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Brief Title: Paclitaxel and TAK-228 in Urothelial Carcinoma
Official Title: Phase II Study of Paclitaxel and TAK-228 in Metastatic Urothelial Carcinoma (UC) and the Impact of PI3K-mTOR Pathway Genomic Alterations
Study ID: NCT03745911
Brief Summary: Phase II Multicentre, single arm, open label study of Paclitaxel and TAK-228 in metastatic urothelial carcinoma (UC) and the impact of PI3K-mTOR pathway genomic alterations
Detailed Description: The PI3K/AKT/mTOR pathway has been shown to be altered in a large percentage of metastatic urothelial carcinoma (UC) tumors. Within this pathway, the PI3 kinase alpha subunit (PIK3CA) is frequently mutated in muscle invasive bladder cancer (MIBC) (15-20%) and PTEN is inactivated in another 30%. Due to TAK-228's effects on the PI3K/AKT/mTOR pathway in preclinical studies and the frequency of pathway alterations in UC tumors, TAK-228 is a rational therapy for bladder cancer. This clinical investigation may also reveal how alterations in the PI3K/AKT/mTOR pathway correlate with treatment response. In preclinical bladder cell line models and xenografts done in our lab, synergistic effect has been seen with the combination with paclitaxel. The primary end-point is objective response rate (ORR) with the goal of increasing the rate from 10% to 26%. Response rates will be measured using RECIST 1.1 criteria. PFS and OS will be measured from the start date of treatment with TAK-228 and paclitaxel. Grade 3, 4 or serious adverse events will be collected and compared to the catalogued events in the phase II trial in breast cancer (NCT01351350). Patient tumors will be analyzed for genetic alterations within the PI3K/AKT/mTOR pathway to determine if alterations within this pathway correlate with response rate, PFS, or OS.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Hospital General Universitario de Elche, Elche, Alicante, Spain
Parc Taulí Hospital Universitario, Sabadell, Barcelona, Spain
Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
Hospital del Mar, Barcelona, , Spain
Hospital de la Santa Creu i Sant Pau, Barcelona, , Spain
Name: Joaquín Bellmunt, MD/PhD
Affiliation: Hospital del Mar
Role: PRINCIPAL_INVESTIGATOR
Name: Alejo Rodríguez-Vida, MD/PhD
Affiliation: Hospital del Mar
Role: PRINCIPAL_INVESTIGATOR