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A Study of SY 5609, a Selective CDK7 Inhibitor, in Advanced Solid Tumors

Primary Purpose

Advanced Solid Tumor, Breast Cancer, Small-cell Lung Cancer

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
SY-5609
Fulvestrant
Gemcitabine
Nab-paclitaxel
Sponsored by
Syros Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Solid Tumor

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥ 18 years
  2. Advanced Solid Tumors for which standard curative or palliative measures do not exist or are no longer effective (Group 1 only).
  3. Postmenopausal women with HR-positive, HER2-negative advanced or metastatic breast cancer. Participants must have failed prior treatment with a cyclin-dependent kinase (CDK) 4/6 inhibitor in combination with hormonal therapy in a previous line of therapy (Group 2 only).
  4. Participants with histologically or cytologically confirmed PDAC with measurable metastatic lesion(s) (Groups 3 and 4 only).
  5. Participants must have at least 1 measurable lesion by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.
  6. All toxicities (except alopecia) from prior cancer treatments must have resolved to ≤ Grade 1 before enrollment.
  7. For women of childbearing potential (WCBP): negative serum β human chorionic gonadotropin pregnancy test within 1 week before the first dose of SY 5609
  8. Adequate organ and marrow function
  9. Participants must be willing and able to comply with all aspects of the protocol
  10. Participants must provide written informed consent before any study-specific screening procedures.
  11. Albumin ≥ 3.0 grams/deciliters (g/dL) (Groups 3 and 4 only).

Exclusion Criteria:

  1. Chemotherapy or limited field radiotherapy within 2 weeks, wide field radiotherapy within 4 weeks, or nitrosoureas or mitomycin C within 6 weeks before entering the study
  2. Major surgery within 2 weeks before starting the study treatment, or not recovered to baseline status from the effects of surgery received > 2 weeks prior
  3. Received any other investigational agents within 4 weeks before enrollment, or < 5 half-lives since completion of previous investigational therapy, whichever is shorter
  4. Received previous noncytotoxic, US Food and Drug Administration-approved anticancer agent within previous 2 weeks, or < 5 half-lives since completion of previous therapy, whichever is shorter
  5. Known brain metastases or carcinomatous meningitis
  6. Immunocompromised participants with increased risk of opportunistic infections
  7. Participants with known active or chronic hepatitis B or active hepatitis C infection. Participants with a history of hepatitis C virus (HCV) infection who have completed curative therapy for HCV at least 12 weeks before Screening and have a documented undetectable viral load at Screening are eligible for enrollment.
  8. Baseline QT interval corrected (QTc) with Fridericia's method > 480 milliseconds

    • NOTE: criterion does not apply to participants with a right or left bundle branch block (QTc interval)

  9. Female participants who are pregnant or breastfeeding
  10. History of clinically significant cardiac disease or clinically relevant uncontrolled cardiac risk factors
  11. Uncontrolled intercurrent illness.
  12. Poorly controlled ascites requiring paracentesis within 1 month prior to entering the study. (Groups 3 and 4 only)

Sites / Locations

  • Banner MD Anderson Cancer Center
  • Cedars-Sinai Medical Center
  • University of California Los Angeles
  • Orlando Health Cancer Institute
  • Emory University
  • The University of Iowa
  • Johns Hopkins University
  • Massachusetts General Hospital
  • Dana Farber Cancer Institute
  • University of Michigan
  • START Midwest, LLC
  • Duke University
  • Stephenson Cancer Center
  • Sidney Kimmel Cancer Center
  • Sarah Cannon Research Institute - Tennessee Oncology
  • South Texas Accelerated Research Theraputics (START), LLC

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Group 1: Single Agent Dose Escalation

Group 2: SY-5609 + Fulvestrant

Group 3: SY-5609 + Gemcitabine

Group 4: SY-5609 + Gemcitabine + Nab-paclitaxel

Arm Description

Dose escalation phase to explore maximum tolerated dose of SY-5609 given as a single agent.

Participants with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2) negative advanced or metastatic breast cancer (BC) that has progressed following prior treatment with a cyclin-dependent kinase (CDK)4/6 inhibitor in combination with hormonal therapy will receive SY-5609 in combination with fulvestrant.

Participants with PDAC will receive SY-5609 in combination with gemcitabine in Safety Lead-in to identify a recommended combination dose for the expansion. The expansion part will assess the safety, tolerability, and preliminary clinical activity of SY-5609 in combination with gemcitabine at the recommended combination dose.

Participants with PDAC will receive SY-5609 in combination with gemcitabine plus nab-paclitaxel in Safety Lead-in to identify a recommended combination dose for the expansion. The expansion part will assess the safety, tolerability, and preliminary clinical activity of SY-5609 in combination with gemcitabine plus nab-paclitaxel at the recommended combination dose.

Outcomes

Primary Outcome Measures

Groups 1 and 2: Dose-Limiting Toxicity of SY-5609
Groups 1 and 2: Number of Participants With Treatment Emergent Adverse Events
Groups 3 and 4 (Safety Lead-ins): Number of Participants With Dose-Limiting Toxicity
Groups 3 and 4 (Safety Lead-ins): Number of Participants With TEAEs
Groups 3 and 4 (Expansions): Progression Free Survival

Secondary Outcome Measures

Groups 1 and 2: Area Under The Concentration Versus Time Curve of SY-6509
Groups 1 and 2: Apparent Clearance of SY-5609
Groups 1 and 2: Apparent Volume of Distribution of SY-5609
Groups 1 and 2: Elimination Half-Life of SY-5609
Groups 1 and 2: Maximum Plasma Concentration (Cmax) of SY-5609
Groups 1 and 2: Time of Maximum Plasma Concentration (Tmax) of SY-5609
Groups 1 and 2: Minimum or Trough Plasma Concentration (Cmin) of SY-5609
Groups 1 and 2: Time of Minimum or Trough Plasma Concentration (Tmin) of SY-5609
Groups 3 and 4 (Safety Lead-ins): Progression Free Survival
Groups 3 and 4 (Safety Lead-ins): Objective Response Rate (ORR)
ORR is defined as the proportion of participants who achieve complete response (CR) and partial remission (PR) (as determined by the investigator).
Groups 3 and 4 (Safety Lead-ins): Complete Response/Remission (CR) Rate
CR rate is defined as proportion of participants who achieve CR (as determined by the investigator).
Groups 3 and 4 (Safety Lead-ins): Disease Control Rate
Groups 3 and 4 (Safety Lead-ins): Time to Response
Time to response is defined as the duration from the date of randomization to the date of the first documented evidence of response as determined by the investigator.
Groups 3 and 4 (Safety Lead-ins): Duration of Response
Duration of response is defined as duration from the date of first documented evidence of response to the date of relapse of disease (as determined by the investigator), or death due to any cause, whichever occurs first.
Groups 3 and 4 (Expansions): Objective Response Rate
ORR is defined as the proportion of participants who achieve CR and partial remission (PR) (as determined by the investigator).
Groups 3 and 4 (Expansions): Complete Response Rate
CR rate is defined as proportion of participants who achieve CR (as determined by the investigator).
Groups 3 and 4 (Expansions): Disease Control Rate
Groups 3 and 4 (Expansions): Time to Response
Time to response is defined as the duration from the date of randomization to the date of the first documented evidence of response as determined by the investigator.
Groups 3 and 4 (Expansions): Duration of Response
Duration of response is defined as duration from the date of first documented evidence of response to the date of relapse of disease (as determined by the investigator), or death due to any cause, whichever occurs first.

Full Information

First Posted
January 22, 2020
Last Updated
March 10, 2023
Sponsor
Syros Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04247126
Brief Title
A Study of SY 5609, a Selective CDK7 Inhibitor, in Advanced Solid Tumors
Official Title
A Phase 1 Study of SY 5609, an Oral, Selective CDK7 Inhibitor, in Adult Patients With Select Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 23, 2020 (Actual)
Primary Completion Date
July 2023 (Anticipated)
Study Completion Date
July 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Syros Pharmaceuticals

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 study consists of 2 parts. Part 1 is dose escalation and will first administer SY-5609 alone to participants with select advanced solid tumors and then in combination with fulvestrant to participants with HR positive, HER2-negative breast cancer. Part 2 is a dose expansion and will first administer SY-5609 in combination with gemcitabine and then SY-5609 in combination with gemcitabine and nab-paclitaxel in participants with pancreatic ductal adenocarcinoma (PDAC) .

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Tumor, Breast Cancer, Small-cell Lung Cancer, Pancreatic Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Group 1: Single Agent Dose Escalation
Arm Type
Experimental
Arm Description
Dose escalation phase to explore maximum tolerated dose of SY-5609 given as a single agent.
Arm Title
Group 2: SY-5609 + Fulvestrant
Arm Type
Experimental
Arm Description
Participants with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2) negative advanced or metastatic breast cancer (BC) that has progressed following prior treatment with a cyclin-dependent kinase (CDK)4/6 inhibitor in combination with hormonal therapy will receive SY-5609 in combination with fulvestrant.
Arm Title
Group 3: SY-5609 + Gemcitabine
Arm Type
Experimental
Arm Description
Participants with PDAC will receive SY-5609 in combination with gemcitabine in Safety Lead-in to identify a recommended combination dose for the expansion. The expansion part will assess the safety, tolerability, and preliminary clinical activity of SY-5609 in combination with gemcitabine at the recommended combination dose.
Arm Title
Group 4: SY-5609 + Gemcitabine + Nab-paclitaxel
Arm Type
Experimental
Arm Description
Participants with PDAC will receive SY-5609 in combination with gemcitabine plus nab-paclitaxel in Safety Lead-in to identify a recommended combination dose for the expansion. The expansion part will assess the safety, tolerability, and preliminary clinical activity of SY-5609 in combination with gemcitabine plus nab-paclitaxel at the recommended combination dose.
Intervention Type
Drug
Intervention Name(s)
SY-5609
Intervention Description
An oral CDK7 Inhibitor
Intervention Type
Drug
Intervention Name(s)
Fulvestrant
Intervention Description
Estrogen receptor antagonist
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Nucleoside metabolic inhibitor
Intervention Type
Drug
Intervention Name(s)
Nab-paclitaxel
Intervention Description
Taxane-type chemotherapy
Primary Outcome Measure Information:
Title
Groups 1 and 2: Dose-Limiting Toxicity of SY-5609
Time Frame
Up to 28 days after first administration
Title
Groups 1 and 2: Number of Participants With Treatment Emergent Adverse Events
Time Frame
From Baseline up to 30 days after last dose of study drug (up to 1 year)
Title
Groups 3 and 4 (Safety Lead-ins): Number of Participants With Dose-Limiting Toxicity
Time Frame
Up to 28 days after first administration
Title
Groups 3 and 4 (Safety Lead-ins): Number of Participants With TEAEs
Time Frame
From Baseline up to 30 days after last dose of study drug (up to 1 year)
Title
Groups 3 and 4 (Expansions): Progression Free Survival
Time Frame
Up to 1 year
Secondary Outcome Measure Information:
Title
Groups 1 and 2: Area Under The Concentration Versus Time Curve of SY-6509
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days)
Title
Groups 1 and 2: Apparent Clearance of SY-5609
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days)
Title
Groups 1 and 2: Apparent Volume of Distribution of SY-5609
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days)
Title
Groups 1 and 2: Elimination Half-Life of SY-5609
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days)
Title
Groups 1 and 2: Maximum Plasma Concentration (Cmax) of SY-5609
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days)
Title
Groups 1 and 2: Time of Maximum Plasma Concentration (Tmax) of SY-5609
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days)
Title
Groups 1 and 2: Minimum or Trough Plasma Concentration (Cmin) of SY-5609
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days)
Title
Groups 1 and 2: Time of Minimum or Trough Plasma Concentration (Tmin) of SY-5609
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days)
Title
Groups 3 and 4 (Safety Lead-ins): Progression Free Survival
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Safety Lead-ins): Objective Response Rate (ORR)
Description
ORR is defined as the proportion of participants who achieve complete response (CR) and partial remission (PR) (as determined by the investigator).
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Safety Lead-ins): Complete Response/Remission (CR) Rate
Description
CR rate is defined as proportion of participants who achieve CR (as determined by the investigator).
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Safety Lead-ins): Disease Control Rate
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Safety Lead-ins): Time to Response
Description
Time to response is defined as the duration from the date of randomization to the date of the first documented evidence of response as determined by the investigator.
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Safety Lead-ins): Duration of Response
Description
Duration of response is defined as duration from the date of first documented evidence of response to the date of relapse of disease (as determined by the investigator), or death due to any cause, whichever occurs first.
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Expansions): Objective Response Rate
Description
ORR is defined as the proportion of participants who achieve CR and partial remission (PR) (as determined by the investigator).
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Expansions): Complete Response Rate
Description
CR rate is defined as proportion of participants who achieve CR (as determined by the investigator).
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Expansions): Disease Control Rate
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Expansions): Time to Response
Description
Time to response is defined as the duration from the date of randomization to the date of the first documented evidence of response as determined by the investigator.
Time Frame
Up to 1 year
Title
Groups 3 and 4 (Expansions): Duration of Response
Description
Duration of response is defined as duration from the date of first documented evidence of response to the date of relapse of disease (as determined by the investigator), or death due to any cause, whichever occurs first.
Time Frame
Up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Advanced Solid Tumors for which standard curative or palliative measures do not exist or are no longer effective (Group 1 only). Postmenopausal women with HR-positive, HER2-negative advanced or metastatic breast cancer. Participants must have failed prior treatment with a cyclin-dependent kinase (CDK) 4/6 inhibitor in combination with hormonal therapy in a previous line of therapy (Group 2 only). Participants with histologically or cytologically confirmed PDAC with measurable metastatic lesion(s) (Groups 3 and 4 only). Participants must have at least 1 measurable lesion by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. All toxicities (except alopecia) from prior cancer treatments must have resolved to ≤ Grade 1 before enrollment. For women of childbearing potential (WCBP): negative serum β human chorionic gonadotropin pregnancy test within 1 week before the first dose of SY 5609 Adequate organ and marrow function Participants must be willing and able to comply with all aspects of the protocol Participants must provide written informed consent before any study-specific screening procedures. Albumin ≥ 3.0 grams/deciliters (g/dL) (Groups 3 and 4 only). Exclusion Criteria: Chemotherapy or limited field radiotherapy within 2 weeks, wide field radiotherapy within 4 weeks, or nitrosoureas or mitomycin C within 6 weeks before entering the study Major surgery within 2 weeks before starting the study treatment, or not recovered to baseline status from the effects of surgery received > 2 weeks prior Received any other investigational agents within 4 weeks before enrollment, or < 5 half-lives since completion of previous investigational therapy, whichever is shorter Received previous noncytotoxic, US Food and Drug Administration-approved anticancer agent within previous 2 weeks, or < 5 half-lives since completion of previous therapy, whichever is shorter Known brain metastases or carcinomatous meningitis Immunocompromised participants with increased risk of opportunistic infections Participants with known active or chronic hepatitis B or active hepatitis C infection. Participants with a history of hepatitis C virus (HCV) infection who have completed curative therapy for HCV at least 12 weeks before Screening and have a documented undetectable viral load at Screening are eligible for enrollment. Baseline QT interval corrected (QTc) with Fridericia's method > 480 milliseconds • NOTE: criterion does not apply to participants with a right or left bundle branch block (QTc interval) Female participants who are pregnant or breastfeeding History of clinically significant cardiac disease or clinically relevant uncontrolled cardiac risk factors Uncontrolled intercurrent illness. Poorly controlled ascites requiring paracentesis within 1 month prior to entering the study. (Groups 3 and 4 only)
Facility Information:
Facility Name
Banner MD Anderson Cancer Center
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85234
Country
United States
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
University of California Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Orlando Health Cancer Institute
City
Orlando
State/Province
Florida
ZIP/Postal Code
32806
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
The University of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
START Midwest, LLC
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49546
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
Stephenson Cancer Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Sidney Kimmel Cancer Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Sarah Cannon Research Institute - Tennessee Oncology
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
South Texas Accelerated Research Theraputics (START), LLC
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34726887
Citation
Marineau JJ, Hamman KB, Hu S, Alnemy S, Mihalich J, Kabro A, Whitmore KM, Winter DK, Roy S, Ciblat S, Ke N, Savinainen A, Wilsily A, Malojcic G, Zahler R, Schmidt D, Bradley MJ, Waters NJ, Chuaqui C. Discovery of SY-5609: A Selective, Noncovalent Inhibitor of CDK7. J Med Chem. 2022 Jan 27;65(2):1458-1480. doi: 10.1021/acs.jmedchem.1c01171. Epub 2021 Nov 2.
Results Reference
derived
PubMed Identifier
32385714
Citation
Sava GP, Fan H, Coombes RC, Buluwela L, Ali S. CDK7 inhibitors as anticancer drugs. Cancer Metastasis Rev. 2020 Sep;39(3):805-823. doi: 10.1007/s10555-020-09885-8.
Results Reference
derived

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A Study of SY 5609, a Selective CDK7 Inhibitor, in Advanced Solid Tumors

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