DETERMINE (Determining Extended Therapeutic Indications for Existing Drugs in Rare Molecularly Defined Indications Using a National Evaluation Platform Trial):An Umbrella-Basket Platform Trial to Evaluate the Efficacy of Targeted Therapies in Rare Adult, Paediatric and Teenage/Young Adult (TYA) Cancers With Actionable Genomic Alterations, Including Common Cancers With Rare Actionable Alterations.Treatment Arm 06: Capmatinib in Adult Patients With Cancers Harbouring MET Dysregulations
This clinical trial is looking at a drug called capmatinib. Capmatinib is approved as standard of care treatment for adult patients with certain types of lung cancer. This means it has gone through clinical trials and been approved by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. Capmatinib works in lung cancer patients with a particular mutation in their cancer known as a METex14 skipping mutation. Investigators now wish to find out if it will be useful in treating patients with other cancer types which have the same mutation or other specific mutations or changes which take place in the MET gene. If the results are positive, the study team will work with the NHS and the Cancer Drugs Fund to see if these drugs can be routinely accessed for patients in the future. This trial is part of a trial programme called DETERMINE. The programme will also look at other anti-cancer drugs in the same way, through matching the drug to rare cancer types or ones with specific mutations.
⁃ A. Confirmed diagnosis of a MET-positive malignancy using an analytically validated next-generation sequencing method (METex14 skipping, MET amplification, MET fusion, or MET activating mutation).
⁃ B. Adult patients ≥18 years old.
⁃ C. Women of childbearing potential are eligible, provided that they meet the following criteria:
• Have a negative serum or urine pregnancy test before enrolment, and
• Agree to use one form of highly effective birth control method (a method that can achieve a failure rate of \<1% when used consistently and correctly), such as:
⁃ I. combined (oestrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation \[oral, intravaginal or transdermal\]) II. progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, or implantable) III. intrauterine device (IUD) IV. Intrauterine hormone-releasing system (IUS) V. bilateral tubal occlusion VI. vasectomised partner VII. sexual abstinence Effective from the first administration of capmatinib, throughout the trial and for seven days after the last administration of capmatinib.
⁃ D. Male patients with partners who are women of childbearing potential are eligible provided that they agree to the following, from first administration of capmatinib, throughout the trial and for seven days after the last administration of capmatinib:
• Agree to take measures not to father children by using a barrier method of contraception (e.g. condom) or sexual abstinence.
• Non-vasectomised male patients with partners who are women of childbearing potential must also be willing to ensure that their partner uses a highly effective method of contraception, as in criterion C above.
• Male patients with pregnant or lactating partners must be advised to use barrier method contraception (for example, condom) to prevent drug exposure of the foetus or neonate.
⁃ All male patients must refrain from donating sperm for the same period.
⁃ E. Patients must be able and willing to undergo a fresh biopsy at baseline and blood samples for translational research. Note that for patients with haematological malignancies or neuroblastomas, blood, bone marrow aspiration and/or trephine or lymph node biopsy samples may be taken.
⁃ F. Adequate organ function as per haematological and biochemical indices within the ranges shown below. These measurements should be performed to confirm the patient's eligibility.
⁃ Haemoglobin (Hb): ≥90 g/L (transfusion allowed)
⁃ Absolute neutrophil count (ANC): ≥1.5 × 10\^9/L (no granulocyte colony-stimulating factor \[GCSF\] support in preceding 72 hours)
⁃ Platelet count: ≥100 × 10\^9/L (unsupported for 72 hours)
⁃ Total bilirubin: \<1.5 × upper limit of normal (ULN) or ≤2.5 × ULN if raised due to metastases (patients with Gilbert's syndrome may be included if total bilirubin is ≤3.0 × ULN and direct bilirubin is ≤1.5 × ULN).
⁃ Alanine aminotransferase (ALT) and aspartate aminotransferase (AST): ≤3 × ULN or ≤5 × ULN if raised due to metastases
⁃ Coagulation - prothrombin (PT) (or international normalized ratio \[INR\]) and activated partial thromboplastin clotting time (aPTT): ≤1.5 × ULN or ≤1.5 × below lower limit of normal (LLN) (unless patient is on anticoagulants e.g. warfarin \[INR should be stable and within indicated therapeutic range\], or direct oral anticoagulants \[DOAC\])
⁃ Estimated glomerular filtration rate (eGFR): eGFR: ≥30 mL/min (uncorrected value)
⁃ Asymptomatic amylase: ≤5 × ULN and no signs and/or symptoms suggesting pancreatitis or pancreatic injury (e.g. elevated amylase, abnormal imaging findings of pancreas, etc.)
⁃ Asymptomatic lipase: ≤5 × ULN and no signs and/or symptoms suggesting pancreatitis or pancreatic injury (e.g. elevated lipase, abnormal imaging findings of pancreas, etc.)