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Phase 1 N=56 Treatment

Pharmacokinetic Drug-drug Interaction Study of Encorafenib and Binimetinib on Probe Drugs in Patients With BRAF V600-mutant Melanoma or Other Advanced Solid Tumors

Advanced Solid Tumors · Metastatic Melanoma

Enrolled (actual)
56
Serious AEs
19.8%
Results posted
Sep 2024
Primary outcome: Primary: Maximum Concentration (Cmax) of Plasma Midazolam on Day -7, Day 1, and Day 14 — 9.45; 11.1; 2.44 nanograms per milliliter (ng/mL)

Study Design & Population

Study type
Interventional
Phase
Phase 1
Interventions
losartan (Drug); dextromethorphan (Drug); caffeine (Drug); omeprazole (Drug); midazolam (Drug); rosuvastatin (Drug); bupropion immediate release (IR) (Drug); encorafenib (Drug); binimetinib (Drug); modafinil (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Pfizer
Primary completion
Jul 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Maximum Concentration (Cmax) of Plasma Midazolam on Day -7, Day 1, and Day 14
9.45; 11.1; 2.44
PRIMARY
Cmax of Plasma Total 1-OH Midazolam on Day -7, Day 1, and Day 14
45.2; 50.5; 56.7
PRIMARY
Cmax of Plasma Free 1-OH Midazolam on Day -7, Day 1, and Day 14
3.36; 4.52; 2.09
PRIMARY
Cmax of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1, and Day 14
41.5; 45.4; 54.1
PRIMARY
Cmax of Plasma Absolute Caffeine on Day -7, Day 1, and Day 14
1150; 1210; 1300
PRIMARY
Cmax of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1, and Day 14
984; 1070; 1110
PRIMARY
Cmax of Plasma Paraxanthine on Day -7, Day 1, and Day 14
357; 319; 247
PRIMARY
Cmax of Plasma Omeprazole on Day -7, Day 1, and Day 14
267; 354; 271
PRIMARY
Cmax of Plasma 5-OH Omeprazole on Day -7, Day 1, and Day 14
91.8; 90.4; 64.4
PRIMARY
Cmax of Plasma Rosuvastatin on Day -7, Day 1 and Day 14
6.98; 30.3; 18.7
PRIMARY
Cmax of Plasma Bupropion on Day -7, Day 1 and Day 14
94.0; 70.9; 71.0
PRIMARY
Cmax of Plasma Hydroxybupropion on Day -7, Day 1 and Day 14
181; 189; 256
PRIMARY
Area Under the Concentration-Time Profile From Time 0 to The Time of The Last Quantifiable Concentration (AUClast) of Plasma Midazolam on Day -7, Day 1, and Day 14
25.7; 27.6; 4.52
PRIMARY
AUClast of Plasma Total 1-OH Midazolam on Day -7, Day 1, and Day 14
135; 173; 142
PRIMARY
AUClast of Plasma Free 1-OH Midazolam on Day -7, Day 1, and Day 14
8.87; 11.1; 4.55
PRIMARY
AUClast of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1, and Day 14
125; 160; 133
PRIMARY
AUClast of Plasma Absolute Caffeine on Day -7, Day 1, and Day 14
5940; 6480; 7520
PRIMARY
AUClast of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1, and Day 14
5100; 5700; 6430
PRIMARY
AUClast of Plasma Paraxanthine on Day -7, Day 1, and Day 14
2160; 1940; 1470
PRIMARY
AUClast of Plasma Omeprazole on Day -7, Day 1, and Day 14
815; 1020; 674
PRIMARY
AUClast of Plasma 5-OH Omeprazole in Arm 1 on Day -7, Day 1 and Day 14
313; 302; 195
PRIMARY
AUClast of Plasma Rosuvastatin on Day -7, Day 1 and Day 14
33.6; 93.8; 52.8
PRIMARY
AUClast of Plasma Bupropion on Day -7, Day 1 and Day 14
339; 261; 250
PRIMARY
AUClast of Plasma Hydroxybupropion on Day -7, Day 1 and Day 14
1090; 1080; 1610
PRIMARY
The Amount Eliminated Via Urine Over an 8-Hour Period (Ae0-8) of Losartan on Day -7, Day 1 and Day 14
0.239; 0.349; 0.286
PRIMARY
Ae0-8 of E-3174 on Day -7, Day 1 and Day 14
0.227; 0.332; 0.205
PRIMARY
Ae0-8 of Dextromethorphan on Day -7, Day 1 and Day 14
0.0264; 0.0323; 0.0225
PRIMARY
Ae0-8 of Dextrorphan on Day -7, Day 1 and Day 14
3.78; 4.41; 3.55
PRIMARY
Cmax of Plasma Encorafenib on Day 14 and Day 21 in Arm 3
3540; 2830
PRIMARY
Cmax of Plasma LHY746 on Day 14 and Day 21 in Arm 3
2460; 2510
PRIMARY
AUClast of Plasma Encorafenib on Day 14 and Day 21 in Arm 3
11900; 9100
PRIMARY
AUClast of Plasma LHY746 on Day 14 and Day 21 in Arm 3
31100; 33100
SECONDARY
Ratio of AUClast Values of the Metabolite Compared to Parent (MRAUClast) for 1-OH Midazolam/Midazolam on Day -7, Day 1 and Day 14
5.00; 5.97; 30.1
SECONDARY
Ratio of AUC From Time Zero Extrapolated to Infinity (AUCinf) Values of the Metabolite Compared to Parent (MRAUCinf) for 1-OH Midazolam/Midazolam on Day -7, Day 1 and Day 14
4.31; 5.21; 29.5
SECONDARY
MRAUClast for Paraxanthine/Caffeine on Day -7, Day 1 and Day 14
0.392; 0.324; 0.211
SECONDARY
MRAUClast for 5-OH Omeprazole/Omeprazole on Day -7, Day 1 and Day 14
0.309; 0.282; 0.277
SECONDARY
MRAUCinf for 5-OH Omeprazole/Omeprazole on Day -7, Day 1 and Day 14
0.312; 0.960; 0.312
SECONDARY
MRAUClast for Hydroxybupropion/Bupropion on Day -7, Day 1 and Day 14
3.01; 3.88; 6.04
SECONDARY
MRAUClast for LHY746/Encorafenib in Arm 3 on Day 14 and Day 21
3.31; 4.62
SECONDARY
Ratio of Cmax Values of the Metabolite Compared to Parent (MRCmax) for 1-OH Midazolam/Midazolam on Day -7, Day 1 and Day 14
4.56; 4.36; 22.2
SECONDARY
MRCmax for Paraxanthine/Caffeine on Day -7, Day 1 and Day 14
0.335; 0.285; 0.205
SECONDARY
MRCmax for 5-OH Omeprazole/Omeprazole on Day -7, Day 1 and Day 14
0.273; 0.244; 0.227
SECONDARY
MRCmax for Hydroxybupropion/Bupropion on Day -7, Day 1 and Day 14
1.80; 2.51; 3.38
SECONDARY
MRCmax for LHY746/Encorafenib in Arm 3 on Day 14 and Day 21
0.883; 1.13
SECONDARY
Ratio of Ae0-8 Values of the Metabolite Compared to Parent (MRAe0-8) for E-3174/Losartan on Day -7, Day 1 and Day 14
0.920; 0.921; 0.693
SECONDARY
MRAe0-8 for Dextrorphan/Dextromethorphan on Day -7, Day 1 and Day 14
151; 144; 167
SECONDARY
Time to Reach Cmax (Tmax) of Plasma Midazolam on Day -7, Day 1 and Day 14
1.00; 0.88; 0.88
SECONDARY
Tmax of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14
1.00; 0.90; 0.88
SECONDARY
Tmax of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14
1.00; 0.90; 0.92
SECONDARY
Tmax of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14
1.00; 0.90; 0.88
SECONDARY
Tmax of Plasma Absolute Caffeine on Day -7, Day 1 and Day 14
1.00; 0.93; 0.90
SECONDARY
Tmax of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1 and Day 14
1.00; 0.94; 0.98
SECONDARY
Tmax of Plasma Paraxanthine on Day -7, Day 1 and Day 14
7.18; 7.63; 6.00
SECONDARY
Tmax of Plasma Omeprazole on Day -7, Day 1 and Day 14
2.20; 3.00; 3.00
SECONDARY
Tmax of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14
2.97; 3.80; 3.00
SECONDARY
Tmax of Plasma Rosuvastatin on Day -7, Day 1 and Day 14
2.40; 1.85; 1.40
SECONDARY
Tmax of Plasma Bupropion on Day -7, Day 1 and Day 14
1.87; 1.93; 1.92
SECONDARY
Tmax of Plasma Hydroxybupropion on Day -7, Day 1 and Day 14
4.00; 7.68; 3.94
SECONDARY
AUCinf of Plasma Midazolam on Day -7, Day 1 and Day 14
27.1; 27.1; 5.10
SECONDARY
AUCinf of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14
150; 172; 154
SECONDARY
AUCinf of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14
9.98; 13.1; 5.52
SECONDARY
AUCinf of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14
139; 167; 143
SECONDARY
AUCinf of Plasma Omeprazole on Day -7, Day 1 and Day 14
1630; 1170; 904
SECONDARY
AUCinf of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14
557; 880; 294
SECONDARY
AUCinf of Plasma Rosuvastatin on Day -7, Day 1 and Day 14
75.4; 139; 62.9
SECONDARY
AUCinf of Plasma Bupropion on Day -7, Day 1 and Day 14
398; 390; 298
SECONDARY
Percent of AUC Extrapolated (AUC%Extrap) of Plasma Midazolam on Day -7, Day 1 and Day 14
19.1; 19.3; 8.76
SECONDARY
AUC%Extrap of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14
15.2; 21.9; 12.6
SECONDARY
AUC%Extrap of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14
14.1; 12.9; 12.8
SECONDARY
AUC%Extrap of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14
15.3; 22.6; 14.1
SECONDARY
AUC%Extrap of Plasma Absolute Caffeine on Day -7, Day 1 and Day 14
48.3; 53.2; 61.0
SECONDARY
AUC%Extrap of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1 and Day 14
46.7; 54.8; 58.0
SECONDARY
AUC%Extrap of Plasma Omeprazole on Day -7, Day 1 and Day 14
7.35; 11.9; 4.22
SECONDARY
AUC%Extrap of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14
12.4; 26.1; 8.07
SECONDARY
Apparent Terminal Elimination Rate Constant (Kel) of Plasma Midazolam on Day -7, Day 1 and Day 14
0.196; 0.188; 0.347
SECONDARY
Kel of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14
0.248; 0.199; 0.259
SECONDARY
Kel of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14
0.231; 0.236; 0.269
SECONDARY
Kel of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14
0.241; 0.197; 0.277
SECONDARY
Kel of Plasma Absolute Caffeine on Day -7, Day 1 and Day 14
0.0870; 0.0753; 0.0575
SECONDARY
Kel of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1 and Day 14
0.0893; 0.0739; 0.0656
SECONDARY
Kel of Plasma Omeprazole on Day -7, Day 1 and Day 14
0.401; 0.296; 0.461
SECONDARY
Kel of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14
0.303; 0.197; 0.386
SECONDARY
Terminal Elimination Half-Life (T1/2) of Plasma Midazolam on Day -7, Day 1 and Day 14
3.54; 3.69; 2.00
SECONDARY
T1/2 of Plasma Total 1-OH Midazolam on Day -7, Day 1 and Day 14
2.80; 3.48; 2.68
SECONDARY
T1/2 of Plasma Free 1-OH Midazolam on Day -7, Day 1 and Day 14
3.00; 2.93; 2.58
SECONDARY
T1/2 of Plasma Glucuronide Conjugated 1-Hydroxymidazolam on Day -7, Day 1 and Day 14
2.87; 3.53; 2.50
SECONDARY
T1/2 of Plasma Absolute Caffeine on Day -7, Day 1 and Day 14
7.97; 9.20; 12.1
SECONDARY
T1/2 of Plasma Baseline-Adjusted Caffeine on Day -7, Day 1 and Day 14
7.76; 9.38; 10.6
SECONDARY
T1/2 of Plasma Omeprazole on Day -7, Day 1 and Day 14
1.73; 2.34; 1.50
SECONDARY
T1/2 of Plasma 5-OH Omeprazole on Day -7, Day 1 and Day 14
2.29; 3.53; 1.80
SECONDARY
T1/2 of Plasma Rosuvastatin on Day -7, Day 1 and Day 14
3.25; 2.13; 1.86
SECONDARY
T1/2 of Plasma Bupropion on Day -7, Day 1 and Day 14
2.81; 3.24; 2.75
SECONDARY
Apparent Clearance (CL/F) of Plasma Midazolam on Day -7, Day 1 and Day 14
73.9; 73.9; 392
SECONDARY
CL/F of Plasma Omeprazole on Day -7, Day 1 and Day 14
12.3; 17.0; 22.1
SECONDARY
Apparent Total Volume of Distribution Following Oral Administration (Vz/F) of Plasma Midazolam on Day -7, Day 1 and Day 14
306; 339; 1030
SECONDARY
Vz/F of Plasma Omeprazole on Day -7, Day 1 and Day 14
29.1; 44.6; 45.9
SECONDARY
Percentage of Dose Recovered in Urine (Fe) for Losartan on Day -7, Day 1 and Day 14
0.478; 0.699; 0.572
SECONDARY
Fe for E-3174 on Day -7, Day 1 and Day 14
0.440; 0.644; 0.396
SECONDARY
Fe for Dextromethorphan on Day -7, Day 1 and Day 14
0.0881; 0.108; 0.0750
SECONDARY
Fe for Dextrorphan on Day -7, Day 1 and Day 14
13.3; 15.6; 12.5
SECONDARY
Cmax of Encorafenib on Day 1 and Day 14
6150; 6060; 3240; 2940
SECONDARY
Cmax of LHY746 on Day 1 and Day 14
943; 953; 2490; 2340
SECONDARY
Cmax of Binimetinib on Day 1 and Day 14
661; 549; 521; 566
SECONDARY
Cmax of AR00426032 on Day 1 and Day 14
57.0; 63.3; 23.3; 27.4
SECONDARY
AUClast of Encorafenib on Day 1 and Day 14
24500; 25900; 12700; 13100
SECONDARY
AUClast of LHY746 on Day 1 and Day 14
5130; 4990; 34000; 32800
SECONDARY
AUClast of Binimetinib on Day 1 and Day 14
2290; 2040; 2190; 2210
SECONDARY
AUClast of AR00426032 on Day 1 and Day 14
236; 256; 108; 122
SECONDARY
Tmax of Encorafenib on Day 1 and Day 14
2.00; 1.87; 1.94; 1.93
SECONDARY
Tmax of LHY746 on Day 1 and Day 14
6.93; 7.42; 2.98; 3.47
SECONDARY
Tmax of Binimetinib on Day 1 and Day 14
1.97; 1.97; 1.98; 1.93
SECONDARY
Tmax of AR00426032 on Day 1 and Day 14
2.02; 2.48; 2.00; 2.00
SECONDARY
AUCinf of Encorafenib on Day 1
26200; 45100
SECONDARY
AUCinf of Binimetinib on Day 1
2970; 3280
SECONDARY
AUCinf of AR00426032 on Day 1
270; 432
SECONDARY
T1/2 of Encorafenib on Day 1 and Day 14
3.98; 3.77; 4.37; 3.58
SECONDARY
T1/2 of LHY746 on Day 1 and Day 14
9.47; 22.5; 9.27; 11.2
SECONDARY
T1/2 of Binimetinib on Day 1 and Day 14
2.62; 2.45; 3.90; 3.70
SECONDARY
T1/2 of AR00426032 on Day 1 and Day 14
2.96; 3.15; 3.97; 3.89
SECONDARY
AUC%Extrap of Encorafenib on Day 1
24.4
SECONDARY
AUC%Extrap of LHY746 on Day 1
52.9
SECONDARY
AUC%Extrap of Binimetinib on Day 1
13.7
SECONDARY
AUC%Extrap of AR00426032 on Day 1
19.8
SECONDARY
Kel of Encorafenib on Day 1
0.174
SECONDARY
Kel of LHY746 on Day 1
0.0732
SECONDARY
Kel of Binimetinib on Day 1
0.265
SECONDARY
Kel of AR00426032 on Day 1
0.234
SECONDARY
CL/F of Encorafenib on Day 1
17.2
SECONDARY
CL/F of Binimetinib on Day 1
15.1
SECONDARY
Vz/F of Encorafenib on Day 1
53.4
SECONDARY
Vz/F of Binimetinib on Day 1
47.6
SECONDARY
Cmax of Binimetinib on Day 14 and Day 21
660; 663
SECONDARY
Cmax of AR00426032 on Day 14 and Day 21
25.9; 24.7
SECONDARY
AUClast of Binimetinib on Day 14 and Day 21
2400; 2290
SECONDARY
AUClast of AR00426032 on Day 14 and Day 21
114; 112
SECONDARY
Tmax of Encorafenib on Day 14 and Day 21
1.00; 1.00
SECONDARY
Tmax of LHY746 on Day 14 and Day 21
2.05; 2.10
SECONDARY
Tmax of Binimetinib on Day 14 and Day 21
1.00; 1.00
SECONDARY
Tmax of AR00426032 on Day 14 and Day 21
2.00; 2.00
SECONDARY
T1/2 of Encorafenib on Day 14 and Day 21
3.48; 3.57
SECONDARY
T1/2 of LHY746 on Day 14 and Day 21
8.67; 8.01
SECONDARY
T1/2 of Binimetinib on Day 14 and Day 21
4.62; 4.55
SECONDARY
T1/2 of AR00426032 on Day 14 and Day 21
5.60; 5.22
SECONDARY
Number of Participants With Treatment-Emergent Adverse Events (TEAEs) in the DDI Phase
26; 9; 11; 24; 6; 10
SECONDARY
Number of Participants With Laboratory Abnormalities in the DDI Phase
0; 1; 0; 3; 2; 0
SECONDARY
Number of Participants With Notable Abnormalities in Vital Signs in the DDI Phase
4; 4; 0; 0; 0; 1
SECONDARY
Number of Participants With Notable Electrocardiogram (ECG) Findings in the DDI Phase
6; 3; 2; 1; 0; 1
SECONDARY
Number of Participants With Left Ventricular Ejection Fraction (LVEF) Abnormalities in the DDI Phase
4; 2; 0
SECONDARY
Number of Participants With Treatment-Emergent Adverse Events (TEAEs) in the Post-DDI Phase
17; 5; 4; 10; 2; 2

Summary

This is an open-label, 3-arm, fixed-sequence study to evaluate the effect of single and multiple oral doses of encorafenib in combination with binimetinib on the single oral dose pharmacokinetics (PK) of cytochrome P450 (CYP) enzyme probe substrates using a probe cocktail, on an organic anion-transporting polypeptide/breast cancer resistance protein (OATP/BCRP) substrate using rosuvastatin and on a CYP2B6 substrate using bupropion. The effect of multiple oral doses of the moderate cytochrome P450 (CYP) inhibitor modafinil on encorafenib in combination with binimetinib will also be assessed. The study will have 2 treatment phases, a drug-drug interaction (DDI) phase followed by a post-DDI phase.

Eligibility Criteria

Key Inclusion Criteria - Patients must meet all of the inclusion criteria to be eligible for enrollment into the study:

  • Histologically confirmed diagnosis of locally advanced, unresectable or metastatic cutaneous melanoma or unknown primary melanoma American Joint Committee on Cancer (AJCC) Stage IIIB, IIIC or IV; or other BRAF V600-mutant advanced solid tumors
  • Presence of BRAF V600E and/or V600K mutation in tumor tissue prior to enrollment, as determined using a local test;
  • Evidence of measurable or non-measurable lesions
  • Patient with unresectable locally advanced or metastatic melanoma who has received no prior treatment or progressed on or after prior systemic therapy; Note: Prior therapy with a BRAF proto-oncogene serine-threonine protein kinase (BRAF) inhibitor and/or a mitogen-activated protein (MAP) kinase (MEK) inhibitor is permitted except in the regimen immediately prior to study entry
  • Patient with other (non-melanoma) BRAF V600E and/or V600K -mutant advanced solid tumors who has progressed on standard therapy or for whom there are no available standard therapies; Note: Prior therapy with a BRAF inhibitor and/or a MEK inhibitor is permitted except in the regimen immediately prior to study entry
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1
  • Adequate bone marrow, hepatic and renal function as specified in the protocol
  • ARM 1 ONLY: Non-smoker who has not used nicotine containing products for at least 3 months prior to the first dose.

Key Exclusion Criteria - Patients meeting any of the following criteria are not eligible for enrollment in the study:

  • Symptomatic brain metastasis. Patients previously treated or untreated for these conditions that are asymptomatic in the absence of corticosteroid and anti-epileptic therapy are allowed. Brain metastases must be stable, with imaging (e.g., magnetic resonance imaging [MRI] or computed tomography [CT] demonstrating no current evidence of progressive brain metastases at screening);
  • Symptomatic or untreated leptomeningeal disease;
  • History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes);
  • Clinically significant cardiac disease
  • Known hyper-coagulability risks other than malignancy (e.g., Factor V Leiden syndrome);
  • Thromboembolic event except catheter-related venous thrombosis ≤ 12 weeks prior to starting study treatment.
  • Discontinuation of prior BRAF and/or MEK inhibitor treatment due to left ventricular dysfunction, pneumonitis/interstitial lung disease, or retinal vein occlusion;
  • ARM 1 ONLY: Positive urine cotinine test at screening
  • ARM 3 ONLY:
  • History of psychosis, depression or mania;
  • History of angioedema;
  • History of mitral valve prolapse;
  • History of left ventricular hypertrophy;
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03864042). 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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