Dose-finding Study of GSK2636771 When Administered in Combination With Enzalutamide in Male Subjects With Metastatic Castration-Resistant Prostate Cancer



Status:Recruiting
Conditions:Prostate Cancer, Cancer, Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - Any
Updated:10/11/2018
Start Date:November 13, 2014
End Date:December 2, 2019
Contact:US GSK Clinical Trials Call Center
Email:GSKClinicalSupportHD@gsk.com
Phone:877-379-3718

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A Phase I, Open-label, Dose-finding Study of GSK2636771 Administered in Combination With Enzalutamide (Xtandi^TM ) in Male Subjects With Metastatic Castration-Resistant Prostate Cancer (mCRPC)

This Phase I, open-label, dose-finding, multicenter study is designed to determine the
recommended Phase II dose (RP2D) for the combination of an orally administered
Phosphatidylinositol-4,5-bisphosphate 3-kinase beta (PI3K-beta) inhibitor (GSK2636771) with
enzalutamide. Subjects with phosphatase and tensin homolog (PTEN)-deficient metastatic
castration-resistant prostate cancer (mCRPC) who are receiving a stable dose of enzalutamide
with a recently demonstrated progression (either by RECIST [Response Evaluation Criteria In
Solid Tumors] version 1.1, prostate-specific antigen [PSA] progression, and/or progression in
bone) per the Prostate Cancer Working Group 2 (PCWG2) criteria will be enrolled. Eligible
subjects will be enrolled in the Dose-Escalation Phase to determine the maximum tolerated
dose (MTD) of the combination therapy using a modified 3+3 dose escalation procedure. The
safety, pharmacokinetics (PK) and clinical efficacy will also be assessed to guide the
selection of the RP2D. The starting dose will be GSK2636771 300 mg once daily in combination
with the recommended dose (160 milligram [mg] once daily) of oral enzalutamide. Once the RP2D
has been established, additional subjects will be enrolled in the Dose Expansion Phase to
further evaluate the safety, PK and preliminary clinical activity. Safety assessments will be
performed throughout the study including physical examinations, vital signs, clinical
laboratory tests, 12 lead electrocardiograms and monitoring of adverse events. Blood samples
will be collected for pharmacokinetic analysis. Subjects will continue treatment until an
unacceptable toxicity, disease progression, withdrawal of consent or death occurs. A
post-treatment follow-up visit will be performed within 30 days of the last dose of study
treatment. Xtandi is a registered trademark of Astellas Pharma Inc


Inclusion Criteria:

- Signed written informed consent provided

- Males >=18 years of age (at the time consent is obtained)

- Histologically or cytologically confirmed diagnosis of prostate adenocarcinoma,
surgically castrated or continuous medical castration (for >=8 weeks prior to
Screening)

- Serum testosterone <50 nanogram per deciliter (ng/dL) (1.7 nanomole per liter [nM/L])

- PTEN deficient tumor as documented from archival or fresh (from biopsy) tumor tissue
analyzed by GlaxoSmithKline selected laboratory

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

- Completed at least 12 weeks of prior continuous therapy with enzalutamide. A 2 week or
less treatment (enzalutamide) holiday will be permitted prior to initiating study
treatment.

- Most recent enzalutamide dose received is 160 mg once daily with no change in dose for
at least 2 weeks prior to Screening.

- Has progressive disease at time of enrollment defined as one or more of the following
criteria: PSA progression defined by PCWG2 criteria or soft tissue disease progression
defined by RECIST 1.1 or bone disease progression defined by PCWG2 criteria Able to
swallow and retain orally administered medication.

- Adequate baseline organ function.

- Must have a QT interval corrected for heart rate according to Fridericia's formula
(QTcF) <470 milli seconds (msec) or <480 msec with bundle branch block.

- Male subject with a female partner of childbearing potential must have either had a
prior vasectomy or agree to use effective contraception from time of Screening until 3
months after the last dose of study treatment.

Exclusion Criteria:

- Prior treatment with: anti-cancer therapy (e.g., chemotherapy with delayed toxicity,
immunotherapy, biologic therapy or chemoradiation) within 21 days (or within 42 days
if prior nitrosourea or mitomycin C containing therapy) prior to enrollment and/or
daily or weekly chemotherapy without the potential for delayed toxicity within 14 days
prior to enrolment. Subjects may remain on luteinizing hormone releasing hormone
(LHRH) agonists (i.e., leuprolide, goserelin, triptorelin or histrelin). Subjects must
have prior enzalutamide treatment; Any PI3K, AKT or mammalian target of rapamycin
(mTOR) inhibitors; Investigational drug(s) within 30 days or 5 half-lives, whichever
is longer, prior to enrollment

- Prior malignancy other than CRPC. Subjects who have been disease-free for 5 years, or
subjects with a history of completely resected non-melanoma skin cancer or
successfully treated in situ carcinoma are eligible.

- Current use of or anticipated requirement during the study of prohibited medication(s)
(any investigational drug(s), Other anti-cancer therapy (chemotherapy, radiation
therapy, immunotherapy, biologic therapy, or hormone therapy other than for
replacement), AR antagonists (e.g., bicalutamide, flutamide, nilutamide), 5-alpha
reductase inhibitors (e.g., finasteride, dutasteride), Androgens (e.g., testosterone,
dihydroepiandrosterone), Herbal medication(s) that may affect PSA levels (e.g., saw
palmetto), Other herbal medications including, but not limited to: St. John's wort,
kava, ephedra (ma huang), gingko biloba, yohimbe and ginseng)

- Any unresolved >=Grade 2 (per CTCAE v 4.0) toxicity from previous anti-cancer therapy
at the time of enrollment, except alopecia or Grade 2 anemia (if hemoglobin is >9.0
g/dL)

- Any >=Grade 2 hypophosphatemia (per CTCAE v4.0) at the time of enrolment

- Serum calcium >=Grade 1 (per CTCAE v4.0) at time of enrolment, unless ionized calcium
is within normal range

- Presence of any clinically significant gastrointestinal (GI) abnormality or other
condition(s) that may alter absorption such as malabsorption syndrome or major
resection of the stomach or substantial portion of the small intestine

- Active peptic ulcer disease or history of abdominal fistula, GI perforation, or intra
abdominal abscess within 28 days prior to enrolment

- Previous major surgery within 28 days prior to enrolment

- Known active infection requiring intravenous (IV) or oral anti-infective treatment

- Presence of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test
result at screening or within 3 months prior to first dose of study treatment.

- A positive pre-study drug/alcohol screening (testing at time of screening is not
required).

- A positive test for human immunodeficiency virus (HIV) antibody (testing at time of
screening is not required).

- Evidence of severe or uncontrolled systemic diseases (e.g., unstable or uncompensated
respiratory, hepatic, renal or cardiac disease)

- History of seizure or any condition that may predispose subject to seizure (e.g.,
prior cortical stroke or significant brain trauma). History of loss of consciousness
or transient ischemic attack within 12 months of randomization

- History or evidence of cardiovascular risk including any of the following: Clinically
significant electrocardiogram abnormalities including second degree (Type II) or third
degree atrioventricular block; history of myocardial infarction, acute coronary
syndromes (including unstable angina), coronary angioplasty, stenting, or bypass
grafting within the past 6 months prior to enrolment, Class III or IV heart failure as
defined by the New York Heart Association functional classification system, LVEF below
50%; known cardiac metastases

- Poorly controlled hypertension (defined as systolic blood pressure of>=150 millimeter
of mercury (mmHg) or diastolic blood pressure of >100 mmHg based on a mean of three
measurements at approximately 2-minute intervals)

- History of congenital platelet function defect (e.g., Bernard-Soulier syndrome,
Chediak-Higashi syndrome, Glanzmann thrombasthenia, storage pool defect)

- Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs
chemically related to GSK2636771or enzalutamide or excipients.

- Any serious and/or unstable pre-existing medical, psychiatric disorder or other
conditions that could interfere with subject's safety, obtaining informed consent or
compliance to the study procedures.

- Exposure to more than 4 investigational medicinal products within 12 months prior to
the first dose of study treatment
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