Activity and Safety Study of BKM120 in Monotherapy in Patient With Metastatic Head and Neck Cancer Recurrent or Progressive
Conditions
Head and Neck Neoplasms - Neoplasm Metastasis - Recurrent Disease - Progressive Disease
Conditions: official terms
Head and Neck Neoplasms - Neoplasm Metastasis - Neoplasms
Conditions: Keywords
Metastatic head and neck cancer, PI3K inhibitor, Recurrent head and meck cancer, Progressive head and neck cancer, BKM120
Study Type
Interventional
Study Phase
Phase 2
Study Design
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Intervention
Name: BKM120
Type: Drug
Overall Status
Recruiting
Summary
The aim of this study is to determine the activity, to assess the safety and tolerance of BKM120 in adult patients with recurrent or metastatic head and neck cancer progressive under patin and cetuximab-based chemotherapy.
Detailed Description
BKM120 is a PI3K inhibitor. The PI3K/AKT signalling pathway deregulation is frequently observed in Head and neck cancer. In addition to its role in tumor genesis, the PI3K/AKT pathway seems to be involved in resistance to cetuximab.

In this context, the study proposal is to evaluate the clinical interest of a monotherapy with a PI3K inhibitor (BKM120, Novartis) in patients with metastatic head and neck cancers refractory or relapsing under platin and cetuximab based- chemotherapy. Since resistance to cetuximab can result from PIK3CA mutation, PIK3CA amplification or mutation upstream in the PI3K pathway, BKM120 activity will be evaluated in two parallel independent cohorts of patients: patients presenting a PI3KCA mutation and patients without a PI3KCA mutation.
Criteria for eligibility
Healthy Volunteers: No
Maximum Age: N/A
Minimum Age: 18 Years
Gender: Both
Criteria: Inclusion Criteria:

- Adult men and women ≥ 18 years at the day of inform consent signature.

- Patients with metastatic or relapsed head and neck cancer.(oropharynx, oral cavity, hypopharynx and larynx). Patients with cancer of nasopharynx (i.e. cavum cancer) are not eligible

- Documented progression or relapse after platin and cetuximab or anti-EGFR*-based chemotherapy (combination or sequential treatment) at time of study drug start

- Documented mutational status of PIK3CA before study drug start (molecular pre-screening).

- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2

- At least one measurable lesion by CT-scan as per RECIST 1.1

- Life expectancy > 12 weeks.

- Patients must be able to swallow capsules.

- Adequate bone marrow, renal and liver function as defined by the following tests (to be carried out 7 days prior to starting 1st treatment cycle):

- Absolute neutrophil count ≥ 1.0 x 109/L,

- Platelet count > 100 x 109/L,

- Haemoglobin value above 9 g/dL,

- INR ≤ 1.5

- Serum Creatinine ≤ 1.5 ULN

- Glomerular filtration rate calculated using Cockroft-Gault formula > 60ml/min (or MDRD formulae for patients older than 65 years)

- Potassium, calcium, magnesium within normal limits for the institution

- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < ULN (or < 3.0 x ULN if liver metastases are present))

- Serum bilirubin within normal range (or ≤ 1.5 ULN if liver metastases are present; or total bilirubin ≤ 3.0 ULN with direct bilirubin within normal range in patients with well documented Gilbert Syndrome- Appendix 03)

- Fasting plasma glucose (FPG) ≤ 120 mg/dL or ≤ 6.7 mmol/L.

- Women of childbearing potential (entering the study after a confirmed menstrual period and who have a negative pregnancy test within ≤ 72 hours before initiating study treatment) must agree to use two methods of medically acceptable forms of contraception during the whole treatment period and for 1 month (= 5 x t½ of BKM120) after the last treatment intake.

- Fertile males must use a highly effective contraception during dosing of any study agent + [5 x t1/2] + 12 weeks = contraception through 16 weeks after final dose of study therapy and should not father a child in this period. Female partner of male study subject: highly effective contraception during dosing of study agent + 4 weeks after final dose of study therapy

- Patient should be able and willing to comply with study visits and procedures as per protocol.

- Patient should understand, sign, and date the written voluntary informed consent form at the screening visit prior to any protocol-specific procedures performed.

- Patients must be covered by a medical insurance

Exclusion Criteria:

- Patient having received previous treatment with PI3K and/or mTOR inhibitors

- Patient with symptomatic CNS metastases NB: Patients with controlled and asymptomatic CNS metastases may participate in this trial. As such, the patient must have completed any prior treatment for CNS metastases > 28 days (including radiotherapy and/or surgery) prior to enrollment in this study and should not be receiving chronic corticosteroid therapy for the CNS metastases.

- Patient with a concurrent malignancy or has a malignancy within 3 years of study enrollment, (with the exception of adequately treated basal or squamous cell carcinoma or non-melanomatous skin cancer)

- Patient has any of the following mood disorders as judged by the Investigator or a Psychiatrist

- Medically documented history of or active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia, a history of suicidal attempt or ideation, or homicidal ideation (immediate risk of doing harm to others)

- Patients with active severe personality disorders (defined according to DSM- IV) are not eligible.

Note: for patients with psychotropic treatments ongoing at baseline, the dose and the schedule should not be modified within the previous 6 weeks prior to start of study drug.

- ≥ CTCAE grade 3 anxiety

- or meets the cut-off score of ≥ 12 in the PHQ-9 or a cut-off of ≥ 15 in the GAD-7 mood scale, respectively,

- or selects a positive response of '1, 2, or 3' to question number 9 regarding potential for suicidal thoughts ideation in the PHQ-9 (independent of the total score of the PHQ-9).

- Patient concurrently using other approved or investigational anti-neoplastic agent

- Patient who has received wide field radiotherapy ≤ 4 weeks or limited field radiation for palliation ≤ 2 weeks prior to starting study drug or who have not recovered to grade 1 or better from related side effects of such therapy (exceptions include alopecia).

- Patient having had major surgery within 14 days prior to starting study drug or has not recovered from major side effects of the surgery

- Patient with poorly controlled diabetes mellitus (i.e. HbA1c > 8 %)

- Patient with active cardiac disease including any of the following:

- Left Ventricular Ejection Fraction (LVEF) < 50% as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO)

- QTc > 480 (female) or 470 msec (male) on screening ECG (using the QTcF formulae)

- Angina pectoris that requires the use of anti-anginal medication

- Ventricular arrhythmias except for benign premature ventricular contractions

- Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication

- Conduction abnormality requiring a pacemaker

- Valvular disease with documented compromise in cardiac function

- Symptomatic pericarditis

- Patient with a history of cardiac dysfunction including any of the following;

- Myocardial infarction within the last 6 months, documented by persistent elevated cardiac enzymes or persistent regional wall abnormalities on assessment of LVEF function

- History of documented congestive heart failure (New York Heart Association functional classification III-IV)

- Documented cardiomyopathy

- Other cardiac arrhythmia not controlled with medication

- Patient currently receiving treatment with QT prolonging medication known to have a risk to induce Torsades de Pointes, and if the treatment cannot be discontinued or switched to a different medication prior to starting study drug

- Patient with impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of BKM120 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection)

- Patient receiving chronic treatment (> 5 days) with steroids or another immunosuppressive agent. Note: Topical applications (e.g., rash), inhaled sprays (e.g., obstructive airways diseases), eye drops or local injections (e.g., intra-articular) are allowed. Patients with previously treated brain metastases, who are on a stable low dose corticosteroids treatment (e.g., dexamethasone 2 mg/day, prednisolone 10 mg/day) for at least 14 days before start of study treatment, are eligible.

- Patient has other concurrent severe and/or uncontrolled medical condition that would, in the investigator's judgment contraindicate her participation in the clinical study (e.g.,chronic pancreatitis, active chronic hepatitis etc.)

- Patient has a history of non-compliance to medical regimen

- Patient is currently being treated with drugs known to be moderate and strong inhibitors or inducers of isoenzyme CYP3A, and the treatment cannot be discontinued or switched to a different medication prior to starting study drug.

- Patient has a known history of HIV infection

- Pregnant or nursing (lactating) woman

- Patient has a known hypersensitivity to any of the excipients of BKM120

- Patient has not recovered to grade 1 or better (except alopecia) from related side effects of any prior antineoplastic therapy

- Patient is currently receiving warfarin or other coumarin derived anti-coagulant, for treatment, prophylaxis or otherwise. Therapy with heparin, low molecular weight heparin (LMWH), or fondaparinux is allowed
Locations
Hopital St André
Bordeaux, France
Status: Recruiting
Contact: Alain Ravaud - 05 56 79 58 08 - alain.ravaud@chu-bordeaux.fr
Hôpital BEAUJON
Clichy, France
Status: Not yet recruiting
Contact: Sandrine FAIVRE, MD - sandrine.faivre@bjn.aphp.fr
Centre Oscar Lambret
Lille, France
Status: Recruiting
Contact: Audrey MAILLIEZ, MD - +33 3 20 29 59 43 - a-mailliez@o-lambret.fr
Centre Léon Bérard
Lyon, France
Status: Recruiting
Contact: Jérome FAYETTE, MD - jerome.fayette@lyon.unicancer.fr
Centre Val d'Aurelle - Paul Lamarque
Montpellier, France
Status: Recruiting
Contact: Didier CUPISSOL, MD - didier.cupissol@montpellier.unicancer.fr
Centre Antoine LACASSAGNE
Nice, France
Status: Recruiting
Contact: Frédéric PEYRADE, MD - frederic.peyrade@nice.unicancer.fr
Institut Curie
Paris, France
Status: Recruiting
Contact: Christophe LETOURNEAU, MD - christophe.letourneau@curie.net
Institut Gustave Roussy
Villejuif, France
Status: Recruiting
Contact: Caroline EVEN, MD - +33 1 42 11 46 17 - caroline.even@gustaveroussy.fr
Start Date
January 2013
Completion Date
September 2016
Sponsors
Centre Leon Berard
Source
Centre Leon Berard
Record processing date
ClinicalTrials.gov processed this data on July 28, 2015
ClinicalTrials.gov page