A Drug-drug Interaction Study to Evaluate the Effects of Pelabresib on the Pharmacokinetics of Repaglinide, Midazolam, and Combined Oral Contraceptive in Patients With Advanced Malignancies
A Phase 1b, Open Label, 2-Part Study to Evaluate the Effect of Pelabresib (DAK539/CPI-0610) on the Pharmacokinetics of Repaglinide, Midazolam, and Combined Drospirenone/Ethinyl Estradiol Oral Contraceptive in Patients With Advanced Malignancies
Novartis Pharmaceuticals
24 participants
May 29, 2026
INTERVENTIONAL
Conditions
Summary
This drug-drug interaction (DDI) study aims to evaluate the impact of pelabresib at steady-state plasma concentrations on the pharmacokinetic (PK) profile of A) a single dose of repaglinide and a single dose of midazolam, and B) a single dose of combined drospirenone and ethinyl estradiol. The study will be conducted in adult participants with advanced malignancies for whom no standard or curative treatment options are available.
Eligibility
Inclusion Criteria12
- Is at least 18 years of age at the time of signing the informed consent.
- Has a confirmed documented diagnosis of an advanced malignancy for which no standard and/or curative treatment options are available
- Has the following acceptable laboratory assessments prior to the first dose of study treatment:
- Platelet count ≥ 150 × 109 /L in the absence of thrombopoietic factors or transfusions within 2 weeks of the screening assessment
- Absolute neutrophil count (ANC) ≥ 1 × 109 /L in the absence of granulocyte growth factors
- Peripheral blood blast count < 5%. Assessment of blasts in bone marrow is not mandatory at screening; however, blasts must be <5% if the bone marrow assessment is performed.
- Serum total bilirubin ≤ 1.5 × upper limit of normal (ULN)
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 × ULN (≤5 × ULN if the elevation can be ascribed to liver involvement)
- Calculated or measured creatinine clearance of ≥30 mL/min*
- Has fully recovered from major surgery and from the acute toxic effects of prior chemotherapy and radiotherapy (residual Grade 1 toxicities and residual alopecia of any grade are allowed).
- Additional inclusion criterion for Arm B
- Is a female participant.
Exclusion Criteria9
- Has a history of hypersensitivity to any of the study treatments or its excipients or to drugs of similar chemical class.
- Is pregnant (confirmed by a pregnancy test at screening) or is breastfeeding.
- Has current known active or chronic infection with HIV, hepatitis B, or hepatitis C.
- Has impaired cardiac function or clinically significant cardiac disease.
- Has a gastrointestinal tumor, impaired GI function, GI disease, or significant resection of stomach or other portion of the gastrointestinal tract that could alter the absorption of pelabresib, midazolam, or repaglinide, including any unresolved nausea, vomiting, or diarrhea.
- Has renal impairment (CrCl less than 50 mL/min).
- Has a gastrointestinal tumor, impaired GI function, GI disease, or significant resection of stomach or other portion of the gastrointestinal tract that could alter the absorption of pelabresib, drospirenone and ethinyl estradiol, including any unresolved nausea, vomiting, or diarrhea.
- Has breast cancer or other estrogen- or progestin-sensitive cancer.
- Has undiagnosed abnormal uterine bleeding.
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Interventions
pelabresib 225 mg orally (PO) once daily (QD) for 14 days, followed by a 7-day break
0.5 mg repaglinide tablet administered orally on Pre-Cycle Day 1 and Cycle 1 Day 14
2 mg/mL midazolam oral solution administered orally on Pre-Cycle Day 1 and Cycle 1 Day 14
3 mg drospirenone tablet administered orally on Pre-Cycle Day 1 and Cycle 1 Day 10
0.03 mg ethinyl estradiol tablet administered orally on Pre-Cycle Day 1 and Cycle 1 Day 10
Locations(3)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT07340190