This is a Phase 1, FIH, Dose Escalation and Dose Expansion study to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) effects, and preliminary antitumor activity of IK-595, a MEK/RAF molecular glue, administered orally as monotherapy in patients with advanced solid tumors with gene alterations in the RAS- MAPK pathway for whom there are no further treatment options known to confer clinical benefit.
This is a Phase 1, FiH clinical study to evaluate the safety, tolerability, PK and pharmacodynamic effects, and preliminary anti-tumor activity of IK-595, a dual mitogen-activated protein kinase kinase (MEK)/ RAF kinase inhibitor, administered orally (PO) as monotherapy in patients with advanced solid tumors with gene alterations in the RAS- MAPK pathway for whom there are no further treatment options known to confer clinical benefit. The study consists of an initial Dose Escalation phase using a Bayesian Optimal Interval (BOIN) design, followed by a Dose Expansion phase in 4 genetically/molecularly defined cohorts using 2-stage adaptive design. During the Dose Escalation phase, backfilling may occur, where ≥ 3 additional patients can be enrolled at a given dose level once that dose level is deemed safe and tolerable by the Safety Review Committee. Backfilling includes, but is not limited to, patients with the following diagnoses: neuroblastoma RAS viral oncogene homolog-mutant (NRASmut) colorectal carcinoma (CRC), NRASmut malignant melanoma , Kirsten rat sarcoma viral oncogene homolog-mutant (KRASmut) CRC, KRASmut pancreatic cancer, KRASmut non-small cell lung cancer(NSCLC), B-Raf proto-oncogene, serine/threonine kinase-mutant (BRAFmut) Class II/III or BRAF fusion positive solid tumors, and Raf-1 proto-oncogene, serine/threonine kinase-mutant (CRAFmut) or fusion positive solid tumors. Various dose levels and schedules will be explored.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
75
Oral tablet administered in 28-day or 30-day cycles until treatment discontinuation criteria are met.
City of Hope
Duarte, California, United States
University of California Irvine
Orange, California, United States
Sarah Cannon Research Institute at HealthOne
Denver, Colorado, United States
Johns Hopkins University of Medicine Sidney Kimmel Comprehensive Care Center
Washington D.C., District of Columbia, United States
University of Miami
Miami, Florida, United States
University of Chicago
Chicago, Illinois, United States
START Midwest
Grand Rapids, Michigan, United States
Washington University School of Medicine
St Louis, Missouri, United States
Thomas Jefferson University
Philadelphia, Pennsylvania, United States
University of Pittsburgh Medical Center- Hillman Cancer Center
Pittsburgh, Pennsylvania, United States
...and 5 more locations
Treatment-emergent adverse events, including treatment-related adverse events, and serious adverse events
• Frequency and severity of treatment-emergent adverse events, including treatment-related adverse events, and serious adverse events
Time frame: From treatment initiation through study completion, average of 36 months
Dose Limiting Toxicities
Number of patients with dose-limiting toxicities (Dose Escalation only)
Time frame: The first 30 days of treatment for each patient during Dose Escalation
Treatment-Emergent Adverse Events
Number and percentage of patients with ≥ 1 treatment-emergent adverse events leading to dose modifications and treatment discontinuation
Time frame: From treatment initiation through study completion, average of 36 months
Recommended Phase 2 Dose (RP2D) and/or maximum tolerated dose (MTD) of IK-595
Selection of dose level to take proceed with in Dose Expansion and/or Phase 2
Time frame: From treatment initiation through dose escalation, approximately 1 year
Pharmacokinetics of IK-595: half-life (t1/2)
half-life (t1/2)
Time frame: From treatment initiation through dose escalation, approximately 1 year
Pharmacokinetics of IK-595: Area Under the Curve (AUC)
AUC
Time frame: Approximately 1 year
Pharmacokinetics of IK-595: Maximum Plasma Concentration (Cmax)
Cmax
Time frame: Approximately 1 year
Pharmacokinetics of IK-595: Minimum Plasma Concentration (Cmin)
Cmin
Time frame: Approximately 1 year
To evaluate pERK fold change from baseline in paired tumor biopsies
To evaluate the pharmacodynamic effects of IK-595 on the levels of phosphorylated extracellular signal-regulated kinase (pERK) in paired tumor biopsies
Time frame: Through study completion, average of 36 months
Antitumor activity per RECIST 1.1: Disease control rate (DCR) of IK-595 as a single agent
Complete Response \[CR\] + Partial Response \[PR\] + stable disease ≥ 16 weeks
Time frame: Through study completion, average of 36 months
Antitumor activity per RECIST 1.1: Time to response (TTR) of IK-595 as a single agent
TTR
Time frame: Through study completion, average of 36 months
Antitumor activity per RECIST 1.1: Duration of response (DOR) of IK-595 as a single agent
DOR
Time frame: Through study completion, average of 36 months
Antitumor activity per RECIST 1.1: Objective response rate (ORR) of IK-595 as a single agent
ORR
Time frame: Through study completion, average of 36 months
Antitumor activity: Median progression-free survival (PFS) of IK-595 as a single agent
PFS
Time frame: Through study completion, average of 36 months
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