Advanced Cancer, KRAS Activating Mutation, Malignant Neoplasm of Lung, Malignant Neoplastic Disease, Metastatic Cancer, Non Small Cell Lung Cancer
Conditions
Keywords
NSCLC, KRAS G12C, Non Small Cell Lung Cancer, Metastatic Cancer, Adagrasib, Avutometinib (VS-6766)
Brief summary
This study will assess the safety and efficacy of avutometinib (VS-6766) in combination with adagrasib in patients with G12C Non-Small Cell Lung Cancer (NSCLC) who have been exposed to prior G12C inhibitor and experienced progressive disease.
Detailed description
This is a multicenter, non-randomized, open-label Phase 1/2 study designed to evaluate safety, tolerability and efficacy of avutometinib (VS-6766) in combination with adagrasib in patients with KRAS G12C mutant NSCLC who have been exposed to prior G12C inhibitor and experienced progressive disease.
Interventions
DRUGavutometinib (VS-6766) and adagrasib
The RP2D of VS-6766 + adagrasib determined in Part A will be used in Part B dose expansion
Sponsors
Verastem, Inc.
Mirati Therapeutics Inc.
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male or female subjects ≥ 18 years of age * Histologic or cytologic evidence of NSCLC * Known KRAS G12C mutation * The subject must have received prior therapy with a KRAS G12C inhibitor and experienced progression * Must have received appropriate treatment with at least one prior systemic regimen, but no more than 3 prior regimens, for Stage 3B-C or 4 NSCLC * Measurable disease according to RECIST 1.1 * An Eastern Cooperative Group (ECOG) performance status ≤ 1 * Adequate organ function * Adequate recovery from toxicities related to prior treatments * Agreement to use highly effective method of contraceptive
Exclusion criteria
* Prior chemotherapy, targeted therapies, radiotherapy, immunotherapy or treatment with an investigational agent within 14 days of receipt of study drug (within 6 weeks for nitrosoureas, mitomycin C and chest radiation; within 6 months prior to Cycle 1 Day 1 for chest radiation \> 30Gy) * History of prior malignancy, with the exception of curatively treated malignancies * Major surgery within 4 weeks (excluding placement of vascular access) * Exposure to strong CYP3A4 inhibitors or inducers within 14 days prior to the first dose and during the course of therapy * Exposure to strong inhibitors of breast cancer resistance protein (BCRP) within 14 days prior to the first dose and during the course of therapy * Symptomatic brain metastases requiring steroids or other local interventions within the 2 weeks prior to initiation of therapy * Known SARS-Cov2 infection ≤28 days prior to first dose of study therapy * Known hepatitis B, hepatitis C, or human immunodeficiency virus infection that is active * Active skin disorder that has required systemic therapy within the past 1 year * History of rhabdomyolysis or interstitial lung disease * Concurrent ocular disorders * Concurrent heart disease or severe obstructive pulmonary disease * Subjects with the inability to swallow oral medications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Part A: To determine RP2D for avutometinib(VS-6766) in combination with adagrasib | From start of treatment to confirmation of RP2D; 28 days | Assessment of Dose-limiting toxicities (DLTs) |
| To determine the efficacy of the optimal regimen identified from Part A | From start of treatment to confirmation of response; 16 weeks | Confirmed overall response rate per RECIST 1.1 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To characterize the safety and toxicity profile: | 24 Months | * Incidence of Adverse events (AEs) and Serious Adverse Events (SAEs) assessed by the toxicity grading of the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE v 5.0) * Severity of Adverse events (AEs) and Serious Adverse Events (SAEs) by toxicity grade assessed by the toxicity grading of the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE v 5.0) * Duration of Adverse events (AEs) and Serious Adverse Events (SAEs) * Incidence of clinically significant changes in lab parameters * Incidence of abnormal vital signs (including systolic and diastolic blood pressure in mmHg) |
| ECG QT Interval | 24 months | Corrected ECG QT interval by Fredericia (QTcF) |
| Duration of Response (DOR) | Time from the first documentation of response to first documentation of progressive disease or death due to any cause, greater than or equal to 6 months | Time of first response to PD as assessed per RECIST 1.1 |
| Disease Control Rate (DCR) | Greater than or equal to 8 weeks | CR and PR stable disease as assessed per RECIST 1.1 |
| Progression Free Survival (PFS) | 24 months | From the time of first dose of study intervention to PD or death from any cause |
| Overall Survival (OS) | Up to 5 years | From time of first dose of study intervention to death |
| Plasma Pharmacokinetics (PK) of avutometinib(VS 6766), adagrasib, and relevant metabolites - Tmax | 10 weeks | time of Maximum concentration (Tmax) |
| Plasma Pharmacokinetics (PK) of avutometinib(VS 6766), adagrasib, and relevant metabolites - AUC | 10 weeks | Area under plasma Concentration (AUC) 0 to t |
| Plasma Pharmacokinetics (PK) of avutometinib(VS 6766), adagrasib, and relevant metabolites - Half-life | 10 weeks | concentration Half-life (T1/2) |
| Clinical Benefit Rate | ≥ 6 months | defined as Complete Response+Partial Response +Stable Disease |
Countries
United States
Contacts
STUDY_DIRECTORMD Verastem
Verastem, Inc.
Outcome results
None listed