Clinical Trials /

Phase 2 Study of TVB-2640 in KRAS Non-Small Cell Lung Carcinomas

NCT03808558

Description:

This is a prospective one-arm, two-stage phase 2 trial of TVB-2640 in KRAS mutant NSCLC patients. 13 patients will be treated with a minimum of 1 cycle of TVB-2640 therapy over 8 weeks.

Related Conditions:
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Phase 2 Study of TVB-2640 in KRAS Non-Small Cell Lung Carcinomas
  • Official Title: A Phase 2 Single-Center Pharmacodynamic Study of TVB-2640 In KRAS Mutant Non-Small Cell Lung Carcinomas

Clinical Trial IDs

  • ORG STUDY ID: STU 022017-058
  • NCT ID: NCT03808558

Conditions

  • KRAS Gene Mutation

Interventions

DrugSynonymsArms
TVB-2640TVB-2640

Purpose

This is a prospective one-arm, two-stage phase 2 trial of TVB-2640 in KRAS mutant NSCLC patients. 13 patients will be treated with a minimum of 1 cycle of TVB-2640 therapy over 8 weeks.

Detailed Description

      Patients with stable disease or partial/complete remissions will continue therapy.

      The endpoints are response rate-RR, disease control rate-DCR, PFS-progression-free survival,
      CTCAEv5.0 toxicities, plasma lipid levels, collection of sebaceous secretion via Sebutape,
      and 11C-acetate PET tumor imaging.

      In the first stage, 13 patients will be enrolled. If fewer than 2 patients achieve response,
      the study will be stopped. If 2 or more patients have a radiographic response, an additional
      21 patients will be enrolled , for a total accrual of 34 patients.
    

Trial Arms

NameTypeDescriptionInterventions
TVB-2640ExperimentalPatients will be administered TVB-2640 100mg/m2 orally once a day for 8 weeks.
  • TVB-2640

Eligibility Criteria

        Inclusion:

          1. Histologically or cytologically confirmed metastatic or advanced-stage NSCLC and
             molecular identification of KRAS mutation. KRAS mutant NSCLC must be refractory,
             relapsed, and/or intolerant of combination platinum-doublet chemotherapy and
             subsequent immune checkpoint inhibitor therapy

             · Molecular characterization (tissue- or blood-based [ie, cell-free/circulating tumor
             DNA]) must have been performed and must have demonstrated a KRAS mutation (exon 12,
             13, or 61 mutation detected by sequencing) by a CLIA-certified assay (source
             documentation required).

          2. Subjects' EGFR mutation and ALK gene rearrangement status must be known prior to study
             entry. Subjects with EGFR mutation or ALK gene rearrangement must have progressed
             after appropriate FDA-approved targeted therapy options prior to eligibility.

          3. Patient has evidence of disease progression on most recent line of therapy.

          4. Patient has measurable disease by RECIST v1.1 (Eisenhauer, 2009).

          5. Age ≥ 18 years.

          6. ECOG performance status of 0 or 1.

          7. Predicted life expectancy of >3 months.

          8. Adequate organ and marrow function as defined below:

               -  absolute neutrophil count ≥ 1,500/mcL

               -  platelets ≥ 75,000/mcL

               -  total bilirubin <2X institutional upper limit of normal

               -  AST and ALT ≤5X institutional upper limit of normal

               -  serum creatinine <1.5X institutional upper limit of normal

               -  LVEF >50%

               -  QTcF <470msec

          9. Women of child-bearing potential and men must agree to use adequate contraception
             (hormonal or barrier method of birth control; abstinence) prior to study entry, for
             the duration of study participation, and for 90 days following completion of therapy.
             Should a woman become pregnant or suspect she is pregnant while participating in this
             study, she should inform her treating physician immediately.

               -  A female of child-bearing potential is any woman (regardless of sexual
                  orientation, having undergone a tubal ligation, or remaining celibate by choice)
                  who meets the following criteria:

                    -  Has not undergone a hysterectomy or bilateral oophorectomy; or

                    -  Has not been naturally postmenopausal for at least 12 consecutive months
                       (i.e., has had menses at any time in the preceding 12 consecutive months).

         10. No significant ischemic heart disease or myocardial infarction within 6 months of
             first dose of TVB-2640 and with current adequate cardiac function as in 3.1.8.

         11. Ability to understand and the willingness to sign a written informed consent.

        Exclusion:

          1. Patient is unable to swallow oral medications or has impairment of GI function or GI
             disease that may significantly alter drug absorption such as active inflammatory bowel
             disease, uncontrolled nausea, vomiting, diarrhea, or malabsorption syndrome.

          2. Patient has a history of risk factors for torsade de pointes such as uncontrolled
             heart failure, severe hypokalemia with potassium less than 3mM/L, history of long QT
             syndrome or require use during study participation of concomitant medications known to
             prolong QT/QTc interval.

          3. Patients who require use of strong CYP3A4/5 agonists or inhibitors during study
             participation.

          4. Patient has uncontrolled or severe intercurrent medical condition including
             uncontrolled brain metastases. Patients with stable brain metastases either treated or
             untreated, on a stable dose of steroids/anticonvulsants, with no dose increase within
             4 weeks before the first dose of TVB-2640, and no anticipated dose change, are
             allowed.

          5. Patient underwent major surgery within 4 weeks before the first dose of TVB-2640 or
             received cancer-directed therapy either chemotherapy, radiotherapy, hormonal therapy,
             biologic or immunotherapy, etc. or an investigational drug or device within 2 weeks (6
             weeks for mitomycin C and nitrosoureas) or 5 half-lives of that agent, whichever is
             shorter before the first dose of TVB-2640. In addition, any drug- related toxicity,
             with the exception of alopecia, an endocrinopathy controlled with replacement therapy,
             or a clinically stable toxicity not expected to increase from study therapy (eg,
             cisplatin-associated ototoxicity) should have recovered to <Grade 1.

          6. If female, patient is pregnant or breast-feeding.

          7. Patient has evidence of a serious active infection-infection requiring treatment with
             intravenous antibiotics.

          8. Patient has known immunodeficiency virus-HIV or hepatitis B or C infection, as such
             patients may be at increased risk for toxicity due to concomitant treatment and
             disease-related symptoms may preclude accurate assessment of the safety of TVB-2640.

          9. Patient has an important medical illness or abnormal laboratory finding that, in the
             Investigator's opinion, would increase the risk of participating in this study.

         10. Patients with prior or concurrent malignancy whose natural history or treatment has
             the potential to interfere with the safety or efficacy assessment of the
             investigational agent.

         11. History of clinically significant dry eye (xerophthalmia) or other corneal abnormality
             or, if a contact lens wearer, does not agree to abstain from contact lens use from
             baseline through the last study drug dose.

         12. Patient has a known allergy or hypersensitivity to components of TVB-2640.

         13. Patient has a prior history of hypersensitivity, drug/radiation-induced, or other
             immune-mediated pneumonitis.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Disease control rate of TVB-2640
Time Frame:every 8 weeks through study completion, an average of 1 year
Safety Issue:
Description:Determine Disease control rate of TVB-2640 in KRAS mutant NSCLC patients through RECIST and toxicity profile.

Secondary Outcome Measures

Measure:Safety profile of TVB-2640
Time Frame:Pretreatment and four weeks of treatment.
Safety Issue:
Description:Secondary endpoints are 11C-acetate tumor uptake pretreatment and at four weeks of treatment and plasma lipidomics pretreatment and at four weeks of treatment.
Measure:Establish the predictive value of 11C-acetate PET
Time Frame:Pretreatment and four weeks of treatment.
Safety Issue:
Description:To establish the predictive value of 11C-acetate PET pretreatment and post-treatment tumor uptake for disease control rate and response rate
Measure:Mean change in fasting plasma lipidomics
Time Frame:Pretreatment and four weeks of treatment.
Safety Issue:
Description:Blood samples for fasting plasma lipidomics will be collected at baseline and four weeks of treatment.
Measure:Mean change in sebaceous secretion of fatty acids
Time Frame:Pretreatment and four weeks of treatment.
Safety Issue:
Description:Sebutabe collection of sebaceous secretion of fatty acids will be performed at baseline and four weeks of treatment

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:David E Gerber

Last Updated

February 23, 2021