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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

Sponsor: Novartis Pharmaceuticals • ClinicalTrials.gov ID: NCT07340190

Registry updated: 2026-10-09

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Description

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.

Interventions

pelabresib (Drug)
pelabresib 225 mg orally (PO) once daily (QD) for 14 days, followed by a 7-day break
repaglinide (Drug)
0.5 mg repaglinide tablet administered orally on Pre-Cycle Day 1 and Cycle 1 Day 14
midazolam (Drug)
2 mg/mL midazolam oral solution administered orally on Pre-Cycle Day 1 and Cycle 1 Day 14
drospirenone (Drug)
3 mg drospirenone tablet administered orally on Pre-Cycle Day 1 and Cycle 1 Day 10
ethinyl estradiol (Drug)
0.03 mg ethinyl estradiol tablet administered orally on Pre-Cycle Day 1 and Cycle 1 Day 10

Eligibility criteria

Key Inclusion Criteria: Key inclusion criteria for all participants (Arm A and Arm B) * 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: 1. Platelet count ≥ 150 × 109 /L in the absence of thrombopoietic factors or transfusions within 2 weeks of the screening assessment 2. Absolute neutrophil count (ANC) ≥ 1 × 109 /L in the absence of granulocyte growth factors 3. 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. 4. Serum total bilirubin ≤ 1.5 × upper limit of normal (ULN) 5. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 × ULN (≤5 × ULN if the elevation can be ascribed to liver involvement) 6. 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. Key Exclusion Criteria: Key exclusion criteria for Arm A * 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. Key exclusion criteria for Arm B * 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. Other protocol-defined inclusion/exclusion criteria may apply.

Conditions

Advanced Malignancies

Locations

Novartis Investigative Site — Bordeaux, France
Novartis Investigative Site — Candiolo, TO, Italy
Novartis Investigative Site — Pozuelo de Alarcón, Madrid, Spain
Novartis Investigative Site — Barcelona, Spain
Novartis Investigative Site — Madrid, Spain
Novartis Investigative Site — Madrid, Spain

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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