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NCT Number: NCT00830869

A Phase 1 Study of IXAZOMIB in Adult Patients With Advanced Nonhematologic Malignancies

This is an open-label, multicenter, phase 1, dose escalation study of IXAZOMIB. The primary purpose of this study is to determine the safety profile, establish the maximum tolerated dose, and inform the phase 2 dose of IXAZOMIB administered intravenously in participants with nonhematologic malignancies.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Princess Margaret Hospital, Toronto, Ontario, Canada

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Each participant must meet all of the following inclusion criteria to be enrolled in the study:

  • Male or female participants 18 years or older.
  • Eastern Cooperative Oncology Group performance status 0-2.
  • A diagnosis of a nonhematologic malignancy for which standard treatment is no longer effective. In the expanded cohort, enrollment will be limited to participants with a diagnosis of NSCLC, H&N cancer (squamous cell cancer), STS, or PC.
  • Suitable venous access for pharmacokinetic (PK) and pharmacodynamic evaluations.
  • Female participants who are post menopausal, surgically sterile, or agree to practice 2 effective methods of contraception or abstain from heterosexual intercourse.

Male participants who agree to practice 2 effective methods of contraception or abstain from heterosexual intercourse.

  • Voluntary written consent must be obtained.
  • Adequate clinical laboratory values during the screening period.
  • In the escalation portion of the study, radiographically or clinically evaluable tumor was required, but measurable disease as defined by response evaluation criteria in solid tumors (RECIST) criteria was not required. In the MTD disease expansion cohorts and the TPEC, clinically measurable disease as defined by RECIST criteria was required for evaluation of NSCLC, H&N cancer, and STS. Prostate specific antigen (PSA) alone was acceptable for evaluation of PC.
  • For participants in the TPEC, tumor tissue that, in the opinion of the investigator, could have been safely biopsied using a core needle.

Exclusion criteria

Participants meeting any of the following exclusion criteria are not to be enrolled in the study:

  • Peripheral neuropathy greater than or equal to (>=) Grade 2.
  • Female participants who are lactating or have a positive serum pregnancy test during the screening period.
  • Major surgery within 14 days before the first dose of treatment.
  • Infection requiring systemic antibiotic therapy or other serious infection within 14 days before the first dose of study treatment.
  • Life-threatening illness unrelated to cancer.
  • Diarrhea greater than (>) Grade 1 based on the National Cancer Institute Common Terminology .Criteria for Adverse Events (NCI CTCAE) categorization.
  • Systemic antineoplastic therapy / or radiotherapy within 21 days before the first dose of study treatment.
  • Systemic treatment with prohibited medications.
  • Participant has symptomatic brain metastasis.
  • Evidence of current uncontrolled cardiovascular conditions, including cardiac arrhythmias, congestive heart failure (CHF), angina, or myocardial infarction within the past 6 months.
  • QTc >470 milliseconds (msec) on a 12-lead electrocardiogram (ECG) obtained during the screening period.
  • Known human immunodeficiency virus (HIV), hepatitis B or hepatitis C positive.
  • Any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol.
  • Treatment with any investigational products within 28 days before the first dose of study treatment.
  • For participants in the TPEC and participants in the MTD disease expansion cohorts who gave informed consent to undergo tumor biopsy, ongoing anticoagulant therapy (example, aspirin, clopidogrel [Plavix ®], warfarin, or heparin) that cannot be held to permit tumor biopsy .
  • Known allergy to boron or excipients.

Treatment and study plan

Ixazomib

Drug

All participants will receive IXAZOMIB IV injection on Days 1, 4, 8, and 11 of each treatment cycle followed by a rest period of 10 days.

The first stage of the study will be initiated at a starting dose of 0.125 mg/m^2. Subsequent doses will increase until a maximum tolerated dose (MTD) is established.

Primary outcomes

  1. Part 1: Number of Participants With Dose Limiting Toxicity (DLT)

    Time frame: Part 1: Cycle 1 Day 1 up to Cycle 1 Day 21

    Toxicity according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 3.0. DLT is any of following related to ixazomib:Grade (GR) 4 neutropenia (absolute neutrophil count<500 cells/cubic meter[cells/mm^3])for>7 days; GR 3 neutropenia with coincident fever and/or infection; GR 4 thrombocytopenia (platelets <25,000 cells/mm3)for>7 days; GR 3 thrombocytopenia with clinically significant bleeding; Platelet count<10,000 cells/mm3; GR 3 peripheral neuropathy;>=GR 3 nausea/emesis in absence of optimal antiemetic therapy; >=GR 3 diarrhoea in absence of optimal supportive therapy;GR 3 QTc prolongation noted on average of 3 electrocardiograms (ECGs);>=GR 3 nonhematological toxicity except GR 3 arthralgia/myalgia or GR 3 fatigue for<1 week; Delay in initiation of subsequent therapy cycle by>7 days due to treatment-related toxicity Other>=GR 2 nonhematological toxicity that opinion of investigator, requires discontinuation of therapy with Ixazomib.

  2. Number of Participants Reporting One or More Treatment-emergent Adverse Events (TEAEs) and Serious Adverse Event (SAEs)

    Time frame: Part 1: Cycle 1 Day 1 up to Cycle 10 Day 41; Part 2: Cycle 1 Day 1 up to Cycle 12 Day 41

  3. Number of Participants With Clinically Significant TEAEs Related to Laboratory Abnormalities

    Time frame: Day 1 up to 30 days after last dose of study drug (Cycle 12 Day 41)

  4. Number of Participants With Clinically Significant Change From Baseline in Vital Signs

    Time frame: Day 1 up to 30 days after last dose of study drug (Cycle 12 Day 41)

    Vital sign measurements included diastolic and systolic blood pressure, heart rate, weight and oral temperature.

Secondary outcomes

  1. Part 1: AUC (0-72): Area Under the Plasma Concentration-time Curve From Time 0 to 72 Hours Post-dose for Ixazomib

    Time frame: Part 1: Cycle 1 Days 1 and 11: pre-dose and at multiple time points (up to 72 hours) post-dose

    AUC (0-72) is a measure of the area under the plasma concentration-time curve from time 0 to 72 hours post-dose for ixazomib.

  2. Part 1: C0: Initial Plasma Concentration After Bolus Intravenous Administration

    Time frame: Part 1: Cycle 1 Day 1 pre-dose and at multiple time points (up to 72 hours) post-dose; Cycle 1 Day 11 pre-dose and at multiple time points (up to 264 hours) post-dose

    C0 is the plasma drug concentration at time zero following bolus intravenous injection.

  3. Part 1: Rac: Accumulation Ratio for Ixazomib

    Time frame: Cycle 1 Day 11 pre-dose and at multiple time points (up to 72 hours) post-dose

    Rac was estimated as the ratio of AUC (0-72) on Day 11 and AUC (0-72) on Day 1. AUC (0-72) is the area under the plasma concentration-time curve from time 0 to 72 hours post-dose.

  4. Part 1: Terminal Phase Elimination Half-life (T1/2) for Ixazomib

    Time frame: Part 1: Cycle 1 Day 11 pre-dose and at multiple time points (up to 264 hours) post-dose

    T1/2 is the time required for half of the drug to be eliminated from the plasma.

  5. Part 1: E Max: Maximum Observed Effect for Ixazomib

    Time frame: Part 1: Cycle 1 Day 1 pre-dose and at multiple time points (up to 72 hours) post-dose; Cycle 1 Day 11 pre-dose and at multiple time points (up to 264 hours) post-dose

    E max is the maximum inhibition of 20S proteasome activity in whole blood.

  6. Part 1: TEmax: Time to Maximum Observed Effect (Emax) for Ixazomib

    Time frame: Part 1: Cycle 1 Days 1 and 11 pre-dose and at multiple time points (up to 72 hours) post-dose; Cycle 1 Day 11 pre-dose and at multiple time points (up to 264 hours) post-dose

    TEmax is the time to reach the Emax, equal to time (hours) to Emax.

  7. Number of Participants With Best Overall Response

    Time frame: Day 18 up to Day 21 of each cycle (Part 1: up to Cycle 10; Part 2: up to Cycle 12)

    Best overall response for a participant is best observed post-baseline disease response as per Response Evaluation Criteria in Solid Tumors (RECIST) 1.0 criteria. Complete Response (CR): disappearance of all target lesions, non-target lesions and normalization of tumor marker level. Partial Response (PR): at least 30% decrease in sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease, taking as reference the baseline smallest sum of longest diameter; persistence of 1 or more non-target lesion(s) or maintenance of tumor marker level above normal limits. Progressive disease: at least 20% increase in the sum of the longest diameter of target lesions, taking as reference the baseline smallest sum of longest diameter or appearance of 1 or more new lesions or unequivocal progression of existing non-target lesions.

  8. Part 2: Ixazomib Concentration in Postdose Clinical Tumor Samples in Ixazomib 1.76 mg/m^2-TPEC

    Time frame: Cycle 1 Days 1 and 4: Predose and (from 4-20 hours) post-dose

    The average data of Days 1 and 4 of Cycle 1 was reported.

  9. 20S Proteasome Activity of Ixazomib in the Tumor Tissue

    Time frame: Cycle 1 Days 1 and 4 pre-dose and at multiple time points (up to 2 hours of tumor biopsy) post-dose

  10. Expression of Biomarker (ATF-3) in Tumor Tissue

    Time frame: Cycle 1 Days 1 and 4 pre-dose and at multiple time points (up to 2 hours of tumor biopsy) post-dose

Sponsors and collaborators

Lead sponsor

Millennium Pharmaceuticals, Inc.

Industry

Registry information

Official study title

An Open-Label, Dose Escalation, Phase 1 Study of IXAZOMIB (MLN9708), a Second-Generation Proteasome Inhibitor, in Adult Patients With Advanced Nonhematologic Malignancies

Important dates

Study start
2009
Primary completion
2012
Study completion
2012
First posted
Jan 28, 2009
Registry last updated
Sep 9, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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