Phase Ib/II Study of Buparlisib Plus Carboplatin or Lomustine in Patients With Recurrent Glioblastoma Multiforme

NCT01934361 | Completed Phase 1 FDA Drug

• 2 other identifiers: CBKM120E21022013-003129-27
• Study Type: interventional
• Target: 35
• Locations: 6 countries
• Sites: 14

Brief Summary

This is a multi-center, phase Ib/ II study (two parts) with patients that had recurrent glioblastoma multiforme. The first part (phase Ib) was to investigate the maximum tolerated dose/Recommended phase ll dose (MTD/RP2D) of once daily buparlisib in combination with every-three-week carboplatin or buparlisib once daily in combination with every-six-week lomustine (CCNU) using a Bayesian model. Once MTD/ RP2D is established in either of the 2 arms, the corresponding phase II portion of the study was to start. Phase II was to assess the treatment effect of buparlisib in combination with carboplatin in terms of Progression Free Survival (PFS) and was to compare the treatment effect of buparlisib with lomustine versus lomustine plus placebo in terms of PFS. A preliminary assessment for both combinations (buparlisib plus carboplatin or lomustine) demonstrated that there was not enough antitumor activity compared to historical data with single agent carboplatin or lomustine. Based on the overall safety profile, and preliminary anti-tumor activity observed in this study, Novartis decided that no additional patients would be enrolled into this study. As a consequence, the Phase II part of the study was not conducted.

Conditions

Recurrent Glioblastoma Multiforme

Keywords

BKM120; Recurrent glioblastoma multiforme; rGBM; buparlisib

Outcome Measures

Primary Outcomes (3)

• Number of Total Dose-limiting Toxicity (DLT) during Dose Escalation part to determine Maximum Tolerated Dose (MTD) [Phase Ib]

  Maximum Tolerated Dose (MTD) is defined as the highest BKM120 dosage that does not cause medically unacceptable Dose Limiting Toxicities (DLTs) in more than 35% of the treated patients during the first cycle of treatment. DLT is defined as treatment-related toxicity occurring during the phase Ib cycle 1 and meeting specific protocol-predefined criteria. The information will be integrated in a Bayesian logistic regression model with overdose control to estimate the MTD.

  Cycle 1 (21 days carboplatin combination or 42 days lomustine combination )

• 12 week Progression Free Survival (PFS) rate (Phase II- Carboplatin combination)

  12-week Progression Free Survival (PFS) is defined as the percentage of patients who are progression free 12 weeks after the date of the start of the treatment ("success"). Patients who progressed, died or discontinued within the 12 weeks of observation are counted as "failure".

  12 weeks

• Progression Free Survival (PFS) [phase II lomustine combinations]

  Progression Free Survival (PFS) is defined as the time from date of randomization to the date of the event, which is the first radiologically documented disease progression \[per local investigator assessment according to Response Assessment in Neuro-Oncology (RANO) criteria\] or death due to any cause.

  Randomization until date of the event (expected average 3 months).

Secondary Outcomes (11)

• Frequency and severity of Adverse Events (AEs) [Phase Ib, Phase II, all treatment arms]

  Until 30 days after treatment discontinuation

• Overall Response Rate (ORR) as per Response Assessment in Neuro-Oncology (RANO) [Phase Ib , both combinations]

  Baseline, every 6 weeks from treatment start until disease progression or until start of another antineoplastic treatment or death which ever occurs first up to 1 year

• Progression Free Survival (PFS) [Phase Ib- both combinations]

  Time from treatment start to the date of the event (expected average 3 months)

• Overall response rate (ORR) [Phae II, carboplatin combination]

  Baseline, every 6 weeks from treatment start until disease progression or until start of another antineoplastic treatment or death which ever occurs first up to 1 year

• Progression Free Survival (PFS) [Phase II, carboplatin combination]

  Time from treatment start to the date of the event (Expected average: 3 months)

Study Arms (5)

Lomustine+ buparlisib (Phase Ib)

EXPERIMENTAL

Drug: buparlisib; Drug: lomustine

carboplatin+ buparlisib (Phase Ib)

EXPERIMENTAL

Drug: buparlisib; Drug: carboplatin

lomustine+ buparlisib (Phase II)

EXPERIMENTAL

Drug: buparlisib; Drug: lomustine

lumustine + placebo (Phase II)

PLACEBO COMPARATOR

Drug: lomustine; Drug: placebo

carboplatin+ buparlisib (Phase II)

EXPERIMENTAL

Drug: buparlisib; Drug: carboplatin

Interventions

buparlisib DRUG

Buparlisib administered orally on a continuous daily schedule. Buparlisib is manufactured as 10mg and 50mg hard gelatin capsules.

Lomustine+ buparlisib (Phase Ib); carboplatin+ buparlisib (Phase II); carboplatin+ buparlisib (Phase Ib); lomustine+ buparlisib (Phase II)

carboplatin DRUG

Carboplatin intravenous infusion will be administered at a dose of AUC 5 in a 21 day cycle (every 3 weeks).

carboplatin+ buparlisib (Phase II); carboplatin+ buparlisib (Phase Ib)

lomustine DRUG

Lomustine will be administered as a single oral dose of 100 mg/m² every 6 weeks in a 42 day cycles.

Lomustine+ buparlisib (Phase Ib); lomustine+ buparlisib (Phase II); lumustine + placebo (Phase II)

placebo DRUG

Placebo will be administered orally on a continuous QD dosing schedule for cycles of 42 days. Buparlisib matching placebo is manufactured as 10 mg and 50 mg hard gelatin capsules.

lumustine + placebo (Phase II)

Eligibility Criteria

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

You may qualify if:

• Patient is an adult ≥ 18 years old at the time of informed consent.
• Patient has histologically confirmed diagnosis of GBM with documented recurrence after first line treatment including radiotherapy and TMZ (SoC), not suitable for curative surgery or re-irradiation.
• Patient has at least one measurable and/or non-measurable lesion as per RANO criteria
• Patient has recovered (to Grade ≤1) from all clinically significant toxicities related to prior antineoplastic therapies.
• Patient has Karnofsky performance status (KPS) ≥70%.
• Patient has adequate organ and bone marrow functions:
• Absolute Neutrophils Count (ANC) ≥ 1.5 x 109/L
• Platelets ≥ 100 x 109/L (in case of transfusion stable for ≥14 days prior to treatment start)
• Hemoglobin ≥ 9.0 g/dL (in case of transfusion stable for ≥14 days prior to treatment start)
• INR ≤ 1,5
• Serum Creatinine ≤ 1.5 x ULN, or Creatinine Clearance \> 45mL/min
• Potassium and calcium (corrected for albumin), sodium and magnesium within institutional normal limits
• Serum Bilirubin ≤ ULN, AST and ALT ≤ ULN
• HbA1c ≤ 8%
• Fasting plasma glucose (FPG) ≤ 120 mg/dL or ≤ 6.7 mmol/L

You may not qualify if:

• Patient has received previous treatment with PI3K inhibitors, lomustine or carboplatin.
• Patient has received previous antineoplastic treatment for recurrent GBM (e.g. VEGF inhibitors, cytotoxic agents).
• Patient has received more than one line of cytotoxic chemotherapy
• Patient has concurrent use of anti-neoplastic agents including investigational therapy
• Patient is currently receiving warfarin or other coumarin derived anti-coagulant, for treatment, prophylaxis or otherwise. Therapy with heparin, low molecular weight heparin (LMWH), or fondaparinux is allowed.
• Patient is currently receiving treatment with drugs known to be moderate or strong inhibitors or inducers of isoenzyme CYP3A. The patient must have discontinued strong inducers for at least one week and must have discontinued strong inhibitors before the treatment is initiated. Switching to a different medication prior to randomization is allowed.
• Patient is currently receiving an enzyme-inducing anti-epileptic drug (EIAED). The patient must have discontinued EIAED therapy for at least two weeks prior to starting study drug.

Sponsors & Collaborators

• Novartis Pharmaceuticals: lead

Study Sites (14)

Barrow Neurological Insitute St. Joseph's Hospital

Phoenix, Arizona, 85013, United States

Location

Highlands Oncology Group

Fayetteville, Arkansas, 72703, United States

Location

Northwestern University

Chicago, Illinois, 60611, United States

Location

Dana Farber Cancer Institute

Boston, Massachusetts, 02215, United States

Location

MD Anderson Cancer Center/University of Texas

Houston, Texas, 77030, United States

Location

Novartis Investigative Site

Heidelberg, Victoria, 3084, Australia

Location

Novartis Investigative Site

Parkville, Victoria, 3050, Australia

Location

Novartis Investigative Site

Leuven, 3000, Belgium

Location

Novartis Investigative Site

Toronto, Ontario, M5G 1Z6, Canada

Location

Novartis Investigative Site

Marseille, 13885, France

Location

Novartis Investigative Site

Paris, 75651, France

Location

Novartis Investigative Site

Saint-Herblain, 44805, France

Location

Novartis Investigative Site

Barcelona, Catalonia, 08036, Spain

Location

Novartis Investigative Site

L'Hospitalet de Llobregat, Catalonia, 08907, Spain

Location

Related Publications (1)

• Rosenthal M, Clement PM, Campone M, Gil-Gil MJ, DeGroot J, Chinot O, Idbaih A, Gan H, Raizer J, Wen PY, Pineda E, Donnet V, Mills D, El-Hashimy M, Mason W. Buparlisib plus carboplatin or lomustine in patients with recurrent glioblastoma: a phase Ib/II, open-label, multicentre, randomised study. ESMO Open. 2020 Jul;5(4):e000672. doi: 10.1136/esmoopen-2020-000672.

  PMID: 32665311 DERIVED

Related Links

• Results for CBMK120E2102 can be found on the Novartis Clinical Trial Results Website

MeSH Terms

Conditions

Glioblastoma

Interventions

NVP-BKM120; Carboplatin; Lomustine

Condition Hierarchy (Ancestors)

Astrocytoma; Glioma; Neoplasms, Neuroepithelial; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Glandular and Epithelial; Neoplasms, Nerve Tissue

Intervention Hierarchy (Ancestors)

Coordination Complexes; Organic Chemicals; Nitrosourea Compounds; Urea; Amides; Nitroso Compounds

Study Officials

• Novartis Pharmaceuticals

  Novartis Pharmaceuticals

  STUDY DIRECTOR

Study Design

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

Study Record Dates

• First Submitted: August 20, 2013
• First Posted: September 4, 2013
• Study Start: February 28, 2014
• Primary Completion: July 7, 2016
• Study Completion: July 7, 2016
• Last Updated: December 9, 2020

Record last verified: 2018-08

Data Sharing

• IPD Sharing: Will not share

Locations

BE (1); CA (1); ES (2); US (5); FR (3); AU (2)