Patient case: 62-year-old male with cholangiocarcinoma; genetic feature: PIK3CA (1047H)

Clinical trial: Phase I Open-Label, Dose-Escalation Study of GSK1059615 in Patients With Solid Tumors or Lymphoma

Summary: This is an open-label, multi-center Phase I study conducted to define the recommended Phase 2 dose, toxicity profile, pharmacokinetics and biologically active dose range of GSK1059615.


Eligibility: Inclusion Criteria:
  -  Written informed consent provided.
  -  18 years old or older.
  -  Histologically- or cytologically- confirmed diagnosis of solid tumor malignancy or lymphoma that is not responsive to accepted standard therapies or for which there is no standard or curative therapy.
  -  Performance Status score of 0 or 1 according to the Eastern Cooperative Oncology Group (ECOG) scale.
  -  A life expectancy of > 12 weeks.
  -  Able to swallow and retain oral medication.
  -  A male is eligible to enter and participate in the study if he either:
  -  agrees to abstain from sexual intercourse from the first dose of study drug and until 21 days after last dose of study medication, or
  -  agrees to use a condom and occlusive cap (diaphragm or cervical/vault cap) with spermicidal foam/gel/film/cream/suppository from the first dose of study drug and until 21 days after last dose of study medication, or
  -  is surgically sterile. NOTE: Male patients must use contraception to prevent pregnancy in a female partner and prevent exposure of any partner to semen by any means (refer to protocol).
  -  A female is eligible to enroll in the study if she is of:
  Non-child bearing potential (i.e., physiologically incapable of becoming pregnant) including any woman who is characterized by at least one of the following:
  -  Has had a hysterectomy
  -  Has had a bilateral oophorectomy (ovariectomy)
  -  Has had a bilateral tubal ligation
  -  Is post-menopausal (total cessation of menses for ≥ 1 year) Childbearing potential, has a negative serum pregnancy test at screening, and agrees to one of the following from at least 2 weeks prior to the first dose of study drug and until 21 days after last dose of study medication:
  -  Use an intrauterine device (IUD) with a documented failure rate of
  -  less than 1% per year.
  -  Have intercourse only with a vasectomized partner who is sterile
  -  and is the sole sexual partner for that woman.
  -  Complete abstinence from sexual intercourse.
  -  Use double barrier contraception defined as condom with
  -  spermicidal jelly, foam, suppository, or film; OR diaphragm with
  -  spermicide; OR male condom and diaphragm. NOTE: Oral contraceptives are not reliable due to potential for drug-drug interaction.
  -  Adequate organ system function as defined in the protocol.
  Exclusion Criteria:
  -  Use of an investigational anti-cancer drug within 28 days or 5 half-lives preceding the first dose of GSK1059615.
  -  Chemotherapy within the last 3 weeks (6 weeks for prior nitrosourea or mitomycin C). Chemotherapy regimens given continuously or on a weekly basis with limited potential for delayed toxicity are permitted with approval of the GSK medical monitor if administered at least 2 weeks prior to the first dose of study drug.
  -  Trastuzumab within the last 4 weeks.
  -  Any major surgery, radiotherapy, or immunotherapy within the last 4 weeks.
  -  Prior use of any PI3K inhibitor.
  -  Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the study drug. (To date there are no known FDA approved drugs chemically related to GSK1059615).
  -  Current use of a prohibited medication or requires any of these medications during treatment with GSK1059615 as per protocol.
  -  Current use of warfarin for therapeutic anticoagulation.
  -  NOTE: Low molecular weight heparin and prophylactic low-dose warfarin are permitted. PT/PTT must meet the inclusion criteria. Patients taking warfarin must have their INR followed closely.
  -  Presence of an active gastrointestinal disease or other condition known to interfere significantly with the absorption, distribution, metabolism, or excretion of drugs.
  -  Unresolved toxicity greater than Grade 1 from previous anti-cancer therapy except alopecia. Patients with stable Grade 2 neuropathy can be enrolled with approval by the GSK Medical Monitor.
  -  QTc interval ≥ 480 msecs.
  -  History of acute coronary syndromes (including unstable angina and myocardial infarction), atrial fibrillation, coronary angioplasty, or stenting within the past 24 weeks.
  -  Class II, III, or IV heart failure as defined by the New York Heart Association (NYHA) functional classification system.
  -  Symptomatic or untreated leptomeningeal or brain metastases. Patients previously treated for these conditions who are asymptomatic and off of corticosteroid and P450-inducing anti-epileptic medication for at least 2 months are permitted.
  -  Primary malignancy of the central nervous system.
  -  Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol.
  -  Concurrent condition that in the investigator's opinion would jeopardize compliance with the protocol.
  -  Nursing female.

Relevance to patient case: not relevant