This phase I trial tests the safety, side effects and best dose of peposertib (M3814) in combination with tuvusertib (M1774) in treating patients with solid tumors that have spread to other places in the body (advanced). Peposertib and tuvusertib stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
PRIMARY OBJECTIVES: I. To determine the safety and tolerability of peposertib (M3814) in combination with tuvusertib (M1774). (DOSE ESCALATION AND EXPANSION COHORT) II. To determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of the combination of peposertib (M3814) and tuvusertib (M1774). (DOSE ESCALATION COHORT) SECONDARY OBJECTIVES: I. To observe and record anti-tumor activity. II. To determine the pharmacokinetic (PK) profiles of peposertib (M3814) and tuvusertib (M1774) when administered in combination. EXPLORATORY OBJECTIVES: I. To explore correlations between pharmacodynamic (PD) and predictive biomarkers (gammaH2AX, phospho-KAP1 and phospho-RPA) with clinical outcomes. II. To explore correlations between baseline genomic alterations of ataxia-telangiectasia mutated (ATM) or markers of replicative stress, ATM expression by immunohistochemistry (IHC), RAD5' foci formation with clinical outcomes. III. To determine metrics of anticancer activity including the objective response rate (ORR) and progression-free survival (PFS). OUTLINE: This a dose-escalation study of peposertib and tuvusertib, followed by a dose-expansion study. Patients receive peposertib orally (PO) once (QD) or twice (BID) daily on days 2-14 of cycle 1 and days 1-14 of subsequent cycles in combination with tuvusertib PO QD daily on days 1-14 of each cycle. Cycles repeat every 28 days in the absence of disease progression, pregnancy, non-compliance, unacceptable toxicity, termination of the study or the study drug is no longer available. Patients also undergo tumor biopsy, blood sample collection, positron emission tomography (PET), computed tomography (CT), and magnetic resonance imaging (MRI) throughout the study. After completion of study treatment, patients are followed up for 30 days after removal from treatment or until initiating a new anticancer therapy or until death, whichever occurs first.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
66
Undergo tissue biopsy
Undergo blood sample collection
Undergo CT
Undergo MRI
Given PO
Undergo PET
Given PO
National Cancer Institute Developmental Therapeutics Clinic
Bethesda, Maryland, United States
RECRUITINGNational Institutes of Health Clinical Center
Bethesda, Maryland, United States
ACTIVE_NOT_RECRUITINGMassachusetts General Hospital Cancer Center
Boston, Massachusetts, United States
RECRUITINGDana-Farber Cancer Institute
Boston, Massachusetts, United States
RECRUITINGNYU Langone Hospital - Long Island
Mineola, New York, United States
RECRUITINGLaura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, United States
RECRUITINGOhio State University Comprehensive Cancer Center
Columbus, Ohio, United States
RECRUITINGIncidence of dose limiting toxicity
Time frame: Up to 28 days
Incidence of adverse events
Descriptive statistics will be used for safety in the Phase 1b escalation study. Patients will be included in this analysis if they receive at least one dose of any study treatment. For toxicity reporting, all adverse events will be graded and analyzed using Common Terminology Criteria for Adverse Events (CTCAE). Type of adverse events, intensity (grading), and attribution will be provided in a listing. All adverse events resulting in discontinuation, dose modification, and/or dosing interruption, and/or treatment delay of drug will also be summarized. Laboratory test results will be classified according to CTCAE.
Time frame: Up to week 12
Pharmacokinetic (PK) analysis
Peposertib (M3814) and tuvusertib (M1774) concentrations in these samples will be quantitatively measured using a liquid chromatography/tandem mass spectrometric method. The individual PK parameters will be derived: maximum concentration (Cmax), time to maximum concentration (Tmax), are under the curve (AUC), half life (T1/2), apparent oral clearance (Cl/F), and apparent volume of distribution in steady state (Vss/F) using non-compartmental methods with the software WinNonlin, as feasible. Advanced population PK methods may be employed to assess the link between drug exposure and biological effects and efficacy. The PK variables will be tabulated and descriptive statistics (e.g., geometric means and coefficients of variation) calculated for each dose level. PK parameters (e.g., T1/2, Cmax, Cl, and AUC) will be compared across dose level using nonparametric statistical testing techniques.
Time frame: Pre, 0.5, 1, 1.5, 2, 3, 4, 6, 8, and 24 hour (h) post dose on cycle (C)1 day (D)1, pre, 0.5, 1, 1.5, 2, 3, 4, 6, and 8 h post dose on C1D10 (dose-escalation); pre, 0.5, 1,1.5, 2, and 3 h post dose on C1D1 and C1D10 (dose-expansion)
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