Patient case: 68-year-old male with non-small cell carcinoma; genetic feature: MET

Clinical trial: A Study of LY2157299 in Participants With Hepatocellular Carcinoma

Summary: The purpose of this study is to estimate the median time to progression in participants with hepatocellular carcinoma (HCC) when treated with LY2157299 as monotherapy and in combination with sorafenib or ramucirumab.

Detailed description: The study consists of four Parts: Part A where HCC participants with an increased alpha feto protein (AFP) level will be treated with either 160 milligrams (mg) LY2157299 or 300 mg LY2157299. Part B where HCC participants with a normal AFP level will be treated with 300 mg LY2157299, Part C where treatment-naïve HCC participants will be treated with 160 mg LY2157299 + sorafenib or 300 mg LY2157299 + sorafenib, and Part D where HCC participants will be treated with either 160 mg or 300 mg LY2157299 + ramucirumab.
  Participants who continue to receive benefit from treatment at the time that the study is considered completed, may enter the treatment extension period and continue to receive the study treatment. The end of the study is the date of last visit or last scheduled procedure for the last active subject in the study.

Eligibility: Inclusion Criteria:
  -  Have histological evidence of a diagnosis of HCC not amenable to curative surgery
  -  Part A: Serum alpha fetoprotein greater than or equal to 1.5 Upper Limits of Normal, Part B: Serum alpha fetoprotein less than 1.5 Upper Limits of Normal. Not applicable for Part C or D
  -  Child-Pugh Stage: A or B7 for Parts A & B, A for Part C, and D
  -  Have the presence of measurable disease as defined by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1). A lesion that has been previously treated by local therapy will qualify as a measurable or evaluable lesion if there was demonstrable progression following locoregional therapy
  -  Have given written informed consent prior to any study-specific procedures
  -  Have adequate hematologic, hepatic and renal function
  -  Have a performance status of equal to or less than 1 on the Eastern Cooperative Oncology Group (ECOG) scale
  -  For Parts A & B: Have received sorafenib and have progressed or were intolerant to sorafenib or are ineligible for sorafenib treatment. For Part C: not received previous systemic treatment. For Part D: have received sorafenib and have progressed or were intolerant to sorafenib or are ineligible for sorafenib treatment or have not received prior systemic treatment.
  -  For Parts A, B, and D: have discontinued sorafenib for at least 2 weeks
  -  Are reliable and willing to make themselves available for the duration of the study and are willing to follow study procedures
  -  Males and females with reproductive potential must agree to use medically approved contraceptive precautions during the trial and for 3 months following the last dose of study drug
  -  Females with childbearing potential must have had a negative serum pregnancy test less than or equal to 7 days prior to the first dose of study drug
  -  Are able to swallow capsules or tablets
  Exclusion Criteria:
  -  Are currently enrolled in, or discontinued within the last 28 days from a clinical trial involving an investigational drug or device or not approved use of a drug or device (other than the study drug used in this study), or concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study
  -  Known HCC with fibro-lamellar or mixed histology
  -  Presence of clinically relevant ascitis
  -  History of liver transplant requiring increased immunosuppressive therapy. (Participants on maintenance immunosuppressive therapy after liver transplant are eligible for Part A & B)
  -  Have received more than 1 line of systemic treatment in Parts A, B and D
  -  Have moderate or severe cardiac disease:
  1. Have the presence of cardiac disease, including a myocardial infarction within 6 months prior to study entry, unstable angina pectoris, New York Heart Association (NYHA) Class III/IV congestive heart failure, or uncontrolled hypertension
  2. Have documented major electrocardiogram (ECG) abnormalities at the investigator's discretion
  3. Have major abnormalities documented by echocardiography with Doppler
  4. Have predisposing conditions that are consistent with development of aneurysms of the ascending aorta or aortic stress
  -  Have serious preexisting medical conditions that, in the opinion of the investigator, that cannot be adequately controlled with appropriate therapy or would preclude participation in this study
  -  Females who are pregnant or lactating
  -  Have a history of any other cancer (except non-melanoma skin cancer or carcinoma in-situ of the cervix) unless in complete remission and off all therapy for that disease for a minimum of 3 years. At the discretion of the investigator, hormone-refractory prostate cancer participants who are stable on GnRH agonist therapy and breast cancer participants who are stable on antiestrogen therapy may have that treatment continued
  -  Have active infection that would interfere with the study objectives or influence study compliance
  -  For Part C, have a known hypersensitivity to sorafenib or its excipients
  -  For Part D, have a serious illness or medical condition(s), including but not limited to the following:
  1. The participant has undergone major surgery within 28 days prior to randomization or has undergone central venous access device placement within 7 days prior to randomization
  2. The participant has uncontrolled arterial hypertension ≥150 / ≥90 millimeters of mercury (mm Hg) despite standard medical management

Relevance to patient case: not relevant