A Study of Sapanisertib, Combination of Sapanisertib With MLN1117, Paclitaxel and Combination of Sapanisertib With Paclitaxel in Women With Endometrial Cancer

NCT ID: NCT02725268

Last Updated: 2021-11-24

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

241 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-04-01

Study Completion Date

2020-10-30

Brief Summary

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The primary purpose of this study is to determine if sapanisertib in combination with weekly paclitaxel improves progression-free survival (PFS) compared to weekly paclitaxel alone.

Detailed Description

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The drugs being evaluated in this study are sapanisertib and MLN1117. Sapanisertib is being evaluated as a single agent and in combination with paclitaxel or MLN1117 to treat women with advanced, recurrent, or persistent endometrial cancer. This study will evaluate the efficacy and safety of each drug or drug combination.

The study will enroll approximately 241 participants. Participants will be randomly assigned (by chance, like flipping a coin) to one of 4 treatment groups:

* Paclitaxel 80 mg/m\^2
* Paclitaxel 80 mg/m\^2 + Sapanisertib 4 mg
* Sapanisertib 30 mg
* Sapanisertib 4 mg + MLN1117 200 mg

Participants will receive either paclitaxel intravenous (IV) weekly, Paclitaxel IV along with sapanisertib orally, sapanisertib orally, or sapanisertib and MLN1117 orally.

This is a multicenter, multinational trial. Participants will make multiple visits to the clinic, with an end of treatment visit (EOT) which will occur 30 to 40 days after receiving their last dose of study drug or before the start of any subsequent anticancer therapy. After EOT, participants will be followed for PFS and overall survival (OS).

Conditions

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Endometrial Neoplasms

Keywords

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Drug Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Paclitaxel 80 mg/m^2

Paclitaxel 80 milligrams per square meter (mg/m\^2), IV, weekly on Days 1, 8, and 15 of a 28-day cycle until disease progression, unacceptable toxicity, or withdraw consent (the median exposure was up to approximately 13 weeks).

Group Type EXPERIMENTAL

Paclitaxel

Intervention Type DRUG

Paclitaxel intravenous solution.

Paclitaxel 80 mg/m^2 + Sapanisertib 4 mg

Paclitaxel 80 mg/m\^2, IV, weekly on Days 1, 8, and 15 of a 28-day cycle along with sapanisertib 4 milligrams (mg), capsule, orally on Days 2-4, 9-11, 16-18, and 23-25 of a 28-day cycle until disease progression, unacceptable toxicity, or withdraw consent (the median exposure was up to approximately 20 weeks).

Group Type EXPERIMENTAL

Paclitaxel

Intervention Type DRUG

Paclitaxel intravenous solution.

Sapanisertib

Intervention Type DRUG

Sapanisertib capsules.

Sapanisertib 30 mg

Sapanisertib 30 mg, capsule, orally, once weekly on Days 1, 8, 15, and 22 of a 28-day cycle until disease progression, unacceptable toxicity, or withdraw consent (the median exposure was up to approximately 6 weeks).

Group Type EXPERIMENTAL

Sapanisertib

Intervention Type DRUG

Sapanisertib capsules.

Sapanisertib 4 mg + MLN1117 200 mg

Sapanisertib 4 mg, capsule, orally and MLN1117 200 mg, capsule, orally on Days 1-3, 8-10, 15-17, and 22-24 of a 28-day cycle until disease progression, unacceptable toxicity, or withdraw consent (the median exposure was up to approximately 8 weeks).

Group Type EXPERIMENTAL

Sapanisertib

Intervention Type DRUG

Sapanisertib capsules.

MLN1117

Intervention Type DRUG

MLN1117 capsules.

Interventions

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Paclitaxel

Paclitaxel intravenous solution.

Intervention Type DRUG

Sapanisertib

Sapanisertib capsules.

Intervention Type DRUG

MLN1117

MLN1117 capsules.

Intervention Type DRUG

Other Intervention Names

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MLN0128 INK128 TAK-228 TAK-117 INK1117

Eligibility Criteria

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Inclusion Criteria

1. Histologic or cytologic diagnosis of endometrial carcinoma (including endometrioid, serous, mixed adenocarcinoma, clear-cell carcinoma, or carcinosarcoma).
2. Evidence that the endometrial cancer is advanced, recurrent, or persistent and has relapsed or is refractory to curative therapy or established treatments.
3. At least 1 prior platinum-based chemotherapeutic regimen, but not more than 2 prior chemotherapeutic regimens, for management of endometrial carcinoma. Prior treatment may include chemotherapy, chemotherapy/radiation therapy, and/or consolidation/maintenance therapy. Chemotherapy administered in conjunction with primary radiation as a radio-sensitized therapy will be considered a systemic chemotherapy regimen.
4. Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, defined as at least 1 lesion that can be accurately measured in at least 1 dimension (longest diameter to be recorded). Each lesion must be greater than or equal to (\>=) 10 millimeter (mm) in long axis when measured by computed tomography (CT), magnetic resonance imaging (MRI), or caliper measurement by clinical exam. Lymph nodes must be \>= 15 mm in short axis when measured by CT or MRI.
5. Tumor accessible and participant consents to undergo fresh tumor biopsies.
6. Female participants 18 years or older.
7. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
8. Female participants who:

* Are postmenopausal for at least 1 year before the screening visit, OR
* Are surgically sterile, OR
* If they are of childbearing potential, agree to practice 1 highly effective method of contraception and 1 additional effective (barrier) method at the same time, from the time of signing the informed consent through 90 days (or longer, as mandated by local labeling \[example, United States Prescribing Information (USPI), Summary of Product Characteristics (SmPC), etc.\]) after the last dose of study drug, OR
* Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant. (Periodic abstinence \[example, calendar, ovulation, symptothermal, postovulation methods\], withdrawal, spermicides only, and lactational amenorrhea are not acceptable methods of contraception. Female and male condoms should not be used together.)
9. Clinical laboratory values as specified below within 4 weeks before the first dose of study drug:

* Bone marrow reserve consistent with absolute neutrophil count (ANC) \>= 1500 per micro liter (/mcL); platelet count \>= 100,000/mcL; hemoglobin A1c (HbA1c) less than (\<) 6.5 percent (%).
* Total bilirubin must be less than or equal to (\<=) 1.5 \* the upper limit of normal (ULN).
* Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) must be \<= 2.5 \* the upper limit of the normal range. AST and ALT may be elevated up to 5 times the ULN if their elevation can be reasonably ascribed to the presence of metastatic disease in liver.
* Creatinine clearance \>= 50 milliliter per minute per 1.73 square meter (mL/min/1.73 m\^2) based either on Cockcroft-Gault estimate or based on a 12- or 24-hour urine collection.
* Fasting serum glucose \< 130 milligram per deciliter (mg/dL) and fasting triglycerides \<= 300 mg/dL.
10. Ability to swallow oral medications, willingness to perform mucositis prophylaxis, and suitable venous access for the study-required blood sampling.
11. Voluntary written consent must be given before performance of any study-related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the participant at any time without prejudice to future medical care.

Exclusion Criteria

1. Positive serum pregnancy test during the screening period or a positive urine pregnancy test on Day 1 before first dose of study drug. Women who are lactating and breastfeeding are not eligible.
2. Previous treatment with any weekly taxane regimen.
3. History of severe hypersensitivity reactions to paclitaxel or any of its excipients.
4. Previous treatment with phosphoinositide 3-kinase (PI3K), serine/threonine-specific protein kinase (AKT), dual PI3K/ mammalian (or mechanistic) target of rapamycin (mTOR) inhibitors, target of rapamycin complex 1/2 (TORC1/2) inhibitors or TORC1 inhibitors.
5. Initiation of treatment with hematopoietic growth factors, transfusions of blood and blood products, or systemic corticosteroids (either intravenous \[IV\] or oral steroids, excluding inhalers) within 1 week before administration of the first dose of study drug (participants already receiving erythropoietin on a chronic basis for \>=4 weeks are eligible).
6. Participants who are taking proton pump inhibitors (PPIs) within 7 days of the first dose of study drug or who require treatment with PPIs throughout the trial or those who are taking H2 receptor antagonists within 24 hours of the first dose of study drug.
7. A prothrombin time (PT) or activated partial thromboplastin time (aPTT) above the ULN or a history of a coagulopathy or bleeding disorder.
8. Known hepatitis B surface antigen-positive, or known or suspected active hepatitis C infection.
9. Sensory or motor neuropathy \>= Grade 2.
10. Central nervous system (CNS) metastasis, endometrial leiomyosarcoma, or endometrial stromal sarcoma.
11. Manifestations of malabsorption due to prior gastrointestinal surgery, gastrointestinal disease, or for some other reason that may alter the absorption of sapanisertib or MLN1117. In addition, participants with enteric stomata are also excluded.
12. Other clinically significant co-morbidities, such as uncontrolled pulmonary disease, active CNS disease, active infection, or any other condition that could compromise participation of the participant in the study.
13. Known human immunodeficiency virus infection.
14. History of any of the following within the last 6 months before administration of the first dose of study drug:

* Ischemic myocardial event, including angina requiring therapy and artery revascularization procedures.
* Ischemic cerebrovascular event, including transient ischemic attack and artery revascularization procedures.
* Requirement for inotropic support (excluding digoxin) or serious (uncontrolled) cardiac arrhythmia (including atrial flutter/fibrillation, ventricular fibrillation, or ventricular tachycardia).
* Placement of a pacemaker for control of rhythm.
* New York Heart Association Class III or IV heart failure.
* Pulmonary embolism.
15. Significant active cardiovascular or pulmonary disease before administration of the first dose of study drug, including:

* Uncontrolled hypertension (that is, either systolic blood pressure \> 180 millimeter of mercury \[mm Hg\] or diastolic blood pressure \> 95 mm Hg).
* Pulmonary hypertension.
* Uncontrolled asthma or oxygen saturation \< 90% by arterial blood gas analysis or pulse oximetry on room air.
* Significant valvular disease; severe regurgitation or stenosis by imaging independent of symptom control with medical intervention; or history of valve replacement.
* Medically significant (symptomatic) bradycardia.
* History of arrhythmia requiring an implantable cardiac defibrillator.
* Baseline prolongation of the rate-corrected QT interval (QTc; example, repeated demonstration of QTc interval \> 480 millisecond \[ms\], or history of congenital long QT syndrome, or torsades de pointes).
16. Diagnosed or treated for another malignancy within 2 years before administration of the first dose of study drug or previously diagnosed with another malignancy and have any evidence of residual disease. Participants with non-melanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
17. Participants with endometrioid histology and histologically confirmed expression of estrogen receptors (ER) and/or progesterone receptors (PgR) who have not received prior endocrine therapy and for whom endocrine therapy is currently indicated.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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European Network of Translational Research in Ovarian Cancer - EUTROC

UNKNOWN

Sponsor Role collaborator

European Network of Individualized Treatment in Endometrial Cancer - ENITEC

OTHER_GOV

Sponsor Role collaborator

Millennium Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director Clinical Science

Role: STUDY_DIRECTOR

Millennium Pharmaceuticals, Inc.

Locations

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University of Alabama Comprehensive Cancer Center

Birmingham, Alabama, United States

Site Status

University of Arizona Cancer Center

Phoenix, Arizona, United States

Site Status

Marin Cancer Care

Greenbrae, California, United States

Site Status

University of California San Diego Medical Center

La Jolla, California, United States

Site Status

University of California at San Francisco (PARENT)

San Francisco, California, United States

Site Status

Stanford School of Medicine

Stanford, California, United States

Site Status

H. Lee Moffitt Cancer Center and Research Institute, Inc

Tampa, Florida, United States

Site Status

Florida Cancer Specialists

West Palm Beach, Florida, United States

Site Status

Augusta University

Augusta, Georgia, United States

Site Status

Franciscan St. Francis Health

Indianapolis, Indiana, United States

Site Status

University of Kansas Medical Center Research Institute, Inc.

Westwood, Kansas, United States

Site Status

Massachusetts General Hospital Cancer Center

Boston, Massachusetts, United States

Site Status

Washington University

St Louis, Missouri, United States

Site Status

NYU Langone Medical Center Clinic

New York, New York, United States

Site Status

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status

Levine Cancer Institute

Charlotte, North Carolina, United States

Site Status

Oklahoma University Health Sciences Center

Oklahoma City, Oklahoma, United States

Site Status

Fox Chase Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center Cancer Center at Magee-Womens Hospital

Pittsburgh, Pennsylvania, United States

Site Status

Sarah Cannon Research Institute

Nashville, Tennessee, United States

Site Status

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status

St George Hospital

Kogarah, New South Wales, Australia

Site Status

Westmead Hospital

Westmead, New South Wales, Australia

Site Status

Royal Brisbane and Women's Hospital

Herston, Queensland, Australia

Site Status

Monash Medical Centre Clayton

Clayton, Victoria, Australia

Site Status

Sunshine Hospital

Footscray, Victoria, Australia

Site Status

Cabrini Hospital Malvern

Malvern, Victoria, Australia

Site Status

Peter MacCallum Cancer Centre-East Melbourne

Melbourne, Victoria, Australia

Site Status

UZ Antwerpen

Edegem, Antwerpen, Belgium

Site Status

Cliniques Universitaires Saint-Luc

Brussels, , Belgium

Site Status

UZ Leuven

Leuven, , Belgium

Site Status

Centre Hospitalier Universitaire de Liege Site Sart Tilman

Liège, , Belgium

Site Status

GasthuisZusters Antwerpen Sint-Augustinus

Wilrijk, , Belgium

Site Status

Tom Baker Cancer Centre

Calgary, Alberta, Canada

Site Status

Juravinski Cancer Clinic

Hamilton, Ontario, Canada

Site Status

LHSC - Victoria Hospital

London, Ontario, Canada

Site Status

Ottawa Hospital Cancer Centre

Ottawa, Ontario, Canada

Site Status

University Health Network - Princess Margaret Cancer Centre

Toronto, Ontario, Canada

Site Status

CHUM Hopital Notre-Dame

Montreal, Quebec, Canada

Site Status

Medizinische Hochschule Hannover

Hanover, Lower Saxony, Germany

Site Status

Universitaetsmedizin Greifswald

Greifswald, Mecklenburg-Vorpommern, Germany

Site Status

Universitaetsklinikum Carl Gustav Carus TU Dresden

Dresden, Saxony, Germany

Site Status

Universitaetsklinikum Schleswig-Holstein - Campus Luebeck

Lübeck, Schleswig-Holstein, Germany

Site Status

Charite - Universitaetsmedizin Berlin - Campus Virchow-Klinikum

Berlin, , Germany

Site Status

Istituto Scientifico Romagnolo Per Lo Studio e La Cura Dei Tumori

Meldola, Forli - Cesena, Italy

Site Status

Spedali Civili di Brescia

Brescia, , Italy

Site Status

Ente Ospedaliero Ospedali Galliera

Genova, , Italy

Site Status

Fondazione IRCCS Istituto Nazionale dei Tumori

Milan, , Italy

Site Status

IEO Istituto Europeo di Oncologia

Milan, , Italy

Site Status

Istituto Tumori Napoli Fondazione G. Pascale

Napoli, , Italy

Site Status

Azienda Unita Sanitaria Locale di Ravenna

Ravenna, , Italy

Site Status

Istituto Nationale Tumori Regina Elena

Roma, , Italy

Site Status

Universita degli Studi di Roma "La Sapienza" - Umberto I Policlinico di Roma

Roma, , Italy

Site Status

Fondazione Policlinico Universitario Agostino Gemelli

Roma, , Italy

Site Status

Maastricht Universitair Medisch Centrum

Maastricht, Limburg, Netherlands

Site Status

Academisch Medisch Centrum

Amsterdam, North Holland, Netherlands

Site Status

Erasmus Medisch Centrum Daniel den Hoed

Rotterdam, South Holland, Netherlands

Site Status

Universitair Medisch Centrum Groningen

Groningen, , Netherlands

Site Status

Universitair Medisch Centrum Utrecht

Utrecht, , Netherlands

Site Status

Haukeland universitetssykehus, Kvinneklinikken

Bergen, , Norway

Site Status

Radiumhospitalet

Oslo, , Norway

Site Status

Stavanger University Hospital

Stavanger, , Norway

Site Status

Hospital Universitari Vall d'Hebron

Barcelona, , Spain

Site Status

MD Anderson Cancer Centre

Madrid, , Spain

Site Status

Hospital Universitario Ramon y Cajal

Madrid, , Spain

Site Status

Hospital Universitario Clinico San Carlos

Madrid, , Spain

Site Status

Hospital Universitario La Paz

Madrid, , Spain

Site Status

Centro Integral Oncologico Clara Campal

Madrid, , Spain

Site Status

Instituto Valenciano de Oncologia IVO

Valencia, , Spain

Site Status

Bristol Haematology and Oncology Centre

Bristol, Avon, United Kingdom

Site Status

Royal Devon and Exeter Hospital (Wonford)

Exeter, Devon, United Kingdom

Site Status

University College London Hospitals

London, Greater London, United Kingdom

Site Status

Royal Marsden Hospital

London, Greater London, United Kingdom

Site Status

Hammersmith Hospital

London, Greater London, United Kingdom

Site Status

The Christie

Manchester, Greater Manchester, United Kingdom

Site Status

Royal Marsden Hospital

Sutton, Surrey, United Kingdom

Site Status

University Hospital Coventry

Coventry, , United Kingdom

Site Status

Beatson West of Scotland Cancer Centre

Glasgow, , United Kingdom

Site Status

Countries

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United States Australia Belgium Canada Germany Italy Netherlands Norway Spain United Kingdom

References

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Han SN, Oza A, Colombo N, Oaknin A, Raspagliesi F, Wenham RM, Braicu EI, Jewell A, Makker V, Krell J, Alia EMG, Baurain JF, Su Z, Neuwirth R, Vincent S, Sedarati F, Faller DV, Scambia G. A randomized phase 2 study of sapanisertib in combination with paclitaxel versus paclitaxel alone in women with advanced, recurrent, or persistent endometrial cancer. Gynecol Oncol. 2023 Nov;178:110-118. doi: 10.1016/j.ygyno.2023.09.013. Epub 2023 Oct 14.

Reference Type DERIVED
PMID: 37839313 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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U1111-1168-1824

Identifier Type: OTHER

Identifier Source: secondary_id

2014-005394-37

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

02725268

Identifier Type: REGISTRY

Identifier Source: secondary_id

C31004

Identifier Type: -

Identifier Source: org_study_id