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    Clinical Trial Results:
    An Extension Protocol for Subjects Who Were Previously Enrolled in Other Tivantinib (ARQ 197) Protocols

    Summary
    EudraCT number
    2010-020151-31
    Trial protocol
    DE   LV   IT  
    Global end of trial date
    14 Jan 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    05 Jun 2021
    First version publication date
    05 Jun 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ARQ197-299
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01178411
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Merck Sharp & Dohme Corp.
    Sponsor organisation address
    2000 Galloping Hill Road, Kenilworth, NJ, United States, 07033
    Public contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
    Scientific contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    14 Jan 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    14 Jan 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    14 Jan 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This is an open label extension study that will allow participants to continue to receive study therapy when the original studies into which they were enrolled have reached their designated end-dates. This extension study is designed to further evaluate the safety and tolerability of tivantinib (ARQ 197) monotherapy or in combination with other drug(s) when given to participants who tolerated previous treatment well and may benefit from the continuing treatment. This study enrolls participants from previous phase 1 (NCT01149720, NCT01517399, NCT01699061, NCT00612703, NCT00827177, and NCT00874042) and phase 2 (NCT00777309, NCT00557609, NCT00988741, NCT01395758, and NCT01055067) tivantinib studies that reached their designated end-dates. Participants in this extension protocol will provide further safety and tolerability information about tivantinib monotherapy or in combination with other drug(s) at the same dose(s), and same schedule(s) in which they were originally enrolled.
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review informed consent, and the protection of human subjects participating in biomedical research.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    31 Aug 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 1
    Country: Number of subjects enrolled
    Italy: 1
    Country: Number of subjects enrolled
    Russian Federation: 2
    Country: Number of subjects enrolled
    United States: 56
    Worldwide total number of subjects
    60
    EEA total number of subjects
    2
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    2
    Adults (18-64 years)
    29
    From 65 to 84 years
    28
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Adult male and female participants previously enrolled in phase 1 or phase 2 studies of tivantinib (ARQ 197) were eligible for enrollment.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Tivantinib (Monotherapy or Combination)
    Arm description
    Participants received tivantinib 360 mg twice daily by mouth as monotherapy or combination therapy.
    Arm type
    Experimental

    Investigational medicinal product name
    Tivantinib
    Investigational medicinal product code
    Other name
    ARQ 197
    Pharmaceutical forms
    Tablet, Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Tivantinib 360 mg (3 x 120 mg tablets or capsules) twice daily by mouth.

    Investigational medicinal product name
    Anti-cancer Combination Therapy
    Investigational medicinal product code
    Other name
    erlotinib, sorafenib, pemetrexed, docataxel, gemcitabine, irinotecan, cetuximab
    Pharmaceutical forms
    Solution for infusion, Tablet
    Routes of administration
    Intravenous use, Oral use
    Dosage and administration details
    Tivantinib 360 mg twice daily in combination with other anti-cancer therapy (eg, erlotinib, sorafenib, pemetrexed, docataxel, gemcitabine, irinotecan, and/or cetuximab) at the same dose and schedule in which they were administered in the original (previous) study.

    Number of subjects in period 1
    Tivantinib (Monotherapy or Combination)
    Started
    60
    Completed
    0
    Not completed
    60
         Adverse event, serious fatal
    1
         Consent withdrawn by subject
    4
         Progressive disease per clinician
    9
         Physician decision
    6
         Adverse event, non-fatal
    5
         Drug manufacturing ended
    1
         Protocol deviation
    1
         Progressive disease per RECIST
    32
         No reason provided
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Tivantinib (Monotherapy or Combination)
    Reporting group description
    Participants received tivantinib 360 mg twice daily by mouth as monotherapy or combination therapy.

    Reporting group values
    Tivantinib (Monotherapy or Combination) Total
    Number of subjects
    60 60
    Age categorical
    Units: Participants
        Adolescents (12-17 years)
    2 2
        Adults (18-64 years)
    29 29
        From 65-84 years
    28 28
        85 years and over
    1 1
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    61.6 ± 14.79 -
    Sex: Female, Male
    Units: Participants
        Female
    31 31
        Male
    29 29
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    0 0
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    4 4
        White
    54 54
        More than one race
    0 0
        Unknown or Not Reported
    2 2
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    12 12
        Not Hispanic or Latino
    48 48
        Unknown or Not Reported
    0 0

    End points

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    End points reporting groups
    Reporting group title
    Tivantinib (Monotherapy or Combination)
    Reporting group description
    Participants received tivantinib 360 mg twice daily by mouth as monotherapy or combination therapy.

    Primary: Extent of Exposure to ARQ 197 in Participants Benefiting from Prior ARQ 197 Therapy

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    End point title
    Extent of Exposure to ARQ 197 in Participants Benefiting from Prior ARQ 197 Therapy [1]
    End point description
    The duration of ARQ 197 exposure in this study was calculated as [(date of last dose of study drug - date of first dose of study drug) + 1]. Results refer to duration of ARQ 197 treatment in the present study only (i.e., does not include treatment received during participation in "feeder" studies). All participants who received ≥1 dose of study drug are included.
    End point type
    Primary
    End point timeframe
    Up to 3,021 days (up to 14-Jan-2019)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Per protocol, only descriptive statistics are presented.
    End point values
    Tivantinib (Monotherapy or Combination)
    Number of subjects analysed
    60
    Units: Days
        median (full range (min-max))
    125 (5 to 3021)
    No statistical analyses for this end point

    Secondary: Number of Participants with ≥1 Treatment-emergent Adverse Event (TEAE)

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    End point title
    Number of Participants with ≥1 Treatment-emergent Adverse Event (TEAE)
    End point description
    An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. All participants who received ≥1 dose of study drug are included.
    End point type
    Secondary
    End point timeframe
    Up to 3021 days
    End point values
    Tivantinib (Monotherapy or Combination)
    Number of subjects analysed
    60
    Units: Participants
    56
    No statistical analyses for this end point

    Secondary: Number of Participants Discontinuing Treatment Due to an AE

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    End point title
    Number of Participants Discontinuing Treatment Due to an AE
    End point description
    An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. All participants who received ≥1 dose of study drug are included.
    End point type
    Secondary
    End point timeframe
    Up to 3,021 days
    End point values
    Tivantinib (Monotherapy or Combination)
    Number of subjects analysed
    60
    Units: Participants
    6
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to 3021 days
    Adverse event reporting additional description
    All participants who received ≥1 dose of study drug are included.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    13.1
    Reporting groups
    Reporting group title
    Tivantinib (Monotherapy or Combination)
    Reporting group description
    Participants received tivantinib 360 mg twice daily by mouth as monotherapy or combination therapy.

    Serious adverse events
    Tivantinib (Monotherapy or Combination)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    19 / 60 (31.67%)
         number of deaths (all causes)
    4
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastases to central nervous system
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Aortic stenosis
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Superior vena caval occlusion
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Radical neck dissection
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombectomy
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Disease progression
         subjects affected / exposed
    2 / 60 (3.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory failure
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary mass
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory arrest
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Injury, poisoning and procedural complications
    Fractured Sacrum
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiopulmonary failure
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal mass
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Duodenal ulcer
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Jaundice cholestatic
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bile duct obstruction
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Pathological fracture
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dehydration
         subjects affected / exposed
    1 / 60 (1.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Tivantinib (Monotherapy or Combination)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    55 / 60 (91.67%)
    Investigations
    Weight decreased
         subjects affected / exposed
    8 / 60 (13.33%)
         occurrences all number
    11
    Nervous system disorders
    Headache
         subjects affected / exposed
    6 / 60 (10.00%)
         occurrences all number
    7
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    7 / 60 (11.67%)
         occurrences all number
    9
    Anaemia
         subjects affected / exposed
    6 / 60 (10.00%)
         occurrences all number
    11
    Thrombocytopenia
         subjects affected / exposed
    7 / 60 (11.67%)
         occurrences all number
    10
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    17 / 60 (28.33%)
         occurrences all number
    28
    Mucosal inflammation
         subjects affected / exposed
    5 / 60 (8.33%)
         occurrences all number
    6
    Oedema peripheral
         subjects affected / exposed
    7 / 60 (11.67%)
         occurrences all number
    8
    Pyrexia
         subjects affected / exposed
    5 / 60 (8.33%)
         occurrences all number
    5
    Pain
         subjects affected / exposed
    7 / 60 (11.67%)
         occurrences all number
    10
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    5 / 60 (8.33%)
         occurrences all number
    6
    Abdominal pain
         subjects affected / exposed
    7 / 60 (11.67%)
         occurrences all number
    13
    Constipation
         subjects affected / exposed
    6 / 60 (10.00%)
         occurrences all number
    6
    Diarrhoea
         subjects affected / exposed
    16 / 60 (26.67%)
         occurrences all number
    25
    Dyspepsia
         subjects affected / exposed
    4 / 60 (6.67%)
         occurrences all number
    5
    Nausea
         subjects affected / exposed
    14 / 60 (23.33%)
         occurrences all number
    23
    Vomiting
         subjects affected / exposed
    20 / 60 (33.33%)
         occurrences all number
    33
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    11 / 60 (18.33%)
         occurrences all number
    14
    Dyspnoea
         subjects affected / exposed
    11 / 60 (18.33%)
         occurrences all number
    16
    Rhinitis allergic
         subjects affected / exposed
    5 / 60 (8.33%)
         occurrences all number
    5
    Oropharyngeal pain
         subjects affected / exposed
    4 / 60 (6.67%)
         occurrences all number
    4
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    6 / 60 (10.00%)
         occurrences all number
    8
    Dry skin
         subjects affected / exposed
    6 / 60 (10.00%)
         occurrences all number
    10
    Rash
         subjects affected / exposed
    7 / 60 (11.67%)
         occurrences all number
    12
    Psychiatric disorders
    Depression
         subjects affected / exposed
    8 / 60 (13.33%)
         occurrences all number
    9
    Insomnia
         subjects affected / exposed
    6 / 60 (10.00%)
         occurrences all number
    6
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    8 / 60 (13.33%)
         occurrences all number
    8
    Musculoskeletal chest pain
         subjects affected / exposed
    4 / 60 (6.67%)
         occurrences all number
    6
    Infections and infestations
    Sinusitis
         subjects affected / exposed
    5 / 60 (8.33%)
         occurrences all number
    8
    Upper respiratory tract infection
         subjects affected / exposed
    7 / 60 (11.67%)
         occurrences all number
    9
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    12 / 60 (20.00%)
         occurrences all number
    14

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    16 Jun 2010
    The primary purposes of amendment (AM) 1 were to allow participants who previously received tivantinib monotherapy to receive combination therapy if that could benefit the participant in the opinion of the Investigator, and to modify laboratory test inclusion criteria.
    18 Feb 2014
    The primary purposes of AM 2 were to clarify that combination dose therapy regimen would be determined with sponsor approval, to allow for participants who had not yet started tivantinib therapy to initiate treatment for the first time, and to modify laboratory test inclusion criteria.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
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