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Afuresertib, an AKT inhibitor, has shown in vitro and in vivo activity in multiple myeloma models. AKT inhibitor has also demonstrated encouraging clinical activity in multiple myeloma. This study is designed to determine the tolerability, safety, pharmacokinetics and efficacy of afuresertib as monotherapy in Japanese relapsed multiple myeloma patients. This is an open label, dose-escalating, phase I study. Afuresertib will be given daily until the subjects meet any study treatment withdrawal criteria including disease progression. A total of up to 24 subjects will be enrolled in the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Afuresertib | Experimental | Three subjects will be enrolled and given afuresertib 125 mg orally and monitored for toxicity. After completion of PK sampling in 3 days (Cycle 0), daily repeated dose of 125 mg will be given for 21 days (Cycle 1). If no DLT event is found after 21 days of repeated dosing, up to 6 subjects will be enrolled and given afuresertib 150 mg. If afuresertib 150 mg is assessed to be tolerable, up to 6 subjects can be enrolled and given afuresertib 200 mg. If afuresertib 200 mg is assessed to be intolerable, up to 6 subjects will be enrolled and given afuresertib 150mg or 175 mg. In any Dose levels, if DLT occurs in more than 2 subjects, that Dose level will be considered as intolerable." |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Afuresertib | Drug | Size 4 and Size 1 opaque white capsules containing 25 mg and 100 mg of afuresertib, respectively, to be administered orally. |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of subjects with Dose-limiting toxicities (DLTs) when afuresertib is given as monotherapy | DLT is defined as an adverse event which is applicable to any of the criteria specified in the protocol and judged to have a reasonable causal relationship with afuresertib. The DLT evaluation period will be from the day of the first dosing in Cycle 1 to Day 21 of Cycle 1 or the day of DLT occurrence if any DLT occurred before Day 21 of Cycle 1. | Day 1 to 21 of Cycle 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Eastern Cooperative Oncology Group (ECOG) performance status (PS) | The performance status will be assessed using the ECOG scale | From Day -3 until 30 days after the last dose of afuresertib |
| Vital signs assessment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Novartis Pharmaceuticals | Novartis Pharmaceuticals | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Novartis Investigative Site | Aichi | 467-8602 | Japan | |||
| Novartis Investigative Site |
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| Label | URL |
|---|---|
| Novartis results database | View source |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D009101 | Multiple Myeloma |
| ID | Term |
|---|---|
| D054219 | Neoplasms, Plasma Cell |
| D009370 | Neoplasms by Histologic Type |
| D020141 | Hemostatic Disorders |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| C000593263 | afuresertib |
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Vital sign measurements will include systolic and diastolic blood pressure and pulse rate
| From Day -3 until 30 days after the last dose of afuresertib |
| Number of participants with adverse events (AEs) | An AE is defined as any untoward medical occurrence in a clinical investigation subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product | From Day -3 until 30 days after the last dose of afuresertib |
| Laboratory assessments | laboratory assessments will include haematologic tests, blood chemistry tests, coagulation tests, urine tests and lipid panel | From Day -3 until 30 days after the last dose of afuresertib |
| 12-lead electrocardiogram (ECG) assessment | Triple 12-lead ECGs will be obtained at designated time points during the study using an ECG machine that automatically calculates the heart rate and measures pulse rate (PR), QRS, QT, and QTc intervals. | From Day -3 until 30 days after the last dose of afuresertib |
| Left ventricular ejection fraction (LVEF) assessment | Echocardiogram and/or Multi-gated Acquisition (MUGA) scans will be performed for evaluation for LVEF | From Day -3 until 30 days after the last dose of afuresertib |
| Composite of pharmacokinetic (PK) parameters of afuresertib monotherapy administered as single and repeated dose | PK parameters will include area under the concentration-time curve from time zero extrapolated to infinite time [AUC (0-infinity)], area under the concentration-time curve over the dosing interval [AUC (0-tau)], maximum observed plasma concentration (Cmax), last observed quantifiable concentration (Clast), apparent clearance following oral dosing (CL/F), pre-dose (trough) concentration at the end of the dosing interval (Ctau), time of occurrence of Cmax (tmax), terminal phase half-life (t1/2), steady state ratio (Rs) and observed accumulation ratio (Ro) | Cycle 0 (Pre-dose, 0.5 hour [hr],1 hr, 2 hr, 3 hr, 4hr, 6 hr, 8 hr, 24 hr, 48 hr, 72 hr) and Cycle 1 Day 8 (Pre-dose, 0.5 hr,1 hr, 2 hr, 3 hr, 4hr, 6 hr, 8 hr, 24 hr) |
| Response rate and clinical benefit rate (rate of minor response or better) | Response evaluations will be determined according to the Response Criteria for multiple myeloma as stringent complete response (sCR), complete response (CR), very good partial response (VGPR), partial response (PR), and minor response (MR). Response rate will be defined as the percentage of subjects with sCR, CR, VGPR or PR. Subjects with unknown or missing response will be treated as non-responder. | Within 4 weeks of Day 1 Cycle 1, at start of each cycle (except Cycle 1), and then every 6 to 9 weeks until 30 days after the last dose of afuresertib |
| Fukuoka |
| 811-1395 |
| Japan |
| Novartis Investigative Site | Miyagi | 980-8574 | Japan |
| Novartis Investigative Site | Niigata | 951-8566 | Japan |
| Novartis Investigative Site | Tokyo | 104-0045 | Japan |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D006474 | Hemorrhagic Disorders |
| D008232 | Lymphoproliferative Disorders |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |