PI3K Inhibitor BYL719 in Combination With the HSP90 Inhibitor AUY922 in Patients With Advanced or Metastatic Gastric Cancer

NCT01613950 | Completed Phase 1

• 2 other identifiers: CBYL719X21032011-005978-40
• Study Type: interventional
• Target: 18
• Locations: 6 countries
• Sites: 9

Brief Summary

The study is intended to investigate the safety of BYL719 and AUY922 in patients with advanced gastric cancer, and to determine the MTD and/or RDE of both drugs in combination. In addition, the preliminary efficacy of BYL719 in combination with AUY922, and the pharmacokinetics of both drugs will be assessed. Patients will be eligible for this study, if their tumors carry either a molecular alteration of PIK3CA, or an amplification of HER2. The study includes a dose escalation part followed by a safety expansion phase.

Conditions

Stomach Neoplasms Esophageal Neoplasms Metastatic Gastric Cancer Mutated PI3KCA Protein Overexpressed HER2 Protein

Keywords

gastric cancer advanced gastric or metastatic gastric cancer PI3K PIK3CA mutation Her2 amplification HSP90 inhibitor PI3K inhibitor PIK3CA amplification

Outcome Measures

Primary Outcomes (1)

• Incidence rate of Dose Limiting Toxicities.

  To determine the maximum tolerated dose (MTD) and/or Recommended dose for expansion (RDE) and schedule of BYL719 and AUY922 when used as a combination in patients with advanced or metastatic gastric cancer carrying a molecular alteration of PIK3CA and/or an amplification of HER2. 1 cycle = 28days

  cycle 1

Secondary Outcomes (11)

• Frequency of adverse events (AEs)

  duration of the study, an expected average of 24 months

• Best Overall Response (BOR) as per Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1

  every 6 weeks

• Plasma concentration versus time profiles of BYL719 as single agent an in combination with AUY922.

  2 months

• Overall response rate (ORR) as per RECIST version 1.1

  an expected average of 12 months

• Progression free survival (PFS) as per RECIST version 1.1

  every 6 weeks

Study Arms (1)

BYL719 + AUY922

EXPERIMENTAL

Dose finding study to estimate the maximum tolerated dose(s) (MTD) and/or recommended dose(s) for safety expansion (RDE) followed by an expansion phase to further assess the safety and preliminary activity of the combination. BYL719 tablets will be administered orally on a daily schedule (q.d.). a b.i.d. regimen may be explored. AUY922 will be administered by IV infusion once per week.

Drug: AUY922; Drug: BYL719

Interventions

AUY922 DRUG

AUY922 is a non-geldanamycin inhibitor of the heat shock protein 90 (HSP90).

BYL719 + AUY922

BYL719 DRUG

BYL719 is an oral α-specific phosphatidylinositol-3-kinase (PI3K) inhibitor.

BYL719 + AUY922

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction;
• Patients must not have a complete gastrectomy;
• gastric tumors carrying PIK3CA mutation or amplification, or HER2-overexpression, or both;
• at least one but no more than three previous lines of treatment for advanced or metastatic disease;
• Patients with PIK3CA mutated or amplified tumors must have failed at least one line but no more than three lines of standard chemotherapy and/or targeted agents;Patients with HER2 amplified tumor must have failed at least one line, but no more than three lines, with or without anti-HER2 therapy. All HER2 positive patients are expected to have received trastuzumab unless contraindications were present or trastuzumab was unavailable;
• Performance Status (PS) ≤ 1 ;
• Adequate bone marrow, liver and other organ functions and laboratory parameters;
• Recovery from all AEs of previous anti-cancer therapies, including surgery and radiotherapy, to baseline or to CTCAE Grade ≤ 1, except for alopecia;Negative serum pregnancy (β hCG) test within 72 hrs before starting study treatment in all pre-menopausal women and women \< 12 months after the onset of menopause.

You may not qualify if:

• Progressive disease during or after prior combination treatment with PI3K-inhibitors and HSP90- inhibitors;
• history of prior significant toxicity from another PI3K- or HSP90- inhibitor requiring discontinuation of treatment;
• primary CNS tumor or uncontrolled CNS metastasest;
• Patients who are currently receiving medication with a known risk of prolonging the QT interval or inducing Torsades de Pointes and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug treatment;
• Patients with diabetes mellitus requiring insulin treatment and/or with clinical signs or with fasting glucose ≥ 140 mg/dL / 7.8 mmol/L, history of clinically significant gestational diabetes mellitus or documented steroid-induced diabetes mellitus;Patients with diarrhea CTCAE Grade ≥ 2 ;
• Patients with acute or chronic pancreatitis; History or current evidence of central serous retinopathy (CSR), retinal vein occlusion (RVO) or ophthalmopathy as assessed by ophthalmologic examination at baseline that would be considered a risk factor for CSR/RVO;
• Impaired gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral BYL719;
• Patients receiving chronic slow-release formulation of Proton Pump Inhibitors (PPI), H2-antagonists or other gastric pH elevating agents;
• Treatment with therapeutic doses of coumarin-based anticoagulants (e.g., warfarin sodium, Coumadin®). Low doses of courmarin-based anticoagulants;

Sponsors & Collaborators

• Novartis Pharmaceuticals: lead

Study Sites (9)

Massachusetts General Hospital Mass General 2

Boston, Massachusetts, 02114, United States

Location

University of Texas/MD Anderson Cancer Center Gastrointestinal Med. Oncology

Houston, Texas, 77030-4009, United States

Location

Novartis Investigative Site

Cologne, 50924, Germany

Location

Novartis Investigative Site

Würzburg, 97080, Germany

Location

Novartis Investigative Site

Chuo-ku, Tokyo, Japan

Location

Novartis Investigative Site

Seoul, Korea, 110 744, South Korea

Location

Novartis Investigative Site

Seoul, 738-736, South Korea

Location

Novartis Investigative Site

Bellinzona, 6500, Switzerland

Location

Novartis Investigative Site

Taipei, 10048, Taiwan

Location

Related Links

• Results for CBYL719X2103 can be found on the Novartis Clinical Trials website

MeSH Terms

Interventions

5-(2,4-dihydroxy-5-isopropylphenyl)-4-(4-morpholin-4-ylmethylphenyl)isoxazole-3-carboxylic acid ethylamide; Alpelisib

Study Officials

• Novartis Pharmaceuticals

  Novartis Pharmaceuticals

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 31, 2012
• First Posted: June 7, 2012
• Study Start: December 1, 2012
• Primary Completion: March 1, 2014
• Study Completion: March 1, 2014
• Last Updated: December 9, 2020

Record last verified: 2017-02

Locations

TW (1); US (2); KR (2); CH (1); DE (2); JP (1)