A Phase 1 interventional study of Midazolam and TAK-788 in Carcinoma, Non-Small-Cell Lung and Lung Neoplasms, sponsored by Millennium Pharmaceuticals, Inc.. Completed at 8 sites in 3 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-07-28.
Sponsored by Millennium Pharmaceuticals, Inc. · Phase 1, Interventional, and Other
The purpose of this study is to characterize the effect of repeated oral administration of TAK-788 160 milligram (mg) once daily on the single oral and intravenous dose pharmacokinetics (PK) of midazolam.
The drug being tested in this study is called TAK-788. The study will characterize the effect of repeated oral administration of TAK-788 160 mg on the single oral- and intravenous-dose PK of midazolam, and will assess the safety and tolerability of TAK-788 in participants with advanced NSCLC.
The study will enroll approximately 26 participants. The study will be conducted in 2 parts: Part A (Cycle 1: PK Cycle) and Part B (Cycle 2 to Cycle 24: Treatment Cycles). In Part A, participants will receive midazolam as an oral dose and intravenous infusion, along with oral dose of TAK-788 in a single 30-day cycle. After completion of Part A, eligible participants may enter Part B. In Part B, participants will continue to receive oral dose of TAK-788 that they were receiving and tolerating at the end of Part A in a 28-day treatment cycle for up to 23 cycles of treatment, or until progressive disease (PD), intolerable toxicity, or another discontinuation criterion is met. Based on the opinion of investigator, if a participant continue to experience clinical benefit, treatment with TAK-788 may be continued after PD.
This multi-center trial will be conducted in Australia, Singapore and the Netherlands. The overall time to participate in this study is 3 years. Participants will make multiple visits to the clinic and will be followed up for 30 days after the last dose of study drug for a follow-up assessment.
Adequate organ function as defined by the following criteria:
Adequate bone marrow function as defined by the following criteria:
Exclusion Criteria:
Significant, uncontrolled, or active cardiovascular disease, including, but not limited to the following:
Midazolam 3 mg, solution, orally, once on Days 1 and 24 and midazolam 1 mg, infusion, intravenously, once on Days 2 and 25 along with TAK-788 160 mg, capsule, orally, once daily from Day 3 through 30 in Cycle 1.
Drug: Midazolam · Drug: TAK-788
TAK-788 160 mg, capsules, orally, once daily in a 28-day treatment cycle from Cycle 2 to Cycle 24, or until progressive disease (PD), intolerable toxicity, or another discontinuation criterion is met, whichever is sooner. Eligible participants from Part A may enter into Part B. Based on the investigator's opinion, if a participant continues to experience clinical benefit, treatment with TAK-788 may be continued after PD.
Drug: TAK-788
Midazolam Oral Solution and Midazolam Intravenous Infusion.
TAK-788 Oral Capsules.
Also known as: AP32788
Part A, Cmax: Geometric Mean Maximum Observed Plasma Concentration (Cmax) for Midazolam Administered Orally With Mobocertinib (Cycle 1 Day 24) and Without Mobocertinib (Cycle 1 Day 1)
As planned, this pharmacokinetic (PK) outcome measure was only assessed in Part A.
Time frame: Cycle 1: Days 1 and 24 pre-dose and at multiple time points (up to 24 hours) post-dose (Cycle length is equal to [=] 30 days)
Part A, AUC∞: Geometric Mean Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for Midazolam Administered Orally With Mobocertinib (Cycle 1 Day 24) and Without Mobocertinib (Cycle 1 Day 1)
As planned, this PK outcome measure was only assessed in Part A.
Time frame: Cycle 1: Days 1 and 24 pre-dose and at multiple time points (up to 24 hours) post-dose (Cycle length = 30 days)
Part A, Cmax: Geometric Mean Maximum Observed Plasma Concentration (Cmax) for Midazolam Administered Intravenously With Mobocertinib (Cycle 1 Day 25) and Without Mobocertinib (Cycle 1 Day 2)
As planned, this PK outcome measure was only assessed in Part A.
Time frame: Cycle 1: Days 2 and 25 pre-dose and at multiple time points (up to 24 hours) post-dose (Cycle length = 30 days)
Part A, AUC∞: Geometric Mean Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for Midazolam Administered Intravenously With Mobocertinib (Cycle 1 Day 25) and Without Mobocertinib (Cycle 1 Day 2)
As planned, this PK outcome measure was only assessed in Part A.
Time frame: Cycle 1: Days 2 and 25 pre-dose and at multiple time points (up to 24 hours) post-dose (Cycle length = 30 days)
Part A, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for Midazolam Administered Orally With Mobocertinib (Cycle 1 Day 24) and Without Mobocertinib (Cycle 1 Day 1)
As planned, this PK outcome measure was only assessed in Part A for midazolam 3 mg oral solution.
Time frame: Cycle 1: Days 1 and 24 pre-dose and at multiple time points (up to 24 hours) post-dose (Cycle length = 30 days)
Part A, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for Midazolam Administered Intravenously With Mobocertinib (Cycle 1 Day 25) and Without Mobocertinib (Cycle 1 Day 2)
As planned, this PK outcome measure was only assessed in Part A for midazolam 1 mg intravenous infusion.
Time frame: Cycle 1: Days 2 and 25 pre-dose and at multiple time points (up to 24 hours) post-dose (Cycle length = 30 days)
Part A and B: Number of Participants Reporting One or More Treatment-emergent Adverse Events (TEAEs)
Time frame: Part A:From Day 1 up to 30 days after the last dose of study drug in Cycle 1 (up to 2 months);Part B:From Day 1 of Cycle 2 up to 30 days after the last dose of study drug in Cycle 19 (up to Month 19) (Cycle length, Part A= 30 days; Part B=28 days)
Part A and B: Number of Participants With Clinically Significant Change From Baseline in Laboratory Values
The clinically significant change from baseline in laboratory values was assessed by the investigator.
Time frame: Part A: Day 1 of Cycle 1; Part B: Day 1 of every Cycle (Cycle 2 to Cycle 19) (Cycle length, Part A=30 days; Part B =28 days)
Part A and B: Number of Participants With Clinically Significant Change From Baseline in Vital Signs
Time frame: Part A: Day 1 up to Day 26 in Cycle 1; Part B: Day 1 of every Cycle (Cycle 2 to Cycle 19) (Cycle length, Part A=30 days; Part B =28 days)
Participants took part in the study at 7 investigative sites in Australia, Singapore, and Netherlands from 23 December 2019 to 07 December 2021.
| Milestone | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| Started | 26 |
| Completed | 0 |
| Not completed | 26 |
| Withdrew: Death | 1 |
| Withdrew: Withdrawal by subject | 4 |
| Withdrew: Progressive disease | 16 |
| Withdrew: Physician decision | 1 |
| Withdrew: Other | 4 |
As planned, this pharmacokinetic (PK) outcome measure was only assessed in Part A.
| nanogram per milliliter (ng/mL) | Part A: Midazolam Alone | Part A: Midazolam + Mobocertinib |
|---|---|---|
| Part A, Cmax: Geometric Mean Maximum Observed Plasma Concentration (Cmax) for Midazolam Administered Orally With Mobocertinib (Cycle 1 Day 24) and Without Mobocertinib (Cycle 1 Day 1) | 17.0 ± 60.2 | 17.5 ± 60.7 |
As planned, this PK outcome measure was only assessed in Part A.
| nanogram*hour per milliliter (ng*h/mL) | Part A: Midazolam Alone | Part A: Midazolam + Mobocertinib |
|---|---|---|
| Part A, AUC∞: Geometric Mean Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for Midazolam Administered Orally With Mobocertinib (Cycle 1 Day 24) and Without Mobocertinib (Cycle 1 Day 1) | 58.3 ± 61.0 | 39.0 ± 61.4 |
As planned, this PK outcome measure was only assessed in Part A.
| ng/mL | Part A: Midazolam Alone | Part A: Midazolam + Mobocertinib |
|---|---|---|
| Part A, Cmax: Geometric Mean Maximum Observed Plasma Concentration (Cmax) for Midazolam Administered Intravenously With Mobocertinib (Cycle 1 Day 25) and Without Mobocertinib (Cycle 1 Day 2) | 70.8 ± 151.0 | 92.2 ± 132.0 |
As planned, this PK outcome measure was only assessed in Part A.
| ng*h/mL | Part A: Midazolam Alone | Part A: Midazolam + Mobocertinib |
|---|---|---|
| Part A, AUC∞: Geometric Mean Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for Midazolam Administered Intravenously With Mobocertinib (Cycle 1 Day 25) and Without Mobocertinib (Cycle 1 Day 2) | 90.4 ± 113.0 | 71.6 ± 96.0 |
As planned, this PK outcome measure was only assessed in Part A for midazolam 3 mg oral solution.
| hour | Part A: Midazolam Alone | Part A: Midazolam + Mobocertinib |
|---|---|---|
| Part A, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for Midazolam Administered Orally With Mobocertinib (Cycle 1 Day 24) and Without Mobocertinib (Cycle 1 Day 1) | 0.517 (0.467 to 2.00) | 0.533 (0.250 to 1.00) |
As planned, this PK outcome measure was only assessed in Part A for midazolam 1 mg intravenous infusion.
| hour | Part A: Midazolam Alone | Part A: Midazolam + Mobocertinib |
|---|---|---|
| Part A, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for Midazolam Administered Intravenously With Mobocertinib (Cycle 1 Day 25) and Without Mobocertinib (Cycle 1 Day 2) | 0.0500 (0.00 to 1.00) | 0.0500 (0.00 to 0.500) |
| Participants | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| Part A and B: Number of Participants Reporting One or More Treatment-emergent Adverse Events (TEAEs) | 26 |
The clinically significant change from baseline in laboratory values was assessed by the investigator.
| Participants | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| Blood creatinine increased | 7 |
| Amylase increased | 3 |
| Lipase increased | 3 |
| Participants | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| Part A and B: Number of Participants With Clinically Significant Change From Baseline in Vital Signs | 0 |
Collected over TEAEs were adverse events that started from Day 1 up to 30 days after the last dose of study drug in Cycle 1 (up to 2 months) for Part A and from Day 1 of Cycle 2 up to 30 days after the last dose of study drug in Cycle 19 (up to Month 19) for Part B (Cycle length, Part A= 30 days and Part B=28 days). Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Parts A and B: Midazolam + Mobocertinib | 4/26 (15.4%) | 20/26 (76.9%) | 26/26 (100%) |
| Event | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| DiarrhoeaGastrointestinal disorders | 6/26 |
| DyspnoeaRespiratory, thoracic and mediastinal disorders | 3/26 |
| DehydrationMetabolism and nutrition disorders | 2/26 |
| PyrexiaGeneral disorders | 2/26 |
| VomitingGastrointestinal disorders | 2/26 |
| ArrhythmiaCardiac disorders | 1/26 |
| Cerebrovascular accidentNervous system disorders | 1/26 |
| HaemoptysisRespiratory, thoracic and mediastinal disorders | 1/26 |
| HypercalcaemiaMetabolism and nutrition disorders | 1/26 |
| IleusGastrointestinal disorders | 1/26 |
| Event | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| DiarrhoeaGastrointestinal disorders | 25/26 |
| NauseaGastrointestinal disorders | 17/26 |
| Decreased appetiteMetabolism and nutrition disorders | 13/26 |
| FatigueGeneral disorders | 13/26 |
| RashSkin and subcutaneous tissue disorders | 9/26 |
| VomitingGastrointestinal disorders | 9/26 |
| Blood creatinine increasedInvestigations | 7/26 |
| DyspepsiaGastrointestinal disorders | 7/26 |
| Dry skinSkin and subcutaneous tissue disorders | 6/26 |
| AnaemiaBlood and lymphatic system disorders | 5/26 |
The safety population was defined as all participants who received at least 1 dose of any study drug (mobocertinib or midazolam).
| Age, Continuous(years) | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| Mean | 61.7 ± 14.62 |
| Sex: Female, Male(Participants) | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| Female | 14 |
| Male | 12 |
| Ethnicity (NIH/OMB)(Participants) | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| Hispanic or Latino | 0 |
| Not Hispanic or Latino | 24 |
| Unknown or Not Reported | 2 |
| Race (NIH/OMB)(Participants) | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 9 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 0 |
| White | 17 |
| More than one race | 0 |
| Unknown or Not Reported | 0 |
| Region of Enrollment(Participants) | Parts A and B: Midazolam + Mobocertinib |
|---|---|
| Australia | 14 |
| Singapore | 7 |
| Netherlands | 5 |
Documents are hosted by the registry — open the source record to download them.
Plan to share: No — De-identified individual participant data from this particular study will not be shared as there is a reasonable likelihood that individual patients could be re-identified (due to the limited number of study participants.
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Carcinoma, Non-Small-Cell Lung→
Millennium Pharmaceuticals, Inc.