Effect of Multiple Doses of Modafinil on the Pharmacokinetics of Single Dose Lorlatinib in Healthy Participants

Healthy Volunteers Clinical Trial

Official title: PHASE 1, OPEN-LABEL, FIXED SEQUENCE, 2-PERIOD STUDY TO INVESTIGATE THE EFFECT OF MULTIPLE DOSES OF MODAFINIL ON THE PHARMACOKINETICS OF SINGLE DOSE LORLATINIB (PF-06463922) IN HEALTHY PARTICIPANTS

Status Completed

Clinical Trial Summary

The primary purpose of the study is to characterize the safety profile of lorlatinib in the presence of a moderate CYP3A4/5 inducer, modafinil. In another drug-drug interaction study for lorlatinib coadministered with a strong CYP3A4/5 inducer, rifampin, all participants experienced increases in liver enzymes after receiving the combination of a single dose lorlatinib (100 mg) with rifampin (600 mg daily (QD)) after multiple doses of rifampin. The AST and ALT continued to increase over the next 24-48 hours, but recovered below the upper limit of normal for all participants upon discontinuation of rifampin.

We hypothesize the combination of lorlatinib with the moderate CYP3A inducer modafinil will not have a safety findings related to liver enzyme elevation similar to what occurred in the study with rifampin and lorlatinib.

Clinical Trial Description

This will be a Phase 1 study in approximately 16 healthy participants employing administration of a single dose of lorlatinib in the fasted state alone, and with multiple doses of modafinil 400 mg once daily. This study will consist of up to 3 lorlatinib treatment groups: 50, 75, or 100 mg single doses of lorlatinib given alone and in combination with multiple doses of modafinil.

Each enrolled participant will receive lorlatinib 50, 75, or 100 mg alone in Period 1 and then lorlatinib 50, 75, or 100 mg in combination with multiple dose modafinil in Period 2 after a washout period of at least 19 days between lorlatinib doses in Periods 1 and 2. A single PK sample is taken prior to lorlatinib dosing in each period. Following administration of lorlatinib in each period, participants will undergo serial PK sampling.

There will be 4 cohorts. Cohorts 1 to 3 will include 2 participants each, while Cohort 4 will include 10 participants. Participants in Cohorts 1 to 4 will be sequentially enrolled such that participants in a new cohort can receive their lorlatinib Period 2 dose only after participants from the prior cohort are 72 hours past their lorlatinib Period 2 combination dose (with modafinil) with no safety concerns. In addition, Cohorts 1 to 3 will employ sentinel dosing such that the second participant in each cohort can receive their lorlatinib Period 2 dose only after the first participant from the same cohort is 72 hours past their lorlatinib and modafinil Period 2 combination dose with no safety concerns. Participants in Cohort 4 may be dosed in parallel, as sentinel dosing of lorlatinib 100 mg will have been completed in Cohort 3. The overall study design will be identical in all 4 cohorts, with the only difference being the dose of lorlatinib administered.

The decision to dose subsequent cohorts during Period 2 with lorlatinib will be made after reviewing the totality of the participants' clinical picture for safety by the investigator. Furthermore, participants in subsequent cohorts will not be dosed if the following liver function abnormalities are observed during the 72 hour time frame for safety evaluation after lorlatinib dosing in Period 2.

For enrollment of each successive cohort, the period of safety evaluation will be at least 72 hours after the Period 2 lorlatinib dosing in the previous cohort. During Period 2, safety laboratory assessments including urinalysis, hematology and chemistry will be performed once daily from Day 14 through Day 20. Only after the review of safety labs for at least 72 hours after lorlatinib+ modafinil dosing during Period 2 of the previous cohort, will participants in a new cohort receive lorlatinib in combination with modafinil in their Period 2. Additional safety laboratory assessments may be performed at any additional times at the discretion of the investigator. If safety events of concern are observed in Cohorts 1, 2, or 3 during Period 2, this study will be terminated. ;

Related Conditions & MeSH terms

• Adult
• Drug Interactions
• Healthy Volunteers
• Humans

• NCT number: NCT03961997
• Study type: Interventional
• Source: Pfizer
• Status: Completed
• Phase: Phase 1
• Start date: August 22, 2019
• Completion date: December 9, 2019