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| Name | Class |
|---|---|
| Amgen | INDUSTRY |
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This open-label, 2-part Phase I/ randomized Phase II multi-center study is conducted to evaluate the safety, tolerability, pharmacokinetics (PK), and clinical activity of afuresertib in combination with carfilzomib versus carfilzomib alone, in subjects with relapsed/refractory MM. Part 1 will evaluate 2 dose levels (125 milligrams [mg] and 150 mg of afuresertib) in 16 subjects (approximately 8 in each parallel arm) to determine an optimal dose of afuresertib for administration in combination with carfilzomib in Part 2. If neither of these dose levels are tolerated, an additional dose level of 100mg of afursertib in combination with carfilzomib may be explored in approximately 8 additional subjects. Part 2 was to investigate the safety, and clinical activity of the combination of afuresertib with carfilzomib (determined in Part 1) compared to carfilzomib alone, in approximately 100 subjects (50 in each parallel arm), however the study was terminated after the discontinuation of the single subject following the transition of the afuresertib development program from GSK to Novartis. The reason for the study termination is that the protocol defined study treatment was no longer aligned with the evolving standard of care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Afuresertib 125 mg+ Carfilzomib (Part 1) | Experimental | Approximately 8 subjects will receive Afuresertib 125 mg daily starting Cycle 1 Day 2 + Carfilzomib 20 mg/m^2: Cycle 1, Day 1, 2; Cycle 2, Day 1. Carfilzomib 27 mg (increased dosage of 27 mg/meter (m)^2 will be administered only if tolerated): Cycle 1, Days 8, 9, 15, and 16; Cycle 2, Days 2, 8, 9, 15, and 16; Cycle 3 and onwards, Days 1, 2, 8, 9, 15, and 16 of each cycle |
|
| Afuresertib 150 mg+ Carfilzomib (Part 1) | Experimental | Approximately 8 subjects will receive oral Afuresertib 150 mg daily starting Cycle 1 Day 2 + Carfilzomib 20 mg/m^2: on Cycle 1, Day 1, 2; Cycle 2, Day 1. Carfilzomib 27 mg/m^2 (increased dosage of 27 mg/m^2 will be administered only if tolerated): Cycle 1, Days 8, 9, 15, and 16; Cycle 2, Days 2, 8, 9, 15, and 16; Cycle 3 and onwards, Days 1, 2, 8, 9, 15, and 16 of each cycle |
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| Afuresertib 100 mg+ Carfilzomib (Part 1) | Experimental | An additional arm with 100 mg of afuresertib may be evaluated if the other 2 arms are not tolerated. Approximately 8 subjects will receive Afuresertib 100 mg daily starting Cycle 1 Day 2 + Carfilzomib 20 mg/m^2: on Cycle 1, Day 1, 2; Cycle 2, Day 1. Carfilzomib 27 mg/m^2 (increased dosage of 27 mg/m^2 will be administered only if tolerated): Cycle 1, Days 8, 9, 15, and 16; Cycle 2, Days 2, 8, 9, 15, and 16; Cycle 3 and onwards, Days 1, 2, 8, 9, 15, and 16 of each cycle |
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| Afuresertib/carfilzomib (Part 2) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Afuresertib | Drug | Afuresertib will be dosed orally in morning, and will be sourced as opaque, white, size 4, 25 mg capsule and size 1, 100 mg capsules. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Part1: Number of participants with adverse events (AEs) as a measure of safety | AEs and serious adverse events (SAEs) will be collected from the screening until the follow-up visit | Until 4 weeks after the last subject's last dose (LSLD) (Approximately assessed up to 4 years) |
| Part1: Safety assessed by monitoring the changes in vital signs | Vital signs assessments included temperature, systolic and diastolic blood pressure, temperature and pulse rate measurements | Until 4 weeks after the LSLD (Approximately assessed up to 4 years) |
| Part1: Safety assessed by monitoring the changes in laboratory parameters | Clinical laboratory parameters will include hematology and clinical chemistry | Until 4 weeks after the LSLD (Approximately assessed up to 4 years) |
| Part1: Safety assessed by monitoring the changes in electrocardiograms (ECG) | Single 12-lead ECGs will be obtained over a brief recording period at the start of each cycle | Until 4 weeks after the LSLD (Approximately assessed up to 4 years) |
| Part 2: Progression Free Survivial (PFS) | PFS defined as the interval between the date of randomization and the earliest date of disease progression as assessed by investigator or death due to any cause | Until 12 months of follow-up after the LSLD (Approximately assessed up to 6 years) |
| Measure | Description | Time Frame |
|---|---|---|
| Part 1: Composite of PK parameters of afuresertib and carfilzomib alone or in combination with each other will be assessed following multiple afuresertib doses and following a single dose of carfilzomib | Peripheral blood will be collected to evaluate PK parameters for Afuresertib (e.g., area under the plasma drug concentration-time curve [AUC], maximum observed plasma drug concentration [Cmax]) and carfilzomib (e.g., AUC, Cmax) |
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Inclusion Criteria:
Exclusion Criteria: Subjects meeting any of the following criteria must not be enrolled in the study:
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| Name | Affiliation | Role |
|---|---|---|
| Novartis Pharmaceuticals | Novartis Pharmaceuticals | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Novartis Investigative Site | Cary | North Carolina | 27518 | United States |
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Approximately 50 subjects will receive Afuresertib Recommended Phase 2 Dose (RP2D) daily starting Cycle 1 Day 1 + Carfilzomib 20 mg/m^2 Cycle 1, Day 1, 2. Carfilzomib 27 mg (increased dosage of 27 mg/m^2 will be administered only if tolerated): Cycle 1, Days 8, 9, 15 and 16; Cycle Days 1, 2, 8, 9, 15 and 16 of each cycle; Cycle 3 and onwards, Days 1, 2, 8, 9 and 15 and 16 of each cycle. |
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| Carfilzomib (Part 2) | Active Comparator | Approximately 50 subjects will receive Carfilzomib 20 mg/m^2: Cycle 1, Day 1, 2. Carfilzomib 27 mg/m^2 (increased dosage of 27 mg/m^2 will be administered only if tolerated): Cycle 1, Days 8, 9 15, and 16; Cycle 2, Days 1, 2, 8, 9, 15 and 16 of each cycle; Cycle 3 and onwards, Days 1, 2, 8, 9, 15 and 16 of each cycle. |
|
| Carfilzomib | Drug | Intravenous (IV) Carfilzomib will be sourced in the US from commercial stock. It will be a single-use 60 mg vial as a sterile, white to off-white lyophilized cake or powder |
|
| Afuresertib (Cycle 1[C1], any Day[D] between 21-28 and C2 D1): 30 min predose; Carfilzomib (C1 D1 and C2 D1): 30 min predose; end of dosing; post dosing time-points for both treatments: 5 min, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10-12, 14-22, 24 hours (hr) |
| Part 1: Afuresertib concentrations | Afuresertib concentrations will be assessed in peripheral blood using a sparse sampling strategy | C1 D15: predose; 1 to 3 hr and 4 to 6 hr post-dose. C2 D1 and any cycle where disease assessments are obtained: pre-treatment and right before subject leaves clinic for the day (C2 and every 3rd cycle; approximately (approx) assessed up to 4 years) |
| Part1: Overall response rate (ORR) | ORR is defined as the percentage of subjects with a confirmed stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR), as assessed by investigator using the 2011 recommendations in the International Myeloma Workshop Consensus (IMWC) Panel 1 | Until 12 months of follow-up after the LSLD (Approximately assessed up to 6 years) |
| Part1: PFS | PFS is defined as the interval between the date of first dose and the earliest date of disease progression as assessed by investigator or death due to any cause | Until 12 months of follow-up after the LSLD (Approximately assessed up to 6 years |
| Part1: Overall survival (OS) | OS is defined as the time until death due to any cause. Subjects will be followed for up to a maximum of 12 months following the LSLD. Subjects who are alive at 12 months following the LSLD will be censored for OS | Until 12 months of follow-up after the LSLD (Approximately assessed up to 8 years |
| Part1: Duration of response (DOR) | DOR defined for those subjects that achieve ORR as the time from first documented evidence of sCR, CR, VGPR, or PR until first documented disease progression or death | Until 12 months of follow-up after the LSLD (Approximately assessed up to 6 years) |
| Part 2: ORR | ORR defined as the percentage of subjects with a confirmed sCR, CR, VGPR or PR, as assessed by investigator using the 2011 recommendations in the IMWC Panel 1 | Until 12 months of follow-up after LSLD (Approximately assessed up to 6 years) |
| Part 2: OS | OS is defined as the time until death due to any cause. Subjects will be followed for up to a maximum of 12 months following the LSLD. Subjects who are alive at 12 months following the LSLD will be censored for OS | Until 12 months of follow-up after the LSLD (Approximately assessed up to 8 years |
| Part 2: DOR | DOR defined for those subjects that achieve ORR as the time from first documented evidence of sCR, CR, VGPR, or PR until first documented disease progression or death | Until 12 months of follow-up after LSLD (Approximately assessed up to 6 years) |
| Part 2: Number of participants with adverse events (AEs) as a measure of safety | AEs and SAEs will be collected from the screening until the follow-up visit | Until 4 weeks after the LSLD (Approximately assessed up to 4 years |
| Part 2: Safety assessed by monitoring the changes in vital signs | Vital signs assessments included temperature, systolic and diastolic blood pressure, temperature and pulse rate measurements | Until 4 weeks after the LSLD (Approximately assessed up to 4 years |
| Part 2: Safety assessed by monitoring the changes in laboratory parameters | Clinical laboratory parameters will include hematology and clinical chemistry | Until 4 weeks after the LSLD (Approximately assessed up to 4 years |
| Part 2: Safety assessed by monitoring the changes in ECG | Single 12-lead ECGs will be obtained over a brief recording period at the start of each cycle. | Until 4 weeks after the LSLD (Approximately assessed up to 4 years |
| Part 2: Afuresertib concentrations | Afuresertib concentrations will be assessed in peripheral blood using a sparse sampling strategy | C1 D1: predose; 1-3 hr post-dose. C1 D15: predose; 1-3 hr and 4-6 hr post-dose. C2 D1 and any cycle where assessments are obtained: pre-treatment and right before subject leaves clinic for the day (C2 and every 3rd cycle; approx assessed up to 4 years) |
| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D012008 | Recurrence |
| D009101 | Multiple Myeloma |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D054219 | Neoplasms, Plasma Cell |
| D009370 | Neoplasms by Histologic Type |
| D020141 | Hemostatic Disorders |
| D014652 | Vascular Diseases |
| 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 |
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| ID | Term |
|---|---|
| C000593263 | afuresertib |
| C524865 | carfilzomib |
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