A Study of XL092 as Single-Agent and Combination Therapy in Subjects With Solid Tumors (STELLAR-001)
Neoplasm Malignant, Renal Cell Carcinoma, Hormone Receptor Positive Breast Carcinoma
About this trial
This is an interventional treatment trial for Neoplasm Malignant
Eligibility Criteria
Inclusion Criteria:
- Cytologically or histologically confirmed solid tumor that is inoperable locally advanced, metastatic, or recurrent.
- Dose-escalation (single-agent and combination therapy): Subjects with a solid tumor that is unresectable or metastatic and for which life-prolonging therapies do not exist or available therapies are intolerable or no longer effective.
- Expansion Cohort A (ccRCC): Subjects with previously treated advanced RCC with clear cell histology (including those with a sarcomatoid component) who have radiographically progressed following treatment with at least one prior systemic anticancer regimen for inoperable locally advanced or metastatic disease.
- Expansion Cohorts B and E (nccRCC): Subjects with previously treated advanced RCC with non-clear cell histology who have radiographically progressed following treatment with at least one prior systemic anticancer regimen for inoperable locally advanced or metastatic disease.
- Expansion Cohorts C and F (HR+ BC): Subjects with breast cancer that is hormone receptor positive (ER+ and/or PR+) and negative for human epidermal growth factor receptor 2 (HER-2) and who have radiographically progressed during or following treatment with at least one prior systemic anticancer regimen for inoperable locally advanced or metastatic disease.
- Expansion Cohorts D and G (mCRPC): Subjects with metastatic CRPC (adenocarcinoma of the prostate). Neuroendocrine differentiation and other features permitted if adenocarcinoma is the primary histology.
Expansion Cohort H (CRC): Subjects with histologically confirmed unresectable, locally advanced, or metastatic adenocarcinoma of the colon or rectum, KRAS/NRAS wild-type (confirmed via local testing report) and determined NOT to have microsatellite instability high (MSI-high) or mismatch repair deficient (dMMR) by local testing, who received the following standard of care chemotherapy regimens as prior therapy for metastatic CRC:
- Fluoropyrimidine, irinotecan and oxaliplatin, with or without an anti-VEGF monoclonal antibody (bevacizumab)
- Anti-EGFR monoclonal antibody (cetuximab or panitumumab)
- BRAF inhibitor (in combination with cetuximab +/- binimetinib) for subjects with BRAF V600E mutations
- Expansion Cohort I (UC, Maintenance Therapy): Subjects with histologically confirmed, unresectable, locally advanced or metastatic transitional cell carcinoma of the urothelium (including the renal pelvis, ureter, urinary bladder, or urethra) who received first-line chemotherapy of gemcitabine + cisplatin and/or gemcitabine + carboplatin.
- Expansion Cohort J (UC, ICI-refractory): Subjects with histologically confirmed, unresectable, locally advanced or metastatic transitional cell carcinoma of the urothelium (including the renal pelvis, ureter, urinary bladder, or urethra) who progressed on or after PD-1/PD-L1 targeting ICI therapy.
- Expansion Cohort K (UC, platinum-refractory): Subjects with histologically confirmed, unresectable, locally advanced or metastatic transitional cell carcinoma of the urothelium (including the renal pelvis, ureter, urinary bladder, or urethra) who progressed on or after first-line platinum-based combination therapy.
- Expansion Cohorts: Subjects must have measurable disease per RECIST 1.1, with exception of Cohort I (UC, Maintenance Therapy).
Tumor tissue material:
- Subjects in the non-biomarker cohort provide archival, if available, or fresh tumor tissue if it can be safely obtained.
- Recovery to baseline or ≤ Grade 1 severity (CTCAE v5) from adverse events (AEs), including immune-related adverse events (irAEs), related to any prior treatments, unless AE(s) are clinically nonsignificant and/or stable on supportive therapy.
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1.
- Adequate organ and marrow function.
- Sexually active fertile subjects and their partners must agree to use highly effective methods of contraception.
- Female subjects of childbearing potential must not be pregnant at screening.
Exclusion Criteria:
- Prior treatment with XL092 (all cohorts), prior treatment with PD-L1/PD-1 targeting immune checkpoint inhibitor (Cohorts E, F, G, H, I, and K only), prior treatment with avelumab (Cohort J only), or prior treatment with regorafenib and/or TAS-102 (Cohort H only).
- Receipt of any type of small molecule kinase inhibitor within 2 weeks before first dose of study treatment.
- Receipt of any type of anticancer antibody, systemic chemotherapy, or hormonal anticancer therapy within 4 weeks before first dose of study treatment.
- Radiation therapy for bone metastasis within 2 weeks, any other radiation therapy within 4 weeks before first dose of study treatment. Subjects with clinically relevant ongoing complications from prior radiation therapy are not eligible.
- Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 4 weeks before first dose of study treatment.
- Uncontrolled, significant intercurrent or recent illness.
- Concomitant use of certain medications.
- Corrected QT interval calculated by the Fridericia formula (QTcF) > 450 ms for males and > 470 ms for females. Single ECGs are no longer permitted.
- Pregnant or lactating females.
- Diagnosis of another malignancy within 2 years before first dose of study treatment, except for superficial skin cancers, or localized, low grade tumors deemed cured and not treated with systemic therapy.
Additional Exclusion Criteria for XL092 + Atezolizumab Combination Therapy Cohorts ONLY:
- Diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 2 weeks prior to first dose of study treatment.
- Administration of a live, attenuated vaccine within 30 days before first dose of study treatment.
Additional Exclusion Criteria for XL092 + Avelumab Combination Therapy Cohorts ONLY:
- Active autoimmune disease that might deteriorate when receiving an immunostimulatory agent.
- Administration of a live, attenuated vaccine within 30 days before first dose of study treatment.
Sites / Locations
- Exelixis Clinical Site #6Recruiting
- Exelixis Clinical Site #49Recruiting
- Exelixis Clinical Site #7Recruiting
- Exelixis Clinical #71Recruiting
- Exelixis Clinical Site #66Recruiting
- Exelixis Clinical Site #15Recruiting
- Exelixis Clinical Site #24Recruiting
- Exelixis Clinical Site #11
- Exelixis Clinical Site #41Recruiting
- Exelixis Clinical Site #36Recruiting
- Exelixis Clinical Site #62Recruiting
- Exelixis Clinical Site #44
- Exelixis Clinical Site #4Recruiting
- Exelixis Clinical Site #45Recruiting
- Exelixis Clinical Site #2Recruiting
- Exelixis Clinical Site #25
- Exelixis Clinical Site #13Recruiting
- Exelixis Clinical Site #9Recruiting
- Exelixis Clinical Site #35Recruiting
- Exelixis Clinical #78Recruiting
- Exelixis Clinical #74Recruiting
- Exelixis Clinical Site #60Recruiting
- Exelixis Clinical Site #59Recruiting
- Exelixis Clinical Site #58Recruiting
- Exelixis Clinical Site #12Recruiting
- Exelixis Clinical Site #61Recruiting
- Exelixis Clinical Site #50Recruiting
- Exelixis Clinical Site #33Recruiting
- Exelixis Clinical Site #3Recruiting
- Exelixis Clinical Site #1Recruiting
- Exelixis Clinical Site #5Recruiting
- Exelixis Clinical Site #8Recruiting
- Exelixis Clinical Site #43Recruiting
- Exelixis Clinical Site #26Recruiting
- Exelixis Clinical Site #52Recruiting
- Exelixis Clinical Site #53Recruiting
- Exelixis Clinical #75Recruiting
- Exelixis Clinical Site #56Recruiting
- Exelixis Clinical Site #63Recruiting
- Exelixis Clinical Site #44Recruiting
- Exelixis Clinical Site #51Recruiting
- Exelixis Clinical Site #65Recruiting
- Exelixis Clinical Site #21Recruiting
- Exelixis Clinical Site #42Recruiting
- Exelixis Clinical Site #10Recruiting
- Exelixis Clinical Site #27Recruiting
- Exelixis Clinical Site #46Recruiting
- Exelixis Clinical Site #37Recruiting
- Exelixis Clinical #72Recruiting
- Exelixis Clinical Site #32Recruiting
- Exelixis Clinical Site #48Recruiting
- Exelixis Clinical Site #14Recruiting
- Exelixis Clinical Site #39Recruiting
- Exelixis Clinical Site #47Recruiting
- Exelixis Clinical Site #22Recruiting
- Exelixis Clinical Site #57Recruiting
- Exelixis Clinical #77Recruiting
- Exelixis Clinical Site #38Recruiting
- Exelixis Clinical Site #28Recruiting
- Exelixis Clinical Site #31Recruiting
- Exelixis Clinical Site #64Recruiting
- Exelixis Clinical Site #67Recruiting
- Exelixis Clinical Site #69Recruiting
- Exelixis Clinical Site #54Recruiting
- Exelixis Clinical #73Recruiting
- Exelixis Clinical Site #79Recruiting
- Exelixis Clinical #76Recruiting
- Exelixis Clinical Site #23Recruiting
- Exelixis Clinical Site #20Recruiting
- Exelixis Clinical Site #18Recruiting
- Exelixis Clinical Site #19Recruiting
- Exelixis Clinical Site #29Recruiting
- Exelixis Clinical Site #30Recruiting
- Exelixis Clinical Site #34Recruiting
- Exelixis Clinical Site #55Recruiting
- Exelixis Clinical Site #17Recruiting
- Exelixis Clinical Site #16Recruiting
- Exelixis Clinical #70Recruiting
- Exelixis Clinical Site #40Recruiting
- Exelixis Clinical Site #68Recruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Experimental
Experimental
Experimental
Experimental
Experimental
XL092 Single-Agent Dose-Escalation Cohorts
XL092 Single-Agent Expansion Cohorts
XL092 + Atezolizumab Dose-Escalation Cohorts
XL092 + Atezolizumab Expansion Cohorts
XL092 + Avelumab Dose-Escalation Cohorts
Subjects will accrue in cohorts of 3-6 subjects in a standard "3 plus 3" design.
The MTD or recommended dose from the dose-escalation stage may be further explored in clear cell renal cell carcinoma (ccRCC), non-clear cell renal cell carcinoma (nccRCC), hormone receptor-positive breast cancer (HR+ BC), and metastatic castration-resistant prostate cancer (mCRPC).
Subjects will accrue in cohorts of 2-6 subjects in a "rolling 6" design.
The MTD or recommended dose from the dose-escalation stage may be further explored in non-clear cell renal cell carcinoma (nccRCC), hormone receptor-positive breast cancer (HR+ BC), metastatic castration-resistant prostate cancer (mCRPC), and colorectal cancer (CRC).
Subjects will accrue in cohorts of 2-6 subjects in a "rolling 6" design.