This is first in human study of DFF332, a small molecule that targets a protein called HIF2α. By acting on HIF2α, DFF332 may be able to stop the growth of certain types of cancer. DFF332 will be tested at different doses as single agent and in combination with Everolimus (RAD001, an mTOR inhibitor), and also in combination with Spartalizumab (PDR001, an anti-PD1) plus Taminadenant (NIR178, an adenosine A2A receptor antagonist), in patients with advanced clear cell renal cell carcinoma and other malignancies with HIF stabilizing mutations.
This is a first in human (FIH), Phase I/Ib, open-label, multi-center study of DFF332 as a single agent and in combination with Everolimus or Spartalizumab plus Taminadenant in patients with advanced clear cell renal cell carcinoma and other malignancies with HIF stabilizing mutations. The study consists of two parts, dose escalation and dose expansion. The dose escalation part of the study will initially evaluate DFF332 single agent. Dose escalation groups receiving DFF332 in combination with Everolimus or DFF332 in combination with Spartalizumab plus Taminadenant will open after at least two dose levels of single agent DFF332 have been evaluated. The dose expansion part of single agent will include two treatment arms: Arm1A will enroll ccRCC patients (age 18 yo or above) and Arm1B will enroll patients with malignancies harboring HIF stabilizing mutations (age 12 yo and above). These include the following: * Malignancies with VHL mutations (e.g. Von Hippel-Lindau disease) * Malignancies with FH mutations (e.g. Hereditary leiomyomatosis and renal cell carcinoma) * Malignancies with mutations in SDHD, SDHAF2, SDHC, SDHB, SDHA (e.g. Hereditary paraganglioma and pheochromocytoma syndrome) * Malignancies with EPAS1/HIF2A mutations * Malignancies with ELOC/TCEB1 mutations The expansion part of the combination therapies will enroll patients with ccRCC and include Arm2A (DFF332 with Everolimus) and Arm3A (DFF332 with Spartalizumab plus Taminadenant). Novartis halted enrollment of study CDFF332A12101 in September 2023 due to business reasons and not due to safety concerns. The DFF332 single agent dose expansion arms and the dose escalation and expansion of the combination arms will not open.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
City of Hope National Medical
Duarte, California, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
WA Uni School Of Med
St Louis, Missouri, United States
Memorial Sloane Ketterin Cancer Ctr
New York, New York, United States
Uni Of TX MD Anderson Cancer Cntr
Houston, Texas, United States
Novartis Investigative Site
Brno, Czechia
Novartis Investigative Site
Villejuif, France
Novartis Investigative Site
Milan, MI, Italy
Novartis Investigative Site
Koto Ku, Tokyo, Japan
Novartis Investigative Site
Singapore, Singapore
...and 1 more locations
Incidence and severity of adverse events (AEs) and serious adverse events (SAEs)
Number of participants with AEs/SAEs to characterize the safety and tolerability of DFF332 as a single agent, in combination with Everolimus (RAD001), and in combination with Spartalizumab (PDR001) plus Taminadenant (NIR178) in patients with advanced clear cell Renal Cell Carcinoma (ccRCC) and advanced malignancies with Hypoxia Inducible Factor (HIF) stabilizing mutations
Time frame: 3 years
Number of participants with dose interruptions and dose reductions
Number of participants with dose interruptions and dose reductions to characterize the tolerability of DFF332 as a single agent, in combination with Everolimus (RAD001), and in combination with Spartalizumab (PDR001) plus Taminadenant (NIR178) in patients with advanced ccRCC and advanced malignancies with HIF stabilizing mutations.
Time frame: 3 years
Dose intensity for DFF332 for dose escalation and expansion
Dose intensity will be computed as the ratio of actual cumulative dose received and actual duration of exposure
Time frame: 3 years
Incidence of Dose Limiting Toxicities (DLTs) in Cycle 1 (28 days) for DFF332 as a single agent and in combinations
Number of participants with DLTs
Time frame: 28 days
Overall Response Rate (ORR)
To assess the anti-tumor activity of DFF332 as single agent and combination in patients with advanced ccRCC and with advanced malignancies with HIF stabilizing mutations based on RECIST v1.1
Time frame: 3 years
Best Overall Response (BOR)
To assess the anti-tumor activity of DFF332 as single agent and combination in patients with advanced ccRCC and with advanced malignancies with HIF stabilizing mutations based on RECIST v1.1
Time frame: 3 years
Progression Free Survival (PFS) for Recommended Dose (RD) only
To assess the anti-tumor activity of DFF332 as single agent and combination in patients with advanced ccRCC and with advanced malignancies with HIF stabilizing mutations based on RECIST v1.1
Time frame: 3 years
Duration of Response (DOR) for Recommended Dose (RD) Only
To assess the anti-tumor activity of DFF332 as single agent and combination in patients with advanced ccRCC and with advanced malignancies with HIF stabilizing mutations based on RECIST v1.1
Time frame: 3 years
Disease Control Rate (DCR)
To assess the anti-tumor activity of DFF332 as single agent and combination in patients with advanced ccRCC and with advanced malignancies with HIF stabilizing mutations based on RECIST v1.1
Time frame: 3 years
Maximum Concentration (Cmax) of DFF332 single agent and combination
PK parameters will be based on plasma concentration of DFF332 and Taminadenant, whole blood concentration of Everolimus, serum concentration of Spartalizumab
Time frame: 3 years
Area under the concentration-time curve (AUC) of DFF332 single agent and combination
PK parameters will be based on plasma concentration of DFF332 single agent and in combination.
Time frame: 3 years
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