Summary

for people ages 18 years and up (full criteria)
at San Francisco, California and other locations
study started

Description

Summary

This phase II trial studies how well vismodegib and focal adhesion kinase (FAK) inhibitor GSK2256098 work in treating patients with meningioma that is growing, spreading, or getting worse. Vismodegib and FAK inhibitor GSK2256098 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Official Title

Phase II Trial of SMO/AKT/NF2 Inhibitors in Progressive Meningiomas With SMO/AKT/NF2 Mutations

Details

PRIMARY OBJECTIVES:

  1. To determine the activity of a smoothened, frizzled class receptor (SMO) and PTCH1 inhibitor in patients with meningiomas harboring SMO mutations as measured by 6-month progression free survival (PFS) and response rate.

II. To determine the activity of a FAK inhibitor in patients with meningiomas harboring neurofibromin 2 (NF2) mutations as measured by 6-month PFS and response rate.

SECONDARY OBJECTIVES:

  1. To determine overall survival and progression-free survival of SMO and FAK inhibitors in patients with meningioma.

II. To determine adverse event rates of SMO and FAK inhibitors in patients with meningioma.

III. To determine the activity of SMO and FAK inhibitor as measured by response rate by central radiology review.

TERTIARY OBJECTIVES:

  1. To evaluate genetic biomarkers in meningioma. II. To evaluate dynamic contrast enhanced magnetic resonance imaging (MRI) during treatment with SMO and FAK inhibitors for meningioma.

III. To evaluate volumetric response by central radiology review.

OUTLINE: Patients are assigned to 1 of 2 treatment arms based on their mutation status.

ARM A (SMO/PTCH1 mutation): Patients receive vismodegib orally (PO) once daily (QD). Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM B (NF2 mutation): Patients receive FAK inhibitor GSK2256098 PO twice daily (BID). Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 6 months for a maximum of 5 years from registration.

Keywords

Intracranial Meningioma Recurrent Meningioma NF2 Gene Mutation Meningioma vismodegib GSK2256098

Eligibility

For people ages 18 years and up

  • Documentation of disease:
  • Histologic documentation: histologically proven intracranial meningioma as documented by central pathology review
  • Molecular documentation: presence of SMO, PTCH1 or NF2 mutation in tumor sample as documented by central laboratory
  • Progressive OR residual disease, as defined by the following:
  • Residual measurable disease: residual measurable disease immediately after surgery without requirement for progression; for grade I disease,progression pre-operatively needs to be documented, with an increase in size of the measurable primary lesion on imaging by 25% or more (bidirectional area); the change must occur between scans separated by no more than 12 months; residual measurable disease will be defined by bidimensionally measurable lesions with clearly defined margins by MRI scans, with a minimum diameter of 10 mm in both dimensions
  • Progressive measurable disease: progression defined as an increase in size of the measurable primary lesion on imaging by 25% or more (bidirectional area); the change must occur between scans separated by no more than 12 months
  • Post radiation patients: patients with measurable and progressive meningioma who have received radiation are potentially eligible, but need to show evidence of progressive disease after completion of radiation; at least 24 weeks must have elapsed from completion of radiation to registration
  • Measurable disease: measurable disease is defined by a bidimensionally measurable main lesion on MRI or computed tomography (CT) images (MRI preferred) with clearly defined margins; multifocal disease is allowed
  • Prior treatment
  • Prior medical therapy is allowed but not required
  • No limit on number of prior therapies
  • No chemotherapy, other investigational agents within 28 days of study treatment
  • No other concurrent investigational agents or other meningioma-directed therapy(chemotherapy, radiation) while on study
  • For patients treated with external beam radiation, interstitial brachytherapy or radiosurgery, an interval > 24 weeks must have elapsed from completion of radiation therapy to registration
  • Steroid dosing stable for at least 4 days
  • Recovered to Common Terminology Criteria for Adverse Events (CTCAE) grade 1 or less toxicity from other agents with exception of alopecia and fatigue
  • No craniotomy within 28 days of registration
  • Not pregnant and not nursing:
  • A female of childbearing potential is a sexually mature female who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months)
  • Eastern Cooperative Oncology Group (ECOG) performance status =< 2
  • Patient history:
  • Patients with history of neurofibromatosis (NF) may have other stable central nervous system (CNS) tumors (schwannoma, acoustic neuroma or ependymoma) if lesions have been stable for 6 months
  • No metastatic meningiomas (as defined by extracranial meningiomas) allowed
  • No history of allergic reactions attributed to compounds of similar or biologic composition to assigned study drug
  • No known active hepatitis B or C
  • No current Child Pugh class B or C liver disease
  • No uncontrolled gastric ulcer disease (grade 3 gastric ulcer disease within 28 days of registration)
  • No uncontrolled diabetes defined as a known diabetic with hemoglobin A1C (HBA1C)> 7.5 OR fasting glucose > 140
  • No uncontrolled hypertension defined as blood pressure (BP) > 140/90
  • No abdominal fistula, gastrointestinal (GI) perforation, or intra-abdominal abscess within 28 days prior to registration
  • Concomitant medications:
  • Chronic concomitant treatment with strong inhibitors of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inhibitors must discontinue the drug for 14 days prior to registration on the study for patients with NF2 mutation enrolled to GSK2256098
  • Chronic concomitant treatment with strong CYP3A4 inducers is not allowed;patients must discontinue the drug 14 days prior to the start of study treatment for patients with NF2 mutation enrolled to GSK2256098
  • Absolute neutrophil count (ANC) >= 1,500/mm3

  • Platelet count >= 100,000/mm3

  • Creatinine OR =< 1.5 mg/dl x upper limit of normal (ULN) OR calculated (calc.)creatinine clearance > 45 mL/min
  • Urine protein:creatinine ratio (UPC) =< 45 mg/mmol; ONLY APPLICABLE for patients with NF2 mutation (GSK2256098)
  • Total bilirubin =< 1.5 x upper limit of normal (ULN); except in case of Gilbert's disease
  • Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 x upper limit of normal (ULN)
  • Fasting triglyceride =< 200 mg/dL; ONLY APPLICABLE for patients with NF2 mutation(GSK2256098)
  • Fasting cholesterol =< 240 mg/dL; ONLY APPLICABLE for patients with NF2 mutation(GSK2256098)
  • Corrected QC interval calculated using Fridericia's formula (QTcF) =< 500 msec; ONLY APPLICABLE for patients with NF2 mutation (GSK2256098)

Locations

  • UCSF Medical Center-Parnassus
    San Francisco California 94143 United States
  • UCSF Medical Center-Mission Bay
    San Francisco California 94158 United States
  • California Pacific Medical Center-Pacific Campus
    San Francisco California 94115 United States
  • Kaiser Permanente-San Francisco
    San Francisco California 94115 United States
  • Kaiser Permanente-South San Francisco
    South San Francisco California 94080 United States
  • Kaiser Permanente-Fresno
    Fresno California 93720 United States
  • Alta Bates Summit Medical Center-Herrick Campus
    Berkeley California 94704 United States
  • Kaiser Permanente-Richmond
    Richmond California 94801 United States
  • Mills-Peninsula Medical Center
    Burlingame California 94010 United States
  • Kaiser Permanente-Oakland
    Oakland California 94611 United States
  • Kaiser Permanente San Leandro
    San Leandro California 94577 United States
  • Kaiser Permanente-San Rafael
    San Rafael California 94903 United States
  • Kaiser San Rafael-Gallinas
    San Rafael California 94903 United States
  • Eden Hospital Medical Center
    Castro Valley California 94546 United States
  • Kaiser Permanente-Redwood City
    Redwood City California 94063 United States
  • Kaiser Permanente-Walnut Creek
    Walnut Creek California 94596 United States
  • Sutter Cancer Research Consortium
    Novato California 94945 United States
  • Palo Alto Medical Foundation Health Care
    Palo Alto California 94301 United States
  • Kaiser Permanente-Vallejo
    Vallejo California 94589 United States
  • Sutter Solano Medical Center/Cancer Center
    Vallejo California 94589 United States
  • Kaiser Permanente-Fremont
    Fremont California 94538 United States
  • Palo Alto Medical Foundation-Fremont
    Fremont California 94538 United States
  • Palo Alto Medical Foundation-Camino Division
    Mountain View California 94040 United States
  • Palo Alto Medical Foundation-Gynecologic Oncology
    Mountain View California 94040 United States
  • Palo Alto Medical Foundation-Sunnyvale
    Sunnyvale California 94086 United States
  • Kaiser Permanente Medical Center - Santa Clara
    Santa Clara California 95051 United States
  • Kaiser Permanente-Deer Valley Medical Center
    Antioch California 94531 United States
  • Sutter Cancer Centers Radiation Oncology Services-Vacaville
    Vacaville California 95687 United States
  • Kaiser Permanente Medical Center-Vacaville
    Vacaville California 95688 United States
  • Kaiser Permanente-Santa Teresa-San Jose
    San Jose California 95119 United States
  • Kaiser Permanente-Santa Rosa
    Santa Rosa California 95403 United States
  • Sutter Pacific Medical Foundation
    Santa Rosa California 95403 United States
  • Palo Alto Medical Foundation-Santa Cruz
    Santa Cruz California 95065 United States

Details

Status
currently not accepting new patients, but might later
Start Date
Sponsor
Alliance for Clinical Trials in Oncology
ID
NCT02523014
Phase
Phase 2
Study Type
Interventional
Last Updated
June 8, 2018