This is a Phase I, First-In-Human, open label, dose escalation study to evaluate the safety,
tolerability, pharmacokinetics, and preliminary anti-cancer activity of ABM-1310 in adult
patients with documented BRAF V600 mutation and locally advanced or metastatic solid tumors
who have no effective standard treatment options available, as monotherapy in Part A, or in
combination with cobimetinib (Cotellic®) in Part B in adult patients who also have documented
progressive disease or intolerance to previous combination treatment of BRAF and MEK
inhibitors. A "3+3" design will be used to determine MTD and RP2D.
This is a Phase I, First-In-Human, open label, dose escalation study to evaluate the safety,
tolerability, pharmacokinetics, and preliminary anti-cancer activity of ABM-1310 in adult
patients with documented BRAF V600 mutation and locally advanced or metastatic solid tumors
who have no effective standard treatment options available, as monotherapy in Part A, or in
combination with cobimetinib (Cotellic®) in Part B in adult patients who also have documented
progressive disease or intolerance to previous combination treatment of BRAF and MEK
inhibitors. The primary objective of this study is to determine the Maximum Tolerated Dose
(MTD) and/or the Recommended Phase II Dose (RP2D) of both single agent and combination
treatment.
Study consists of two Parts:
Part A: The starting dose of ABM-1310 is 25 mg po bid, and dose escalation will be guided by
a "3+3" design. ABM-1310 will be administered twice daily on a continuous schedule. Each
treatment cycle consists of 28 days.
Part B: The starting dose of ABM-1310 will be a dose below the MTD that has been demonstrated
to be safe in Part A Monotherapy. A classic "3+3" design will guide the dose escalation. At
each dose level, ABM-1310 will be administered in combination with 60 mg cobimetinib
(Cotellic ®) once daily (qd) for the first 21 days of each 28-day treatment cycle.
Dose limiting toxicity (DLT) will be evaluated and managed per the pre-defined DLT criteria
and rules specified in the protocol. MTD and/or RP2D will be confirmed in a dose confirmation
cohort.
Inclusion Criteria:
1. Male and female subjects age 18 years and older who are able to sign informed consent
and to comply with the protocol
2. Patients with histologically or cytologically-documented, locally advanced, or
metastatic solid tumor malignancy that has either (a) failed prior standard therapy,
(b) for which no standard therapy exists, or (c) standard therapy is not considered
appropriate by the patient or treating physician. There is no limit to the number of
prior treatment regimens.
- Documentation of positive BRAF V600E mutation, or any other BRAF V600 mutation is
required for enrollment.
- Patients with stable brain metastasis that are asymptomatic, or that are
symptomatic but on a stable low dose up to 4 mg of dexamethasone (or equivalent)
per day of corticosteroids for at least 2 weeks prior to screening, are eligible
for enrollment. (Modernizing Clinical Trial Eligibility Criteria: Recommendations
of the American Society of Clinical Oncology- Friends of Cancer Research Brain
Metastases Working Group 2017).
- Part B: patients with documented progressive disease on or intolerance to
previous combination treatment of BRAF and MEK inhibitors.
3. Must have at least one measurable lesion as defined by RECIST V1.1 criteria for solid
tumors
- Measurable brain lesions that are 0.5 - 3 cm in longest diameter as defined by
the modified RECIST V1.1 criteria (Appendix A) are allowed.
- Brain lesion size > 3 cm is not eligible.
4. ECOG performance status of 0 or 1
5. Adequate organ function confirmed at screening and within 28 days of initiating
treatment, as evidenced by:
- Absolute Neutrophil Count (ANC) ≥ 1.0 x 10^9/L
- Hemoglobin (Hgb) ≥ 9 g/dl
- Platelets (Plt) ≥ 100 x 10^9/L
- AST/ALT ≤ 2.5 x Upper Limit of Normal (ULN) or ≤ 5.0 x ULN if liver metastases
are present
- Total bilirubin ≤ 1.5 x ULN, or direct bilirubin <ULN for patients with total
bilirubin levels >1.5 ULN
- Serum creatinine <1.5 x ULN or measured or calculated (per institutional
standard) creatinine clearance of > 60 mL/min.
6. Negative pregnancy test within 72 hours before starting study treatment in all
pre-menopausal women and women <12 months after the onset of menopause
7. Male and female subjects must agree to take sufficient contraceptive methods to avoid
pregnancy before first dose of study treatment, during the study, and for at least 60
days after ceasing study treatment
Exclusion Criteria:
1. Women who are pregnant or breast-feeding
2. Women of child-bearing potential (WOCBP) who does not use adequate birth control
3. Patients with any hematologic malignancy. This includes leukemia (any form), lymphoma,
and multiple myeloma
4. Have a second primary malignancy that, in the judgment of the investigator, may affect
the interpretation of results
5. Patients with carcinomatous meningitis (leptomeningeal disease (LMD))
6. Patients with history of stroke ≤ 6 months prior to starting study drug
7. Patients who have had an experience of seizure within 14 days prior to first treatment
8. Impaired cardiac function or clinically significant cardiac diseases, including but
not limited to any of the following:
- Left Ventricular Ejection Fraction (LVEF) < 45% as determined by MUGA scan or
ECHO
- Congenital long QT syndrome
- QTcF ≥ 450 msec (mean) on screening (Triplicate 12-Lead ECG)
- Unstable angina pectoris ≤ 6 months prior to starting study drug
- Acute myocardial infarction ≤ 6 months prior to starting study drug
- Use of pacemaker
9. Patients with
- Unresolved diarrhea ≥ CTCAE Grade 2, or
- Impairment of gastrointestinal (GI) function, or
- GI disease or conditions that may significantly alter the absorption of ABM-1310
(e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea,
malabsorption syndrome, or small bowel resection)
10. Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g.,
uncontrolled hypertriglyceridemia [triglycerides >500 mg/dL], active or uncontrolled
infection) that could cause unacceptable safety risks or compromise compliance with
the protocol
11. Extensive prior radiotherapy to more than 30% of bone marrow reserves, or prior bone
marrow/stem cell transplantation within 5 years
12. Patients who have received chemotherapy, targeted therapy or immunotherapy ≤ 4 weeks
prior to starting study drug or who have not recovered from side effects of such
therapy, except:
- ≤ 6 weeks for nitrosourea or mitomycin-C
- ≤ 5 half-lives or 2 weeks for small molecule inhibitor treatment, whichever is
longer
13. Patients who have received wide field radiotherapy ≤ 4 weeks or limited field
radiation for palliation ≤ 2 weeks, prior whole-brain radiotherapy (WBRT) ≤ 4 weeks or
stereotactic radiosurgery (SRS) ≤ 2 weeks prior to starting study drug or patients who
have not recovered from side effects of such therapy
14. Patients who have undergone major surgery ≤ 4 weeks in general prior to starting study
drug or who have not recovered from side effects of such therapy. However, a minimum
of 2 weeks recovery time from major surgery prior to starting study drug is acceptable
if in investigator's opinion the patient has recovered from surgery.
15. Patients who are currently receiving treatment with therapeutic doses of warfarin
sodium or any other coumarin-derivative anticoagulants
16. Patients who have received systemic corticosteroids ≤ 2 weeks prior to starting study
drug or who have not recovered from the side effects of such treatment. Therapeutic
doses of corticosteroids up to 4 mg/day of dexamethasone, or equivalent is allowed.
Note: Patients that are taking replacement doses of steroids are eligible
17. Patients who are currently receiving treatment with medication that has known risk to
prolong the QT interval, and the treatment cannot either be discontinued or switched
to a different medication prior to starting study drug
18. Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is not
mandatory; patients with well controlled HIV might be enrolled per investigator's
discretion)
19. Known history of active infection with Hepatitis B (e.g., HBsAg reactive), or
Hepatitis C (e.g., HCV RNA (qualitative) is detected)
20. History of alcohol or drug abuse ≤ 3 months prior to first dose
21. Has a history or current evidence of any condition, therapy, or laboratory abnormality
that, in the opinion of the investigator, might confound the results of the trial,
interfere with the patient's participation and compliance in the trial