Absorption, Metabolism, Excretion and Pharmacokinetics of a Single Dose [14C]AZD2014 Followed by a Multiple Dose Phase
Condition: Solid Malignancies
MeSH terms: Neoplasms
Intervention: [14C]AZD2014; Multiple dose AZD2014; Fulvestrant; Paclitaxel
Intervention description: Radiolabelled dual TORC1/TORC2 inhibitor; Dual TORC1/TORC2 inhibitor; Hormonal Agent; Taxane
Intervention MeSH terms: Paclitaxel; Fulvestrant
Phase: Phase 1
Study type: Interventional
Primary purpose: Other
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 4.0
Sex: All
Minimum age: 18 Years
Maximum age: 130 Years
Healthy volunteers: No
Keywords: Radiolabelled

Summary:

      This Phase 1, open label, single centre, non-randomised study in patients with advanced solid
      malignancies consists of two parts:

        1. Single Dose Period - will characterise the absorption, metabolism, excretion and
           pharmacokinetics of a single oral dose of [14C]AZD2014 from the body

        2. Multiple Dose Period - will further assess the safety and tolerability and anti-tumour
           activity of multiple doses of AZD2014 when given as a monotherapy or given in
           combination with paclitaxel or fulvestrant.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Provision of signed, written & dated informed consent prior to any study specific
             procedures.

          -  Male or female patients aged at least 18 years.

          -  Have a body mass index (BMI) ≥18 kg/m2 and ≤35 kg/m2 & weigh at least 50 kg.

          -  Histological or cytological confirmation of a solid malignant tumour that is
             refractory or resistant to standard therapies or for which no suitable effective
             standard therapies exist. SqNSCLC patients are excluded from the 50mg BD AZD2014 in
             combination with paclitaxel cohort.

          -  For patients intending to enter combination therapy with fulvestrant or paclitaxel,
             this should be deemed as an appropriate treatment option by Investigator.

          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 with no
             deterioration over previous 2 weeks & minimum life expectancy of 12 weeks.

          -  At least one lesion (measurable and/or non-measurable but evaluable) that can be
             accurately assessed at baseline by computerised tomography (CT) magnetic resonance
             imaging (MRI) or plain X-ray & is suitable for repeated assessment

          -  Able & willing to stay in hospital for approximately 9 days

          -  Females should be using adequate contraceptive measures, should not be breast feeding
             & must have negative pregnancy test prior to start of dosing if of childbearing
             potential or must have evidence of non-childbearing potential

          -  Male patients should be surgically sterile or willing to use barrier contraception ie,
             condoms and spermicide &refrain from donating sperm from start of dosing until 16
             weeks after discontinuing of study treatment.

          -  Regular bowel movements (ie, on average production of at least 1 stool per day)

        Exclusion Criteria:

          -  Involvement in planning and/or conduct of the study

          -  Previous enrolment in present study

          -  Another study with an investigational product in last 28 days

          -  Chemotherapy, biological therapy, radiation therapy, androgens, thalidomide,
             immunotherapy, other anticancer agents & any investigational agents within 21 days of
             starting treatment (not including palliative radiotherapy at focal sites), or
             corticosteroids within 14 days

          -  Major surgery within 4 weeks, or minor surgery within 14 days

          -  Exposure to strong and moderate inhibitors or inducers of cytochrome P450 (CYP) 3A4/5,
             P-glycoprotein (Pgp) (multidrug resistance gene [MDR1]), and breast cancer resistance
             protein (BCRP), if taken within stated washout periods

          -  Exposure to specific substrates of the drug organic anion-transporting polypeptide
             (OATP)1B1, OATP1B3, organic anion transporting polypeptide (OCT)1 and OCT2 within
             appropriate washout period

          -  Any haemopoietic growth factors (eg, filgrastim [granulocyte colony-stimulating
             factor; G-CSF], sargramostim [granulocyte-macrophage colony-stimulating factor;
             GM-CSF]) within 14 days prior to receiving study treatment

          -  Previous treatment with AZD2014 or AZD8055

          -  Patients who have received fulvestrant within 3 months

          -  With exception of alopecia, any unresolved toxicities chemotherapy/radiotherapy should
             be no greater than CTCAE grade 1

          -  Participated in another absorption, distribution, metabolism and excretion study
             within 1 year

          -  Spinal cord compression and/or brain metastases unless asymptomatic or treated &
             stable off steroids for at least 4 weeks

          -  Severe or uncontrolled systemic diseases (eg, severe hepatic impairment, interstitial
             lung disease [bilateral, diffuse, parenchymal lung disease]), or current unstable or
             uncompensated respiratory or cardiac conditions, or uncontrolled hypertension, active
             bleeding diatheses or active infection including hepatitis B, hepatitis C and human
             immunodeficiency virus (HIV).

          -  Recent history of drug abuse or alcohol abuse

          -  Patients who have undergone any of the following procedures or experienced conditions
             currently or in preceding 12 months:

               -  Coronary artery bypass graft

               -  Angioplasty

               -  Vascular stent

               -  Myocardial infarction

               -  Angina pectoris

               -  Congestive heart failure New York Heart Association Grade 2

               -  Ventricular arrhythmias requiring continuous therapy

               -  Uncontrolled supraventricular arrhythmias including atrial fibrillation

               -  Haemorrhagic or thrombotic stroke, including transient ischaemic attacks or other
                  central nervous system bleeding

          -  Abnormal echocardiogram at baseline (left ventricular ejection fraction [LVEF] <55%
             and shortening fraction [SF] <15%)

          -  Torsades de Pointes either currently or within 12 months

          -  Mean resting QTcF ≥470 ms

          -  Medications known to prolong QT interval, or that increase the risk of QTc
             prolongation or arrhythmic events (such as heart failure, hypokalaemia, congenital
             long QT syndrome, family history of either long QT syndrome), or unexplained sudden
             death under 40 years of age

          -  Laboratory values as listed below:

               -  Absolute neutrophil count <1.5x109/L

               -  Platelet count <100x109/L

               -  Haemoglobin <90 g/L

               -  Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >2.5 times
                  upper limit of normal (ULN) if no demonstrable liver metastases or >5xULN in the
                  presence of liver metastases

               -  Total bilirubin >1.5xULN if no demonstrable liver metastases or >3xULN in the
                  presence of liver metastases

               -  Serum creatinine >1.5xULN concurrent with creatinine clearance <50 mL/min
                  (measured or calculated by Cockcroft and Gault equation), confirmation of
                  creatinine clearance is only required when creatinine is >1.5xULN

               -  Clinically relevant and treatment resistant abnormalities in potassium, sodium,
                  calcium (corrected for plasma albumin) or magnesium

          -  Pre-existing renal disease including glomerulonephritis, nephritic syndrome, Fanconi
             Syndrome or renal tubular acidosis

          -  Abnormal fasting glucose >126 mg/dL (>7 mmol/L)

          -  Patients with diabetes Type 1 or uncontrolled Type 2 (glycosylated haemoglobin [HbA1c]
             >8% [64 mmol/mol] assessed locally)

          -  Current refractory nausea and vomiting, chronic gastrointestinal disease or inability
             to swallow the formulated product or previous significant bowel resection that would
             preclude adequate absorption

          -  History of hypersensitivity to active or inactive excipients of AZD2014 or drugs with
             a similar chemical structure or class to AZD2014

          -  Judgment that patient is unsuitable to participate in study and unlikely to comply
             with study procedures, restrictions & requirements