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NCT01001299

A Pharmacokinetic Study of RO5185426 in Combination With a Drug Cocktail in Patients With Metastatic Melanoma

Completed Phase 1 Results posted Last updated 15 August 2017
What this trial tests

Phase 1 trial testing Drug cocktail in Malignant Melanoma in 25 participants. Completed in 29 February 2012.

Timeline
30 November 2009
Primary endpoint
29 February 2012
29 February 2012

Quick facts

Lead sponsorHoffmann-La Roche
PhasePhase 1
StatusCompleted
Study typeINTERVENTIONAL
Designparallel
Maskingnone
Primary purposetreatment
Enrollment25
Start date30 November 2009
Primary completion29 February 2012
Estimated completion29 February 2012
Sites5 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Hoffmann-La Roche — full company profile →

Who can join

18 and older, any sex, with Malignant Melanoma. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Geometric Mean Ratio of Area Under the Plasma Concentration-Time Curve From Time Zero to the Last Observed Sampling Time (AUC[0-last]) of Probe Parent Drugs Primary · Day 1, 20: 0, 1, 3, 4, 6, 8, 24 hours, additionally for caffeine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120,dextromethorphan 0.5, 1.5, 2, 12, 18, 48,midazolam 0.08, 0.25, 0.5, 0.75, 2, 10,omeprazole 0.5, 1.5, 2, 2.5, 12, 18,S-warfarin 12, 48, 72, 96, 120 hours

AUC(0-last) was defined as the area under the plasma concentration-time curve calculated using the linear trapezoidal rule from time zero to the last observed sampling time. To assess the potential for drug-drug interactions, the geometric mean ratios and corresponding 90 percent (%) confidence interval (CI) of AUC(0-last) of parent probe drug before (Day 1) and after treatment with vemurafenib (Day 20) was calculated. Ratio and corresponding 90% CI of AUC(0-last) (Day 20/Day 1) for each of the 5 probe drugs is reported.

Caffeine (n = 19)
GroupValue95% CI
Vemurafenib2.562.24 – 2.93
Dextromethorphan (n = 20)
GroupValue95% CI
Vemurafenib1.471.21 – 1.78
Midazolam (n = 20)
GroupValue95% CI
Vemurafenib0.610.50 – 0.74
Omeprazole (n = 20)
GroupValue95% CI
Vemurafenib1.130.92 – 1.37
S-warfarin (n = 20)
GroupValue95% CI
Vemurafenib1.181.12 – 1.24
Geometric Mean Ratio of Maximum Plasma Concentration (Cmax) of Probe Parent Drugs Primary · Day 1, 20: 0, 1, 3, 4, 6, 8, 24 hours, additionally for caffeine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120,dextromethorphan 0.5, 1.5, 2, 12, 18, 48,midazolam 0.08, 0.25, 0.5, 0.75, 2, 10,omeprazole 0.5, 1.5, 2, 2.5, 12, 18,S-warfarin 12, 48, 72, 96, 120 hours

To assess the potential for drug-drug interactions, the geometric mean ratios and corresponding 90% CI of Cmax of parent probe drug before (Day 1) and after treatment with vemurafenib (Day 20) was calculated. Ratio and corresponding 90% CI of Cmax (Day 20/Day 1) for each of the 5 probe drugs is reported.

Caffeine (n = 19)
GroupValue95% CI
Vemurafenib1.050.98 – 1.13
Dextromethorphan (n = 20)
GroupValue95% CI
Vemurafenib1.361.07 – 1.72
Midazolam (n = 20)
GroupValue95% CI
Vemurafenib0.650.54 – 0.78
Omeprazole (n = 20)
GroupValue95% CI
Vemurafenib1.170.92 – 1.49
S-warfarin (n = 20)
GroupValue95% CI
Vemurafenib1.000.93 – 1.08
Geometric Mean Ratio of AUC(0-last) and Cmax of Metabolites of Probe Parent Drugs Primary · Day 1, 20: 0, 1, 3, 4, 6, 8, 24 hours, additionally for paraxanthine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120, dextrorphan 0.5, 1.5, 2, 12, 18, 48, OH-midazolam 0.08, 0.25, 0.5, 0.75, 2, 10, OH-omeprazole 0.5, 1.5, 2, 2.5, 12, 18 hours

AUC(0-last) was defined as the area under the plasma concentration-time curve calculated using the linear trapezoidal rule from time zero to the last observed sampling time. To assess the potential for drug-drug interactions, the geometric mean ratios and corresponding 90% CI of AUC(0-last) and Cmax of metabolites of parent probe drug before (Day 1) and after treatment with vemurafenib (Day 20) was calculated. Ratio and corresponding 90% CI of AUC(0-last) and Cmax (Day 20/Day 1) for each of the 4 probe drug metabolites is reported (paraxanthine \[caffeine metabolite\], dextrorphan \[dextrometh

Paraxanthine - AUC(0-last) (n = 19)
GroupValue95% CI
Vemurafenib1.150.98 – 1.36
Paraxanthine - Cmax (n = 19)
GroupValue95% CI
Vemurafenib0.600.53 – 0.68
Dextrorphan - AUC(0-last) (n = 20)
GroupValue95% CI
Vemurafenib1.461.22 – 1.75
Dextrorphan - Cmax (n = 20)
GroupValue95% CI
Vemurafenib1.210.97 – 1.51
OH-Midazolam - AUC(0-last) (n = 20)
GroupValue95% CI
Vemurafenib1.341.17 – 1.54
OH-Midazolam - Cmax (n = 20)
GroupValue95% CI
Vemurafenib1.231.04 – 1.44
OH-Omeprazole - AUC(0-last) (n = 20)
GroupValue95% CI
Vemurafenib1.161.06 – 1.28
OH-Omeprazole - Cmax (n = 20)
GroupValue95% CI
Vemurafenib1.010.87 – 1.18
AUC(0-last) and Area Under the Plasma Concentration-Time Curve From Time Zero Extrapolated to Infinity (AUC[0-inf]) of Probe Parent Drugs and Their Metabolites on Day 1 Primary · Day 1: 0, 1, 3, 4, 6, 8, 24 hours, additionally for caffeine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120,dextromethorphan 0.5, 1.5, 2, 12, 18, 48,midazolam 0.08, 0.25, 0.5, 0.75, 2, 10,omeprazole 0.5, 1.5, 2, 2.5, 12, 18,S-warfarin 12, 48, 72, 96, 120 hours

AUC(0-last) was defined as the area under the plasma concentration-time curve calculated using the linear trapezoidal rule from time zero to the last observed sampling time. AUC(0-inf) was defined as the area under the plasma concentration-time curve calculated using the linear trapezoidal rule from time zero extrapolated to infinity. Timeframe reported for parent probe drug is also applicable for their metabolite except S-warfarin, as S-warfarin does not have a metabolite.

Caffeine - AUC(0-last) (n = 19)
GroupValue95% CI
Vemurafenib56350.1± 24744.07
Caffeine - AUC(0-inf) (n = 19)
GroupValue95% CI
Vemurafenib58337.5± 25287.72
Paraxanthine - AUC(0-last) (n = 19)
GroupValue95% CI
Vemurafenib45584.3± 15667.21
Paraxanthine - AUC(0-inf) (n = 19)
GroupValue95% CI
Vemurafenib47589.5± 16667.35
S-Warfarin - AUC(0-last) (n = 20)
GroupValue95% CI
Vemurafenib14964.5± 4566.80
S-Warfarin - AUC(0-inf) (n = 20)
GroupValue95% CI
Vemurafenib17832.5± 6785.62
Omeprazole - AUC(0-last) (n = 20)
GroupValue95% CI
Vemurafenib3110.4± 2956.30
Omeprazole - AUC(0-inf) (n = 20)
GroupValue95% CI
Vemurafenib3181.0± 3107.71
AUC(0-last) and AUC(0-inf) of Probe Parent Drugs and Their Metabolites on Day 20 Primary · Day 20: 0, 1, 3, 4, 6, 8, 24 hours, additionally for caffeine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120,dextromethorphan 0.5, 1.5, 2, 12, 18, 48,midazolam 0.08, 0.25, 0.5, 0.75, 2, 10,omeprazole 0.5, 1.5, 2, 2.5, 12, 18,S-warfarin 12, 48, 72, 96, 120 hours

AUC(0-last) was defined as the area under the plasma concentration-time curve calculated using the linear trapezoidal rule from time zero to the last observed sampling time. AUC(0-inf) was defined as the area under the plasma concentration-time curve calculated using the linear trapezoidal rule from time zero extrapolated to infinity. Timeframe reported for parent probe drug is also applicable for their metabolite except S-warfarin, as S-warfarin does not have a metabolite.

Caffeine - AUC(0-last) (n = 19)
GroupValue95% CI
Vemurafenib140991.9± 56983.62
Caffeine - AUC(0-inf) (n = 19)
GroupValue95% CI
Vemurafenib161490.6± 81139.12
Paraxanthine - AUC(0-last) (n = 19)
GroupValue95% CI
Vemurafenib51344.3± 14888.54
Paraxanthine - AUC(0-inf) (n = 19)
GroupValue95% CI
Vemurafenib55060.5± 15481.99
S-Warfarin - AUC(0-last) (n = 20)
GroupValue95% CI
Vemurafenib17804.4± 5956.35
S-Warfarin - AUC(0-inf) (n = 20)
GroupValue95% CI
Vemurafenib22233.3± 9485.43
Omeprazole - AUC(0-last) (n = 20)
GroupValue95% CI
Vemurafenib3155.6± 3090.03
Omeprazole - AUC(0-inf) (n = 20)
GroupValue95% CI
Vemurafenib3224.9± 3200.67
Area Under the Plasma Concentration-Time Curve From Time Zero to 8, 12, and 24 Hours (AUC[0-8], AUC[0-12], AUC[0-24]) of Vemurafenib Primary · 0, 0.5, 1, 2, 4, 8, 12, 13, 14, 16, 18, 24 hours on Day 19

Area under the plasma concentration-time curve calculated using the linear trapezoidal rule from time zero to 8, 12, and 24 hours (AUC\[0-8\], AUC\[0-12\], AUC\[0-24\], respectively).

AUC(0-8)
GroupValue95% CI
Vemurafenib422± 121
AUC(0-12)
GroupValue95% CI
Vemurafenib601± 170
AUC(0-24)
GroupValue95% CI
Vemurafenib1176± 368
Cmax of Probe Parent Drugs and Their Metabolites on Day 1 Primary · Day 1: 0, 1, 3, 4, 6, 8, 24 hours, additionally for caffeine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120,dextromethorphan 0.5, 1.5, 2, 12, 18, 48,midazolam 0.08, 0.25, 0.5, 0.75, 2, 10,omeprazole 0.5, 1.5, 2, 2.5, 12, 18,S-warfarin 12, 48, 72, 96, 120 hours

Timeframe reported for parent probe drug is also applicable for their metabolite except S-warfarin as S-warfarin does not have a metabolite.

Caffeine - Cmax (n = 19)
GroupValue95% CI
Vemurafenib4768.9± 1108.43
Paraxanthine - Cmax (n = 19)
GroupValue95% CI
Vemurafenib1839.1± 477.75
S-Warfarin - Cmax (n = 20)
GroupValue95% CI
Vemurafenib469.4± 127.22
Omeprazole - Cmax (n = 20)
GroupValue95% CI
Vemurafenib913.7± 610.63
OH-Omeprazole - Cmax (n = 20)
GroupValue95% CI
Vemurafenib331.3± 127.60
Dextromethorphan - Cmax (n = 20)
GroupValue95% CI
Vemurafenib3.38± 4.236
Dextrorphan - Cmax (n = 20)
GroupValue95% CI
Vemurafenib6.49± 5.041
Midazolam - Cmax (n = 20)
GroupValue95% CI
Vemurafenib41.88± 29.197
Cmax of Probe Parent Drugs and Their Metabolites on Day 20 Primary · Day 20: 0, 1, 3, 4, 6, 8, 24 hours, additionally for caffeine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120,dextromethorphan 0.5, 1.5, 2, 12, 18, 48,midazolam 0.08, 0.25, 0.5, 0.75, 2, 10,omeprazole 0.5, 1.5, 2, 2.5, 12, 18,S-warfarin 12, 48, 72, 96, 120 hours

Timeframe reported for parent probe drug is also applicable for their metabolite except S-warfarin as S-warfarin does not have a metabolite.

Caffeine - Cmax (n = 19)
GroupValue95% CI
Vemurafenib4990.5± 1005.33
Paraxanthine - Cmax (n = 19)
GroupValue95% CI
Vemurafenib1154.9± 446.30
S-Warfarin - Cmax (n = 20)
GroupValue95% CI
Vemurafenib468.3± 115.63
Omeprazole - Cmax (n = 20)
GroupValue95% CI
Vemurafenib945.8± 535.41
OH-Omeprazole - Cmax (n = 20)
GroupValue95% CI
Vemurafenib348.7± 168.43
Dextromethorphan - Cmax (n = 20)
GroupValue95% CI
Vemurafenib4.19± 5.342
Dextrorphan - Cmax (n = 20)
GroupValue95% CI
Vemurafenib7.10± 4.332
Midazolam - Cmax (n = 20)
GroupValue95% CI
Vemurafenib26.18± 13.811
Cmax of Vemurafenib Primary · 0, 0.5, 1, 2, 4, 8, 12, 13, 14, 16, 18, 24 hours on Day 19
GroupValue95% CI
Vemurafenib61.7± 17.2
Time to Reach Maximum Plasma Concentration (Tmax) of Probe Parent Drugs and Their Metabolites on Day 1 Primary · Day 1: 0, 1, 3, 4, 6, 8, 24 hours, additionally for caffeine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120,dextromethorphan 0.5, 1.5, 2, 12, 18, 48,midazolam 0.08, 0.25, 0.5, 0.75, 2, 10,omeprazole 0.5, 1.5, 2, 2.5, 12, 18,S-warfarin 12, 48, 72, 96, 120 hours

Timeframe reported for parent probe drug is also applicable for their metabolite except S-warfarin as S-warfarin does not have a metabolite.

Caffeine - Tmax (n = 19)
GroupValue95% CI
Vemurafenib1.001.00 – 3.00
Paraxanthine - Tmax (n = 19)
GroupValue95% CI
Vemurafenib8.004.00 – 24.00
S-Warfarin - Tmax (n = 20)
GroupValue95% CI
Vemurafenib3.001.00 – 6.00
Omeprazole - Tmax (n = 20)
GroupValue95% CI
Vemurafenib3.001.00 – 8.00
OH-Omeprazole - Tmax (n = 20)
GroupValue95% CI
Vemurafenib3.001.00 – 8.00
Dextromethorphan - Tmax (n = 20)
GroupValue95% CI
Vemurafenib1.500.50 – 3.00
Dextrorphan - Tmax (n = 20)
GroupValue95% CI
Vemurafenib1.500.50 – 4.00
Midazolam - Tmax (n = 20)
GroupValue95% CI
Vemurafenib0.500.25 – 2.00
Tmax of Probe Parent Drugs and Their Metabolites on Day 20 Primary · Day 20: 0, 1, 3, 4, 6, 8, 24 hours, additionally for caffeine 0.5, 1.5, 2, 12, 18, 48, 72, 96, 120,dextromethorphan 0.5, 1.5, 2, 12, 18, 48,midazolam 0.08, 0.25, 0.5, 0.75, 2, 10,omeprazole 0.5, 1.5, 2, 2.5, 12, 18,S-warfarin 12, 48, 72, 96, 120 hours

Timeframe reported for parent probe drug is also applicable for their metabolite except S-warfarin as S-warfarin does not have a metabolite.

Caffeine - Tmax (n = 19)
GroupValue95% CI
Vemurafenib2.001.00 – 122.00
Paraxanthine - Tmax (n = 19)
GroupValue95% CI
Vemurafenib24.008.00 – 122.00
S-Warfarin - Tmax (n = 20)
GroupValue95% CI
Vemurafenib3.001.00 – 8.00
Omeprazole - Tmax (n = 20)
GroupValue95% CI
Vemurafenib2.51.0 – 8.0
OH-Omeprazole - Tmax (n = 20)
GroupValue95% CI
Vemurafenib3.001.00 – 8.00
Dextromethorphan - Tmax (n = 20)
GroupValue95% CI
Vemurafenib1.500.50 – 3.00
Dextrorphan - Tmax (n = 20)
GroupValue95% CI
Vemurafenib1.501.00 – 3.00
Midazolam - Tmax (n = 20)
GroupValue95% CI
Vemurafenib0.500.25 – 1.05
Tmax of Vemurafenib Primary · 0, 0.5, 1, 2, 4, 8, 12, 13, 14, 16, 18, 24 hours on Day 19
GroupValue95% CI
Vemurafenib3.100.00 – 26.1

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to 28 days after the last dose of study drug (median treatment duration: 144 days). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Vemurafenib
Serious: 12/25 (48%)
Deaths:

Serious adverse events (10 terms)

ReactionSystemVemurafenib
Squamous cell carcinoma of skinNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Basal cell carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
KeratoacanthomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Febrile neutropeniaBlood and lymphatic system disorders
UveitisEye disorders
Gastrointestinal haemorrhageGastrointestinal disorders
PyrexiaGeneral disorders
Blood alkaline phosphatase increasedInvestigations
DehydrationMetabolism and nutrition disorders
Cerebrovasular accidentNervous system disorders
Other adverse events (79 terms — click to expand)

ReactionSystemVemurafenib
FatigueGeneral disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Photosensitivity reactionSkin and subcutaneous tissue disorders
HyperkeratosisSkin and subcutaneous tissue disorders
PruritusSkin and subcutaneous tissue disorders
Rash maculo-papularSkin and subcutaneous tissue disorders
AlopeciaSkin and subcutaneous tissue disorders
NauseaGastrointestinal disorders
HeadacheNervous system disorders
Skin papillomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Actinic KeratosisSkin and subcutaneous tissue disorders
DiarrhoeaGastrointestinal disorders
Pain in extremityMusculoskeletal and connective tissue disorders
AnaemiaBlood and lymphatic system disorders
Oedema peripheralGeneral disorders
PyrexiaGeneral disorders
Nipple swellingReproductive system and breast disorders
RashSkin and subcutaneous tissue disorders
Dry eyeEye disorders
VomitingGastrointestinal disorders
ChillsGeneral disorders
SunburnInjury, poisoning and procedural complications
Gamma-glutamyltransferase increasedInvestigations
Decreased appetiteMetabolism and nutrition disorders
HypokalaemiaMetabolism and nutrition disorders
HyponatraemiaMetabolism and nutrition disorders
DysgeusiaNervous system disorders
AcneSkin and subcutaneous tissue disorders
Palmar-plantar erythrodysaesthesia syndromeSkin and subcutaneous tissue disorders
HypertensionVascular disorders
Upper respiratory tract infectionInfections and infestations
Blood alkaline phosphatase increasedInvestigations
Blood creatinine increasedInvestigations
Weight decreasedInvestigations
White blood cell count decreasedInvestigations
Joint stiffnessMusculoskeletal and connective tissue disorders
Muscle spasmsMusculoskeletal and connective tissue disorders
Musculoskeletal painMusculoskeletal and connective tissue disorders
AnxietyPsychiatric disorders
InsomniaPsychiatric disorders

Most-reported serious reactions: Squamous cell carcinoma of skin, Basal cell carcinoma, Keratoacanthoma, Febrile neutropenia, Uveitis, Gastrointestinal haemorrhage, Pyrexia, Blood alkaline phosphatase increased.

Data from ClinicalTrials.gov NCT01001299 adverse events section.

Sponsor's own description

This open-label single-arm study will evaluate the effect of RO5185426 \[RG7204; PLEXXIKON: PLX4032\] on the pharmacokinetics of five CYP450 substrates (caffeine, warfarin + vitamin K, omeprazole, dextromethorphan, midazolam) administered as a drug cocktail to patients with metastatic melanoma. The study will also evaluate efficacy and safety of RO5185426. On day 1, patients will receive the drug cocktail. On days 6 to 19, patients will receive RO5185426 twice daily. On day 20, patients will receive RO5185426 and the drug cocktail and on days 21 to 25, patients will receive RO5185426. Assessments will be made at regular intervals during the dosing periods and at follow-up. Patients may continue on study treatment (RO5185426) until the development of progressive disease or unacceptable toxicity. Target sample size \<50.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. RAS mutations in cutaneous squamous-cell carcinomas in patients treated with BRAF inhibitors.
    Su F, Viros A, Milagre C, Trunzer K, et al · · 2012 · cited 802× · PMID 22256804 · DOI 10.1056/nejmoa1105358
  2. Biological challenges of BRAF inhibitor therapy.
    Puzanov I, Burnett P, Flaherty KT. · · 2011 · cited 28× · PMID 21393075 · DOI 10.1016/j.molonc.2011.01.005

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