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Binimetinib and Hydroxychloroquine in Patients With Advanced KRAS Mutant Non-Small Cell Lung Cancer

Primary Purpose

Non-Small Cell Lung Cancer, KRAS Mutation-Related Tumors

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Binimetinib Pill
Hydroxychloroquine Pill
Sponsored by
Abramson Cancer Center at Penn Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Small Cell Lung Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Metastatic or incurable NSCLC
  2. Presence of a non-synonymous mutation in KRAS
  3. Patient must have received at least one prior systemic therapy for metastatic NSCLC or be intolerant/ineligible/refuse available therapies with known benefit
  4. Ability and willingness to sign a written informed consent document
  5. Age ≥18 years old
  6. At least one measureable lesion according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
  7. ECOG performance status 0-1
  8. Adequate organ function
  9. Women of childbearing potential must have a negative serum pregnancy test performed within 72hours of the first dose of study therapy. Subjects of reproductive potential must agree to use acceptable birth control methods (see Appendix B for childbearing potential).
  10. Qtc < 500 mSec on EKG
  11. Must be able to swallow tablets
  12. Must be willing to comply with protocol procedures (including completion of diaries and outcome measures

Exclusion Criteria:

  1. Currently participating in or has participated in a study of an investigational agent or anticipated use of an investigational device within 4 weeks of the first dose of study treatment.
  2. Untreated symptomatic central nervous system (CNS) metastases and/or carcinomatous meningitis.
  3. Prior monoclonal antibody within 4 weeks prior to enrollment, or individuals who have not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier.
  4. Known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin, non-invasive bladder tumors, or in situ cervical cancer
  5. Active infection requiring systemic therapy with IV antibiotics
  6. History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
  7. Known psychiatric or substance abuse disorders as documented in the chart that, in the opinion of the investigator, would interfere with cooperation with the requirements of the trial.
  8. Pregnant or breastfeeding women
  9. Anticipated receipt of any live vaccine within 30 days prior to the first dose of trial treatment.
  10. Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to study drug, or excipients or to dimethyl sulfoxide (DMSO).
  11. Patients receiving cytochrome P450 enzyme-inducing anticonvulsant drugs (EIADs) (i.e.

    phenytoin, carbamazepine, Phenobarbital, primidone or oxcarbazepine) within 4 weeks of the start of the study treatment

  12. Known Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV) infection (subjects with laboratory evidence of cleared HBV and/or HCV will be permitted)
  13. Patients with a previously documented retinal vein occlusion.
  14. History or evidence of increased cardiovascular risk including any of the following:

    • Current clinically significant uncontrolled arrhythmias. Exception: Subjects with controlled atrial fibrillation for > 30 days prior to randomization are eligible.
    • History of acute coronary syndromes (including myocardial infarction and unstable angina), coronary angioplasty, or stenting within 6 months prior to randomization.
    • Ejection fraction of ≤50% as measured by echocardiography or MUGA
  15. Any other conditions judged by the investigator that would limit the evaluation of the subject

Sites / Locations

  • Abramson Cancer Center of the University of Pennsylvania

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Binimetinib and Hydroxychloroquine

Arm Description

Hydroxychloroquine (HCQ)in combination with Binimetinib (B). The starting dose for HCQ will be 400mg. Tablets of HCQ are available in 200 mg strength. HCQ will be administered in divided doses (every 12 hours) with or without food. The starting dose of B is 45mg. B will be administered in divided doses (every 12 hours) with or without food

Outcomes

Primary Outcome Measures

Objective Response Rate
Number of Patients with Adverse Events as assessed by CTCAE v5.0

Secondary Outcome Measures

progression-free survival (PFS)
Number of changes in ctDNA KRAS allelic frequency (blood)
Overall survival (OS)

Full Information

First Posted
January 11, 2021
Last Updated
June 27, 2023
Sponsor
Abramson Cancer Center at Penn Medicine
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT04735068
Brief Title
Binimetinib and Hydroxychloroquine in Patients With Advanced KRAS Mutant Non-Small Cell Lung Cancer
Official Title
The LIMIT KRAS Mutant NSCLC Trial: Lysosome Inhibition to Enhance MAPK Inhibition Targeting KRAS Mutant NSCLC: A Phase 2 Open Label Trial of Binimetinib and Hydroxychloroquine in Patients With Advanced KRAS Mutant Non-Small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 9, 2021 (Actual)
Primary Completion Date
August 21, 2022 (Actual)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Abramson Cancer Center at Penn Medicine
Collaborators
Pfizer

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will evaluate using hydroxychloroquine (HCQ) along with binimetinib as an effective method for treating cancer. All patients will receive binimetinib at a standard dose approved for other cancers. The dose of HCQ will also be fixed based on ongoing phase I studies. Eligible subjects will have lung cancer that has a mutation in a key cancer gene called KRAS, and the cancer has spread to other parts of their body.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Small Cell Lung Cancer, KRAS Mutation-Related Tumors

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Binimetinib and Hydroxychloroquine
Arm Type
Experimental
Arm Description
Hydroxychloroquine (HCQ)in combination with Binimetinib (B). The starting dose for HCQ will be 400mg. Tablets of HCQ are available in 200 mg strength. HCQ will be administered in divided doses (every 12 hours) with or without food. The starting dose of B is 45mg. B will be administered in divided doses (every 12 hours) with or without food
Intervention Type
Drug
Intervention Name(s)
Binimetinib Pill
Intervention Description
Patients will be treated with B 45 mg two times daily and HCQ 400 mg twice daily beginning on day 1. The dose of HCQ is based on an ongoing Phase 1 trial, and may be modified in a future amendment prior to the first patient enrolled. Efforts will be made to ensure dose homogeneity throughout the trial. Treatment will be administered on an outpatient basis on a 28 day cycle
Intervention Type
Drug
Intervention Name(s)
Hydroxychloroquine Pill
Intervention Description
Patients will be treated with B 45 mg two times daily and HCQ 400 mg twice daily beginning on day 1. The dose of HCQ is based on an ongoing Phase 1 trial, and may be modified in a future amendment prior to the first patient enrolled. Efforts will be made to ensure dose homogeneity throughout the trial. Treatment will be administered on an outpatient basis on a 28 day cycle
Primary Outcome Measure Information:
Title
Objective Response Rate
Time Frame
2 years
Title
Number of Patients with Adverse Events as assessed by CTCAE v5.0
Time Frame
2 years
Secondary Outcome Measure Information:
Title
progression-free survival (PFS)
Time Frame
2 years
Title
Number of changes in ctDNA KRAS allelic frequency (blood)
Time Frame
2 years
Title
Overall survival (OS)
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Metastatic or incurable NSCLC Presence of a non-synonymous mutation in KRAS Patient must have received at least one prior systemic therapy for metastatic NSCLC or be intolerant/ineligible/refuse available therapies with known benefit Ability and willingness to sign a written informed consent document Age ≥18 years old At least one measureable lesion according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 ECOG performance status 0-1 Adequate organ function Women of childbearing potential must have a negative serum pregnancy test performed within 72hours of the first dose of study therapy. Subjects of reproductive potential must agree to use acceptable birth control methods (see Appendix B for childbearing potential). Qtc < 500 mSec on EKG Must be able to swallow tablets Must be willing to comply with protocol procedures (including completion of diaries and outcome measures Exclusion Criteria: Currently participating in or has participated in a study of an investigational agent or anticipated use of an investigational device within 4 weeks of the first dose of study treatment. Untreated symptomatic central nervous system (CNS) metastases and/or carcinomatous meningitis. Prior monoclonal antibody within 4 weeks prior to enrollment, or individuals who have not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier. Known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin, non-invasive bladder tumors, or in situ cervical cancer Active infection requiring systemic therapy with IV antibiotics History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator. Known psychiatric or substance abuse disorders as documented in the chart that, in the opinion of the investigator, would interfere with cooperation with the requirements of the trial. Pregnant or breastfeeding women Anticipated receipt of any live vaccine within 30 days prior to the first dose of trial treatment. Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to study drug, or excipients or to dimethyl sulfoxide (DMSO). Patients receiving cytochrome P450 enzyme-inducing anticonvulsant drugs (EIADs) (i.e. phenytoin, carbamazepine, Phenobarbital, primidone or oxcarbazepine) within 4 weeks of the start of the study treatment Known Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV) infection (subjects with laboratory evidence of cleared HBV and/or HCV will be permitted) Patients with a previously documented retinal vein occlusion. History or evidence of increased cardiovascular risk including any of the following: Current clinically significant uncontrolled arrhythmias. Exception: Subjects with controlled atrial fibrillation for > 30 days prior to randomization are eligible. History of acute coronary syndromes (including myocardial infarction and unstable angina), coronary angioplasty, or stenting within 6 months prior to randomization. Ejection fraction of ≤50% as measured by echocardiography or MUGA Any other conditions judged by the investigator that would limit the evaluation of the subject
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Charu Aggarwal, MD
Organizational Affiliation
Abramson Cancer Center at Penn Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Abramson Cancer Center of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Binimetinib and Hydroxychloroquine in Patients With Advanced KRAS Mutant Non-Small Cell Lung Cancer

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