KRAS P.G12C, Non Small Cell Lung Cancer
Conditions
Brief summary
This study aims to provide a comprehensive understanding of sotorasib's mechanisms of action and resistance in NSCLC patients.
Interventions
DRUGSotorasib 120Mg Tab
Daily sotorasib treatment until progression, unacceptable toxicity, death, or lost to follow-up
Sponsors
Gustave Roussy, Cancer Campus, Grand Paris
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age higher than 18 years; * ECOG less or equal to 1 at the time of screening; * Pathologically documented, previously treated, locally-advanced and unresectable or metastatic NSCLC with KRAS p.G12C mutation confirmed through molecular testing (results of both tissue and liquid biopsy are accepted); * Subjects will have progressed or experienced disease recurrence on or after receiving at least 1 prior systemic therapy for locally advanced and unresectable or metastatic disease. * Life expectancy of longer than 3 months from the time of screening, in the opinion of the investigator; * Patients must have lesions easily accessible to biopsy and must have accepted to perform pre-treatment, on-treatment and end-of-treatment biopsies; * Have adequate bone marrow reserve and organ function, based on local laboratory data within 14 days prior to registration * Patients must understand, sign and date the written informed consent from prior to any protocol-specific procedures performed. * Patients should be able and willing to comply with study visits and procedures as per protocol. * Patients must be affiliated to a Social Security System or beneficiary of the same.
Exclusion criteria
* Patient unwilling to participate to the biological investigations and to perform biopsies and blood sample collection as required in the protocol; * Use of known cytochrome P450 (CYP) 3A4 or P-gp sensitive substrates (with a narrow therapeutic window), within 14 days or 5 half-lives of the drug or its major active metabolite, whichever is longer, prior to registration, that was not reviewed and approved by the principal investigator. * Use of strong inducers of CYP3A4 (including herbal supplements such as St. John's wort) within 14 days or 5 half-lives (whichever is longer) prior to registration, that was not reviewed and approved by the principal investigator. * Inadequate washout period prior to registration, defined as: Any cytotoxic chemotherapy, investigational agents or other anticancer drug(s) from a previous cancer treatment regimen or clinical study shorter than 14 days or 5 half-lives; * Prior treatment with a KRAS inhibitor. * Major surgery within 28 days of registration. * Significant gastrointestinal disorder that results in significant malabsorption, requirement for intravenous alimentation, or inability to take oral medication. * Significant cardiovascular disease, such as New York Heart Association cardiac disease (Class II or greater), myocardial infarction within 6 months prior to registration, unstable arrhythmias or unstable angina. * Severe infections within 2 weeks prior to registration, but not limited to hospitalization for complications of infection, bacteremia or severe pneumonia. Prophylactic antibiotics are allowed. * Baseline or unresolved pneumonitis from prior treatment; * Current CTCAE version 5.0 grade higher or equal to 2 peripheral neuropathy. * Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures at a frequency greater than monthly. Subjects with PleurX catheters in place may be considered for the study with Principal Investigator approval. * Known history of Human Immunodeficiency Virus (HIV) infection * Exclusion of hepatitis infection based on the following results and/or criteria: 1. Positive hepatitis B surface antigen (HepBsAg) (indicative of chronic Hepatitis B or recent acute hepatitis B) 2. Negative HepBsAg with a positive for hepatitis B core antibody (Hepatitis B core antibody testing is not required for screening, however if this is done and is positive, then hepatitis B surface antibody \[Anti-HBs\] testing is necessary. Undetectable anti-HBs in this setting would suggest unclear and possible infection, and needs exclusion). 3. Positive Hepatitis C virus antibody: Hepatitis C virus RNA by polymerase chain reaction is necessary. Detectable Hepatitis C virus RNA renders the subject ineligible. * Leptomeningeal disease and active brain metastases. Subjects who have had brain metastases resected or have received whole brain radiation therapy or stereotactic radiosurgery ending at least 2 weeks prior to registration are eligible if they meet all of the following criteria: 1. residual neurological symptoms grade less or equal to 2; 2. on stable doses of dexamethasone or equivalent for at least 2 weeks, if applicable; and 3. follow-up brain imaging performed within 30 days of enrollment shows no progression or new lesions appearing. * Female subject is pregnant or breastfeeding or planning to become pregnant or breastfeed during treatment and for an additional 7 days after the last dose of sotorasib or during treatment if planning to become pregnant. * Female subjects of childbearing potential unwilling to use 1 highly effective method of contraception during treatment and for an additional 7 days after the last dose of sotorasib * Female subjects of childbearing potential with a positive pregnancy test assessed at Screening or day 1 by a serum pregnancy test and/or urine pregnancy test. * Male subjects with a female partner of childbearing potential who are unwilling to practice sexual abstinence (refrain from heterosexual intercourse) or use contraception during treatment and for an additional 7 days after the last dose of sotorasib * Male subjects with a pregnant partner who are unwilling to practice abstinence or use a condom during treatment and for an additional 7 days after the last dose of sotorasib * Male subjects unwilling to abstain from donating sperm during treatment and for an additional 7 days after the last dose of investigational product. * Any evidence of primary malignancy other than locally advanced or metastatic lung cancer at within 3 years of registration, except adequately resected non-melanoma skin cancer, curatively treated in-situ disease, or other solid tumors curatively treated; * Participation in another clinical trial evaluating an experimental drug (except non-interventional research). * Patient under guardianship or deprived of his liberty by a judicial or administrative decision or incapable of giving its consent. * Hypersensitivity to the active substance or to any excipient * Patients with hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Tumor response assessment | at 4 months after treatment start | To evaluate tumor response at 4 months and decipher relevant biomarkers associated with primary (progression within the first 4 months) and acquired resistance to sotorasib (progression after 4 months). |
Countries
France
Contacts
Primary ContactLynda MATI
Outcome results
None listed