Alisertib in Adults With Nonhematological Malignancies, Followed by Alisertib in Lung, Breast, Head and Neck or Gastroesophageal Malignancies

This is an open-label, multicenter study with a phase 1 dose escalation portion and a 2-stage, phase 2 portion, investigating MLN8237 (alisertib) in patients with advanced nonhematological malignancies.

Following the determination of the Recommended Phase 2 Dose (RP2D) and schedule (Phase 1), 20 response-evaluable patients in each of the 5 tumor indications will be enrolled (Phase 2-Stage 1). An interim analysis will determine which tumor indications will proceed to enroll an additional 25 patients (Phase 2-Stage 2) to further evaluate Overall Response Rate (ORR) and other secondary endpoints.

Eligibility Criteria:
Inclusion Criteria:

Each patient must meet all of the following inclusion criteria to be enrolled in the study:

* 18 years or older
* Histologically or cytologically confirmed metastatic and/or advanced solid tumor (Phase 1 only)
* Phase 2 requires Non-small cell lung cancer (NSCLC); Small-cell lung cancer; Breast adenocarcinoma (female patients only); Squamous cell cancer of the head and neck (HNSCC); or Gastroesophageal adenocarcinoma
* Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
* Female patients who are post menopausal, surgically sterile, or agree to practice 2 effective methods of contraception or abstain from heterosexual intercourse
* Male patients who agree to practice effective barrier contraception or agree to abstain from heterosexual intercourse
* Voluntary written consent
* Wiling to comply with scheduled visits, treatment plan, laboratory tests and other trial procedures
* Measurable disease (Phase 2 only)

Exclusion Criteria:

Patients meeting any of the following exclusion criteria are not to be enrolled in the study:

* Female patients who are pregnant or lactating
* Serious medical or psychiatric illness that could interfere with protocol completion
* Receipt of more than 2 previous cytotoxic chemotherapeutic regimens (4 previous regimens for breast cancer). There is no limit on the number of prior noncytotoxic therapies
* Prior treatment with Aurora A-targeted agents, including MLN8237
* Prior treatment with high-dose chemotherapy
* Prior allogeneic bone marrow or other organ transplant
* Antineoplastic therapy, radiation therapy or any experimental therapy 21 days prior to first dose of MLN8237
* Symptomatic brain metastasis
* Radiotherapy to greater than 25% of bone marrow
* Diagnosis or treatment of another malignancy within 2 years preceding first dose of study drug except nonmelanoma skin cancer or in situ malignancy completely resected
* Myocardial infarction within 6 months of enrollment
* Uncontrolled cardiovascular condition
* Major surgery within 14 days of first dose of MLN8237
* Active infection requiring systemic therapy, or other serious infection
* Inability to swallow oral medication
* Known history of human immunodeficiency virus (HIV) infection, hepatitis B, or hepatitis C
* Patients requiring full systemic anticoagulation
* History of uncontrolled sleep apnea syndrome
* Treatment with clinically significant enzyme inducers within 14 days prior to the first dose of MLN8237 and during the study