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A Study of SDX-7320 in Combination With Eribulin for People With Breast Cancer

Primary Purpose

Breast Cancer, Metastatic Triple-Negative Breast Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Eribulin
SDX-7320
Placebo
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring Evexomostat (SDX-7320), Eribulin, 22-074

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female with histologically and/or cytologically confirmed diagnosis of triple-negative metastatic breast cancer defined as estrogen and progesterone receptor staining <10%; and HER2-negative defined as IHC 0 to 1+ (note: if IHC is equivocal, non-amplified status by FISH is acceptable)
  • Advanced (local regionally recurrent, not amenable to curative therapy or surgery) or metastatic stage with up to 2 prior lines of therapy in the advanced or metastatic setting
  • Received prior anthracycline and taxane chemotherapy in the neoadjuvant, adjuvant, or metastatic settings and considered appropriate for treatment with single agent eribulin
  • Evidence of metabolic dysfunction defined as HbA1c > 5.5 and/or BMI ≥ 30 kg/m^2
  • Measurable disease per the Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1), OR at least one evaluable, predominantly lytic bone lesion
  • Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≤1.
  • Adult ≥18 at the time of informed consent and has provided written informed consent before the performance of any study-related activities and according to local guidelines.
  • Adequate bone marrow and organ function as defined by the following laboratory values (as assessed by central laboratory for eligibility):

    • Absolute neutrophil count (ANC) ≥ 1,000 µL
    • Platelet count ≥ 140,000 µL
    • Hemoglobin ≥9.0 g/dL:
    • Calcium (corrected for serum albumin) and magnesium ≤ Grade 1 according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 5.0, and not considered by the Investigator to be clinically significant
    • Potassium within normal limits, with or without correction with supplements.
    • In absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5×the upper limit of normal (ULN). If the patient has liver metastases, ALT and AST ≤5×ULN.
    • Total bilirubin ≤1.5×ULN except for patient with Gilbert's syndrome who may only be included if the total bilirubin is ≤3.0×ULN or direct bilirubin ≤1.5×ULN
    • Creatinine ≤1.5 mg/dL.
  • Patient is, in the Investigator's opinion, willing and able to comply with the study requirements, including the ability to fast prior to treatment days.
  • If sexually active female of childbearing potential, willing to use a contraception method listed below:

    • Oral, intravaginal, or transdermal combined (estrogen and progestin containing) hormonal contraception
    • Oral, injectable, or implantable progestin-only hormonal contraception
    • Intrauterine device (IUD)
    • Intrauterine hormone-releasing system (IUS)
    • Bilateral tubal occlusion
    • Vasectomized partner with documentation of successful vasectomy.
    • Complete abstinence from heterosexual intercourse
  • If a sexually active male, willing to use barrier contraception (condoms)

Exclusion Criteria:

  • Three or greater prior lines of therapy for metastatic TNBC
  • Known primary brain malignancy, brain metastases or active CNS pathology, any of which as determined by the Investigator
  • Currently participating in a study of an investigational agent
  • Body mass index < 18.5 kg/m2
  • Known hypersensitivity to SDX-7320 or eribulin
  • Established diagnosis of diabetes mellitus type I or uncontrolled or insulin-dependent type II. Uncontrolled is defined as fasting blood glucose >140 mg/dL and/or HbA1c ≥8%
  • Use of combination antihyperglycemic therapy (single agent metformin on stable dose for at least 3 months prior to enrollment is allowable)
  • Child Pugh score of B or C.
  • Concurrent malignancy or malignancy within 3 years of randomization, with the exception of adequately treated, basal or squamous cell carcinoma, nonmelanomatous skin cancer or curatively resected cervical cancer.
  • Uncontrolled human immunodeficiency virus (HIV) infection. (Testing is not mandatory.)
  • Evidence of uncontrolled active Hepatitis B or C infection
  • History of Stevens-Johnson Syndrome (SJS), erythema multiforme (EM), toxic epidermal necrolysis (TEN), or other severe medication-related cutaneous reactions.
  • Any other concurrent severe and/or uncontrolled medical condition that would, in the Investigator's judgment, contraindicate patient participation in the clinical study (e.g., chronic active hepatitis, severe hepatic impairment).
  • Clinically significant, uncontrolled heart disease and/or recent cardiac events including any of the following:

    • History of angina pectoris, coronary artery bypass graft (CABG) symptomatic pericarditis, or myocardial infarction within 6 months prior to study entry.
    • History of documented congestive heart failure (New York Heart Association functional classification III-IV).
    • Documented cardiomyopathy.
    • Left ventricular ejection fraction (LVEF) <45%, as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO).
    • History of any cardiac arrhythmias, (e.g., ventricular tachycardia), complete left bundle block, high grade atrioventricular (AV) block (e.g., bifascicular block, Mobitz type II and third-degree AV block) supraventricular, nodal arrhythmias, or conduction abnormality in the previous 12 months.
    • Uncontrolled hypertension, defined by a systolic blood pressure (SBP) ≥160 mmHg and/or diastolic blood pressure (DBP) ≥100 mmHg, with or without antihypertensive medication. Initiation or adjustment of antihypertensive medication(s) is allowed prior to screening
    • Long QT syndrome, family history of idiopathic sudden death or congenital long QT syndrome or any of the following: risk factors for torsades de pointe including uncorrected hypokalemia or hypomagnesemia, history of cardiac failure or history of clinically significant/symptomatic bradycardia; concomitant medications with a known risk to prolong the QT interval and known to cause torsades de pointe that cannot be discontinued or replaced by safe alternative medications.
    • Bradycardia (heart rate less than 50 at rest), by electrocardiogram (ECG) or pulse.
    • Inability to determine the QT interval on the ECG (i.e., unreadable or not interpretable) or corrected QT (QTcF) >450 msec for males and >470 msec for females (using Fridericia's correction) during Screening, based on the mean of triplicate ECGs
  • Currently receiving any of the following medications and cannot be discontinued 7 days prior to the start of the treatment:

    • Medications with a known risk to prolong the QT interval or induce Torsade de Pointes (TdP). CredibleMeds list of drugs known to cause TdP may be used as a reference for this study to determine which drugs are prohibited using the following link: https://crediblemeds.org/new-drug-list or a crediblemeds mobile application.
    • Herbal preparations/medications, with the exception of cannabinoids, CBD compounds, etc.
  • Participation in a prior investigational study within 14 days prior to the start of the study treatment or within 5 half-lives of study drug, whichever is longer.
  • History of acute pancreatitis within 1 year of Screening or past medical history of chronic pancreatitis
  • Pregnant patients

Sites / Locations

  • Memorial Sloan Kettering Basking Ridge (All Protocol Activities)Recruiting
  • Memorial Sloan Kettering Monmouth (All Protocol Activities)Recruiting
  • Memorial Sloan Kettering Bergen (All Protocol Activities)Recruiting
  • Memorial Sloan Kettering Suffolk - Commack (All Protocol Activities)Recruiting
  • Memorial Sloan Kettering Westchester (All Protocol Activities)Recruiting
  • Memorial Sloan Kettering Cancer Center (All Protocol Activities)Recruiting
  • Memorial Sloan Kettering Nassau (All Protocol Activities)Recruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

SDX-7320 plus Eribulin (safety run-in period)

SDX-7320 plus Eribulin

Eribulin Plus Placebo

Arm Description

During the safety run-in period, the first 15 patients enrolled will be assigned to received study drug SDX-7320 plus Eribulin. Not randomized.

Patients randomized to SDX-7320 plus Eribulin.

Patients randomized to the control arm will receive placebo plus Eribulin.

Outcomes

Primary Outcome Measures

change in insulin resistance scores (HOMA-IR)
The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) is a validated tool for the assessment of insulin resistance.87 HOMA-IR is calculated as follows: fasting serum insulin (μU/mL) × fasting plasma glucose (mmol L -1 )/22.5).

Secondary Outcome Measures

Type, frequency and severity of treatment-emergent adverse events
(TEAEs) and laboratory toxicities per the NCI CTCAE version 5.0.
Overall response rate
Response rate will be assessed by RECIST v1.1

Full Information

First Posted
October 4, 2022
Last Updated
July 3, 2023
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
SynDevRx, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05570253
Brief Title
A Study of SDX-7320 in Combination With Eribulin for People With Breast Cancer
Official Title
Phase 2 Randomized Control Trial of Evexomostat (SDX-7320) in Combination With Eribulin for Patients With Metastatic Triple-Negative Breast Cancer and Metabolic Dysfunction: The ARETHA Study
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 3, 2022 (Actual)
Primary Completion Date
October 2027 (Anticipated)
Study Completion Date
October 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
SynDevRx, Inc.

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 researchers are doing this study to find out whether the study drug, SDX-7320, when combined with the standard chemotherapy eribulin, is an effective treatment for people with TNBC and metabolic dysfunction. The researchers will also look at whether the study treatment (SDX-7320 combined with eribulin) is safe and causes few or mild side effects in participants. The researchers will compare this treatment approach to eribulin alone.
Detailed Description
The study includes a safety run-in period in which the first 15 patients enrolled will be assigned to receive the study drug SDX-7320 in combination with eribulin. Upon safety confirmation, randomization will commence for the subsequent 40 patients enrolled.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Metastatic Triple-Negative Breast Cancer
Keywords
Evexomostat (SDX-7320), Eribulin, 22-074

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Model Description
This is a single-center, placebo-controlled phase 2 randomized control trial.
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
55 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SDX-7320 plus Eribulin (safety run-in period)
Arm Type
Experimental
Arm Description
During the safety run-in period, the first 15 patients enrolled will be assigned to received study drug SDX-7320 plus Eribulin. Not randomized.
Arm Title
SDX-7320 plus Eribulin
Arm Type
Experimental
Arm Description
Patients randomized to SDX-7320 plus Eribulin.
Arm Title
Eribulin Plus Placebo
Arm Type
Placebo Comparator
Arm Description
Patients randomized to the control arm will receive placebo plus Eribulin.
Intervention Type
Drug
Intervention Name(s)
Eribulin
Intervention Description
Eribulin 1.4 mg/m2 IV on days 1 and 8 of an every 21 day cycle.
Intervention Type
Drug
Intervention Name(s)
SDX-7320
Intervention Description
SDX-7320 at the dose of 49 mg/m2 SC on a Q14D basis
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
change in insulin resistance scores (HOMA-IR)
Description
The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) is a validated tool for the assessment of insulin resistance.87 HOMA-IR is calculated as follows: fasting serum insulin (μU/mL) × fasting plasma glucose (mmol L -1 )/22.5).
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Type, frequency and severity of treatment-emergent adverse events
Description
(TEAEs) and laboratory toxicities per the NCI CTCAE version 5.0.
Time Frame
2 years
Title
Overall response rate
Description
Response rate will be assessed by RECIST v1.1
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female with histologically and/or cytologically confirmed diagnosis of triple-negative metastatic breast cancer defined as estrogen and progesterone receptor staining <10%; and HER2-negative defined as IHC 0 to 1+ (note: if IHC is equivocal, non-amplified status by FISH is acceptable) Advanced (local regionally recurrent, not amenable to curative therapy or surgery) or metastatic stage with up to 2 prior lines of therapy in the advanced or metastatic setting Received prior anthracycline and taxane chemotherapy in the neoadjuvant, adjuvant, or metastatic settings and considered appropriate for treatment with single agent eribulin Evidence of metabolic dysfunction defined as HbA1c > 5.5 and/or BMI ≥ 30 kg/m^2 Measurable disease per the Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1), OR at least one evaluable, predominantly lytic bone lesion Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≤1. Adult ≥18 at the time of informed consent and has provided written informed consent before the performance of any study-related activities and according to local guidelines. Adequate bone marrow and organ function as defined by the following laboratory values (as assessed by central laboratory for eligibility): Absolute neutrophil count (ANC) ≥ 1,000 µL Platelet count ≥ 140,000 µL Hemoglobin ≥9.0 g/dL: Calcium (corrected for serum albumin) and magnesium ≤ Grade 1 according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 5.0, and not considered by the Investigator to be clinically significant Potassium within normal limits, with or without correction with supplements. In absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5×the upper limit of normal (ULN). If the patient has liver metastases, ALT and AST ≤5×ULN. Total bilirubin ≤1.5×ULN except for patient with Gilbert's syndrome who may only be included if the total bilirubin is ≤3.0×ULN or direct bilirubin ≤1.5×ULN Creatinine ≤1.5 mg/dL. Patient is, in the Investigator's opinion, willing and able to comply with the study requirements, including the ability to fast prior to treatment days. If sexually active female of childbearing potential, willing to use a contraception method listed below: Oral, intravaginal, or transdermal combined (estrogen and progestin containing) hormonal contraception Oral, injectable, or implantable progestin-only hormonal contraception Intrauterine device (IUD) Intrauterine hormone-releasing system (IUS) Bilateral tubal occlusion Vasectomized partner with documentation of successful vasectomy. Complete abstinence from heterosexual intercourse If a sexually active male, willing to use barrier contraception (condoms) Exclusion Criteria: Three or greater prior lines of therapy for metastatic TNBC Known primary brain malignancy, brain metastases or active CNS pathology, any of which as determined by the Investigator Currently participating in a study of an investigational agent Body mass index < 18.5 kg/m2 Known hypersensitivity to SDX-7320 or eribulin Established diagnosis of diabetes mellitus type I or uncontrolled or insulin-dependent type II. Uncontrolled is defined as fasting blood glucose >140 mg/dL and/or HbA1c ≥8% Use of combination antihyperglycemic therapy (single agent metformin on stable dose for at least 3 months prior to enrollment is allowable) Child Pugh score of B or C. Concurrent malignancy or malignancy within 3 years of randomization, with the exception of adequately treated, basal or squamous cell carcinoma, nonmelanomatous skin cancer or curatively resected cervical cancer. Uncontrolled human immunodeficiency virus (HIV) infection. (Testing is not mandatory.) Evidence of uncontrolled active Hepatitis B or C infection History of Stevens-Johnson Syndrome (SJS), erythema multiforme (EM), toxic epidermal necrolysis (TEN), or other severe medication-related cutaneous reactions. Any other concurrent severe and/or uncontrolled medical condition that would, in the Investigator's judgment, contraindicate patient participation in the clinical study (e.g., chronic active hepatitis, severe hepatic impairment). Clinically significant, uncontrolled heart disease and/or recent cardiac events including any of the following: History of angina pectoris, coronary artery bypass graft (CABG) symptomatic pericarditis, or myocardial infarction within 6 months prior to study entry. History of documented congestive heart failure (New York Heart Association functional classification III-IV). Documented cardiomyopathy. Left ventricular ejection fraction (LVEF) <45%, as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO). History of any cardiac arrhythmias, (e.g., ventricular tachycardia), complete left bundle block, high grade atrioventricular (AV) block (e.g., bifascicular block, Mobitz type II and third-degree AV block) supraventricular, nodal arrhythmias, or conduction abnormality in the previous 12 months. Uncontrolled hypertension, defined by a systolic blood pressure (SBP) ≥160 mmHg and/or diastolic blood pressure (DBP) ≥100 mmHg, with or without antihypertensive medication. Initiation or adjustment of antihypertensive medication(s) is allowed prior to screening Long QT syndrome, family history of idiopathic sudden death or congenital long QT syndrome or any of the following: risk factors for torsades de pointe including uncorrected hypokalemia or hypomagnesemia, history of cardiac failure or history of clinically significant/symptomatic bradycardia; concomitant medications with a known risk to prolong the QT interval and known to cause torsades de pointe that cannot be discontinued or replaced by safe alternative medications. Bradycardia (heart rate less than 50 at rest), by electrocardiogram (ECG) or pulse. Inability to determine the QT interval on the ECG (i.e., unreadable or not interpretable) or corrected QT (QTcF) >450 msec for males and >470 msec for females (using Fridericia's correction) during Screening, based on the mean of triplicate ECGs Currently receiving any of the following medications and cannot be discontinued 7 days prior to the start of the treatment: Medications with a known risk to prolong the QT interval or induce Torsade de Pointes (TdP). CredibleMeds list of drugs known to cause TdP may be used as a reference for this study to determine which drugs are prohibited using the following link: https://crediblemeds.org/new-drug-list or a crediblemeds mobile application. Herbal preparations/medications, with the exception of cannabinoids, CBD compounds, etc. Participation in a prior investigational study within 14 days prior to the start of the study treatment or within 5 half-lives of study drug, whichever is longer. History of acute pancreatitis within 1 year of Screening or past medical history of chronic pancreatitis Pregnant patients
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Neil Iyengar, MD
Phone
646-888-8103
Email
iyengarn@mskcc.org
First Name & Middle Initial & Last Name or Official Title & Degree
Tiffany Trainia, MD
Phone
646-888-4558
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Neil Iyengar, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Sloan Kettering Basking Ridge (All Protocol Activities)
City
Basking Ridge
State/Province
New Jersey
ZIP/Postal Code
07920
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Iyengar, MD
Phone
646-888-8103
Facility Name
Memorial Sloan Kettering Monmouth (All Protocol Activities)
City
Middletown
State/Province
New Jersey
ZIP/Postal Code
07748
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Iyengar, MD
Phone
646-888-8103
Facility Name
Memorial Sloan Kettering Bergen (All Protocol Activities)
City
Montvale
State/Province
New Jersey
ZIP/Postal Code
07645
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Iyengar, MD
Phone
646-888-8103
Facility Name
Memorial Sloan Kettering Suffolk - Commack (All Protocol Activities)
City
Commack
State/Province
New York
ZIP/Postal Code
11725
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Iyengar, MD
Phone
646-888-8103
Facility Name
Memorial Sloan Kettering Westchester (All Protocol Activities)
City
Harrison
State/Province
New York
ZIP/Postal Code
10604
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Iyengar, MD
Phone
646-888-8103
Facility Name
Memorial Sloan Kettering Cancer Center (All Protocol Activities)
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Iyengar, MD
Phone
646-888-8103
First Name & Middle Initial & Last Name & Degree
Tiffany Traina, MD
Phone
646-888-4558
Facility Name
Memorial Sloan Kettering Nassau (All Protocol Activities)
City
Uniondale
State/Province
New York
ZIP/Postal Code
11553
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Iyengar, MD
Phone
646-888-8103

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Memorial Sloan Kettering Cancer Center supports the international committee of medical journal editors (ICMJE) and the ethical obligation of responsible sharing of data from clinical trials. The protocol summary, a statistical summary, and informed consent form will be made available on clinicaltrials.gov when required as a condition of Federal awards, other agreements supporting the research and/or as otherwise required. Requests for deidentified individual participant data can be made beginning 12 months after publication and for up to 36 months post publication. Deidentified individual participant data reported in the manuscript will be shared under the terms of a Data Use Agreement and may only be used for approved proposals. Requests may be made to: crdatashare@mskcc.org.
Links:
URL
http://www.mskcc.org/mskcc/html/44.cfm
Description
Memorial Sloan Kettering Cancer Center

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A Study of SDX-7320 in Combination With Eribulin for People With Breast Cancer

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