ONC201 is a small molecule which selectively targets the G protein-coupled receptor DRD2. Downstream of target engagement, ONC201 activates the integrated stress response (ISR) in tumor cell leading to inactivation of Akt and extracellular signal-regulated kinase (ERK) signaling as well as induction of the TRAIL pathway. ONC201 also inhibits dopamine receptor 2 (DRD2), resulting in anti-tumor responses in preclinical models. Single agent ONC201 has been examined in open-label Phase I studies in patients with advanced, treatment refractory solid malignancies. Due to its differential anti-proliferative and pro-apoptotic response in tumor cells, treatment was overall well tolerated, and the recommended phase II dose of ONC201 was set at 625mg every three weeks. An additional dose-escalation phase I study (NCT02609230) is further evaluating weekly versus three week dosing in patients with advanced solid tumors and multiple myeloma. Preliminary data from these phase I studies suggests a possible clinical benefit in patients with advanced, chemo-refractory endometrial cancers, with at least one mixed response noted in a patient with clear cell histology. Hypothesis: Single agent ONC201 will demonstrate clinical benefit in women with recurrent or metastatic endometrial cancers, especially in those women with alterations in the Phosphoinositide 3 kinase (PI3K)/Akt/mammalian target of Rapamycin (mTOR) pathway.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
19
ONC201 will be administered at a dose of 625 mg by mouth weekly until disease progression, unacceptable toxicity, or if the patient discontinues for any other reason. Radiologic tumor assessment would be performed at baseline, Cycle 3 Day 1, Cycle 5 Day 1, and at the end of every 3 cycles beyond cycle 5. All patients including those removed from the study due to unacceptable toxicity, will undergo radiologic tumor assessment at the time of discontinuation (End of treatment).
Fox Chase Cancer Center
Philadelphia, Pennsylvania, United States
Progression free survival (PFS) rate at 12 weeks
PFS will be calculated from the day of starting the treatment until 12 weeks
Time frame: 12 weeks
Objective Response rate (ORR) as determined by Response Criteria In Solid Tumors (RECIST)1.1 criteria
ORR will be calculated from the day of starting the treatment until disease progression
Time frame: 1-2 years
Safety profile of ONC201 will be determined by adverse events according to Common terminology criteria for Adverse Events (CTCAE) 4.03
Safety profile of ONC201 will be determined by type, frequency, severity and timing and relationship of Adverse Events and lab abnormalities to ONC201
Time frame: 1-2 years
Duration of response
Duration or response will be determined from the time when a partial or complete response is seen until disease progression
Time frame: 1-2 years
Duration of stable disease
Duration of stable disease will be calculated from the time of first treatment until disease progression
Time frame: 1-2 years
Median progression free survival
Progression free survival will be calculated from the time of the start of the treatment until disease progression
Time frame: 1-2 years
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