E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10065252 |
E.1.2 | Term | Solid tumor |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To determine the overall response rate (ORR) as measured by the proportion of subjects with best overall confirmed response of complete response (CR) or partial response (PR) by the Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1) or Response Assessment in Neuro-Oncology (RANO) criteria, as appropriate, following treatment with LOXO-101 in adult subjects with an advanced cancer harboring a fusion involving NTRK1, NTRK2, or NTRK3 (collective referred to as NTRK fusions) for each tumor-specific disease cohort |
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E.2.2 | Secondary objectives of the trial |
• To evaluate the duration of response (DOR) in subjects with best overall response of CR or PR. • To estimate the proportion of subjects that has any tumor regression as a best response. •To evaluate the duration of progression-free survival (PFS) following initiation of LOXO-101. • To evaluate the duration of overall survival (OS) following initiation of LOXO-101. • To assess the safety profile and tolerability of LOXO-101. • To compare the duration of PFS following initiation of LOXO-101 to that following the line of therapy immediately preceding LOXO-101 in subjects who have received prior therapy. • To evaluate the clinical benefit rate (CBR) based on the proportion of subjects with best overall response of CR, PR, or stable disease lasting 16 or more weeks following initiation of LOXO-101. • To evaluate the concordance of prior molecular profiling that detected an NTRK fusion within the subject’s tumor with the diagnostic test being evaluated by the Sponsor
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Locally-advanced or metastatic malignancy with an NTRK1, NTRK2 or NTRK3 gene fusion, identified through molecular assays as routinely performed at CLIA or other similarly-certified laboratories. 2. Subjects must have received prior standard therapy appropriate for their tumor type and stage of disease, or in the opinion of the Investigator, would be unlikely to tolerate or derive clinical benefit from appropriate standard of care therapy. 3. Subjects must have at least one measurable lesion as defined by RECIST 1.1 (Eisenhauer 2009). Subjects without RECIST measurable disease (e.g., evaluable disease only) will be eligible for enrollment to Cohort 8, regardless of tumor type. Subjects in Cohort 7 (primary CNS tumors) should meet the following criteria: a. Have received prior treatment including radiation and/or chemotherapy, with radiation completed > 12 weeks prior to C1D1 of therapy, as recommended or appropriate for that CNS tumor type. b. Have ≥ 1 site of bi-dimensionally measurable disease (confirmed by magnetic resonance imaging [MRI] and evaluable by RANO criteria), with the size of at least one of the measurable lesions ≥ 1 cm in each dimension and noted on more than one imaging slice. c. Imaging study performed within 28 days before enrollment while on stable dose steroid medication for at least 5 days immediately before and during the imaging study. 4. At least 18 years of age. 5. Eastern Cooperative Oncology Group (ECOG) score of ≤ 2. 6. Archived tumor tissue. If archival tissue is known to not be available then an on-study tumor biopsy should be attempted if it can be safely performed. 7. Adequate organ function as defined by the following criteria: a. Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) < 2.5 × upper limit of normal (ULN), or AST and ALT < 5 × ULN if liver function abnormalities are due to underlying malignancy. b. Total bilirubin < 2.5 × ULN, except in the setting of biliary obstruction. Subjects with a known history of Gilberts Disease and an isolated elevation of indirect bilirubin are eligible. c. Serum creatinine < 2.0 × ULN OR an estimated glomerular filtration rate ≥ 30 mL/minute using the Cockroft-Gault formula: (140 – age) x body weight (kg) × 0.85 (if female) serum creatinine (mg/dL) × 72 8. Ability to swallow capsules, comply with outpatient treatment, laboratory monitoring, and required clinic visits for the duration of study participation. 9. Willingness of men and women of reproductive potential to observe conventional and effective birth control for the duration of treatment and for 3 months following study completion. |
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E.4 | Principal exclusion criteria |
1. Investigational agent or anticancer therapy within 2 weeks prior to planned start of LOXO-101 or 5 half-lives, whichever is shorter, and with recovery of clinically significant toxicities from that therapy. Symptomatic or unstable brain metastases. (Note: Subjects with asymptomatic brain metastases are eligible to participate in the study). Subjects with primary CNS tumors are eligible. 3. Uncontrolled concurrent malignancy that would limit assessment of efficacy of LOXO-101. 4. Active uncontrolled systemic bacterial, viral, or fungal infection, unstable cardiovascular disease or other systemic disease that would limit compliance with study procedures. 5. Malabsorption syndrome or other condition affecting oral absorption. 6. Inability to discontinue treatment with a strong CYP3A4 inhibitor or inducer prior to start of treatment initiation. 7. Pregnancy or lactation. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Best overall response of confirmed CR or PR as measured by RECIST 1.1 or RANO criteria, as appropriate to tumor type. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Every 2-3 months from baseline until disease progression |
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E.5.2 | Secondary end point(s) |
• DOR: determined for subjects with best overall response of confirmed CR or PR • CBR: best overall response of confirmed CR, PR, or stable disease lasting 16 or more weeks following the initiation of LOXO-101. • PFS: number of months from initiation of LOXO 101 to the earlier of disease progression or death due to any cause. • OS: number of months from the initiation of LOXO 101 to the date of death due to any cause. • Comparison of PFS following initiation of LOXO 101 to that following the line of therapy immediately preceding LOXO 101 in each subject who has received prior therapy. • Incidence, severity, and duration of adverse events, including all, serious, and those considered treatment-related. • Changes from baseline in clinical safety laboratory values and vital signs.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Every 2-3 months from baseline until disease progression or toxicity onset or death |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 7 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
European Union |
Korea, Republic of |
Singapore |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 1 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |