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Preoperative Ceritinib (LDK378) in Glioblastoma Multiforme and CNS Metastasis

Study Purpose

This is two parallel studies to examine pharmacokinetic (PK), pharmacodynamic (PD), and pharmacogenetic (PG) endpoints following short-interval therapy (10-14) daily doses without dose reduction and interruption) with the ALK (anaplastic lymphoma kinase) small-molecule inhibitor, ceritinib. The Phase 0 study will investigate: 1. first recurrence GBM patients and. 2. patients with CNS metastases from solid tumors such as, but not limited to, NSCLC (non-small cell lung cancer) and melanoma. The CNS (central nervous system) metastases Phase 0 is designed to identify PK effects (in addition to PD, and PG effects on ALK-positive NSCLC metastases), while the GBM Phase 0 is designed to identify PK, PD, and PG effects in all patients.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - One prior resection of GBM or MRI evidence of solid tumor CNS metastasis.
  • - All GBM and NSLC metastases must be ALK+ - Eastern Cooperative Oncology Group performance status ≤2.
  • - Archival tumor tissue block available for research use.
  • - Ability to understand written informed consent.
  • - Recovery from toxicities related to prior anticancer therapies to ≤ grade 2 (CTCAE v 4.03).
Exception: patients with any grade alopecia.
  • - The following lab criteria are met: - Absolute neutrophil count ≥ 1.5 x 10(9th power)/L.
  • - Hemoglobin ≥ 8 g/dL.
  • - Platelets ≥ 75 x 10(9th power)/L.
  • - Serum total bilirubin ≤ 1.5 x upper limit of normal(ULN), except for patients with Gilbert's syndrome who may be included if total bilirubin ≤ 3.0 x ULN and direct bilirubin ≤ 1.5 x ULN.
  • - Aspartate transaminase (AST) < 3.0 x ULN, except for patients with liver metastasis, who are only included if AST < 5 x ULN; alanine transaminase (ALT) < 3.0 x ULN, except for patients with liver metastasis, who are only included if ALT < 5 x ULN.
  • - Creatinine clearance ≥ 30 mL/min.
  • - Patient has following lab values or has lab values corrected with supplements to be within normal limits at screening: - Potassium ≥ LLN.
  • - Magnesium ≥ LLN.
  • - Phosphorus ≥ LLN.
  • - Total calcium (corrected for serum albumin) ≥ LLN.

Exclusion Criteria:

  • - Co-morbid condition(s) that prevent safe surgical treatment.
  • - Active infection or fever > 38.5°C.
  • - Patients with known hypersensitivity to any excipients of ceritinib.
  • - Prior therapy with ceritinib.
  • - Patients with known history of extensive disseminated bilateral interstitial fibrosis or interstitial lung disease, including a history of pneumonitis, hypersensitivity pneumonitis, interstitial pneumonia, obliterative bronchiolitis, and clinically significant radiation pneumonitis (affecting activities of daily living or requiring therapeutic intervention) - Clinically significant uncontrolled heart disease and/or recent cardiac event (within 6 months), such as: - history of documented congestive heart failure (New York Heart Association functional classification III-IV); - uncontrolled hypertension defined by a Systolic Blood Pressure ≥ 160 mm Hg and/or Diastolic Blood Pressure ≥ 100 mm Hg, with or without antihypertensive medication.
  • - initiation or adjustment of antihypertensive medication(s) is allowed prior to screening; - ventricular arrhythmias; supraventricular and nodal arrhythmias not controlled with medication; - other cardiac arrhythmia not controlled with medication; - corrected QTc > 450 msec using Fridericia correction on the screening ECG.
  • - Impaired GI function or GI disease that may alter absorption of ceritinib or inability to swallow up to five ceritinib capsules daily.
  • - Ongoing GI adverse events > grade 2 (e.g. nausea, vomiting, or diarrhea) at the start of the study.
  • - Receiving medications that meet 1 of the following criteria and cannot be discontinued at least 1 week prior to start of treatment with ceritinib and for the duration of participation: - Medication with a known risk of prolonging the QT interval or inducing Torsades de Pointes.
  • - Strong inhibitors or strong inducers of CYP3A4/5.
  • - Medications with a low therapeutic index that are primarily metabolized by CYP3A4/5, CYP2C8 and/or CYP2C9.
  • - Therapeutic doses of warfarin sodium (Coumadin) or any other coumadin-derived anti-coagulant.
Anticoagulants not derived from warfarin are allowed.
  • - Pregnant or nursing (lactating) women.
  • - Women of child-bearing potential, unless they are using highly effective methods of contraception during dosing and for 3 months after the last dose of study treatment.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT02605746
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Early Phase 1
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

St. Joseph's Hospital and Medical Center, Phoenix
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Nader Sanai, MD
Principal Investigator Affiliation Barrow Brain and Spine, Phoenix AZ
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other, Industry
Overall Status Completed
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Glioblastoma, Brain Metastases
Additional Details

This study is being done to learn about a new drug, Ceritinib (LKD378). The results of the study may reveal how the drug works for cancer that spreads to the brain (metastases) and for a type of brain cancer called glioblastoma (GBM). Subjects are persons scheduled to have surgery to remove the tumor.This study would test how much of the new drug is present in the tumor, blood, and cerebrospinal fluid (CSF) after taking the drug orally for 10-14 days before surgery. It is only given to patients who are already scheduled to have surgery to remove a tumor that has returned. If the drug seems to be working for a subject's tumor, subject will have the option to continue to receive it as part of a continuation study looking at the drug effect on preventing the tumor from recurring. Small samples of blood, tumor tissue, and CSF will be taken. These samples will be sent to and analyzed at the Barbara Ann Karmanos Cancer Institute (KCI) and to the Translational Genomics Research Institute (TGen). Subject involvement will be for 10-14 days before surgery and for 30 days following surgery. Patients with ALK+ solid tumors will be provided the option of continuing therapy until tumor progression. ALK positivity will be assessed by approved FISH test (Abbott Molecular Inc) using Vysis break apart probes (defined as 15% or more positive tumor cells), the Ventana IHC (immunohistochemistry) test, and/or NGS (next generation sequencing).

Arms & Interventions

Arms

Experimental: 2-4 hours

All patients will be orally-administered 10-14 doses of ceritinib 750mg with the final dose occurring at one of three intervals before brain tumor resection. This arm has the last ceritinib dose 2-4 hours prior to craniotomy for tumor resection.

Experimental: 4-8 hours

All patients will be orally-administered 10-14 doses of ceritinib 750mg with the final dose occurring at one of three intervals before brain tumor resection. This arm has the last ceritinib dose 4-8 hours prior to craniotomy for tumor resection.

Experimental: 22-26 hours

All patients will be orally-administered 10-14 doses of ceritinib 750mg with the final dose occurring at one of three intervals before brain tumor resection. This arm has the last ceritinib dose 22-26 hours prior to craniotomy for tumor resection.

Interventions

Drug: - ceritinib 750mg

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Barrow Brain and Spine, Phoenix, Arizona

Status

Address

Barrow Brain and Spine

Phoenix, Arizona, 85013