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Phase II Study of Tipifarnib in Squamous Head and Neck Cancer With HRAS Mutations

An Open Label Phase II Study of Tipifarnib in Advanced Non-Hematological Malignancies With HRAS Mutations

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02383927
Enrollment
63
Registered
2015-03-10
Start date
2015-05-13
Completion date
2020-12-14
Last updated
2024-07-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

HRAS Mutant Tumor, Other Squamous Cell Carcinoma (SCC) With HRAS Mutant Tumor, Squamous Cell Carcinoma Head and Neck Cancer (HNSCC), Thyroid Cancer

Brief summary

Phase II study to investigate the antitumor activity in terms of objective response rate (ORR) of tipifarnib in subjects with advanced tumors that carry HRAS mutations and for whom there is no standard curative therapy available.

Detailed description

This Phase II study will investigate the antitumor activity in terms of ORR of tipifarnib in subjects with locally advanced, unresectable or metastatic, relapsed and/or refractory tumors that carry HRAS mutations and for whom there is no curative therapy available. Subjects with information available on tumor HRAS status previously generated are eligible. All subjects must consent to provide at least 10 tumor slides from a prior diagnostic biopsy for a retrospective testing of HRAS gene status at a central facility. Subjects will be enrolled into three nonrandomized cohorts: * Cohort 1: Malignant thyroid tumors with HRAS mutations. * Cohort 2: Squamous Cell Carcinoma Head and Neck Cancer with HRAS mutations. * Cohort 3: Squamous Cell Carcinoma (SCC) with HRAS mutations other than HNSCC.

Interventions

DRUGTipifarnib

FTase inhibitor

Sponsors

Kura Oncology, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* histologically or cytologically confirmed diagnosis of thyroid cancer (cohort 1) or Squamous Cell Carcinoma head and neck cancer (cohort 2) or Squamous Cell Carcinoma other than HNSCC (cohort 3) for which there is no curative therapy available. * tumor that carries a missense HRAS mutation ith a variant allele frequency (VAF) \> 20%. * Subject consents to provide at least 10 unstained tumor slides for retrospective testing of HRAS gene tumor status * Subject has measurable disease according to RECIST v1.1 and has relapsed or is refractory to prior therapy. * At least 2 weeks since the last systemic therapy or radiotherapy regimen prior to enrolment * ECOG PS 0 or 1 * Acceptable liver function * Acceptable renal function * Acceptable hematologic status • Serum albumin ≥ 3.5 g/dL. Subjects with tumors potentially highly sensitive to tipifarnib (HRAS mutant VAF ≥ 35%) may be enrolled despite a serum albumin \< 3.5 g/dL.

Exclusion criteria

* Prior treatment with an FTase inhibitor * History of relevant coronary heart disease or myocardial infarction within last 3 years, NYHA Grade III or greater congestive heart failure, cerebro-vascular attack within the prior year, or serious cardiac arrhythmia requiring medication except atrial fibrillation. * Known uncontrolled brain, leptomeningeal or epidural metastases (unless treated and well controlled for at least 4 weeks prior to Cycle 1 Day 1). Controlled brain metastases that require continuous high dose corticosteroid use within 4 weeks of Day 1. * Non-tolerable \> Grade 2 neuropathy or evidence of unstable neurological symptoms within 4 weeks first dose * Major surgery, other than diagnostic surgery, within 4 weeks prior to first dose, without complete recovery. * Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy. Known infection with HIV, or an active infection with hepatitis B or hepatitis C

Design outcomes

Primary

MeasureTime frameDescription
Antitumor Activity by Objective Response Rate (ORR)Up to approximately 3 yearsThe ORR of tipifarnib was response assessments according to RECIST 1.1. The estimate of the ORR was calculated based on the maximum likelihood estimator (i.e., crude percentage of subjects whose best overall response was complete response \[CR\] or partial response \[PR\]). The estimate of the ORR was accompanied by 2-sided 95% confidence interval (CI). The 95% CI was estimated using the Wilson score test-based method. CR: Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (\< 10 mm short axis). PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits.

Secondary

MeasureTime frameDescription
Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)Up to approximately 3 yearsAn adverse event (AE) was any untoward medical occurrence in a subject or clinical investigation subject administered a pharmaceutical product, which did not necessarily have a causal relationship with this treatment. TEAEs were defined as AEs that started on or after the first dose of study drug and within 30 days of the last administration of study drug or immediately before the initiation of any other anticancer therapy. The Investigator was required to grade the severity/ intensity of each AE according to NCI-CTCAE version 4.03. If a severity/intensity of Grade 4 (life-threatening) or 5 (death) was applied to an AE, then the Investigator also reported the event as a serious AE.

Other

MeasureTime frameDescription
Progression-free Survival (PFS)Up to approximately 3 yearsPFS was defined as the time from first dose (Cycle 1 Day 1) to either first observation of progressive disease (PD) or occurrence of death due to any cause within 126 days (approximately 2 time-intervals for tumour assessments) of either first administration of tipifarnib or the last tumour assessment. Observation of PD could have been by either documented radiographic progression (i.e., scan results) or documentation of symptomatic or clinical progression agreed upon and documented by investigators. In subjects without a progression date or with a death date more than 126 days after the first administration of study drugs or the last tumour assessment, the PFS time should have been censored on the date of last tumour assessment or date of first administration of study tipifarnib.
Duration of Response (DOR)Up to approximately 3 yearsDOR was the number of months from start date of PR or CR (whichever response was achieved first) to the first date that PD was documented (in subjects with an objective response). PD was determined by the Investigator using RECIST 1.1. The DOR was right-censored at the date for subjects who achieved CR or PR and met one of the following conditions: 1) when non-protocol anticancer treatment started before documentation of PD, 2) when death prior to documented PD or documented PD after more than 1 missed disease assessment visit, or 3) when alive and did not have documentation of PD before a data analysis cut-off date (therefore, analysis cut-off date was used as the censoring date). Median and 95% CI were calculated via Kaplan-Meier analysis.
Overall Survival (OS)Up to approximately 4 yearsAn analysis of OS was conducted to estimate median OS time and corresponding 95% CI. OS was defined as the time from first dose (Cycle 1 Day 1) to the occurrence of death due to any cause. In subjects without a death date, the OS was censored on 1) the last date of survival status if alive, 2) a data analysis cut-off date for subjects with no survival status documentation, or 3) the date a subject withdrew consent or was lost to follow-up if there was no additional information. Median and 95% CI were calculated via Kaplan-Meier analysis.
Antitumor Activity - Best Overall Response (BOR)Up to approximately 3 yearsBOR according to RECIST 1.1. Stable disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits.

Countries

Belgium, France, Germany, Greece, Italy, Netherlands, South Korea, Spain, United Kingdom, United States

Participant flow

Recruitment details

Subjects with thyroid cancer with Harvey Rat sarcoma virus (HRAS) mutations were enrolled in Cohort 1; subjects with any solid tumour with HRAS mutation were enrolled in Stage 1 of Cohort 2; subjects with head and neck squamous cell carcinoma (HNSCC) with HRAS mutations were enrolled in Stage 2 of Cohort 2; subjects with any squamous cell carcinoma (SCC) (excluding HNSCC) with HRAS mutation were enrolled in Cohort 3.

Pre-assignment details

Only consented subjects who met all the eligibility criteria were enrolled in the study. All screening evaluations were to be completed within 4 weeks (28 days) of Cycle 1 Day 1.

Participants by arm

ArmCount
Cohort 1
Subjects with thyroid cancer with HRAS mutations. Subjects received tipifarnib as monotherapy orally BID on Days 1-7 and 15-21 of each 28-day treatment cycle. In the absence of unacceptable tipifarnib-related emergent toxicity or disease progression, subjects could receive treatment with tipifarnib for up to 12 months at the discretion of the Investigator. Treatment beyond 12 months may have continued upon agreement of the Investigator and the Sponsor.
13
Cohort 2/Stage 1
Subjects with any solid tumour with HRAS mutation. Subjects received tipifarnib as monotherapy orally BID on Days 1-7 and 15-21 of each 28-day treatment cycle. In the absence of unacceptable tipifarnib-related emergent toxicity or disease progression, subjects could receive treatment with tipifarnib for up to 12 months at the discretion of the Investigator. Treatment beyond 12 months may have continued upon agreement of the Investigator and the Sponsor.
10
Cohort 2/Stage 2
Subjects with HNSCC with HRAS mutations. Subjects received tipifarnib as monotherapy orally BID on Days 1-7 and 15-21 of each 28-day treatment cycle. In the absence of unacceptable tipifarnib-related emergent toxicity or disease progression, subjects could receive treatment with tipifarnib for up to 12 months at the discretion of the Investigator. Treatment beyond 12 months may have continued upon agreement of the Investigator and the Sponsor.
30
Cohort 3
Subjects with any SCC (excluding HNSCC) with HRAS mutation. Subjects received tipifarnib as monotherapy orally BID on Days 1-7 and 15-21 of each 28-day treatment cycle. In the absence of unacceptable tipifarnib-related emergent toxicity or disease progression, subjects could receive treatment with tipifarnib for up to 12 months at the discretion of the Investigator. Treatment beyond 12 months may have continued upon agreement of the Investigator and the Sponsor.
10
Total63

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyAdverse Event4135
Overall StudyDisease Progression88154
Overall StudyMiscellaneous1001
Overall StudyPhysician Decision0020
Overall StudyTermination by Symptomatic Deterioration0060
Overall StudyWithdrawal by Subject0140

Baseline characteristics

CharacteristicCohort 2/Stage 2Cohort 3Cohort 2/Stage 1TotalCohort 1
Age, Continuous61.0 years
STANDARD_DEVIATION 14.4
67.0 years
STANDARD_DEVIATION 11.7
59.1 years
STANDARD_DEVIATION 16.9
65.32 years
STANDARD_DEVIATION 11.6
61.7 years
STANDARD_DEVIATION 7.4
Eastern Cooperative Oncology Group (ECOG) performance score
Performance score 0
3 Participants1 Participants3 Participants14 Participants7 Participants
Eastern Cooperative Oncology Group (ECOG) performance score
Performance score 1
27 Participants9 Participants7 Participants49 Participants6 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants0 Participants0 Participants3 Participants1 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
28 Participants10 Participants10 Participants60 Participants12 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian
4 Participants0 Participants1 Participants7 Participants2 Participants
Race/Ethnicity, Customized
Black or African American
1 Participants0 Participants1 Participants4 Participants2 Participants
Race/Ethnicity, Customized
Other
1 Participants0 Participants1 Participants4 Participants2 Participants
Race/Ethnicity, Customized
White
24 Participants10 Participants7 Participants48 Participants7 Participants
Sex: Female, Male
Female
8 Participants5 Participants2 Participants19 Participants4 Participants
Sex: Female, Male
Male
22 Participants5 Participants8 Participants44 Participants9 Participants
Stage of cancer
Stage I
0 Participants1 Participants0 Participants1 Participants0 Participants
Stage of cancer
Stage II
2 Participants0 Participants0 Participants2 Participants0 Participants
Stage of cancer
Stage III
2 Participants0 Participants1 Participants4 Participants1 Participants
Stage of cancer
Stage IV
26 Participants9 Participants9 Participants56 Participants12 Participants
Type of tumour
Head and neck
30 Participants0 Participants0 Participants30 Participants0 Participants
Type of tumour
Other
0 Participants6 Participants3 Participants9 Participants0 Participants
Type of tumour
Salivary
0 Participants0 Participants7 Participants7 Participants0 Participants
Type of tumour
Skin
0 Participants4 Participants0 Participants4 Participants0 Participants
Type of tumour
Thyroid
0 Participants0 Participants0 Participants13 Participants13 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
6 / 139 / 1024 / 309 / 10
other
Total, other adverse events
13 / 1310 / 1029 / 309 / 10
serious
Total, serious adverse events
6 / 135 / 1020 / 309 / 10

Outcome results

Primary

Antitumor Activity by Objective Response Rate (ORR)

The ORR of tipifarnib was response assessments according to RECIST 1.1. The estimate of the ORR was calculated based on the maximum likelihood estimator (i.e., crude percentage of subjects whose best overall response was complete response \[CR\] or partial response \[PR\]). The estimate of the ORR was accompanied by 2-sided 95% confidence interval (CI). The 95% CI was estimated using the Wilson score test-based method. CR: Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (\< 10 mm short axis). PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits.

Time frame: Up to approximately 3 years

Population: The Full Analysis Set (FAS) Population excluding subjects for the following reasons: no baseline data; failure to receive at least 1 dose of tipifarnib; no post-baseline endpoint data subsequent to at least 1 dose of study drug.

ArmMeasureValue (NUMBER)
Cohort 1Antitumor Activity by Objective Response Rate (ORR)0.0 percentage of participants
Cohort 2/Stage 1Antitumor Activity by Objective Response Rate (ORR)0.0 percentage of participants
Cohort 2/Stage 2Antitumor Activity by Objective Response Rate (ORR)43.5 percentage of participants
Cohort 3Antitumor Activity by Objective Response Rate (ORR)28.6 percentage of participants
Secondary

Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)

An adverse event (AE) was any untoward medical occurrence in a subject or clinical investigation subject administered a pharmaceutical product, which did not necessarily have a causal relationship with this treatment. TEAEs were defined as AEs that started on or after the first dose of study drug and within 30 days of the last administration of study drug or immediately before the initiation of any other anticancer therapy. The Investigator was required to grade the severity/ intensity of each AE according to NCI-CTCAE version 4.03. If a severity/intensity of Grade 4 (life-threatening) or 5 (death) was applied to an AE, then the Investigator also reported the event as a serious AE.

Time frame: Up to approximately 3 years

Population: The ASaT Population consists of all enrolled subjects who received at least 1 dose of tipifarnib.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Cohort 1Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)Serious TEAEs6 Participants
Cohort 1Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)TEAEs13 Participants
Cohort 2/Stage 1Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)Serious TEAEs5 Participants
Cohort 2/Stage 1Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)TEAEs10 Participants
Cohort 2/Stage 2Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)Serious TEAEs20 Participants
Cohort 2/Stage 2Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)TEAEs30 Participants
Cohort 3Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)TEAEs10 Participants
Cohort 3Number of Subjects That Experienced One or More Treatment-emergent Adverse Events (TEAEs)Serious TEAEs9 Participants
Other Pre-specified

Antitumor Activity - Best Overall Response (BOR)

BOR according to RECIST 1.1. Stable disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits.

Time frame: Up to approximately 3 years

Population: The FAS Population excluding subjects for the following reasons: no baseline data; failure to receive at least 1 dose of tipifarnib; no post-baseline endpoint data subsequent to at least 1 dose of study drug.

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Cohort 1Antitumor Activity - Best Overall Response (BOR)PD2 Participants
Cohort 1Antitumor Activity - Best Overall Response (BOR)PR0 Participants
Cohort 1Antitumor Activity - Best Overall Response (BOR)Not evaluable0 Participants
Cohort 1Antitumor Activity - Best Overall Response (BOR)SD9 Participants
Cohort 1Antitumor Activity - Best Overall Response (BOR)CR0 Participants
Cohort 2/Stage 1Antitumor Activity - Best Overall Response (BOR)SD6 Participants
Cohort 2/Stage 1Antitumor Activity - Best Overall Response (BOR)PD2 Participants
Cohort 2/Stage 1Antitumor Activity - Best Overall Response (BOR)Not evaluable0 Participants
Cohort 2/Stage 1Antitumor Activity - Best Overall Response (BOR)PR0 Participants
Cohort 2/Stage 1Antitumor Activity - Best Overall Response (BOR)CR0 Participants
Cohort 2/Stage 2Antitumor Activity - Best Overall Response (BOR)SD11 Participants
Cohort 2/Stage 2Antitumor Activity - Best Overall Response (BOR)CR0 Participants
Cohort 2/Stage 2Antitumor Activity - Best Overall Response (BOR)PR10 Participants
Cohort 2/Stage 2Antitumor Activity - Best Overall Response (BOR)PD2 Participants
Cohort 2/Stage 2Antitumor Activity - Best Overall Response (BOR)Not evaluable0 Participants
Cohort 3Antitumor Activity - Best Overall Response (BOR)PD1 Participants
Cohort 3Antitumor Activity - Best Overall Response (BOR)PR2 Participants
Cohort 3Antitumor Activity - Best Overall Response (BOR)CR0 Participants
Cohort 3Antitumor Activity - Best Overall Response (BOR)SD4 Participants
Cohort 3Antitumor Activity - Best Overall Response (BOR)Not evaluable0 Participants
Other Pre-specified

Duration of Response (DOR)

DOR was the number of months from start date of PR or CR (whichever response was achieved first) to the first date that PD was documented (in subjects with an objective response). PD was determined by the Investigator using RECIST 1.1. The DOR was right-censored at the date for subjects who achieved CR or PR and met one of the following conditions: 1) when non-protocol anticancer treatment started before documentation of PD, 2) when death prior to documented PD or documented PD after more than 1 missed disease assessment visit, or 3) when alive and did not have documentation of PD before a data analysis cut-off date (therefore, analysis cut-off date was used as the censoring date). Median and 95% CI were calculated via Kaplan-Meier analysis.

Time frame: Up to approximately 3 years

Population: The Per Protocol (PP) Population was a subset of the FAS population that excluded subjects due to major deviations from the protocol that may have substantially affected the results of the primary analysis. Only participants participants with response data were included.

ArmMeasureValue (MEDIAN)
Cohort 2/Stage 2Duration of Response (DOR)6.2 months
Cohort 3Duration of Response (DOR)NA months
Other Pre-specified

Overall Survival (OS)

An analysis of OS was conducted to estimate median OS time and corresponding 95% CI. OS was defined as the time from first dose (Cycle 1 Day 1) to the occurrence of death due to any cause. In subjects without a death date, the OS was censored on 1) the last date of survival status if alive, 2) a data analysis cut-off date for subjects with no survival status documentation, or 3) the date a subject withdrew consent or was lost to follow-up if there was no additional information. Median and 95% CI were calculated via Kaplan-Meier analysis.

Time frame: Up to approximately 4 years

Population: The FAS Population excluding subjects for the following reasons: no baseline data; failure to receive at least 1 dose of tipifarnib; no post-baseline endpoint data subsequent to at least 1 dose of study drug.

ArmMeasureValue (MEDIAN)
Cohort 1Overall Survival (OS)36.7 months
Cohort 2/Stage 1Overall Survival (OS)13.8 months
Cohort 2/Stage 2Overall Survival (OS)10.8 months
Cohort 3Overall Survival (OS)10.4 months
Other Pre-specified

Progression-free Survival (PFS)

PFS was defined as the time from first dose (Cycle 1 Day 1) to either first observation of progressive disease (PD) or occurrence of death due to any cause within 126 days (approximately 2 time-intervals for tumour assessments) of either first administration of tipifarnib or the last tumour assessment. Observation of PD could have been by either documented radiographic progression (i.e., scan results) or documentation of symptomatic or clinical progression agreed upon and documented by investigators. In subjects without a progression date or with a death date more than 126 days after the first administration of study drugs or the last tumour assessment, the PFS time should have been censored on the date of last tumour assessment or date of first administration of study tipifarnib.

Time frame: Up to approximately 3 years

Population: The FAS Population excluding subjects for the following reasons: no baseline data; failure to receive at least 1 dose of tipifarnib; no post-baseline endpoint data subsequent to at least 1 dose of study drug.

ArmMeasureValue (MEDIAN)
Cohort 1Progression-free Survival (PFS)4.6 months
Cohort 2/Stage 1Progression-free Survival (PFS)6.4 months
Cohort 2/Stage 2Progression-free Survival (PFS)5.5 months
Cohort 3Progression-free Survival (PFS)8.0 months

Source: ClinicalTrials.gov · Data processed: Feb 26, 2026