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BKM120+ temozolomide

Phase 3

Breast Cancer | Small molecule | Oncology |Novartis AG|Trials Updated: Apr 11, 2022

BKM120+ temozolomide target and mechanism

ModalitySmall molecule

Also known as BKM120

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLEDDMCBiomarker
Total Trials16
Total Enrollment2,431

FDA Designations

No designations recorded

BKM120+ temozolomide clinical trials

BKM120+ temozolomide · 16 trials · 15 indications

Phase 3 1Phase 2 7Phase 1 8
NCT01610284Phase III Study of BKM120/Placebo With Fulvestrant in Postmenopausal Patients With Hormone Receptor Positive HER2-negative Locally Advanced or Metastatic Breast Cancer Refractory to Aromatase InhibitorBreast Cancer
COMPLETED1,147 Analytics
PHASE3COMPLETED
Phase III Study of BKM120/Placebo With Fulvestrant in Postmenopausal Patients With Hormone Receptor Positive HER2-negative Locally Advanced or Metastatic Breast Cancer Refractory to Aromatase Inhibitor
Breast CancerUnlock trial analytics

Study Endpoints

Primary Endpoints

Progression Free Survival (PFS) Based on Local Investigator Assessment - Full Analysis Set (FAS) in Full Population, Main Study Cohort and PI3K Unknown Cohort
Date of randomization to the date of first documented tumor progression or death from any cause, whichever occurs first, reported between day of first patient randomized up to approximately 4 years

Progression Free Survival (PFS) is defined as the time from date of randomization to the date of first radiologically documented progression or death due to any cause. If a patient did not progress or die at the time of the analysis data cut-off or start of new antineoplastic therapy, PFS was censored at the date of the last adequate tumor assessment before the earliest of the cut-off date or the start date of additional anti-neoplastic therapy. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria RECIST v1.1, as 20% increase in the sum of diameter of all measured target lesions, taking as reference the smallest sum of diameter of all target lesions recorded at or after baseline and/or unequivocal progression of the non-target lesions and/or appearance of a new lesion. In addition to the relative increase of 20%, the sum must demonstrate an absolute increase of at least 5 mm.

Percent of Patients With Objective Response
up to three years

Percent of patients with Objective response and the Binomial Exact 95% confidence interval. Objective response is defined as having a best response of Complete Response (defined as disappearance of all target lesions and any pathological lymph nodes must have reduction in short axis to \<10mm) or Partial Response (defined as at least a 30% decrease in the sum of diameters of target lesions from the baseline sum diameters) by RECIST v1.1 criteria.

Rate of Clinical Benefit
Disease was evaluated radiologically at baseline and every 2 cycles on treatment then every 3 months up to 2 years. Participants in this study cohort were followed for response on average approximately 2 months.

Clinical benefit rate (CBR) was defined as the percentage of participants achieving complete response (CR), partial response (PR), or stable disease (SD) for 4 months or longer based on RECIST 1.1 criteria on treatment. Per RECIST 1.1 for target lesions: CR is the complete disappearance of all target lesions and PR is at least a 30% decrease in the sum of longest diameter (LD) of target lesions, taking as reference baseline sum LD. PD is at least a 20% increase in sum LD of target lesions (smallest sum LD reference), new lesions, and/or unequivocal progression of existing non-target lesions. Stable disease (SD) is defined as any condition not meeting the above criteria.

Pathological Complete Response (pCR) Rate at the Time of Surgery - All Participants
After 6 weeks

Rate of pCR (as defined by NSABP criteria - absence of invasive disease in the breast \[ypT0\]) is the number of of participants with pathological complete response (pCR) at the time of surgery. Participants were to be considered in pCR if there was no invasive cancer in the breast or only non-invasive in situ cancer in the breast specimen. NSABP guidelines do not take into account the histological nodal status to define the pCR.

Pathological Complete Response (pCR) Rate at the Time of Surgery - PIK3CA Wild Type (WT)
After 6 weeks

Rate of pCR (as defined by NSABP criteria - absence of invasive disease in the breast \[ypT0\]) is the number of of participants with pathological complete response (pCR) at the time of surgery. Participants were to be considered in pCR if there was no invasive cancer in the breast or only non-invasive in situ cancer in the breast specimen. NSABP guidelines do not take into account the histological nodal status to define the pCR.

Pathological Complete Response (pCR) Rate at the Time of Surgery - PIK3CA Mutant (MT)
After 6 weeks

Rate of pCR (as defined by NSABP criteria - absence of invasive disease in the breast \[ypT0\]) is the number of of participants with pathological complete response (pCR) at the time of surgery. Participants were to be considered in pCR if there was no invasive cancer in the breast or only non-invasive in situ cancer in the breast specimen. NSABP guidelines do not take into account the histological nodal status to define the pCR.

Participant Clinical Benefit Response Rate
Week 16

Clinical benefit rate for patients with solid tumors will be assessed using RECIST 1.1 and will include responses of Complete Response (CR) or Partial Response (PR) or Stable Disease (SD) at \>=16 weeks. For hematologic tumors other appropriate hematological response criteria was applied. Response criteria: CR=Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm., PR=At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters, SD=Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study, PD= At least a 20% increase in the sum of diameter of all measured target lesions, taking as reference the smallest sum of diameter of all target lesions recorded at or after baseline

Progression-free Survival (PFS)Assessed by Local Investigator's Assessment (Phase ll)
Every 8 weeks from randomization until disease progression up to 10 months after futility was analyzed

PFS was defined as the time from the date of randomization to the date of the event, defined as the first radiologically documented disease progression or death due to any cause. Progression was defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

Progression Free Survival (PFS) Rate as Per Investigator Local Review Measured Using RECIST 1.1 of Patients at Week 12
Week 12

PFS rate was defined as the percentage of participants who were progression free at 12 weeks. Participants were considered as a "success" for PFS rate evaluated at 12 weeks if they presented an overall response at their 2nd post-baseline tumor assessment.The enrollment into the study in either histology group would stop for futility if a PFS rate \<50% at 12 weeks was observed. No statistical analysis was planned for this primary outcome. The results of the primary objective was based on the data from the interim analysis that took place at the cut off dates: 10-Apr-2013 for non-squamous and 08-Jan-2014 for squamous group.

Best Overall Response Rate (BORR) According to PI3K Activation Pathway Status
24 months

BOR was determined based on investigator assessment of overall lesion response using RECIST criteria guidelines. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

Dose Escalation Analysis: Number of DLTs Observed in Evaluable Patients
8 weeks (10 weeks cohort 4 - this cohort was not opened)

The maximum tolerated dose (MTD) was defined as the highest dose at which no more than 1 of 6 evaluable patients or 0 of 3 evaluable patients experience a dose limiting toxicity (DLT). The study was carried out using a 3+3 dose escalation design. DLTs were defined per NCI CTCAE v 4.0. The following were considered DLT if they occur at any point whilst the patient is on study: 1) Any ≥ grade 3 non-haematological toxicity (excluding nausea, vomiting or diarrhoea) that requires hospital admission or which does not resolve to ≤ grade 2 within 7 consecutive days of optimal treatment. 2) Any ≥ grade 3 nausea, vomiting or diarrhoea will be considered DLT only if any of them persist for \>48 hours despite maximum supportive care. 3) ≥ Grade 3 pneumonitis 4) Any ≥ Grade 4 haematological toxicity. 5) Mood deterioration from baseline. DLT will be any grade ≥3 mood change if BL score of 2. DLT will be any grade ≥2 mood change if baseline score of ≤ 1.

Safety and Tolerability Analysis: Patients With Buparlisib Related Adverse Events
8 weeks (10 weeks cohort 4 - this cohort was not opened)

Adverse events (AEs) and Serious Adverse Events (SAEs) were also analysed for frequency. For further details, please consult the AEs/SAEs section.

Determine MTD and RP2D of the Combination of BKM120 and Olaparib, and the Combination of BYL719 and Olaparib
2 years

To determine the maximally tolerated dose (MTD) and recommended phase 2 dose (RP2D) of the combination of BKM120 and olaparib, and the combination of BYL719 and olaparib in patients with recurrent TNBC and HGSC.

Dose Limiting Toxicity (DLT)
During Cycle 1 (28 days)

An adaptive Bayesian logistic regression model (BLRM) for dose escalation with overdose control will guide the dose escalation. The recommended dose is the one with the highest posterior probablity of DLT in the target interval(16%,33%) among the doses fulfilling the overdose criterion that there is less than 25 % chance of excessive toxicity. A clinical synthesis of the available toxicity information including adverse event that are not DLTs, Pharmacokinetics, Pharmacodynamics, efficacy as well as the recommnendations from the BLRM will be used to determine the dose.

Plasma concentration of pharmacokinctis (PK) parameter Tmax
predose,0.5,1,1.5,2,3,4,6,8,12,24,48,72,96,144,192,240,288,336 hours post dose

Measurment of effect of liver impairment on PK of BKM120 by assessment of the PK parameter TMax (time to maximum concentration)

Plasma concentration of PK parameter Cmax
predose,0.5,1,1.5,2,3,4,6,8,12,24,48,72,96,144,192,240,288,336 hours post dose

Measurment of effect of liver impairment on PK of BKM120 by assessment of the PK parameter CMax (maximum concentration)

Plasma concentration of PK parameter AUC-t
predose,0.5,1,1.5,2,3,4,6,8,12,24,48,72,96,144,192,240,288,336 hours post dose

Measurment of effect of liver impairment on PK of BKM120 by assessment of the PK parameter AUC-t (Area under the curve at specified timepoint) The specific key measure(s) or observation(s) that will be used to determine the effect of the intervention(s). Example: Change in left ventricular end systolic volume (LVESD) as measured by echocardiography Time to tumor progression Overall tumor response

Plasma concentration of PK parameter AUC-last
predose,0.5,1,1.5,2,3,4,6,8,12,24,48,72,96,144,192,240,288,336 hours post dose

Measurment of effect of liver impairment on PK of BKM120 by assessment of the PK parameter AUC-last (Area under the curve at last timepoint) The specific key measure(s) or observation(s) that will be used to determine the effect of the intervention(s). Example: Change in left ventricular end systolic volume (LVESD) as measured by echocardiography Time to tumor progression Overall tumor response

Plasma concentration of PK parameter AUC-inf
predose,0.5,1,1.5,2,3,4,6,8,12,24,48,72,96,144,192,240,288,336 hours post dose

Measurment of effect of liver impairment on PK of BKM120 by assessment of the PK parameter AUC-inf (Area under the curve to time infinity)

Plasma concentration of PK parameter CL/F
predose,0.5,1,1.5,2,3,4,6,8,12,24,48,72,96,144,192,240,288,336 hours post dose

infMeasurment of effect of liver impairment on PK of BKM120 by assessment of the PK parameter CL/F (clearance)

Plasma concentration of PK parameter Vz/F
predose,0.5,1,1.5,2,3,4,6,8,12,24,48,72,96,144,192,240,288,336 hours post dose

FMeasurment of effect of liver impairment on PK of BKM120 by assessment of the PK parameter Vz/F (Volume distribution)

Plasma concentration of PK parameter terminal T 1/2
predose,0.5,1,1.5,2,3,4,6,8,12,24,48,72,96,144,192,240,288,336 hours post dose

Measurment of effect of liver impairment on PK of BKM120 by assessment of the PK parameter terminal T 1/2 (terminal half-life)

Maximum Tolerated Dose (MTD) and/or recommended phase II dose (RP2D) and schedule of BKM120+GSK1120212
in average 1 year
establish Maximum tolerate dose (MTD)
every day up to first 4 weeks
Maximum Tolerated Dose (MTD) of BKM120
throughout the study

Secondary Endpoints

Overall Survival (OS) - Full Analysis Set (FAS) in Full Population, Main Study Cohort and PI3K Unknown Cohort
Every 3 months following end of treatment visit, assessed for approximately 5 years
Overall Response Rate (ORR) - Full Analysis Set (FAS) in Full Population, Main Study Cohort and PI3K Unknown Cohort
From the date of randomization until the date of the first documented disease progression or date of death from any cause whichever came first, assessed for approximately 5 years
Clinical Benefit Rate (CBR) - Full Analysis Set (FAS) in Full Population, Main Study Cohort and PI3K Unknown Cohort
From the date of randomization until the date of the first documented disease progression or date of death from any cause whichever came first, assessed for approximately 5 years
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
BKM120 100mg + FulvestrantEXPERIMENTALBKM120 100 mg per day and fulvestrant given until progression or as described in the protocol.
Placebo + FulvestrantPLACEBO_COMPARATORBKM120 matching placebo daily and fulvestrant given until progression or as described in the protocol.
BKM120EXPERIMENTALBKM120, 100mg capsule for oral use, taken once daily for two or more months for a maximum of one year. Each cycle is 28 days.
BKM120 + Trastuzumab + paclitaxelEXPERIMENTALBKM120 (oral, pan-class I PI3K inhibitor) in combination with trastuzumab and paclitaxel.
BKM120 PBO + Trastuzumab + paclitaxelPLACEBO_COMPARATORBKM120 placebo in combination with trastuzumab and paclitaxel
BKM120 and paclitaxelEXPERIMENTALAdult females with histologically confirmed, inoperable, locally advanced or metastatic HER2- BC who received study drug plus paclitaxel.
Placebo and paclitaxelACTIVE_COMPARATORAdult females with histologically confirmed, inoperable, locally advanced or metastatic HER2- BC who received placebo plus paclitaxel.
Squamous BKM120 100mg qdEXPERIMENTALDiagnosed patients with non-small cell lung cancer (NSCLC) that progressed after one prior, platinum-based chemotherapy line for metastatic disease.
Non-Squamous BKM120 100mg qdEXPERIMENTALDiagnosed patients with non-squamous NSCLC that progressed after one or two prior antineoplastic therapy lines for metastatic disease.
All PatientsEXPERIMENTAL -
BKM120 plus radiotherapyEXPERIMENTALThree cohorts of patients will be treated with escalating doses of oral buparlisib. The doses will be 50mg, 80mg and 100mg, once daily. Patients will be treated with buparlisib for a total of fourteen days. One week after commencing buparlisib, patients will start palliative radiotherapy treatment. Radiotherapy treatment will be delivered as 20Gy in 5 fractions over a one week period. There will be an expansion cohort at the MTD. Patients in an optional fourth cohort will take buparlisib for 4 weeks at the MTD.
Arm BKMEXPERIMENTALBKM120 and Olaparib
Arm BYLEXPERIMENTALBYL719 and Olaparib
BKM120 at: 80 and 100mg/day dose levelsEXPERIMENTAL -
BKM120 + Temozolomide (Concomitant Phase)EXPERIMENTALCranial radiation: Days 1 - 5 every 7 days for 42 days60 Gy in 30 fractions; Temozolomide: 75 mg/m2 Daily, orally; BKM120: 0, or 40, or 60, or 80 mg/d Daily, orally or Days 1-5 every 7 days, orally
BKM120 + temozolomide with/without radiotherapyEXPERIMENTALAdjuvant phase cycle 1: Temozolomide 150 mg/m2 - Days 1 - 5 every 28 days Daily; BKM120 60, or 80, or 100 mg/d; Adjuvant phase cycle 2+: Temozolomide 200\* mg/m2 - Day 1 \~ 5 every 28 days Daily BKM120 0, or 40, or 60, or 80 or 100 mg/d
Mild Hepatic Impaired GroupEXPERIMENTALSubjects can only be enroled into this group if they fit the Child -Pugh score criteria of severity category - mildly hepatically impaired
Moderate Hepatic Impaired groupEXPERIMENTALSubjects can only be enroled into this group if they fit the Child -Pugh score criteria of severity category - moderately hepatically impaired
Severe Hepatic Impaired GroupEXPERIMENTALSubjects can only be enroled into this group if they fit the Child -Pugh score criteria of severity category - Severely hepatically impaired
Control GroupEXPERIMENTALMatching healthy control subjects who do not have hepatic impairment and are matched to the hepatic impaired subjects by sex, age, gender and BMI
BKM120 + GSK1120212 DEEXPERIMENTALDose Escalation
BKM120 + GSK1120212 NSCLC patientsEXPERIMENTALAdvanced RAS or BRAF mutant NSCLC patients
BKM120 + GSK1120212 ovarian cancer patientsEXPERIMENTALAdvanced RAS or BRAF mutant ovarian cancer patients
BKM120 + GSK1120212 pancreatic cancer patientsEXPERIMENTALAdvanced RAS or BRAF mutant pancreatic cancer patients

Interventions

NameTypeDescription
FulvestrantDRUGIntramuscular fulvestrant 500 mg (Day 1 and Day 15 of Cycle 1 and Day 1 of every cycle thereafter)
BKM120DRUGBKM120 100 mg once daily
BKM120 matching placeboDRUGBKM120 matching placebo, once daily
TrastuzumabDRUGTrastuzumab is a humanized monoclonal antibody directed against the extracellular juxtamembrane domain of the HER2 receptor. Administered 4mg/kg i.v. load followed by 2mg/kg i.v. weekly.
PaclitaxelDRUGPaclitaxel is a cytotoxic agent with proven antitumor activity in a variety of solid tumors. The antitumor activity of paclitaxel is based on tubulin-binding and stabilization of non-functional microtubule bundles, thereby blocking normal mitotic spindle development and subsequent cell division. Administered weekly 80mg/m2 i.v.
BKM120 PlaceboDRUGNeoadjuvant BKM120 placebo Administered orally 100 mg/day.
BKM120 and OlaparibDRUGOlaparib twice daily (starting dose 50 mg) and BKM120 once daily (starting dose 40 mg). Both drugs are given orally.
BYL719 and OlaparibDRUGOlaparib twice daily (starting dose 100 mg) and BYL719 once daily (starting dose 250 mg). Both drugs are given orally.
BKM120 + temozolomideDRUGThe investigational drug, BKM120, will be supplied as 10-mg and 50-mg hard gelatin capsules. BKM120 will be administered on a once daily dosing schedule at a dose of 40 mg, or 60 mg, or 80 mg, or 100 mg (p.o.), in combination with the approved dosing of temozolomide and SoC delivery of cranial irradiation for GBM. The patient will be dosed with BKM120 on a flat scale of mg/day and the dose of BKM120 will not be adjusted to body weight or body surface area. Patients should not eat for 2 hours after the administration of BKM120. Temozolomide in 5 mg, 20 mg, 100 mg, 140 mg, 180 mg or 250 mg capsules will be administered in combination with the investigational drug BKM120.
BKM120 +temozolomide with/without radiotherapyDRUGThe investigational drug, BKM120, will be supplied as 10-mg and 50-mg hard gelatin capsules. BKM120 will be administered on a continuous once daily dosing schedule at a dose of 40 mg, or 60 mg, or 80 mg, or 100 mg (p.o.), in combination with the approved dosing of temozolomide and SoC delivery of cranial irradiation for GBM. The patient will be dosed with BKM120 on a flat scale of mg/day and the dose of BKM120 will not be adjusted to body weight or body surface area. Patients should not eat for 2 hours after the administration of BKM120. Temozolomide in 5 mg, 20 mg, 100 mg, 140 mg, 180 mg or 250 mg capsules will be administered in combination with the investigational drug BKM120.
GSK1120212DRUG -
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Eligibility Criteria

Age Range18 Years to N/A
SexFEMALE
Healthy VolunteersNo
Study Sites268

Key Inclusion Criteria: * Locally advanced or metastatic breast cancer * HER2-negative and hormone receptor-positive status (common breast cancer classification tests) * Postmenopausal woman * A tumor sample must be shipped to a Novartis designated laboratory for identification of biomarkers (PI3K ...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilCanadaChinaCzechiaFranceGermanyGreeceHungaryIsraelItalyJapanNetherlandsPeruPolandRussiaSingaporeSlovakiaSouth AfricaSouth KoreaSpainSwitzerlandTaiwanThailandUnited KingdomHong KongTurkey (Türkiye)Bulgaria
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Competitive Landscape -Breast Cancer 609 trials

Frequently asked questions about BKM120+ temozolomide

What is BKM120 plus temozolomide?

BKM120 plus temozolomide is an investigational combination of the small molecule BKM120 with the chemotherapy agent temozolomide, being studied in oncology by Novartis AG. It has been evaluated in clinical trials for advanced solid tumors and other cancer types, including advanced breast cancer, endometrial cancer, and non-small-cell lung carcinoma.

What is BKM120 plus temozolomide used for?

BKM120 plus temozolomide has been studied in advanced breast cancer, advanced carcinomas with squamous cell histology, advanced endometrial cancer, advanced solid tumors, breast cancer, carcinoma, and non-small-cell lung cancer. These are investigational uses in clinical research, not approved indications.

Who makes BKM120 plus temozolomide?

Novartis AG, which trades under the ticker NVS, is the developer of BKM120 and the studies combining it with temozolomide and other agents. The company sponsored the clinical trial program evaluating this small molecule in oncology settings.

What phase is BKM120 plus temozolomide in?

BKM120 plus temozolomide is in Phase 1 development. It is investigational and has not been approved for any indication. The broader BKM120 program includes completed Phase 1 and Phase 2 trials, with no active trials currently listed.

What clinical trials is BKM120 plus temozolomide in?

Four BKM120 trials are recorded, all completed: NCT02220855 in relapsed or refractory thymomas, NCT02128724 combining BKM120 with palliative thoracic radiotherapy in non-small-cell lung carcinoma, NCT01833169 in PI3K-activated tumors, and NCT01816594, the NeoPHOEBE study in HER2-positive primary breast cancer. Total enrollment across these trials was 1,720 participants.

Is BKM120 the same as buparlisib?

Yes, BKM120 is also known as buparlisib. The same compound has been studied under several combination labels, including BKM120 plus temozolomide, BKM120 plus paclitaxel, and BKM120 with olaparib, so searches for any of these names refer to the same investigational agent.