Mass Balance, Pharmacokinetics and Metabolism Study of Alisertib

The drug being tested in this study is called alisertib (MLN8237). Alisertib is being tested
to treat participants who have advanced solid tumors or lymphomas. This study looked at mass
balance, pharmacokinetics (PK), metabolism, elimination and safety of alisertib.

The study enrolled 3 patients. The study consisted of 2 parts: Part A and Part B.
Participants received:

- [^14C]-alisertib 35 mg in Part A

- alisertib 50 mg in Part B

Participants were asked to take a single dose of [^14C]-alisertib oral solution containing
80-100 μCi of total radioactivity (1.19-1.48 mCi/mmol) in Part A and alisertib 50 mg, orally,
twice daily for 7 days in 21-day cycles until disease progression or unacceptable toxicity in
Part B.

This single center trial was conducted in United States. The overall time to participate in
this study was up to 117 days. Participants remained confined to clinic in Part A and made
multiple visits to the clinic in Part B. Participants were contacted 30 days after last dose
of alisertib in Part A (if not continuing in Part B), or were contacted by telephone or a
final visit 30 days after receiving their last dose of alisertib in Part B for a follow-up
assessment.

Inclusion Criteria:

Each participants 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 tumors or
lymphomas for which standard curative or life-prolonging treatment does not exist, or
is no longer effective or tolerable.

- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.

- Expected survival longer than 3 months from enrollment in the study.

- Radiographically or clinically evaluable tumor.

- Suitable venous access for the conduct of blood sampling.

- Recovered from the reversible effects of prior antineoplastic treatment (with the
exception of alopecia and Grade 1 neuropathy).

- Female participants who are postmenopausal for at least 1 year OR are surgically
sterile OR if of childbearing potential, agree to practice 2 effective methods of
contraception at the same time.

- Male participants who agree to practice effective barrier contraception during the
entire study and through 4 months after the last dose of study drug OR agree to
abstain from heterosexual intercourse.

Exclusion Criteria:

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

- Female participants who are lactating or have a positive serum pregnancy test.

- Treatment with any investigational products or systemic antineoplastic treatment
within 21 days before the first dose of alisertib.

- Medical conditions requiring daily, chronic, or regular use of proton pump
inhibitors(PPIs) within 7 days preceding the first dose of alisertib, or H2-receptor
antagonists within 24 hours preceding the first dose of alisertib.

- Participants requiring systemic anticoagulation (excluding low-dose aspirin, or
low-dose anticoagulation to maintain patency of venous access devices). Low molecular
weight heparin, administered as preventive treatment, is allowed if the participant
has tolerated treatment with a stable dose and schedule without bleeding complications
for more than 1 month.

- Major surgery within the 14 days preceding the first dose of alisertib.

- Infection requiring systemic intravenous (IV) antibiotic therapy within 14 days
preceding the first dose of study drug, or other severe infection.

- Life-threatening or uncontrolled medical illness unrelated to cancer.

- Ongoing nausea or vomiting that is Grade 2 or worse in intensity.

- Diarrhea that is Grade 2 or worse in intensity or use of an antimotility agent to
control diarrhea to an intensity of Grade 1 or lower level.

- Known GI disease or GI procedures that could interfere with the oral absorption,
excretion, or tolerance of alisertib.

- History of urinary and/or fecal incontinence.

- History of uncontrolled sleep apnea syndrome and other conditions that could result in
excessive daytime sleepiness such as severe chronic obstructive pulmonary disease.

- Inability to swallow tablets, or inability or unwillingness to avoid taking anything
by mouth except for water and prescribed medications for 2 hours before and 1 hour
after the first dose of alisertib.

- Inadequate bone marrow or other organ function as specified in study protocol.

- Any cardiovascular condition specified in the study protocol.

- Known or suspected human immunodeficiency virus (HIV) positive or hepatitis B surface
antigen-positive status, or known or suspected active hepatitis C infection.

- Inability to comply with study visits and procedures including required inpatient
confinement (approximately 11-17 days).

Please note that there are additional exclusion criteria. The study center will determine
if you meet all of the criteria.