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CancerPhase 1NCT01340846

A Pharmacokinetics Study of the Effects of GSK2118436 on Warfarin, the Effects of Ketoconazole and Gemfibrozil on GSK2118436, and the Effects of Repeat Doses of GSK2118436 in Subjects With BRAF Mutant Solid Tumors

A Phase 1 study testing Warfarin, Ketoconazole and Gemfibrozil in people with Cancer, run by GlaxoSmithKline at 11 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

GSK2118436 is an orally administered, potent and selective small molecule BRAF inhibitor that is being developed for the treatment of BRAF mutation-positive tumors. This is a 4-part study (in 4 separate cohorts of subjects) designed to examine the interaction potential of GSK2118436, either as a perpetrator (i.e.… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cancer
What is being tested?
Warfarin, Ketoconazole and Gemfibrozil
Could I receive a placebo?
No, everyone receives an active treatment
How many people
48 participants
Where
11 sitesin 3 countries
Study dates
3 Sep 2012to 14 Nov 2012
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female at least 18 years of age at the time of signing the informed consent form;
  • Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form;
  • Body weight >/= 45 kg and a body mass index >/= 19 kg/m2 and </= 35 kg/m2 (inclusive);
  • Able to swallow and retain oral medication;
  • BRAF V600 mutation-positive tumor as determined in a CLIA-approved laboratory or equivalent (the local BRAF testing may be subject to subsequent verification by centralized testing);
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1; NOTE: Subjects with a performance status of 2 can be enrolled if the patient's confinement to bed and inability to carry out work activities is due solely to cancer-related pain, as assessed by the Investigator;
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  • Women of child-bearing potential and men with reproductive potential must be willing to practice acceptable methods of birth control. Additionally, women of childbearing potential must have a negative serum pregnancy test within 14 days prior to the first dose of study medication;
  • Must have adequate organ function as defined by the following values:
  • Absolute neutrophil count (ANC) >/=1.2 x 109/L Hemoglobin >/= 9 g/dL Platelets >/= 100 x 109/L Serum bilirubin >/= 1.5 x Upper Limit of Normal (ULN) AST and ALT >/= 2.5 x ULN; <5 x ULN if liver metastases are present (with approval of GSK medical monitor) Serum creatinine >/= ULN or calculated creatinine clearance >/= 60 mL/min PT/INR and partial thromboplastin time (PTT) >/= 1.3 x ULN Left ventricular ejection fraction >/= institutional lower limit of normal by ECHO
  • CYP2C9 genotype of *1/*1 (wildtype), *1/*2 or *1/*3 (Part A only)

Who cannot join

  • Currently receiving cancer therapy (e.g., chemotherapy with delayed toxicity, extensive radiation therapy, immunotherapy, biologic therapy) within the last three weeks; chemotherapy regimens without delayed toxicity within the last 2 weeks;
  • The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 28 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is warranted by the data);
  • Current use of a prohibited medication or herbal preparation or requires any of these medications during the study;
  • Consumption of red wine, Seville oranges, grapefruit or grapefruit juice from 7 days prior to the first dose of study medication;
  • History of sensitivity to heparin or heparin-induced thrombocytopenia;
  • Any major surgery within the last 4 weeks;
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  • Unresolved toxicity greater than National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0 (NCI CTCAE v4.0) [NCI, 2009] Grade 2 from previous anti-cancer therapy except alopecia;
  • Presence of active GI disease or other condition (e.g., small bowel or large bowel resection) that will interfere significantly with the absorption of drugs. If clarification is needed as to whether a condition will significantly affect absorption of drugs, contact the GSK medical monitor;
  • A history of known Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV) infection (subjects with laboratory evidence of HBV clearance may be enrolled);
  • Presence of invasive malignancy, other than the primary diagnosis;
  • Parts B and C: Subjects with brain metastases are excluded if their brain metastases are either:
  • Symptomatic Treated (surgery, radiation therapy) but not clinically and radiographically stable one month after local therapy, or Asymptomatic and untreated but > 1 cm in the longest dimension Patients with small (≤ 1 cm in the longest dimension), asymptomatic brain metastases that do not need immediate local therapy can be enrolled with the approval of the GSK medical monitor. Subjects on a stable dose of corticosteroids for more than one month, or those who have been off corticosteroids for at least two weeks can be enrolled. Subjects must also be off of enzyme-inducing anticonvulsants for more than four weeks; Note: Any brain metastases is exclusionary for Part A (must be excluded by prior imaging);
  • Corrected QT (QTcB) interval >/= 480 msecs;
  • History of acute coronary syndromes (including unstable angina), coronary angioplasty, or stenting within the past 24 weeks;
  • Class II, III, or IV heart failure as defined by the New York Heart Association (NYHA) functional classification system; abnormal cardiac valve morphology documented by ECHO (subjects with minimal abnormalities [i.e., mild regurgitation/stenosis] can be entered on study - if clarification is needed as to whether an ECHO abnormality is minimal, please contact the GSK medical monitor); or history of known cardiac arrhythmias (except sinus arrythmias) within the past 24 weeks;
  • Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the study drugs, or excipients (note: to date there are no known drugs chemically related to GSK2118436 which are approved by the FDA);
  • Uncontrolled medical conditions (e.g., diabetes mellitus, hypertension, liver disease), psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol; or unwillingness or inability to follow the procedures required in the protocol;
  • Subjects with known glucose 6 phosphate dehydrogenase (G6PD) deficiency;
  • Pregnant females as determined by positive hCG test at screening or prior to dosing;
  • Lactating females who are actively breast feeding;
  • Subject is mentally or legally incapacitated;
  • Part A only: Use of warfarin or exogenous Vitamin K (other than from dietary sources) within 30 days prior to treatment with study medication;
  • Part A only: Subjects with history of GI bleeding, or GI ulceration;
  • Part A only: Subjects with known history of Protein C and/or Protein S deficiency, or any other type of coagulopathy;
  • Part A only: Subjects requiring any type of anticoagulation, or taking Aspirin at doses greater than 81 mg/day;
  • Part A only: Subjects with brain metastases;
  • Part A only: Any subject who by history regularly consumes a large quantity of foods rich in vitamin K will be excluded unless he/she restricts the vitamin K intake for at least one week prior to the first dose of warfarin. For study purposes, large quantities of vitamin K-containing food will be defined as 10 or more portions per week of the following: kale, spinach, turnip greens, cauliflower, chick peas, brussels sprouts, green tea, liver, soybean oil and soy protein products.

Trial locations and contacts

11 sites in 3 countries.

11 sites in 3 countries

United States8 sites
  • GSK Investigational Site

    Columbus, Ohio, 43210

  • GSK Investigational Site

    Detroit, Michigan, 48201

  • GSK Investigational Site

    Greenville, South Carolina, 29605

  • GSK Investigational Site

    Nashville, Tennessee, 37203

  • GSK Investigational Site

    Oklahoma City, Oklahoma, 73104

  • GSK Investigational Site

    Salt Lake City, Utah, 84112

  • GSK Investigational Site

    Sarasota, Florida, 34232

  • GSK Investigational Site

    Scottsdale, Arizona, 85259

Other trials in United States

United Kingdom2 sites
  • GSK Investigational Site

    Headington, OX3 7LJ

  • GSK Investigational Site

    London, W1G 6AD

Other trials in United Kingdom

Australia1 site
  • GSK Investigational Site

    Nedlands, Western Australia, 6009

Other trials in Australia

About this study

Official title: A Four-Part, Open-Label Study to Evaluate the Effects of Repeat Dose GSK2118436 on the Single Dose Pharmacokinetics of Warfarin, the Effects of Repeat Dose Oral Ketoconazole and Oral Gemfibrozil on the Repeat Dose Pharmacokinetics of GSK2118436, and the Repeat Dose Pharmacokinetics of GSK2118436 in Subjects With BRAF Mutant Solid Tumors

GSK2118436 is an orally administered, potent and selective small molecule BRAF inhibitor that is being developed for the treatment of BRAF mutation-positive tumors. This is a 4-part study (in 4 separate cohorts of subjects) designed to examine the interaction potential of GSK2118436, either as a perpetrator (i.e., effect of GSK2118436 on warfarin; Part A) or victim (i.e., effect of other drugs on GSK2118436; Part B: ketoconazole and Part C: gemfibrozil), as well as to evaluate the single and repeat dose pharmacokinetic parameters of GSK2118436 (Part D). A sufficient number of subjects will be screened to obtain approximately 12 evaluable subjects each for Part A, Part B, Part C and Part D. Following completion of this study, subjects may continue dosing with GSK2118436 in the roll-over study, Protocol BRF114144.

Conditions
Cancer
Being tested
Warfarin, Ketoconazole, Gemfibrozil, GSK2118436 150mg, GSK2118436 75mg
Keywords
gemfibrozil, BRAF, Drug Interactions, GSK2118436, warfarin, ketoconazole, BRAF inhibitor, oncology, BRAF positive tumor
Medical subject headings
Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • WarfarinDrug

    Warfarin dosed at 15mg on Day 1 and Day 22

  • KetoconazoleDrug

    Ketoconazole dosed at 400mg daily on Days 19 through 22

  • GemfibrozilDrug

    Gemfibrozil dosed at 600mg twice daily on Days 19 through 22

  • GSK2118436 150mgDrug

    GSK2118436 dosed at 150mg twice daily

  • GSK2118436 75mgDrug

    GSK2118436 dosed at 75mg twice daily

Study groups in NCT01340846
Study groupRoleWhat they receive
Part AExperimentalWarfarin dosed at 15mg
Receives: Drug: Warfarin; Drug: GSK2118436 150mg
Part BExperimentalKetoconazole dosed at 400mg
Receives: Drug: Ketoconazole; Drug: GSK2118436 75mg
Part CExperimentalGemfibrozil dosed at 600mg
Receives: Drug: Gemfibrozil; Drug: GSK2118436 75mg
Part DExperimentalGSK2118436 dosed alone
Receives: Drug: GSK2118436 150mg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximum plasma concentration (Cmax) of S-warfarin with and without GSK2118436

    Measured: Up to 168 hours after dosing on Day 1 (warfarin alone) and Day 22 (warfarin in combination with GSK2118436)

  2. Area under the concentration time curve (AUC) of S-warfarin with and without GSK2118436

    Measured: Up to 168 hours after dosing on Day 1 (warfarin alone) and Day 22 (warfarin in combination with GSK2118436)

  3. Maximum plasma concentration (Cmax) of GSK2118436 with and without an inhibitor

    Measured: Up to 12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

  4. Area under the concentration time curve (AUC) of GSK2118436 with and without an inhibitor

    Measured: Up to12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

  5. Cmax of GSK2118436 and metabolites after single and multiple 75mg HPMC dose

    Measured: Up to 24 hours after dosing on Day 1 and up to 12 hours after dosing on Day 18

  6. AUC of GSK2118436 and metabolites after single and multiple 75mg HPMC dose

    Measured: Up to 24 hours after dosing on Day 1 and up to 12 hours after dosing on Day 18

  7. Time to Cmax (Tmax) of GSK2118436 and metabolites after single and multiple 75mg HPMC dose

    Measured: Up to 24 hours after dosing on Day 1 and up to 12 hours after dosing on Day 18

  8. Half-life of GSK2118436 and metabolites after single 75mg HPMC dose

    Measured: Up to 24 hours after dosing on Day 1

  9. Cmax of GSK2118436 and metabolites after single and multiple 150mg HPMC dose

    Measured: Up to 24 hours after dosing on Day 1 and up to 12 hours after dosing on Day 18

  10. AUC of GSK2118436 and metabolites after single and multiple 150mg HPMC dose

    Measured: Up to 24 hours after dosing on Day 1 and up to 12 hours after dosing on Day 18

  11. Tmax of GSK2118436 and metabolites after single and multiple 150mg HPMC dose

    Measured: Up to 24 hours after dosing on Day 1 and up to 12 hours after dosing on Day 18

  12. Half-life of GSK2118436 and metabolites after single 150mg HPMC dose

    Measured: Up to 24 hours after dosing on Day 1

Secondary outcomes (15)
  1. Cmax of R-warfarin with and without GSK2118436

    Measured: Up to 168 hours after dosing on Day 1 (warfarin alone) and Day 22 (warfarin in combination with GSK2118436)

  2. Time to Cmax (Tmax) of R-warfarin

    Measured: Up to 168 hours after dosing on Day 1 (warfarin alone) and Day 22 (warfarin in combination with GSK2118436)

  3. Trough concentration of GSK2118436

    Measured: Up to168 hours after dosing on Day 22

  4. Number of subjects with adverse events as a measure of safety and tolerability

    Measured: From date of first dose to transition to Rollover protocol BRF114144 (22 - 29 days) or study follow up visit if subject does not transition to BRF114144 (approximately 29 - 39 days)

  5. Tmax for GSK2118436 with and without an inhibitor

    Measured: Up to 12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

  6. AUC, Cmax, Tmax and trough concentration of GSK2118436 metabolites with and without an inhibitor, and AUC ratio of metabolites to parent

    Measured: Up to 12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

  7. Inhibitor concentrations in combination with GSK2118436

    Measured: Up to12 hours after dosing on Day 22 (GSK2118436 in combination with inhibitor)

  8. AUC of R-warfarin with and without GSK2118436

    Measured: Up to 168 hours after dosing on Day 1 (warfarin alone) and Day 22 (warfarin in combination with GSK2118436)

  9. Terminal half-life (t1/2) of R-warfarin

    Measured: Up to 168 hours after dosing on Day 1 (warfarin alone) and Day 22 (warfarin in combination with GSK2118436)

  10. Cmax of GSK2118436

    Measured: Up to168 hours after dosing on Day 22

  11. Trough concentration for GSK2118436 with and without an inhibitor

    Measured: Up to 12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

  12. Cmax of GSK2118436 metabolites with and without an inhibitor

    Measured: Up to 12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

  13. Tmax of GSK2118436 metabolites with and without an inhibitor

    Measured: Up to 12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

  14. Trough concentration of GSK2118436 metabolites with and without an inhibitor

    Measured: Up to 12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

  15. AUC ratio of metabolites to parent with and without an inhibitor

    Measured: Up to 12 hours after dosing on Day 18 (GSK2118436 alone) and Day 22 (GSK2118436 in combination with inhibitor)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Apr 2011 (estimated)
  2. Study start3 Sep 2012
  3. Primary completion14 Nov 2012
  4. Study completion14 Nov 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
48 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01340846
Sponsor's protocol ID
113771
Status last verified
Nov 2017
First submitted
14 Apr 2011
Last updated
13 Nov 2017
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Warfarin, Ketoconazole and Gemfibrozil in people with Cancer, run by GlaxoSmithKline at 11 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 27 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Nov 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United States, United Kingdom, Australia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximum plasma concentration (Cmax) of S-warfarin with and without GSK2118436 (time frame: Up to 168 hours after dosing on Day 1 (warfarin alone) and Day 22 (warfarin in combination with GSK2118436)). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Nov 2017.

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