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This research study is evaluating the experimental drug palbociclib in combination with another experimental drug PD-0325901 as a possible treatment for cancers with KRAS mutations, particularly for those which started in the lung.
This will be an open label Phase I dose escalation study evaluating the combination of the CDK4/6 inhibitor palbociclib (PD-0332991) and the MEK inhibitor PD-0325901. To determine the maximally tolerated dose (MTD) and recommended phase 2 dose (RP2D), a 3+3 dose escalation protocol will be undertaken. Once the RP2D has been determined, the study will then evaluate, in a randomized phase II study design, the combination of palbociclib and PD-0325901 compared to PD-0325901 alone and palbociclib alone in KRAS mutant NSCLC.
Secondary Outcomes:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Palbociclib and PD-0325901 | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Palbociclib | Drug | Palbociclib will be administered orally once daily, 3 weeks out of every 4 in each cycle. The initial dose for phase 1 of the study will be 75 mg daily. Dosing will be adjusted until Maximum Tolerated Dose (MTD) and the Recommended Phase 2 Dose (RP2D) are established. No pre-medications for palbociclib are required. It should be administered without food with patients fasting for 1 hour prior and 2 hours post drug administration. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and tolerability | Toxicities will be graded using version 4.0 of the NCI Common Terminology Criteria for Adverse Events (CTCAE). | 2 Years |
| Maximum Tolerated Dose and Recommended Phase 2 Dose | A standard 3+3 design will be implemented to discover the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of the combination of study drugs. A dose will be declared the MTD if zero or 1 patient out of 6 experience a dose limiting toxicity (DLT) at the highest dose level below the maximally administered dose. This is generally the RP2D. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum plasma concentration (Cmax) of palbociclib | Cmax (ng/ml) of palbociclib will be assessed utilizing serial blood draws on cycle 1 day 1 and on cycle 1 day 15 (steady state). | 1 month |
| Time to maximum concentration (tmax) of palbociclib |
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Inclusion Criteria:
Participants must have normal organ and marrow function as defined below:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Geoffrey Shapiro, MD. Ph.D | Dana-Farber Cancer Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dana Farber Cancer Institute | Boston | Massachusetts | 02215 | United States |
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| ID | Term |
|---|---|
| C500026 | palbociclib |
| C506614 | mirdametinib |
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| PD-0325901 | Drug | PD-0325901 will be administered orally twice daily, 3 weeks out of every 4 in each cycle. The initial dose for phase 1 of the study will be 2 mg twice daily. Dosing will be adjusted until Maximum Tolerated Dose (MTD) and the Recommended Phase 2 Dose (RP2D) are established. PD-0325901 will be administered using a flat-dosing plan. No premedications are required. As the effect of food on PD-0325901 is uncertain, patients will be permitted to dose either fasting or after food. |
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tmax (h) of palbociclib will be assessed utilizing serial blood draws on cycle 1 day 1 and on cycle 1 day 15 (steady state).
| 1 month |
| AUC-12 of palbociclib | The AUC-12 (ng.h/ml) of palbociclib will be assessed utilizing serial blood draws on cycle 1 day 1 and on cycle 1 day 15 (steady state). | 1 month |
| Clearance (CL/F) of palbociclib | Clearance (L/h) of palbociclib will be assessed utilizing serial blood draws on cycle 1 day 1 and on cycle 1 day 15 (steady state). | 1 month |
| Maximum plasma concentration (Cmax) of PD-0325901 | Cmax (ng/ml) of PD-0325901 will be assessed utilizing serial blood draws on cycle 1 day 1 and on cycle 1 day 15 (steady state). | 1 month |
| Time to maximum concentration (tmax) of PD-0325901 | tmax of PD-0325901 will be assessed utilizing serial blood draws on cycle 1 day 1 and on cycle 1 day 15 (steady state). | 1 month |
| AUC-12 of PD-0325901 | AUC-12 (ng.h/ml) of PD-0325901 will be assessed utilizing serial blood draws on cycle 1 day 1 and on cycle 1 day 15 (steady state). | 1 month |
| Clearance (CL/F ) of PD-0325901 | Clearance (L/h) of PD-0325901 will be assessed utilizing serial blood draws on cycle 1 day 1 and on cycle 1 day 15 (steady state). | 1 month |
| Target engagement of palbociclib by immunohistochemistry (IHC) of phospho-Rb in tumor | IHC for phospho-Rb will be performed in pre- and on-treatment tumor biopsies to assess palbociclib target engagement. | 2 Years |
| Target engagement of palbociclib by immunohistochemistry (IHC) of phospho-Rb in skin | IHC for phospho-Rb will be performed in pre- and on-treatment skin biopsies to assess palbociclib target engagement. | 2 Years |
| Target engagement of PD-0325901 by immunohistochemistry (IHC) of phospho-ERK in tumor | IHC for phospho-ERK will be performed in pre- and on-treatment tumor biopsies to assess PD-0325901 target engagement. | 2 Years |
| Cell cycle arrest by palbociclib using serum thymidine kinase 1 (TK1) assays | Serial serum collections (pre- and on-treatment) will be assayed for TK1 activity to assess cell cycle arrest mediated by palbociclib. | 2 Years |
| Quantitative non-invasive genotyping for KRAS in cfDNA | Serial cfDNA samples will be collected and assessed for KRAS plasma allellic burden as a measure of anti-tumor activity of the combination of palbociclib and PD-0325901. | 2 Years |
| Overall Response Rate | The preliminary clinical efficacy of palbociclib and PD-0325901 in advanced KRAS-mutant solid tumors will be assessed using CT and MRI scans per RECIST version 1.1. | 2 Years |