This is a Phase I/Ib study in which the safety of the combination therapy of RMC-4630 and LY3214996 in the treatment of KRAS mutant cancers will be studied.
This is a phase I / Ib study in which the safety of the combination therapy of RMC-4630 and LY3214996 in the treatment of KRAS mutant cancers colorectal cancer (CRC), non-small cell lung cancer (NSCLC) and pancreatic ductal adenocarcinoma will be studied. The phase I dose-escalation study is designed to identify the recommended phase 2 dose (RP2D) of the combination regimen of RMC-4630 (SHP2-inhibitor) plus LY3214996 (ERK-inhibitor) in patients with KRASm CRC, NSCLC or PDAC. The phase Ib expansion cohort is designed to further characterize the safety of the selected dose from the first stage of the study and to explore the clinical activity of RMC-4630 in combination with LY3214996 in patients with metastatic KRASm PDAC.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Netherlands Cancer Institute - Antoni van Leeuwenhoek
Amsterdam, North Holland, Netherlands
Phase I - Maximum tolerated dose (MTD)
Maximum Tolerated Dose (MTD) of the combination of RMC-4630 and LY3214996. Dose escalation will follow 3+3 design. The CTCAE criteria will be used to determine if adverse events and lab abnormalities will be accounted as dose limiting toxicity (DLT)
Time frame: Through study completion, an average of 2 year
Phase Ib - Clinical activity of the RMC-4630 and LY3214996 combination in patients with KRASm PDAC
Response and progression evaluated using internationally accepted response criteria and definitions proposed by the RECIST criteria
Time frame: Tumor assessed every 8 weeks through study completion, with an expected average of 4 treatment cycles (each cycle is 28 days)
Observed plasma concentrations of RMC-4630 and LY3214996
Blood samples are obtained and plasma concentrations of RMC-4630 and LY3214996 are measured using a validated LC-MS/MS method.
Time frame: Prior to initial dose on day 1, day 8, day 15, day 22 and 0.5, 1, 2, 4, 8, 24 hours post dose on day 1 and day 15.
Area under de plasma - time concentration curve of RMC-4630 and LY3214996
Blood samples are obtained and plasma concentrations of RMC-4630 and LY3214996 are measured using a validated LC-MS/MS method.
Time frame: Prior to initial dose on day 1, day 15, and 0.5, 1, 2, 4, 8, 24 hours post dose.
Elimination half-life of RMC-4630 and LY3214996 (T1/2)
Blood samples are obtained and plasma concentrations of RMC-4630 and LY3214996 are measured using a validated LC-MS/MS method.
Time frame: Prior to initial dose on day 1, day 15, and 0.5, 1, 2, 4, 8, 24 hours post dose.
Total body clearance of RMC-4630 and LY3214996
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Blood samples are obtained and plasma concentrations of RMC-4630 and LY3214996 are measured using a validated LC-MS/MS method.
Time frame: Prior to initial dose on day 1, day 15, and 0.5, 1, 2, 4, 8, 24 hours post dose.
Volume of distribution of RMC-4630 and LY3214996
Blood samples are obtained and plasma concentrations of RMC-4630 and LY3214996 are measured using a validated LC-MS/MS method.
Time frame: Prior to initial dose on day 1, day 15, and 0.5, 1, 2, 4, 8, 24 hours post dose.
Baseline molecular status of potential predictive markers of tumor response
Baseline molecular status of potential predictive markers of tumor response wil be studied in tumor biopsies taken before treatment, during treatment and (optional) after treatment using the Ampliseq SOCV1panel
Time frame: Before start of treatment, during treatment and (optional) after treatment discontinuation with RMC-4630 and LY3214996 with an expected average of 4 treatment cycles (each cycle is 28 days)
Pharmacodynamic biomarkers of RMC-4630 and LY3214996
To evaluate pharmacodynamic (PD) biomarkers of the RMC-4630- LY3214996 combination, the expression levels of relevant down-stream proteins are measured in tumor biopsies, using the Ampliseq SOCV1panel. Markers to be assessed include molecular status (mutation/amplification/expression) of markers related to the RAF/MEK/ERK and PI3K/AKT pathway (e.g. BRAF, HRAS, NRAS, KRAS, PIK3CA, PTEN, pS6-RP, c-MET, EGFR, HER-3, pERK, pAKT, pEGFR, and pRSK).
Time frame: Before start of treatment, during treatment and (optional) after treatment discontinuation with RMC-4630 and LY3214996 with an expected average of 4 treatment cycles (each cycle is 28 days)
Potential mechanism of resistance
Potential mechanisms of are studied in tumor biopsies taken before treatment, during treatment and (optional) after treatment using the Ampliseq SOCV1panel
Time frame: Before start of treatment, during treatment and (optional) after treatment discontinuation with RMC-4630 and LY3214996 with an expected average of 4 treatment cycles (each cycle is 28 days)