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MedulloblastomaPhase 1/2NCT01125800

A Phase I Dose Finding and Safety Study of Oral LDE225 in Children and a Phase II Portion to Assess Preliminary Efficacy in Recurrent or Refractory MB

A Phase 1/2 study testing LDE225 in people with Medulloblastoma and Rhabdomyosarcoma, run by Novartis Pharmaceuticals at 14 sites in 6 countries.

Completed

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

Official record
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Trial summary

Phase I dose-escalation study to characterize the safety, tolerability, pharmacokinetics and pharmacodynamics of LDE225 given orally on a daily dosing schedule in children with recurrent or refractory medulloblastoma, or other tumors potentially dependent on Hedgehog signaling pathway. Read more about this study

Who is it for?
Ages 12 months to 18 years
Conditions the study is for
Medulloblastoma, Rhabdomyosarcoma, Neuroblastoma
What is being tested?
LDE225
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
76 participants
Where
14 sitesin 6 countries
Study dates
Feb 2011to Oct 2014
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 12 months to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Phase I - Patients aged ≥12 months and <18 years, Phase II - Patients ≥12 months
  • Phase I - Histologically confirmed diagnosis of medulloblastoma, rhabdomyosarcoma, neuroblastoma, hepatoblastoma, high grade glioma, or osteosarcoma, that has progressed despite treatment with standard therapies, or for which no standard treatments are available (patients with brainstem gliomas are excluded). Phase II - Histologically confirmed diagnosis of recurrent or relapsed medulloblastoma with at least one measurable lesion.
  • Performance Status: Karnofsky ≥60% for patients >10 yrs, Lansky ≥50 for patients less than or equal to 10 yrs
  • Protocol-defined renal , liver and bone marrow function
  • Negative pregnancy test before starting study treatment. If of child bearing potential must use 'highly effective' methods of contraception.
  • All patients must consent to provide a tumor sample

Who cannot join

  • Systemic anti-cancer treatment within 2 weeks prior to first dose (6 weeks for nitrosourea, mitomycin and monoclonal antibodies).
  • Focal radiotherapy within 4 weeks prior to first dose, or full spinal radiotherapy within 3 months of first dose.
  • Unresolved toxicity greater than CTCAE grade 1 from previous anti-cancer therapy or radiotherapy (excluding neurotoxicity, alopecia, ototoxicity, lymphopenia or other specifications in the eligibility criteria for this study), or incomplete recovery from previous surgery, unless agreed by Novartis and the Principal Investigator (PI) and documented.
  • Major surgery, serious illness or traumatic injury within 2 weeks of starting study therapy. Patients anticipated to require major surgery within the first 2 cycles of treatment.
  • Patients requiring a nasogastric tube for drug administration (G-tubes are permitted)
  • Impaired cardiac function
Show all 9Show fewer
  • Pregnant or breast-feeding females
  • Impairment of gastrointestinal (GI) function or GI disease
  • Other protocol-defined inclusion/exclusion criteria may apply

Trial locations and contacts

14 sites in 6 countries.

14 sites in 6 countries

United States4 sites
  • Children's Healthcare of Atlanta Childern Hosp - ATL

    Atlanta, Georgia, 30342

  • Sidney Kimmel Comprehensive Cancer Center/Johns Hopkins Med. John Hopkins

    Baltimore, Maryland, 21231

  • Dana Farber Cancer Institute DFCI (3)

    Boston, Massachusetts, 02115

  • Seattle Children's Hospital CPKC412A2114

    Seattle, Washington, 98105

Other trials in United States

Italy3 sites
  • Novartis Investigative Site

    Bologna, BO, 40139

  • Novartis Investigative Site

    Milan, MI, 20133

  • Novartis Investigative Site

    Roma, RM, 00168

Other trials in Italy

Canada2 sites
  • Novartis Investigative Site

    Toronto, Ontario, M5G 1X8

  • Novartis Investigative Site

    Toronto, Ontario, M5G 2M9

Other trials in Canada

France2 sites
  • Novartis Investigative Site

    Paris, 75231

  • Novartis Investigative Site

    Villejuif, 94805

Other trials in France

United Kingdom2 sites
  • Novartis Investigative Site

    Newcastle upon Tyne, NE1 4LP

  • Novartis Investigative Site

    Sutton, Surrey, SM2 5PT

Other trials in United Kingdom

Australia1 site
  • Novartis Investigative Site

    Parkville, Victoria, 3052

Other trials in Australia

About this study

Official title: A Phase I/II Study of LDE225 in Pediatric Patients With Recurrent or Refractory Medulloblastoma or Other Tumors Potentially Dependent on the Hedgehog-signaling Pathway and Adult Patients With Recurrent or Refractory Medulloblastoma

Phase I dose-escalation study to characterize the safety, tolerability, pharmacokinetics and pharmacodynamics of LDE225 given orally on a daily dosing schedule in children with recurrent or refractory medulloblastoma, or other tumors potentially dependent on Hedgehog signaling pathway.

Phase II study is to assess preliminary efficacy in both adult and pediatric patients with recurrent or refractory MB.

Being tested
LDE225
Keywords
Recurrent,, refractory,, medulloblastoma,, rhabdomyosarcoma,, neuroblastoma,, hepatoblastoma,, astrocytoma,, children,, pediatric,, hedgehog pathway inhibitor, adult
Medical subject headings
Medulloblastoma, Rhabdomyosarcoma, Neuroblastoma, Hepatoblastoma, Glioma, Astrocytoma, Recurrence

What participants receive

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

  • LDE225Drug

    Also called sonidegib

    LDE225/sonidegib capsules were supplied to the Investigators at dose strengths of 50 mg, 100 mg, 200 mg, and 250 mg.

Study groups in NCT01125800
Study groupRoleWhat they receive
LDE225 233mg/m2 daily doseExperimentalPediatric dose.
Receives: Drug: LDE225
LDE225 372mg/m2 daily doseExperimentalPediatric dose.
Receives: Drug: LDE225
LDE225 425 mg/m2 daily doseExperimentalPediatric dose.
Receives: Drug: LDE225
LDE225 680 mg/m2 daily doseExperimentalPediatric dose.
Receives: Drug: LDE225
LDE225 800 mg/m2 daily doseExperimentalAdult dose
Receives: Drug: LDE225

What is being measured

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

  1. Number of Participants With Dose-limiting Toxicities (DLT) in Phase I

    DLT was defined as an adverse event (AE) or abnormal laboratory value assessed as unrelated to disease, disease progression, intercurrent illness, or concomitant medications. DLT included any grade 3 or 4 clinically-evident toxicity, Hematology: ≥ CTCAE grade 3 neutropenia (ANC <1.0x10^9/L); ≥ CTCAE grade 3 thrombocytopenia (platelets <50x10^9/L); ≥ CTCAE grade 3 anemia (Hgb <80 g/L); Febrile neutropenia (ANC <1x10^9/L, fever ‡ 38.5°C), Renal: ≥ CTCAE grade 3 serum creatinine (>3xULN), Hepatic: ≥ CTCAE grade 3 total bilirubin (>3xULN); ≥ 10xULN ALT elevation; grade 2 total bilirubin (>1.5ULN) together with ≥ grade 3 ALT elevation (>5xULN), Cardiac: ≥ CTCAE grade 3, Other AEs: ≥ CTCAE grade 3 vomiting or nausea despite optimal antiemetic therapy, diarrhea despite optimal antidiarrheal treatment.

    Measured: Baseline, End of dose escalation part (Day 42)

  2. Maximum Tolerated Dose (MTD) of Sonidegib for Prolonged Use

    MTD was defined as highest dose level for which no more than 1 participant in a dose cohort experienced dose-limiting toxicity (DLT), based on Bayesian logistic regression model (BLRM) employing the escalation with overdose control (EWOC) principle. DLT was defined as an adverse event (AE) or abnormal laboratory value assessed as unrelated to disease, disease progression, intercurrent illness, or concomitant medications.k

    Measured: Baseline, End of dose escalation part (Day 42)

  3. Percentage of Participants With Objective Response Rate (ORR) by Treatment

    The tumor response to the sonidegib treatment was measured by ORR. The ORR was defined as the percentage of participants with partial response or complete response as their best overall response. Participants with stable disease, progressive disease tumor assessment were considered as non-responders. Response evaluation criteria was gadolinium chelate-enhanced brain tumor magnetic resonance imaging (Gd-MRI) for Medulloblastoma and central nervous system (CNS) tumors and response evaluation criteria in solid tumors (RECIST) version 1.0 for non-CNS tumors assessed by MRI. Complete Response (CR), Progressive Disease (PD) and Incomplete Response/Stable Disease (SD) were defined as disappearance of all non-target lesions, unequivocal progression of existing non-target lesions and Neither CR nor PD, respectively.

    Measured: Baseline, Day 28 of Cycle 2, End of treatment (Within 14 days of last dose)

Secondary outcomes (6)
  1. Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Treatment Related AEs and Death During the Study

    An AE was defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of study drug, whether or not related to study drug. A SAE was defined as an event which was fatal or life threatening, required or prolonged hospitalization, was significantly or permanently disabling or incapacitating, constituted a congenital anomaly or a birth defect, or encompassed any other clinically significant event that could jeopardize the participant or require medical or surgical intervention to prevent one of the aforementioned outcomes. Treatment related AEs were defined as AEs that were suspected to be related to study treatment as per investigator. On-treatment deaths were deaths which occurred up to 30 days after last date of study treatment.

    Measured: Baseline (start of study treatment) up to End of treatment (Within 14 days of last dose)

  2. Area Under the Drug Concentration Time Curve From Time Zero to 24 Hours After Dosing (AUC0-24h) of Sonidegib in Phase I

    AUC(0-24h) was defined as the area under the drug concentration time curve calculated using linear trapezoidal summation from time zero to 24 hours after dosing.

    Measured: Pre-dose, 0.5, 1, 2, 4, 7 hours (± 15 min) post-dose at Day 1 and Day 22 of Cycle 1

  3. Time to Reach Maximum Observed Plasma Concentration (Tmax) of Sonidegib in Phase I

    Tmax was defined as the time required to reach maximum observed plasma concentration. Tmax was directly determined from the raw plasma concentration time data.

    Measured: Pre-dose, 0.5, 1, 2, 4, 7 hours (± 15 min) post-dose at Day 1 and Day 22 of Cycle 1

  4. Maximum Observed Plasma Concentration (Cmax) of Sonidegib in Phase I

    Maximum observed plasma concentration following drug administration was calculated from the raw plasma concentration time data.

    Measured: Pre-dose, 0.5, 1, 2, 4, 7 hours (± 15 min) post-dose at Day 1 and Day 22 of Cycle 1

  5. Percentage of Pediatric Participants With Objective Response Rate (ORR) by Hedgehog (Hh) Signaling Pathway Status

    ORR was determined in the participants with mutations on Hh gene (Hh positive) and the participants without mutations on Hh gene (Hh negative).

    Measured: Baseline, Day 28 of Cycle 2, End of treatment (Within 14 days of last dose)

  6. Duration of Response by Treatment

    Duration of overall response (complete response (CR) or partial response (PR)) was calculated for those participants whose best overall response was CR or PR. The start date was the date of the first documented tumor response (CR or PR) and the end date was the date of the event defined as the first documented progression or death due to underlying cancer or after the same treatment line. If a participant did not have a progression or death, the duration of response was censored at the date of last adequate tumor assessment in that treatment line.

    Measured: Baseline, Day 28 of Cycle 2, End of treatment (Within 14 days of last dose)

Timeline

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

  1. First posted18 May 2010 (estimated)
  2. Study startFeb 2011
  3. Primary completionOct 2014
  4. Study completionOct 2014

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 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
76 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01125800
Sponsor's protocol ID
CLDE225X2104
Other IDs
2010-019348-37
Status last verified
Feb 2016
First submitted
12 May 2010
Last updated
20 Mar 2017
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing LDE225 in people with Medulloblastoma and Rhabdomyosarcoma, run by Novartis Pharmaceuticals at 14 sites in 6 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 6 inclusion and 9 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 20 Mar 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in United States, Italy, Canada, France, United Kingdom and 1 more country. 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 combined 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.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Mar 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Number of Participants With Dose-limiting Toxicities (DLT) in Phase I (time frame: Baseline, End of dose escalation part (Day 42)). The study lists 3 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 20 Mar 2017.

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