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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Memorial Sloan-Kettering Cancer Center (MSKCC) MSKCC (3)
New York, New York, United States
Medical University of South Carolina Oncology Dept
Charleston, South Carolina, United States
University of Texas/MD Anderson Cancer Center Onc. Dept,
Houston, Texas, United States
University of Wisconsin / Paul P. Carbone Comp Cancer Center Univ Wisc
Madison, Wisconsin, United States
Array BioPharma Investigative Site
Parkville, Victoria, Australia
Array BioPharma Investigative Site
Leuven, Belgium
Array BioPharma Investigative Site
Edmonton, Alberta, Canada
Array BioPharma Investigative Site
Vancouver, British Columbia, Canada
Array BioPharma Investigative Site
Toronto, Ontario, Canada
Array BioPharma Investigative Site
Bordeaux, France
...and 9 more locations
Incidence of Dose Limiting Toxicities and exposure (AUC C1D15) to WNT974 and LGX818 (phase lb)
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.
Time frame: 12 months
Overall response rate in phase II
Phase II: To estimate the preliminary anti-tumor activity of the RP2D(s) of the combination of WNT974, LGX818 and cetuximab in patients with BRAFV600-mutant metastatic CRC harboring upstream Wnt pathway mutations
Time frame: 30 months
Overall response rate (ORR) (phase lb)
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.
Time frame: 36 months
Overall survival (OS) (phase lb/ll)
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.
Time frame: 36 months
Duration of response (DOR) (phase lb/ll)
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.
Time frame: 36 months
Time to response (TTR) (phase lb/ll)
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.
Time frame: 36 months
Progression free survival (PFS) (phase lb/ll)
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.
Time frame: 36 months
Disease control rate (DCR) (phase lb/ll)
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.
Time frame: 36 months
Plasma concentration of WNT974, LHA333, LGX818 (phase lb/ll)
To characterize the pharmacokinetics (PK) of WNT974, its pharmacologically active metabolite LHA333, and LGX818 when used in combination therapy with cetuximab
Time frame: 30 months
Number of participants with Adverse Events as a measure of safety and tolerability (phase lb/ll)
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
Time frame: 30 months
Number of participants with Serious Adverse Events as a measure of safety and tolerability(phase lb/ll)
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
Time frame: 30 months
Biomarker activations for WNT and RTK-MAPK pathways (phase Ib/II)
Phase Ib/II: To assess the pharmacodynamic effect of WNT974, LGX818 in combination with cetuximab and a potential relationship with clinical outcome
Time frame: 32 months
Number of participants with dose interruptions and dose reductions (phase Ib/II)
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
Time frame: 30 months
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