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Phase 1/1b Study of Oral PMD-026 in Patients With Metastatic Breast Cancer and Metastatic Triple Negative Breast Cancer

Primary Purpose

Metastatic Breast Cancer, Triple Negative Breast Cancer

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PMD-026
Sponsored by
Phoenix Molecular Designs
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Breast Cancer focused on measuring invasive breast cancer, ER-negative breast cancer, PR-negative breast cancer, HER2-negative breast cancer, triple negative breast cancer, Triple-Negative Breast Cancer, TNBC, Breast cancer, Breast malignancy, breast malignancies, metastatic breast cancer, Metastatic TNBC, Metastatic Triple-Negative Breast Cancer, Metastatic Triple Negative Breast Cancer, advanced breast cancer, solid tumor, late stage breast cancer/late-stage breast cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed informed consent
  2. Age ≥ 18 years
  3. ECOG Performance Status ≤ 2
  4. [Part 1 - Dose Escalation] Histologically or cytologically diagnosed metastatic breast cancer that has progressed on or after standard of care therapy and for which no standard of care therapy is available that would confer clinical benefit
  5. [Part 2 - Dose Expansion] Histologically or cytologically diagnosed metastatic triple-negative breast cancer with <1% expression of ER and PR and negative for HER2 (either 0 or 1+ by IHC or IHC 2+ and fluorescence in situ hybridization (FISH) negative) from the time of initial diagnosis that has progressed on or after standard of care therapy and for which no standard of care therapy is available that would confer clinical benefit
  6. [Part 1 - Dose Escalation] Evaluable or measurable disease by RECISTv1.1
  7. [Part 2 - Dose Expansion] Measurable disease by RECISTv1.1
  8. Adequate laboratory parameters including:

    1. Absolute Neutrophil Count (ANC) ≥ 1500/mm^3
    2. Platelets ≥ 100,000/mm^3
    3. AST/SGOT ≤ 2.5 x ULN (≤ 5 x ULN if known liver involvement)
    4. ALT/SGPT ≤ 2.5 x ULN (≤ 5 x ULN if known liver involvement)
    5. Total bilirubin ≤ 1.5 x ULN (unless diagnosis of Gilbert's syndrome in which case < 3.0 times ULN)
    6. Serum creatinine ≤ 1.5 x ULN or estimated GFR ≥ 60 mL/min
  9. If residual treatment related toxicity from prior therapy:

    1. Treatment related toxicity resolved to at least Grade 1 (alopecia excepted), or
    2. Treatment related toxicity resolved to at least Grade 2 with prior approval of the Medical Monitor
  10. Available archival or fresh tumor tissue (Formalin-fixed paraffin-embedded [FFPE])
  11. [Females] The patient must be postmenopausal, surgically sterile, or agree to use adequate contraception (adequate as determined by the PI - may include abstinence) throughout the study and for a least 30 days following the last dose of PMD-026
  12. [Males] The patient must be surgically sterile or must agree to use adequate contraception (adequate as determined by the PI - may include abstinence) throughout the study and for at least 30 days following the last dose of PMD-026
  13. [Males] The patient must agree to refrain from donating sperm throughout the study and for at least 30 days following the last dose of PMD-026
  14. [Females] If of childbearing potential, the patient must have a negative serum pregnancy test

Exclusion Criteria:

  1. ≤ 14 days from prior chemotherapy, biological or investigational therapy
  2. Use of any medications known to result in a prolongation of the QT/QTc interval
  3. Use of any medication that is a strong inducer or substrate of cytochrome P450 3A
  4. Use of any medications that is a substrate of BCRP
  5. Use of any medication that is a substrate of MATE2K
  6. ≤ 28 days from prior irradiation (including therapeutic radioisotopes such as strontium 89)
  7. ≤ 7 days from limited field irradiation for palliation
  8. ≤ 28 days from major surgical procedures
  9. ≤ 7 days from minor surgical procedures (no waiting period required following central catheter placement)
  10. Central nervous system metastases, unless appropriately treated and neurologically stable for ≥ 28 days
  11. Known history of leptomeningeal metastases
  12. Uncontrolled bacterial, viral, or fungal infection (s) requiring systemic therapy
  13. Pregnant or currently breast-feeding
  14. Known Hepatitis B or Hepatitis C infection
  15. Known HIV-positive with CD4+ cell counts < 350 cells/uL
  16. Known HIV-positive with a history of an AIDS-defining opportunistic infection
  17. History of clinically significant cardiovascular abnormalities including:

    1. Congestive heart failure (NYHA classification ≥ 3 in within 6 months of first dose of PMD-026
    2. Unstable angina pectoris
    3. Myocardial infarction within 12 months of study entry
    4. Arrhythmias requiring continued treatment (controlled atrial fibrillation allowed)
    5. QTcF interval > 460 msec (using Fridericia's formula)
  18. Presence of active gastrointestinal disease or other condition that is expected to interfere significantly with the absorption, distribution, metabolism, or excretion of oral therapy (e.g. ulcerative disease, uncontrolled nausea, vomiting, diarrhea Grade ≥ 2, and malabsorption syndrome)
  19. Inadequately controlled hypertension defined as systolic blood pressure >180 mmHg or diastolic blood pressure >100 mmHg (patients with values above these levels must have their blood pressure controlled prior to starting treatment)
  20. Serious active infection at the time of treatment, or another serious underlying medical condition that would impair the ability of the patient to receive protocol treatment
  21. Other known active cancer(s) likely to require treatment in the next year that would impact the assessment of any study endpoints
  22. Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol

Sites / Locations

  • Banner MD Anderson Cancer Center
  • The University of Arizona Cancer Center
  • University of California, Los Angeles (UCLA)
  • University of California, San Diego (UCSD)
  • Florida Cancer Specialists & Research Institute
  • Moffitt Cancer Center
  • Columbia University
  • Ohio State University
  • South Texas Accelerated Research Therapeutics

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PMD-026

Arm Description

Oral PMD-026 (dose: 25 - 1000 mg), given daily until disease progression or unacceptable toxicity

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability)
Toxicities will be assessed in each patient by tracking the occurrence of graded Adverse Events (AEs). AEs will be graded according to the National Cancer Institute Common Terminology for Adverse Events (NCI CTCAE) v5.0.
Maximum tolerated dose (MTD) of PMD-026
The MTD will be defined as the dose level at which no more than one of six patients experiences a dose limiting toxicity (DLT) after 21 days of treatment have occurred, with the next higher dose having at least 2 of 3 or 2 of 6 patients experiencing a DLT.
Recommended Phase 2 Dose (RP2D) of PMD-026
The RP2D will be determined following the determination of the MTD and an overall assessment of safety as determined by the Safety Committee.
Efficacy in Patients
Anti-tumor activity (efficacy) will be assessed in all patients.

Secondary Outcome Measures

Plasma Concentration
The plasma concentration will be measured as part of pharmacokinetic (PK) testing.
Time to Response
The time to response will be evaluated by disease assessments.
Duration of Response
The duration of response will be evaluated by disease assessments from time of first response (CR or PR) to time of disease progression.
Effect of food on PMD-026 PK
The effect of food on plasma concentration will be measured as part of pharmacokinetic (PK) testing.

Full Information

First Posted
October 2, 2019
Last Updated
August 15, 2023
Sponsor
Phoenix Molecular Designs
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1. Study Identification

Unique Protocol Identification Number
NCT04115306
Brief Title
Phase 1/1b Study of Oral PMD-026 in Patients With Metastatic Breast Cancer and Metastatic Triple Negative Breast Cancer
Official Title
Phase 1/1b Multicenter, Open-Label, First-in-Human Dose Escalation and Dose Expansion Study to Assess Safety and Tolerability of Orally Administered PMD-026 in Patients With Metastatic Breast Cancer With Expansion in Metastatic Triple Negative Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 14, 2019 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
March 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Phoenix Molecular Designs

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to test the safety and tolerability of PMD-026 in patients with metastatic breast cancer and triple negative breast cancer. PMD-026 is a targeted oral agent designed to kill tumor cells in metastatic breast cancer and triple negative breast cancer.
Detailed Description
This study will evaluate the safety and tolerability of PMD-026 using an accelerated titration design to define the MTD in metastatic breast cancer, followed by an expansion at the RP2D in triple negative breast cancer. All patients will receive daily oral doses of PMD-026 until either disease progression or unacceptable toxicity. Patients will have disease assessments initially after 6 weeks of treatment, and every 9 weeks thereafter. Patients enrolled to the Dose Escalation Phase must have histologically or cytologically diagnosed metastatic breast cancer that has progressed on or after standard of care therapy. Patients enrolled to the Dose Expansion Phase must have histologically or cytologically diagnosed metastatic triple negative breast cancer from initial diagnosis (ER/PgR <1%, HER2 negative) that has progressed on or after standard of care therapy. All patients must provide tumor tissue (archival preferred) prior to study entry. A subset (N=12) of patients in Part 2 of the study will participate in a 1- week evaluation of the effect of food on PMD-026 oral absorption. PMD-026 is an oral, reversible small molecule inhibitor of RSK1-4 with high selectivity for RSK2. High levels of RSK2 expression have been associated with worse overall survival in breast cancer. Inhibiting RSK2 may inhibit growth of breast cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer, Triple Negative Breast Cancer
Keywords
invasive breast cancer, ER-negative breast cancer, PR-negative breast cancer, HER2-negative breast cancer, triple negative breast cancer, Triple-Negative Breast Cancer, TNBC, Breast cancer, Breast malignancy, breast malignancies, metastatic breast cancer, Metastatic TNBC, Metastatic Triple-Negative Breast Cancer, Metastatic Triple Negative Breast Cancer, advanced breast cancer, solid tumor, late stage breast cancer/late-stage breast cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PMD-026
Arm Type
Experimental
Arm Description
Oral PMD-026 (dose: 25 - 1000 mg), given daily until disease progression or unacceptable toxicity
Intervention Type
Drug
Intervention Name(s)
PMD-026
Intervention Description
Oral RSK1-4 inhibitor
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability)
Description
Toxicities will be assessed in each patient by tracking the occurrence of graded Adverse Events (AEs). AEs will be graded according to the National Cancer Institute Common Terminology for Adverse Events (NCI CTCAE) v5.0.
Time Frame
Through study completion, an average of 12 weeks
Title
Maximum tolerated dose (MTD) of PMD-026
Description
The MTD will be defined as the dose level at which no more than one of six patients experiences a dose limiting toxicity (DLT) after 21 days of treatment have occurred, with the next higher dose having at least 2 of 3 or 2 of 6 patients experiencing a DLT.
Time Frame
Up to 21 days
Title
Recommended Phase 2 Dose (RP2D) of PMD-026
Description
The RP2D will be determined following the determination of the MTD and an overall assessment of safety as determined by the Safety Committee.
Time Frame
Up to 14 months
Title
Efficacy in Patients
Description
Anti-tumor activity (efficacy) will be assessed in all patients.
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Plasma Concentration
Description
The plasma concentration will be measured as part of pharmacokinetic (PK) testing.
Time Frame
24 hours
Title
Time to Response
Description
The time to response will be evaluated by disease assessments.
Time Frame
6 weeks
Title
Duration of Response
Description
The duration of response will be evaluated by disease assessments from time of first response (CR or PR) to time of disease progression.
Time Frame
6 weeks
Title
Effect of food on PMD-026 PK
Description
The effect of food on plasma concentration will be measured as part of pharmacokinetic (PK) testing.
Time Frame
24 hours
Other Pre-specified Outcome Measures:
Title
RSK2 Expression
Description
RSK2 expression will be evaluated in breast cancer tissue through immunohistochemistry (IHC).
Time Frame
6 weeks
Title
PMD-026 Activity in Tissue
Description
PMD-026 activity will be evaluated in Lehmann subtypes in breast cancer tissue.
Time Frame
6 weeks
Title
RSK2 Expression and Response
Description
The relationship between RSK2 expression and response will be evaluated following RSK2 IHC and disease assessments.
Time Frame
12 weeks
Title
PMD-026 pharmacodynamics and RSK signaling
Description
PMD-026 pharmacodynamics will be evaluated on RSK signaling.
Time Frame
2 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent Age ≥ 18 years ECOG Performance Status ≤ 2 [Part 1 - Dose Escalation] Histologically or cytologically diagnosed metastatic breast cancer that has progressed on or after standard of care therapy and for which no standard of care therapy is available that would confer clinical benefit [Part 2 - Dose Expansion] Histologically or cytologically diagnosed metastatic triple-negative breast cancer with <1% expression of ER and PR and negative for HER2 (either 0 or 1+ by IHC or IHC 2+ and fluorescence in situ hybridization (FISH) negative) from the time of initial diagnosis that has progressed on or after standard of care therapy and for which no standard of care therapy is available that would confer clinical benefit [Part 1 - Dose Escalation] Evaluable or measurable disease by RECISTv1.1 [Part 2 - Dose Expansion] Measurable disease by RECISTv1.1 Adequate laboratory parameters including: Absolute Neutrophil Count (ANC) ≥ 1500/mm^3 Platelets ≥ 100,000/mm^3 AST/SGOT ≤ 2.5 x ULN (≤ 5 x ULN if known liver involvement) ALT/SGPT ≤ 2.5 x ULN (≤ 5 x ULN if known liver involvement) Total bilirubin ≤ 1.5 x ULN (unless diagnosis of Gilbert's syndrome in which case < 3.0 times ULN) Serum creatinine ≤ 1.5 x ULN or estimated GFR ≥ 60 mL/min If residual treatment related toxicity from prior therapy: Treatment related toxicity resolved to at least Grade 1 (alopecia excepted), or Treatment related toxicity resolved to at least Grade 2 with prior approval of the Medical Monitor Available archival or fresh tumor tissue (Formalin-fixed paraffin-embedded [FFPE]) [Females] The patient must be postmenopausal, surgically sterile, or agree to use adequate contraception (adequate as determined by the PI - may include abstinence) throughout the study and for a least 30 days following the last dose of PMD-026 [Males] The patient must be surgically sterile or must agree to use adequate contraception (adequate as determined by the PI - may include abstinence) throughout the study and for at least 30 days following the last dose of PMD-026 [Males] The patient must agree to refrain from donating sperm throughout the study and for at least 30 days following the last dose of PMD-026 [Females] If of childbearing potential, the patient must have a negative serum pregnancy test Exclusion Criteria: ≤ 14 days from prior chemotherapy, biological or investigational therapy Use of any medications known to result in a prolongation of the QT/QTc interval Use of any medication that is a strong inducer or substrate of cytochrome P450 3A Use of any medications that is a substrate of BCRP Use of any medication that is a substrate of MATE2K ≤ 28 days from prior irradiation (including therapeutic radioisotopes such as strontium 89) ≤ 7 days from limited field irradiation for palliation ≤ 28 days from major surgical procedures ≤ 7 days from minor surgical procedures (no waiting period required following central catheter placement) Central nervous system metastases, unless appropriately treated and neurologically stable for ≥ 28 days Known history of leptomeningeal metastases Uncontrolled bacterial, viral, or fungal infection (s) requiring systemic therapy Pregnant or currently breast-feeding Known Hepatitis B or Hepatitis C infection Known HIV-positive with CD4+ cell counts < 350 cells/uL Known HIV-positive with a history of an AIDS-defining opportunistic infection History of clinically significant cardiovascular abnormalities including: Congestive heart failure (NYHA classification ≥ 3 in within 6 months of first dose of PMD-026 Unstable angina pectoris Myocardial infarction within 12 months of study entry Arrhythmias requiring continued treatment (controlled atrial fibrillation allowed) QTcF interval > 460 msec (using Fridericia's formula) Presence of active gastrointestinal disease or other condition that is expected to interfere significantly with the absorption, distribution, metabolism, or excretion of oral therapy (e.g. ulcerative disease, uncontrolled nausea, vomiting, diarrhea Grade ≥ 2, and malabsorption syndrome) Inadequately controlled hypertension defined as systolic blood pressure >180 mmHg or diastolic blood pressure >100 mmHg (patients with values above these levels must have their blood pressure controlled prior to starting treatment) Serious active infection at the time of treatment, or another serious underlying medical condition that would impair the ability of the patient to receive protocol treatment Other known active cancer(s) likely to require treatment in the next year that would impact the assessment of any study endpoints Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol
Facility Information:
Facility Name
Banner MD Anderson Cancer Center
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85234
Country
United States
Facility Name
The University of Arizona Cancer Center
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Facility Name
University of California, Los Angeles (UCLA)
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
University of California, San Diego (UCSD)
City
San Diego
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Florida Cancer Specialists & Research Institute
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34232
Country
United States
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
South Texas Accelerated Research Therapeutics
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase 1/1b Study of Oral PMD-026 in Patients With Metastatic Breast Cancer and Metastatic Triple Negative Breast Cancer

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