Galunisertib (LY2157299) Plus Stereotactic Body Radiotherapy (SBRT) in Advanced Hepatocellular Carcinoma (HCC)

NCT02906397 | Completed Phase 1 FDA Drug FDA Device

• 1 other identifier: 826247 (UPCC 24216)
• Study Type: interventional
• Target: 15
• Locations: 1 country
• Sites: 1

Brief Summary

To determine the safety and tolerability of galunisertib when combined with Stereotactic Body Radiotherapy (SBRT) (hypofractionated radiation).

Conditions

ADVANCED HEPATOCELLULAR CARCINOMA (HCC)

Outcome Measures

Primary Outcomes (1)

• Safety based upon standard laboratory and clinical adverse event monitoring

  Number of participants with treatment-related adverse events as assessed by CTCAE v4

  Cycle 1 Day 15 through date of progression assessed up to 90 months

Secondary Outcomes (5)

• Progression free survival (PFS) who are receiving the combination of galunisertib plus SBRT as compared to the PFS of Galunisertib alone in historical controls.

  Cycle 1 Day 15 through date of progression assessed up to 90 months

• Response rate

  Cycle 3 Day 1 and every 8 weeks thereafter up to 90 months

• Overall survival (OS)

  Cycle 1 Day 1 to death due to any cause or last patient contact alive up to 90 months

• Inhibition of TGF-β signaling by intervention as evidenced by downstream changes in this pathway

  Cycle 1 Day 15 through date of progression assessed up to 90 months

• Promotion of anti-tumor immunity with addition of intervention to SBRT

  Cycle 1 Day 15 through date of progression assessed up to 90 months

Study Arms (1)

Experimental: Galunisertib/SBRT

EXPERIMENTAL

Galunisertib (LY2157299) 150mg by mouth twice a day on days 1-14 of 28 day cycles SBRT 18Gy, delivered in one fraction between Cycle 1 D15 and D28

Drug: Galunisertib 150mg by mouth twice a day; Radiation: Stereotactic Body Radiotherapy (SBRT)

Interventions

Galunisertib 150mg by mouth twice a day DRUG

on days 1-14 of 28 day cycles

Also known as: LY2157299

Experimental: Galunisertib/SBRT

Stereotactic Body Radiotherapy (SBRT) RADIATION

18GY delivered in one fraction between C1D15 and C1D28

Experimental: Galunisertib/SBRT

Eligibility Criteria

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

You may qualify if:

• Patients must have histologically confirmed hepatocellular carcinoma (HCC) that is inoperable (where surgery is not indicated due to disease extension, co-morbidities or other technical reasons)
• ≥18 years of age and ability to understand and the willingness to sign a written informed consent document. A legally authorized representative signature in the event that the subject is not able to sign themselves is permitted.
• Patients must have either not been eligible for sorafenib therapy, have failed sorafenib therapy, have discontinued sorafenib therapy due to intolerable toxicity or have refused sorafenib
• ECOG performance status ≤2
• Childs Pugh score of ≤7
• Life expectancy of at least 12 weeks
• Must be able to swallow tablets
• Must be willing to comply with protocol procedures (including completion of diaries and outcome measures)
• Local or loco-regional therapy (ie surgery, radiation therapy, hepatic arterial embolization, chemoembolization, radiofrequency ablation, percutaneous ethanol injection or cryoablation) must have been completed ≥4 weeks prior to enrollment
• Must be willing to undergo a pretreatment biopsy
• A history of prior radiotherapy is permitted, as long as the prior radiated site is not overlapping with the site of planned SBRT
• Measurable disease as defined by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
• An index lesion measuring between 1cm-10cm that is amenable to hypofractionated radiation therapy at the discretion of the treating radiation oncologist
• Women of childbearing potential must have a negative serum pregnancy test performed at screening
• Subjects must use an approved contraceptive method (for example, intrauterine device, birth control pills or barrier device) which has an expected failure rate of \<1%, if appropriate for at least 3 months after the last dose of galunisertib.

You may not qualify if:

• Any history of a serious medical or psychiatric condition that would prevent the patient from signing the informed consent form
• Pregnant or breastfeeding women.
• Use of any other chemotherapy, radiotherapy or experimental drug within 4 weeks prior to first study treatment date
• A history of radiotherapy that, in the opinion of the investigator, would render SBRT unsafe to administer
• Those who have not recovered from adverse events ≤ grade 1 secondary to therapy administered \>4 weeks prior to first study treatment date, with the exception of stable grade 2 neuropathy
• Subjects may not receive concomitant anticancer agents. Antiviral agents aimed at treating infectious hepatitis are permitted
• History of or suspected hypersensitivity to radiation or to galunisertib
• Uncontrolled ascites
• Subjects with a history of or evidence of cardiac disease during screening, defined as any one of the following: myocardial infarction within 6 months prior to study entry, unstable angina pectoris, New York Heart Association Class III/IV congestive heart failure, uncontrolled hypertension.
• Subjects with a documented major ECG abnormalities (not responding to medical treatments) or not clinically stable for at least 6 months.
• Subjects with major abnormalities documented by ECHO with Doppler (for example, moderate or severe heart valve function defect) that is not stable for at least 6 months.. Note: Left ventricular \[LV\] ejection fraction \<50% is allowed only if clinically stable for at least 6 months (evaluation based on the institutional lower limit of normal).
• Subjects with a predisposition toward developing aneurysms of the ascending aorta or aortic stress including a family history of aneurysms, Marfan Syndrome, Ehlers Danlos Type IV, bicuspid aortic valve or evidence of damage to the large vessels of the heart documented by previously obtained or screening CT scan/MRI
• Subjects with uncontrolled brain metastases. Subjects with brain metastases must have stable neurological status following local therapy (surgery or radiation) for at least 4 weeks prior to first study treatment and must be off steroids
• Any concurrent condition requiring the continued or anticipated use of systemic steroids beyond physiologic replacement dosing (excluding non-systemic inhaled, topical skin and/or eye drop-containing corticosteroids) or immunosuppressive therapy (excludes low-dose methotrexate). All other systemic corticosteroids above physiologic replacement dosing must be discontinued at least 4 weeks prior to first study treatment
• Active drug or alcohol use or dependence as documented in the chart that, in the opinion of the investigator, would interfere with adherence to study requirements

Sponsors & Collaborators

• Abramson Cancer Center at Penn Medicine: lead

Study Sites (1)

Abramson Cancer Center of the University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

MeSH Terms

Interventions

LY-2157299; Radiosurgery

Intervention Hierarchy (Ancestors)

Radiotherapy; Therapeutics; Stereotaxic Techniques; Neurosurgical Procedures; Surgical Procedures, Operative; Investigative Techniques

Study Officials

• Kim Reiss Binder, MD

  Abramson Cancer Center at Penn Medicine

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: September 15, 2016
• First Posted: September 20, 2016
• Study Start: March 30, 2017
• Primary Completion: July 21, 2021
• Study Completion: July 21, 2021
• Last Updated: March 25, 2022

Record last verified: 2022-03

Locations

US (1)