Clinical trial • Phase I/II • Oncology

BRIGATINIB for Anaplastic large-cell lymphoma | Inflammatory myofibroblastic tumour | Other solid tumors

Phase I/II trial of BRIGATINIB for Anaplastic large-cell lymphoma | Inflammatory myofibroblastic tumour | Other solid tumors.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Anaplastic large-cell lymphoma | Inflammatory myofibroblastic tumour | Other solid tumors
Trial Stage
Phase I/II
Drug Modality
Small molecule
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
03-10-2024
First CTIS Authorization Date
31-10-2024

Trial design

None/Not specified-controlled, adaptive Phase I/II trial in Netherlands, France, Denmark and others.

Comparator
None/Not specified
Adaptive
True, dose-escalation in Phase 1 with DSMB selection of RP2D based on PK equivalence to adult exposure (approximately ±20%), DLT incidence (<2/6 patients at RP2D) and observed responses; interim safety/PK-driven decisions for RP2D.
Biomarker Stratified
True, biomarker: ALK positivity; strata: ALK+ ALCL | ALK+ IMT | ALK+ other solid tumors
Single Multiple Or Escalation Dose Combined
Yes
Target Sample Size
11

Eligibility

Recruits 11 paediatric patients.

Vulnerable Population
Pediatric and adolescent participants are included (patients ≥1 and <26 years). The study materials include age-specific subject information sheets and informed consent forms for multiple age groups (e.g. minors under 7, 7-11, 12-17, young adults) and parent/guardian LAR forms; consent is provided by parents/legal guardians for minors with assent/age-appropriate information for children/adolescents as per those documents. Documents are available in multiple country/language versions (examples: FR, DE, NL, ES, IT, FI, SE, PL, CZ, DK, BE languages), indicating adapted consent/assent handling for vulnerable populations.

Inclusion criteria

  • {"criterion_text":"- Patients must be ≥ 1 and < 26 years of age at the time of enrollment, and able to swallow brigatinib tablets at the time of enrollment, with a minimum weight of 10 kg.\n- Patients must have a histologically confirmed diagnosis of cancer at baseline. In patients where a repeat biopsy at relapse (or moment of refractory disease) is considered not feasible by the treating physician, archived material from diagnosis needs to be available for central review.\n- Patients are required to provide prior results showing an activating ALK aberration in the tumor per local laboratory results, and material needs to be available for central laboratory confirmation of ALK status. For ALK+ ALCL, detection of ALK with immunohistochemistry (IHC) is sufficient for inclusion, all others require molecular evidence of a ALK fusion gene or mutation by FISH, PCR or NGS. ALK detection will be confirmed centrally with FISH.\n- Phase 1: • Patients with ALCL must be relapsed/refractory or intolerant to standard therapies. Refractory disease for ALCL is defined as: o no response to at least one course of ALCL99/other standard of care chemotherapy (SD or PD of measurable lesions), and/or o MRD-positivity by qualitative PCR for NPM-ALK after at least one course of ALCL99/other standard of care chemotherapy (before the second course of chemotherapy). • Patients with relapsed/refractory (R/R) IMT must not be suitable for curative surgical resection without causing mutilation. Newly diagnosed patients with locally advanced IMT, for whom surgery may not be feasible for close proximity to vital structures, without prior tumor-shrinkage, may also be included, as well as metastatic disease. • Patients with other solid tumors (excluding IMT) must have relapsed or refractory disease.\n- Phase 2: • Patients with ALCL must be relapsed/refractory. Refractory disease for ALCL is defined as: o no response to at least one course of ALCL99/other standard of care chemotherapy (SD or PD of measurable lesions), and/or o MRD-positivity by qualitative PCR for NPM-ALK after at least one course of ALCL99/other standard of care chemotherapy (before the second course of chemotherapy). • Patients with R/R IMT Relapsed/refractory IMT, or newly diagnosed, including locally advanced and metastatic IMT which cannot be surgically resected without causing mutilation.\n- Performance Status: • Karnofsky performance status ≥40% for patients >16 years of age or Lansky Play Scale ≥40% for patients ≤16 years of age for ALCL patients in phase 2. • Karnofsky performance status ≥50% for patients >16 years of age or Lansky Play Scale ≥50% for patients ≤16 years of age, for IMT and other solid tumors and for ALCL patients in phase 1.\n- Patients must not be receiving other investigational medications (defined as medicinal products not yet approved for any indications, including alternative/herbal therapies) within 30 days of first dose of study drug or while on study.\n- Cohort B1R and B2R: Patients who were previously treated in the phase 1 or phase 2 part of this study, who completed brigatinib treatment as defined in this protocol, who responded to prior brigatinib treatment on protocol, and who developed a relapse or progression within 12 months after completion of brigatinib treatment (defined as per the EOT visit date)."}

Exclusion criteria

  • {"criterion_text":"- Patients receiving systemic treatment with strong or moderate CYP3A inhibitors or inducers within 14 days or five half-lives, whichever the less, prior to the first dose of study drug (refer to Section 5.2 for a list of example medications).\n- Diagnosis of another concurrent primary malignancy."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Phase 1: dose-limiting toxicities (DLTs) during the first course of therapy.","definition_or_measurement_approach":"DLTs assessed during the first course of therapy in Phase 1 per protocol-defined DLT criteria."}
  • {"endpoint_text":"- Phase 1: Brigatinib plasma PK parameters to be determined: o maximum observed concentration (Cmax), o time of first occurrence of maximum observed concentration (Tmax), o area under the concentration-time curve from time 0 to the time of the last quantifiable concentration (AUClast).","definition_or_measurement_approach":"Plasma PK sampling to determine Cmax, Tmax and AUClast for brigatinib as specified in protocol."}
  • {"endpoint_text":"- Phase 1: The RP2D will be selected by the DSMB and will be based on the dose that results in equivalent (approximately ±20% of the adult values) PK exposure to the adult comparator and with <2 out of 6 patients at this dose level present with a DLT and taking into account responses observed in phase 1.","definition_or_measurement_approach":"RP2D selection by DSMB using PK exposure comparison to adult values (≈±20%), DLT incidence threshold (<2/6 patients with DLT) and observed responses in Phase 1."}
  • {"endpoint_text":"- Cohort B1: Overall response rate (ORR), defined as the percentage of patients with CR or PR according to RECIST 1.1 after 1 course and best ORR during brigatinib treatment.","definition_or_measurement_approach":"ORR measured per RECIST 1.1 as proportion of patients achieving CR or PR after one course and best response during treatment."}
  • {"endpoint_text":"- Cohort B2: EFS (using the IPNHL response criteria), defined as the time between start of study treatment and first event being progressive disease, relapse, death of any cause and second malignancies, whatever happens first. Patients consolidated with HSCT will be censored.","definition_or_measurement_approach":"Event-free survival measured from treatment start to first event (progression, relapse, death, second malignancy) per IPNHL criteria; HSCT-consolidated patients censored."}
  • {"endpoint_text":"- Cohort B1R: Overall response rate (ORR), defined as the percentage of patients with CR or PR according to RECIST 1.1 after 1 course and best ORR during brigatinib re-treatment.","definition_or_measurement_approach":"ORR on re-treatment measured per RECIST 1.1 as proportion with CR or PR after one course and best response during re-treatment."}
  • {"endpoint_text":"- Cohort B2R: EFS (using the IPNHL response criteria), defined as the time between restart of study treatment and first event being progressive disease, relapse, death of any cause and second malignancies, whatever happens first. Patients consolidated with HSCT will be censored.","definition_or_measurement_approach":"Event-free survival from restart of treatment to first event (progression, relapse, death, second malignancy) per IPNHL criteria; HSCT-consolidated patients censored."}

Recruitment

Planned Sample Size
54
Recruitment Window Months
135
Consent Approach
Informed consent is handled with age-appropriate ICFs: parent/guardian LAR consent for minors and assent/information sheets for children and adolescents; specific ICFs exist for multiple age bands (e.g. under 7, 7-11, 12-17, young adults) and for retreatment. Documents are provided in country/language-specific versions (examples include French, German, Dutch, Spanish, Italian, Finnish, Swedish, Polish, Czech, Danish, Belgian language variants), indicating consent and assent are managed per local regulations and age group.

Geography

Total Number Of Sites
28
Total Number Of Participants
54

Netherlands

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
16-10-2025
Processing Time Days
356
Number Of Sites
1
Number Of Participants
6

Sites

Site Name
Prinses Maxima Centrum voor Kinderoncologie B.V.
Department Name
Paediatric Oncology
Principal Investigator Name
Natasha van Eijkelenburg
Contact Person Name
Natasha van Eijkelenburg

France

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
15-10-2025
Processing Time Days
355
Number Of Sites
6
Number Of Participants
8

Sites

Site Name
Centre Hospitalier Universitaire De Nantes
Department Name
Hématologie - Oncologie Pédiatrique
Principal Investigator Name
Marie-Laure Couec
Principal Investigator Email
marielaure.couec@chu-nantes.fr
Contact Person Name
Marie-Laure Couec
Contact Person Email
marielaure.couec@chu-nantes.fr
Site Name
Pellegrin Hospital
Department Name
Unité d'Hématologie et d’Oncologie Pédiatriques
Principal Investigator Name
Stephane Ducassou
Principal Investigator Email
stephane.ducassou@chu-bordeaux.fr
Contact Person Name
Stephane Ducassou
Site Name
Centre Hospitalier Regional De Marseille
Department Name
Hématologie et oncologie pédiatrique
Principal Investigator Name
Nicolas Andre
Principal Investigator Email
nicolas.andre@ap-hm.fr
Contact Person Name
Nicolas Andre
Contact Person Email
nicolas.andre@ap-hm.fr
Site Name
Institut Gustave Roussy
Department Name
Cancérologie de l’Enfant et de l’Adolescent
Principal Investigator Name
Veronique Minard-Colin
Principal Investigator Email
veronique.minard@gustaveroussy.fr
Contact Person Name
Veronique Minard-Colin
Site Name
CHRU De Nancy
Department Name
Onco-hematologie pediatrique
Principal Investigator Name
Cecile Pochon
Principal Investigator Email
c.pochon@chru-nancy.fr
Contact Person Name
Cecile Pochon
Contact Person Email
c.pochon@chru-nancy.fr
Site Name
Hospices Civils De Lyon
Department Name
Hématologie et oncologie pédiatrique
Principal Investigator Name
Nathalie Garnier
Principal Investigator Email
nathalie.garnier@ihope.fr
Contact Person Name
Nathalie Garnier
Contact Person Email
nathalie.garnier@ihope.fr

Denmark

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
15-10-2025
Processing Time Days
355
Number Of Sites
1
Number Of Participants
3

Sites

Site Name
Rigshospitalet
Department Name
Dept. of Pediactrics and Adolescent Medicine
Principal Investigator Name
Ruta Tuckuviene
Principal Investigator Email
ruta.tuckuviene@regionh.dk
Contact Person Name
Ruta Tuckuviene
Contact Person Email
ruta.tuckuviene@regionh.dk

Netherlands

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
16-10-2025
Processing Time Days
356
Number Of Sites
1
Number Of Participants
6

Sites

Site Name
Prinses Maxima Centrum voor Kinderoncologie B.V.
Department Name
Paediatric Oncology
Principal Investigator Name
Natasha van Eijkelenburg
Contact Person Name
Natasha van Eijkelenburg

Belgium

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
15-10-2025
Processing Time Days
355
Number Of Sites
1
Number Of Participants
3

Sites

Site Name
Universitair Ziekenhuis Gent
Department Name
Pediatric Hemato-Oncology & Stem Cell Transplantation
Principal Investigator Name
Barbara De Moerloose
Principal Investigator Email
barbara.demoerloose@uzgent.be
Contact Person Name
Barbara De Moerloose
Contact Person Email
barbara.demoerloose@uzgent.be

Germany

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
15-10-2025
Processing Time Days
355
Number Of Sites
7
Number Of Participants
6

Sites

Site Name
University Hospital Cologne AöR
Department Name
Experimental Pediatric Oncology, University Children's Hospital
Principal Investigator Name
Matthias Fischer
Principal Investigator Email
matthias.fischer@uk-koeln.de
Contact Person Name
Matthias Fischer
Contact Person Email
matthias.fischer@uk-koeln.de
Site Name
Universitaetsklinikum Augsburg
Department Name
Children’s Cancer Center
Principal Investigator Name
Michael Fruhwald
Principal Investigator Email
michael.fruehwald@uk-augsburg.de
Contact Person Name
Michael Fruhwald
Site Name
Charite Universitaetsmedizin Berlin KöR
Department Name
Department of Pediatric Oncology and Hematology - Early Phase Clinical Trial Unit
Principal Investigator Name
Anne Thorwarth
Principal Investigator Email
Anne.thorwarth@charite.de
Contact Person Name
Anne Thorwarth
Contact Person Email
Anne.thorwarth@charite.de
Site Name
Universitaetsklinikum Muenster AöR
Department Name
Klinik für Kinder- und Jugendmedizin Pädiatrische Hämatologie und Onkologie
Principal Investigator Name
Birgit Burkhardt
Principal Investigator Email
birgit.burkhardt@ukmuenster.de
Contact Person Name
Birgit Burkhardt
Contact Person Email
birgit.burkhardt@ukmuenster.de
Site Name
Universitaetsklinikum Essen AöR
Department Name
Department of Pediatric Oncology and Hematology
Principal Investigator Name
Ivana Eikelberg
Principal Investigator Email
Ivana.Eikelberg@uk-essen.de
Contact Person Name
Ivana Eikelberg
Contact Person Email
Ivana.Eikelberg@uk-essen.de
Site Name
Universitaetsklinikum Frankfurt AöR
Department Name
Klinik für Kinder- und Jegendmedizin
Principal Investigator Name
Marie Luckowitsch
Principal Investigator Email
Marie.Luckowitsch@unimedizin-ffm.de
Contact Person Name
Marie Luckowitsch
Site Name
University Medical Center Hamburg-Eppendorf
Department Name
Pediatric Hematology and Oncology
Principal Investigator Name
Wilhelm Woessmann
Principal Investigator Email
w.woessmann@uke.de
Contact Person Name
Wilhelm Woessmann
Contact Person Email
w.woessmann@uke.de

Italy

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
15-10-2025
Processing Time Days
355
Number Of Sites
4
Number Of Participants
5

Sites

Site Name
Fondazione IRCCS Istituto Nazionale Dei Tumori
Department Name
Pediatria Oncologica
Principal Investigator Name
Michela Casanova
Principal Investigator Email
michela.casanova@istitutotumori.mi.it
Contact Person Name
Michela Casanova
Site Name
Azienda Ospedaliera di Padova
Department Name
U.O.C. Oncoematologia Pediatrica
Principal Investigator Name
Marta Pillon
Principal Investigator Email
marta.pillon@unipd.it
Contact Person Name
Marta Pillon
Contact Person Email
marta.pillon@unipd.it
Site Name
Fondazione IRCCS San Gerardo Dei Tintori
Department Name
Clinica Pediatrica
Principal Investigator Name
Alessandra Sala
Principal Investigator Email
alessandra.sala@irccs-sangerardo.it
Contact Person Name
Alessandra Sala
Site Name
Ospedale Pediatrico Bambino Gesu
Department Name
Dipartimento di Onco-Ematologia e Terapia Cellulare e Genica
Principal Investigator Name
Franco Locatelli
Principal Investigator Email
franco.locatelli@opbg.net
Contact Person Name
Franco Locatelli
Contact Person Email
franco.locatelli@opbg.net

Spain

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
15-10-2025
Processing Time Days
355
Number Of Sites
3
Number Of Participants
6

Sites

Site Name
Hospital Infantil Universitario Nino Jesus
Department Name
Department of Onco-Haematology and Haematopoietic Transplant.
Principal Investigator Name
Maitane Andion
Principal Investigator Email
maitane.andion@salud.madrid.org
Contact Person Name
Maitane Andion
Site Name
Hospital Universitario Y Politecnico La Fe
Department Name
Department of Pediatric Oncology.
Principal Investigator Name
Adela Cañete
Principal Investigator Email
canyete_ade@gva.es
Contact Person Name
Adela Cañete
Contact Person Email
canyete_ade@gva.es
Site Name
Hospital Universitari Vall D Hebron
Department Name
Department of Pediatric Oncology and Haematology.
Principal Investigator Name
Raquel Hladun
Principal Investigator Email
raquel.hladun@vallhebron.cat
Contact Person Name
Raquel Hladun
Contact Person Email
raquel.hladun@vallhebron.cat

Czechia

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
14-10-2025
Processing Time Days
354
Number Of Sites
1
Number Of Participants
4

Sites

Site Name
Fakultni Nemocnice V Motole
Department Name
Klinika detske hematologie a onkologie 2. LF UK
Principal Investigator Name
Lucie Sramkova
Principal Investigator Email
Lucie.Sramkova@fnmotol.cz
Contact Person Name
Lucie Sramkova
Contact Person Email
Lucie.Sramkova@fnmotol.cz

Poland

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
17-10-2025
Processing Time Days
357
Number Of Sites
1
Number Of Participants
5

Sites

Site Name
Uniwersytet Jagiellonski Collegium Medicum
Department Name
Klinika Onkologii i Hematologii Dziecięcej
Principal Investigator Name
Aleksandra Wieczorek
Principal Investigator Email
a.wieczorek@uj.edu.pl
Contact Person Name
Aleksandra Wieczorek
Contact Person Email
a.wieczorek@uj.edu.pl

Finland

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
13-10-2025
Processing Time Days
353
Number Of Sites
1
Number Of Participants
2

Sites

Site Name
HUS-Yhtymae
Department Name
Hemat.Onco & SCT
Principal Investigator Name
Antti Kyronlahti
Principal Investigator Email
Antti.Kyronlahti@hus.fi
Contact Person Name
Antti Kyronlahti
Contact Person Email
Antti.Kyronlahti@hus.fi

Austria

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
13-10-2025
Processing Time Days
353
Number Of Sites
1
Number Of Participants
3

Sites

Site Name
St. Anna Kinderspital GmbH
Department Name
Department of Pediatric Hematology and Oncology
Principal Investigator Name
Andishe Attarbaschi
Principal Investigator Email
andishe.attarbaschi@stanna.at
Contact Person Name
Andishe Attarbaschi
Contact Person Email
andishe.attarbaschi@stanna.at

Sweden

Earliest CTIS Part Ii Submission Date
25-10-2024
Latest Decision Or Authorization Date
06-05-2026
Processing Time Days
558
Number Of Sites
1
Number Of Participants
3

Sites

Site Name
Queen Silvia Childrens Hospital - Sahlgrenska University Hospital - Vaestra Goetalandsregionen
Department Name
Barncancercentrum
Principal Investigator Name
Karin Mellgren
Principal Investigator Email
karin.mellgren@vgregion.se
Contact Person Name
Karin Mellgren
Contact Person Email
karin.mellgren@vgregion.se

Sponsor

Primary sponsor

Full Name
Prinses Maxima Centrum voor Kinderoncologie B.V.
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Netherlands

Third parties

  • {"country":"Netherlands","full_name":"Allucent (NL) B.V.","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"","full_name":"Takeda","duties_or_roles":"Monetary support","organisation_type":""}

Investigational products

Investigational Product Name
BRIGATINIB (oral solution)
Active Substance
BRIGATINIB
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
ORAL USE
Investigational Product Name
Alunbrig 180 mg film-coated tablets
Active Substance
BRIGATINIB
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
EU/1/18/1264/009
Investigational Product Name
Alunbrig 90 mg film-coated tablets
Active Substance
BRIGATINIB
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
EU/1/18/1264/006
Investigational Product Name
Alunbrig 30 mg film-coated tablets
Active Substance
BRIGATINIB
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
EU/1/18/1264/001

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