Safety, PK of AKT and MEK Combination
Diagnosis: Solid Tumor/Phase I
NCT ID: NCT01138085
(View complete trial on ClinicalTrials.gov)
DFCI Protocol ID: 12-512
This study is a Phase 1 dose-escalation open-label study to determine the recommended Phase II dose and regimen for the combination of the orally administered MEK inhibitor GSK1120212 and the orally administered AKT kinase inhibitor GSK2141795. The recommended dose and regimen of the combination in Part 2 will be selected based on the safety, pharmacokinetic, and pharmacodynamic profiles observed after the treatment of subjects with solid tumors in Part 1. The study consists of two parts. Part 1 will identify the maximum tolerated dose using a Zone-Based, modified 3+3 dose escalation procedure. Dose escalation will continue based on predefined parameters until a maximum tolerated dose is established. The initial regimen will be continuous oral daily dosing. This regimen may be adjusted based on emerging data. Part 2 will explore further the safety, tolerability, and clinical activity of the combination of GSK1120212 and GSK2141795 at the recommended dose(s) identified in Part 1 in up to 40 subjects with pancreatic cancer, endometrial cancer or colorectal cancer.
Massachusetts General Hospital, Beth-Israel Deaconess Medical Center
Daniel Cho, MD,
Beth Israel Deaconess Medical Center
Rebecca Heist, MD,
Massachusetts General Hospital
Beth-Israel Deaconess Medical Center:
Cancer Trials Call Center, 617-667-3060
Massachusetts General Hospital:
Cancer Trials Call Center, 877-789-6100
- Part 1 - Dose Escalation
Subjects eligible for enrollment in the study must meet all of the following criteria:
- Male or female 18 years or older, at the time of signing the informed consent.
- Capable of giving written informed consent, which includes compliance with the
requirements and restrictions listed in the consent form.
- Histologically or cytologically-confirmed diagnosis of solid tumor malignancy that is
not responsive to standard therapies or for which there is no approved or curative
therapy or for subjects who refuse standard therapy.
- Performance Status score of 0 or 1 according to the Eastern Cooperative Oncology
Group (ECOG) scale.
- Able to swallow and retain oral medication.
- A female subject is eligible to participate if she is of:
Non-childbearing potential defined as pre-menopausal females with a documented tubal
ligation or hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea
(in questionable cases a blood sample with simultaneous follicle stimulating hormone [FSH]
> 40 MlU/ml and estradiol < 40 pg/ml [<140 pmol/L] is confirmatory). Females on hormone
replacement therapy [HRT] and whose menopausal status is in doubt will be required to use
one of the contraception methods in Section 7.3.2 if they wish to continue their HRT
during the study. Otherwise, they must discontinue HRT to allow confirmation of
post-menopausal status prior to study enrollment. For most forms of HRT, at least 2 to 4
weeks will elapse between the cessation of therapy and the blood draw; this interval
depends on the type and dosage of HRT. Following confirmation of their post-menopausal
status, they can resume use of HRT during the study without use of a contraceptive method.
Child-bearing potential and agrees to use one of the contraception methods listed in
Section 7.3.2 for an appropriate period of time (as determined by the product label or
investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy
at that point. Female subjects must agree to use contraception until four weeks after the
last dose of study medication.
Note: Oral contraceptives are not reliable due to potential drug-drug interaction.
- Male subjects must agree to use one of the contraception methods listed in protocol.
This criterion must be followed from the time of the first dose of study medication
until three months after the last dose of study medication. However, the Sponsor
advises that contraception be used for a total of 16 weeks following the last dose
(based on the lifecycle of sperm).
- Adequate organ system function as defined in protocol. Definitions of Adequate Organ
Absolute neutrophil count (ANC) ≥ 1.5 X 109/L Hemoglobin ≥ 9.5 g/dL Platelets ≥ 75 X 109/L
PT/INR and PTT ≤ 1.1 X ULN
Total bilirubin ≤ 1.5 x ULN (isolated bilirubin > 1.5 x ULN is acceptable if bilirubin is
fractionated and direct bilirubin < 35%) AST and ALT ≤ 2.5 X ULN
Creatinine ≤ ULN OR Calculated creatinine clearance ≥ 50 mL/min OR 24-hour urine
creatinine clearance ≥ 50 mL/min
Calcium phosphate product (CPP) ≤4.0 mmol2/L2 (50mg2/dL)
Fasting Serum Glucose < 126mg/dL Cardiac Ejection fraction ≥ LLN by ECHO or MUGA
Inclusion Criteria for Part 2 - Expansion Cohort:
- Histologically- or cytologically-confirmed diagnosis of metastatic pancreatic cancer,
metastatic endometrial cancer or metastatic colorectal cancer.
- Subjects with metastatic pancreatic cancer and an ECOG Performance Status of 2 may
Subjects meeting any of the following criteria must not be enrolled in the study:
- Chemotherapy, radiotherapy, or immunotherapy within 28 days (or 42 days for prior
nitrosoureas or mitomycin C) prior to the first dose of GSK2141795. Cancer therapy
given continuously or on a weekly basis with limited potential for delayed toxicity
is permitted with approval of a GSK Medical Monitor if dosing of that therapy is
terminated at least five half-lives prior to the first dose of the investigational
study drug and any drug-related toxicity has recovered to Grade 1 or less.
- Use of an investigational anti-cancer drug within 28 days or five half-lives,
whichever is shorter, prior to the first dose of the investigational study drugs. A
minimum of 10 days between termination of the investigational drug and administration
of GSK1120212 and GSK2141795 is required. In addition, any drugrelated toxicity
should have recovered to Grade 1 or less.
- Current use of a prohibited medication (see Section 6.2) or requires any of these
medications during treatment with the investigational drugs.
- Anticoagulants at therapeutic doses (e.g., warfarin, low molecular weight heparin,
direct thrombin inhibitors) are permitted only after consultation with the GSK
Medical Monitor. Low dose (prophylactic) anticoagulants are permitted provided that
the subject's PT and PTT meet entry criteria and do not increase from baseline while
taking study drug.
- Unresolved toxicity greater than National Cancer Institute (NCI) Common Terminology
Criteria for Adverse Events, version 4.0 (NCI-CTCAE v4) Grade 1 from previous
anti-cancer therapy unless agreed to by a GSK Medical Monitor and the Investigator,
and where a GSK Medical Monitor and the investigator consider that the ongoing
toxicity will not introduce additional risk factors and will not interfere with the
- Presence of active GI disease or other condition that will interfere significantly
with the absorption, distribution, metabolism, or excretion of drugs or may
predispose a subject to GI ulceration.
- Previously diagnosed with diabetes mellitus (type 1 or 2).
- History of known HIV infection.
- Primary malignancy of the central nervous system.
- Symptomatic or untreated leptomeningeal or brain metastases or spinal cord
compression. Subjects who were previously treated for these conditions, and are
stable for 3 months and who have been without anti-epileptic medications or steroids
for at least 2 months are eligible.
- QTc interval ≥ 480 msecs.
- History of acute coronary syndromes (including unstable angina and myocardial
infarction), atrial fibrillation, coronary angioplasty, or stenting within the past
- Class II, III, or IV heart failure as defined by the New York Heart Association
(NYHA) functional classification 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.
- Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs
chemically related to the study drug, dimethyl sulfoxide (DMSO), or excipients. To
date there are no known FDA approved drugs chemically related to the investigational
- Evidence of severe or uncontrolled systemic diseases (e.g., unstable or uncompensated
respiratory, hepatic, renal, or cardiac disease).
- Pregnant or lactating females.
- History of retinal vein occlusion (RVO) or central serous retinopathy (CSR).
- Visible retinal pathology as assessed by ophthalmologic exam that is considered a
risk factor for retinal vein thrombosis or central serous retinopathy.
- Intraocular pressure > 21mm Hg measured by tonography.
- Glaucoma diagnosed within one month prior to the first dose of the investigational
- Other clinically significant ECG abnormalities including 2nd degree (type II) or 3rd
degree atrioventricular (AV) block.
- History of hepatitis B or C. NOTE: Subjects with evidence of cleared hepatitis B
infection are permitted.