Description:
This study will be conducted in adult participants diagnosed with any form of an advanced or
progressive MSS CRC for which 1st and 2nd line standard therapy (at least one of which
contained fluorouracil) is no longer effective or is intolerable. This is a phase 1b,
multi-center, open label study designed to assess safety and tolerability of grapiprant in
combination with pembrolizumab, to determine the recommended phase 2 dose (RP2D) with
pembrolizumab, and to evaluate and characterize the PK of grapiprant alone and in combination
with pembrolizumab. Disease response, pharmacodynamics, and response biomarkers will also be
assessed.
Title
- Brief Title: Grapiprant and Pembrolizumab in Patients With Advanced or Progressive MSS Colorectal Cancer
- Official Title: An Open-label, Single-arm, Phase 1b Study to Evaluate the Safety and Efficacy of Grapiprant (ARY-007) in Combination With Pembolizumab in Patients With Advanced or Progressive Microsatellite Stable (MSS) Colorectal Cancer (CRC)
Clinical Trial IDs
- ORG STUDY ID:
ARYS-001
- SECONDARY ID:
Keynote-878
- NCT ID:
NCT03658772
Conditions
- Microsatellite Stable Colorectal Cancer
Interventions
Drug | Synonyms | Arms |
---|
grapiprant | ARYS-007, IK-007 | Cohort 1 |
grapiprant and pembrolizumab | ARYS-007, MK3475, KEYNOTE-878, IK-007 | Cohort 1 |
Purpose
This study will be conducted in adult participants diagnosed with any form of an advanced or
progressive MSS CRC for which 1st and 2nd line standard therapy (at least one of which
contained fluorouracil) is no longer effective or is intolerable. This is a phase 1b,
multi-center, open label study designed to assess safety and tolerability of grapiprant in
combination with pembrolizumab, to determine the recommended phase 2 dose (RP2D) with
pembrolizumab, and to evaluate and characterize the PK of grapiprant alone and in combination
with pembrolizumab. Disease response, pharmacodynamics, and response biomarkers will also be
assessed.
Trial Arms
Name | Type | Description | Interventions |
---|
Cohort 1 | Experimental | Single Agent run-in with grapiprant and then combination treatment of grapiprant and pembrolizumab. | - grapiprant
- grapiprant and pembrolizumab
|
Cohort 2 | Experimental | Participants will be treated with grapiprant in combination with pembrolizumab. | - grapiprant and pembrolizumab
|
Eligibility Criteria
Key Inclusion Criteria:
- Male and female adult patients 18 years of age or older on day of signing informed
consent.
- Patients must have a histologically confirmed advanced, metastatic, or progressive
Microsatellite Stable (MSS) Colorectal Cancer (CRC) per institutional standards.
- Patient has received at least two prior lines of therapy for advanced or metastatic
CRC, at least one of which included fluorouracil.
- Highly effective birth control.
- Measurable disease.
- Accessible tumor that can be safely accessed for multiple core biopsies and patient is
willing to provide tissue from newly obtain biopsies before and during treatment.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
- Adequate organ function.
- Able to swallow and absorb oral tablets.
Key Exclusion Criteria:
- Prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent
directed to another stimulatory or co-inhibitory T-cell receptor
- Current use of NSAIDs, COX-2 inhibitors and aspirin products within 3 days (preferably
7 days) before treatment initiation or at anytime during the study unless used for
management of AE.
- History of severe hypersensitivity reactions to chimeric or humanized antibodies
- Has received prior systemic anticancer therapy including investigational agents within
4 weeks prior to treatment, or 5 half-lives, whichever is shorter.
- Diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in
dosing exceeding 10 mg daily of prednisone equivalent) or any other form of
immunosuppressive therapy within 7 days prior the first dose of study drug.
- Known additional malignancy that is progressing or has required active treatment
within the past 3 years.
- Known active CNS metastases and/or carcinomatous meningitis.
- Active autoimmune disease that has required systemic treatment in past 2 years.
- History of non-infectious pneumonitis that required steroids or has current
pneumonitis.
- Active infection requiring systemic therapy.
- Recent (within the last 12 months) or current GI ulcer, colitis or non-immune colitis.
- Known history of human immunodeficiency virus (HIV) infection, Hepatitis B, or active
Hepatitis C virus infection.
- Clinically significant (i.e. active) cardiovascular disease
- Allogeneic tissue/solid organ transplant
- Medical conditions requiring concomitant administration of strong CYP3A4 or P
glycoprotein inhibitors or inducers.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety and tolerability of grapiprant alone and in combination with pembrolizumab |
Time Frame: | Up to 90 days after the end of treatment (average of 7 months) |
Safety Issue: | |
Description: | Number of incidence, severity, and duration of treatment emergent adverse events using CTCAE v5.0 |
Secondary Outcome Measures
Measure: | Overall Response Rate (ORR) |
Time Frame: | 7 months |
Safety Issue: | |
Description: | Proportion of participants who achieved PR or better during the study per RECIST 1.1 |
Measure: | Duration of Response (DOR) |
Time Frame: | 7 months |
Safety Issue: | |
Description: | Time when criteria for response are met, to the first documentation of relapse or progression |
Measure: | Progression -free survival (PFS) |
Time Frame: | Up to 12 months |
Safety Issue: | |
Description: | Participants who discontinue treatment without disease progression |
Measure: | Disease control rate (DCR) |
Time Frame: | 7 months |
Safety Issue: | |
Description: | Percentage of participants who achieved a CR, PR and stable disease |
Measure: | Overall survival (OS) |
Time Frame: | Up to 2 years from start of study drug. |
Safety Issue: | |
Description: | Date of study drug to date of death due to any cause. If no documentation of death at time of the analysis will be censored as of the date last known to be alive, or the data cutoff date, whichever is earlier. |
Measure: | Duration of treatment (DOT) |
Time Frame: | 7 months |
Safety Issue: | |
Description: | Time of duration on treatment |
Measure: | Serum tumor marker changes |
Time Frame: | 7 months |
Safety Issue: | |
Description: | Assess changes in serum tumor markers including but not limited to carcinoembryonic antigen (CEA), when appropriate (eg. CA-19.9, CA125, and lactate dehyrogenase (LDH)) with disease response. |
Measure: | Pharmacodynamic immune effects in paired tumor biopsies |
Time Frame: | predose through cycle 3 (each cycle is 21 days) |
Safety Issue: | |
Description: | Assess changes in tumor infiltrating helper T cells, cytotoxic T cells and regulatory monocyte/macrophages with study drug treatment |
Measure: | PGEM as a pharmacodynamic and predictive biomarker |
Time Frame: | PreScreening through 7 months |
Safety Issue: | |
Description: | Evaluate disease response in all evaluable participants and in those with a positive initial assessment of Urine prostaglandin E2 metabolite (PGEM) |
Measure: | PK of grapiprant: Tmax |
Time Frame: | Safety Run-in (7 days); Days 1 and 2 of first 2 cycles (every 21 days), followed by Day 1 of every even cycle beginning with cycle 4 (every 42 days) through end of treatment (average of 4 months) |
Safety Issue: | |
Description: | First time to reach maximum [peak] observed plasma concentration |
Measure: | PK of grapiprant: AUC0 last |
Time Frame: | Safety Run-in (7 days); Days 1 and 2 of first 2 cycles (every 21 days), followed by Day 1 of every even cycle beginning with cycle 4 (every 42 days) through end of treatment (average of 4 months). |
Safety Issue: | |
Description: | Area under the plasma concentration time curve from time 0 to the end of the dosing interval (AUC0 last) |
Measure: | Plasma decay half-life (t1/2) |
Time Frame: | Safety Run-in (7 days); Days 1 and 2 of first 2 cycles (every 21 days), followed by Day 1 of every even cycle beginning with cycle 4 (every 42 days) through end of treatment (average of 4 months) |
Safety Issue: | |
Description: | Measurement of half-life of grapiprant after dosing |
Measure: | Apparent oral clearance (CL/F) |
Time Frame: | Safety Run-in (7 days); Days 1 and 2 of first 2 cycles (every 21 days), followed by Day 1 of every even cycle beginning with cycle 4 (every 42 days) through end of treatment (average of 4 months) |
Safety Issue: | |
Description: | Rate of elimination of the drug from plasma after oral administration |
Measure: | Peak to trough ratio |
Time Frame: | Safety Run-in (7 days); Days 1 and 2 of first 2 cycles (every 21 days), followed by Day 1 of every even cycle beginning with cycle 4 (every 42 days) through end of treatment (average of 4 months) |
Safety Issue: | |
Description: | Measure how drug effect is sustained over dose interval |
Measure: | Observed accumulation ratio |
Time Frame: | Safety Run-in (7 days); Days 1 and 2 of first 2 cycles (every 21 days), followed by Day 1 of every even cycle beginning with cycle 4 (every 42 days) through end of treatment (average of 4 months) |
Safety Issue: | |
Description: | Relationship between the dosing interval and the rate of elimination for the drug. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Arrys Therapeutics |
Trial Keywords
- Keynote-878
- ARY-007
- Immuno-Oncology
- checkpoint inhibitor
- EP4
- IK-007
Last Updated
May 25, 2021