This study is conducted sequentially in 3 parts. The primary objective for Part 1 is to determine the maximum tolerated dose of DES-1357 in participants with confirmed dMMR/MSI-H colorectal cancer (CRC). The primary objective for Part 2 is to assess the chronic tolerability and to identify the recommended Phase 2 dose (RP2D), to evaluate preliminary antitumor activity of the selected dose level of DES-1357, and to assess the pharmacokinetics (PK) and pharmacodynamics of DES-1357. The primary objective for Part 3 is to evaluate antitumor activity of the selected dose level of DES-1357.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
88
DES-1357 oral capsules.
Part 1: Number of Participants With Dose-Limiting Toxicities (DLTs)
A DLT is a toxicity that occurs during cycle 1 that meets the protocol-defined DLT criteria and is graded according to National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 6.0
Time frame: Part 1: Cycle 1 (Cycle length=21 days)
Part 2: Incidence and Severity of Treatment- related Treatment Emergent Adverse Events (TEAEs) Through at least 3 Cycles of DES-1357
A TEAE is defined as an AE with onset dates on or after the start of the study treatment or AEs that started prior to the start of the study treatment but worsened in severity after start of the study treatment.
Time frame: Part 2: From the first dose of DES-1357 through at least 3 treatment cycles (Cycle length=21days)
Part 2: Best Overall Response (BOR)
Best overall response is defined as the single best patient level response category (Complete Response \[CR\], Partial Response \[PR\], Stable Disease \[SD\], Progressive disease \[PD\], or Not Evaluable \[NE\]) per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Time frame: Part 2: From baseline through disease progression or end of treatment (EOT); tumor assessments every 8 weeks and at the EOT visit; assessed up to approximately 11 months
Part 2: Maximum Observed Concentration (Cmax) of DES-1357
Time frame: Part 2: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 2: Time to Maximum Concentration (Tmax) of DES-1357
Time frame: Part 2: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 2: Area Under the Curve (AUC) of DES-1357
Time frame: Part 2: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 2: Half Life (t1/2) of DES-1357
Time frame: Part 2: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 2: Clearance (CL) of DES-1357
Time frame: Part 2: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 2: Volume of Distribution (Vd) of DES-1357
Time frame: Part 2: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 2: Change in Pharmacodynamic Markers Levels Following Treatment With DES-1357
Blood and tumor tissue samples will be collected for pharmacodynamic assessments. Biomarker evaluations may include circulating tumor Deoxyribonucleic Acid (ctDNA), carcinoembryonic antigen (CEA), Werner Syndrome Helicase (WRN) expression, phospho-H2AX expression, and other exploratory molecular analyses performed using immunohistochemistry and Ribonucleic Acid (RNA) sequencing methods.
Time frame: Part 2: Blood Samples: At Day 1 (pre-dose) of Cycles 1, 2, 3, 5, 7, and 9; Tumor tissue: At Screening and Cycle 1 Day 15 (±3 days, pre-dose) (Cycle length=21days)
Part 3: Objective Response Rate (ORR) by Independent Review Committee (IRC)
ORR is defined as the percentage of participants with a confirmed objective response (CR or PR) as determined per RECIST Version 1.1.
Time frame: Part 3: From baseline through EOT; tumor assessments every 8 weeks and at the EOT visit; assessed up to approximately 8 months
Part 1: Number of Participants With Treatment-related Adverse Events (AEs) Including TEAEs and Serious AEs
Participants with treatment related AEs, TEAEs and SAEs will be reported, plus treatment-related delays, dose reductions, and/or treatment discontinuations.
Time frame: Part 1: From the first dose of DES-1357 through 30 days after the last dose (Cycle length=21 days)]
Part 2: ORR According to RECIST Version 1.1
ORR is defined as the percentage of participants with a confirmed objective response (CR or PR) as determined per RECIST Version 1.1.
Time frame: Part 2: From baseline through EOT; tumor assessments every 8 weeks and at the EOT visit; assessed up to approximately 11 months
Part 2 and Part 3: Disease Control Rate (DCR) According to RECIST Version 1.1
DCR is defined as the percentage of participants who achieve best response of CR, PR, or SD per RECIST version 1.1.
Time frame: Part 2 and Part 3: From baseline through EOT; tumor assessments every 8 weeks and at the EOT visit; assessed up to approximately 11 months
Part 3: Duration of Response (DOR) According to RECIST Version 1.1
DOR is defined as the time from the first objective response (CR or PR) to the first documented PD per RECIST version 1.1 or death.
Time frame: Part 3: From first documented objective response until first documented PD or death; assessed up to approximately 8 months
Part 1 and Part 3: Maximum Observed Concentration (Cmax) of DES-1357
Time frame: Part 1 and Part 3: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 1 and Part 3: Time to Maximum Concentration (Tmax) of DES-1357
Time frame: Part 1 and Part 3: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Part 1 and Part 3: Area Under the Curve (AUC) of DES-1357
Time frame: Part 1 and Part 3: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 1 and Part 3: Half Life (t1/2) of DES-1357
Time frame: Part 1 and Part 3: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 1 and Part 3: Clearance (CL) of DES-1357
Time frame: Part 1 and Part 3: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 1 and Part 3: Volume of Distribution (Vd) of DES-1357
Time frame: Part 1 and Part 3: Cycle 1 Day 1: predose, 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours postdose; Cycle 1 Day 15: predose, 1, 2, 4, 8, 12 and 24 hours postdose; Cycle 1 Days 3, 5, and 21: at predose (Cycle length=21 days)
Part 1 and Part 3: Change in Pharmacodynamic Markers Level of DES-1357
Blood and tumor tissue samples will be collected for pharmacodynamic assessments. Biomarker evaluations may include ctDNA, CEA, WRN expression, phospho-H2AX expression, and other exploratory molecular analyses performed using immunohistochemistry and RNA sequencing methods.
Time frame: Part 1 and Part 3: Blood Samples: At Day 1 (pre-dose) of Cycles 1, 2, 3, 5, 7, and 9; Tumor tissue: At Screening and Cycle 1 Day 15 (±3 days, pre-dose) (Cycle length=21days)
Part 2: ORR by an IRC According to RECIST Version 1.1
Part 2: ORR is defined as the percentage of participants with a confirmed objective response (CR or PR) as determined per RECIST Version 1.1.
Time frame: Part 2: From baseline through EOT; tumor assessments every 8 weeks and at the EOT visit; assessed up to approximately 11 months
Part 2: DCR by an IRC According to RECIST Version 1.1
Part 2: DCR is defined as the percentage of participants who achieve best response of CR, PR, or SD per RECIST version 1.1.
Time frame: Part 2: From baseline through EOT; tumor assessments every 8 weeks and at the EOT; assessed up to approximately 11 months
Part 2 and Part 3: Characterization of Biomarker Profiles Following Treatment With DES-1357
Blood and tumor tissue samples will be collected for biomarker analyses. Biomarker assessments may include Deoxyribonucleic Acid (DNA) damage/replication stress markers, ctDNA, WRN expression, and other relevant molecular biomarkers.
Time frame: Part 2 and Part 3: Blood Samples: At Day 1 (pre-dose) of Cycles 1, 2, 3, 5, 7, and 9; Tumor tissue: At Screening and Cycle 1 Day 15 (±3 days, pre-dose) (Cycle length=21days)
Part 3: European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ C30) Questionnaire
Quality-of-life will be assessed through a participant-reported outcome using EORTC QLQ C30
Time frame: Part 3: Screening, and at Cycle 1 Days 1, 8, 15, 21 and at Day 21 for subsequent cycles up to 37 days after last dose of DES-1357 (Cycle length=21days)
Part 3: Progression-Free Survival (PFS)
PFS is defined as the time from the first dose of DES-1357 to the earlier of the date of the first documented disease progression (per RECIST version 1.1) or death due to any cause.
Time frame: Part 3: From first dose of DES-1357 up to first documented disease progression or death; assessed for up to approximately 8 months
Part 3: Overall Survival (OS)
OS is defined as the time from the date of the first dose of study treatment to the date of death due to any cause.
Time frame: Part 3: From first dose of DES-1357 to date of death due to any cause; assessed for up to approximately 8 months