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| Name | Class |
|---|---|
| Parexel | INDUSTRY |
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This study will be conducted to quantify the magnitude of the effect of itraconazole co-administration on the PK of savolitinib. The exposure to savolitinib is predicted to increase when co-administered with the potent cytochrome P (CYP) 3A4 inhibitor itraconazole since CYP3A4 (via CYP450) is involved in the metabolism and elimination of savolitinib.
This study will be an open-label, 3-period, fixed-sequence study in non-Japanese healthy male subjects conducted at a single study centre.
The study will comprise:
A screening period of maximum 28 days;
Three treatment periods:
The Follow-up Visit will occur at least 14 days after the last dose of savolitinib PK sample in Treatment Period 3.
Subjects will be admitted to the study centre on 2 different occasions: Study Day-1 (Study Day -1) to Study Day 3 of Treatment Period 1 and Day -1 (Study Day 14) of Treatment Period 2 to Day 3 (Study Day 20) of Treatment Period 3.
The study drugs will be administered as follows:
Each subject will be involved in the study for up to 60 days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Savolitinib and/or Itraconazole | Experimental | Treatment Period 1: Single administration of savolitinib (200 mg) will occur on Study Day 1 after a high-fat, high-calorie breakfast followed by PK sampling for 48 hours Treatment Period 2: Itraconazole will be administered (200 mg BID) on Study Day 15, and (200 mg QD) on Study Days 16 and 17, 1 hour before breakfast (and before dinner, when applicable) Treatment Period 3: A single combination of itraconazole (200 mg) 1 hour before breakfast + savolitinib (200 mg) after a high-fat, high-calorie breakfast on Study Day 18, and a single dose of itraconazole (200 mg) on Study Day 19, 1 hour before breakfast |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Savolitinib | Drug | On Study Day 1 and Study Day 18, savolitinib will be administered as single dose after a high-fat, high-calorie breakfast |
|
| Measure | Description | Time Frame |
|---|---|---|
| Savolitinib area under plasma concentration-time curve from time zero to infinity (AUC) ratios of geometric means of test treatment (savolitinib+itraconazole), relative to reference treatment (savolitinib alone) | To assess the effect of itraconazole on the PK of savolitinib | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib maximum observed plasma concentration (Cmax) ratios of geometric means of test treatment (savolitinib+itraconazole), relative to reference treatment (savolitinib alone) | To assess the effect of itraconazole on the PK of savolitinib | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Measure | Description | Time Frame |
|---|---|---|
| Savolitinib:Area under the plasma concentration-curve from time zero to time of last quantifiable concentration [AUC(0-t)] ratios of geometric means of test treatment (savolitinib+itraconazole), relative to reference treatment (savolitinib alone) | To assess the effect of itraconazole on the pharmacokinetics of metabolites M2 and M3 | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
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Inclusion Criteria:
Exclusion criteria:
(1) Systolic BP <90 mmHg or ≥140 mmHg (2) Diastolic BP <50 mmHg or ≥90 mmHg (3) Heart rate <45 or >85 beats per minute (BPM) 9) Any clinically important abnormalities in rhythm, conduction or morphology of the 12-lead resting ECG that may interfere with the interpretation of QTc interval changes.
These include healthy subjects with any of the following:
10) A history of additional risk factors for torsades de pointes (TdP) (eg, chronic hypokalaemia not correctable with supplements, congenital or familial long QT syndrome, or family history of unexplained sudden death under 40 years of age in first-degree relatives or any concomitant medication known to prolong the QT interval and cause TdP).
11) Known or suspected history of drug abuse, as judged by the PI. 12) Current smokers or those who have smoked or used nicotine products within the previous 30 days.
13) History of alcohol abuse or excessive intake of alcohol as judged by the PI.
14) Excessive intake of caffeine-containing drinks or food (eg, coffee, tea, chocolate,) as judged by the PI.
15) Use of drugs with enzyme inducing properties such as St John's Wort within 3 weeks prior to the first administration of the IMP.
16) Any intake of grapefruit, grapefruit juice, Seville oranges, Seville orange marmalade, or other products containing grapefruit or Seville oranges within 7 days of the first admission on Study Day -1.
17) Use of any prescribed or non-prescribed medication including antacids, analgesics (other than use of ibuprofen) up to 72 hours before first dosing day until final follow-up visit, herbal remedies, megadose vitamins (intake of 20 to 600 times the recommended daily dose) and minerals during the 2 weeks prior to the first administration of IMP or longer (5 times half-life) if the medication has a long half-life.
18) Positive screen for drugs of abuse, cotinine (nicotine) and/or alcohol at screening or on each admission to the study centre .
19) History of severe allergy/hypersensitivity or ongoing clinically important allergy/hypersensitivity, as judged by the PI or history of hypersensitivity to drugs with a similar chemical structure or class to savolitinib or itraconazole.
20) Plasma donation within 1 month of screening or any blood donation/loss more than 500 mL during the 3 months prior to screening.
21) Has received another new chemical entity (defined as a compound which has not been approved for marketing) within 30 days or 5 ½ lives (whichever is longer) of the first administration of IMP in this study.
Note: subjects consented and screened, but not randomized in this study or a previous Phase I study, are not excluded.
22) Involvement of any AstraZeneca, Parexel, or study centre employee or their close relatives 23) Judgment by the PI that the subject should not participate in the study if they have any ongoing or recent (ie, during the screening period) minor medical complaints that may interfere with the interpretation of study data or are considered unlikely to comply with study procedures, restrictions, and requirements.
24) Subjects who are vegans, vegetarians or have medical dietary restrictions. 25) Subjects who cannot communicate reliably with the PI. 26) Vulnerable subjects, eg, kept in detention, protected adults under guardianship, trusteeship, or committed to an institution by governmental or juridical order.
27) Subjects who have previously received savolitinib.
In addition, any of the following is regarded as a criterion for exclusion from the genetic research:
28) Previous bone marrow transplant. 29) Non-leukocyte depleted whole blood transfusion within 120 days of the date of the genetic sample collection.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Research Site | Glendale | California | 91206 | United States |
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| Itraconazole | Drug | Twice daily on first day of dosing (Study Day 15) followed by once daily for 4 days (Study Day 16 - Study Day 19) administered 1 hour before any breakfast (and 1 hour before dinner on Study Day 15) |
|
| M2 and M3: Cmax ratios of geometric means of test treatment (savolitinib+itraconazole), relative to reference treatment (savolitinib alone) | To assess the effect of itraconazole on the pharmacokinetics of metabolites M2 and M3 | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| M2 and M3: AUC ratios of geometric means of test treatment (savolitinib+itraconazole), relative to reference treatment (savolitinib alone) | To assess the effect of itraconazole on the pharmacokinetics of metabolites M2 and M3 | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| M2 and M3: AUC(0-t) ratios of geometric means of test treatment (savolitinib+itraconazole), relative to reference treatment (savolitinib alone) | To assess the effect of itraconazole on the pharmacokinetics of metabolites M2 and M3 | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib, M2 and M3: Cmax | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib, M2 and M3: AUC | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib, M2 and M3: AUC(0-t) | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib, M2 and M3: tmax | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib, M2 and M3: t½,λz | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib, M2 and M3: λz | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib: CL/F | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Savolitinib: Vz/F | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Metabolite-to-parent ratios (MRCmax) | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Metabolite-to-parent ratios (MRAUC) | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Metabolite-to-parent ratios [MRAUC(0-t)] | To describe the PK parameters and the PK profiles for savolitinib, M2 and M3 when savolitinib is administered alone and in combination with itraconazole | Savolitinib,M2andM3:Treatment Periods1and3 (Study Days 1 and 18)pre-dose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 18, 24, 36 and 48 hours post-dose. Itraconazole:Treatment Period 3 (Study day 18)pre-dose, and 1 and 2 hours post-dose. |
| Number of subjects with adverse events | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in systolic blood pressure (BP) | To assess the safety and tolerability of savolitinib in combination with itraconazole | Screening (Day -28), treatment period 1 (Study Day -1 and 1 to 14) and treatment period 3 (Study Day 1 to 3) |
| Number of subjects with abnormal findings in diastolic BP | To assess the safety and tolerability of savolitinib in combination with itraconazole | Screening (Day -28), treatment period 1 (Study Day -1 and 1 to 14) and treatment period 3 (Study Day 1 to 3) |
| Number of subjects with abnormal findings in pulse rate | To assess the safety and tolerability of savolitinib in combination with itraconazole | Screening (Day -28), treatment period 1 (Study Day -1 and 1 to 14) and treatment period 3 (Study Day 1 to 3) |
| Number of subjects with abnormal findings in electrocardiogram (ECG) | To assess the safety and tolerability of savolitinib in combination with itraconazole | Screening (Day -28), treatment period 1 (Days 1 to 14), treatment period 3 (Days 1 to 3) and follow-up visit (At least 14 days after last savolitinib dose) |
| Number of subjects with abnormal findings in physical examination | To assess the safety and tolerability of savolitinib in combination with itraconazole | Study Day -1, Day 1 (pre-dose) of Treatment Periods 1, 2, and 3 (Study Days 1, 15, and 18) |
| Number of subjects with abnormal findings in white blood cell (WBC) count | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in red blood cell (RBC) count | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in hemoglobin (Hb) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in hematocrit (HCT) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in mean corpuscular volume (MCV) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in mean corpuscular hemoglobin (MCH) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in mean corpuscular hemoglobin concentration (MCHC) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in neutrophils absolute count | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in lymphocytes absolute count | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in monocytes absolute count | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in eosinophils absolute count | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in basophils absolute count | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in platelets | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in reticulocytes absolute count | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in sodium | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in potassium | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in urea | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in creatinine clearence | To assess the safety and tolerability of savolitinib in combination with itraconazole | Screening (Day -28 to Day -1) |
| Number of subjects with abnormal findings in albumin | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in calcium | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in phosphate | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in glucose (fasting) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in C-reactive protein (CRP) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in alkaline phosphatase (ALP) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in alanine aminotransferase (ALT) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in aspartate aminotransferase (AST) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in gamma glutamyl transpeptidase (GGT) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in total bilirubin (TBL) | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in unconjugated bilirubin | To assess the safety and tolerability of savolitinib in combination with itraconazole | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| Number of subjects with abnormal findings in urinalysis | To assess the safety and tolerability of savolitinib in combination with itraconazole The parameters assessed will be glucose, protein and blood | From Screening (Day -28) up to the Follow-up visit (at least 14 days after savolitinib dose) |
| ID | Term |
|---|---|
| C000593259 | 1-(1-(imidazo(1,2-a)pyridin-6-yl)ethyl)-6-(1-methyl-1H-pyrazol-4-yl)-1H-(1,2,3)triazolo(4,5-b)pyrazine |
| D017964 | Itraconazole |
| ID | Term |
|---|---|
| D014230 | Triazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D010879 | Piperazines |
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