This study will assess the safety, efficacy, and pharmacokinetics of THE-630 in participants with advanced gastrointestinal stromal tumors (GIST).
The drug being tested in this study is called THE-630, an orally administered KIT tyrosine kinase inhibitor. The study will be conducted in two parts: a dose escalation phase, followed by an expansion phase. The patient population of the initial dose escalation phase (Phase 1) of the trial will include patients with unresectable or metastatic GIST. Patients must have disease progression on or be intolerant to imatinib therapy and have also received at least 1 of the following: sunitinib, regorafenib, ripretinib, or avapritinib. The primary objective of the dose escalation phase is to determine the safety profile of oral THE-630, including the dose limiting toxicities (DLTs), maximum tolerated dose (MTD), and the recommended Phase 2 dose (RP2D). Once a recommended dose has been determined in the escalation phase, the expansion phase (Phase 2) will enroll 3 cohorts of patients with unresectable or metastatic GIST defined by prior therapy: * Cohort 1: Patients with unresectable or metastatic GIST who have progressed on or are intolerant to imatinib, sunitinib, regorafenib and ripretinib (≥5th Line). * Cohort 2: Patients with unresectable or metastatic GIST who have progressed on or are intolerant to imatinib, sunitinib and 0-1 additional lines of therapy in the advanced/metastatic setting (3rd-4th Line). * Cohort 3: Patients with unresectable or metastatic GIST who have progressed on or are intolerant to imatinib (including in the adjuvant setting) and who have not received additional systemic therapy for advanced GIST (2nd Line). The safety and tolerability of orally administered THE-630 will continue to be assessed in the expansion cohorts. However, the primary objective of the expansion component of the trial is to evaluate the anti-tumor activity of THE-630 in these GIST patient populations.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Oral THE-630 administered once daily in a continuous regimen
HonorHealth Research Institute
Scottsdale, Arizona, United States
Mayo Clinic Florida
Jacksonville, Florida, United States
University of Miami Sylvester Comprehensive Cancer Center
Miami, Florida, United States
Dana Farber Cancer Institute
Boston, Massachusetts, United States
Memorial Sloan Kettering Cancer Center
New York, New York, United States
Oregon Health & Science University
Portland, Oregon, United States
Fox Chase Cancer Center
Philadelphia, Pennsylvania, United States
Dose Escalation (Phase 1): Safety Analysis - Number of Participants With Treatment-emergent Adverse Events (TEAEs) as Assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Safety Analysis - Number of Participants With Dose-limiting Toxicities (DLTs) Following Oral Administration of THE-630
Time frame: 28 days
Dose Escalation (Phase 1): Safety Analysis - Maximum Tolerated Dose (MTD) of Orally Administered THE-630
The MTD is defined as the highest dose at which ≤1 of 6 DLT-assessment eligible patients experience a DLT within the first 28 days of treatment (end of Cycle 1).
Time frame: 28 days
Dose Escalation (Phase 1): Recommended Phase 2 Dose (RP2D) of Orally Administered THE-630
The RP2D was expected to be equal to the MTD or less than the MTD, if aspects of tolerability or efficacy not encompassed by the MTD determination suggested utilizing a lower dose.
Time frame: 28 days
Expansion (Phase 2): Efficacy Assessment - For Each Expansion Phase Cohort (Cohorts 1, 2, and 3), Confirmed Objective Response Rate (ORR), According to Modified Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Plasma Pharmacokinetic (PK) Parameters of THE-630 and Its Active Metabolite - Cmax (Maximum Observed Concentration)
Cmax of THE-630 and its active metabolite after single oral dose and at steady state after multiple oral doses
Time frame: Cycle 1 Day 1 and Cycle 1 Day 15 (each cycle is 28 days)
Dose Escalation (Phase 1): Plasma PK Parameters of THE-630 and Its Active Metabolite - Tmax (Time of First Occurrence of Cmax)
Tmax of THE-630 and its active metabolite after single oral dose and at steady state after multiple oral doses
Time frame: Cycle 1 Day 1 and Cycle 1 Day 15 (each cycle is 28 days)
Dose Escalation (Phase 1): Plasma PK Parameters of THE-630 and Its Active Metabolite - AUC 0-24 (Area Under the Concentration-time Curve From Time Zero to 24 Hours)
AUC 0-24 of THE-630 and its active metabolite after single oral dose and at steady state after multiple oral doses
Time frame: Cycle 1 Day 1 and Cycle 1 Day 15 (each cycle is 28 days)
Dose Escalation (Phase 1): Plasma PK Parameters of THE-630 and Its Active Metabolite - AUC 0-t (Area Under the Concentration-time Curve From Time Zero to Time t)
AUC 0-t of THE-630 and its active metabolite after single oral dose and at steady state after multiple oral doses
Time frame: Cycle 1 Day 1 and Cycle 1 Day 15 (each cycle is 28 days)
Dose Escalation (Phase 1): Efficacy Assessment - Confirmed ORR, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Efficacy Assessment - Best Overall Response, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Efficacy Assessment - Best Target Lesion Response, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Efficacy Assessment - Time to Response, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Efficacy Assessment - Duration of Response (DOR), According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Efficacy Assessment - Disease Control Rate (DCR), According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Efficacy Assessment - Clinical Benefit Rate (CBR) at 16 Weeks, According to Modified RECIST 1.1
Time frame: 16 weeks
Dose Escalation (Phase 1): Efficacy Assessment - Progression Free Survival (PFS), According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Dose Escalation (Phase 1): Efficacy Assessment - Overall Survival (OS)
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Efficacy Assessment - Best Overall Response, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Efficacy Assessment - Best Target Lesion Response, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Efficacy Assessment - Time to Response, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Efficacy Assessment - DOR, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Efficacy Assessment - DCR, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Efficacy Assessment - CBR at 16 Weeks, According to Modified RECIST 1.1
Time frame: 16 weeks
Expansion (Phase 2): Efficacy Assessment - PFS, According to Modified RECIST 1.1
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Efficacy Assessment - OS
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Safety Analysis - Number of Participants With Treatment-emergent Adverse Events as Assessed by NCI CTCAE v5.0
Time frame: Up to 24 months after first dose
Expansion (Phase 2): Plasma PK Parameters of THE-630 and Its Active Metabolite - Cmax (Maximum Observed Concentration)
Cmax of THE-630 and its active metabolite after single oral dose and at steady state after multiple oral doses
Time frame: Cycle 1 Day 1 and Cycle 1 Day 15 (each cycle is 28 days)
Expansion (Phase 2): Plasma PK Parameters of THE-630 and Its Active Metabolite - Tmax (Time of First Occurrence of Cmax)
Tmax of THE-630 and its active metabolite after single oral dose and at steady state after multiple oral doses
Time frame: Cycle 1 Day 1 and Cycle 1 Day 15 (each cycle is 28 days)
Expansion (Phase 2): Plasma PK Parameters of THE-630 and Its Active Metabolite - AUC 0-24 (Area Under the Concentration-time Curve From Time Zero to 24 Hours)
AUC 0-24 of THE-630 and its active metabolite after single oral dose and at steady state after multiple oral doses
Time frame: Cycle 1 Day 1 and Cycle 1 Day 15 (each cycle is 28 days)
Expansion (Phase 2): Plasma PK Parameters of THE-630 and Its Active Metabolite - AUC 0-t (Area Under the Concentration-time Curve From Time Zero to Time t)
AUC 0-t of THE-630 and its active metabolite after single oral dose and at steady state after multiple oral doses
Time frame: Cycle 1 Day 1 and Cycle 1 Day 15 (each cycle is 28 days)
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