Clinical trial NCT02490800: Phase 1/2a Study of Oral BAL101553 in Adult Patients With Solid Tumors or Glioblastoma or High-grade Glioma
Official title: An Open-label Phase 1/2a Study of Oral BAL101553 in Adult Patients With Advanced Solid Tumors and in Adult Patients With Recurrent or Progressive Glioblastoma or High-grade Glioma
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
PHASE2
Conditions: Neoplasms
Keywords: Advanced solid tumors
Recurrent glioblastoma
High-grade glioma
Lead sponsor: Basilea Pharmaceutica
Sponsor class: INDUSTRY
First posted: 2015-07-07
Enrollment: 72
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: First in human, open-label, dose escalation (Phase I) and expansion study (Phase 2a) of oral lisavanbulin (BAL101553) in adult patients with advanced solid tumors and adult patients with recurrent or progressive glioblastoma (GBM) or high-grade glioma (HGG).

Detailed description: This was the first study of the oral formulation (hard capsules) of lisavanbulin. Lisavanbulin was administered once daily during each day of a 28-day treatment cycle to adults with advanced or recurrent solid tumors or recurrent or progressive GBM / HGG who had failed standard therapy, or for whom no effective standard therapy was available.

In Phase 1, the highest dose of lisavanbulin was determined that could safely be given to adults with advanced or recurrent solid tumors, recurrent or progressive GBM / HGG.

In Phase 2a, the tolerability and potential anticancer activity of oral lisavanbulin was assessed in patients with recurrent GBM whose tumor tissue tests positive for end-binding protein 1 (EB1). The study also measured pharmacokinetics.

Eligibility criteria: Main Inclusion Criteria:

1. Age ≥ 18 years
2. Patients who had in the Phase 1 portion either of the following:

   1. a histologically- or cytologically confirmed advanced or recurrent solid tumor, who failed standard therapy, or for whom no effective standard therapy was available to them
   2. histologically-confirmed GBM or HGG, with progressive or recurrent disease after prior radiotherapy, with or without chemotherapy. This also included patients with histologically-confirmed low-grade glioma who presented with unequivocal evidence by imaging of transformation to GBM / HGG

   Phase 2a dose expansion portion:

   Recurrent, histologically confirmed, glioblastoma with tumor tissue positive for EB1; eligible patients with de novo glioblastoma after prior radical chemo-radiotherapy or secondary glioblastoma after prior chemotherapy or radiotherapy.
3. Phase 1: Patients had to have measurable disease; according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria v1.1 for patients with advanced or recurrent solid tumors, and per radiological assessment in neuro-oncology (RANO) criteria for patients with recurrent or progressive GBM /HGG. Phase 2a: Patients had to be evaluable per RANO criteria.
4. Life expectancy ≥ 12 weeks
5. Acceptable organ and marrow function at baseline (protocol defined laboratory parameters)
6. Patients with advanced solid tumors had to have an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 and patients with recurrent or progressive glioblastoma had to have an ECOG performance status ≤ 2

Main Exclusion Criteria:

1. Patients with advanced or recurrent solid tumors who had received chemotherapy, radiotherapy, immunotherapy, or investigational agents within 4 weeks (2 weeks for single fraction of palliative radiotherapy, 6 weeks for nitrosoureas or mitomycin C) prior to starting study drug or who had not recovered from side effects of prior therapies

   Patients with recurrent or progressive GBM / HGG who had: received radiotherapy within 6 weeks (Phase 1) or 12 weeks (Phase 2a), unless there was a new area of enhancement consistent with recurrent tumor outside the radiation field; received administration of prior anti-tumor chemotherapy within 4 weeks, or within 6 weeks for nitrosoureas; undergone surgical resection within 4 weeks (Phase 2a: 2 weeks) or a stereotactic biopsy/core biopsy within 1 week prior to starting study drug;
2. Patients who have had prior exposure to lisavanbulin
3. Inability to swallow oral medication
4. Increase in steroid dose in GBM or HGG patients within 5 days prior to first study-drug administration or requirement for \> 6 mg/day dexamethasone or equivalent for symptom control.
5. Patients with gastrointestinal disease or those who have had a procedure that was expected to interfere with the oral absorption or tolerance of lisavanbulin
6. Symptomatic brain metastases or leptomeningeal disease, which was indicative of active disease, in patients with advanced or recurrent solid tumors.
7. Peripheral neuropathy ≥ CTCAE grade 2.
8. Uncontrolled intercurrent illness that would have unduly increased the risk of toxicity or limit compliance with study requirements
9. Systolic blood pressure (SBP) ≥ 160 mmHg or diastolic blood pressure (DBP) ≥ 100 mmHg at the screening visit.
10. Blood pressure (BP) combination treatment with more than two antihypertensive medications.
11. Women who were pregnant or breast-feeding. Men or women of reproductive potential who were not willing to apply effective birth control

Primary outcomes:
measure: Phase 1: Maximum Tolerated Dose (MTD) of Daily Oral Lisavanbulin
timeFrame: During first 28 day cycle
measure: Phase 2a: Best Objective Response
timeFrame: Until the study discontinuation, on average 161 days (maximum of 381 days)
measure: Phase 2a: Objective Response Rate (ORR)
timeFrame: Until the study discontinuation, on average 161 days (maximum of 381 days)
Secondary outcomes:
measure: Number of Patients With CTCAE Grade 3-4 TEAEs
timeFrame: TEAEs were defined as all events occurring after lisavanbulin treatment began and up to 28 days after last study drug administration which corresponded to a maximum of 1653 days (4,5 years)
measure: Cmax of Avanbulin (BAL27862)
timeFrame: Plasma PK profiles were obtained on Cycle 1, Day 1 and on Cycle 2, Day 1 (pre-dose and from 0 up to 24 h post-dose) for all patients in the Phase 1 study who received lisavanbulin. For Phase 2 a study, PK parameters were obtained only on Cycle 1, Day 1
measure: Tmax of Avanbulin (BAL27862)
timeFrame: Plasma PK profiles were obtained on Cycle 1, Day 1 and on Cycle 2, Day 1 (pre-dose and from 0 up to 24 h post-dose) for all patients in the Phase 1 study who received lisavanbulin. For Phase 2 a study, PK parameters were obtained only on Cycle 1, Day 1
measure: AUC of Avanbulin (BAL27862)
timeFrame: Plasma PK profiles were obtained on Cycle 1, Day 1 and on Cycle 2, Day 1 (pre-dose and from 0 up to 24 h post-dose) for all patients in the Phase 1 study who received lisavanbulin. For Phase 2 a study, PK parameters were obtained only on Cycle 1, Day 1
measure: Phase 1: Best Objective Response
timeFrame: Until the end of treatment, on average 151 days (maximum of 1653 days), every other 28 day cycle
measure: Phase 1: Objective Response Rate (ORR)
timeFrame: Until the study discontinuation, on average 151 days (maximum 1653 days), every other 28 day cycle
measure: Phase 2a: PFS
timeFrame: 1 year
measure: Phase 2a: PFS at 6 Months
timeFrame: 6 months
measure: Phase 2a: Overall Survival (OS) at 12 Months
timeFrame: 1 year
Other outcomes:
Locations:
city: Leuven
country: Belgium
facility: UZ Leuven
city: Frankfurt
country: Germany
facility: Klinikum der Goethe-Universität Frankfurt
city: Heidelberg
country: Germany
facility: Universitätsklinikum Heidelberg
city: Regensburg
country: Germany
facility: Universitätsklinikum Regensburg
city: Tübingen
country: Germany
facility: Universitätsklinikum Tübingen
city: Basel
country: Switzerland
facility: Universitätsspital Basel
city: Bern
country: Switzerland
facility: Inselspital Universitätsspital Bern
city: St. Gallen
country: Switzerland
facility: Kantonsspital St. Gallen
city: Zürich
country: Switzerland
facility: Universitätsspital Zürich
city: Glasgow
country: United Kingdom
facility: Beatson West of Scotland Cancer Centre
city: London
country: United Kingdom
facility: University College London NHS Foundation Trust
city: Newcastle upon Tyne
country: United Kingdom
facility: Sir Bobby Robson Cancer Trials Research Centre; Northern Centre for Cancer Care
city: Sutton
country: United Kingdom
facility: Royal Marsden Hospital
Study officials:
affiliation: Basilea Pharmaceutica International Ltd, Allschwil
name: Thomas Kaindl, MD
role: STUDY_DIRECTOR
References: