A Study of MEK162 and AMG 479 in Patients With Selected Solid Tumors

This is a multi-center, open-label, phase Ib/II study. First, the aim of the phase Ib part is to estimate the MTD(s) and/or to identify the recommended phase II dose(s) (RP2D) for the combination of MEK162 and AMG 479 (ganitumab), followed by the phase II part to assess the clinical efficacy and to further assess the safety of the combination in selected patient populations. The dose escalation part of the study will be guided by a Bayesian Logistic Regression Model (BLRM). At least 18 patients are expected to be enrolled in the dose escalation part.

Following MTD/ RP2D declaration, patients will be enrolled in three phase II arms to assess efficacy of the combination as well as to better understand the safety, tolerability, PK, antibody concentrations and PD of the combination at MTD/RP2D. Phase II arm 1 will consist of approximately 25 patients with KRAS-mutant colorectal adenocarcinoma. Phase II arm 2 will consist of approximately 20 patients with metastatic pancreatic adenocarcinoma. Phase II arm 3 will consist of approximately 28 patients with mutant BRAFV600 melanoma.

Patients will be treated until progression of disease, unacceptable toxicity develops, or withdrawal of informed consent, whichever occurs first. All patients will be followed up - at minimum patients must complete the safety follow-up assessments 30 days after the last dose of the study treatment.

• Metastatic Pancreatic Adenocarcinoma
• BRAF Mutated Melanoma

• Drug: MEK162
  Supplied as tablets of dosage strength 15 mg in high-density polyethylene bottles with child-resistant closure.
  Other Name: Binimetinib
• Drug: AMG 479
  Supplied as sterile liquid for intravenous infusion in vials in boxes. Until April 2013 a frozen formulation with a concentration of 30 mg/ml was used; from May 2013 onwards a refrigerated formulation with a concentration of 70 mg/ml was used.
  Other Name: Ganitumab

• Experimental: Dose escalation
  Dose finding group chosen in order to establish a safe and tolerated dose of binimetinib in combination with ganitumab in patients with selected advanced solid tumors.
  Interventions:

  • Drug: MEK162
  • Drug: AMG 479
• Experimental: KRAS mutated colorectal adenocarcinoma

  Patients with KRAS mutant colorectal cancer.

  The starting dose (30 mg bid) of binimetinib chosen for this study was a fraction of the MTD (60 mg bid) and the RP2D (45 mg bid) determined for single agent use. The starting dose for ganitumab was 12 mg/kg q2w which had been shown to be a well-tolerated dose in combination with other anti-cancer agents.

  Interventions:

  • Drug: MEK162
  • Drug: AMG 479
• Experimental: Metastatic pancreatic adenocarcinoma

  Patients with metastatic pancreatic cancer.

  The starting dose (30 mg bid) of binimetinib chosen for this study was a fraction of the MTD (60 mg bid) and the RP2D (45 mg bid) determined for single agent use. The starting dose for ganitumab was 12 mg/kg q2w which had been shown to be a well-tolerated dose in combination with other anti-cancer agents.

  Interventions:

  • Drug: MEK162
  • Drug: AMG 479
• Experimental: BRAF mutated melanoma

  Patients with mutant BRAF V600 melanoma.

  The starting dose (30 mg bid) of binimetinib chosen for this study was a fraction of the MTD (60 mg bid) and the RP2D (45 mg bid) determined for single agent use. The starting dose for ganitumab was 12 mg/kg q2w which had been shown to be a well-tolerated dose in combination with other anti-cancer agents.

  Interventions:

  • Drug: MEK162
  • Drug: AMG 479

Inclusion Criteria:

• Patients aged ? 18 years
• Patients with advanced solid tumors (CRC, melanoma) with documented somatic KRAS or BRAFV600 mutations in tumor tissue. Patients with metastatic pancreatic adenocarcinoma may be enrolled irrespectively of KRAS or BRAFV600 mutational status.
• Patients must have relapsed or progressed following standard therapy or patients for whom no standard anticancer therapy exists.
• Measurable disease as determined by RECIST v1.1. World Health Organization (WHO) Performance Status (PS) ? 2.
• Adequate organ function
• Negative serum pregnancy test

Exclusion Criteria:

• Prior therapy with MEK- or IGF-1R- inhibitor
• History or current evidence of central serous retinopathy (CSR), retinal vein occlusion (RVO) or retinal degenerative disease
• Patients with known history of severe infusion reactions to monoclonal antibodies
• Patients with primary CNS tumor or CNS tumor involvement
• History of thromboembolic event requiring full-dose anticoagulation therapy
• Clinically significant cardiac disease
• History of another malignancy within 2 years
• Pregnant or nursing (lactating) women

Other protocol-defined inclusion/exclusion criteria may apply