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Relapsed or Refractory Solid Tumors or Lymphoma in ChildrenPhase 1/2NCT03458728

Safety, Tolerability, Efficacy and Pharmacokinetics of Copanlisib in Pediatric Patients

A Phase 1/2 study testing Copanlisib (BAY806946) in people with Relapsed or Refractory Solid Tumors or Lymphoma in Children and Neuroblastoma, run by Bayer at 14 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This study is designed to investigate whether the use of copanlisib is safe, feasible and beneficial to pediatric patients with solid solid tumors or lymphoma that are recurrent or refractory to standard therapy. Read more about this study

Who is it for?
Ages 6 months to 21 years
What is being tested?
Copanlisib (BAY806946)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
31 participants
Where
14 sitesUnited States
Study dates
30 Apr 2018to 1 Feb 2023
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 6 months to 21 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Signed informed consent form by patients and/or patients' parents/legal guardians and age appropriate assent form by the patients obtained before any study specific procedure
  • Male or female patients from 6 months to ≤ 21 years old at the time of study enrollment
  • Confirmation of diagnosis:
  • Phase I: Patients must have histologic verification of a solid tumor or lymphoma malignancy at diagnosis, with measurable or evaluable disease, for which there is no standard curative anti-cancer treatment or treatment is no longer effective and must have received ≥ 1 prior line of therapy.
  • Phase II: patients must have histologically verified tumor at initial diagnosis and radiologically or histologically confirmed status at inclusion as indicated in the following: neuroblastoma, osteosarcoma, rhabdomyosarcoma or Ewing sarcoma.
  • Patients with solid tumors must have measurable disease (evaluable disease is acceptable for neuroblastoma and Ewing sarcoma). Tumor assessment will be done via computed tomography (CT), magnetic resonance imaging (MRI) or positron emission tomography-computed tomography (PET-CT). Tumor lesions situated in a previously irradiated area, or in an area subjected to other loco-regional therapy, may be considered measurable if there has been demonstrated progression in the lesion. Bone scans (if clinically indicated) should be obtained within ≤ 4 weeks prior to the start of treatment.
  • Performance level: Lansky ≥ 50% for patients ≤ 16 years of age and Karnofsky ≥ 50% for patients > 16 years of age.
  • Adequate bone marrow, renal and liver function.

Who cannot join

  • Active or uncontrolled infection (National Cancer Institute (NCI)-CTCAE Grade ≥ 2).
  • History or concurrent condition of interstitial lung disease of any severity and/or severely impaired lung function (as judged by the investigator).
  • Diabetes mellitus.
  • Uncontrolled arterial hypertension despite optimal medical management (per institutional guidelines).
  • Patients with central nervous system (CNS) malignancies.

Trial locations and contacts

14 sites in 1 country.

14 sites in 1 country

United States14 sites
  • Children's Healthcare of Atlanta

    Atlanta, Georgia, 30322

  • The Children's Hospital

    Aurora, Colorado, 80045

  • Children's Hospital of Alabama

    Birmingham, Alabama, 35233

  • Dana-Farber Cancer Institute

    Boston, Massachusetts, 02215

  • Cincinnati Children's Hospital and Medical Center

    Cincinnati, Ohio, 45229

  • Texas Children's Hospital

    Houston, Texas, 77030

  • Riley Hospital For Children

    Indianapolis, Indiana, 46202

  • St. Jude Children's Research Hospital

    Memphis, Tennessee, 38105

  • Columbia University Medical Center

    New York, New York, 10032

  • Children's Hospital of Orange County

    Orange, California, 92868-3974

  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • Children's Hospital of Pittsburgh of UPMC

    Pittsburgh, Pennsylvania, 15224

  • Seattle Children's Hospital

    Seattle, Washington, 98105

  • Children's National Medical Center

    Washington D.C., District of Columbia, 20010-2970

Other trials in United States

About this study

Official title: A Non-randomized, Open-label, Multi-center, Phase I/II Study of Phosphatidylinositol-3-kinase (PI3K) Inhibitor Copanlisib in Pediatric Patients With Relapsed/Refractory Solid Tumors or Lymphoma

This study is designed to investigate whether the use of copanlisib is safe, feasible and beneficial to pediatric patients with solid solid tumors or lymphoma that are recurrent or refractory to standard therapy.

Being tested
Copanlisib (BAY806946)
Keywords
Phase I: relapsed or refractory solid tumors or lymphoma, Phase II: relapsed or refractory solid tumors (neuroblastoma, osteosarcoma, rhabdomyosarcoma or Ewing sarcoma)
Medical subject headings
Recurrence, Neuroblastoma, Osteosarcoma, Rhabdomyosarcoma, Sarcoma, Ewing, Lymphoma

What participants receive

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

  • Copanlisib (BAY806946)Drug

    Copanlisib will be dosed on Day 1, Day 8, and Day 15 of every 28-day cycle. Phase 1: 2 or 3 dose cohorts may be evaluated in phase 1 of the study. Phase 2: RP2D for copanlisib in pediatric patients, as defined in the Phase I part of the study, will be used.

Study groups in NCT03458728
Study groupRoleWhat they receive
Dose escalation of BAY806946 in Phase 1ExperimentalIt is estimated that 2 or 3 dose cohorts may be evaluated in phase 1 of the study. Safety and MTD/RP2D dose will be evaluated in 2 age groups (< 1 year old and ≥ 1 year old).
Receives: Drug: Copanlisib (BAY806946)
Patients with Neuroblastoma in Phase 2ExperimentalRecommended Phase 2 dose (RP2D) for copanlisib in pediatric patients, as defined in the Phase I part of the study, will be used.
Receives: Drug: Copanlisib (BAY806946)
Patients with Osteosarcoma in Phase 2ExperimentalRP2D for copanlisib in pediatric patients, as defined in the Phase I part of the study, will be used.
Receives: Drug: Copanlisib (BAY806946)
Patients with Rhabdomyosarcoma in Phase 2ExperimentalRP2D for copanlisib in pediatric patients, as defined in the Phase I part of the study, will be used.
Receives: Drug: Copanlisib (BAY806946)
Patients with Ewing sarcoma in Phase 2ExperimentalRP2D for copanlisib in pediatric patients, as defined in the Phase I part of the study, will be used.
Receives: Drug: Copanlisib (BAY806946)

What is being measured

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

  1. Phase 1: The Maximum Tolerated Dose (MTD): the Highest Dose Level of Copanlisib That Can be Given so That Not More Than 1 Out of 6 Patients Experience a DLT During the DLT Evaluation Period.

    Maximum tolerated dose (MTD) for copanlisib was defined as the highest dose level where 6 patients have been treated and ≤ 1 participant experienced a DLT. This endpoint was performed on SAF.

    Measured: Cycle 1 (28 days)

  2. Phase 1: Number of Subjects With Dose Limiting Toxicity (DLT)

    DLT was observed during first cycle of treatment, and assessed as possibly, probably or definitely related to treatment with copanlisib. The DLT observation period for the purposes of dose-escalation was the first cycle of therapy.

    Measured: Cycle 1 (28 days)

  3. Phase 1: Number of Subjects With Treatment-emergent Adverse Events (TEAEs)

    TEAE was defined as any event arising or worsening after start of study drug administration until 30 days after the last dose of the study drug intake (end of safety follow-up).

    This endpoint was performed on SAF.

    Measured: After the first study intervention up to 30 days after the last dose of the study drug intake (end of safety follow up), with a maximum of 145 days.

  4. Phase 1: Number of Subjects With Serious Adverse Events (SAEs)

    This endpoint was performed on SAF.

    Measured: Up to 150 days.

  5. Phase 1: Number of Participants With Treatment-related Adverse Events (AEs).

    This endpoint was performed on SAF.

    Measured: Up to 145 days.

  6. Phase 2: Objective Response Rate (ORR)

    ORR was defined separately in each indication, as the number of responders divided by the number of subjects in FAS in the indication.

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

  7. Phase 2: Disease Control Rate (DCR)

    The DCR was defined as the number of subjects with disease control divided by the number of subjects in FAS or per protocol set (PPS) in the indication.

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

  8. Phase 2: Progression-free Survival (PFS)

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

Secondary outcomes (9)
  1. Phase 1: Copanlisib Maximum Drug Concentration (Cmax)

    Cmax: maximum concentration after the 3rd dose in a sequence of 3 nominal doses of copanlisib.

    PK analysis set: All participants with at least one intake of study drug and with at least one valid measurement for copanlisib were included in the copanlisib PK analysis.

    Measured: Age ≥ 6 years: Pre-dose, Post-dose on Cycle 1 Day 1 and Day 15 (1-1.25 hour (h), 1.5- 3h, 22-24h). Age < 6 years: Pre-dose, Post-dose on Cycle 1 Day 1 and Day 15 (1-1.25h, 22-24h). Cycle length is 28 days.

  2. Phase 1: Area Under the Curve (AUC(0-168))

    AUC(0-168): Area under the concentration-time curve [AUC] from 0 to 168 hours after the 3rd dose in a sequence of 3 nominal doses of copanlisib.

    PK analysis set: All participants with at least one intake of study drug and with at least one valid measurement for copanlisib were included in the copanlisib PK analysis.

    Measured: Age ≥ 6 years: Pre-dose, Post-dose on Cycle 1 Day 1 and Day 15 (1-1.25 hour (h), 1.5- 3h, 22-24h). Age < 6 years: Pre-dose, Post-dose on Cycle 1 Day 1 and Day 15 (1-1.25h, 22-24h). Cycle length is 28 days.

  3. Phase 1: Objective Response Rate (ORR)

    ORR by dose cohort is defined as the number of responders divided by the number of subjects in FAS in the indication.

    The analysis of ORR was performed on FAS.

    Measured: Up to 150 days

  4. Phase 2: Duration of Response (DOR)

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

  5. Phase 2: PFS in Each Indication Except for Osteosarcoma

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

  6. Phase 2: Overall Survival (OS)

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

  7. Phase 2: Number of Participants With Treatment-emergent AEs

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

  8. Phase 2: Number of Subjects With Treatment Emergent SAEs

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

  9. Phase 2: Number of Subjects With Treatment-emergent Clinically Significant Change in Laboratory Parameters, ECGs and Vital Signs

    Measured: Data was not collected for this endpoint due to study was terminated before the initiation of phase 2.

Timeline

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

  1. First posted8 Mar 2018
  2. Study start30 Apr 2018
  3. Primary completion1 Feb 2023
  4. Study completion1 Feb 2023

Why it stopped: no anticipated benefit over available standard therapies

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
Parallel groups
Masking
None (open label)
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03458728
Sponsor's protocol ID
19176
Other IDs
2017-000383-15, 2017
Status last verified
Nov 2023
First submitted
19 Feb 2018
Last updated
4 Dec 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: Availability of this study's data will later be determined according to Bayer's commitment to the EFPIA/PhRMA "Principles for responsible clinical trial data sharing". This pertains to scope, timepoint and process of data access. As such, Bayer commits to sharing upon request from qualified researchers patient-level clinical trial data, study-level clinical trial data, and protocols from clinical trials in patients for medicines and indications approved in the US and EU as necessary for conducting legitimate research. This applies to data on new medicines and indications that have been approved by the EU and US regulatory agencies on or after January 01, 2014. Interested researchers can use www.vivli.org to request access to anonymized patient-level data and supporting documents from clinical studies to conduct research. Information on the Bayer criteria for listing studies and other relevant information is provided in the member section of the portal.

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Copanlisib (BAY806946) in people with Relapsed or Refractory Solid Tumors or Lymphoma in Children and Neuroblastoma, run by Bayer at 14 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 8 inclusion and 5 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: stopped early, as of the sponsor's last update on 4 Dec 2023. 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. 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 4 Dec 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?

Phase 1: The Maximum Tolerated Dose (MTD): the Highest Dose Level of Copanlisib That Can be Given so That Not More Than 1 Out of 6 Patients Experience a DLT During the DLT Evaluation Period. (time frame: Cycle 1 (28 days)). The study lists 8 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 4 Dec 2023.

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