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Not yet taking people in United StatesEarly phase 1

How immunotherapy cancer drugs affect the way the liver handles other medicines

Tests whether immunotherapy changes how the liver processes other drugs in adults with cancer.

Plain-language title generated from the registry record
Registry title: Immune Checkpoint Inhibitor (ICI)-Drug-Drug Interaction (DDI) Study

Key facts

Where
Indianapolis, United StatesSee the site
Phase
Early phase 1

Where in United States

  • Indiana University Melvin and Bren Simon Comprehensive Cancer CenterIndianapolis, United StatesNo longer taking part

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  4. What happens if I want to stop?
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Trial details

Who runs it
Indiana University
Trial code
NCT07389525
Record updated
15 July 2026
Original description
Immune checkpoint inhibitors (ICIs) (also called "immunotherapy") are an effective family of anti-cancer drugs, but they can cause serious side effects. Some evidence suggests these side effects might happen because ICIs interact with other drugs that you may already be taking, making those drugs work differently, or causing more side effects. The purpose of this study is to see whether ICIs impact how the liver processes other drugs. To do this, participants will be given a probe cocktail of 7 different FDA-approved drugs that are processed in different ways in the liver.Read full original descriptionShow less

Assessment of Drug-Drug Interactions Between Immune Checkpoint Inhibitors and Cytochrome P450 Substrates: Immune Checkpoint Inhibitor (ICI)-Drug-Drug Interaction (DDI) Study

Immune checkpoint inhibitors (ICIs) (also called "immunotherapy") are an effective family of anti-cancer drugs, but they can cause serious side effects. Some evidence suggests these side effects might happen because ICIs interact with other drugs that you may already be taking, making those drugs work differently, or causing more side effects. The purpose of this study is to see whether ICIs impact how the liver processes other drugs. To do this, participants will be given a probe cocktail of 7 different FDA-approved drugs that are processed in different ways in the liver.

Inclusion: ≥ 18 years old at the time of informed consent; Diagnosed with cancer AND initiating therapy with single agent or combination therapy that includes an immune checkpoint inhibitor (e.g., atezolizumab, cemiplimab, durvalumab, ipilimumab, nivolumab, pembrolizumab, relatlimab, tremelimumab); Ability to provide written informed consent and HIPAA authorization.

Exclusion: Poor performance status that makes it unlikely the patient will complete 3 cycles of immune checkpoint inhibitor (at the treating oncologist's discretion); Concomitant treatment with systemic immunosuppressant drugs (see Appendix 3 for list); Note: patients may be re-screened for trial eligibility if they discontinue any exclusionary drugs for ≥7 days prior to Study Visit 1; Concomitant treatment with a CYP/transporter probe cocktail drug or strong inhibitors, inducers, or agents that affect the pharmacokinetics of the relevant CYP enzymes or drug transporters (see Appendix 4 for list); Note: patients may be re-screened for trial eligibility if they discontinue any exclusionary drugs for ≥7 days prior to Study Visit 1; Are unwilling/unable to avoid drugs of abuse, tobacco products or marijuana, or consuming more than 2 alcoholic drinks per day during the study; Inability to take oral medication; Past medical history of chronic kidney disease, signs and symptom of kidney disease (e.g., decreased urine output, swelling in feet and ankles), or estimated glomerular filtration rate <45 mL/minute/1.73 m2 BSA; Note: if a prospective patient's kidney function returns to the normal range, they can be re-screened for trial inclusion); Diagnosis or past medical history of autoimmune disorder, including systemic lupus erythematosus, Crohn's disease, Sjogren's syndrome, multiple sclerosis, type 1 diabetes mellitus, Behcet's disease, and ankylosing spondylitis; History of intolerance, allergic reaction, or hypersensitivity to any of the study drugs (tizanidine, bupropion, flurbiprofen, omeprazole, dextromethorphan, midazolam, rosuvastatin); Current infection requiring medical treatment (note: if a prospective patient's infection resolves, they can be re-screened for trial inclusion); Low baseline hemoglobin, defined as <10 g/dL; Note: if a prospective patient's hemoglobin returns to the normal range, they can be re-screened for trial inclusion); Past medical history of chronic liver disease, signs and symptom of liver disease (e.g., jaundice, ascites), or aspartate aminotransferase >96 U/L, alanine aminotransferase > 80 IU/L, alkaline phosphatase >260 U/L, or total bilirubin > 2.6 mg/dL; Note: if a prospective patient's liver function tests return to the normal ranges, they can be re-screened for trial inclusion); Actively pregnant or breastfeeding; Body weight less than 50 kg or a BMI >35.

ClinicalTrials.gov NCT07389525