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    Clinical Trial Results:
    Phase Ib/II trial of copanlisib, a selective PI3K inhibitor, in combination with cetuximab in patients with recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) harboring a PI3KCA mutation/amplification and/or a PTEN loss

    Summary
    EudraCT number
    2015-004340-19
    Trial protocol
    FR  
    Global end of trial date
    21 Feb 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    12 Mar 2022
    First version publication date
    12 Mar 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    UC-0130/1507
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02822482
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    UNICANCER
    Sponsor organisation address
    101 rue de Tolbiac, Paris, France, 75013
    Public contact
    Nourredine AIT RAHMOUNE, UNICANCER, +33 171936704, n.ait-rahmoune@unicancer.fr
    Scientific contact
    Nourredine AIT RAHMOUNE, UNICANCER, +33 171936704, n.ait-rahmoune@unicancer.fr
    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
    22 Apr 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    21 Feb 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    21 Feb 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study is to determine the MTD of copanlisib used in combination with cetuximab and the RP2D in the phase Ib part and to evaluate the efficacy of the combination at the RP2D in the phase II. Determination of the MTD will be based on the occurrence of DLT during cycle 1.
    Protection of trial subjects
    In order to ensure the protection of the rights, safety and well-being of trial subjects, this clinical trial was performed in compliance with the principles laid down in the declaration of Helsinki, good Clinical Practice and European regulation
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    14 Dec 2015
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    4 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 11
    Worldwide total number of subjects
    11
    EEA total number of subjects
    11
    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)
    0
    Adults (18-64 years)
    8
    From 65 to 84 years
    3
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Date of first inclusion: 07-Mar-2017 Date of early study termination date: 22-Mar-2019

    Pre-assignment
    Screening details
    Patients with recurrent and/or metastatic HNSCC after failure of platinum-based chemotherapy, not amenable to curative treatment with surgery and/or chemotherapy and/or radiotherapy.

    Period 1
    Period 1 title
    Phase Ib (first step) (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Phase Ib - Determination of MDT
    Arm description
    The Phase IB is to determine the maximum tolerated dose (MTD) of copanlisib used in combination with cetuximab and the recommended phase II dose (RP2D) in the phase Ib part.
    Arm type
    Experimental

    Investigational medicinal product name
    copanlisib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    The phase Ib was designed as a dose-escalation study. The objective of this phase was to determine the RP2D. The study was conducted using the modified Fibonacci "3+3" method. -Dose level -1: 3 to 6 patients - Dose level 1: 3 to 6 patients - Dose level 2: 3 to 6 patients 30 mg Dose Level # -1 45 mg Dose Level # 1 60 mg Dose Level # 2

    Investigational medicinal product name
    Cetuximab
    Investigational medicinal product code
    Other name
    Cetuximab
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Injection
    Dosage and administration details
    Weekly infusion, with a loading dose of 400 mg/m² then 250 mg/m².

    Number of subjects in period 1
    Phase Ib - Determination of MDT
    Started
    11
    Completed
    11

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Phase Ib - Determination of MDT
    Reporting group description
    The Phase IB is to determine the maximum tolerated dose (MTD) of copanlisib used in combination with cetuximab and the recommended phase II dose (RP2D) in the phase Ib part.

    Reporting group values
    Phase Ib - Determination of MDT Total
    Number of subjects
    11 11
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    8 8
        From 65-84 years
    3 3
        85 years and over
    0 0
    Gender categorical
    Units: Subjects
        Female
    0 0
        Male
    11 11

    End points

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    End points reporting groups
    Reporting group title
    Phase Ib - Determination of MDT
    Reporting group description
    The Phase IB is to determine the maximum tolerated dose (MTD) of copanlisib used in combination with cetuximab and the recommended phase II dose (RP2D) in the phase Ib part.

    Primary: Determination of the MTD

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    End point title
    Determination of the MTD [1]
    End point description
    End point type
    Primary
    End point timeframe
    DLTs occurence At least, 3 patients will be treated at each dose level until a DLT is encountered during the first cycle of 29 days (DLT period).
    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: Early termination of the study due to poor recruitment and short study treatment duration. Only 11 patients were included during the phase 1b
    End point values
    Phase Ib - Determination of MDT
    Number of subjects analysed
    11
    Units: Nimber of DLT
    2
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events occured during all the course of study treatment
    Adverse event reporting additional description
    Concerning the adverse event (not serious) the number of "Subjects affected number" and the "Occurrences all number" are not available and are always noted "1" in the section of adverse event.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20
    Reporting groups
    Reporting group title
    Phase Ib - Determination of MDT
    Reporting group description
    -

    Serious adverse events
    Phase Ib - Determination of MDT
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 11 (72.73%)
         number of deaths (all causes)
    9
         number of deaths resulting from adverse events
    1
    Investigations
    Weight loss
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Haemorrhage
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oral hemorrhage
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Interstitial lung disease
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Skin and subcutaneous tissue disorders
    Ulcero-necrotic skin lesion
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Shoulder pain
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Lung abscess
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Septicemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular access related infection
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    HYPOKALEMIA
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Phase Ib - Determination of MDT
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    11 / 11 (100.00%)
    Investigations
    Blood bilirubin increased
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    GGT increased
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Potassium increased
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Weight loss
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Creatinine increased
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Eosinophil count increased
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hypercalcaemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Vascular disorders
    Bleeding
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hypertension
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Nervous system disorders
    Somnolence
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Thrombocytopenia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Leukopenia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Lymphopenia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Oedema
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Oedema lower limb
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Oedema upper limb
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Face oedema
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    General physical health deterioration
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Inflammation
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Neck oedema
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Pain
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Thoracic pain
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Xerosis
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Dysphagia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    HYPOCHONDRIUM PAIN RIGHT
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Oral haemorrhage
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Oral lesion
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hepatobiliary disorders
    Cholestasis
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Vasovagal attack
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Dyspnoea
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Interstitial pneumonitis
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Sputum bloody
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Localised skin reaction
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Skin erythema
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Unspecified nail disease
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Erythema periorbital
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Rash acneiform
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Cervical pain
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Cervicalgia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Shoulder pain
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Infections and infestations
    Bronchopulmonary infection
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Device related infection
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Lung abscess
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Medical device site pustule
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Septicaemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Tracheostomy infection
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Folliculitis
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Paronychia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Cytolysis
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Decreased appetite
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hyperglycaemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hyperkalaemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hypoalbuminemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hypocalcaemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hypokalaemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1
    Hypomagnesaemia
         subjects affected / exposed
    1 / 11 (9.09%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 May 2016
    -Update of IB, IMP labelling -The protocol was clarify concerning the flow-chart, the definition of DLT. Addition of new criteria for IMP discontinuation, modification of inclusion criterai (protection of patients). Clarification of rules related to management of hyperglycemia due to IMP. Introduction of rules in case of hypertension due to IMP. -information ans consent were updated
    23 Mar 2017
    - Patients without PI3KCA mutation/amplification and/or a PTEN loss can be included -update of adverses rections due to IMP
    27 Feb 2018
    -Adition of Metformine (premedication) for the IMP administration - Extension of the inclusion period - Update of adverse reaction due to IMP

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    01 Apr 2019
    Early termination of study due to poor recruitment and short study treatment duration
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Early termination of study due to poor recruitment and short study treatment duration. Only 11 patients were included during the phase 1b of the study(determination of MTD).
    For support, Contact us.
    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
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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