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First-in-Human Study of STX-478 as Monotherapy and in Combination With Other Antineoplastic Agents in Participants With Advanced Solid Tumors

Primary Purpose

Breast Cancer, Gynecologic Cancer, HNSCC

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
STX-478
Fulvestrant
Sponsored by
Scorpion Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring Breast Neoplasms, Neoplasms by Site, Neoplasms, Breast Diseases, HER2-negative breast cancer, HR-positive breast cancer, Gynecologic cancer, Endometrial cancer, Ovarian cancer, Cervical cancer, Head and neck cancer, Head and neck squamous cell carcinoma, Fulvestrant, Antineoplastic Agents, PI3Kα, PI3K alpha, PI3Kα mutation, Alpelisib, STX-478, PI3Kα inhibitor, Estrogen Receptor Antagonists, Estrogen Antagonists, Hormone Receptor Antagonists, Hormone Antagonists, Hormones, Hormone Substitutes, and Hormone Antagonists, Physiological Effects of Drugs

Eligibility Criteria

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

Key Inclusion Criteria: Has an advanced or refractory solid tumor malignancy that is metastatic or locally advanced and unresectable (as specified by Cohort) Has a new or recent tumor biopsy (collected at screening, if feasible) or archival tumor specimen within 10 years prior to screening Has a tumor that harbors a documented PI3Kα mutation (cohort specific criterion for cohort-specific mutation types) obtained either from tumor or plasma samples, determined by PCR or NGS-based assay as an FDA-approved test in US, CE marked in EU, or obtained as part of normal clinical care in a CLIA certified or similarly certified laboratory. Is ≥18 years of age at the time of signing the ICF Has an ECOG performance status score of 0 or 1 at screening Key Exclusion Criteria: Has history (within ≤2 years before screening) of a solid tumor or hematological malignancy that is histologically distinct from the cancers being studied Has symptomatic brain or spinal metastases Has a tumor with known mutations/deletions in PTEN and activating mutations in AKT (E17K) confirmed by a CLIA-certified or similarly certified laboratory Has an established diagnosis of diabetes mellitus type 1 or has uncontrolled diabetes mellitus type 2 (based on FPG and HbA1c thresholds defined in the inclusion criteria) requiring antihyperglycemic medication Cohorts A0, A1, A2, A3, A4, A5 and B: Has had prior treatment with PI3K/AKT/mTOR inhibitor(s), except in certain circumstances Has had treatment with any local or systemic antineoplastic therapy or investigational anticancer agent within 14 days or 4 half-lives, whichever is longer, prior to the initiation of study treatment up to a maximum washout period of 28 days Has toxicities from previous anticancer therapies that have not resolved to baseline levels or CTCAE grade ≤1, with the exception of alopecia and peripheral neuropathy Has had radiotherapy within 14 days before the initiation of study treatment

Sites / Locations

  • University of California, San FranciscoRecruiting
  • University of Colorado Anschutz Medical CenterRecruiting
  • Yale UniversityRecruiting
  • Massachusetts General HospitalRecruiting
  • Dana Farber Cancer CenterRecruiting
  • Karmanos Cancer InstituteRecruiting
  • Saint Luke's Cancer InstituteRecruiting
  • Memorial Sloan Kettering Cancer CenterRecruiting
  • University Hospitals Cleveland Medical CenterRecruiting
  • University of OklahomaRecruiting
  • Mary Crowley Cancer ResearchRecruiting
  • Texas Oncology - Baylor Charles A. Sammons Cancer CenterRecruiting
  • The University of Texas MD Anderson Cancer CenterRecruiting
  • NEXT VirginiaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Part 1.1: Dose Escalation (Advanced Solid Tumors and Breast)

Part 1.2-DE: Dose expansion at MTD

Part 1.2-DS: RP2D Selection (Breast)

Part 1.3: RP2D Expansion (Breast)

Part 2.1: RP2D Selection

Part 2.2: RP2D Expansion

Arm Description

Cohort A0: Advanced Solid tumors expressing PI3Kα mutations. Cohort A1: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.

Cohort A2: Gynecologic cancers Cohort A3: HNSCC Cohort A4: Other solid tumors not included in Cohorts A0, A1, or A2 Mutations for Cohorts A2, A3, and A4: PI3Kα H1047X mutations or other kinase domain mutations Cohort A5: Solid tumors expressing PI3Kα helical domain mutations (E542/E545)

Recommended Phase 2 dose (RP2D) Cohort A1: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.

Cohort A1: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.

Cohort B: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.

Cohort B: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.

Outcomes

Primary Outcome Measures

Part 1.1 (Dose Escalation): Number of participants who experience at least 1 Dose Limiting Toxicity (DLT)
Part 1.1 (Dose Escalation): Proportion of participants who experience at least 1 DLT during the first 28 days of treatment.
Part 1.1 (Dose Escalation): Cmax of STX-478
Part 1.1 (Dose Escalation): AUC(0-inf) of STX-478
Part 1.1 (Dose Escalation): AUC(0-t) of STX-478
Part 1.1 (Dose Escalation): AUC(0-τ) of STX-478
Part 1.1 (Dose Escalation): Change from baseline in ctDNA levels.
Part 1.1 (Dose Escalation): Changes in circulating markers of glucose metabolism as assessed by changes in circulating glycosylated hemoglobin [HbA1c]
Part 1.1 (Dose Escalation): Changes in circulating markers of glucose metabolism as assessed by circulating fasting plasma glucose.
Part 1.1 (Dose Escalation): Changes in circulating markers of glucose metabolism as assessed by circulating C-peptide.
Part 1.1 (Dose Escalation): Objective response rate (ORR).
Part 1.1 (Dose Escalation): Incidence of TEAEs/SAEs ≥ grade 2.
Part 1.1 (Dose Escalation): Frequency of TEAEs according to CTCAE v5.0 criteria.
RP2D Selection (Parts 1.2-DS and 2.1): Cmax of STX-478
RP2D Selection (Parts 1.2-DS and 2.1): AUC(0-inf) of STX-478
RP2D Selection (Parts 1.2-DS and 2.1): AUC(0-t) of STX-478
RP2D Selection (Parts 1.2-DS and 2.1): AUC(0-τ) of STX-478
RP2D Selection (Parts 1.2-DS and 2.1): Change from baseline in ctDNA levels.
RP2D Selection (Parts 1.2-DS and 2.1): Changes in circulating markers of glucose metabolism as assessed by changes in circulating glycosylated hemoglobin [HbA1c]
RP2D Selection (Parts 1.2-DS and 2.1): Changes in circulating markers of glucose metabolism as assessed by circulating fasting plasma glucose.
RP2D Selection (Parts 1.2-DS and 2.1): Changes in circulating markers of glucose metabolism as assessed by circulating C-peptide
Parts 1.2-DS and 2.1 (RP2D Selection): ORR
Parts 1.2-DS and 2.1 (RP2D Selection): Frequency counts and percentages of AEs based on MedDRA and CTCAE v5.0
Parts 1.2-DS and 2.1 (RP2D Selection): Proportion of participants with DLTs.
Parts 1.2-DS and 2.1 (RP2D Selection): Change in ECOG performance status.
Parts 1.2-DE, 1.3, and 2.2 (Dose Expansion): ORR defined as the percentage of participants with partial response or complete response based on RECIST 1.1.

Secondary Outcome Measures

Full Information

First Posted
March 1, 2023
Last Updated
September 29, 2023
Sponsor
Scorpion Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05768139
Brief Title
First-in-Human Study of STX-478 as Monotherapy and in Combination With Other Antineoplastic Agents in Participants With Advanced Solid Tumors
Official Title
First-in-Human Study of STX-478, a Mutant-Selective PI3Kα Inhibitor as Monotherapy and in Combination With Other Antineoplastic Agents in Participants With Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 17, 2023 (Actual)
Primary Completion Date
June 1, 2026 (Anticipated)
Study Completion Date
June 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Scorpion Therapeutics, 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
Study STX-478-101 is a multipart, open-label, phase 1/2 study evaluating the safety, tolerability, pharmacokinetics (PK), and preliminary antitumor activity of STX-478 in participants with advanced solid tumors with certain mutations. Part 1 will evaluate STX-478 as monotherapy in participants with advanced solid tumors and breast cancer; Part 2 will evaluate STX-478 therapy as combination therapy with fulvestrant in participants with breast cancer. Each study part will include a 28-day screening period, followed by treatment with STX-478 monotherapy or combination therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Gynecologic Cancer, HNSCC, Solid Tumors, Adult
Keywords
Breast Neoplasms, Neoplasms by Site, Neoplasms, Breast Diseases, HER2-negative breast cancer, HR-positive breast cancer, Gynecologic cancer, Endometrial cancer, Ovarian cancer, Cervical cancer, Head and neck cancer, Head and neck squamous cell carcinoma, Fulvestrant, Antineoplastic Agents, PI3Kα, PI3K alpha, PI3Kα mutation, Alpelisib, STX-478, PI3Kα inhibitor, Estrogen Receptor Antagonists, Estrogen Antagonists, Hormone Receptor Antagonists, Hormone Antagonists, Hormones, Hormone Substitutes, and Hormone Antagonists, Physiological Effects of Drugs

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
220 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Part 1.1: Dose Escalation (Advanced Solid Tumors and Breast)
Arm Type
Experimental
Arm Description
Cohort A0: Advanced Solid tumors expressing PI3Kα mutations. Cohort A1: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.
Arm Title
Part 1.2-DE: Dose expansion at MTD
Arm Type
Experimental
Arm Description
Cohort A2: Gynecologic cancers Cohort A3: HNSCC Cohort A4: Other solid tumors not included in Cohorts A0, A1, or A2 Mutations for Cohorts A2, A3, and A4: PI3Kα H1047X mutations or other kinase domain mutations Cohort A5: Solid tumors expressing PI3Kα helical domain mutations (E542/E545)
Arm Title
Part 1.2-DS: RP2D Selection (Breast)
Arm Type
Experimental
Arm Description
Recommended Phase 2 dose (RP2D) Cohort A1: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.
Arm Title
Part 1.3: RP2D Expansion (Breast)
Arm Type
Experimental
Arm Description
Cohort A1: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.
Arm Title
Part 2.1: RP2D Selection
Arm Type
Experimental
Arm Description
Cohort B: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.
Arm Title
Part 2.2: RP2D Expansion
Arm Type
Experimental
Arm Description
Cohort B: HR+/HER2- breast cancer expressing PI3Kα H1047X mutations or other kinase domain mutations.
Intervention Type
Drug
Intervention Name(s)
STX-478
Intervention Description
STX-478 is a second generation, mutant-selective, oral PI3Kα small molecule allosteric inhibitor.
Intervention Type
Drug
Intervention Name(s)
Fulvestrant
Other Intervention Name(s)
Faslodex
Intervention Description
Fulvestrant will be administered according to local labeling.
Primary Outcome Measure Information:
Title
Part 1.1 (Dose Escalation): Number of participants who experience at least 1 Dose Limiting Toxicity (DLT)
Time Frame
First 28 days of treatment
Title
Part 1.1 (Dose Escalation): Proportion of participants who experience at least 1 DLT during the first 28 days of treatment.
Time Frame
First 28 days of treatment
Title
Part 1.1 (Dose Escalation): Cmax of STX-478
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): AUC(0-inf) of STX-478
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): AUC(0-t) of STX-478
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): AUC(0-τ) of STX-478
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): Change from baseline in ctDNA levels.
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): Changes in circulating markers of glucose metabolism as assessed by changes in circulating glycosylated hemoglobin [HbA1c]
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): Changes in circulating markers of glucose metabolism as assessed by circulating fasting plasma glucose.
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): Changes in circulating markers of glucose metabolism as assessed by circulating C-peptide.
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): Objective response rate (ORR).
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): Incidence of TEAEs/SAEs ≥ grade 2.
Time Frame
12 months
Title
Part 1.1 (Dose Escalation): Frequency of TEAEs according to CTCAE v5.0 criteria.
Time Frame
12 months
Title
RP2D Selection (Parts 1.2-DS and 2.1): Cmax of STX-478
Time Frame
12 months
Title
RP2D Selection (Parts 1.2-DS and 2.1): AUC(0-inf) of STX-478
Time Frame
12 months
Title
RP2D Selection (Parts 1.2-DS and 2.1): AUC(0-t) of STX-478
Time Frame
12 months
Title
RP2D Selection (Parts 1.2-DS and 2.1): AUC(0-τ) of STX-478
Time Frame
12 months
Title
RP2D Selection (Parts 1.2-DS and 2.1): Change from baseline in ctDNA levels.
Time Frame
12 months
Title
RP2D Selection (Parts 1.2-DS and 2.1): Changes in circulating markers of glucose metabolism as assessed by changes in circulating glycosylated hemoglobin [HbA1c]
Time Frame
12 months
Title
RP2D Selection (Parts 1.2-DS and 2.1): Changes in circulating markers of glucose metabolism as assessed by circulating fasting plasma glucose.
Time Frame
12 months
Title
RP2D Selection (Parts 1.2-DS and 2.1): Changes in circulating markers of glucose metabolism as assessed by circulating C-peptide
Time Frame
12 months
Title
Parts 1.2-DS and 2.1 (RP2D Selection): ORR
Time Frame
12 months
Title
Parts 1.2-DS and 2.1 (RP2D Selection): Frequency counts and percentages of AEs based on MedDRA and CTCAE v5.0
Time Frame
12 months
Title
Parts 1.2-DS and 2.1 (RP2D Selection): Proportion of participants with DLTs.
Time Frame
12 months
Title
Parts 1.2-DS and 2.1 (RP2D Selection): Change in ECOG performance status.
Time Frame
12 months
Title
Parts 1.2-DE, 1.3, and 2.2 (Dose Expansion): ORR defined as the percentage of participants with partial response or complete response based on RECIST 1.1.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Has an advanced or refractory solid tumor malignancy that is metastatic or locally advanced and unresectable (as specified by Cohort) Has a new or recent tumor biopsy (collected at screening, if feasible) or archival tumor specimen within 10 years prior to screening Has a tumor that harbors a documented PI3Kα mutation (cohort specific criterion for cohort-specific mutation types) obtained either from tumor or plasma samples, determined by PCR or NGS-based assay as an FDA-approved test in US, CE marked in EU, or obtained as part of normal clinical care in a CLIA certified or similarly certified laboratory. Is ≥18 years of age at the time of signing the ICF Has an ECOG performance status score of 0 or 1 at screening Key Exclusion Criteria: Has history (within ≤2 years before screening) of a solid tumor or hematological malignancy that is histologically distinct from the cancers being studied Has symptomatic brain or spinal metastases Has a tumor with known mutations/deletions in PTEN and activating mutations in AKT (E17K) confirmed by a CLIA-certified or similarly certified laboratory Has an established diagnosis of diabetes mellitus type 1 or has uncontrolled diabetes mellitus type 2 (based on FPG and HbA1c thresholds defined in the inclusion criteria) requiring antihyperglycemic medication Cohorts A0, A1, A2, A3, A4, A5 and B: Has had prior treatment with PI3K/AKT/mTOR inhibitor(s), except in certain circumstances Has had treatment with any local or systemic antineoplastic therapy or investigational anticancer agent within 14 days or 4 half-lives, whichever is longer, prior to the initiation of study treatment up to a maximum washout period of 28 days Has toxicities from previous anticancer therapies that have not resolved to baseline levels or CTCAE grade ≤1, with the exception of alopecia and peripheral neuropathy Has had radiotherapy within 14 days before the initiation of study treatment
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
For questions concerning enrollment
Phone
Please email:
Email
clinicaltrials@scorpiontx.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Streit, MD
Organizational Affiliation
Scorpion Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94158
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Colorado Anschutz Medical Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Recruiting
Facility Name
Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520
Country
United States
Individual Site Status
Recruiting
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114-2696
Country
United States
Individual Site Status
Recruiting
Facility Name
Dana Farber Cancer Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Individual Site Status
Recruiting
Facility Name
Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Individual Site Status
Recruiting
Facility Name
Saint Luke's Cancer Institute
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Individual Site Status
Recruiting
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Recruiting
Facility Name
University Hospitals Cleveland Medical Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Oklahoma
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104-5418
Country
United States
Individual Site Status
Recruiting
Facility Name
Mary Crowley Cancer Research
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Individual Site Status
Recruiting
Facility Name
Texas Oncology - Baylor Charles A. Sammons Cancer Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
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
NEXT Virginia
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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First-in-Human Study of STX-478 as Monotherapy and in Combination With Other Antineoplastic Agents in Participants With Advanced Solid Tumors

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