Advanced Malignant Solid NeoplasmPhase 1NCT01822522
Cabozantinib S-Malate in Treating Patients With Advanced Solid Tumors and Human Immunodeficiency Virus
A Phase 1 study testing Cabozantinib S-malate, Laboratory Biomarker Analysis and Pharmacological Study in people with Advanced Malignant Solid Neoplasm and HIV Infection, run by National Cancer Institute (NCI) at 20 sites in United States.
Trial summary
This phase I trial studies the side effects and best dose of cabozantinib s-malate in treating patients with solid tumors that have spread to other places in the body and usually cannot be cured or controlled with treatment and human immunodeficiency virus. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Advanced Malignant Solid Neoplasm, HIV Infection, Metastatic Malignant Solid Neoplasm
- What is being tested?
- Cabozantinib S-malate, Laboratory Biomarker Analysis and Pharmacological Study
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 20 sitesUnited States
- Study dates
- 21 Jun 2013to 12 May 2021
- Phase
- Phase 1
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Participants must have known HIV infection and histologically confirmed solid malignancy that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective; any number of prior cancer therapies will be permitted; at least 4 weeks must have elapsed since prior chemotherapy or biological therapy, 6 weeks if the regimen included carmustine (BCNU) or mitomycin C; prior radiation therapy to the thoracic cavity, abdomen, or pelvis must be completed at least 3 months prior to registration; radiotherapy to any other site (including bone or brain metastases) must be completed at least 28 days prior to registration
- Serologic documentation of HIV infection at any time prior to study entry, as evidenced by positive enzyme-linked immunosorbent assay (ELISA), positive western blot, or any other federally approved licensed HIV test; alternatively, this documentation may include a record that another physician has documented that the participant has HIV infection based on prior ELISA and western blot, or other approved diagnostic tests
- Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60%)
- Life expectancy of greater than 12 weeks
- Leukocytes >= 3,000/mcL (within 1 week of study entry)
- Absolute neutrophil count >= 1,500/mcL (within 1 week of study entry)
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- Platelets >= 100,000/mcL (within 1 week of study entry)
- Total bilirubin=< 1.5 x upper limit of normal (ULN) (within 1 week of study entry) (if, however, the participant has Gilbert's disease or unconjugated hyperbilirubinemia that is considered to be secondary to with atazanavir or indinavir therapy, then the total bilirubin must be =< 3 x ULN)
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 3.0 x institutional upper limit of normal (within 1 week of study entry)
- Creatinine =< 1.5 x ULN (within 1 week of study entry)
- Creatinine clearance >= 50 mL/min/1.73 m^2 for participants with creatinine levels above institutional normal (within 1 week of study entry)
- Hemoglobin >= 9 g/dL (within 1 week of study entry)
- Serum albumin >= 2.8 g/dL (within 1 week of study entry)
- Lipase < 2.0 x ULN and no radiologic or clinical evidence of pancreatitis (within 1 week of study entry)
- Urine protein/creatinine ratio (UPCR) =< 1 (within 1 week of study entry)
- Serum phosphorus >= lower limit of normal (LLN) (within 1 week of study entry)
- Calcium >= LLN (within 1 week of study entry)
- Magnesium >= LLN (within 1 week of study entry)
- Potassium >= LLN (within 1 week of study entry)
- A cluster of differentiation (CD)4+ lymphocyte count > 50/mcL will be required within 2 weeks of study participation
- Women of childbearing potential must have a negative pregnancy test within 7 days before enrollment; women of childbearing potential include women who have experienced menarche and who have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or are not postmenopausal; postmenopause is defined as amenorrhea >= 12 consecutive months; note: women who have been amenorrheic for 12 or more months are still considered to be of childbearing potential if the amenorrhea is possibly due to prior chemotherapy, antiestrogens, ovarian suppression or any other reversible reason
- The effects of cabozantinib on the developing human fetus are unknown; for this reason and because tyrosine kinase inhibitors agents as well as other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 6 months after completion of cabozantinib administration; sexually active participants (men and women) must agree to use medically accepted barrier methods of contraception (e.g., male or female condom) during the course of the study and for 6 months after the last dose of study drug(s), even if oral contraceptives are also used; all participants of reproductive potential must agree to use both a barrier method and a second method of birth control during the course of the study and for 6 months after the last dose of study drug
- Participating participants MUST receive appropriate care and treatment for HIV infection, including antiretroviral medications, when clinically indicated and should be under the care of a physician experienced in HIV management; participants will be eligible regardless of antiretroviral medication (including no antiretroviral medication) provided there is no intention to initiate therapy or the regimen has been stable for at least 4 weeks with no intention to change the regimen within 8 weeks following study entry; as study-specific (antiretroviral-based) strata fill, however, only participants who are receiving the therapies eligible for the remaining open strata will be accrued
- Ability to understand and the willingness to sign a written informed consent document
- Participants must in the opinion of the investigator be capable of complying with this protocol
Who cannot join
- Prior treatment with cabozantinib (XL184)
- The participant has received radionuclide treatment within 6 weeks of the first dose of study treatment
- The participant has received prior treatment with a small molecule kinase inhibitor or a hormonal therapy (including investigational kinase inhibitors or hormones) within 4 weeks or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment; note: participants with prostate cancer currently receiving luteinizing hormone-releasing hormone (LHRH) or gonadotropin-releasing hormone (GnRH) agonists may be maintained on these agents
- The participant has received any other type of investigational agent within 28 days before the first dose of study treatment
- The participant has not recovered to baseline or Common Terminology Criteria for Adverse Events (CTCAE) =< grade 1 from toxicity due to all prior therapies except alopecia and other non-clinically significant adverse events (AEs)
- The participant has a primary brain tumor
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- The participant has active brain metastases or epidural disease; participants with brain metastases previously treated with whole brain radiation or radiosurgery or participants with epidural disease previously treated with radiation or surgery who are asymptomatic and do not require steroid treatment for at least 4 weeks before starting study treatment are eligible; participants with treated brain metastasis should not take enzyme-inducing anticonvulsive therapies (EIACDs) within 2 weeks of registration, though non-enzyme inducing anticonvulsive drugs such as levetiracetam are allowed; neurosurgical resection of brain metastases or brain biopsy is permitted if completed at least 3 months before starting study treatment; baseline brain imaging with contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) scans for participants with known brain metastases is required to confirm eligibility
- The participant has prothrombin time (PT)/international normalized ratio (INR) or partial thromboplastin time (PTT) test >= 1.3 x the laboratory ULN within 7 days before the first dose of study treatment
- The participant requires concomitant treatment, in therapeutic doses, with anticoagulants such as warfarin or warfarin-related agents, heparin, thrombin or factor xabans (Xa) inhibitors, or antiplatelet agents (e.g., clopidogrel); low dose aspirin (=< 81 mg/day), low-dose warfarin (=< 1 mg/day), and prophylactic low molecular weight heparin (LMWH) are permitted
- The participant requires chronic concomitant treatment with the following strong cytochrome P450 family 3, subfamily A, polypeptide 4 (CYP3A4) inducers OTHER than antiretroviral agents: dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital, primidone, modafinil, and other enzyme inducing anti-convulsant drugs (EIACD), and St. John's wort; use of efavirenz or etravirine is permitted for participants considered for the CYP3A4-inducer based antiretroviral therapy (ART) regimen arm (Stratum B) of the trial; because the lists of CYP3A4 inducers are constantly changing, it is important to regularly consult a frequently-updated list; medical reference texts such as the Physicians' Desk Reference may also provide this information; as part of the enrollment/informed consent procedures, the participant will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the participant is considering a new over-the-counter medicine or herbal product
- The participant requires concomitant treatment with the following inhibitors of CYP3A4:
- Antibiotics: clarithromycin, erythromycin, telithromycin, troleandomycin
- Antifungals: itraconazole, ketoconazole, voriconazole, fluconazole, posaconazole
- Antidepressants: nefazodone
- Antidiuretic: conivaptan
- Gastrointestinal (GI): cimetidine, aprepitant
- Hepatitis C: boceprevir, telaprevir
- Miscellaneous: Seville oranges, grapefruit, or grapefruit juice and/or pummelos, star fruit, exotic citrus fruits, or grapefruit hybrids); use of any of anti-retrovirals (delavirdine) or protease inhibitors (ritonavir, indinavir, lopinavir/ritonavir, saquinavir, nelfinavir) is permitted; specifically, ritonavir and cobicistat is permitted for participants considered for the CYP3A4-inhibitor based ART regimen arm (Stratum A) of the trial; because the lists of CYP3A4 inhibitors are constantly changing, it is important to regularly consult a frequently-updated list; medical reference texts such as the physicians' desk reference may also provide this information; as part of the enrollment/informed consent procedures, the participant will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the participant is considering a new over-the-counter medicine or herbal product
- The participant has experienced any of the following:
- Clinically-significant gastrointestinal bleeding within 6 months before the first dose of study treatment
- Hemoptysis of >= 0.5 teaspoon (2.5 mL) of red blood within 3 months before the first dose of study treatment
- Any other signs indicative of pulmonary hemorrhage within 3 months before the first dose of study treatment
- The participant has radiographic evidence of cavitating pulmonary lesion(s)
- The participant has tumor invading or encasing any major blood vessels
- The participant has uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:
- Cardiovascular disorders including:
- Congestive heart failure (CHF): New York Heart Association (NYHA) class III (moderate) or class IV (severe) at the time of screening
- Concurrent uncontrolled hypertension defined as sustained blood pressure (BP) > 140 mmHg systolic, or > 90 mmHg diastolic despite optimal antihypertensive treatment within 7 days of the first dose of study treatment
- Any history of congenital long QT syndrome
- Any of the following within 6 months before the first dose of study treatment:
- Unstable angina pectoris
- Clinically-significant cardiac arrhythmias
- Stroke (including transient ischemic attack [TIA], or other ischemic event)
- Myocardial infarction
- Thromboembolic event requiring therapeutic anticoagulation (note: participants with a venous filter [e.g. vena cava filter] are not eligible for this study)
- Gastrointestinal disorders particularly those associated with a high risk of perforation or fistula formation including:
- Any of the following within 28 days before the first dose of study treatment
- Active peptic ulcer disease
- Inflammatory bowel disease (including ulcerative colitis and Crohn's disease), diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis
- Malabsorption syndrome
- Any of the following within 6 months before the first dose of study treatment:
- Abdominal fistula
- Gastrointestinal perforation
- Bowel obstruction or gastric outlet obstruction
- Intra-abdominal abscess; note: complete resolution of an intra-abdominal abscess must be confirmed prior to initiating treatment with cabozantinib even if the abscess occurred more than 6 months before the first dose of study treatment
- Other disorders associated with a high risk of fistula formation including percutaneous endoscopic gastrostomy (PEG) tube placement within 3 months before the first dose of study therapy
- Other clinically significant disorders such as:
- Active infection requiring systemic treatment within 28 days before the first dose of study treatment; participants with HIV infection will be eligible provided they meet the criteria; participants with known hepatitis B infection should be screened for active disease prior to study participation; participants with known hepatitis C infection must not be actively receiving treatment for the infection
- Serious non-healing wound/ulcer/bone fracture within 28 days before the first dose of study treatment
- History of organ transplant
- Concurrent uncompensated hypothyroidism or thyroid dysfunction within 7 days before the first dose of study treatment
- History of major surgery as follows:
- Major surgery within 3 months of the first dose of cabozantinib if there were no wound healing complications or within 6 months of the first dose of cabozantinib if there were wound complications
- Minor surgery within 1 month of the first dose of cabozantinib if there were no wound healing complications or within 3 months of the first dose of cabozantinib if there were wound complications
- In addition, complete wound healing from prior surgery must be confirmed at least 28 days before the first dose of cabozantinib irrespective of the time from surgery
- The participant is unable to swallow tablets that are whole (do not crush or chew or administer via nasogastric [NG]-tube)
- The participant has a corrected QT interval calculated by the Fridericia formula (QTcF) > 500 ms within 28 days before randomization; note: if initial QTcF is found to be > 500 ms, two additional electrocardiogram (ECGs) separated by at least 3 minutes should be performed; if the a
Trial locations and contacts
20 sites in 1 country.
20 sites in 1 country
United States20 sites
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
Boston Medical Center
Boston, Massachusetts, 02118
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
University of Hawaii Cancer Center
Honolulu, Hawaii, 96813
Thomas Street Clinic
Houston, Texas, 77009
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
Ben Taub General Hospital
Houston, Texas, 77030
UC San Diego Moores Cancer Center
La Jolla, California, 92093
Louisiana State University
Lafayette, Louisiana, 70503
UCLA Center for Clinical AIDS Research and Education
Los Angeles, California, 90035
UCLA / Jonsson Comprehensive Cancer Center
Los Angeles, California, 90095
UC San Diego Medical Center - Hillcrest
San Diego, California, 92103
Virginia Mason Medical Center
Seattle, Washington, 98101
Harborview Medical Center
Seattle, Washington, 98104
Fred Hutchinson Cancer Research Center
Seattle, Washington, 98109
Siteman Cancer Center at Washington University
St Louis, Missouri, 63110
Washington University School of Medicine
St Louis, Missouri, 63110
Montefiore Medical Center-Einstein Campus
The Bronx, New York, 10461
Montefiore Medical Center-Weiler Hospital
The Bronx, New York, 10461
Montefiore Medical Center - Moses Campus
The Bronx, New York, 10467
About this study
Official title: Phase I Trial of Cabozantinib (XL184) for Advanced Solid Tumors in Persons With HIV Infection
This phase I trial studies the side effects and best dose of cabozantinib s-malate in treating patients with solid tumors that have spread to other places in the body and usually cannot be cured or controlled with treatment and human immunodeficiency virus. Cabozantinib s-malate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Read the detailed description
PRIMARY OBJECTIVES:
- To determine the safety and tolerability of cabozantinib (XL184) (cabozantinib s-malate) as a single agent in solid tumor participants with human immunodeficiency virus (HIV) infection and to determine the maximal tolerated dose (MTD) in this patient population.
SECONDARY OBJECTIVES:
- To investigate possible pharmacokinetic interactions between cabozantinib and antiretroviral therapy in persons with HIV infection.
II. To investigate the effects of therapy on participant immune status and HIV viral load.
III. To preliminarily assess objective response rates associated with treatment for commonly represented tumors.
OUTLINE: This is a dose-escalation study.
Patients receive cabozantinib s-malate orally (PO) once daily (QD) on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 30 days.
- Conditions
- Advanced Malignant Solid Neoplasm, HIV Infection, Metastatic Malignant Solid Neoplasm, Recurrent Malignant Solid Neoplasm, Unresectable Solid Neoplasm
- Being tested
- Cabozantinib S-malate, Laboratory Biomarker Analysis, Pharmacological Study
- Medical subject headings
- HIV Infections, Neoplasm Metastasis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cabozantinib S-malateDrug
Also called BMS-907351, Cabometyx, Cometriq, XL-184
Given PO
Laboratory Biomarker AnalysisOther
Correlative studies
Correlative studies
| Study group | Role | What they receive |
|---|---|---|
| Stratum A Treatment (cabozantinib s-malate): 20 mg/day | Experimental | Patients receive cabozantinib s-malate 20 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
This arm includes patients who are on ritonavir-boosted or cobicistat-boosted antiretroviral regimens Receives: Drug: Cabozantinib S-malate; Other: Laboratory Biomarker Analysis; Other: Pharmacological Study |
| Stratum A Treatment (cabozantinib s-malate): 40 mg/day | Experimental | Patients receive cabozantinib s-malate 40 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
This arm includes patients who are on ritonavir-boosted or cobicistat-boosted antiretroviral regimens Receives: Drug: Cabozantinib S-malate; Other: Laboratory Biomarker Analysis; Other: Pharmacological Study |
| Stratum A Treatment (cabozantinib s-malate): 60 mg/day | Experimental | Patients receive cabozantinib s-malate 60 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
This arm includes patients who are on ritonavir-boosted or cobicistat-boosted antiretroviral regimens Receives: Drug: Cabozantinib S-malate; Other: Laboratory Biomarker Analysis; Other: Pharmacological Study |
| Stratum B Treatment (cabozantinib s-malate): 60 mg/day | Experimental | Patients receive cabozantinib s-malate 60 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
This arm includes patients who are on efavirenz or etravirine-based antiretroviral regimens Receives: Drug: Cabozantinib S-malate; Other: Laboratory Biomarker Analysis; Other: Pharmacological Study |
| Stratum B Treatment (cabozantinib s-malate): 100 mg/day | Experimental | Patients receive cabozantinib s-malate 100 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
This arm includes patients who are on efavirenz or etravirine-based antiretroviral regimens Receives: Drug: Cabozantinib S-malate; Other: Laboratory Biomarker Analysis; Other: Pharmacological Study |
| Stratum C Treatment (cabozantinib s-malate): 60 mg/day | Experimental | Patients receive cabozantinib s-malate 60 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
This arm includes patients who are on antiretroviral regimens that do not include the agents specified on stratum A or B, or who are not on antiretroviral therapy Receives: Drug: Cabozantinib S-malate; Other: Laboratory Biomarker Analysis; Other: Pharmacological Study |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of Adverse Events
Will be reported using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The number of participant who experienced an adverse event
Measured: Up to 30 days after completion of study treatment. Study treatment was between 1 and 82 weeks.
Maximal Tolerated Dose (MTD) of Cabozantinib-s-malate
Will be graded according to the NCI CTCAE version 5.0. Dose-limiting toxicity (DLT) will be defined as any cabozantinib s-malate related grade 3 or 4 non-hematologic toxicity including grade 3 nausea and/or vomiting and grade 3 diarrhea despite prophylaxis and/or treatment or any of the following grade 4 hematologic toxicities: thrombocytopenia and neutropenia of any duration (with or without fever or documented infection); additionally, treatment delay of greater than 7 days due to unresolved toxicity or any dose reduction required due to a cabozantinib-related adverse event will be considered a DLT.
Measured: Up to 28 days after treatment initiation
Secondary outcomes (5)
Response Rates
Will be using the new international criteria proposed by the revised Response Evaluation Criteria in Solid Tumors guideline (version 1.1). Binomial proportions and their 95% confidence intervals will be used. Responses are categorized as complete or partial.
Measured: Up to 30 days after completion of study treatment. Study treatment was between 1 and 82 weeks. The median number 28-day cycles was 3.5.
Human Immunodeficiency Virus (HIV) Viral Load
Detectable HIV viral load at visit 04 (day 22)
Measured: Day 22 of treatment
CD4+ Cell Counts
Change in CD4 counts from baseline to visit 04
Measured: Day 22 of treatment
CD8+ Cell Counts
Change in CD8 cell counts from baseline to visit 04.
Measured: Day 22 of treatment
Pharmacokinetic Parameters
Cmax at the maximum tolerated dose: 20 mg for stratum A, 60 mg for stratums B and C
Measured: Day 1
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Apr 2013 (estimated)
- Study start21 Jun 2013
- Primary completion22 May 2019
- Study completion12 May 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Advanced Malignant Solid NeoplasmStudies of the same condition, open and under way.
- More trials run by National Cancer Institute (NCI)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Model description
- In this study, cabozantinib doses were escalated within 3 strata defined by the participant's antiretroviral regimen
- Masking
- None (open label)
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Cancer Institute (NCI)
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Missak Haigentz, Principal investigator, AIDS Malignancy Consortium
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01822522
- Sponsor's protocol ID
- NCI-2013-00740
- Other IDs
- NCI-2013-00740, AMC-087, AMC-087, AMC-087, U01CA121947, UM1CA121947
- Status last verified
- Dec 2022
- First submitted
- 1 Apr 2013
- Last updated
- 10 Jan 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 10 Jan 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase I Trial of Cabozantinib (XL184) for Advanced Solid Tumors in Persons With HIV Infection
- ClinicalTrials.gov ID
- NCT01822522
- Acronym / sponsor ID
- NCI-2013-00740
- Conditions
- Advanced Malignant Solid Neoplasm, HIV Infection, Metastatic Malignant Solid Neoplasm, Recurrent Malignant Solid Neoplasm, Unresectable Solid Neoplasm
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- National Cancer Institute (NCI)US National Institutes of Health
- Study start
- 21 Jun 2013 (actual)
- Primary completion
- 22 May 2019 (actual)
- Study completion
- 12 May 2021 (actual)
- First posted
- 2 Apr 2013 (estimated)
- Results
- Posted 10 Jan 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase I trial studies the side effects and best dose of cabozantinib s-malate in treating patients with solid tumors that have spread to other places in the body and usually cannot be cured or controlled with treatment and human immunodeficiency virus. Cabozantinib s-malate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Detailed description
PRIMARY OBJECTIVES:
- To determine the safety and tolerability of cabozantinib (XL184) (cabozantinib s-malate) as a single agent in solid tumor participants with human immunodeficiency virus (HIV) infection and to determine the maximal tolerated dose (MTD) in this patient population.
SECONDARY OBJECTIVES:
- To investigate possible pharmacokinetic interactions between cabozantinib and antiretroviral therapy in persons with HIV infection.
II. To investigate the effects of therapy on participant immune status and HIV viral load.
III. To preliminarily assess objective response rates associated with treatment for commonly represented tumors.
OUTLINE: This is a dose-escalation study.
Patients receive cabozantinib s-malate orally (PO) once daily (QD) on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 30 days.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 6
- Model description
- In this study, cabozantinib doses were escalated within 3 strata defined by the participant's antiretroviral regimen
| Arm | Type | Receives |
|---|---|---|
| Stratum A Treatment (cabozantinib s-malate): 20 mg/day | Experimental | Drug: Cabozantinib S-malate, Other: Laboratory Biomarker Analysis, Other: Pharmacological StudyPatients receive cabozantinib s-malate 20 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. This arm includes patients who are on ritonavir-boosted or cobicistat-boosted antiretroviral regimens |
| Stratum A Treatment (cabozantinib s-malate): 40 mg/day | Experimental | Drug: Cabozantinib S-malate, Other: Laboratory Biomarker Analysis, Other: Pharmacological StudyPatients receive cabozantinib s-malate 40 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. This arm includes patients who are on ritonavir-boosted or cobicistat-boosted antiretroviral regimens |
| Stratum A Treatment (cabozantinib s-malate): 60 mg/day | Experimental | Drug: Cabozantinib S-malate, Other: Laboratory Biomarker Analysis, Other: Pharmacological StudyPatients receive cabozantinib s-malate 60 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. This arm includes patients who are on ritonavir-boosted or cobicistat-boosted antiretroviral regimens |
| Stratum B Treatment (cabozantinib s-malate): 60 mg/day | Experimental | Drug: Cabozantinib S-malate, Other: Laboratory Biomarker Analysis, Other: Pharmacological StudyPatients receive cabozantinib s-malate 60 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. This arm includes patients who are on efavirenz or etravirine-based antiretroviral regimens |
| Stratum B Treatment (cabozantinib s-malate): 100 mg/day | Experimental | Drug: Cabozantinib S-malate, Other: Laboratory Biomarker Analysis, Other: Pharmacological StudyPatients receive cabozantinib s-malate 100 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. This arm includes patients who are on efavirenz or etravirine-based antiretroviral regimens |
| Stratum C Treatment (cabozantinib s-malate): 60 mg/day | Experimental | Drug: Cabozantinib S-malate, Other: Laboratory Biomarker Analysis, Other: Pharmacological StudyPatients receive cabozantinib s-malate 60 mg PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. This arm includes patients who are on antiretroviral regimens that do not include the agents specified on stratum A or B, or who are not on antiretroviral therapy |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (25 listed)
- Participants must have known HIV infection and histologically confirmed solid malignancy that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective; any number of prior cancer therapies will be permitted; at least 4 weeks must have elapsed since prior chemotherapy or biological therapy, 6 weeks if the regimen included carmustine (BCNU) or mitomycin C; prior radiation therapy to the thoracic cavity, abdomen, or pelvis must be completed at least 3 months prior to registration; radiotherapy to any other site (including bone or brain metastases) must be completed at least 28 days prior to registration
- Serologic documentation of HIV infection at any time prior to study entry, as evidenced by positive enzyme-linked immunosorbent assay (ELISA), positive western blot, or any other federally approved licensed HIV test; alternatively, this documentation may include a record that another physician has documented that the participant has HIV infection based on prior ELISA and western blot, or other approved diagnostic tests
- Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60%)
- Life expectancy of greater than 12 weeks
- Leukocytes >= 3,000/mcL (within 1 week of study entry)
Key exclusion criteria (57 listed)
- Prior treatment with cabozantinib (XL184)
- The participant has received radionuclide treatment within 6 weeks of the first dose of study treatment
- The participant has received prior treatment with a small molecule kinase inhibitor or a hormonal therapy (including investigational kinase inhibitors or hormones) within 4 weeks or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment; note: participants with prostate cancer currently receiving luteinizing hormone-releasing hormone (LHRH) or gonadotropin-releasing hormone (GnRH) agonists may be maintained on these agents
- The participant has received any other type of investigational agent within 28 days before the first dose of study treatment
- The participant has not recovered to baseline or Common Terminology Criteria for Adverse Events (CTCAE) =< grade 1 from toxicity due to all prior therapies except alopecia and other non-clinically significant adverse events (AEs)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Cabozantinib S-malateAlso: BMS-907351, Cabometyx, Cometriq, XL-184Given PO | Drug | Stratum A Treatment (cabozantinib s-malate): 20 mg/day, Stratum A Treatment (cabozantinib s-malate): 40 mg/day, Stratum A Treatment (cabozantinib s-malate): 60 mg/day, Stratum B Treatment (cabozantinib s-malate): 100 mg/day, Stratum B Treatment (cabozantinib s-malate): 60 mg/day, Stratum C Treatment (cabozantinib s-malate): 60 mg/day |
| Laboratory Biomarker AnalysisCorrelative studies | Other | Stratum A Treatment (cabozantinib s-malate): 20 mg/day, Stratum A Treatment (cabozantinib s-malate): 40 mg/day, Stratum A Treatment (cabozantinib s-malate): 60 mg/day, Stratum B Treatment (cabozantinib s-malate): 100 mg/day, Stratum B Treatment (cabozantinib s-malate): 60 mg/day, Stratum C Treatment (cabozantinib s-malate): 60 mg/day |
| Pharmacological StudyCorrelative studies | Other | Stratum A Treatment (cabozantinib s-malate): 20 mg/day, Stratum A Treatment (cabozantinib s-malate): 40 mg/day, Stratum A Treatment (cabozantinib s-malate): 60 mg/day, Stratum B Treatment (cabozantinib s-malate): 100 mg/day, Stratum B Treatment (cabozantinib s-malate): 60 mg/day, Stratum C Treatment (cabozantinib s-malate): 60 mg/day |
Primary outcome
Incidence of Adverse Events
Time frame: Up to 30 days after completion of study treatment. Study treatment was between 1 and 82 weeks.
Will be reported using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The number of participant who experienced an adverse event
Maximal Tolerated Dose (MTD) of Cabozantinib-s-malate
Time frame: Up to 28 days after treatment initiation
Will be graded according to the NCI CTCAE version 5.0. Dose-limiting toxicity (DLT) will be defined as any cabozantinib s-malate related grade 3 or 4 non-hematologic toxicity including grade 3 nausea and/or vomiting and grade 3 diarrhea despite prophylaxis and/or treatment or any of the following grade 4 hematologic toxicities: thrombocytopenia and neutropenia of any duration (with or without fever or documented infection); additionally, treatment delay of greater than 7 days due to unresolved toxicity or any dose reduction required due to a cabozantinib-related adverse event will be considered a DLT.
5 secondary outcomes
Response Rates
Time frame: Up to 30 days after completion of study treatment. Study treatment was between 1 and 82 weeks. The median number 28-day cycles was 3.5.
Human Immunodeficiency Virus (HIV) Viral Load
Time frame: Day 22 of treatment
CD4+ Cell Counts
Time frame: Day 22 of treatment
CD8+ Cell Counts
Time frame: Day 22 of treatment
Pharmacokinetic Parameters
Time frame: Day 1
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Jan 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Missak Haigentz principal investigator
AIDS Malignancy Consortium
20 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing Cabozantinib S-malate, Laboratory Biomarker Analysis and Pharmacological Study in people with Advanced Malignant Solid Neoplasm and HIV Infection, run by National Cancer Institute (NCI) at 20 sites in United States.
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 25 inclusion and 57 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 10 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 20 sites in United States. 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?
Yes. Results are posted in the registry (first posted 10 Jan 2023). 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?
Incidence of Adverse Events (time frame: Up to 30 days after completion of study treatment. Study treatment was between 1 and 82 weeks.). The study lists 2 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 10 Jan 2023; AzTrials last refreshed its copy on 1 Nov 2026.