STARTRK-NG: Study Of Entrectinib (Rxdx-101) in Children and Adolescents With Locally Advanced Or Metastatic Solid Or Primary CNS Tumors And/Or Who Have No Satisfactory Treatment Options
Study Details
Study Description
Brief Summary
This is an open-label, Phase 1/2 multicenter dose escalation study in pediatric patients with relapsed or refractory extracranial solid tumors (Phase 1), with additional expansion cohorts (Phase 2) in patients with primary brain tumors harboring NTRK1/2/3 or ROS1 gene fusions, and extracranial solid tumors harboring NTRK1/2/3 or ROS1 gene fusions.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
Phase 1/Phase 2 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Active Comparator: Extracranial solid tumors harboring NTRK1/2/3, Arm closed for further enrollment ROS1, ALK non-gene fusion molecular alterations Oral entrectinib (RXDX-101) |
Drug: Entrectinib
TRKA/B/C, ROS1, and ALK inhibitor
Other Names:
|
Active Comparator: CNS tumors harboring- NTRK1/2/3, ROS1, ALK Arm closed for further enrollment molecular alterations, including gene fusions Oral entrectinib (RXDX-101) |
Drug: Entrectinib
TRKA/B/C, ROS1, and ALK inhibitor
Other Names:
|
Active Comparator: Neuroblastoma Arm closed for further enrollment Oral entrectinib (RXDX-101) |
Drug: Entrectinib
TRKA/B/C, ROS1, and ALK inhibitor
Other Names:
|
Active Comparator: Non-neuroblastoma, extracranial solid tumors Arm closed for further enrollment harboring - NTRK1/2/3, ROS1, ALK gene fusions Oral entrectinib (RXDX-101) |
Drug: Entrectinib
TRKA/B/C, ROS1, and ALK inhibitor
Other Names:
|
Active Comparator: Any participant unable to swallow capsules Arm closed for further enrollment Any participant who otherwise meet all other eligibility criteria Oral entrectinib (RXDX-101) |
Drug: Entrectinib
TRKA/B/C, ROS1, and ALK inhibitor
Other Names:
|
Active Comparator: Expansion: CNS tumors harboring NTRK1/2/3, ROS1 gene fusions Oral entrectinib (RXDX-101) |
Drug: Entrectinib
TRKA/B/C, ROS1, and ALK inhibitor
Other Names:
|
Active Comparator: Expansion: Extracranial solid tumors harboring NTRK1/2/3, ROS1 NTRK 1,2,3 and ROS1 fusions Oral entrectinib (RXDX-101) |
Drug: Entrectinib
TRKA/B/C, ROS1, and ALK inhibitor
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Maximum Tolerated Dose (MTD) [Approximately 6 months]
Assessed by National Cancer Institute Common Terminology for Adverse Events Criteria (NCI CTCAE v4.03)
- Recommended Phase 2 Dose (RP2D) of F1 Formulation In Pediatric Participants Able To Swallow Intact Capsules [Approximately 6 months]
Assessed by NCI CTCAE v4.03
- Recommended Phase 2 Dose (RP2D) of F06 Formulation In Pediatric Participants Able To Swallow Intact Capsules [Approximately 6 months]
Assessed by NCI CTCAE v4.03
- Recommended Phase 2 Dose (RP2D) of F06 Formulation In Pediatric In Participants Dosed Via Feeding Tube (Nasogastric Tube Or Gastric Tube) [Approximately 6 months]
Assessed by NCI CTCAE v4.03
- Recommended Phase 2 Dose (RP2D) Of Minitablets/F15 Formulation In Pediatric Participants Unable To Swallow Intact Capsules [Approximately 6 months]
Assessed by NCI CTCAE v4.03
- Cohort B: Objective Response Rate (ORR) [Approximately 6 months]
Assessed by RANO per the BICR
- Cohort D: ORR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR
Secondary Outcome Measures
- Safety and Tolerability - AE, ECG and Labs assessed by NCI CTCAE v4.03 [Approximately 24 months]
AE, ECG and Labs assessed by NCI CTCAE v4.03
- Maximum observed plasma drug concentration (Cmax) using F1 Formulation [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Maximum observed plasma drug concentration (Cmax) using F06 Formulation given intact [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Maximum observed plasma drug concentration (Cmax) using F06 Formulation administered via feeding tube [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Maximum observed plasma drug concentration (Cmax) using minitablets/F15 [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Time to Cmax, by inspection (Tmax) using F1 Formulation [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Time to Cmax, by inspection (Tmax) using F06 Formulation given intact [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Time to Cmax, by inspection (Tmax) using F06 Formulation administered via feeding tube [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Time to Cmax, by inspection (Tmax) using minitablets/F15 [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- AUC at steady state (AUCss) using F1 Formulation [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- AUC at steady state (AUCss) using F06 Formulation given intact [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- AUC at steady state (AUCss) using F06 Formulation administered via feeding tube [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- AUC at steady state (AUCss) using minitablets/F15 [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Terminal half life (t½) using F1 Formulation [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Terminal half life (t½) using F06 Formulation given intact [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Terminal half life (t½) using F06 Formulation administered via feeding tube [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Terminal half life (t½) using minitablets/F15 [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Area under the drug concentration by time curve (AUC) using F1 Formulation [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Area under the drug concentration by time curve (AUC) using F06 Formulation given intact [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Area under the drug concentration by time curve (AUC) using F06 Formulation administered via feeding tube [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Area under the drug concentration by time curve (AUC) using minitablets/F15 [Approximately 24 months]
Assessed by plasma concentrations obtained on Days 1, 2, 8, 15, 22 (Cycle 1), Days 1, 2 (Cycle 2) and on Day 1 of every cycle thereafter
- Cohort A, D, or E: Clinical Benefit Rate (CBR) [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Cohort B or E: CBR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Cohort C: CBR [Approximately 6 months]
Assessed by the Curie scale per the BICR and investigator
- Cohort A, D, or E: Progression-free Survival (PFS) [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Cohort B or E: PFS [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Cohort C: PFS [Approximately 6 months]
Assessed by the Curie scale per the BICR and investigator
- Cohort A, D, or E: Overall Survival (OS) [Approximately 6 months]
Assessed by RECIST v1.1
- Cohort B or E: OS [Approximately 6 months]
Assessed by RANO
- Cohort A, D, or E: ORR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Cohort B or E: ORR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Cohort C: ORR [Approximately 6 months]
Assessed by the Curie scale per the BICR and investigator
- Cohort A, D, or E: Time to response (TTR) [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Cohort B or E: TTR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Cohort C: TTR [Approximately 6 months]
Assessed by the Curie scale per the BICR and investigator
- Cohort A, D, or E: Duration of Response (DOR) [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Cohort B or E: DOR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Cohort C: DOR [Approximately 6 months]
Assessed by the Curie scale per the BICR and investigator
- Phase 2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort B or E): ORR [Approximately 6 months]
Assessed by RANO per the investigator
- Phase 2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort D or E): ORR [Approximately 6 months]
Assessed by RECIST v1.1 per the investigator
- Phase 1/2 Participants with NTRK1/2/3 gene fusions (Cohort A, D, or E): ORR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 gene fusions (Cohort B or E): ORR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 1/2 Participants with ROS1 gene fusions (Cohort A, D, or E): ORR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with ROS1 gene fusions (Cohort B or E): ORR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort A, D, or E): ORR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort B or E): ORR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort B or E): DOR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort D or E): DOR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 gene fusions (Cohort A, D, or E): DOR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 gene fusions (Cohort B or E): DOR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 1/2 Participants with ROS1 gene fusions (Cohort A, D, or E): DOR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with ROS1 gene fusions (Cohort B or E): DOR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort A, D, or E): DOR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort B or E): DOR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort B or E): TTR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort D or E): TTR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 gene fusions (Cohort A, D, or E): TTR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 gene fusions (Cohort B or E): TTR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 1/2 Participants with ROS1 gene fusions (Cohort A, D, or E): TTR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with ROS1 gene fusions (Cohort B or E): TTR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort A, D, or E): TTR [Approximately 6 months]
Assessed by RECIST v1.1 per the BICR and investigator
- Phase 1/2 Participants with NTRK1/2/3 or ROS1 gene fusions (Cohort B or E): TTR [Approximately 6 months]
Assessed by RANO per the BICR and investigator
Eligibility Criteria
Criteria
Inclusion Criteria:
- Disease status:
-
Phase 1 portion (closed): Participants must have measurable or evaluable disease, as defined by RECIST v1.1
-
Phase 2 portion:
-
Part B: Participants must have measurable or evaluable disease, as defined by RANO
-
Part C (closed): Participants must have measurable or evaluable disease, as defined by RECIST v1.1 ± Curie Scale
-
Part D: Participants must have measurable or evaluable disease, as defined by RECIST v1.1
-
Part E (closed): Participants must have measurable or evaluable disease, as defined by RECIST v1.1 ± Curie Scale or RANO
- Tumor type:
- Phase 1 portion:
- Part A: Relapsed or refractory extracranial solid tumors
-
Phase 2 portion
-
Part B: Primary brain tumors with NTRK1/2/3 or ROS1 gene fusions; gene fusions are defined as those predicted to translate into a fusion protein with a functional TRKA/B/C or ROS1 kinase domain, without a concomitant second oncodriver as determined by a nucleic acid-based diagnostic testing method
-
Part D: Extracranial solid tumors (including NB) with NTRK1/2/3 or ROS1 gene fusions; gene fusions are defined as those predicted to translate into a fusion protein with a functional TRKA/B/C or ROS1 kinase domain, without a concomitant second oncodriver as determined by a nucleic acid-based diagnostic testing method
-
Histologic/molecular diagnosis of malignancy at diagnosis or the time of relapse
-
Archival tumor tissue from diagnosis or, preferably, at relapse
-
Performance status: Lansky or Karnofsky score ≥ 60% and minimum life expectancy of at least 4 weeks
-
Prior therapy: Participants must have a disease that is locally advanced, metastatic, or where surgical resection is likely to result in severe morbidity, and who have no satisfactory treatment options for solid tumors and primary CNS tumors that are neurotrophic tyrosine receptor kinase (NTRK) or ROS1 fusion-positive
-
Participants must have recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to enrollment
-
Adequate organ and neurologic function
-
Females of childbearing potential must have a negative serum pregnancy test during screening and be neither breastfeeding nor intending to become pregnant during study participation. Agreement to remain abstinent or use use combined contraceptive methods prior to study entry, for the duration of study participation and in the following 90 days after discontinuation of study treatment.
-
For male participants with a female partner of childbearing potential or a pregnant female partner: Agreement to remain abstinent or use a condom during the treatment period and for at least 3 months after the last dose of study drug
Exclusion Criteria:
-
Receiving other experimental therapy
-
Known congenital long QT syndrome
-
History of recent (3 months) symptomatic congestive heart failure or ejection fraction ≤50% at screening
-
Known active infections
-
Familial or personal history of congenital bone disorders, bone metabolism alterations or osteopenia
-
Receiving Enzyme Inducing Antiepileptic Drugs (EIAEDs) within 14 days of first dose.
-
Prior treatment with approved or investigational TRK or ROS1 inhibitors
-
Known hypersensitivity to entrectinib or any of the other excipients of the investigational medicinal product
-
Patients with NB with bone marrow space-only disease
-
Incomplete recovery from acute effects of any surgery prior to treatment.
-
Active gastrointestinal disease or other malabsorption syndromes that would impact drug absorption.
-
Other severe acute or chronic medical or psychiatric condition or lab abnormality that may increase the risk associated with study participation, drug administration or may interfere with the interpretation of study results.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Children'S Hospital of Orange County | Orange | California | United States | 92868-3874 |
2 | Rady Childrens Hospital | San Diego | California | United States | 92123 |
3 | UCSF Benioff Children's Hospital; UCSF Pediatrics Hematology Oncology | San Francisco | California | United States | 94158 |
4 | Children's Hospital Colorado; Center For Cancer/Blood Disorder | Aurora | Colorado | United States | 80045 |
5 | Children's National Medical Center; Department of Pediatrics | Washington | District of Columbia | United States | 20037 |
6 | Egleston Children's Hospital at Emory University Atlanta; Pediatric Hematology/Oncology | Atlanta | Georgia | United States | 30322 |
7 | University of Chicago; Comer Children's Hospital/Department of Pediatrics | Chicago | Illinois | United States | 60637 |
8 | Johns Hopkins University | Baltimore | Maryland | United States | 21205 |
9 | Dana Farber Cancer Institute | Boston | Massachusetts | United States | 02215 |
10 | University of Minnesota Childrens' Hospital | Minneapolis | Minnesota | United States | 55455 |
11 | Washington University,St. Louis Children's Hospital; Neurology, Movement Disorder | Saint Louis | Missouri | United States | 63110 |
12 | Morgan Stanley Children's Hospital; Herbert Irving Cancer Center | New York | New York | United States | 10032 |
13 | Memorial Sloan Kettering Cancer Center; Pediatrics | New York | New York | United States | 10065 |
14 | Cincinnati Children's Hospital Medical Center | Cincinnati | Ohio | United States | 45229 |
15 | Nationwide Children's Hospital; Dept. of Pulmonology | Columbus | Ohio | United States | 43205 |
16 | Oregon Health & Science Uni | Portland | Oregon | United States | 97239 |
17 | Children's Hospital of Philadelphia | Philadelphia | Pennsylvania | United States | 19104 |
18 | St. Jude Children'S Research Hospital | Memphis | Tennessee | United States | 38105 |
19 | Cook Childrens Medical Center | Fort Worth | Texas | United States | 76104 |
20 | Texas Children's Cancer and Hematology Center | Houston | Texas | United States | 77030 |
21 | Primary Children's Hospital | Salt Lake City | Utah | United States | 84113 |
22 | The Hospital for Sick Children | Toronto | Ontario | Canada | M5G 1X8 |
23 | Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine | Shanghai | China | 200092 | |
24 | Centre Leon Berard; Pediatrie | Lyon | France | 69373 | |
25 | Hôpital de la Timone, Oncologie Pédiatrique | Marseille | France | 13385 | |
26 | Hopital Purpan; Pediatrie - Hematologie - Oncologie pediatrique | Toulouse | France | 31500 | |
27 | Institut Gustave Roussy; Service de Pathologie Morphologique | Villejuif | France | 94805 | |
28 | Universitaetsklinikum Heidelberg | Heidelberg | Germany | 69120 | |
29 | Hong Kong Children's Hospital | Hong Kong | Hong Kong | ||
30 | Fondazione IRCCS Istituto Nazionale dei Tumori; Struttura Complessa di Pediatria Oncologica | Milano | Lombardia | Italy | 20133 |
31 | A. O. Città della Salute e della Scienza di Torino; SC Oncoematologia e Centro Trapianti AOOIRM | Torino | Piemonte | Italy | 10126 |
32 | Seoul National University Hospital | Seoul | Korea, Republic of | 03080 | |
33 | Hospital Sant Joan de Deu; Servicio de Oncologia y Hematologia | Esplugues de Llobregat | Barcelona | Spain | 08950 |
34 | Hospital Infantil Universitario Nino Jesus | Madrid | Spain | 28009 | |
35 | National Taiwan University Hospital; Department of Paediatrics | Taipei | Taiwan | 100 | |
36 | Chang Gung Memorial Hospital, Linkou; Department of Pediatric Internal Medicine | Taoyuan City | Taiwan | 333 | |
37 | Leeds General Infirmary | Leeds | United Kingdom | LS1 3EX | |
38 | Royal Victoria Infirmary; Pharmacy | Newcastle upon Tyne | United Kingdom | NE1 4LP | |
39 | Royal Marsden NHS Foundation Trust | Sutton | United Kingdom | SM2 5PT |
Sponsors and Collaborators
- Hoffmann-La Roche
Investigators
- Study Director: Clinical Trials, Hoffmann-La Roche
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- RXDX-101-03
- CO40778