This was a clinical study with an orally administered drug, BDTX-189 in participants with advanced solid tumors that had select mutations or alterations in human epidermal growth factor receptor 2 (HER2/ErbB2) genes or epidermal growth factor receptor (EGFR/ErbB1). The main goals of this study were to: * Find the recommended dose of BDTX-189 that can be given safely to participants * Learn more about the side effects of BDTX-189 * Learn what the body does to BDTX-189 after it has been taken (pharmacokinetics or PK) * Determine the preliminary antitumor activity of BDTX-189 in participants with select allosteric ErbB gene mutations
BDTX-189 is an irreversible, small molecular inhibitor that is highly selective versus wild-type EGFR and potent for cancer driver mutations of the ErbB family, including extracellular, transmembrane, and kinase domain allosteric mutations of HER2, as well as EGFR and HER2 exon 20 insertion mutations. These allosteric ErbB mutations are found in 1 - 2 % of most solid tumors and enriched in some cancers with a prevalence of about 2 - 7% such as in non-small cell lung cancer, breast cancer, colorectal cancer, bladder cancer, and endometrial cancer. Currently approved HER2 and EGFR directed therapies are not active against the spectrum of allosteric mutations at relevant and tolerated exposure levels. This Phase 1/2 multi-center, open-label trial was a first-in-human study that evaluated BDTX-189 orally administered daily as a single agent in patients with solid tumors harboring select mutations or alterations. The Phase 1 portion was a dose escalation primarily designed to assess the safety and tolerability of BDTX-189 and to determine a recommended Phase 2 dose (RP2D). Phase 1 focused on patients with a solid tumor and with alterations such as: * Allosteric HER2 or HER3 mutation(s) * EGFR or HER2 exon 20 insertion mutation(s) * HER2 amplified or overexpressing tumors * EGFR exon 19 deletion or L858R mutation Eligible mutations must have been determined by a validated next-generation sequencing (NGS) test routinely used by each institution and performed in a CLIA-certified or equivalent laboratory. The Phase 2 portion was not initiated.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
91
Participants received a daily, oral dose of BDTX-189 as part of a 3 week cycle.
9250
Scottsdale, Arizona, United States
9405
Long Beach, California, United States
9474
Orange, California, United States
7141
New Haven, Connecticut, United States
4080
Lake Mary, Florida, United States
4100
Orlando, Florida, United States
Number of Dose Limiting Toxicities as a Determinant of the Recommended Phase 2 Dose (RP2D)
Certain toxicities will be considered dose-limiting unless clearly attributable to an extraneous cause, such as underlying disease.
Time frame: After the first dose of treatment for up to 21 days.
Phase 1: Incidence of Treatment-emergent Adverse Events as a Measure of Safety and Tolerability of BDTX-189
Adverse events will be assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.
Time frame: From Cycle 1 Day 1 (each cycle is 21 days) until 30 days post last dose
Phase 1: Plasma Concentration of BDTX-189 as a Measure of Pharmacokinetics
Blood samples will be taken to measure the plasma concentrations of BDTX-189 in both a fed and fasted state.
Time frame: Multiple time points during Cycles 1-4 (each cycle is 21 days)
Phase 1: Objective Response Rate as a Preliminary Measure of Antitumor Activity
Objective response is defined as the proportion of participants who achieved a complete response (CR; disappearance of all target and non-target lesions) or partial response (PR; at least a 30% decrease from baseline in the sum of diameters of target lesions) per RECIST version 1.1.
Time frame: Assessed until disease progression or death for up to 12 months
Phase 1: Progression-free Survival as a Measure of Antitumor Activity
Progression-free survival is the time from first study dose until disease progression (PD; target lesion increase of 20% and at least 5mm from smallest on-study lesion sum, the appearance of new lesions, or unequivocal progression of non-target lesions) per RECIST v1.1.
Time frame: Assessed until disease progression or death for up to 12 months
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9535
Plantation, Florida, United States
4060
Sarasota, Florida, United States
9035
Atlanta, Georgia, United States
9530
Rolling Meadows, Illinois, United States
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