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Study of TPX-0022 in Patients With Advanced NSCLC, Gastric Cancer or Solid Tumors Harboring Genetic Alterations in MET (SHIELD-1)

Primary Purpose

Advanced Solid Tumor, Metastatic Solid Tumors, MET Gene Alterations

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
elzovantinib (TPX-0022)
Sponsored by
Turning Point Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Solid Tumor focused on measuring Non Small Cell Lung, Non Small Cell Lung Cancer, Non-small cell lung cancer, NSCLC, TPX-0022, EGFR wild-type (wt), advanced non-small cell lung cancer, advanced/metastatic disease, Non-small cell lung carcinoma (NSCLC), treatment of lung cancer after first metastasis, treatment of gastric cancer after first metastasis, treatment of hepatocellular cancer after first metastasis, lung cancer, lung adenocarcinoma, Non small cell lung carcinoma, MET exon 14 deletion, MET exon 14 skipping, MET exon 14 mutation, MET mutation, MET amplification, MET inhibitor, MET dysregulation, MET activation, MET signaling, MET pathway, MET fusion, gastric cancer, hepatocellular cancer, SRC, CSF1R, cancer, first in human

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥ 18 (or age ≥ 20 as required by local regulation).
  2. Histological or cytological confirmation of advanced/metastatic MET exon 14 skipping mutation (METΔex14) NSCLC, MET amplified NSCLC, or MET amplified gastric cancers as determined by FISH, qPCR or NGS by local liquid biopsy or tissue, solid tumors with MET fusions or oncogenic MET mutations or MET amplified other than GI/NSCLC.
  3. ECOG performance status ≤ 1.
  4. Existence of measurable or evaluable disease (according to Response evaluation criteria in solid tumors [RECIST v1.1] criteria).
  5. Subjects with asymptomatic primary CNS tumors or brain metastases are eligible for the study if they meet protocol specified criteria.
  6. Adequate organ function.
  7. Life expectancy ≥ 12 weeks.

Exclusion Criteria:

  1. Locally advanced solid tumor that is a candidate for curative treatment through radical surgery and/or radiotherapy, or chemotherapy.
  2. Presence or history of any other primary malignancy within the past 3 years other than a history of adequately treated basal or squamous cell carcinoma of the skin, or any adequately treated in situ carcinoma.
  3. Major surgery within four weeks of the start of therapy.
  4. Additional exclusion criteria for subjects with NSCLC with MET alterations: known oncogene drivers (ALK, ROS1, or EGFR) conferring sensitivity to targeted therapies.
  5. Additional exclusion criteria for subjects with HCC with MET alterations: liver dysfunction greater than Child-Pugh Class A.
  6. Clinically significant cardiovascular disease (either active or within six months before enrollment): myocardial infarction, unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure (New York Heart Association Classification Class ≥ II), cerebrovascular accident or transient ischemic attack, symptomatic bradycardia, requirement for anti-arrhythmic medication. Ongoing cardiac dysrhythmias of CTCAE version 5.0 grade ≥ 2.
  7. Any of the following cardiac criteria:

    • Mean resting corrected QT interval (ECG interval measured from the onset of the QRS complex to the end of the T wave) for heart rate (QTc) > 470 msec obtained from three ECGs, using the screening clinic ECG machine-derived QTc value
    • Any clinically important abnormalities in rhythm, conduction, or morphology of resting ECG (e.g., complete left bundle branch block, third degree heart block, second degree heart block, PR interval > 250 msec)
    • Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, congenital long QT syndrome, family history of long QT syndrome, or any concomitant medication known to prolong the QT interval
  8. Known clinically significant active infections not controlled with systemic treatment (bacterial, fungal, viral including HIV positivity).
  9. Peripheral neuropathy ≥ Grade 2.

Sites / Locations

  • Local Institution - 2102
  • Local Institution - 2108
  • Local Institution - 2105
  • Local Institution - 2111
  • Local Institution - 2107
  • Local Institution - 2109
  • Local Institution - 2106
  • Local Institution - 2113
  • Local Institution - 2103
  • Local Institution - 2104
  • Local Institution - 2101
  • Local Institution - 2112
  • Local Institution - 4202
  • Local Institution - 4201
  • Local Institution - 4203
  • Local Institution - 4204
  • Local Institution - 6304
  • Local Institution - 6301
  • Local Institution - 6303
  • Local Institution - 6302
  • Local Institution - 4104
  • Local Institution - 4103
  • Local Institution - 4101
  • Local Institution - 4102

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Phase 1 elzovantinib

Arm Description

The dose-escalation part of the study will determine the safety, tolerability, MTD, and RP2D of elzovantinib. The dose-expansion part of the study will determine the safety, tolerability, PK, and preliminary efficacy in specific cohorts. Dose expansion cohorts: Cohort I (NSCLC, METΔex14, treatment Naive) Enrollment Closed; Cohort II (NSCLC with METΔex14, MET therapy pre-treated) Enrollment closed; Cohort III (MET amplified NSCLC, GCN≥10); Cohort IV (MET amplified GI cancer GC/GEJ, CRC/HCC, GCN≥10); Cohort V (NSCLC or GI MET amplified, GCN≥5 and < 10); Cohort VI (Solid tumors with MET fusions, or oncogenic MET mutations or MET amplified other than GI/NSCLC

Outcomes

Primary Outcome Measures

Incidence of first cycle dose-limiting toxicities (DLTs) of elzovantinib
Evaluate the safety and tolerability of elzovantinib
Define the Recommended Phase 2 Dose
Determine the maximum tolerated dose (MTD) and/or Recommended Phase 2 Dose (RP2D) of elzovantinib

Secondary Outcome Measures

Adverse events (AEs)
Evaluate the overall safety profile of elzovantinib
Cmax (maximum plasma concentration) of elzovantinib
Evaluate the maximum plasma concentration of elzovantinib
AUC (area under plasma concentration time curve) of elzovantinib
Evaluate the AUC of elzovantinib
Cmax (maximum plasma concentration) of TPX-0022 under different food intake conditions
Determine the effect of food (specifically, a high-fat, high-calorie meal) on the single-dose PK (Cmax) of elzovantinib at the RP2D
AUC (area under plasma concentration time curve) of elzovantinib under different food intake conditions
Determine the effect of food (specifically, a high-fat, high-calorie meal) on the single-dose PK (AUC) of elzovantinib at the RP2D
Preliminary Objective Response Rate (ORR)
Determine the preliminary objective response rate (ORR) by Blinded Independent Central Review (BICR) of elzovantinib
Clinical benefit rate (CBR)
Determine the CBR of elzovantinib
Time to response (TTR)
Determine the TTR of elzovantinib
Duration of Response (DOR)
Determine the DOR of elzovantinib
Progression free survival (PFS)
Determine the PFS of elzovantinib
Intracranial tumor response
Determine the intracranial tumor response in subjects with measurable brain metastases, as determined by BICR
Overall survival (OS)
Determine efficacy and safety of elzovantinib

Full Information

First Posted
June 13, 2019
Last Updated
June 26, 2023
Sponsor
Turning Point Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03993873
Brief Title
Study of TPX-0022 in Patients With Advanced NSCLC, Gastric Cancer or Solid Tumors Harboring Genetic Alterations in MET
Acronym
SHIELD-1
Official Title
A Phase 1/2 of Study of the Safety, Tolerability, Pharmacokinetics, and Efficacy of TPX-0022 in Adult Subjects With Locally Advanced or Metastatic NSCLC, Gastric Cancer, or Solid Tumors Harboring Genetic Alterations in MET
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 21, 2019 (Actual)
Primary Completion Date
November 30, 2023 (Anticipated)
Study Completion Date
November 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Turning Point Therapeutics, Inc.

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
A phase 1/2, first-in-human, open-label study of the safety, tolerability, PK, and efficacy of the novel MET/CSF1R/SRC inhibitor TPX-0022 in adult subjects with advanced or metastatic NSCLC, Gastric Cancer, or solid tumors harboring genetic alterations in MET. (SHIELD-I)
Detailed Description
Dose Escalation: To evaluate the overall safety profile of TPX-0022, single and multiple dose PK profiles and preliminary efficacy in adults subjects with advanced solid tumors harboring genetic alterations in MET. Dose Expansion: To evaluate the preliminary efficacy and overall safety profile of TPX-0022 at the RP2D in defined cohorts of adult subjects in NSCLC, Gastric Cancer and advanced solid tumors harboring genetic alterations in MET.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Tumor, Metastatic Solid Tumors, MET Gene Alterations
Keywords
Non Small Cell Lung, Non Small Cell Lung Cancer, Non-small cell lung cancer, NSCLC, TPX-0022, EGFR wild-type (wt), advanced non-small cell lung cancer, advanced/metastatic disease, Non-small cell lung carcinoma (NSCLC), treatment of lung cancer after first metastasis, treatment of gastric cancer after first metastasis, treatment of hepatocellular cancer after first metastasis, lung cancer, lung adenocarcinoma, Non small cell lung carcinoma, MET exon 14 deletion, MET exon 14 skipping, MET exon 14 mutation, MET mutation, MET amplification, MET inhibitor, MET dysregulation, MET activation, MET signaling, MET pathway, MET fusion, gastric cancer, hepatocellular cancer, SRC, CSF1R, cancer, first in human

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
180 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Phase 1 elzovantinib
Arm Type
Experimental
Arm Description
The dose-escalation part of the study will determine the safety, tolerability, MTD, and RP2D of elzovantinib. The dose-expansion part of the study will determine the safety, tolerability, PK, and preliminary efficacy in specific cohorts. Dose expansion cohorts: Cohort I (NSCLC, METΔex14, treatment Naive) Enrollment Closed; Cohort II (NSCLC with METΔex14, MET therapy pre-treated) Enrollment closed; Cohort III (MET amplified NSCLC, GCN≥10); Cohort IV (MET amplified GI cancer GC/GEJ, CRC/HCC, GCN≥10); Cohort V (NSCLC or GI MET amplified, GCN≥5 and < 10); Cohort VI (Solid tumors with MET fusions, or oncogenic MET mutations or MET amplified other than GI/NSCLC
Intervention Type
Drug
Intervention Name(s)
elzovantinib (TPX-0022)
Intervention Description
Oral elzovantinib (TPX-0022) capsules
Primary Outcome Measure Information:
Title
Incidence of first cycle dose-limiting toxicities (DLTs) of elzovantinib
Description
Evaluate the safety and tolerability of elzovantinib
Time Frame
Within 28 days of the first elzovantinib dose for each patient
Title
Define the Recommended Phase 2 Dose
Description
Determine the maximum tolerated dose (MTD) and/or Recommended Phase 2 Dose (RP2D) of elzovantinib
Time Frame
Approximately 48 months
Secondary Outcome Measure Information:
Title
Adverse events (AEs)
Description
Evaluate the overall safety profile of elzovantinib
Time Frame
Approximately 48 months
Title
Cmax (maximum plasma concentration) of elzovantinib
Description
Evaluate the maximum plasma concentration of elzovantinib
Time Frame
Up to 72 hours post-dose
Title
AUC (area under plasma concentration time curve) of elzovantinib
Description
Evaluate the AUC of elzovantinib
Time Frame
Up to 72 hours post-dose
Title
Cmax (maximum plasma concentration) of TPX-0022 under different food intake conditions
Description
Determine the effect of food (specifically, a high-fat, high-calorie meal) on the single-dose PK (Cmax) of elzovantinib at the RP2D
Time Frame
Up to 72 hours post-dose
Title
AUC (area under plasma concentration time curve) of elzovantinib under different food intake conditions
Description
Determine the effect of food (specifically, a high-fat, high-calorie meal) on the single-dose PK (AUC) of elzovantinib at the RP2D
Time Frame
Up to 72 hours post-dose
Title
Preliminary Objective Response Rate (ORR)
Description
Determine the preliminary objective response rate (ORR) by Blinded Independent Central Review (BICR) of elzovantinib
Time Frame
Approximately 48 months
Title
Clinical benefit rate (CBR)
Description
Determine the CBR of elzovantinib
Time Frame
Approximately 48 months
Title
Time to response (TTR)
Description
Determine the TTR of elzovantinib
Time Frame
Approximately 48 months
Title
Duration of Response (DOR)
Description
Determine the DOR of elzovantinib
Time Frame
Approximately 48 months
Title
Progression free survival (PFS)
Description
Determine the PFS of elzovantinib
Time Frame
Approximately 48 months
Title
Intracranial tumor response
Description
Determine the intracranial tumor response in subjects with measurable brain metastases, as determined by BICR
Time Frame
Approximately 48 months
Title
Overall survival (OS)
Description
Determine efficacy and safety of elzovantinib
Time Frame
Approximately 48 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 (or age ≥ 20 as required by local regulation). Histological or cytological confirmation of advanced/metastatic MET exon 14 skipping mutation (METΔex14) NSCLC, MET amplified NSCLC, or MET amplified gastric cancers as determined by FISH, qPCR or NGS by local liquid biopsy or tissue, solid tumors with MET fusions or oncogenic MET mutations or MET amplified other than GI/NSCLC. ECOG performance status ≤ 1. Existence of measurable or evaluable disease (according to Response evaluation criteria in solid tumors [RECIST v1.1] criteria). Subjects with asymptomatic primary CNS tumors or brain metastases are eligible for the study if they meet protocol specified criteria. Adequate organ function. Life expectancy ≥ 12 weeks. Exclusion Criteria: Locally advanced solid tumor that is a candidate for curative treatment through radical surgery and/or radiotherapy, or chemotherapy. Presence or history of any other primary malignancy within the past 3 years other than a history of adequately treated basal or squamous cell carcinoma of the skin, or any adequately treated in situ carcinoma. Major surgery within four weeks of the start of therapy. Additional exclusion criteria for subjects with NSCLC with MET alterations: known oncogene mutations (eg, ALK, ROS1, KRAS, EGFR, etc.) for which there are approved therapies. Additional exclusion criteria for subjects with HCC with MET alterations: liver dysfunction greater than Child-Pugh Class A. Clinically significant cardiovascular disease (either active or within six months before enrollment): myocardial infarction, unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure (New York Heart Association Classification Class ≥ II), cerebrovascular accident or transient ischemic attack, symptomatic bradycardia, requirement for anti-arrhythmic medication. Ongoing cardiac dysrhythmias of CTCAE version 5.0 grade ≥ 2. Any of the following cardiac criteria: Mean resting corrected QT interval (ECG interval measured from the onset of the QRS complex to the end of the T wave) for heart rate (QTc) > 470 msec obtained from three ECGs, using the screening clinic ECG machine-derived QTc value Any clinically important abnormalities in rhythm, conduction, or morphology of resting ECG (e.g., complete left bundle branch block, third degree heart block, second degree heart block, PR interval > 250 msec) Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, congenital long QT syndrome, family history of long QT syndrome, or any concomitant medication known to prolong the QT interval Known clinically significant active infections not controlled with systemic treatment (bacterial, fungal, viral including HIV positivity). Peripheral neuropathy ≥ Grade 2.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bristol-Myers Squibb
Organizational Affiliation
Bristol-Myers Squibb
Official's Role
Study Director
Facility Information:
Facility Name
Local Institution - 2102
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Local Institution - 2108
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Local Institution - 2105
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Facility Name
Local Institution - 2111
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Local Institution - 2107
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Local Institution - 2109
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Local Institution - 2106
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Local Institution - 2113
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Local Institution - 2103
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Local Institution - 2104
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43614
Country
United States
Facility Name
Local Institution - 2101
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-4009
Country
United States
Facility Name
Local Institution - 2112
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
Facility Name
Local Institution - 4202
City
La Tronche
State/Province
Rhone-Alpes
ZIP/Postal Code
38700
Country
France
Facility Name
Local Institution - 4201
City
Lyon
State/Province
Rhone-Alpes
ZIP/Postal Code
69008
Country
France
Facility Name
Local Institution - 4203
City
Saint-Mandé
State/Province
Val-de-Marne
ZIP/Postal Code
94160
Country
France
Facility Name
Local Institution - 4204
City
Villejuif
State/Province
Val-de-Marne
ZIP/Postal Code
94805
Country
France
Facility Name
Local Institution - 6304
City
Seoul
ZIP/Postal Code
05505
Country
Korea, Democratic People's Republic of
Facility Name
Local Institution - 6301
City
Seoul
State/Province
Seoul-teukbyeolsi [Seoul]
ZIP/Postal Code
06351
Country
Korea, Republic of
Facility Name
Local Institution - 6303
City
Seoul
ZIP/Postal Code
03080
Country
Korea, Republic of
Facility Name
Local Institution - 6302
City
Seoul
ZIP/Postal Code
120-752
Country
Korea, Republic of
Facility Name
Local Institution - 4104
City
Madrid
ZIP/Postal Code
28036
Country
Spain
Facility Name
Local Institution - 4103
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Facility Name
Local Institution - 4101
City
Madrid
ZIP/Postal Code
28050
Country
Spain
Facility Name
Local Institution - 4102
City
Pamplona
ZIP/Postal Code
31008
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://www.bms.com/researchers-and-partners/clinical-trials-and-research.html
Description
BMS Clinical Trial Information
URL
https://www.bmsstudyconnect.com/s/US/English/USenHome
Description
BMS Clinical Trial Patient Recruiting
URL
https://www.fda.gov/Safety/MedWatch/SafetyInformation/default.htm
Description
FDA Safety Alerts and Recalls

Learn more about this trial

Study of TPX-0022 in Patients With Advanced NSCLC, Gastric Cancer or Solid Tumors Harboring Genetic Alterations in MET

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