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TKI258

Phase 3

Adenocarcinoma, Scirrhous | Small molecule | Oncology |Novartis AG|Trials Updated: Jul 22, 2022

TKI258 development status

Highest phase Phase 3 (NCT01223027)
Phase scored for NVSPhase 2
Registered trials 27 across 10 sponsors since Oct 2005

TKI258 target and mechanism

ModalitySmall molecule

Also known as TKI258 (dovitinib), Dovitinib, RTK Inhibitor, dovitinib lactate, CHIR-258, receptor tyrosine kinase inhibitor TKI258, RTK inhibitor TKI258

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLED
Total Trials21
Total Enrollment1,648

FDA Designations

No designations recorded

TKI258 clinical trials

TKI258 · 21 trials · 36 indications

Phase 3 1Phase 2 10Phase 1 10
NCT01223027Study of Dovitinib Versus Sorafenib in Patients With Metastatic Renal Cell CarcinomaMetastatic Renal Cell Carcinoma
COMPLETED564 Analytics
PHASE3COMPLETED
Study of Dovitinib Versus Sorafenib in Patients With Metastatic Renal Cell Carcinoma
Metastatic Renal Cell CarcinomaUnlock trial analytics

Study Endpoints

Primary Endpoints

Progression Free Survival (PFS) Per Independent Central Radiology Review
Until disease progression or discontinuation of treatment due to unacceptable toxicity up to 30-Jun-2014 (discontinuation)

Assessed according to RECIST 1.1. PFS was defined as the time from the date of randomization to the date of the first documented disease progression or death due to any cause. If a patient had not progressed or died, on the date of the analysis cut-off or when he/she received any further anti-neoplastic therapy, PFS was censored on the date of last tumor assessment before the cutoff date or the anti-neoplastic therapy date. The distribution of PFS was estimated using the Kaplan-Meier method. The median PFS along with 95% confidence intervals was presented by treatment group.

Clinical Benefit Rate
2 years

The primary outcome measure is the clinical benefit rate, defined as an objective response (complete \[CR\] or partial \[PR\]) or stable disease \[SD\] of ≥6 months duration according to the RECIST version 1.1 criteria.

Number of Participants With Adverse Events of Grades 3 and 4 Severity
Until the last patient discontinued dovitinib up to 30 months

Participants with grades 3 and 4 severity adverse events were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03, unless otherwise specified. AEs are provided by System Organ Class (SOC). A patient with multiple adverse events within a primary system organ class was counted only once in the total row.

Clinical Benefit Rate (CBR)
Week 16

CBR determined by investigator assessment for each tumor assessment \& defined as responses of Complete Response (CR) or Partial Response (PR) or Stable Disease (SD) ≥ 16 wks. Confirmed CR/PR or SD prior to 16 wks,but discontinued prior to 16 wks for reasons other than progressive disease,will have their clinical benefit defined non-evaluable; confirmed CR/PR or SD prior to 16 wks,but progressed prior to 16 wks,will be considered not achieving clinical benefit;if CR/PR/SD occurred prior to 16 wks,but progressed at or after 16 wks without evidence of CR/PR/SD at or after 16 wks,will also be considered not achieving clinical benefit. CBR will be analyzed by comparing achieved CBR with a historical control rate of each tumor type,\& if there is at least 90% probability that the response rate in a tumor type exceeds the historical rate,then the tumor type will be considered a success. CBR: CR+PR+SD the assessment criteria was RECIST 1.1

disease control rate (DCR)
up to 8 weeks after the start date of study treatment

Eight-week DCR is defined as the proportion of patients with best overall response of CR, PR or SD at the end of Week 8 as per local investigator's assessment.

Antitumor Activity of Dovitinib in Terms of Disease Control Rate (DCR): Complete Response+Partial Response +Stable Disease
12 Weeks

DCR is defined as the proportion of patients with a best overall response of Complete Responses (CR), Partial Response (PR) and Stable Disease (SD) at 12 weeks according to RECIST (version 1.1). Complete Response (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 1;Partial Response (PR): At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters. Progressive Disease (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. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm2. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR or CR nor an increase in lesions which would qualify for PD.

Progression Free Survival (PFS) Rate
up to 18 weeks

The 18-week PFS was defined as the percentage of participants who did not have a progression event at week 18. Participants who progressed, died, had response assessment of unknown (UNK) or discontinued before 18 weeks of observation without progression were counted as "failure". Progressive disease was assessed as per investigator assessment using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.

Overall Survival - Overall Survival
Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first.

The overall survival (OS), defined as the time from date of randomization to the date of death from any cause. If a patient was not known to have died at the date of analysis cut-off, OS was censored at the last date of contact. Survival information was collected every 6 wks until at least 130 deaths have been observed

Overall response rate
4 weeks
Complete responses (CR) or partial response (PR) defined according to RECIST
Every 8 weeks
Maximum tolerated dose (MTD) is defined as the highest dose level at which less than 33% of patients experience study treatment-related dose limiting toxicities (DLT)
First course, 21 days

All toxicities and adverse events will be summarized with frequencies and descriptive measures, and tabulated according to body system, severity and relation to treatment.

Overall safety profile characterized by type, frequency, severity (according to National Cancer Institute [NCI] CTCAE version 4.0), timing, seriousness and relationship to study treatment
Up to 30 days post-treatment

All toxicities and adverse events will be summarized with frequencies and descriptive measures, and tabulated according to body system, severity and relation to treatment.

TKI258 pharmacokinetics (PK) parameters: Cmax (Maximum (peak) concentration of drug)
multiple time-points over 72h post dose on day Day 19 and Day 26 (PK phase)
TKI258 pharmacokinetics (PK) parameters: AUC 0-24 hr (Area Under the Curve)
multiple time-points over 72h post dose on day Day 19 and Day 26 (PK phase)
TKI258 pharmacokinetics (PK) parameters: AUC 0-72 hr
multiple time-points over 72h post dose on day Day 19 and Day 26 (PK phase)
TKI258 pharmacokinetics (PK) parameters: Tmax (Time to maximum concentration)
multiple time-points over 72h post dose on day Day 19 and Day 26 (PK phase)
TKI258 pharmacokinetics (PK) parameters: T1/2 (Half-life time)
multiple time-points over 72h post dose on day Day 19 and Day 26 (PK phase)
TKI258 pharmacokinetics (PK) parameters: CL/F (Apparent Oral Clearance)
multiple time-points over 72h post dose on day Day 19 and Day 26 (PK phase)
TKI258 pharmacokinetics (PK) parameters: Vz/F (apparent volume of distribution)
multiple time-points over 72h post dose on day Day 19 and Day 26 (PK phase)
Composite of Pharmacokinetics of TKI258, FMI capsule (supplied in 100 mg strength) and FMI tablet (supplied in 250 mg strength), in patients with advanced solid tumors, excluding breast cancer based on PK parameters AUClast and Cmax
9 days
Pharmacokinetic (PK) parameter of Cmax following a single dose of TKI258 and at the steady state
Day 1, Day 19

Cmax will be evaluated after a single dose of TKI258 and at the steady state following a 5 days on/2 days off dosing schedule. Cmax is the maximum (peak) plasma, blood, serum, or other body fluid drug concentration after a single dose administration (mass x volume - 1).

Pharmacokinetic (PK) parameter of Tmax following a single dose of TKI258 and at the steady state
Day 1, Day 19

Tmax will be evaluated after a single dose of TKI258 and at the steady state following a 5 days on/2 days off dosing schedule. Tmax is the time to to reach maximum (peak) plasma, blood, serum, or other body fluid drug concentration after a single dose administration (mass x volume - 1).

Pharmacokinetic (PK) parameter of AUClast following a single dose of TKI258 and at steady state
Day 1, Day 19

AUClast will be evaluated after a single dose of TKI258 and at the steady state following a 5 days on/2 days off dosing schedule. AUC from time zero to the last measurable concentration sampling time t(last) (mass x time x volume\^-1)

Pharmacokinetic (PK) parameter of AUCinf following a single dose of TKI258
Day 1, Day 19

AUCinf is the time to zero to infinity (mass x time x volume)

Determine the relative bioavailability of the final market image form of TKI258 (monohydrate tablets) as compared to the clinical service form of TKI258 (anhydrate capsules)
relative bioavailability (9 days)
Determine the effect of food on the bioavailability of TKI258
food effect (22 days)
Determine the relative bioavailability of the final market image form of TKI258 (monohydrate capsules) as compared to the clinical service form of TKI258 (anhydrate capsules)
9 days
Maximum tolerated dose (MTD) of TKI258
30 days
Phase I: To determine the MTD of TKI258, administered orally on a 5 days on/2 days off schedule to adult patients with advanced or metastatic RCC whose diseases have progressed despite standard therapy or for whom no standard anticancer therapy exists.
at end of phase I
Phase II: To determine anti-tumor activity of TKI258 in advanced or metastatic RCC patients with predominant clear cell histology that have been previously treated with VEGF receptor tyrosine kinase inhibitor (sunitinib and/or sorafenib).
at end of phase II
Cohort1: Find out about the routes and rates of excretion of TKI258 and its metabolites
Day 15
Cohort 2: Safety and Tolerability of TKI258
Time to patient withdrawal due to disease progression or tolerability issues
Dose Expansion: Determine the maximum tolerated dose based on dose limiting toxicity of TKI258
end of dose escalation
Dose Expansion: Determine the plasma and whole blood pharmacokinetics of orally administered TKI258
PK run-in days 1 & 2, cycle 1 days 1, 8, 15, 16, 28, cycle 2 day 15, cycle 2+ day 28
Dose Escalation: Assess tumor response according to RECIST as measured by response rate and lack of early progressive disease (<=2 months)
every 8 weeks

Secondary Endpoints

Overall Survival (OS)
until at least 386 deaths are documented in the clinical database.
Progression Free Survival (PFS) Per Investigator's Radiology Review
Until disease progression or discontinuation of treatment due to unacceptable toxicity
Percentage of Participants With Overall Response Rate (ORR) by Central Radiology Review
Until disease progression or discontinuation of treatment due to unacceptable toxicity
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Dovitinib + best supportive care (BSC)EXPERIMENTALPatients randomized to the dovitinib treatment arm received 500 mg of dovitinib orally on 5 days on/2 days off dosing schedule.
Sorafenib + BSCACTIVE_COMPARATORPatients in the sorafenib control arm received400 mg of sorafenib (2 x 200 mg tablets) orally taken twice daily.
DovitinibEXPERIMENTALDovitinib 500 mg PO OD (5 days on, 2 days off); Each cycle = 28 days
dovitinib + fulvestrantEXPERIMENTALParticipants were given dovitinib and fulvestrant coadministration starting with last assigned dose and regimen which patient received in parent study. Additional dose modifications were at the discretion of the investigator based on guidance provided in the protocol and IB.
TKI258EXPERIMENTALDovitinib (TKI) will be dosed on a flat scale of 500 mg on a 5 days on/2 days off dosing schedule.
Dovitinib (TKI258)EXPERIMENTALPatients will receive Dovitinib (TKI258) on an outpatient basis at the dose of 500 mg qd for 5 days followed by 2 days off, every week for cycle of 4 weeks (28d) until disease progression, unacceptable toxicity, or consent withdrawal.
SorafenibEXPERIMENTALtablet
FGFR3 wild typeEXPERIMENTAL -
FGFR3 mutantEXPERIMENTAL -
TKI258 - PositiveEXPERIMENTALThese are the participants who had a positive T(4;14) status
TKI258 - NegativeEXPERIMENTALThese are the participants who had a negative T(4;14) status
TKI258 Non-interpretableEXPERIMENTALThese are the participants who had a non-interpretable T(4;14) status
Treatment (dovitinib lactate, gemcitabine, and capecitabine)EXPERIMENTALPatients receive dovitinib lactate PO on days 1-5, 8-12, and 15-19, gemcitabine hydrochloride IV over 30 minutes on days 1 and 8, and capecitabine PO twice daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
500 mg FMI capsule + 250 mg FMI tabletEXPERIMENTALBE phase sequence 1= 3 weeks on FMI capsule then 1 week on FMI tablet
500 mg TKI258 FMI capsule +250 mg FMI tabletEXPERIMENTALBE phase sequence 2= 3 weeks on FMI tablet then 1 week on FMI capsule
TKI258 normal hepatic functionEXPERIMENTALTKI258 Capsule, @ 500 mg p.o. o.d. 5 days on/2 days off
TKI258 mild hepatic impairmentEXPERIMENTALTKI258 capsule @ 500 or 400 mg p.o. o.d. 5 days on/2 days off
TKI258 moderate hepatic impairmentEXPERIMENTALTKI258 capsule @ starting dose at 400 mg p.o. o.d. 5 days on/2 days off
TKI258 severe hepatic impairmentEXPERIMENTALTKI258 capsule Starting dose to be determined based on the study outcome of the mild and moderate hepatic impairment groups
Arm 1 - TKI258 - bioavailabilityEXPERIMENTAL -
TKI258 - food effectEXPERIMENTAL -
TKI258 - bioavailabilityEXPERIMENTAL -
TKI258 - foodEXPERIMENTAL -

Interventions

NameTypeDescription
DovitinibDRUGDovitinib is formulated as an oral gelatin capsule of 100 mg strength and was dosed on a flat scale of 500 mg on a 5 days on/2 days off dosing schedule. Medication labels complied withthe legal requirements of each country and were printed in the local language.
SorafenibDRUGSorafenib is formulated as a round, oral, biconvex, red film-coated tablet that contains 200 mg of sorafenib (tosylate). Sorafenib was administered twice daily without food at least 1 hour before or 2 hours after a meal. Sorafenib was supplied according to local practice.
fulvestrantDRUGFulvestrant is generally available as solution for injection in pre-filled syringes containing 250 mg of fulvestrant in 5 mL solution.
Dovitinib (TKI258)DRUGDovitinib (TKI) will be dosed on a flat scale of 500 mg on a 5 days on/2 days off dosing schedule.
TKI258DRUGTKI258 is dosed on a flat scale of 500 mg, to be administered orally on a 5 days on / 2 days off dosing schedule which will be repeated every week.
dovitinib lactateDRUGGiven PO
gemcitabine hydrochlorideDRUGGiven IV
capecitabineDRUGGiven PO
laboratory biomarker analysisOTHERCorrelative studies
enzyme-linked immunosorbent assayOTHERCorrelative studies
pharmacological studyOTHERCorrelative studies
fluvoxamineDRUGperpetrator drug; 7 days of dosing
TKI258 (dovitinib)DRUGbioavailability (anhydrate capsules) food (monohydrae capsules)
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites199

Inclusion Criteria: * Patients with metastatic renal cell carcinoma (mRCC) with histological or cytological confirmation of clear cell carcinoma or a component of clear cell * Patients must have received one and only one prior VEGF-targeted therapy and one and only one prior mTOR inhibitor therapy ...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilCanadaColombiaCzechiaFranceGermanyGreeceHungaryIsraelItalyJapanNetherlandsNorwayPolandSaudi ArabiaSlovakiaSouth KoreaSpainSwedenSwitzerlandThailandUnited KingdomDenmarkFinlandNew ZealandChinaHong KongSingaporeTaiwanTurkey (Türkiye)
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Frequently asked questions about TKI258

What is TKI258?

TKI258 is an investigational small molecule oncology drug also known as dovitinib. It is being studied in advanced solid tumors and several cancer types, including advanced or metastatic renal cell cancer, metastatic breast cancer, melanoma, and scirrhous gastric carcinoma. It is in Phase 2 clinical development and is not approved for commercial use.

What is TKI258 used for?

TKI258 has been studied in clinical trials for advanced solid malignancies and advanced solid tumors, as well as advanced or metastatic renal cell cancer, metastatic breast cancer, melanoma, and scirrhous gastric adenocarcinoma. These are investigational uses in Phase 2 research, not approved indications.

Who is developing TKI258?

TKI258 is developed by Novartis AG, which trades under the ticker NVS. Novartis has sponsored the clinical research program for the drug, including Phase 1 and Phase 2 studies conducted in Japan, the United States, and several other countries.

What phase is TKI258 in?

TKI258 is in Phase 2 clinical development. Its clinical program includes Phase 2 studies in advanced scirrhous gastric carcinoma and in advanced or metastatic endometrial cancer, along with Phase 1 studies in advanced solid tumors. The drug is investigational and has not been approved by the FDA.

What clinical trials is TKI258 in?

TKI258 has been evaluated in completed trials including NCT01576380, a Phase 2 study in advanced scirrhous gastric carcinoma in Japan, NCT01379534, a Phase 2 study in advanced or metastatic endometrial cancer, NCT01471548, a Phase 1 dose escalation study, and NCT01421004, a Phase 1 bioequivalence study.

Is TKI258 the same as dovitinib?

Yes, TKI258 is the same drug as dovitinib. TKI258 is the code name and dovitinib is the international nonproprietary name used for the same investigational compound. Both names refer to the Novartis small molecule being studied in Phase 2 oncology trials.