This is a Phase 1a/b, multicenter, open-label, dose escalation (1a) and dose expansion (1b) study. The purpose of this study is to measure safety, tolerability, and preliminary efficacy with the combination of tipifarnib with osimertinib in patients with advanced/metastatic EGFR-mutated non-small cell lung cancer.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Oral administration
Oral administration
Providence Medical Group
Santa Rosa, California, United States
The Valley Hospital
Ridgewood, New Jersey, United States
For Dose Escalation determine a safe and tolerable Phase 2 dose of tipifarnib when used in combination with osimertinib
Occurrence of DLTs during first treatment cycle
Time frame: At the end of Cycle 1 (each cycle is 28 days)
For Dose Escalation characterize the safety of the combination DLTs will be listed for patients who complete the evaluation period for DLT
Descriptive statistics of adverse events per NCI Common Terminology Criteria for Adverse Events (CTCAE v5.0)
Time frame: DLTs will be evaluated at the end of cycle 1 (28 days), but also through study completion, an average of 1.5 years
For Dose Expansion characterize the safety profile of tipifarnib in combination with osimertinib as per NCI CTCAE v5.0 using descriptive statistics of adverse events
Descriptive statistics of adverse events per the NCI CTCAE v5.0
Time frame: Through study completion, an average of 2 years
For Dose Expansion characterize the safety profile of tipifarnib in combination with osimertinib as per NCI CTCAE v5.0 using the percentage of patients who discontinue the combination for related adverse events
Percentage of patients who discontinue the combination for tipifarnib and/or osimertinib related adverse events prior to completing 6 cycles of treatment
Time frame: First 6 cycles of treatment (28 day treatment cycle)
To evaluate the efficacy of tipifarnib in combination with osimertinib
Objective Response Rate (ORR), measures evaluated according to RECIST v.1.1 assessed by investigator
Time frame: Assessed every 8 weeks for the first year and every 12 weeks thereafter up to end of study at approximately 2 years
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To evaluate the efficacy of tipifarnib in combination with osimertinib
Duration of Response (DOR) assessed from (CR) or (PR) until (PD), initiation of new anticancer treatment or study withdrawal
Time frame: Assessed every 8 weeks for the first year and every 12 weeks thereafter up to end of study at approximately 2 years
To evaluate the efficacy of tipifarnib in combination with osimertinib
Progression-free survival (PFS) measures evaluated according to RECIST v.1.1 assessed by investigator
Time frame: Assessed every 8 weeks for the first year and every 12 weeks thereafter up to end of study at approximately 2 years
To study pharmacokinetics (PK) of tipifarnib and osimertinib in combination
Area under the concentration-time curve (AUC) from time 0 to time of last concentration measured and from time 0 extrapolated to infinity
Time frame: Cycles 1-6 (28 day treatment cycle)
To study pharmacokinetics (PK) of tipifarnib and osimertinib in combination
Maximum plasma concentration
Time frame: Cycles 1-6 (28 day treatment cycle)
To study pharmacokinetics (PK) of tipifarnib and osimertinib in combination
Time to maximum observed concentration
Time frame: Cycles 1-6 (28 day treatment cycle)
To study pharmacokinetics (PK) of tipifarnib and osimertinib in combination
Terminal elimination rate constant
Time frame: Cycles 1-6 (28 day treatment cycle)
To study pharmacokinetics (PK) of tipifarnib and osimertinib in combination
Terminal half-life
Time frame: Cycles 1-6 (28 day treatment cycle)
To study pharmacokinetics (PK) of tipifarnib and osimertinib in combination
Apparent clearance and apparent volume of distribution
Time frame: Cycles 1-6 (28 day treatment cycle)
To evaluate circulating tumor DNA (ctDNA) as an indicator or response in both ctDNA positive and negative patients by changes in genetic alterations
Determine prevalence of tumor-derived genetic alterations of ctDNA collected at baseline, on-treatment and at disease progression
Time frame: Monthly for duration of trial participation (an average of 2 years)
To evaluate circulating tumor DNA (ctDNA) clearance rates for patients positive at baseline
Clearance rates for patients who are ctDNA positive at baseline
Time frame: Monthly for duration of trial participation (an average of 2 years)
To evaluate circulating tumor DNA (ctDNA) time to detection changes associated with disease progression
Time to detection of ctDNA changes associated with disease progression
Time frame: Monthly for duration of trial participation (an average of 2 years)