Phase 2
N=40
Study Evaluating the Safety and Efficacy of Eribulin Mesilate in Combination With Irinotecan Hydrochloride in Children With Refractory or Recurrent Solid Tumors
Refractory or Recurrent Solid Tumors · Rhabdomyosarcoma · Non-Rhabdomyosarcoma Soft Tissue Sarcoma · Ewing Sarcoma
Bottom Line
View on ClinicalTrials.gov: NCT03245450 ↗Enrolled (actual)
40
Serious AEs
42.5%
Results posted
Jun 2022
Primary outcome: Primary: Phase 1: Recommended Phase 2 Dose (RP2D) of Eribulin Mesilate in Combination With Irinotecan Hydrochloride — 1.4; 40 mg/m^2
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Eribulin mesilate (Drug); Irinotecan hydrochloride (Drug)
- Age
- Pediatric, Adult · 0+ yrs
- Sex
- All
- Sponsor
- Eisai Inc.
- Primary completion
- May 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Phase 1: Recommended Phase 2 Dose (RP2D) of Eribulin Mesilate in Combination With Irinotecan Hydrochloride |
1.4; 40 | — |
| PRIMARY Phase 2: Objective Response Rate (ORR) |
11.1; 11.1; 11.1 | — |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (TEAEs) |
3; 4; 3; 3; 9; 9 | — |
| SECONDARY Number of Participants With Serious Adverse Event (SAE) |
1; 3; 0; 1; 5; 4 | — |
| SECONDARY Phase 1, Cmax: Maximum Observed Plasma Concentration of Eribulin, Irinotecan and Its Active Metabolite SN-38 |
369.3; 179.4; 348.7; 323.3; 538.8; 399.5 | — |
| SECONDARY Phase 1, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) of Eribulin, Irinotecan and Its Active Metabolite SN-38 |
0.080; 0.135; 0.080; 0.050; 0.250; 0.305 | — |
| SECONDARY Phase 1, T1/2: Half-life of Eribulin, Irinotecan and Its Active Metabolite SN-38 |
27.50; 34.70; 30.00; 25.30; 5.140; 4.430 | — |
| SECONDARY Phase 1, Total Clearance (CL) of Eribulin and Irinotecan |
3.1781; 2.4581; 2.9060; 1.7521; 27.27; 30.30 | — |
| SECONDARY Phase 1, Volume of Distribution (Vz) of Eribulin and Irinotecan |
124.70; 126.96; 130.78; 63.35; 248.5; 195.1 | — |
| SECONDARY Phase 1, AUC(0-t): Area Under the Concentration-time Curve From Zero (Pre-dose) to Time of Last Quantifiable Concentration of Eribulin, Irinotecan and Its Active Metabolite SN-38 |
422.5; 403.7; 616.9; 603.5; 1812.6; 3686.1 | — |
| SECONDARY Phase 1, AUC(0-inf): Area Under the Concentration-time Curve From Zero (Pre-dose) Extrapolated to Infinite Time of Eribulin, Irinotecan and Its Active Metabolite SN-38 |
438.1; 506.0; 666.9; 576.9; 5036.1; 3698.5 | — |
| SECONDARY Phase 2: Progression Free Survival (PFS) |
2.69; 1.35; 6.70 | — |
| SECONDARY Phase 2: Clinical Benefit Rate (CBR) |
55.6; 33.3; 55.6 | — |
| SECONDARY Model Predicted Apparent Total Body Clearance (CL) of Eribulin |
2.89 | — |
| SECONDARY Volume of Distribution Estimates From the Population PK Model for Eribulin |
4.08; 2.03; 106 | — |
Summary
The Phase 1 part of the study is conducted to determine the maximum tolerated dose (MTD) and Recommended Phase 2 Dose (RP2D) of eribulin mesilate in combination with irinotecan hydrochloride in pediatric participants with relapsed/refractory solid tumors (excluding central nervous system [CNS] tumors).
The Phase 2 part of the study is conducted to assess the objective response rate (ORR) and duration of response (DOR) of eribulin mesilate in combination with irinotecan hydrochloride in pediatric participants with relapsed/refractory rhabdomyosarcoma (RMS), non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) and ewing sarcoma (EWS).
Eligibility Criteria
Participants must be
- >=12 months to less than or equal to ( 6 months and =12 months participant in order to maximize safety for infant participants. In Phase 2, participants aged >6 months and =50% Karnofsky (for participants >16 years of age) or Lansky (for participants =50% radiation of pelvis.
- At least 84 days must have elapsed after stem cell infusion prior to study drug administration
- No evidence of active graft-versus-host disease (GVHD) and at least 100 days must have elapsed after allogeneic bone marrow transplant or stem cell infusion prior to study drug administration
- Participants must have adequate bone marrow function, defined as:
- Peripheral absolute neutrophil count (ANC) >=1.0*10^9/liter (L).
- Platelet count >=100*10^9/L (not receiving platelet transfusions within a 7-day period prior to study drug administration).
- Hemoglobin (Hb) at least 8.0 grams per deciliter (g/dL) at baseline (blood transfusions are allowed during the screening period to correct Hb values =50 milliliters/minute/1.73 m^2, based on a 12 or 24 hours (h) urine creatinine collection.
- Participants must have adequate liver function, defined as:
- Bilirubin (sum of conjugated + unconjugated) =2 g/dL.
- All participants and/or their parents or guardians must sign a written informed consent.
- Participants must be willing to comply with all aspects of the protocol.
Exclusion Criteria
- Females who are breastfeeding or pregnant at Screening or Baseline. A separate baseline assessment is required if a negative screening pregnancy test was obtained more than 72 h before the first dose of study drug.
- Females of childbearing potential who:
- Do not agree to use a highly effective method of contraception for the entire study period and for 6 months after study drug discontinuation, that is:
- Total abstinence (if it is their preferred and usual lifestyle)
- An intrauterine device (IUD) or intrauterine system (IUS)
- A contraceptive implant
- An oral contraceptive OR
- Do not have a vasectomized partner with confirmed azoospermia.
- Males who have not had a successful vasectomy (confirmed azoospermia) or they and their female partners do not meet the criteria above (that is, not of childbearing potential or practicing highly effective contraception throughout the study period or for 3 months after study drug discontinuation). No sperm donation is allowed during the study period or for 3 months after study drug discontinuation.
- Concomitant Medications:
- Participants receiving corticosteroids who have not been on a stable dose for at least 7 days prior to study drug administration.
- Participants who are currently receiving other anticancer agents.
- Participants who are receiving cyclosporine, tacrolimus or other agents to prevent GVHD post bone marrow transplant.
- Participants who are receiving strong cytochrome P450 3A4 (CYP3A4) inhibitors and inducers including traditional herbal medicinal products (example, St. John's Wort).
- Phase 1: Received prior therapy with eribulin mesilate within 6 months prior to study drug administration.
- Phase 2: Received prior therapies with eribulin mesilate or irinotecan hydrochloride (for prior irinotecan hydrochloride, participants can be included if there was no tumor progression during irinotecan therapy).
- Any other malignancy that required treatment (except non-melanoma skin cancer, or histologically confirmed complete excision of carcinoma in situ), within 2 years prior to study drug administration.
- Has hypersensitivity to either study drug or any of the excipients.
- Has a known prior history of viral hepatitis (B or C) as demonstrated by positive serology (presence of antigens) or have an uncontrolled infection requiring treatment
- Has >Grade 1 peripheral sensory neuropathy or >Grade 1 peripheral motor neuropathy graded according to the Modified ("Balis") Pediatric Scale of Peripheral Neuropathies.
- Has cardiac pathology, defined as:
- Participants with known congestive heart fa
Data sourced from ClinicalTrials.gov (NCT03245450). 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.