Alectinib: Participants will receive twice-daily alectinib capsules on Days 1-28 of each 28-day cycle
Study summary
This study will evaluate the safety, pharmacokinetics, and efficacy of alectinib in children and adolescents with ALK fusion-positive solid or CNS tumors for whom prior treatment has proven to be ineffective or for whom there is no satisfactory standard treatment available.
Eligibility
Sex
ALL
Min age
—
Max age
17 Years
Healthy volunteers
No
Inclusion Criteria
* Histologically confirmed diagnosis of CNS or solid tumors with documented evidence of ALK gene fusions as assessed centrally through the use of the investigational F1CDx assay or based on pre-existing NGS test results
* Disease status: prior treatment proven to be ineffective (i.e. relapsed or refractory), or for whom there is no satisfactory standard treatment available. Disease should be measurable and evaluable as defined by Response Evaluation Criteria in Solid Tumors (RECIST) v 1.1, or Response Assessment in Neuro-oncology criteria (RANO) +/- bone marrow criteria for primary CNS tumors or International Neuroblastoma Response Criteria (INRC)
* Available tumor tissue for submission to the Sponsor from active disease, obtained subsequent to last anti-cancer therapy regimen administered and obtained prior to study enrollment (preferred option), or archival tumor tissue from original diagnosis, or willingness to undergo a core or excisional biopsy sample collection prior to enrollment
* For participants \< 16 years old, Lansky Performance Status \>/= 50%
* For participants \>/= 16 years old, Karnofsky Performance Status \>/= 50%
* Adequate bone marrow function as defined by the protocol within at least 28 days prior to initiation of study drug
* Participant and/or caregiver willingness and ability to complete clinical outcome assessments throughout the study using either electronic, paper, or interviewer methods
* For females of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception, and agreement to refrain from donating eggs, as defined by the protocol
* For males who are not surgically sterile: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception, and agreement to refrain from donating sperm, as defined by the protocol
Exclusion Criteria
* Medical history of: prior use of ALK inhibitors; diagnosis of Anaplastic Large Cell Lymphoma (ALCL); any gastrointestinal disorder that may affect absorption of oral medications, such as mal-absorption syndrome or status post-major bowel resection; history of organ transplant; stem cell infusions as defined by the protocol
* Substance abuse within 12 months prior to screening
* Familial or personal history of congenital bone disorders, bone metabolism alterations, or osteopenia
* Treatment with investigational therapy 28 days prior to initiation of study drug
* Liver or kidney disease as defined by the protocol
* National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grade \>/=3 toxicities attributed to any prior therapy such as radiotherapy (excluding alopecia), which have not shown improvement and are strictly considered to interfere with alectinib
* Co-administration of anti-cancer therapies other than those administered in this study
* Active hepatitis B or C virus (HBV, HBC), or known HIV-positivity or AIDS-related illness
* Any clinically significant concomitant disease or condition that could interfere with, or for which the treatment might interfere with, the conduct of the study or the absorption of oral medications or that would, in the opinion of the Principal Investigator, pose an unacceptable risk to the participant in this study
* Any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol requirements and/or follow-up procedures; such conditions should be discussed with the participant before trial entry
* Planned procedure or surgery during the study except as permitted treatment as defined by the protocol
* Infection considered by the investigator to be clinically uncontrolled or of unacceptable risk to the participant upon induction of neutropenia, including participants who are, or should be, on antimicrobial agents for the treatment as active infection
* Pregnant or breastfeeding, or intending to become pregnant during the study or within 3 months after the final dose of alectinib
Primary outcome measure(s)
Incidence of Participants with Dose-Limited Toxicities (DLTs) — Cycle 1 (cycle length = 28 days)
Percentage of Participants with Adverse Events — Up to 10 years
Plasma Concentration of Alectinib — Up to 10 years
Plasma Concentration of Alectinib Metabolite (M4) — Up to 10 years
Confirmed Objective Response Rate (ORR): Defined as the Proportion of Participants with Complete Response (CR) or Partial Response (PR) on two Consecutive Occasions >/= 4 Weeks Apart, as Determined by Blinded Independent Central Review (BICR) — Up to 10 years
Trial sites (31)
Facility
City
Region
Status
Lucile Packard Children's Hospital
Palo Alto
California
Johns Hopkins All Children's Hospital
St. Petersburg
Florida
University of Michigan, C.S. Mott Children's Hospital
Ann Arbor
Michigan
Children's Minnesota
Minneapolis
Minnesota
Memorial Sloan Kettering Cancer Center
New York
New York
Cincinnati Children's Hospital Medical Center
Cincinnati
Ohio
St. Jude Children'S Research Hospital
Memphis
Tennessee
Sydney Children's Hospital
Randwick
New South Wales
Royal Children's Hospital
Parkville
Victoria
Hospital de Cancer de Barretos
Barretos
São Paulo
Graacc-Grupo de Apoio ao adolescente e a crianca com cancer
São Paulo
São Paulo
The Hospital for Sick Children
Toronto
Ontario
CHU Sainte-Justine
Montreal
Quebec
Beijing Children's Hospital, Capital Medical University
Beijing
China
Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Shanghai
China
Rigshospitalet
København Ø
Denmark
Centre Léon Bérard, Institut d?Hémato-Oncologie Pédiatrique
Lyon
France
Hôpital de la Timone, Oncologie Pédiatrique
Marseille
France
Institut Curie - Centre de Lutte Contre le Cancer (CLCC) de Paris
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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