A Phase 1 interventional study of Alisertib in Advanced Solid Tumors and Relapsed/Refractory Lymphoma, sponsored by Millennium Pharmaceuticals, Inc.. Completed at 7 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-11-15.
Sponsored by Millennium Pharmaceuticals, Inc. · Phase 1, Interventional, and Treatment
The purpose of this study is to evaluate the effect of moderate or severe hepatic impairment on the single-dose pharmacokinetics of alisertib in adult participants with cancer.
The drug being tested in this study is called alisertib. Alisertib was tested to assess how it was processed by the body in participants with advanced solid tumors or relapsed/refractory lymphoma with varying degrees of liver function. This study also assessed laboratory results and safety.
The study enrolled 36 participants. Participants were assigned to 1 of the 3 treatment groups based on the status of their liver function: Normal hepatic function (Total bilirubin ≤ upper limit of the normal range [ULN] and alanine aminotransferase [ALT] level ≤ ULN), moderate hepatic impairment (Total bilirubin > 1.5-3 x ULN and ALT level = Any), or severe hepatic impairment (Total bilirubin > 3 x ULN and ALT level = Any). All participants were administered one 50 mg dose of alisertib on Day 1, Cycle 1. Alisertib was administered again on Days 8 through 14 of Cycle 1, followed by a 14-day rest period. Doses administered on Days 8-14 were 50, 30, or 20 mg of alisertib, depending on hepatic function. Alisertib was then continued at the same dose as in Cycle 1, Days 8-14 in 21-day cycles (7 days of alisertib followed by a 14-day rest period) for up to 1 year (approximately 16 cycles).
This multicenter trial was conducted in USA only. The overall time to participate in this study was up to 312 Days. Participants made multiple visits to the clinic including an end-of-study visit 30 days after the last dose of study drug for a follow-up assessment.
5,578 studies on the registry are indexed under Lymphoma; 825 are open to participants now.
This study's enrollment of 36 is close to the median of 40 across 4,508 interventional studies indexed under Lymphoma.
Browse Lymphoma studies →Millennium Pharmaceuticals, Inc. is the lead sponsor of 173 studies on the registry; none are open to participants now.
Of its 73 completed or terminated interventional studies of FDA-regulated products, 72 (99%) have results posted.
Counted across the registry records on this site, refreshed daily.
Female participants who:
Male participants, even if surgically sterilized (ie, status postvasectomy), who:
Clinical laboratory values as specified below:
Absolute neutrophil count (ANC) ≥ 1500/μL and platelet count ≥ 75,000/μL.
Exclusion Criteria:
A medical condition requiring use of pancreatic enzymes; daily, chronic, or regular use of proton pump inhibitors (PPIs); or histamine 2 (H2) receptor antagonists. Participants who intermittently use these medications, must meet the following criteria:
Symptomatic brain metastasis. Participants with brain metastases:
Known history of hepatitis C infection or suspected currently active hepatitis C infection, or known or suspected history of hepatitis B infection. Participants with known or suspected history of hepatitis B infection were to be screened and excluded when any of the following conditions were met:
Any of the following cardiovascular conditions:
Alisertib 50 mg, orally, once, on Cycle 1 Day 1, followed by, alisertib 50 mg, orally, twice daily (BID) for 7 days (Cycle 1 Day 8 to 14) followed by a 14-day rest period. Starting at Cycle 2 Day 1, alisertib 50 mg, BID for 7 days, followed by a 14-day rest period unless a dose reduction is indicated. Participants may continue to receive alisertib until they experience progressive disease or unacceptable alisertib-related toxicities for up to 12 months (approximately 16 cycles), unless it is determined by the investigator, with agreement by the sponsor, that a participant would derive clinical benefit from continued treatment beyond 12 months. Normal hepatic function includes participants with total bilirubin ≤ upper limit of the normal range \[ULN\] and alanine aminotransferase \[ALT\] level ≤ ULN.
Drug: Alisertib
Alisertib 50 mg, orally, once, on Cycle 1 Day 1, followed by alisertib 30 mg, BID for 7 days (Cycle 1 Day 8 to 14), followed by a 14-day rest period. Starting at Cycle 2 Day 1, alisertib 30 mg, BID for 7 days followed by a 14-day rest period unless a dose reduction is indicated. Participants may continue to receive alisertib until they experience progressive disease or unacceptable alisertib-related toxicities for up to 12 months (approximately 16 cycles), unless it is determined by the investigator, with agreement by the sponsor, that a participant would derive clinical benefit from continued treatment beyond 12 months. Moderate hepatic impairment includes participants with total bilirubin \> 1.5-3 x ULN and any ALT level.
Drug: Alisertib
Alisertib 50 mg, orally, once, on Cycle 1 Day 1, followed by, alisertib 20 mg, BID for 7 days (Cycle 1 Day 8 to 14) followed by a 14-day rest period. Starting at Cycle 2 Day 1, alisertib 20 mg, BID for 7 days followed by a 14-day rest period unless a dose reduction is indicated. Participants may continue to receive alisertib until they experience progressive disease or unacceptable alisertib-related toxicities for up to 12 months (approximately 16 cycles), unless it is determined by the investigator, with agreement by the sponsor, that a participant would derive clinical benefit from continued treatment beyond 12 months. Severe hepatic impairment includes participants with total bilirubin \> 3 x ULN and any ALT level.
Drug: Alisertib
Alisertib will be supplied as enteric coated tablets.
Also known as: MLN8237
Unbound Cmax: Maximum Observed Plasma Concentration for Alisertib
Time frame: Cycle 1 Day 1 Pre-dose and, and at multiple timepoints (up to 168 hours) post-dose
Unbound AUClast: Area Under the Concentration-Time Curve From Time 0 to the Time of the Last Quantifiable Concentration for Alisertib
Time frame: Cycle 1 Day 1 Pre-dose and, and at multiple timepoints (up to 168 hours) post-dose
Unbound AUC0-∞: Area Under the Concentration-Time Curve From Time 0 to Infinity for Alisertib
Time frame: Cycle 1 Day 1 Pre-dose and, and at multiple timepoints (up to 168 hours) post-dose
Percentage of Participants Who Experienced at Least 1 Treatment-Emergent Adverse Event
An adverse event is any unfavorable and unintended sign (eg, a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A treatment-emergent adverse event is defined as an adverse event with an onset that occurs after receiving study drug.
Time frame: Baseline to 30 days after last dose (Up to 312 Days)
Percentage of Participants Who Experienced at Least 1 Serious Adverse Event
A serious adverse event is any untoward medical occurrence or effect that at any dose of a drug results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, or is medically important due to other reasons than the above mentioned criteria.
Time frame: Baseline to 30 days after last dose (Up to 312 Days)
Percentage of Participants With Clinically Significant Laboratory Values
Laboratory assessments include serum chemistry and hematology. An abnormal laboratory value was assessed as an AE if that value led to discontinuation or delay in treatment, dose modification, therapeutic intervention, or was considered by the investigator to be a clinically significant change from baseline.
Time frame: Baseline to the end of the study (Up to 312 Days)
Percentage of Participants With Clinically Significant Vital Signs
Vital signs include measurements of sitting diastolic and systolic blood pressure, heart rate, and temperature. Any vital signs determined by the investigator to be clinically significant were recorded as AEs.
Time frame: Baseline to the end of the study (Up to 312 days)
Cmax: Maximum Observed Plasma Concentration for Alisertib Metabolites M1 and M2
Time frame: Cycle 1 Day 1 Pre-dose and, and at multiple timepoints (up to 168 hours) post-dose
Tmax: Time of First Occurrence of Cmax for Alisertib Metabolites M1 and M2
Time frame: Cycle 1 Day 1 Pre-dose and, and at multiple timepoints (up to 168 hours) post-dose
AUClast: Area Under the Concentration-Time Curve From Time 0 to the Time of the Last Quantifiable Concentration for Alisertib Metabolites M1 and M2
The area under the plasma concentration-time curve from time 0 to the time of the last quantifiable concentration (AUC0-last) of the alisertib metabolites M1 and M2 was determined from the concentration-time curve of each participant using non-compartmental methods.
Time frame: Cycle 1 Day 1 Pre-dose and, and at multiple timepoints (up to 168 hours) post-dose
Dose-normalized Trough Concentration of Alisertib on Cycle 1 Day 14
A single blood sample will be collected pre-dose on Cycle 1 Day 14. The concentration of alisertib was determined in the plasma sample and dose-normalized.
Time frame: Pre-dose on Day 14 of Cycle 1
Participants took part in the study at 6 investigative sites in the United States from 21 August 2014 to 18 July 2016.
| Milestone | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Started | 16 | 12 | 8 |
| Completed | 16 | 12 | 8 |
| Not completed | 0 | 0 | 0 |
| nmol/L | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Unbound Cmax: Maximum Observed Plasma Concentration for Alisertib | 17.3 ± 9.09 | 28.1 ± 7.82 | 18.5 ± 5.80 |
| h*nmol/L | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Unbound AUClast: Area Under the Concentration-Time Curve From Time 0 to the Time of the Last Quantifiable Concentration for Alisertib | 248.5 ± 131.41 | 859.1 ± 387.85 | 735.4 ± 444.61 |
| h*nmol/L | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Unbound AUC0-∞: Area Under the Concentration-Time Curve From Time 0 to Infinity for Alisertib | 304.3 ± 119.09 | 937.6 ± 428.98 | 778.0 ± 610.51 |
An adverse event is any unfavorable and unintended sign (eg, a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A treatment-emergent adverse event is defined as an adverse event with an onset that occurs after receiving study drug.
| percentage of participants | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Percentage of Participants Who Experienced at Least 1 Treatment-Emergent Adverse Event | 100 | 100 | 100 |
A serious adverse event is any untoward medical occurrence or effect that at any dose of a drug results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, or is medically important due to other reasons than the above mentioned criteria.
| percentage of participants | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Percentage of Participants Who Experienced at Least 1 Serious Adverse Event | 44 | 67 | 88 |
Laboratory assessments include serum chemistry and hematology. An abnormal laboratory value was assessed as an AE if that value led to discontinuation or delay in treatment, dose modification, therapeutic intervention, or was considered by the investigator to be a clinically significant change from baseline.
| percentage of participants | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Gamma-glutamyltransferase increased | 13 | 0 | 0 |
| Alanine aminotransferase increased | 0 | 8 | 0 |
| Aspartate aminotransferase increased | 0 | 8 | 0 |
| Blood bilirubin increased | 0 | 8 | 0 |
| Transaminases increased | 0 | 8 | 0 |
| Blood sodium decreased | 6 | 8 | 0 |
| Blood calcium increased | 6 | 0 | 0 |
| Blood phosphorus decreased | 6 | 0 | 0 |
| Platelet count decreased | 6 | 8 | 0 |
| Blood alkaline phosphatase increased | 6 | 8 | 0 |
| Blood creatinine increased | 0 | 8 | 0 |
| Neutrophil count decreased | 0 | 8 | 0 |
| White blood cell count decreased | 0 | 8 | 0 |
Vital signs include measurements of sitting diastolic and systolic blood pressure, heart rate, and temperature. Any vital signs determined by the investigator to be clinically significant were recorded as AEs.
| percentage of participants | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Pyrexia | 25 | 8 | 38 |
| Sinus tachycardia | 6 | 0 | 0 |
| nmol/L | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Metabolite M1 | 370.3 ± 282.02 | 1774.0 ± 904.10 | 2001.9 ± 1094.75 |
| Metabolite M2 | 154.6 ± 82.54 | 173.8 ± 54.39 | 207.3 ± 151.60 |
| hours | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Metabolite M1 | 3.500 (1.88 to 7.92) | 24.000 (1.00 to 48.30) | 24.150 (9.08 to 96.70) |
| Metabolite M2 | 9.000 (5.88 to 49.30) | 24.050 (9.00 to 72.10) | 24.150 (9.08 to 96.70) |
The area under the plasma concentration-time curve from time 0 to the time of the last quantifiable concentration (AUC0-last) of the alisertib metabolites M1 and M2 was determined from the concentration-time curve of each participant using non-compartmental methods.
| h*nmol/L | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Metabolite M1 | 8366.3 ± 10790.88 | 159665.0 ± 116960.23 | 196750.0 ± 117472.08 |
| Metabolite M2 | 8923.1 ± 6539.00 | 17326.0 ± 8562.96 | 16987.5 ± 9384.25 |
A single blood sample will be collected pre-dose on Cycle 1 Day 14. The concentration of alisertib was determined in the plasma sample and dose-normalized.
No measurements were reported for this outcome.
Collected over First dose of study drug to 30 days past last dose (Up to 312 Days). Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Alisertib: Normal Hepatic Function | 2/16 (12.5%) | 7/16 (43.8%) | 15/16 (93.8%) |
| Alisertib: Moderate Hepatic Impairment | 3/12 (25%) | 8/12 (66.7%) | 12/12 (100%) |
| Alisertib: Severe Hepatic Impairment | 4/8 (50%) | 7/8 (87.5%) | 8/8 (100%) |
| Event | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| Abdominal painGastrointestinal disorders | 0/16 | 2/12 | 3/8 |
| Colorectal adenocarcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/16 | 0/12 | 1/8 |
| Rectal cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/16 | 0/12 | 1/8 |
| Pancreatic carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/16 | 0/12 | 1/8 |
| StomatitisGastrointestinal disorders | 0/16 | 0/12 | 1/8 |
| PyrexiaGeneral disorders | 2/16 | 0/12 | 1/8 |
| HyperbilirubinaemiaHepatobiliary disorders | 0/16 | 0/12 | 1/8 |
| Hepatic failureHepatobiliary disorders | 0/16 | 0/12 | 1/8 |
| Biliary tract infectionInfections and infestations | 0/16 | 0/12 | 1/8 |
| SepsisInfections and infestations | 0/16 | 0/12 | 1/8 |
| Event | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment |
|---|---|---|---|
| NauseaGastrointestinal disorders | 9/16 | 3/12 | 0/8 |
| AscitesGastrointestinal disorders | 0/16 | 6/12 | 1/8 |
| ThrombocytopeniaBlood and lymphatic system disorders | 1/16 | 5/12 | 0/8 |
| HyperbilirubinaemiaHepatobiliary disorders | 0/16 | 5/12 | 0/8 |
| DiarrhoeaGastrointestinal disorders | 6/16 | 4/12 | 0/8 |
| FatigueGeneral disorders | 6/16 | 3/12 | 3/8 |
| AlopeciaSkin and subcutaneous tissue disorders | 6/16 | 3/12 | 1/8 |
| VomitingGastrointestinal disorders | 4/16 | 4/12 | 0/8 |
| DehydrationMetabolism and nutrition disorders | 1/16 | 4/12 | 0/8 |
| ConstipationGastrointestinal disorders | 5/16 | 2/12 | 0/8 |
Safety population was defined as all participants who received at least 1 dose of alisertib.
| Age, Continuous(years) | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment | Total |
|---|---|---|---|---|
| Mean | 61.2 ± 10.07 | 54.9 ± 9.89 | 54.0 ± 7.05 | 57.5 ± 9.77 |
| Sex: Female, Male(Participants) | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment | Total |
|---|---|---|---|---|
| Female | 5 | 7 | 2 | 14 |
| Male | 11 | 5 | 6 | 22 |
| Race/Ethnicity, Customized(Participants) | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment | Total |
|---|---|---|---|---|
| Hispanic or Latino | 1 | 1 | 2 | 4 |
| Not Hispanic or Latino | 14 | 11 | 6 | 31 |
| Not Reported | 1 | 0 | 0 | 1 |
| Race/Ethnicity, Customized(Participants) | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment | Total |
|---|---|---|---|---|
| White | 14 | 11 | 6 | 31 |
| Black or African American | 2 | 1 | 2 | 5 |
| Region of Enrollment(Participants) | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment | Total |
|---|---|---|---|---|
| United States | 16 | 12 | 8 | 36 |
| Height(cm) | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment | Total |
|---|---|---|---|---|
| Mean | 172.9 ± 14.62 | 162.9 ± 7.79 | 178.2 ± 8.10 | 170.1 ± 12.66 |
| Weight(kg) | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment | Total |
|---|---|---|---|---|
| Mean | 84.6 ± 20.997 | 85.5 ± 33.881 | 85.8 ± 11.847 | 85.2 ± 24.044 |
| Body surface area(m^2) | Alisertib: Normal Hepatic Function | Alisertib: Moderate Hepatic Impairment | Alisertib: Severe Hepatic Impairment | Total |
|---|---|---|---|---|
| Mean | 2.030 ± 0.3073 | 1.897 ± 0.4028 | 2.056 ± 0.1970 | 1.986 ± 0.3292 |
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Millennium Pharmaceuticals, Inc.