Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: A Phase 1/2A Study of Minerval in Adult Patients With Advanced Solid Tumours

Summary: This is a phase 1/2A, open label, non-randomized study in patients with advanced solid tumours including malignant glioma

Detailed description: This is an open label, non-randomized study in patients with advanced solid tumours including malignant glioma. The study will be performed in two phases - a dose escalation phase following a standard "3+3" design to establish dose-limiting toxicity (DLT) and a safe dose of 2-OHOA followed by two expanded safety cohorts (approximately 10 of whom have malignant glioma and approximately 10 of whom have other advanced solid tumours that are suitable for biopsy) treated at the maximum tolerated dose (MTD). If the MTD is well tolerated in the expanded safety cohorts, that dose becomes the recommended phase 2 dose (RP2D). During each dose cohort, at least one week must elapse between the first and subsequent patients receiving treatment with 2-OHOA. Patients may receive palliative localized radiotherapy, if needed (however, this lesion cannot be a target lesion for evaluation of the treatment response).
  Safety, pharmacokinetics (PK), pharmacodynamics and efficacy will be evaluated during the study at pre-defined timepoints

Eligibility: Inclusion Criteria
  -  Males or females providing written, informed consent
  -  Histologically- or cytologically-confirmed advanced solid malignancy that is refractory to standard-of-care treatment, or for which there is no standard therapy. If this is glioma:Grade III / Grade IV malignant glioma recurring or progressing after first or second line standard-of-care treatment and true progressive disease, confirmed according to the RANO criteria 4.
  -  Life-expectancy of at least 12 weeks
  -  Eastern cooperative oncology group (ECOG) performance status of 0-2
  -  Safety laboratory tests and ECGs within specified limits.
  -  Using adequate contraception, where applicable
  -  Presence of lesions suitable for biopsy (mandatory for non-glioma patients enrolled in the expanded safety cohort and highly desirable for non-glioma patients enrolled in the dose escalation phase)
  Exclusion Criteria
  -  Anti cancer therapy within 4 weeks (6 weeks for mitomycin and nitrosureas and 2 weeks for palliative radiotherapy)
  -  NCI Common terminology criteria for adverse events (CTCAE) >Grade 1 toxicities from prior chemotherapy or radiotherapy that could impact on safety outcome assessment
  -  Recent >Grade 1 intracranial or intratumoural haemorrhage either by CT or MRI scan. Patients with resolving haemorrhage changes, punctuate haemorrhage or haemosiderin may enter the study
  -  Significant or uncontrolled cardiovascular disease, unstable angina or myocardial infarction within the preceding 6 months
  -  Known impairment of GI function that could alter the absorption of study drug
  -  History of uncontrolled hyperlipidemia and/or the need for concurrent lipid lowering therapy
  -  Concurrent severe and/or uncontrolled other medical disease that could compromise participation in the study
  -  Taking warfarin, phenytoin or sulphonylureas (glibenclamide, glimepiride, glipizide, glyburide or nateglanide)
  -  Pregnant or breast feeding Other protocol specific criteria may apply

Relevance to patient case: not relevant