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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01742286
Registration number
NCT01742286
Ethics application status
Date submitted
30/11/2012
Date registered
5/12/2012
Titles & IDs
Public title
Phase I Study of LDK378 in Pediatric, Malignancies With a Genetic Alteration in Anaplastic Lymphoma Kinase (ALK)
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Scientific title
A Phase I, Open-label, Dose Escalation Study of LDK378 in Pediatric Patients With Malignancies That Have a Genetic Alteration in Anaplastic Lymphoma Kinase (ALK)
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Secondary ID [1]
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2012-002074-31
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Secondary ID [2]
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CLDK378X2103
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
ALK-activated Tumors
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Condition category
Condition code
Cancer
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Cancer
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0
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Lymphoma (non Hodgkin's lymphoma) - Low grade lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Ceritinib
Experimental: LDK378 - All participants were administered a single-agent LDK378 (Ceritinib) orally, once daily, continuously in fasted or fed conditions.
Treatment: Drugs: Ceritinib
LDK378 is a capsule taken by mouth, contents can be mixed with food for pediatric patients or mixed with water and given via nasogastric/gastric (NG/G) tube. For patients in fasted group: 1-2 tablespoons (15-30 mL) of an appropriate food such as apple sauce or non-fat yogurt and a glass of water were allowed.
For patients in the fed cohort: LDK378 was taken with, or within 30 minutes after finishing a low-fat light snack containing 100-300 calories and 1.5-2 grams of fat.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Incidence Rate of Dose Limiting Toxicities (DLTs) Occurring During First Cycle of Treatment
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Assessment method [1]
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A DLT is defined as an adverse event or abnormal laboratory value assessed as unrelated to disease, disease progression, inter-current illness, or concomitant therapies that occurs within the first 21 days of treatment with LDK378 and meets a specified defined criteria. A participant with multiple occurrences of DLTs under one treatment is counted only once in the Adverse Event category for that treatment. A participant with multiple DLTs within a primary system organ class is counted only once in the total row.
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Timepoint [1]
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up to day 21 after the patient's first dose; cycle = within the first 21 days of patient's first dose
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Secondary outcome [1]
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Summary of Best Overall Response by Overall Response Rate (ORR) Per Investigator Assessment
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Assessment method [1]
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ORR is the percentage of participants with a best overall response of complete response (CR) or partial response (PR). ORR was assessed per Investigator as per RECIST 1.1 in participants with neuroblastoma and other solid tumors, and by International Working Group (IWG) criteria in patients with lymphoma. Per RECIST 1.1 (for neuroblastoma \& other solid tumors): CR: disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to \< 10 mm. PR: at least a 30% decrease in the sum of diameter of all target lesion, taking as reference the baseline sum diameters. Per IWG criteria (for patients with lymphoma): CR: normalization of all index nodal lesions or complete disappearance of all index extranodal lesions. PR: at least 50% decrease from baseline in the sum of diameters of all index lesions.
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Timepoint [1]
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30 months
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Secondary outcome [2]
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Duration of Response (DoR) Per Investigator Assessment
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Assessment method [2]
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DOR is defined as the time from first documented response (PR or CR) to the date of first documented disease progression (PD) or death due to any cause. DOR was assessed per Investigator as per RECIST 1.1 in participants with neuroblastoma and other solid tumors, and by International Working Group (IWG) criteria in patients with lymphoma. Per RECIST 1.1 (for neuroblastoma \& other solid tumors): CR: disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to \< 10 mm. PR: at least a 30% decrease in the sum of diameter of all target lesion, taking as reference the baseline sum diameters. Per IWG criteria (for patients with lymphoma): CR: normalization of all index nodal lesions or complete disappearance of all index extranodal lesions. PR: at least 50% decrease from baseline in the sum of diameters of all index lesions.
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Timepoint [2]
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30 months
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Secondary outcome [3]
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Progression Free Survival (PFS) Based on Investigator Assessment
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Assessment method [3]
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PFS is the time from date of randomization/start of treatment to the date of event defined as the first documented progression or death due to any cause. PFS was assessed per Investigator as per RECIST 1.1 in participants with neuroblastoma and other solid tumors, and by International Working Group (IWG) criteria in patients with lymphoma. Per RECIST 1.1 (for neuroblastoma \& other solid tumors): CR: disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to \< 10 mm. PR: at least a 30% decrease in the sum of diameter of all target lesion, taking as reference the baseline sum diameters. Per IWG criteria (for patients with lymphoma): CR: normalization of all index nodal lesions or complete disappearance of all index extranodal lesions. PR: at least 50% decrease from baseline in the sum of diameters of all index lesions.
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Timepoint [3]
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30 months
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Secondary outcome [4]
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Plasma Concentration Time Profiles by Treatment Group in Escalation Phase
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Assessment method [4]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. Only PK plasma concentrations with non-missing sampling date and time, and for which the last dose date and time prior to the PK sample draw are non-missing, were included in the PK analysis.
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Timepoint [4]
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0hr pre-dose, 2hrs post-dose, 4hrs post-dose, 6hrs post-dose & 24hrs post-dose in Cycle1 Day1 & Cycle 2 day 1; 0hr pre-dose in Cycle 1 Day 15, Cycle 2 Day1, Cycle 2 Day 2, Cycle 3 day 1 & Cycle 4 Day 1
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Secondary outcome [5]
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Plasma Concentration Time Profiles by Treatment Group in Expansion Phase
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Assessment method [5]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. Only PK plasma concentrations with non-missing sampling date and time, and for which the last dose date and time prior to the PK sample draw are non-missing, were included in the PK analysis.
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Timepoint [5]
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0hr pre-dose Cycle 1 Day 1, cycle 1 Day 15; 0hr pre-dose, 2hrs post-dose, 4hrs post-dose, 6hrs post-dose & 24hrs post-dose in Cycle2 Day1; 0hr pre-dose in Cycle2 Day2, Cycle 3 Day 1 & Cycle 4 Day 1
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Secondary outcome [6]
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Pharmacokinetics (PK) Parameters: AUC0 - 24h & AUClast in Cycle 1 Day 1 - Dose Escalation Phase (Single Dose)
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Assessment method [6]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. AUC: Area under the plasma (serum, or blood) concentration versus time curve AUClast: Area under the concentration-time curve from time zero to the last measureable concentration time AUC0-24h: Area under the plasma concentration-time curve t=0-24 h
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Timepoint [6]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [7]
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Pharmacokinetics (PK) Parameters: AUC0 - 24h & AUClast in Cycle 2 Day 1 - Dose Escalation Phase (Single Dose)
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Assessment method [7]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. AUC: Area under the plasma (serum, or blood) concentration versus time curve AUClast: Area under the concentration-time curve from time zero to the last measureable concentration time; AUC0-24h: Area under the plasma concentration-time curve t=0-24 h
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Timepoint [7]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [8]
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Pharmacokinetics (PK) Parameters: AUC0 - 24h & AUClast in Cycle 2 Day 1 - Dose Expansion Phase (Multiple Dose)
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Assessment method [8]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. In this phase ceritinib was expanded at 500mg/m2 fed and 510mg/m2 fasted administered orally once daily and was assessed only at steady state, Cycle 2 Day 1.
AUC: Area under the plasma (serum, or blood) concentration versus time curve AUClast: Area under the plasma (serum, or blood) concentration versus time curverea under the concentration-time curve from time zero to the last measureable concentration time AUC0-24h: Area under the plasma concentration-time curve t=0-24 h
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Timepoint [8]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [9]
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PK Parameter: Cmax in Cycle 1 Day 1 - Dose Escalation Phase (Single Dose)
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Assessment method [9]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. Cmax: Maximum (peak) concentration of drug
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Timepoint [9]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [10]
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PK Parameter: Cmax in Cycle 2 Day 1 - Dose Escalation Phase (Single Dose)
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Assessment method [10]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. Cmax: Maximum (peak) concentration of drug.
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Timepoint [10]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [11]
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PK Parameter: Cmax in Cycle 2 Day 1 - Dose Expansion Phase (Multiple Dose)
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Assessment method [11]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. In this phase ceritinib was expanded at 500mg/m2 fed and 510mg/m2 fasted administered orally once daily and was assessed only at steady state, Cycle 2 Day 1.
Cmax: Maximum (peak) concentration of drug
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Timepoint [11]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [12]
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PK Parameter: Tmax in Cycle 1 Day 1 - Dose Escalation Phase (Single Dose)
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Assessment method [12]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. Tmax: The time to reach maximum plasma concentration
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Timepoint [12]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [13]
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PK Parameter: Tmax in Cycle 2 Day 1 - Dose Escalation Phase (Single Dose)
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Assessment method [13]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. Tmax: The time to reach maximum plasma concentration
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Timepoint [13]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [14]
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PK Parameter: Tmax in Cycle 2 Day 1 - Dose Expansion Phase (Multiple Dose)
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Assessment method [14]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. In this phase ceritinib was expanded at 500mg/m2 fed and 510mg/m2 fasted administered orally once daily and was assessed only at steady state, Cycle 2 Day 1.
Characterize single and multiple-dose PK of LDK378 in pediatric patients. Tmax: The time to reach maximum plasma concentration
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Timepoint [14]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Secondary outcome [15]
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PK Parameter: Racc in Dose Escalation Phase Cycle 2 Day 1
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Assessment method [15]
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Characterize single and multiple-dose PK of LDK378 in pediatric patients. Racc: Accumulation ratio
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Timepoint [15]
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0hr pre-dose, 2, 4, 6 & 24hrs post-dose
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Eligibility
Key inclusion criteria
* Diagnosed with a locally advanced or metastatic malignancy that has progressed despite standard therapy, or for which no effective standard therapy exists
* Age = 12 months and < 18 years
* The tumor must carry a genetic alteration of ALK
* Patients must have evaluable or measurable disease.
* Karnofsky performance status score = 60% for patients > 12 years of age; Lansky score = 50% for patients = 12 years of age.
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Minimum age
12
Months
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Maximum age
17
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria:
* Symptomatic central nervous system (CNS) metastases who are neurologically unstable or require increasing doses of steroids or local CNS-directed therapy (such as radiotherapy, surgery or intrathecal chemotherapy) to control their CNS disease
* Inadequate end organ function as defined by specified laboratory values
* Body surface area (BSA) < 0.35 m2
* Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of LDK378 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, or malabsorption syndrome)
* Use of medications that are known to be strong inhibitors or inducers of CYP3A4/5 that cannot be discontinued at least 1 week prior to start of treatment with LDK378 and for the duration of the study
* Use of medications that are mainly metabolized by CYP3A4/5 or CYP2C9 that cannot be discontinued at least 1 week prior to start of treatment with LDK378 and for the duration of the study
* History of interstitial lung disease or interstitial pneumonitis, including clinically significant radiation pneumonitis
* History of pancreatitis or history of increased amylase or lipase that was due to pancreatic disease.
* Medications with a known risk of prolongation of QT interval
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
28/08/2013
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
26/04/2019
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Sample size
Target
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Accrual to date
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Final
83
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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Novartis Investigative Site - Randwick
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Recruitment hospital [2]
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Novartis Investigative Site - Parkville
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Recruitment postcode(s) [1]
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2130 - Randwick
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Recruitment postcode(s) [2]
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3052 - Parkville
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Massachusetts
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United States of America
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New York
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United States of America
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Ohio
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United States of America
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State/province [4]
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Tennessee
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Country [5]
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United States of America
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State/province [5]
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Texas
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Country [6]
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Canada
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State/province [6]
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Ontario
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Country [7]
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France
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State/province [7]
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Paris
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Country [8]
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France
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State/province [8]
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Villejuif Cedex
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Country [9]
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Germany
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State/province [9]
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Nordrhein-Westfalen
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Country [10]
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Germany
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State/province [10]
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Berlin
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Country [11]
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Germany
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State/province [11]
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Essen
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Country [12]
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Italy
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State/province [12]
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MI
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Country [13]
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Korea, Republic of
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State/province [13]
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Seoul
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Country [14]
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Netherlands
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State/province [14]
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CS
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Country [15]
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Netherlands
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State/province [15]
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Amsterdam
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Country [16]
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Netherlands
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State/province [16]
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Rotterdam
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Country [17]
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Spain
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State/province [17]
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Catalunya
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Country [18]
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Spain
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State/province [18]
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Comunidad Valenciana
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Country [19]
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Spain
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State/province [19]
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Madrid
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Country [20]
0
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United Kingdom
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State/province [20]
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Birmingham
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Country [21]
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United Kingdom
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State/province [21]
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Surrey
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Novartis Pharmaceuticals
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study was to estimate the maximum tolerated dose and/or recommended dose for expansion of LDK378 as a single agent, assess safety, tolerability and anti-tumor activity and characterize single and multiple-dose pharmacokinetics when administered orally to pediatric patients with ALK-activated tumors, with and without food.
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Trial website
https://clinicaltrials.gov/study/NCT01742286
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Trial related presentations / publications
Fischer M, Moreno L, Ziegler DS, Marshall LV, Zwaan CM, Irwin MS, Casanova M, Sabado C, Wulff B, Stegert M, Wang L, Hurtado FK, Branle F, Geoerger B, Schulte JH. Ceritinib in paediatric patients with anaplastic lymphoma kinase-positive malignancies: an open-label, multicentre, phase 1, dose-escalation and dose-expansion study. Lancet Oncol. 2021 Dec;22(12):1764-1776. doi: 10.1016/S1470-2045(21)00536-2. Epub 2021 Nov 12. Brivio E, Zwaan CM. ALK inhibition in two emblematic cases of pediatric inflammatory myofibroblastic tumor: Efficacy and side effects. Pediatr Blood Cancer. 2019 May;66(5):e27645. doi: 10.1002/pbc.27645. Epub 2019 Jan 29.
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Public notes
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Contacts
Principal investigator
Name
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Novartis Pharmaceuticals
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Address
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Novartis Pharmaceuticals
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/86/NCT01742286/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/86/NCT01742286/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT01742286