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Phase 3 N=187 Randomized Double-blind Treatment

Study of AG-120 in Previously Treated Advanced Cholangiocarcinoma With IDH1 Mutations (ClarIDHy)

Advanced Cholangiocarcinoma · Metastatic Cholangiocarcinoma

Enrolled (actual)
187
Serious AEs
30.7%
Results posted
Apr 2022
Primary outcome: Primary: Progression Free Survival (PFS) as Determined by the Independent Radiology Committee (IRC) — 2.7; 1.4 months — p=<0.0001

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
AG-120 (Drug); Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Institut de Recherches Internationales Servier
Primary completion
Jan 2019

Outcome Measures

OutcomeResultp-value
PRIMARY
Progression Free Survival (PFS) as Determined by the Independent Radiology Committee (IRC)
2.7; 1.4 <0.0001 sig
SECONDARY
Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
97.6; 96.6; 95.3; 35.0; 23.7; 27.9
SECONDARY
Percentage of Participants Who Experienced Laboratory Abnormalities Reported as Grade 3 or Higher Adverse Events
7.3; 0.0; 9.3; 2.4; 0.0; 2.3
SECONDARY
Percentage of Participants With Clinically Significant Grade 3 or Higher Vital Signs AEs
0.8; 0.0; 2.3; 0.8; 1.7; 0.0
SECONDARY
Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status
39.7; 31.1; 59.5; 67.2; 0.0; 1.6
SECONDARY
Percentage of Participants Who Required At Least One Concomitant Medications During the Treatment
99.2; 98.3; 95.3
SECONDARY
Percentage of Participants With Abnormal Electrocardiogram (ECG) Changes Reported as Adverse Events
9.8; 3.4; 2.3; 0.8; 0.0; 0.0
SECONDARY
Overall Survival (OS)
10.3; 7.5 0.093
SECONDARY
Objective Response Rate (ORR) as Assessed by the Investigator RECIST Version 1.1
3.2; 1.6 0.466
SECONDARY
ORR as Assessed by the IRC Per RECIST v1.1
2.4; 0 0.299
SECONDARY
Duration of Response (DOR) as Assessed by the Investigator
NA; NA
SECONDARY
DOR as Assessed by the IRC Per RECIST v1.1
NA
SECONDARY
Time to Response (TTR) as Assessed by the Investigator
NA; NA
SECONDARY
TTR as Assessed by the IRC Per RECIST v1.1
NA
SECONDARY
PFS as Determined by Investigator
2.7; 1.4 <0.0001 sig
SECONDARY
Change From Baseline in Health-Related Quality of Life (HRQOL) Based on European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire- Core 30 Subscales Scores
-2.4; -13.3; 2.2; 12.5; 7.9; 4.3
SECONDARY
Change From Baseline in HRQOL Based on: Quality of Life Questionnaire - Cholangiocarcinoma and Gallbladder Cancer Module (QLQ-BIL21)
5.1; 10.1; 4.3; 3.6; 2.3; -2.1
SECONDARY
Percentage of Participants With Change Based on HRQOL: Patient Global Impression of Change (PGI-C)
1.5; 0.0; 4.5; 13.6; 22.4; 9.1
SECONDARY
Percentage of Participants With Severity Based on HRQOL: Patient Global Impression of Severity (PGI-S)
55.2; 31.8; 23.9; 27.3; 16.4; 31.8
SECONDARY
Percentage of Participants With Each EuroQol 5 Dimensions 5 Levels (EQ-5D-5L) Dimension Response
52.0; 41.7; 28.0; 25.0; 16.0; 33.3
SECONDARY
Change From Baseline in EQ-5D-5L Visual Analogue Scale (EQ-5D-5L VAS) Score
4.6; -2.8
SECONDARY
Maximum Observed Plasma Concentration (Cmax) of AG-120
4424.0; 5050.5
SECONDARY
Time to Reach Maximal Plasma Concentration (Tmax) of AG-120
2.63; 2.07
SECONDARY
Area Under the Plasma Concentration-time Curve From Time Zero to 24 Hours (AUC0-24)
91219.4
SECONDARY
Area Under the Plasma Concentration-time Curve From Time Zero to 4 Hours (AUC0-4)
10972.2; 16651.7
SECONDARY
Accumulation Ratio Based on AUC0-4 (Racc AUC0-4)
1.6881
SECONDARY
Accumulation Ratio Based on Cmax (Racc Cmax)
1.2369
SECONDARY
Plasma 2-hydroxyglutarate (2-HG) Levels of AG-120: B (Baseline Effect Value)
1107.70; 795.09
SECONDARY
Plasma 2-hydroxyglutarate (2-HG) Levels of AG-120: AUEC0-4
3334.3; 368.4
SECONDARY
Plasma 2-hydroxyglutarate (2-HG) Levels of AG-120: %BAUEC0-4
20.22090; 74.9750
SECONDARY
Plasma 2-hydroxyglutarate (2-HG) Levels of AG-120: Rtrough
97.66
SECONDARY
Plasma 2-hydroxyglutarate (2-HG) Levels of AG-120: %BRtrough
73.726

Summary

Study AG120-C-005 is a Phase 3, multicenter, randomized, double-blind, placebo-controlled study of orally administered AG-120. Participants, all personnel involved in the evaluation of participants' response to treatment (e.g., Investigators, study coordinators, study pharmacists), and designated Sponsor team members will be blinded to study treatment. Participants are required to have a histologically-confirmed diagnosis of isocitrate dehydrogenase-1 (IDH1) gene-mutated cholangiocarcinoma that is not eligible for curative resection, transplantation, or ablative therapies prior to enrollment. IDH1 mutation testing will be performed at participating investigative sites. Participants must have progression of disease and have received at least 1 but not more than 2 prior treatment regimens for advanced disease (nonresectable or metastatic). All participants must have received either a gemcitabine or a 5 fluorouracil (5-FU) based chemotherapy regimen.

Eligibility Criteria

Inclusion Criteria

  • Be ≥18 years of age.
  • Have a histopathological diagnosis (fresh or banked tumor biopsy sample, preferably collected within the last 3 years) of nonresectable or metastatic cholangiocarcinoma and are not eligible for curative resection, transplantation, or ablative therapies.
  • Have documented IDH1 gene-mutated disease (from a fresh tumor biopsy or the most recent banked tumor tissue available) based on central laboratory testing (R132C/L/G/H/S mutation variants tested).
  • Have an Eastern Cooperative Oncology Group performance status (ECOG PS) score of 0 or 1
  • Have an expected survival of ≥3 months.
  • Have at least one evaluable and measurable lesion as defined by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Participants who have received prior local therapy (including but not limited to embolization, chemoembolization, radiofrequency ablation, or radiation therapy) are eligible provided measurable disease falls outside of the treatment field or within the field and has shown ≥20% growth in size since post-treatment assessment.
  • Have documented disease progression following at least 1 and no more than 2 prior systemic regimens for advanced disease (nonresectable or metastatic). Participants must have received at least 1 gemcitabine- or 5-FU-containing regimen for advanced cholangiocarcinoma. Participants who have received systemic adjuvant chemotherapy will be permitted provided there is documented disease progression during or within 6 months of completing the therapy.

Exclusion criteria

  • Received a prior IDH inhibitor.
  • Received systemic anticancer therapy or an investigational agent <2 weeks prior to Day 1 (washout from prior immune based anticancer therapy is 4 weeks). In addition, the first dose of study treatment should not occur before a period ≥5 half-lives of the investigational agent has elapsed.
  • Received radiotherapy to metastatic sites of disease <2 weeks prior to Day 1.
  • Underwent hepatic radiation, chemoembolization, and radiofrequency ablation <4 weeks prior to Day 1.
  • Have known symptomatic brain metastases requiring steroids. Participants with previously diagnosed brain metastases are eligible if they have completed their treatment and have recovered from the acute effects of radiation therapy or surgery prior to study entry, have discontinued corticosteroid treatment for these metastases for at least 4 weeks and have radiographically stable disease for at least 3 months prior to study entry. Note: up to 10 mg per day of prednisone equivalent will be allowed.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02989857). 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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