrated or continuous medical castration (for >=8 weeks prior to Screening)
  • Serum testosterone =Grade 2 (per CTCAE v 4.0) toxicity from previous anti-cancer therapy at the time of enrollment, except alopecia or Grade 2 anemia (if hemoglobin is >9.0 g/dL)
  • Any >=Grade 2 hypophosphatemia (per CTCAE v4.0) at the time of enrolment
  • Serum calcium >=Grade 1 (per CTCAE v4.0) at time of enrolment, unless ionized calcium is within normal range
  • Presence of any clinically significant gastrointestinal (GI) abnormality or other condition(s) that may alter absorption such as malabsorption syndrome or major resection of the stomach or substantial portion of the small intestine
  • Active peptic ulcer disease or history of abdominal fistula, GI perforation, or intra abdominal abscess within 28 days prior to enrolment
  • Previous major surgery within 28 days prior to enrolment
  • Known active infection requiring intravenous (IV) or oral anti-infective treatment
  • Presence of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test result at screening or within 3 months prior to first dose of study treatment.
  • A positive pre-study drug/alcohol screening (testing at time of screening is not required).
  • A positive test for human immunodeficiency virus (HIV) antibody (testing at time of screening is not required).
  • Evidence of severe or uncontrolled systemic diseases (e.g., unstable or uncompensated respiratory, hepatic, renal or cardiac disease)
  • History of seizure or any condition that may predispose subject to seizure (e.g., prior cortical stroke or significant brain trauma). History of loss of consciousness or transient ischemic attack within 12 months of randomization
  • History or evidence of cardiovascular risk including any of the following: Clinically significant electrocardiogram abnormalities including second degree (Type II) or third degree atrioventricular block; history of myocardial infarction, acute coronary syndromes (including unstable angina), coronary angioplasty, stenting, or bypass grafting within the past 6 months prior to enrolment, Class III or IV heart failure as defined by the New York Heart Association functional classification system, LVEF below 50%; known cardiac metastases
  • Poorly controlled hypertension (defined as systolic blood pressure of>=150 millimeter of mercury (mmHg) or diastolic blood pressure of >100 mmHg based on a mean of three measurements at approximately 2-minute intervals)
  • History of congenital platelet function defect (e.g., Bernard-Soulier syndrome, Chediak-Higashi syndrome, Glanzmann thrombasthenia, storage pool defect)
  • Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to GSK2636771or enzalutamide or excipients.
  • Any serious and/or unstable pre-existing medical, psychiatric disorder or other conditions that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures.
  • Exposure to more than 4 investigational medicinal products within 12 months prior to the first dose of study treatment
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02215096). 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.

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