This Study in Patients With Different Types of Cancer (Solid Tumours) Aims to Find a Safe Dose of Xentuzumab in Combination With Abemaciclib With or Without Hormonal Therapies. The Study Also Tests How Effective These Medicines Are in Patients With Lung and Breast Cancer.



Status:Recruiting
Conditions:Breast Cancer, Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - Any
Updated:4/5/2019
Start Date:May 4, 2017
End Date:November 8, 2021
Contact:Boehringer Ingelheim Call Center
Email:clintriage.rdg@boehringer-ingelheim.com
Phone:1-800-243-0127

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An Open Label, Phase Ib, Dose-escalation Study Evaluating the Safety and Tolerability of Xentuzumab and Abemaciclib in Patients With Locally Advanced or Metastatic Solid Tumours and in Combination With Endocrine Therapy in Patients With Locally Advanced or Metastatic Hormone Receptor-positive, HER2-, Breast Cancer, Followed by Expansion Cohorts.

For each dose finding cohorts (A, B, C and D):

The primary objective of each dose finding cohort is to determine the maximum tolerated dose
(MTD) / recommended phase II dose (RP2D) of xentuzumab in combination with abemaciclib with
or without hormonal therapy (letrozole, anastrozole, fulvestrant). Dose limiting toxicities
(DLT) will be assessed during the first treatment cycle to assess the MTD/RP2D.

In case that no MTD is reached a RP2D dose will be determined taking into account safety data
and other available information. This will be agreed with the Steering Committee.

For each expansion cohorts (E, F, D1 and D2):

The objectives of the expansion cohorts are to assess the anti-tumour activity of xentuzumab
in combination with abemaciclib in patients with non-small cell lung cancer (cohort E).

Tentatively a cohort F may be opened to assess the anti-tumour activity of the triplet
combination xentuzumab / abemaciclib and fulvestrant in a single-arm expansion group of
patients with locally advanced / metastatic hormone receptor positive (HR+) breast cancer who
have progressed following prior aromatase inhibitor therapy and prior CDK4/6 inhibitor
treatment. Cohort F will only be opened if indicated by emerging data from ongoing clinical
trials.

The primary objective of cohorts D1 and D2 is to assess the anti-tumour activity of the
triplet combination xentuzumab, abemaciclib and fulvestrant in patients with locally advanced
/ metastatic HR+ breast cancer who have progressed on prior endocrine therapy. Cohort D1 will
assess the anti-tumour activity for subjects with visceral metastasis and Cohort D2 for
subjects with non-visceral metastasis.


Inclusion Criteria:

Cohort A (Solid Tumours)

- Age >= 18 years (>=20 years for Japan only) at screening

- Signed and dated written informed consent in accordance with GCP (Good Clinical
Practice and local legislation prior to admission to the trial

- WHO/ECOG (World Health Organization / Eastern Cooperative Oncology Group) performance
status 0-1 assessed at screening

- Patient must be able to swallow oral capsules.

- Male or female patients ready and able to use highly effective methods of birth
control during the study and for 3 weeks following the last dose of abemaciclib per
ICH (International Conference on Harmonization) M3(R2) that result in a low failure
rate of less than 1% per year when used consistently and correctly. A list of
contraception methods meeting these criteria is provided in the patient information.
Women of childbearing potential must have a negative serum pregnancy test at
screening.

- Patients with histologically or cytologically confirmed diagnosis of advanced and/or
metastatic, measurable or evaluable, non-resectable solid tumours

- Patients must have received and failed, or have been intolerant to, all treatment
known to confer clinical benefit or have no therapeutic options available as deemed
appropriate by their treating physician

- Life expectancy >= 3 months in the opinion of the investigator assessed at screening;

Cohorts B, C, D, F (Breast Cancer):

- Age >= 18 years (>=20 years for Japan only) at screening

- Signed and dated written informed consent in accordance with GCP and local legislation
prior to admission to the trial

- WHO/ECOG performance status 0-1 assessed at screening

- Patient must be able to swallow oral capsules.

- Women who have postmenopausal status due to either surgical/natural menopause or
chemical ovarian suppression (initiated at least 28 days prior to Day 1 of Cycle 1)
with a gonadotropin-releasing hormone (GnRH) agonist such as goserelin or
radiation-induced ovarian suppression.

- postmenopausal status due to surgical/natural menopause requires at least one of
the following conditions:

- prior bilateral oophorectomy

- age ≥ 60 years

- age < 60 years and amenorrheic (in the absence of tamoxifen,toremifene,
ovarian suppression, or chemotherapy) for at least 12 months; and
follicle-stimulating hormone (FSH) and estradiol within the postmenopausal
range as per institutional reference ranges.

- Postmenopausal status due to radiation-induced ovarian suppression must be
confirmed by FSH and estradiol level in the postmenopausal range

- Histologically or cytologically proven diagnosis of breast cancer with evidence of
locally advanced or metastatic disease not amenable to resection or radiation

- HR+ (local lab results at screening or, if not available, at the time of diagnosis) To
fulfil the requirement of HR+ disease, the primary tumour or metastatic lesion of the
breast cancer must express at least one of the hormone receptors (estrogen receptor
[ER] or progesterone receptor [PgR]) by immunohistochemistry (IHC). Estrogen receptor
and PgR assays are considered positive if there are at least 1% positive tumour nuclei
in the sample as defined in the relevant American Society of Clinical Oncology
(ASCO)/College of American Pathologists (CAP) Guidelines (Hammond et al. 2010).

- HER2 negative (local lab results at screening or, if not available, at the time of
diagnosis) as defined by the most recent American Society of Clinical Oncology
(ASCO)/College of American Pathologists (CAP) Guidelines (Hammond et al. 2010).

- Previous adjuvant and neoadjuvant chemotherapy is permitted. 0-2 prior lines of
chemotherapy for the metastatic setting are allowed.

- At least 1 lesion (measurable or non-measurable) that can be accurately assessed at
baseline with CT or MRI or PET-CT (CT portion of diagnostic quality) and which is
suitable for accurate repeated measurement. For Cohort F only: patients should have at
least one measurable lesion.

- Cohort B, C, D, F Must be eligible for the corresponding hormonal therapy (letrozole,
anastrozole or fulvestrant). For Cohorts B and C previous treatment with fulvestrant
or exemestane is allowed. For Cohort D and F prior therapy with non steroidal
aromatase inhibitors (anastrozole, letrozole) or exemestane are permitted

- Cohort F only: Postmenopausal with locally advanced or metastatic HR+ breast cancer
and refractory to aromatase inhibitors therapy and CDK4/6 inhibitor treatment (e.g.,
palbociclib or ribociclib) for locally advanced or metastatic breast cancer.Resistance
to aromatase inhibitors therapy is defined as the following:

- disease recurrence while on, or within 12 months of end of adjuvant treatment
with letrozole, anastrozole, or exemestane;

- or disease progression while on, or within one month of end of letrozole,
anastrozole, or exemestane.

Cohort E (NSCLC (Non-Small Cell Lung Cancer)):

- Age >= 18 years (>=20 years for Japan only) at screening

- Signed and dated written informed consent in accordance with GCP and local legislation
prior to admission to the trial

- WHO/ECOG performance status 0-1 assessed at screening

- Patient must be able to swallow oral capsules.

- Male or female patients ready and able to use highly effective methods of birth
control during the study and for 12 weeks following the last dose of abemaciclib per
ICH M3 (R2) that result in a low failure rate of less than 1% per year when used
consistently and correctly. A list of contraception methods meeting these criteria is
provided in the patient information. Women of childbearing potential must have a
negative serum pregnancy test at screening.

- Histologically or cytologically confirmed diagnosis of stage IV NSCLC.

- The participant must have progressed after platinum-based chemotherapy AND
immunotherapy (unless deemed inappropriate candidates for immunotherapy by their
treating physician) AND have received a maximum of 2 other prior chemotherapy for
advanced and/or metastatic disease OR must be judged by the physician as ineligible
for further standard second-line chemotherapy. Prior treatment with epidermal growth
factor receptor-tyrosine kinase inhibitor (EGFR-TKI) and anaplastic lymphoma kinase
(ALK) inhibitors is mandatory in participants whose tumour has EGFR-activating
mutations or ALK translocations. Prior targeting agents and neoadjuvant/adjuvant
therapies are permitted.

- Have adequate organ function including haematology, renal, and liver.

- Have measureable disease per Response Evaluation Criteria In Solid Tumours (RECIST)
1.1.

- Further inclusion criteria apply

Exclusion Criteria:

Cohorts A, B, C, D (dose finding), E and F:

- Any documented active or suspected malignancy or history of malignancy, other than the
disease under study, within 3 years prior to screening, except appropriately treated
basal cell carcinoma of the skin or in situ carcinoma of uterine cervix or ductal
carcinoma in situ (DCIS) if properly treated in opinion of the investigator.

- Patients who must or wish to continue the intake of restricted medications or any drug
considered likely to interfere with the safe conduct of the trial

- Previous treatment in this trial

- Currently enrolled in another investigational device or drug study, or less than 21
days since ending another investigational device or drug study(s), or receiving other
investigational treatment(s).

- Chronic alcohol or drug abuse or any condition that, in the investigator's opinion,
makes them an unreliable study subject or unlikely to complete the trial

- Women who are pregnant, nursing, or who plan to become pregnant while in the trial.
Men who plan to father a child while in the trial.

- Prior anti-cancer chemotherapy, biological or radiation therapy, androgens,
thalidomide, other anticancer agents, or any investigational drug within 21 days (14
days for nonmyelosuppressive agents); and/or 4 weeks for immunotherapy, before
starting any of the trial drugs.

- Prior anti CDK (Cyclin-dependent Kinase) agents (except cohort F)

- Prior radiotherapy to >= 25% of bone marrow regardless of when it was received

- Unresolved treatment related toxicity from previous therapy of > CTCAE grade 1 at
study entry (except for stable sensory neuropathy ≤ CTCAE grade 2 and alopecia)

- Previous treatment with IGF (Insulin-like Growth Factor)-1R targeting compounds

- Known active uncontrolled or symptomatic CNS metastases, carcinomatous meningitis, or
leptomeningeal disease, as indicated by clinical symptoms, cerebral oedema, and/or
progressive growth. History of CNS metastases or cord compression are eligible if they
have been definitively treated (e.g. radiotherapy, stereotactic surgery) and are
clinically stable, off anticonvulsants and steroids for at least 4 weeks. Patients
with brain metastases are eligible if they are asymptomatic, completed radiotherapy
for at least 4 weeks or are on a stable dose of steroids for at least 4 weeks.
Patients are not eligible if they have spinal cord compression.

- Any evidence of severe or uncontrolled systemic disease as judged by the Investigator.

- Inadequate bone marrow reserve or organ function as demonstrated by any of the
following: ANC < 1.5 x 109/L, platelets < 100 x 109/L, haemoglobin <90g/L, ALT > 2.5 x
ULN or > 5 x ULN in the presence of liver metastases, total bilirubin >1.5 x ULN or >3
x ULN in patients with Gilbert's Syndrome, serum creatinine > 1.5 x ULN concurrent
with creatinine clearance <= 50 mL/min.

- Pre-existing renal disease including glomerulonephritis, nephritic syndrome, Fanconi
Syndrome or renal tubular acidosis

- Refractory nausea and vomiting, chronic GI diseases, inability to swallow the product,
or previous significant bowel resection that would preclude adequate absorption of
abemaciclib or resulting in baseline Grade 2 or higher diarrhoea.

- History of hypersensitivity to active or inactive excipients of xentuzumab,
abemaciclib or letrozole/anastrozole/fulvestrant, or loperamide hydrochloride, or
drugs with similar chemical structures

- Patients with Diabetes Type I or uncontrolled Type II (defined by HgBA1C > 8%)

- Patients with advanced/metastatic, symptomatic, visceral spread, that are at risk of
life threatening complications in the short term including patients with massive
uncontrolled effusions (pleural, pericardial, peritoneal), pulmonary lymphangitis, and
over 50% of liver involvement in metastases.

- Prior hematopoietic stem cell or bone marrow transplant

- Have a personal history of any of the following conditions: syncope of either
unexplained or cardiovascular etiology, ventricular arrhythmia (including but not
limited to ventricular tachycardia and ventricular fibrillation), or sudden cardiac
arrest. Subjects with controlled atrial fibrillation for >30 days prior to study
treatment are eligible.

- Erythropoietin, G-CSF, and GM-CSF are not allowed within 2 weeks prior to study. The
primary prophylactic use of G-CSF is not permitted but it may be used to treat
treatment emergent neutropenia.

- Have had major surgery (excluding biopsy) < 28 days of the initial dose of any of the
study drugs or planned major surgery during study participation.

- Have active bacterial or fungal infection (that is, requiring IV antibiotics or
therapy at time of initiating study treatment), and/or known viral infection (for
example, human immunodeficiency virus [HIV] antibodies, hepatitis B surface antigen,
or hepatitis C antibodies). Screening is not required for enrolment.

- Patients with baseline Grade >=2 hyperglycaemia or patients with baseline Grade >= 2
diarrhoea

- Patients needing treatment with CYP3A4 inhibitors/inducers cannot be included in the
trial.

- Further exclusion criteria apply
We found this trial at
6
sites
333 Cedar St
New Haven, Connecticut 06504
(203) 432-4771
Phone: +001 (203) 785-5944
Yale University School of Medicine Founded in 1810, the Yale School of Medicine is a...
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Chapel Hill, North Carolina 27599
(919) 962-2211
Phone: +001 (919) 966-8218
University of North Carolina at Chapel Hill Carolina’s vibrant people and programs attest to the...
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9280 W. Sunset Road Suite 100
Las Vegas, Nevada 89148
702.952.1251
Phone: +001 (702) 952-3400
Comprehensive Cancer Centers of Nevada Comprehensive Cancer Centers of Nevada (CCCN) is the award-winning multidisciplinary...
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Marseille, 13273
Phone: +33 (0)4 91 22 35 37
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Marseille,
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Minneapolis, Minnesota 55455
Phone: +001 (612) 626-8487
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Minneapolis, MN
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405 Hilgard Avenue
Santa Monica, California 90404
Phone: +001 (310) 794-6500
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Santa Monica, CA
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