This BVD-523-ABC study builds on the safety and clinical activity experience of previous studies that have evaluated ulixertinib as a novel targeted cancer treatment in cohorts of patients with specific genetic alterations and tumor histologies that result in aberrant MAPK pathway signaling. Early clinical data have demonstrated anti-tumor activity with ulixertinib treatment and have identified specific groups of patients for whom additional development is warranted.
This multi-center, phase II study will be conducted in two parts and assess the clinical benefit, safety, pharmacokinetics, and pharmacodynamics of ulixertinib (BVD-523) in patients with advanced malignancies. Part A (tumor histology agnostic) will be open label and enroll patients to one of six groups based on their tumor alteration. Targeted enrollment per group was 38 patients with a total targeted enrollment of 228 patients. Actual enrollment was total of 104 patients with 77 patients allocated to treatment. * Group 1: Patients with tumors, other than colorectal cancer (CRC), having a BRAF alteration that results in an amino acid change at positions G469, L485, or L597. * Group 2: Patients with tumors, other than CRC, having a defined Class 2 BRAF alteration (see Appendix 2 of protocol). * Group 3: Patients with tumors, other than CRC, having an atypical BRAF alteration (non V600) that is not specified in Group 1 or Group 2. * Group 4: Patients with CRC having any atypical BRAF alteration. * Group 5: Patients with tumors, other than CRC, harboring alterations in MEK1/2. * Group 6: Patients with CRC harboring alterations in MEK1/2. Part B (tumor histology specific) will randomly enroll patients with one of up to three specified tumor histologies to receive either ulixertinib or the physician's choice of treatment in a 2:1 ratio. Tumors must harbor a specified MEK or atypical BRAF alteration. If a patient progresses on physician's choice of treatment, crossover to the ulixertinib arm is permitted.The specific histologies to be included in this part will be selected based on available data and discussion with the clinical investigators, the medical monitor, and the sponsor. Total enrollment was targeted to approximately 80-100 patients per histology with up to three histologies included; however, the study was terminated prior to any patients enrolling in Part B.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
104
Oral, 600 mg, twice daily, for 28-days in each treatment cycle
Physician's choice will be restricted to two approved (not off-label) treatments for each tumor histology (agents targeting BRAF or MEK kinases and experimental agents are not permitted as physician choice)).
Mayo Clinic
Phoenix, Arizona, United States
Hoag Memorial Hospital Presbyterian
Newport Beach, California, United States
Christiana Care Health Services / Helen F. Graham Cancer Center
Newark, Delaware, United States
Johns Hopkins Sibley Memorial Hospital
Washington D.C., District of Columbia, United States
University of Florida
Gainesville, Florida, United States
Mayo Clinic
Jacksonville, Florida, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Mayo Clinic
Rochester, Minnesota, United States
Metro-Minnesota Community Oncology Research Consortium (MMCORC)
Saint Louis Park, Minnesota, United States
Washington University School of Medicine - Siteman Cancer Center
St Louis, Missouri, United States
...and 12 more locations
Part A: Overall Response Rate (ORR) According to RECIST 1.1
ORR will be defined as the percentage of patients achieving a Best Overall Response (BOR) of confirmed Complete Response (CR) and/or Partial Response (PR). Patients will be evaluated at baseline \& at periodic follow-up visits through the time their participation in the study is complete.The best responses will occur at different time points for each patient.
Time frame: Up to 25 months
Part A: Progression Free Survival (PFS) According to RECIST 1.1
PFS will be defined as time from first day of study drug to disease progression or death. Patients with no event will be censored at the last available tumor assessment. This analysis will be based on investigator assessment.
Time frame: 18 months
Part A: Overall Survival (OS) According to RECIST 1.1
OS will be defined as time from first day of study drug to death. Patients with no event will be censored at the last date the patient is known to be alive.
Time frame: 18 months
Part A: Pharmacokinetic Concentration of BVD-523 at Steady State
Single time point taken prior to taking study drug (trough) at steady state. Steady state is defined as patients who have received at least 5 days, or 10 consecutive doses, of study drug.
Time frame: Single time point drawn at Visit 4/approximately day 15 (or whenever the patient reaches steady state).
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