Trial Outcomes & Findings for Linsitinib in Treating Patients With Gastrointestinal Stromal Tumors (NCT NCT01560260)

NCT ID: NCT01560260

Last Updated: 2018-09-21

Results Overview

Determine the response rate, Complete Response (CR) or Partial Response (PR), to treatment with linsitinib (OSI-906) in patients with advanced wild-type (WT) gastrointestional stromal tumor (GIST) as determined by RECIST 1.1.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

20 participants

Primary outcome timeframe

At 6 months

Results posted on

2018-09-21

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment (Linsitinib)
Patients receive linsitinib orally (PO) twice daily (BID) on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Overall Study
STARTED
20
Overall Study
COMPLETED
20
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Linsitinib in Treating Patients With Gastrointestinal Stromal Tumors

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Linsitinib)
n=20 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Age, Categorical
<=18 years
1 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
19 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
Age, Continuous
41 years
STANDARD_DEVIATION 13 • n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
Sex: Female, Male
Male
8 Participants
n=5 Participants
Region of Enrollment
United States
20 participants
n=5 Participants

PRIMARY outcome

Timeframe: At 6 months

Population: 0 out of 20 patients had a response

Determine the response rate, Complete Response (CR) or Partial Response (PR), to treatment with linsitinib (OSI-906) in patients with advanced wild-type (WT) gastrointestional stromal tumor (GIST) as determined by RECIST 1.1.

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=20 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Number of Participants With Complete Response or Partial Response Using Response Evaluation Criteria in Solid Tumors Guideline Version 1.1
0 participants

SECONDARY outcome

Timeframe: Up to 2 years

Prolonged non-progression is of clinical benefit (CR + PR + SD at 9 months).

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=20 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Clinical Benefit Rate Defined as Stable Disease (SD) >= 9 Months, Partial Response (PR) or Complete Response (CR)
40 percentage of participants

SECONDARY outcome

Timeframe: Estimates at 9 months

Analyzed using Kaplan-Meier curves for the all treated and per protocol populations.

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=20 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Overall Survival (OS)
80 percentage of participants

SECONDARY outcome

Timeframe: Time from date of enrollment to time of progression or death due to any cause, estimates at 9 months

Analyzed using Kaplan-Meier curves for the all treated and per protocol populations.

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=20 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Progression Free Survival (PFS)
52 percentage of participants

SECONDARY outcome

Timeframe: Up to 37 weeks

Population: No responses were observed.

Analyzed using Kaplan-Meier curves for the all treated and per protocol populations.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 37 weeks

Population: Data was not collected for this outcome measure due to limited activity seen with the study treatment.

Analyzed using Kaplan-Meier curves for the all treated and per protocol populations

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 37 weeks

Population: 285 Adverse Events reported during the study.

To determine the tolerability and adverse event profile of OSI-906 in patients with advanced GIST.

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=285 Adverse Events
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Tolerability and Adverse Event Profile of Linsitinib
Related to study drug
101 Adverse Events
Tolerability and Adverse Event Profile of Linsitinib
Related to study drug Grade 3 or higher
2 Adverse Events

SECONDARY outcome

Timeframe: Up to 37 weeks

Population: Depending on the patient samples available, the available samples varied from 17 to 14.

To explore patterns of protein expression in serum and tumor tissues as predictors of response and progression-free survival in advanced WT GIST treated with OSI-906. All Insulin Growth Factor Receptor (IGFR) and phosphorylated AKT (pAKT) evaluation was performed in a blinded manner. Distribution and intensity of positive tumor cell staining was assessed for these markers. Loss of succinate dehydrogenase complex flavoprotein subunit A (SDHA) protein expression has been correlated with the presence of a mutation in SDHA. Loss of succinate dehydrogenase complex iron sulfur subunit B (SDHB) protein expression occurs from bi-allelic inactivation of any of the succinate dehydrogenase (SDH) subunit genes. Loss of expression of one member of the complex alters the structure or production of SDH proteins such that the complex is no longer able to form. This results in elevated intracellular levels of succinate as well as loss of demethylase activity.

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=17 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Patterns of Protein Expression in Serum and Tumor Tissues as Predictors of Response and PFS
SDHA deficiency
6 Participants
Patterns of Protein Expression in Serum and Tumor Tissues as Predictors of Response and PFS
SDHB deficiency
15 Participants
Patterns of Protein Expression in Serum and Tumor Tissues as Predictors of Response and PFS
High to intermediate paKT stain
6 Participants
Patterns of Protein Expression in Serum and Tumor Tissues as Predictors of Response and PFS
High expression of IGFR
10 Participants
Patterns of Protein Expression in Serum and Tumor Tissues as Predictors of Response and PFS
Intermediate levels of IGFR
4 Participants

SECONDARY outcome

Timeframe: Up to 37 weeks

Evaluate the number of participants with metabolic response to OSI-906 using fluorodeoxyglucose positron emission tomography (FDG-PET). Evaluation of metabolic response to linsitinib based on two criteria (EORTC and PERCIST).

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=17 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Number of Participants With Metabolic Response to Linsitinib Using FDG-PET.
Partial metabolic response rate
2 Participants
Number of Participants With Metabolic Response to Linsitinib Using FDG-PET.
Stable disease metabolic response rate
11 Participants

SECONDARY outcome

Timeframe: Baseline and 8 weeks

To measure changes in tumor metabolism by FDG-PET qualitatively and semi-quantitatively with SUV from baseline to first CT response evaluation and correlate the findings with size changes as defined by conventional cross-sectional imaging scans. SUVmax determined by: SUVmax = \[VOI activity (mCi/ml) \* body wt (g)\]/injected dose (mCi) SUVpeak determined by identifying the hottest cubic centimeter within a VOI centered on the lesion with the highest FDG.

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=17 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Changes in Tumor Metabolism by FDG-PET Qualitatively and Semi-quantitatively With Standard Uptake Value (SUV)
SUVmax
19 Standard uptake value (SUV)
Interval 8.0 to 28.0
Changes in Tumor Metabolism by FDG-PET Qualitatively and Semi-quantitatively With Standard Uptake Value (SUV)
SUVpeak
16 Standard uptake value (SUV)
Interval 7.0 to 31.0

SECONDARY outcome

Timeframe: Up to 37 weeks

Population: Data was not collected in correlation to FDG-PET response results.

To investigate correlations between glucose, insulin, tumor tissue and blood biomarkers with FDG-PET metabolic response.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 3 years

Time to progression will be evaluated using cumulative incidence.

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=20 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Time to Progression
9.1 months
Interval 1.84 to 30.1

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 37 weeks

To determine if the number of participants with tumor metabolic response correlates with anatomic response and clinical benefit.

Outcome measures

Outcome measures
Measure
Treatment (Linsitinib)
n=17 Participants
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Determine the Number of Participants With Tumor Metabolic Response Correlating With Anatomic Response and Clinical Benefit.
Partial metabolic response
2 Participants
Determine the Number of Participants With Tumor Metabolic Response Correlating With Anatomic Response and Clinical Benefit.
Stable disease metabolic response
11 Participants

Adverse Events

Treatment (Linsitinib)

Serious events: 8 serious events
Other events: 20 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Treatment (Linsitinib)
n=20 participants at risk
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Gastrointestinal disorders
Abdominal Distension - Grade 3 (Unrelated)
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Abdominal Pain - Grade 3 (Unrelated)
15.0%
3/20 • Number of events 4
Gastrointestinal disorders
Constipation - Grade 2 (Unrelated)
5.0%
1/20 • Number of events 1
General disorders
Edema Limbs - Grade 2 (Unlikely Related)
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Gastric Hemorrhage - Grade 3 (Unrelated)
5.0%
1/20 • Number of events 1
Metabolism and nutrition disorders
Hyperglycemia - Grade 3 (Definitely Related)
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Hypoxia - Grade 3 (Unlikely Related)
5.0%
1/20 • Number of events 1
Infections and infestations
Lung Infection - Grade 3 (Unrelated)
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Intra-abdominal hemorrhage - Grade 3 (Unrelated)
5.0%
1/20 • Number of events 1
Skin and subcutaneous tissue disorders
Rash maculo-papular - Grade 3 (Unrelated)
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Pancreatitis - Grade 3 (Unlikely Related)
5.0%
1/20 • Number of events 2
Renal and urinary disorders
Renal Calculi - Grade 3 (Unrelated)
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pleural Effusion - Grade 2 (Unlikely Related)
5.0%
1/20 • Number of events 1
Cardiac disorders
Supraventricular Tachycardia - Grade 2 (Unrelated)
5.0%
1/20 • Number of events 1
Vascular disorders
Thromboembolic event (Grade 2 - Unlikely Related)
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Upper gastrointestinal hemorrhage - Grade 3 (Unlikely Related)
5.0%
1/20 • Number of events 2
Nervous system disorders
Seizure - Grade 2 (Unrelated)
5.0%
1/20 • Number of events 1
Surgical and medical procedures
Fistula Repair - Grade 3 (Unrelated)
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Upper gastrointestinal hemorrhage - Grade 3 (Unrelated)
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Abdominal Pain - Grade 3 (Unlikely Related)
5.0%
1/20 • Number of events 1

Other adverse events

Other adverse events
Measure
Treatment (Linsitinib)
n=20 participants at risk
Patients receive linsitinib PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Linsitinib: Given PO Pharmacological Study: Correlative studies
Renal and urinary disorders
Urinary Frequency
5.0%
1/20 • Number of events 1
Renal and urinary disorders
Urinary Tract Infection
5.0%
1/20 • Number of events 1
Ear and labyrinth disorders
Vertigo
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Vomiting
40.0%
8/20 • Number of events 12
Investigations
Weight Loss
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Respiratory, Thoracic and Mediastinal Disorders - Other
5.0%
1/20 • Number of events 1
Investigations
Serum Amylase Increased
5.0%
1/20 • Number of events 4
Skin and subcutaneous tissue disorders
Skin and Subcutaneous Tissue Disorders - Other
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Sore Throat
5.0%
1/20 • Number of events 2
Gastrointestinal disorders
Toothache
5.0%
1/20 • Number of events 1
Infections and infestations
Upper Respiratory Infection
10.0%
2/20 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Sinus Disorder
5.0%
1/20 • Number of events 1
Nervous system disorders
Sinus Pain
5.0%
1/20 • Number of events 1
Infections and infestations
Sinusitis
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Abdominal Distension
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Abdominal Pain
40.0%
8/20 • Number of events 10
Investigations
Alanine Aminotransferase Increased
10.0%
2/20 • Number of events 3
Investigations
Alkaline Phosphatase Increased
10.0%
2/20 • Number of events 3
Skin and subcutaneous tissue disorders
Alopecia
5.0%
1/20 • Number of events 1
Blood and lymphatic system disorders
Anemia
20.0%
4/20 • Number of events 5
Metabolism and nutrition disorders
Anorexia
25.0%
5/20 • Number of events 7
Musculoskeletal and connective tissue disorders
Arthralgia
5.0%
1/20 • Number of events 2
Gastrointestinal disorders
Ascites
10.0%
2/20 • Number of events 3
Investigations
Aspartate Aminotransferase Increased
10.0%
2/20 • Number of events 6
Cardiac disorders
Atrial Fibrillation
5.0%
1/20 • Number of events 1
Musculoskeletal and connective tissue disorders
Back Pain
15.0%
3/20 • Number of events 4
Blood and lymphatic system disorders
Blood and Lymphatic System Disorders - Other
5.0%
1/20 • Number of events 1
Eye disorders
Blurred Vision
5.0%
1/20 • Number of events 1
General disorders
Chills
15.0%
3/20 • Number of events 4
Psychiatric disorders
Confusion
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Constipation
40.0%
8/20 • Number of events 8
Respiratory, thoracic and mediastinal disorders
Cough
5.0%
1/20 • Number of events 2
Investigations
Creatinine Increased
15.0%
3/20 • Number of events 3
Gastrointestinal disorders
Dental Caries
5.0%
1/20 • Number of events 1
Psychiatric disorders
Depression
15.0%
3/20 • Number of events 3
Gastrointestinal disorders
Diarrhea
40.0%
8/20 • Number of events 13
Nervous system disorders
Dizziness
25.0%
5/20 • Number of events 6
Gastrointestinal disorders
Dry Mouth
5.0%
1/20 • Number of events 1
Skin and subcutaneous tissue disorders
Dry Skin
15.0%
3/20 • Number of events 3
Nervous system disorders
Dysgeusia
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Dyspepsia
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Dysphagia
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Dyspnea
30.0%
6/20 • Number of events 7
General disorders
Edema Limbs
10.0%
2/20 • Number of events 3
Respiratory, thoracic and mediastinal disorders
Epistaxis
5.0%
1/20 • Number of events 1
Reproductive system and breast disorders
Erectile Dysfunction
5.0%
1/20 • Number of events 1
Eye disorders
Eye Disorders - Other
5.0%
1/20 • Number of events 1
General disorders
Fatigue
75.0%
15/20 • Number of events 22
General disorders
Fever
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Flatulence
5.0%
1/20 • Number of events 1
General disorders
Flu-like Symptoms
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Gastrointestinal Disorders - Other
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Gastrointestinal Pain
10.0%
2/20 • Number of events 2
General disorders
General Disorders and Administration Site Conditions - Other
5.0%
1/20 • Number of events 1
Musculoskeletal and connective tissue disorders
Generalized Muscle Weakness
5.0%
1/20 • Number of events 1
Nervous system disorders
Headache
10.0%
2/20 • Number of events 2
Hepatobiliary disorders
Hepatobiliary Disorders - Other
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Hoarseness
5.0%
1/20 • Number of events 1
Metabolism and nutrition disorders
Hyperglycemia
10.0%
2/20 • Number of events 3
Skin and subcutaneous tissue disorders
Hyperhidrosis
5.0%
1/20 • Number of events 1
Metabolism and nutrition disorders
Hyperkalemia
5.0%
1/20 • Number of events 1
Vascular disorders
Hypertension
5.0%
1/20 • Number of events 1
Metabolism and nutrition disorders
Hypoalbuminemia
5.0%
1/20 • Number of events 1
Metabolism and nutrition disorders
Hyponatremia
5.0%
1/20 • Number of events 1
Metabolism and nutrition disorders
Hypophosphatemia
5.0%
1/20 • Number of events 1
Endocrine disorders
Hypothyroidism
5.0%
1/20 • Number of events 1
Psychiatric disorders
Insomnia
25.0%
5/20 • Number of events 5
Investigations
Investigations - Other
5.0%
1/20 • Number of events 1
Investigations
Lipase Increased
5.0%
1/20 • Number of events 7
Nervous system disorders
Memory Impairment
5.0%
1/20 • Number of events 1
Metabolism and nutrition disorders
Metabolism and Nutrition Disorders - Other
5.0%
1/20 • Number of events 1
Musculoskeletal and connective tissue disorders
Musculoskeletal and Connective Tissue Disorders - Other
5.0%
1/20 • Number of events 1
Musculoskeletal and connective tissue disorders
Myalgia
25.0%
5/20 • Number of events 5
Skin and subcutaneous tissue disorders
Nail Discoloration
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Nasal Congestion
5.0%
1/20 • Number of events 1
Gastrointestinal disorders
Nausea
65.0%
13/20 • Number of events 17
Nervous system disorders
Nervous System Disorders - Other
5.0%
1/20 • Number of events 1
General disorders
Pain
10.0%
2/20 • Number of events 3
Musculoskeletal and connective tissue disorders
Pain in Extremity
10.0%
2/20 • Number of events 2
Skin and subcutaneous tissue disorders
Palmar-plantar Erythrodysesthesia Syndrome
10.0%
2/20 • Number of events 2
Cardiac disorders
Palpitations
10.0%
2/20 • Number of events 2
Cardiac disorders
Paroxysmal Atrial Tachycardia
5.0%
1/20 • Number of events 1
Nervous system disorders
Peripheral Sensory Neuropathy
15.0%
3/20 • Number of events 3
Respiratory, thoracic and mediastinal disorders
Pleural Effusion
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pneumonitis
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Postnasal Drip
5.0%
1/20 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Productive Cough
5.0%
1/20 • Number of events 1
Skin and subcutaneous tissue disorders
Pruritus
15.0%
3/20 • Number of events 3
Skin and subcutaneous tissue disorders
Rash Maculo-papular
15.0%
3/20 • Number of events 3
Renal and urinary disorders
Renal Colic
5.0%
1/20 • Number of events 1

Additional Information

Kristen Nuyen, Research Project Manager

Sarcoma Alliance for Research through Collaboration (SARC)

Phone: 734-930-7600

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60