An Early Phase 1 interventional study of Alectinib and Alpelisib in Advanced Breast Carcinoma, Advanced Malignant Solid Neoplasm and Advanced Ovarian Carcinoma, sponsored by OHSU Knight Cancer Institute. Withdrawn. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-01-23.
Sponsored by OHSU Knight Cancer Institute · Early Phase 1, Interventional, and Treatment
SMMART-ACT is a feasibility pilot study to determine if testing samples from a participant's cancer using a precision medicine approach can be used to identify specific drugs or drug combinations that can help control their disease. The safety and tolerability of the drug or drug combination is also to be studied. Another purpose is for researchers to study tumor cells to try to learn why some people respond to a certain therapy and others do not, and why some cancer drugs stop working. The study population will include participants with advanced breast, ovarian, prostate, or pancreatic malignancies, or sarcomas.
PRIMARY OBJECTIVE:
I. Feasibility of utilizing a SMMART-ACT Tumor Board to select personalized advanced cancer treatment plans based on a pre-determined set of drug agents with recommended phase 2 doses (RP2Ds).
SECONDARY OBJECTIVES:
I. Safety and tolerability of assigned ACT intervention per cancer type; II. Preliminary indications of efficacy based on disease-specific responses; and.
III. Estimated survival benefit per cancer type.
EXPLORATORY OBJECTIVES:
I. Durability of a response compared to the most recent therapy on which progression occurred.
II. Changes in ability to conduct activities of daily living (ADL). III. Changes in quality of life (QOL).
IV. Feasibility of SMMART centric assessments of ongoing responses to treatment to identify mechanisms of therapy induced change, per investigator discretion. Such mechanisms may include, but will not be limited to, the following:
IVa. Changes in tumor and tumor ecosystem biology; IVb. Response and resistance to therapy.
OUTLINE:
PRE-SCREENING: Participants undergo a screening biopsy and blood collection for review and assessment of their tumor, utilizing one or more of the SMMART-Clinical Analytics Platform (SMMART-CAP) assays. The clinical assays may be used to provide an optimal and individualized treatment approach which may or may not include a SMMART-ACT treatment regimen.
SMMART-ACT TREATMENT: Prior to enrollment, participants must receive a treatment recommendation, via a SMMART-ACT Tumor Board, that consists of one or more of the pre-defined SMMART-ACT treatment regimen options. Participants are considered enrolled in SMMART-ACT if they receive a targeted SMMART-ACT treatment regimen, which may be administered in monotherapy or in combination with other targeted agents or immunotherapies, chemotherapies, or radiation. A combination treatment plan may include a two-week monotherapy lead-in, followed by a combination treatment regimen. Regardless of overall recommended treatment plan details, each SMMART-ACT study intervention must have an established RP2D that was determined in a prior clinical trial. All participants are required to undergo an On-Treatment Biopsy after two weeks on the first dose of study drug(s), and before starting Cycle 2, regardless of whether the participant is on a monotherapy, monotherapy-induction or combination regimen. Participants will continue to receive the study agent(s) after their On-Treatment Biopsy according to the biopsy results and the results of ongoing safety and clinical assessments. Treatment cycles repeat every 21 to 28 days in the absence of disease progression or unacceptable toxicity. Cycles are determined based on the study agent(s). Upon disease progression, participants are given the option to undergo an additional repeat biopsy.
Participants completing study treatment due to disease progression are followed every 3 months for 1 year, then every 6 months for 5 years. Participants completing study treatment without disease progression are followed every 6-12 weeks for up to 5 years or until disease progression, start of a new therapy, withdrawal from the study, or death, whichever occurs first.
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PRE-SCREENING: Biospecimen collection, as per institutional standards, must be consented to and collection must be feasible, with the following exceptions for tissue collections:
PRIMARY TREATMENT: Absolute neutrophil count (ANC) >= 1,500 / uL (1.5 K/cu mm) (assessed at primary [post pre-screening] screening, or by the time that study intervention commences)
PRIMARY TREATMENT: Creatinine =\< 1.5 x institutional upper limit of normal (IULN) OR measured or calculated creatinine clearance (glomerular filtration rate [GFR] can also be used in place of creatinine or creatinine clearance [CrCl]) >= 50 mL/min/1.73m\^2. (assessed at primary [post pre-screening] screening, or by the time that study intervention commences)
PRIMARY TREATMENT: Body mass index (BMI) >16.0 and \< 35.0 kg/m\^2
PRIMARY TREATMENT: Toxicities due to prior therapies should be resolved to baseline or grade 1 (per Common Terminology Criteria for Adverse Events [CTCAE] v5.0) before administration of study intervention. The following exceptions are permitted:
CANCER SPECIFIC BREAST CANCER: Lesion(s) remain measurable after systemic therapies, as follows:
Exclusion Criteria:
PRIMARY TREATMENT: Uncontrolled intercurrent illness and infection that may interfere with planned treatment including, but not limited to the following:
Administered in monotherapy or in combination with other targeted agents or immunotherapies, chemotherapies, or radiation. Combination treatment plans may include a two-week monotherapy lead-in, followed by a combination treatment regimen. Each ACT study intervention must have an established RP2D determined in a prior clinical trial. Participants undergo a Pre-Treatment Biopsy, plus an On-Treatment Biopsy after two weeks on first dose of study drug(s) and prior to starting Cycle 2, regardless of regimen. Participants continue to receive study agent(s) after the On-Treatment Biopsy, according to the biopsy results and the results of ongoing safety and clinical assessments. Treatment cycles repeat every 21 to 28 days in the absence of disease progression or unacceptable toxicity. Cycles are determined based on the study agent(s). Upon disease progression, participants are given the option to undergo an additional biopsy.
Drug: Alectinib · Drug: Alpelisib · Drug: Anastrozole · Biological: Atezolizumab · Biological: Bevacizumab · Procedure: Biopsy · Procedure: Biospecimen Collection · Drug: Capecitabine · Drug: Carboplatin · Drug: Cobimetinib · Drug: Entrectinib · Drug: Eribulin · Drug: Fulvestrant · Biological: Hyaluronidase-zzxf/Pertuzumab/Trastuzumab · Drug: Irinotecan · Drug: Letrozole · Drug: Nab-paclitaxel · Drug: Niraparib · Drug: Olaparib · Drug: Paclitaxel · Drug: Palbociclib · Biological: Pertuzumab · Other: Quality-of-Life Assessment · Biological: Trastuzumab · Biological: Trastuzumab Emtansine · Drug: Vemurafenib · Drug: Vinorelbine · Drug: Vismodegib
Given orally (PO)
Also known as: AF-802, AF802, Alecensa, ALK Inhibitor RO5424802, CH5424802, RG7853, RO5424802
Given PO
Also known as: BYL719, Phosphoinositide 3-kinase Inhibitor BYL719, Piqray, VIJOICE
Given PO
Also known as: Anastrazole, Arimidex, ICI D1033, ICI-D1033, ZD-1033
Given IV
Also known as: MPDL 3280A, MPDL 328OA, MPDL-3280A, MPDL3280A, MPDL328OA, RG7446, RO5541267, Tecentriq
Given IV
Also known as: ABP 215, Anti-VEGF, Anti-VEGF Humanized Monoclonal Antibody, Anti-VEGF Monoclonal Antibody SIBP04, Anti-VEGF rhuMAb, Avastin, Bevacizumab awwb, Bevacizumab Biosimilar ABP 215, Bevacizumab Biosimilar BEVZ92, Bevacizumab Biosimilar BI 695502, Bevacizumab Biosimilar CBT 124, Bevacizumab Biosimilar CT-P16, Bevacizumab Biosimilar FKB238, Bevacizumab Biosimilar GB-222, Bevacizumab Biosimilar HD204, Bevacizumab Biosimilar HLX04, Bevacizumab Biosimilar IBI305, Bevacizumab Biosimilar LY01008, Bevacizumab Biosimilar MIL60, Bevacizumab Biosimilar Mvasi, Bevacizumab Biosimilar MYL-1402O, Bevacizumab Biosimilar QL 1101, Bevacizumab Biosimilar QL1101, Bevacizumab Biosimilar RPH-001, Bevacizumab Biosimilar SCT501, Bevacizumab Biosimilar Zirabev, Bevacizumab-awwb, Bevacizumab-bvzr, BP102, BP102 Biosimilar, HD204, Immunoglobulin G1 (Human-Mouse Monoclonal rhuMab-VEGF Gamma-Chain Anti-Human Vascular Endothelial Growth Factor), Disulfide With Human-Mouse Monoclonal rhuMab-VEGF Light Chain, Dimer, Mvasi, MYL-1402O, QL1101, Recombinant Humanized Anti-VEGF Monoclonal Antibody, rhuMab-VEGF, SCT501, SIBP 04, SIBP-04, SIBP04, Zirabev
Undergo tissue biopsy
Also known as: BIOPSY_TYPE, Bx
Undergo collection of blood
Also known as: Biological Sample Collection, Biospecimen Collected, Specimen Collection
Given PO
Also known as: Ro 09-1978/000, Xeloda
Given IV
Also known as: Blastocarb, Carboplat, Carboplatin Hexal, Carboplatino, Carboplatinum, Carbosin, Carbosol, Carbotec, CBDCA, Displata, Ercar, JM-8, Nealorin, Novoplatinum, Paraplatin, Paraplatin AQ, Paraplatine, Platinwas, Ribocarbo
Given PO
Also known as: Cotellic, GDC-0973, MEK Inhibitor GDC-0973, XL518
Given PO
Also known as: Rozlytrek, RXDX 101, RXDX-101, RXDX101
Given IV
Also known as: ER-086526
Given by injection
Also known as: Faslodex, Faslodex(ICI 182,780), ICI 182,780, ICI 182780, ZD9238
Given phesgo SC
Also known as: Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf, Pertuzumab/Trastuzumab/Hyaluronidase-zzxf, Phesgo
Given IV
Given PO
Also known as: CGS 20267, Femara
Given IV
Also known as: ABI 007, ABI-007, Abraxane, Albumin-bound Paclitaxel, Albumin-Stabilized Nanoparticle Paclitaxel, Nanoparticle Albumin-bound Paclitaxel, Nanoparticle Paclitaxel, Paclitaxel Albumin, paclitaxel albumin-stabilized nanoparticle formulation, Protein-bound Paclitaxel
Given PO
Also known as: MK-4827, MK4827
Given PO
Also known as: AZD 2281, AZD-2281, AZD2281, KU-0059436, Lynparza, PARP Inhibitor AZD2281
Given IV
Also known as: Anzatax, Asotax, Bristaxol, Praxel, Taxol, Taxol Konzentrat
Given IV
Also known as: 6-Acetyl-8-cyclopentyl-5-methyl-2-((5-(piperazin-1-yl)pyridin-2-yl)amino)-8h-pyrido(2,3-d)pyrimidin-7-one, Ibrance, PD 0332991, PD 332991, PD 991, PD-0332991
Given subcutaneously (SC)
Also known as: 2C4, 2C4 Antibody, EG1206A, HLX11, HS627, MoAb 2C4, Monoclonal Antibody 2C4, Omnitarg, Perjeta, Pertuzumab Biosimilar EG1206A, Pertuzumab Biosimilar HLX11, Pertuzumab Biosimilar HS627, rhuMAb2C4, RO4368451
Ancillary studies
Also known as: Quality of Life Assessment
Given SC
Also known as: ABP 980, ALT02, Anti-c-ERB-2, Anti-c-erbB2 Monoclonal Antibody, Anti-ERB-2, Anti-erbB-2, Anti-erbB2 Monoclonal Antibody, Anti-HER2/c-erbB2 Monoclonal Antibody, Anti-p185-HER2, c-erb-2 Monoclonal Antibody, HER2 Monoclonal Antibody, Herceptin, Herceptin Biosimilar PF-05280014, Herceptin Trastuzumab Biosimilar PF-05280014, Herzuma, Kanjinti, MoAb HER2, Monoclonal Antibody c-erb-2, Monoclonal Antibody HER2, Ogivri, Ontruzant, PF-05280014, QL 1701, QL-1701, QL1701, rhuMAb HER2, RO0452317, SB3, Trastuzumab Biosimilar ABP 980, Trastuzumab Biosimilar ALT02, trastuzumab biosimilar EG12014, Trastuzumab Biosimilar HLX02, Trastuzumab Biosimilar PF-05280014, Trastuzumab Biosimilar QL1701, Trastuzumab Biosimilar SB3, Trastuzumab Biosimilar SIBP-01, Trastuzumab-anns, Trastuzumab-dkst, Trastuzumab-dttb, Trastuzumab-pkrb, Trastuzumab-qyyp, Trazimera
Given intravenously (IV)
Also known as: Ado Trastuzumab Emtansine, ADO-Trastuzumab Emtansine, Kadcyla, PRO132365, RO5304020, T-DM1, Trastuzumab-DM1, Trastuzumab-MCC-DM1, Trastuzumab-MCC-DM1 Antibody-Drug Conjugate, Trastuzumab-MCC-DM1 Immunoconjugate
Given PO
Also known as: BRAF (V600E) kinase inhibitor RO5185426, BRAF(V600E) Kinase Inhibitor RO5185426, PLX-4032, PLX4032, RG 7204, RG7204, RO 5185426, Zelboraf
Given IV
Also known as: Dihydroxydeoxynorvinkaleukoblastine
Given PO
Also known as: Erivedge, GDC-0449, Hedgehog Antagonist GDC-0449
Proportion of participants who receive an ACT therapy based an ACT Tumor Board recommendation.
At interim analysis, if greater than or equal to 11 of the first 15 enrolled participants (80%) receive C1D1 of the recommended ACT drug regimen, the feasibility threshold will be met. If not attained, reasons as to why the feasibility endpoint was not met will be reviewed.
Time frame: From time of SMMART-ACT Tumor Board review to first dose of SMMART-ACT study drug regime as evaluated at interim analysis (approximately 2 years)
Incidence of treatment-emergent adverse events
Measured by Common Terminology Criteria for Adverse Events version 5.0.
Time frame: First dose of study drug up to 30 days after last dose study drug(s)
Rate of treatment discontinuation due to toxicities and/or intolerability.
Measured by Common Terminology Criteria for Adverse Events version 5.0.
Time frame: First dose of study drug to last dose study drug(s)
Overall response rate (ORR)
Will be assessed by ORR = complete response (CR)+ partial response (PR) per Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 or in accordance with definition for pseudoprogression indications for immuno monotherapy regimens. Will be estimated using the Kaplan-Meier method.
Time frame: At 6 months from cycle 1 day 1 +/- 2 weeks (each cycle may be 21 or 28 days, depending on the assigned SMMART ACT regimen)
Progression free survival
Will be censored at the date of last adequate assessment visit and will be estimated using the Kaplan Meier method.
Time frame: From the first dose of study drug until the earliest date of disease progression, as measured by investigator assessment, or death due to any cause (until the end of long-term follow-up (LTFU)), LTFU is up to 5 years
Disease-specific survival
Will be estimated using cumulative incidence methods.
Time frame: Time from the first day of treatment with study intervention to death as a result of the disease at time of last follow-up, LTFU is up to five years from time of last dose of study therapy
Overall survival
Will be censored on the last date a participant is known to be alive and will summarized descriptively using the Kaplan-Meier method. The median and 95% confidence interval, will be included in the estimations, if possible.
Time frame: From the time of first dose of study drug until death from any cause (until the end of long-term follow-up), LTFU is up to 5 years
No study locations are listed for this record.
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OHSU Knight Cancer Institute