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MLN0128

Phase 2

Clear-cell Metastatic Renal Cell Carcinoma | Small molecule | Oncology |Takeda Pharmaceutical Company Limited|Last Updated: Nov 19, 2021

Success Probability

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Trial Design

RandomizedACTIVE_CONTROLLEDBiomarker
Total Trials1
Total Enrollment96

FDA Designations

No designations recorded

Clinical trial landscape

MLN0128 · 3 trials · 3 indications

Phase 2 1Phase 1 2
NCT02724020MLN0128 and MLN0128 + MLN1117 Compared With Everolimus in the Treatment of Adults With Advanced or Metastatic Clear-Cell Renal Cell CarcinomaClear-cell Metastatic Renal Cell Carcinoma
COMPLETED96 Analytics
PHASE2COMPLETED
MLN0128 and MLN0128 + MLN1117 Compared With Everolimus in the Treatment of Adults With Advanced or Metastatic Clear-Cell Renal Cell Carcinoma
Clear-cell Metastatic Renal Cell CarcinomaUnlock trial analytics

Study Endpoints

Primary Endpoints

Progression-Free Survival (PFS)
From first dose of study drug up to disease progression or death, assessed up to 43 months

PFS was defined as the time from the date of randomization to the date of first documentation of progressive disease (PD) or death due to any cause, whichever occurs first. Per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria. PD was defined as at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.

Dose Escalation Phase: Maximum Tolerated Dose (MTD)
Cycle 1: Days 1 to 28

MTD is the highest dose level at which the participants tolerate treatment without dose-limiting toxicities during the first cycle (28 days) of therapy.

Dose Escalation Phase: Number of Participants With at Least 1 Dose Limiting Toxicity (DLT)
Cycle 1: Days 1 to 28

DLT was defined as any of the following occurring during Cycle 1 (Days 1-28) and attributable to MLN0128P: Grade ≥ 3 nonhematologic toxicity; Grade 3 thrombocytopenia with hemorrhage; Grade 4 neutropenia lasting \> 7 days in the absence of growth factor support; Grade 4 neutropenia of any duration associated with fever 38.5 degrees C and/or infection; Any other Grade 4 hematologic toxicity; Inability to administer at least 75 % of doses of MLN0128 within Cycle 1 due to drug-related toxicity; Any clinically significant occurrence which the investigators and sponsor agree would place participants at undue safety risk; Participants who experienced an adverse event (AE) that met the definition for a DLT.

Objective Response Rate (ORR)
At screening and thereafter every 2 cycles of treatment until disease progression (Up to 65.8 weeks)

ORR was defined as the percentage of participants with Complete Response (CR) and Partial Response (PR) based on Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). Each cycle was a 28 day cycle. CR was defined as the disappearance of all target lesions and for non-target lesions, the disappearance of all non-target lesions and normalization of tumor marker level. PR was defined of at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD and for non-target lesions.

Percentage of Participants With Treatment Emergent Adverse Events (AEs), Serious Adverse Events(SAEs), AEs Resulting in Discontinuation of MLN0128 and Fatal AEs Within 30 Days of Last Dose of Study Drug
First dose of study drug through 30 days after the administration of the last dose of study drug (Up to approximately 91.4 weeks)

An Adverse Event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug. A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant.

Dose Escalation Phase: Number of Participants With Dose Limiting Toxicities (DLTs)
Cycle 1 (28 days)

DLTs were defined as MLN0128-related treatment-emergent adverse events (TEAEs) that occurred within the Cycle 1 (first 28 days of treatment) as per Common Terminology Criteria for Adverse Events (CTCAE): Any ≥Grade 3 or non-hematologic toxicity except for Grade 3 nausea and/or vomiting and diarrhea, Grade 3 hyperglycemia lasting ≤ 14 days, Grade 3 rash lasting ≤ 3 days; Grade 4 neutropenia lasting \>7 days in the absence of growth factor support; Grade 4 neutropenia of any duration associated with fever ≥38.5 degree celsius and/or systemic infection; Any other Grade 4 hematologic toxicity; Inability to administer at least 75% of planned doses of MLN0128 within Cycle 1 due to drug-related toxicity and any clinically significant occurrence that the investigators and sponsor agreed would place participants at an undue safety risk.

Number of Participants Experiencing One or More Treatment-Emergent Adverse Events (AEs), Serious Adverse Events (SAEs), AEs Resulting in Discontinuation of MLN0128 and Fatal AEs Within 30 Days of Last Dose of Study Drug
First dose of study drug through 30 days after the administration of the last dose of study drug (Up to approximately 244 weeks)

An Adverse Event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug. A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant.

Dose Expansion: Objective Response Rate (ORR)
From the first dose of study drug up to disease progression or death (Up to approximately 240 weeks)

ORR is defined as the percentage of participants who achieved complete response (CR) or partial response (PR based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. CR is defined as disappearance of all target lesions and PR was defined of at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD and for non-target lesions. Data was categorized as per type of cancer.

Dose Expansion Phase: Duration of Objective Response
From the first dose of study drug up to disease progression or death (Up to approximately 240 weeks)

Duration of objective response is defined as the number of months from the start date of CR or PR (whichever occurred first) based on RECIST Criteria version 1.1 to the first date of objectively documented progressive disease (PD) for participants who achieved CR or PR. PD is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).

Dose Expansion: Duration of Stable Disease (SD)
From the first dose of study drug up to disease progression or death (Up to approximately 240 weeks)

Duration of SD was evaluated for participants with best response of SD and is defined as number of months from date of first dose to date of PD. As per RECIST 1.1, SD is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. PR was defined of at least a 30% decrease in sum of longest diameter (LD) of target lesions, taking as reference the baseline sum LD and for non-target lesions. PD is defined as at least a 20% increase in sum of diameters of target lesions, taking as reference smallest sum on study (this includes baseline sum if that is smallest on study).

Secondary Endpoints

Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
From first dose of study drug through 30 days after the last dose of study drug (approximately up to 31 months)
Overall Survival (OS)
From first dose of study drug through 30 days after the last dose of study drug (up to 51 months)
Time-to-progression (TTP)
From first dose of study drug up to disease progression or death (up to 51 months)
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Arm A: Single-agent Everolimus 10 mg QDACTIVE_COMPARATOREverolimus 10 mg capsules, orally, once daily in a 28-day treatment cycle until disease progression, consent withdrawal, death, or transfer to the Post-trial Access (PTA) program (Median duration of treatment was 15.43 weeks up to end of study).
Arm B: Single-agent MLN0128 30 mg QWEXPERIMENTALMLN0128 30 mg capsules, orally, once weekly on Days 1, 8, 15, and 22 of a 28-day treatment cycle until disease progression, unacceptable toxicity, consent withdrawal, death, or transfer to the PTA program (Median duration of treatment was 9.64 weeks up to end of study).
Arm C: Combination of MLN0128 4 mg QD + MLN1117 200 mg QDEXPERIMENTALMLN0128 4 mg and MLN1117 200 mg capsules, orally, both once daily for 3 days per week (QD X 3) on Days 1-3, 8-10, 15-17, and 22-24 of a 28-day treatment cycle until disease progression, unacceptable toxicity, consent withdrawal, death, or transfer to the PTA program (Median duration of treatment was 9.43 weeks up to end of study).
MLN0128P 30 mg QWEXPERIMENTALMLN0128 and paclitaxel (MLN0128P): MLN0128 30 mg, capsule, orally, once weekly (QW) + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in the Dose Escalation Phase.
MLN0128P 40 mg QWEXPERIMENTALMLN0128 40 mg, capsule, orally, once a week (QW) + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in the Dose Escalation Phase.
MLN0128P 6 mg QD×3d QWEXPERIMENTALMLN0128 6 mg, capsule, orally, once daily 3 days on/4 days off each week + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in the Dose Escalation Phase.
MLN0128P 7 mg QD×3d QWEXPERIMENTALMLN0128 7 mg, capsule, orally, once daily 3 days on/4 days off each week + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in the Dose Escalation Phase.
MLN0128P 8 mg QD×3d QWEXPERIMENTALMLN0128 8 mg, capsule, orally, once daily 3 days on/4 days off each week + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in the Dose Escalation Phase.
MLN0128P 9 mg QD×3d QWEXPERIMENTALMLN0128 9 mg, capsule, orally, once daily 3 days on/4 days off each week + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in the Dose Escalation Phase.
MLN0128P 10 mg QD×3d QWEXPERIMENTALMLN0128 10 mg, capsule, orally, once daily 3 days on/4 days off each week + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in the Dose Escalation Phase.
MLN0128P 7 mg QD×5d QWEXPERIMENTALMLN0128 7 mg, capsule, orally, once daily 5 days on/2 days off each week + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in the Dose Escalation Phase.
MLN0128P 8 mg QD×3d QW HER2-EXPERIMENTALMLN0128 8 mg, capsule, orally, once daily 3 days on/4 days off each week + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 of a 4-week cycle in human epidermal growth factor receptor 2 negative (HER-) cancer participants until disease progression or unacceptable toxicity for up to 1 year in the Expansion Phase.
MLN0128PH 8 mg QD×3d QW HER2+EXPERIMENTALMLN0128 + paclitaxel + trastuzumab (MLN0128PH): MLN0128 8 mg, capsule, orally, once daily 3 days on/4 days off each week + paclitaxel 80 mg/m\^2, 1 hour infusion, on Days 1, 8 and 15 plus trastuzumab 4 mg/kg loading dose on Day 1 followed by 2 mg/kg, intravenous each week of a 4-week cycle in HER+ cancer participants until disease progression or unacceptable toxicity for up to 1 year in the Expansion Phase.
MLN0128 QDEXPERIMENTALMLN0128 2 mg, 4 mg, 6 mg or 7 mg, capsule, orally, once daily (QD) in 28-day cycle in the Dose Escalation Phase until Maximum Tolerated Dose (MTD) was established (Up to 52.1 weeks).
MLN0128 QWEXPERIMENTALMLN0128 7 mg, 10 mg, 15 mg, 20 mg, 30 mg or 40 mg capsule, orally, once weekly (QW) in 28-day cycle in the Dose Escalation Phase until Maximum Tolerated Dose (MTD) was established (Up to 139.4 weeks).
MLN0128 QDx3d QWEXPERIMENTALMLN0128 6 mg, 9 mg, 12 mg, 16 mg or 20 mg capsule, orally, once daily every 3 days a week (QDx3d QW) in 28-day cycle in the Dose Escalation Phase until Maximum Tolerated Dose (MTD) was established (Up to 129.4 weeks).
MLN0128 QDx5d QWEXPERIMENTALMLN0128 7 mg, 10 mg or 13 mg capsule, orally, once daily every 5 days a week (QDx5d QW) in 28-day cycle in the Dose Escalation Phase until Maximum Tolerated Dose (MTD) was established (Up to 161.9 weeks).
MLN0128 5 mg QDEXPERIMENTALMLN0128 5 mg, capsule, orally, QD in 28-day cycle until disease progression or unacceptable toxicity in the Dose Expansion Phase (Up to 98.3 weeks).
MLN0128 30 mg QWEXPERIMENTALMLN0128 30 mg, capsule, orally QW in 28-day cycle until disease progression or unacceptable toxicity in the Dose Expansion Phase (Up to 240 weeks).
MLN0128 40 mg QWEXPERIMENTALMLN0128 40 mg, capsule, orally, QW in 28-day cycle until disease progression or unacceptable toxicity in the Dose Expansion Phase (Up to 100.1 weeks).

Interventions

NameTypeDescription
EverolimusDRUGEverolimus capsules.
MLN0128DRUGMLN0128 capsules.
MLN1117DRUGMLN1117 capsules.
paclitaxelDRUGpaclitaxel intravenous infusion
trastuzumabDRUGtrastuzumab intravenous infusion
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites36

Inclusion Criteria: 1. Male or female participants aged 18 years or older. 2. Histologically confirmed renal cell carcinoma (RCC) with a clear-cell component. 3. Evidence that the RCC is advanced or metastatic. 4. Radiologic evidence of PD (according to RECIST Version 1.1) either during or within 6...

Countries:United StatesCanadaCzechiaFranceItalyPolandSpainUnited Kingdom
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Frequently asked questions about MLN0128

What is MLN0128 used for?

MLN0128 is an investigational small molecule being studied for the treatment of advanced solid malignancies and clear-cell metastatic renal cell carcinoma. It has been evaluated in clinical trials for these oncology indications, including as a single agent and in combination with other therapies.

How does MLN0128 work?

MLN0128 is a small molecule that targets specific molecular pathways involved in cancer cell growth. It has been studied in biomarker-selected patient populations, suggesting its mechanism may be relevant to tumors with particular genetic or molecular characteristics.

Who is developing MLN0128?

MLN0128 is being developed by Takeda Pharmaceutical Company Limited, which trades under the ticker TAK. The company has sponsored clinical trials of the drug in patients with advanced solid malignancies and clear-cell metastatic renal cell carcinoma.

What phase is MLN0128 in?

MLN0128 has completed Phase 1 and Phase 2 clinical trials. The Phase 1 trials evaluated the drug in advanced solid malignancies, and the Phase 2 trial compared it with everolimus in clear-cell metastatic renal cell carcinoma. All trials are completed.

What clinical trials has MLN0128 been in?

MLN0128 has been studied in three completed trials. NCT01058707 was a Phase 1 dose escalation study in advanced solid malignancies. NCT01351350 was a Phase 1 study combining MLN0128 with paclitaxel and trastuzumab. NCT02724020 was a Phase 2 trial comparing MLN0128 with everolimus in renal cell carcinoma.

Is MLN0128 the same as MLN1117?

No, MLN0128 is not the same as MLN1117. In one clinical trial, MLN0128 was studied both alone and in combination with MLN1117, which is a separate investigational drug. The trial compared these treatments with everolimus in patients with advanced or metastatic clear-cell renal cell carcinoma.