A Phase I Trial of Dinaciclib (SCH727965) and MK-2206 in Metastatic Pancreatic Cancer With an Expansion Cohort in Advanced Pancreatic Cancer
PRIMARY OBJECTIVES:
I. Determine the maximum tolerated dose (MTD), safety, and toxicity of the combination of
MK-2206 (Akt inhibitor MK2206) and dinaciclib in patients with advanced pancreatic
adenocarcinoma.
SECONDARY OBJECTIVES:
I. Assess the preliminary efficacy of the combination of MK-2206 and dinaciclib in
metastatic pancreatic cancer patients as determined by disease control rate in an expansion
cohort of patients at the MTD.
II. Characterize the pharmacokinetic (PK) profile of the combination of MK-2206 and
dinaciclib.
III. Analyze pre-treatment tumor specimens for activation of RAS downstream pathway
signaling as potential predictors of treatment benefit.
IV. Correlate post-treatment pharmacodynamic (PD) changes in phosphorylated extracellular
signal-regulated kinase (p-ERK), p-AKT, p-S6, phosphorylated deoxyribonucleic acid
(DNA)-directed ribonucleic acid (RNA) polymerase II subunit RPB1 (pPOLR2), phosphorylated
retinoblastoma protein (pRB), Ki-67, and cleaved caspase-3 in tumor biopsies and peripheral
blood mononuclear cells with MK-2206 and dinaciclib exposure and treatment response to
demonstrate proof-of-concept and assess for post-treatment predictive biomarkers.
V. To assess the effect of polymorphic variations in candidate genes (cytochrome P450 3A4/5
[CYP3A4/5], ATP-binding cassette, sub-family B [MDR/TAP], member 1 [ABCB1]) and other
genetic alterations that may be discovered during the conduct of the study, on MK-2206 and
dinaciclib disposition, toxicity, and efficacy.
OUTLINE: This is a dose-escalation study of dinaciclib and Akt inhibitor MK2206. Patients
are randomized to 1 of 2 treatment arms.
ARM A: Patients receive dinaciclib intravenously (IV) over 2 hours on day 1 of course 1.
ARM B: Patients receive Akt inhibitor MK2206 orally (PO) on day 1 of course 1.
After day 1, all patients receive Akt inhibitor MK2206 PO on days 1, 8, and 15 and
dinaciclib IV over 2 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence
of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up periodically.
Interventional
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Treatment
Maximum tolerable dose (MTD) of dinaciclib in combination with Akt inhibitor MK2206 defined as the highest dose at which 0 or 1 dose-limiting toxicities are observed in six patients
The proportion of dose-limiting toxicities at each dose level will be reported with exact binomial proportions and 95% confidence intervals.
28 days
Yes
Nilofer Azad
Principal Investigator
Johns Hopkins University
United States: Food and Drug Administration
NCI-2013-00153
NCT01783171
January 2013
Name | Location |
---|---|
Johns Hopkins University | Baltimore, Maryland 21205 |
University of Wisconsin Hospital and Clinics | Madison, Wisconsin 53792-0001 |
University of Colorado | Denver, Colorado 80217 |