Clinical Trials /

Study of WNT974 in Combination With LGX818 and Cetuximab in Patients With BRAF-mutant Metastatic Colorectal Cancer (mCRC) and Wnt Pathway Mutations

NCT02278133

Description:

The purpose of this study is to assess the safety and anti-tumor activity of the triple combination of WNT974, LGX818 and cetuximab in BRAFV600-mutant mCRC with RNF43 mutations or RSPO fusions. The design of this study is based upon the translational and pre-clinical data that suggest that Wnt pathway signals, increased due to RNF43 mutations or RSPO fusions, cooperate with the EGFR and BRAF signals to maintain the growth of BRAFV600 CRCs. Inhibition of these signals with the triple combination of WNT974, LGX818 and cetuximab may result in anti-tumor activity.

Related Conditions:
  • Colorectal Carcinoma
Recruiting Status:

Completed

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Study of WNT974 in Combination With LGX818 and Cetuximab in Patients With BRAF-mutant Metastatic Colorectal Cancer (mCRC) and Wnt Pathway Mutations
  • Official Title: A Phase Ib/II Multi-center, Open Label, Dose Escalation Study of WNT974, LGX818 and Cetuximab in Patients With BRAFV600-mutant KRAS Wild-type Metastatic Colorectal Cancer Harboring Wnt Pathway Mutations

Clinical Trial IDs

  • ORG STUDY ID: CWNT974X2102C
  • NCT ID: NCT02278133

Conditions

  • Metastatic Colorectal Cancer

Interventions

DrugSynonymsArms
WNT974WNT974, LGX818 and cetuximab combo
LGX818WNT974, LGX818 and cetuximab combo
CetuximabWNT974, LGX818 and cetuximab combo

Purpose

The purpose of this study is to assess the safety and anti-tumor activity of the triple combination of WNT974, LGX818 and cetuximab in BRAFV600-mutant mCRC with RNF43 mutations or RSPO fusions. The design of this study is based upon the translational and pre-clinical data that suggest that Wnt pathway signals, increased due to RNF43 mutations or RSPO fusions, cooperate with the EGFR and BRAF signals to maintain the growth of BRAFV600 CRCs. Inhibition of these signals with the triple combination of WNT974, LGX818 and cetuximab may result in anti-tumor activity.

Trial Arms

NameTypeDescriptionInterventions
WNT974, LGX818 and cetuximab comboExperimentalPhase l: Dose Escalation phase; Phase ll: SIngle group assessing the triple combination of WNT974, LGX818 and cetuximab
  • WNT974
  • LGX818
  • Cetuximab

Eligibility Criteria

        Inclusion Criteria:

          -  Male or female aged ≥ 18 years

          -  Histological or cytological confirmed metastatic colorectal cancer

          -  Written documentation of KRAS wild-type status and BRAFV600-mutation with RNF43
             mutation and/or RSPO fusion

          -  Progression of disease after at least one prior standard of care regimen or intolerant
             to irinotecan based regimens

          -  Availability of a representative tumor specimen (primary or metastatic, archival or
             newly obtained)

          -  Measurable disease as per RECIST v1.1

          -  Eastern cooperative oncology group (ECOG) performance status ≤ 2

        Exclusion Criteria:

          -  Phase II only: Prior treatment with RAF inhibitors, Wnt pathway inhibitors, cetuximab,
             panitumumab, and/or other EGFR inhibitors

          -  Symptomatic brain metastasis. Patients previously treated or untreated for these
             conditions that are asymptomatic in the absence of corticosteroid and anti-epileptic
             therapy are allowed to enroll

          -  Current treatment with medications or consuming foods that are strong inhibitors or
             inducers of CYP3A4/5 or herbal medications and that cannot be discontinued at least
             one week prior to the start of treatment.

          -  Symptomatic or untreated leptomeningeal disease

          -  Acute or chronic pancreatitis

          -  Clinically significant cardiac disease

          -  Patients with any of the following laboratory values at Screening/baseline

               -  Absolute neutrophil count (ANC) <1,500/mm3

               -  Platelets < 100,000/mm3

               -  Hemoglobin < 9.0 g/dL

               -  Serum creatinine >1.5 x ULN or calculated or directly measured CrCl < 50% lower
                  limit of normal

               -  Serum total bilirubin >1.5 x ULN

               -  AST/SGOT and/or ALT/SGPT > 2.5 x ULN, (> 5 x ULN if liver metastases present)

          -  Patients with impaired hepatic function as defined by Childs-Pugh class B or C

          -  Impairment of gastrointestinal (GI) function or GI disease that may significantly
             alter the absorption of oral WNT974/LGX818

        Other protocol-defined inclusion/exclusion criteria may apply
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Incidence of Dose Limiting Toxicities and exposure (AUC C1D15) to WNT974 and LGX818 (phase lb)
Time Frame:12 months
Safety Issue:
Description:Phase Ib: To estimate the MTD(s) and/or RP2D(s) of the triple combination of WNT974, LGX818 and cetuximab in patients with BRAFV600-mutant, KRAS wild-type (WT) mCRC harboring upstream Wnt pathway mutations.

Secondary Outcome Measures

Measure:Overall response rate (ORR) (phase lb)
Time Frame:36 months
Safety Issue:
Description:To assess additional parameters of clinical activity of WNT974 in combination with LGX818 and cetuximab in BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation.
Measure:Overall survival (OS) (phase lb/ll)
Time Frame:36 months
Safety Issue:
Description:To assess additional parameters of clinical activity of WNT974 in combination with LGX818 and cetuximab in BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation.
Measure:Duration of response (DOR) (phase lb/ll)
Time Frame:36 months
Safety Issue:
Description:To assess additional parameters of clinical activity of WNT974 in combination with LGX818 and cetuximab in BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation.
Measure:Time to response (TTR) (phase lb/ll)
Time Frame:36 months
Safety Issue:
Description:To assess additional parameters of clinical activity of WNT974 in combination with LGX818 and cetuximab in BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation.
Measure:Progression free survival (PFS) (phase lb/ll)
Time Frame:36 months
Safety Issue:
Description:To assess additional parameters of clinical activity of WNT974 in combination with LGX818 and cetuximab in BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation.
Measure:Disease control rate (DCR) (phase lb/ll)
Time Frame:36 months
Safety Issue:
Description:To assess additional parameters of clinical activity of WNT974 in combination with LGX818 and cetuximab in BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation.
Measure:Plasma concentration of WNT974, LHA333, LGX818 (phase lb/ll)
Time Frame:30 months
Safety Issue:
Description:To characterize the pharmacokinetics (PK) of WNT974, its pharmacologically active metabolite LHA333, and LGX818 when used in combination therapy with cetuximab
Measure:Number of participants with Adverse Events as a measure of safety and tolerability (phase lb/ll)
Time Frame:30 months
Safety Issue:
Description:To characterize the safety and tolerability of WNT974 in combination with LGX818 and cetuximab in patients with BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation
Measure:Number of participants with Serious Adverse Events as a measure of safety and tolerability(phase lb/ll)
Time Frame:30 months
Safety Issue:
Description:To characterize the safety and tolerability of WNT974 in combination with LGX818 and cetuximab in patients with BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation
Measure:Biomarker activations for WNT and RTK-MAPK pathways (phase Ib/II)
Time Frame:32 months
Safety Issue:
Description:Phase Ib/II: To assess the pharmacodynamic effect of WNT974, LGX818 in combination with cetuximab and a potential relationship with clinical outcome
Measure:Number of participants with dose interruptions and dose reductions (phase Ib/II)
Time Frame:30 months
Safety Issue:
Description:To characterize the safety and tolerability of WNT974 in combination with LGX818 and cetuximab in patients with BRAFV600-mutant mCRC with evidence of upstream Wnt pathway activation

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:Array BioPharma

Trial Keywords

  • metastatic,
  • Colorectal cancer,
  • WNT974,
  • LGX818,
  • cetuximab,
  • BRAF-mutant,
  • mCRC,
  • BRAFV600-mutant,
  • KRAS

Last Updated

October 9, 2017