Patient case: 50-year-old male with glioblastoma; genetic feature: IDH1 (R132H)

Clinical trial: Phase 1/2a Study of BAL101553 as 48-hour Infusions in Patients With Advanced Solid Tumors or Recurrent Glioblastoma

Summary: Single-agent, open-label, multi-center sequential dose escalation and expansion study of BAL101553, administered as an intravenous (IV) infusion over 48 hours to adults with advanced or recurrent solid tumors or recurrent glioblastoma.

Detailed description: This is the first study of prolonged intravenous infusion of BAL101553. BAL101553 will be administered as an intravenous infusion over 48 hours, to adults with advanced or recurrent solid tumors or recurrent glioblastoma who have failed standard therapy, or for whom no effective standard therapy is available.
  The primary goal of the study is to find the highest dose of BAL101553 that can safely be given to humans and to assess what side effects occur. The study will start by treating patients with a low dose. Once it has been shown that this low dose is well tolerated, new patients will be treated at higher dose levels ("dose escalation"). Once the highest, well tolerated dose is identified, 20 new patients with platinum-resistant/refractory ovarian cancer and 20 new patients with recurrent glioblastoma will be treated at that dose (this part is called "dose expansion") to further assess the tolerability and potential anticancer activity of oral BAL101553. The study will also measure pharmacokinetics, pharmacodynamic effects and assess biomarkers.

Eligibility: Inclusion Criteria:
  1. Age ≥ 18 years
  2. Phase 1: Patients with either histologically or cytologically confirmed advanced or recurrent solid tumor, who failed standard therapy or for whom no effective standard therapy is available.
  Phase 2a: Patients with platinum-resistant/refractory ovarian, fallopian tube or primary peritoneal cancer (high-grade serous, endometrioid, or carcinosarcoma histotypes) or glioblastoma in first relapse.
  3. Patients with solid tumors must have measurable disease according to Response Evaluation Criteria in Solid Tumors [RECIST] v1.1.
  Patients with recurrent glioblastoma must have measurable disease defined by contrast-enhancing magnetic resonance imaging.
  4. Life expectancy ≥ 12 weeks
  5. Acceptable organ and marrow function at baseline (protocol defined laboratory parameters)
  6. Patients with solid tumors must have an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 and patients with recurrent glioblastoma must have an ECOG performance status ≤ 2.
  7. Other protocol-defined inclusion criteria may apply.
  Exclusion Criteria:
  1. Patients with solid tumors who have received chemotherapy, radiotherapy, immunotherapy, or investigational agents within 4 weeks prior to starting study drug or who have not recovered from side effects of prior therapies.
  Patients with recurrent glioblastoma who have: received radiotherapy within 12 weeks, unless there is a new area of enhancement consistent with recurrent tumor outside the radiation field, or there is histological confirmation of unequivocal tumor progression; received administration of prior antitumor chemotherapy within 4 weeks, or within 6 weeks for nitrosoureas; undergone surgical resection within 4 weeks or a stereotactic biopsy/core biopsy within 1 week prior to starting study drug, or have been treated previously with bevacizumab.
  2. Patients who have had prior exposure to BAL101553.
  3. Peripheral neuropathy ≥ CTCAE grade 2.
  4. Uncontrolled intercurrent illness that would unduly increase the risk of toxicity or limit compliance with study requirements
  5. Systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg at the screening visit.
  6. Blood pressure (BP) combination treatment with more than two antihypertensive medications.
  7. Women who are pregnant or breast-feeding. Men or women of reproductive potential who are not willing to apply effective birth control.
  8. Other protocol-defined exclusion criteria may apply.

Relevance to patient case: not relevant