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RO5126766 for Patients With Advanced KRAS-Mutant Lung Cancer

Primary Purpose

Advanced Non-small Cell Lung Cancer

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
RO5126766
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Non-small Cell Lung Cancer focused on measuring RO5126766 (CH5126766), KRAS-Mutant, 18-285

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically or cytologically proven diagnosis of advanced NSCLC
  • Documented presence of KRAS mutation
  • Prior treatment with a PD-1/L1 inhibitor. Patients who were deemed not eligible for therapy with a PD-1/L1 inhibitor by their treating physician will also be eligible in the dose expansion phase.
  • Prior treatment with chemotherapy
  • Able to take oral medications
  • Measurable and/or evaluable disease (RECIST 1.1) indicator lesion not previously irradiated
  • Karnofsky performance status (KPS) ≥ 70% (ECOG of 0 or 1 also acceptable)
  • Age≥ 18 years old
  • Hematological and biochemical indices within the ranges shown below Hematological and biochemical indices within the ranges shown below (These measurements must be performed within two weeks [Day 14 to Day 1] before the patient is entered into the trial).

    • AST, ALT ≤ 2.5 x ULN - Total bilirubin ≤ 1.5 x ULN -Albumin≥2.5g/dL
    • Creatinine < 1.5 x ULN OR calculated creatinine clearance ≥50mL/min
    • Absolute neutrophil count (ANC) ≥ 1,200 cells/mm3
    • Hemoglobin ≥9.0 g/dL
    • Platelets ≥100,000/mm^3.
  • A negative serum pregnancy test obtained within two weeks prior to the administration of the study drug in all women of child bearing potential

Exclusion Criteria:

  • Patients with symptomatic brain metastasis requiring escalating doses of steroids
  • Patients with grade 2 or greater diarrhea prior to study initiation despite maximal medical management
  • History of any bowel disease including abdominal fistula, gastro-intestinal perforation
  • History of acute pancreatitis within 1 year of study entry or history of chronic pancreatitis
  • History of or ongoing alcohol abuse that, in the opinion of the treating physician, would compromise compliance or impart excess risks associated with study participation.
  • Pregnant or lactating women
  • Any type of systemic therapy (chemotherapy or experimental drugs) within 3 weeks of starting treatment on protocol (within 6 weeks for for nitrosoureas and mitomycin C)
  • Radiotherapy within 2 weeks of starting treatment on protocol
  • Prior treatment with MEK, RAF, or ERK inhibitor(s)
  • Significant uncontrolled or active cardiovascular disease, specifically including, but not restricted to:

    • History of clinically significant (as determined by the treating physician) atrial arrhythmia
    • Any ventricular arrhythmia
    • History of congenital long QT syndrome.
    • Abnormal QTc (≥ 450 msec in males and ≥ 470 msec in females)
    • Ejection fraction ≤ 50% as assessed by echocardiogram
    • Concurrent congestive heart failure
    • Prior history of class III/ IV heart failure (New York Heart Association [NYHA]
    • Myocardial infarction within the last 6 months
    • Unstable angina or severe obstructive pulmonary disease
  • Patients with baseline risk factors for central serous retinopathy or retinal vein occlusion such as evidence of new optic disc cupping, evidence of new visual field defects, and intraocular pressure >21 mmHg Uncontrolled hypertension (Diastolic blood pressure > 100 mmHg; Systolic blood pressure > 150 mmHg).
  • History of central serous retinopathy or retinal vein occlusion
  • History of prior malignancy within 2 years that requires/ed treatment. Patients who are considered NED from a malignancy may be considered on a case by case basis.
  • Known active hepatitis B, hepatitis C or human immunodeficiency virus (HIV) infections
  • Patients exposed to CYP3A4 inhibitors within 7 days prior to the first dose and CYP3A4 inducers 7 days prior to the first dose. RO5126766 (CH5126766) is metabolised mainly by CYP3A4 therefore concomitant administration of strong inhibitors and inducers of cytochrome p450 3A4 enzymes is forbidden during study treatment (for a complete list please see Appendix A).
  • Any other condition that, in the opinion of the investigator, may compromise the safety, compliance of the patient, or would preclude the patient from successful completion of the study

Sites / Locations

  • Miami Cancer Institute
  • Memorial Sloan Kettering Cancer Center
  • Lehigh Valley Health Network

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

RO5126766 (CH5126766)

Arm Description

The study will begin with a standard 3+3 design. The study will enroll 3 patients at the previously identified MTD15 (4mg two times per week on days 1 and 4). The period of evaluation for dose limiting toxicity will be through completion of cycle 1. If ≤1 of the 3 initial patients at the proposed dose experience a DLT, then 3 additional patients will be enrolled for a total of 6 planned patients at that dose level. Otherwise, 3 patients will be enrolled at dose level -1. If ≤ 1 of these patients experience a DLT, then 3 additional patients will be enrolled at the same dose level. If more than 1 patient experiences a DLT in dose level -1, the study will be terminated.

Outcomes

Primary Outcome Measures

The maximum tolerated dose (MTD)
will be defined as the highest dose level at which ≤ 1 of 6 patients experienced a DLT.The NCI Common Terminology Criteria for Adverse Events Version 5.0 (NCI CTCAE) will be used to grade toxicities during the trial. DLTs are defined as any toxicity occurring during the first cycle of treatment (i.e. 4 weeks), excluding toxicites clearly related to disease progression or disease-related processes.
overall response rate (dose expansion)
by RECIST 1.1

Secondary Outcome Measures

Full Information

First Posted
September 20, 2018
Last Updated
October 2, 2023
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
Dana-Farber Cancer Institute, Chugai Pharma USA
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1. Study Identification

Unique Protocol Identification Number
NCT03681483
Brief Title
RO5126766 for Patients With Advanced KRAS-Mutant Lung Cancer
Official Title
A Phase 1 Trial of RO5126766 (CH5126766) in Patients With Advanced KRAS-Mutant Lung Adenocarcinomas
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 31, 2018 (Actual)
Primary Completion Date
September 2024 (Anticipated)
Study Completion Date
September 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
Dana-Farber Cancer Institute, Chugai Pharma USA

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to test the safety of RO5126766 at different doses to find out what effects, if any, it has on people with advanced lung cancer who have previously received treatment with a PD-1 or PD-L1 inhibitor.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Non-small Cell Lung Cancer
Keywords
RO5126766 (CH5126766), KRAS-Mutant, 18-285

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
Single arm, open label, multi-institution study of RO5126766 (CH5127566) in patients with KRAS mutant NSCLC.
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RO5126766 (CH5126766)
Arm Type
Experimental
Arm Description
The study will begin with a standard 3+3 design. The study will enroll 3 patients at the previously identified MTD15 (4mg two times per week on days 1 and 4). The period of evaluation for dose limiting toxicity will be through completion of cycle 1. If ≤1 of the 3 initial patients at the proposed dose experience a DLT, then 3 additional patients will be enrolled for a total of 6 planned patients at that dose level. Otherwise, 3 patients will be enrolled at dose level -1. If ≤ 1 of these patients experience a DLT, then 3 additional patients will be enrolled at the same dose level. If more than 1 patient experiences a DLT in dose level -1, the study will be terminated.
Intervention Type
Drug
Intervention Name(s)
RO5126766
Other Intervention Name(s)
(CH5126766)
Intervention Description
RO5126766 (CH5126766) is given 4mg twice weekly (Day 1 and Day 4 of each week) and should be taken by mouth on an empty stomach, either one hour before or two hours after a meal.
Primary Outcome Measure Information:
Title
The maximum tolerated dose (MTD)
Description
will be defined as the highest dose level at which ≤ 1 of 6 patients experienced a DLT.The NCI Common Terminology Criteria for Adverse Events Version 5.0 (NCI CTCAE) will be used to grade toxicities during the trial. DLTs are defined as any toxicity occurring during the first cycle of treatment (i.e. 4 weeks), excluding toxicites clearly related to disease progression or disease-related processes.
Time Frame
1 year
Title
overall response rate (dose expansion)
Description
by RECIST 1.1
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically proven diagnosis of advanced NSCLC Documented presence of KRAS mutation Prior treatment with a PD-1/L1 inhibitor. Patients who were deemed not eligible for therapy with a PD-1/L1 inhibitor by their treating physician will also be eligible in the dose expansion phase. Prior treatment with chemotherapy Able to take oral medications Measurable and/or evaluable disease (RECIST 1.1) indicator lesion not previously irradiated Karnofsky performance status (KPS) ≥ 70% (ECOG of 0 or 1 also acceptable) Age≥ 18 years old Hematological and biochemical indices within the ranges shown below Hematological and biochemical indices within the ranges shown below (These measurements must be performed within two weeks [Day 14 to Day 1] before the patient is entered into the trial). AST, ALT ≤ 2.5 x ULN - Total bilirubin ≤ 1.5 x ULN -Albumin≥2.5g/dL Creatinine < 1.5 x ULN OR calculated creatinine clearance ≥50mL/min Absolute neutrophil count (ANC) ≥ 1,200 cells/mm3 Hemoglobin ≥9.0 g/dL Platelets ≥100,000/mm^3. A negative serum pregnancy test obtained within two weeks prior to the administration of the study drug in all women of child bearing potential Exclusion Criteria: Patients with symptomatic brain metastasis requiring escalating doses of steroids Patients with grade 2 or greater diarrhea prior to study initiation despite maximal medical management History of any bowel disease including abdominal fistula, gastro-intestinal perforation History of acute pancreatitis within 1 year of study entry or history of chronic pancreatitis History of or ongoing alcohol abuse that, in the opinion of the treating physician, would compromise compliance or impart excess risks associated with study participation. Pregnant or lactating women Any type of systemic therapy (chemotherapy or experimental drugs) within 3 weeks of starting treatment on protocol (within 6 weeks for for nitrosoureas and mitomycin C) Radiotherapy within 2 weeks of starting treatment on protocol Prior treatment with MEK, RAF, or ERK inhibitor(s) Significant uncontrolled or active cardiovascular disease, specifically including, but not restricted to: History of clinically significant (as determined by the treating physician) atrial arrhythmia Any ventricular arrhythmia History of congenital long QT syndrome. Abnormal QTc (≥ 450 msec in males and ≥ 470 msec in females) Ejection fraction ≤ 50% as assessed by echocardiogram Concurrent congestive heart failure Prior history of class III/ IV heart failure (New York Heart Association [NYHA] Myocardial infarction within the last 6 months Unstable angina or severe obstructive pulmonary disease Patients with baseline risk factors for central serous retinopathy or retinal vein occlusion such as evidence of new optic disc cupping, evidence of new visual field defects, and intraocular pressure >21 mmHg Uncontrolled hypertension (Diastolic blood pressure > 100 mmHg; Systolic blood pressure > 150 mmHg). History of central serous retinopathy or retinal vein occlusion History of prior malignancy within 2 years that requires/ed treatment. Patients who are considered NED from a malignancy may be considered on a case by case basis. Known active hepatitis B, hepatitis C or human immunodeficiency virus (HIV) infections Patients exposed to CYP3A4 inhibitors within 7 days prior to the first dose and CYP3A4 inducers 7 days prior to the first dose. RO5126766 (CH5126766) is metabolised mainly by CYP3A4 therefore concomitant administration of strong inhibitors and inducers of cytochrome p450 3A4 enzymes is forbidden during study treatment (for a complete list please see Appendix A). Any other condition that, in the opinion of the investigator, may compromise the safety, compliance of the patient, or would preclude the patient from successful completion of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregory Riely, MD, PhD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Miami Cancer Institute
City
Miami
State/Province
Florida
ZIP/Postal Code
33143
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Lehigh Valley Health Network
City
Allentown
State/Province
Pennsylvania
ZIP/Postal Code
18103
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.mskcc.org/mskcc/html/44.cfm
Description
Memorial Sloan Kettering Cancer Center

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RO5126766 for Patients With Advanced KRAS-Mutant Lung Cancer

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