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The purpose of this study is to evaluate the effect of food on the pharmacokinetics (PK) of the experimental drug, entinostat, in women with breast cancer and men and women with non-small cell lung cancer. The safety and tolerability of entinostat will also be evaluated when entinostat is given by itself as well as with the approved drugs, exemestane (Aromasin®) or erlotinib (Tarceva®). A biomarker (chemical "marker" in the blood/tissue that may be related to your response to the study drug) will also be tested.
This is Phase 1, randomized, open-label, study of entinostat. The study is designed to evaluate any food effect on the pharmacokinetics of entinostat.
Patients will be randomized to receive entinostat with or without food on Cycle 1 Day 1 (C1D1). Patients randomized to receive entinostat with food on C1D1 will receive a second dose of entinostat without food on Cycle 1 Day 15 (C1D15). Patients randomized to receive entinostat without food on C1D1 will receive a second dose of entinostat with food on C1D15. Each cycle in the study will be for 28 days duration. Blood samples will be obtained pre-dose and serial blood samples will be taken after each dose to assess pharmacokinetics. For Cycle 2 and all subsequent cycles, all patients will continue to receive entinostat on Days 1 and 15 of each cycle. Those with breast cancer will also receive exemestane orally once daily starting on Cycle 2 Day 1. Those with NSCLC will also receive erlotinib starting on Cycle 2 Day 1.
Patients will be assessed at screening and at pre-prescribed times during study enrollment using standard assessments. Patients will also be assessed for tumor response after each 2 cycles. Patients will continue receiving study treatment until tumor progression or adverse events occur which necessitate discontinuing therapy as determined by the Investigator.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| entinostat C1D1 fed | Experimental | Entinostat: Beginning C1D1 fed; C1D15 fasted. Erlotinib: NSCLC pts beginning C2D1,150 mg, po, qd. Exemestane: Breast cancer pts beginning C2D1,25 mg, po, qd. |
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| entinostat C1D1 fasted | Experimental | Entinostat: Beginning C1D1 fasted; C1D15 fed. Erlotinib: NSCLC pts beginning C2D1,150 mg, po, qd. Exemestane: Breast cancer pts beginning C2D1,25 mg, po, qd. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| entinostat | Drug | 10 mg, po, q14 days, until progression or intolerable toxicity |
|
| Measure | Description | Time Frame |
|---|---|---|
| Difference in pharmacokinetics of entinostat when subjects fed or fasted | The pharmacokinetics of entinostat will be analyzed from patient plasma samples: maximum plasma concentration, time of maximum plasma concentration, area under the plasma concentration-time curve from baseline to last measurable concentration and extrapolated to infinity, terminal elimination rate constant. | C1D1 (sequential), D2, 4, 6, 8, 11; C1D15 (sequential), 16, 18, 20, 22 25; C2D1 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in laboratory values from baseline | Chemistry, hematology blood samples: changes from baseline will be evaluated. | Screening, C1D1, C1D15, C2D1, C3D1 |
| Change in ECG results from baseline |
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Inclusion Criteria:
Breast Cancer Patients Only
NSCLC Patients Only:
All Patients:
Exclusion Criteria:
MI or arterial thromboembolic events within 6 months, or experiencing severe or unstable angina, New York Heart Association (NYHA) Class III or IV disease and a QTc interval > 0.47 seconds.
Uncontrolled heart failure or hypertension, uncontrolled diabetes mellitus, uncontrolled systemic infection.
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| Name | Affiliation | Role |
|---|---|---|
| William McCulloch, M.D. | Syndax Pharmaceuticals | Study Director |
| Howard A Burris, M.D. | Tennessee Oncology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Florida Cancer Specialists | Sarasota | Florida | 34232 | United States | ||
| Peggy and Charles Stephenson Cancer Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22508830 | Background | Witta SE, Jotte RM, Konduri K, Neubauer MA, Spira AI, Ruxer RL, Varella-Garcia M, Bunn PA Jr, Hirsch FR. Randomized phase II trial of erlotinib with and without entinostat in patients with advanced non-small-cell lung cancer who progressed on prior chemotherapy. J Clin Oncol. 2012 Jun 20;30(18):2248-55. doi: 10.1200/JCO.2011.38.9411. Epub 2012 Apr 16. |
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| entinostat | Drug | 10 mg, po, q14 days, until progression or intolerable toxicity |
|
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| Erlotinib | Drug | Erlotinib: NSCLC pts beginning C2D1,150 mg, po, qd. |
|
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| Erlotinib | Drug | Erlotinib: NSCLC pts beginning C2D1,150 mg, po, qd. |
|
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| Exemestane | Drug | Exemestane: Breast cancer pts beginning C2D1,25 mg, po, qd. |
|
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| Exemestane | Drug | Exemestane: Breast cancer pts beginning C2D1,25 mg, po, qd. |
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Changes from baseline will be evaluated including analysis of QTc prolongation and QTc change from baseline.
| Screening, C1D1 (sequential), D2, 4, 6, 8, 11; C1D15 (sequential), D16, 18, 20, 22, 25; C2D1; EOT |
| Difference in pharmacodynamics from baseline | Blood samples will be analyzed for changes from baseline in protein lysine acetylation as measured by peripheral blood monocytes. The food effect, changes after entinostat, and changes after exemestane and erlotinib will be evaluated. | C1D1, D2, D8; C1D15, D16, D22; C2D1; C3D1; EOT |
| Adverse events | Incidence of treatment emergent adverse events, serious adverse events, adverse events resulting in permanent discontinuation of study drug, and deaths occurring within 30-days of the last dose of study drug. | C1D1 , D2, 4, 6, 8, 11; C1D15, 16, 18, 20, 22 25; C2D1; D1 of each subsequent cycle through end of treatment |
| Oklahoma City |
| Oklahoma |
| 73104 |
| United States |
| Sarah Cannon Research Institute | Nashville | Tennessee | 37203 | United States |
| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D001943 | Breast Neoplasms |
| D008171 | Lung Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D012140 | Respiratory Tract Diseases |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| ID | Term |
|---|---|
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001982 | Bronchial Diseases |
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| ID | Term |
|---|---|
| C118739 | entinostat |
| D000069347 | Erlotinib Hydrochloride |
| C056516 | exemestane |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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