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A Study of ERAS-007 in Patients With Advanced Gastrointestinal Malignancies (HERKULES-3)

Primary Purpose

Metastatic Colorectal Cancer, Metastatic Pancreatic Ductal Adenocarcinoma

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ERAS-007
Encorafenib
Cetuximab
Palbociclib
Sponsored by
Erasca, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Cancer focused on measuring BRAF, V600E, KRAS, NRAS, mutation, Braftovi, encorafenib, Erbitux, cetuximab, Ibrance, palbociclib, ERK, MAPK, CDK4/6, CRC, colorectal cancer, EGFR, GI neoplasm, gastrointestinal neoplasm, PDAC, Pancreas Cancer

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age ≥ 18 years.
  • Willing and able to give written informed consent.
  • Have histologically or cytologically confirmed metastatic CRC harboring applicable mutation(s) (e.g., BRAF V600E; KRAS or NRAS mutations) based on an analytically validated assay performed on tumor tissue in a certified testing laboratory.
  • Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.
  • Adequate bone marrow and organ function.
  • Have ECOG performance status of 0 or 1.
  • Willing to comply with all protocol-required visits, assessments, and procedures.
  • Able to swallow oral medication.

Exclusion Criteria:

  • Prior therapy with a RAS, MEK, or ERK inhibitor. Depending on which treatment arm the patient is assigned, other therapies could also be prohibitive.
  • Anti-cancer therapy ≤ 21 days or 4 half-lives prior to first dose of study drug, whichever is shorter.
  • Palliative radiation ≤ 7 days prior to first dose of study drug.
  • Symptomatic brain metastasis or leptomeningeal disease.
  • Gastrointestinal conditions that may affect absorption of oral medications
  • Active infection requiring systemic therapy, or history of HIV infection, hepatitis B virus, or hepatitis C virus.
  • History of chronic inflammatory bowel disease or Crohn's disease requiring medical intervention (immunomodulatory or immunosuppressive medications or surgery) ≤ 12 months prior to first study drug dose.
  • Active, clinically significant interstitial lung disease or pneumonitis.
  • Impaired cardiovascular function or clinically significant cardiovascular disease.
  • History of thromboembolic or cerebrovascular events ≤ 6 months prior to first dose.
  • Major surgery within 28 days of enrollment, or anticipation of major surgery during study treatment.
  • Known intolerance or contraindication to encorafenib, cetuximab, or palbociclib.
  • Pregnant or breastfeeding women.
  • Any evidence of severe or uncontrolled systemic disease or evidence of any other significant clinical disorder or laboratory finding that renders the patient inappropriate to participate in the study.

Sites / Locations

  • University of Alabama at Birmingham (O'Neal Comprehensive Cancer Center)Recruiting
  • City of HopeRecruiting
  • University of California Irvine College of MedicineRecruiting
  • UCSF Mount Zion Medical CtrRecruiting
  • The Johns Hopkins HospitalRecruiting
  • Massachusetts General HospitalRecruiting
  • Henry Ford Cancer InstituteRecruiting
  • Washington University (Siteman Cancer Center)Recruiting
  • Duke Cancer InstituteRecruiting
  • Stephenson Cancer CenterRecruiting
  • Sarah Cannon Research Institute (Tennessee Oncology)Recruiting
  • The University of Texas MD Anderson Cancer CenterRecruiting
  • Virginia Cancer SpecialistsRecruiting
  • University of Washington - Seattle Cancer Care AllianceRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Dose Escalation (Parts A1a, A2a, or A3a): ERAS-007 in combination with encorafenib and cetuximab

Dose Escalation (Parts B1a, B2a, B3a or B4a): ERAS-007 in combination with palbociclib

Dose Expan (Parts A1b, A1c, A2b, A2c, A3b, or A3c): ERAS-007 in combo with encorafenib & cetuximab

Dose Expansion (Parts B1b, B2b, B3b, and B4b): ERAS-007 in combination with palbociclib

Arm Description

ERAS-007 will be orally administered in combination with encorafenib and cetuximab to study participants with BRAFm CRC in sequential ascending doses until unacceptable toxicity, disease progression, or withdrawal of consent.

ERAS-007 will be orally administered in combination with palbociclib to study participants with KRASm or NRASm CRC and KRASm PDAC in sequential ascending doses until unacceptable toxicity, disease progression, or withdrawal of consent.

ERAS-007 will be orally administered at the recommended dose (as determined from Parts A1a, A2a or A3a) in combination with encorafenib and cetuximab to study participants with BRAFm CRC.

ERAS-007 will be orally administered at the recommended dose (as determined from Parts B1a, B2a, B3a or B4a) in combination with palbociclib to study participants with KRASm or NRASm CRC.

Outcomes

Primary Outcome Measures

Dose Limiting Toxicities (DLT)
Based on adverse events observed during dose escalation
Maximum Tolerated Dose (MTD)
Based on adverse events observed during dose escalation
Recommended Dose (RD)
Based on adverse events observed during dose escalation
Adverse Events
Incidence and severity of treatment-emergent AEs and serious AEs

Secondary Outcome Measures

Plasma concentration (Cmax)
Maximum plasma or serum concentration of ERAS-007 and other cancer therapies
Time to achieve Cmax (Tmax)
Time to achieve maximum plasma or serum concentration of ERAS-007 and other cancer therapies
Area under the curve
Area under the plasma concentration-time curve of ERAS-007 and other cancer therapies
Half-life
Half-life of ERAS-007 and other cancer therapies
Objective Response Rate (ORR)
Based on assessment of radiographic imaging per RECIST version 1.1
Duration of Response (DOR)
Based on assessment of radiographic imaging per RECIST version 1.1

Full Information

First Posted
September 1, 2021
Last Updated
June 13, 2023
Sponsor
Erasca, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05039177
Brief Title
A Study of ERAS-007 in Patients With Advanced Gastrointestinal Malignancies
Acronym
HERKULES-3
Official Title
A Phase 1b/2 Study of Agents Targeting the Mitogen-Activated Protein Kinase Pathway in Patients With Advanced Gastrointestinal Malignancies (HERKULES-3)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 20, 2021 (Actual)
Primary Completion Date
August 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Erasca, Inc.

4. Oversight

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

5. Study Description

Brief Summary
To evaluate the safety and tolerability of escalating doses of ERAS-007 in combination with other cancer therapies in study participants with advanced GI malignancies. To determine the Maximum Tolerated Dose (MTD) and/or Recommended Dose (RD) of ERAS-007 administered in combination with other cancer therapies. To evaluate the antitumor activity of ERAS-007 in combination with other cancer therapies. To evaluate the PK profiles of ERAS-007 and other cancer therapies when administered in combination.
Detailed Description
This is a Phase 1b/2, open-label, multicenter clinical study evaluating ERAS-007 in combination with other cancer therapies in study participants with GI malignancies. This study will serve as a platform study, allowing for evaluation of safety/tolerability and efficacy of ERAS-007 in combination with other cancer therapies. The study will initially commence with dose escalation of ERAS-007 administered in combination with encorafenib and cetuximab in study participants with metastatic colorectal cancer (CRC) harboring B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation; and dose escalation of ERAS-007 administered in combination with palbociclib in study participants with metastatic CRC harboring Kirsten rat sarcoma (KRAS) or neuroblastoma rat sarcoma (NRAS) mutations and metastatic pancreatic adenocarcinoma with (PDAC) KRAS mutation. Dose expansion will follow and will test ERAS-007 administered at the RD identified from each dose escalation arm in study participants with metastatic CRC.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Cancer, Metastatic Pancreatic Ductal Adenocarcinoma
Keywords
BRAF, V600E, KRAS, NRAS, mutation, Braftovi, encorafenib, Erbitux, cetuximab, Ibrance, palbociclib, ERK, MAPK, CDK4/6, CRC, colorectal cancer, EGFR, GI neoplasm, gastrointestinal neoplasm, PDAC, Pancreas Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation (Parts A1a, A2a, or A3a): ERAS-007 in combination with encorafenib and cetuximab
Arm Type
Experimental
Arm Description
ERAS-007 will be orally administered in combination with encorafenib and cetuximab to study participants with BRAFm CRC in sequential ascending doses until unacceptable toxicity, disease progression, or withdrawal of consent.
Arm Title
Dose Escalation (Parts B1a, B2a, B3a or B4a): ERAS-007 in combination with palbociclib
Arm Type
Experimental
Arm Description
ERAS-007 will be orally administered in combination with palbociclib to study participants with KRASm or NRASm CRC and KRASm PDAC in sequential ascending doses until unacceptable toxicity, disease progression, or withdrawal of consent.
Arm Title
Dose Expan (Parts A1b, A1c, A2b, A2c, A3b, or A3c): ERAS-007 in combo with encorafenib & cetuximab
Arm Type
Experimental
Arm Description
ERAS-007 will be orally administered at the recommended dose (as determined from Parts A1a, A2a or A3a) in combination with encorafenib and cetuximab to study participants with BRAFm CRC.
Arm Title
Dose Expansion (Parts B1b, B2b, B3b, and B4b): ERAS-007 in combination with palbociclib
Arm Type
Experimental
Arm Description
ERAS-007 will be orally administered at the recommended dose (as determined from Parts B1a, B2a, B3a or B4a) in combination with palbociclib to study participants with KRASm or NRASm CRC.
Intervention Type
Drug
Intervention Name(s)
ERAS-007
Intervention Description
Administered orally
Intervention Type
Drug
Intervention Name(s)
Encorafenib
Other Intervention Name(s)
Braftovi
Intervention Description
Administered orally
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Other Intervention Name(s)
Erbitux
Intervention Description
Administered via intravenous infusion
Intervention Type
Drug
Intervention Name(s)
Palbociclib
Other Intervention Name(s)
Ibrance
Intervention Description
Administered orally
Primary Outcome Measure Information:
Title
Dose Limiting Toxicities (DLT)
Description
Based on adverse events observed during dose escalation
Time Frame
Study Day 1 up to Day 29
Title
Maximum Tolerated Dose (MTD)
Description
Based on adverse events observed during dose escalation
Time Frame
Study Day 1 up to Day 29
Title
Recommended Dose (RD)
Description
Based on adverse events observed during dose escalation
Time Frame
Study Day 1 up to Day 29
Title
Adverse Events
Description
Incidence and severity of treatment-emergent AEs and serious AEs
Time Frame
Assessed up to 24 months from time of first dose
Secondary Outcome Measure Information:
Title
Plasma concentration (Cmax)
Description
Maximum plasma or serum concentration of ERAS-007 and other cancer therapies
Time Frame
Study Day 1 up to Day 29
Title
Time to achieve Cmax (Tmax)
Description
Time to achieve maximum plasma or serum concentration of ERAS-007 and other cancer therapies
Time Frame
Study Day 1 up to Day 29
Title
Area under the curve
Description
Area under the plasma concentration-time curve of ERAS-007 and other cancer therapies
Time Frame
Study Day 1 up to Day 29
Title
Half-life
Description
Half-life of ERAS-007 and other cancer therapies
Time Frame
Study Day 1 up to Day 29
Title
Objective Response Rate (ORR)
Description
Based on assessment of radiographic imaging per RECIST version 1.1
Time Frame
Assessed up to 24 months from time of first dose
Title
Duration of Response (DOR)
Description
Based on assessment of radiographic imaging per RECIST version 1.1
Time Frame
Assessed up to 24 months from time of first dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years. Willing and able to give written informed consent. Have histologically or cytologically confirmed metastatic CRC harboring applicable mutation(s) (e.g., BRAF V600E; KRAS or NRAS mutations) or metastatic PDAC harboring KRAS mutation based on an analytically validated assay performed on tumor tissue in a certified testing laboratory. Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Adequate bone marrow and organ function. Have ECOG performance status of 0 or 1. Willing to comply with all protocol-required visits, assessments, and procedures. Able to swallow oral medication. Exclusion Criteria: Prior therapy with a RAS, MEK, or ERK inhibitor. Depending on which treatment arm the patient is assigned, other therapies could also be prohibitive. Anti-cancer therapy ≤ 21 days or 4 half-lives prior to first dose of study drug, whichever is shorter. Palliative radiation ≤ 7 days prior to first dose of study drug. Symptomatic brain metastasis or leptomeningeal disease. Gastrointestinal conditions that may affect absorption of oral medications Active infection requiring systemic therapy, or a known history of HIV infection, hepatitis B virus, or hepatitis C virus. History of chronic inflammatory bowel disease or Crohn's disease requiring medical intervention (immunomodulatory or immunosuppressive medications or surgery) ≤ 12 months prior to first study drug dose. Active, clinically significant interstitial lung disease or pneumonitis. Impaired cardiovascular function or clinically significant cardiovascular disease. History of thromboembolic or cerebrovascular events ≤ 6 months prior to first dose. Major surgery within 28 days of enrollment, or anticipation of major surgery during study treatment. Known intolerance or contraindication to encorafenib, cetuximab, or palbociclib. Pregnant or breastfeeding women. Any evidence of severe or uncontrolled systemic disease or evidence of any other significant clinical disorder or laboratory finding that renders the patient inappropriate to participate in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Erasca Clinical Team
Phone
+1-858-465-6511
Email
clinicaltrials@erasca.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Saswati Hazra
Organizational Affiliation
Clinical Development
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama at Birmingham (O'Neal Comprehensive Cancer Center)
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Individual Site Status
Recruiting
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Individual Site Status
Recruiting
Facility Name
University of California Irvine College of Medicine
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Individual Site Status
Recruiting
Facility Name
UCSF Mount Zion Medical Ctr
City
San Francisco
State/Province
California
ZIP/Postal Code
94158
Country
United States
Individual Site Status
Recruiting
Facility Name
The Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Individual Site Status
Recruiting
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Individual Site Status
Recruiting
Facility Name
Henry Ford Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Individual Site Status
Recruiting
Facility Name
Washington University (Siteman Cancer Center)
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Individual Site Status
Recruiting
Facility Name
Duke Cancer Institute
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Individual Site Status
Recruiting
Facility Name
Stephenson Cancer Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Individual Site Status
Recruiting
Facility Name
Sarah Cannon Research Institute (Tennessee Oncology)
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Individual Site Status
Recruiting
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Name
Virginia Cancer Specialists
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Washington - Seattle Cancer Care Alliance
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of ERAS-007 in Patients With Advanced Gastrointestinal Malignancies

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