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Phase 1/2 Trial of S241656 in Selected RAS/MAPK Mutation- Positive Malignancies

Code de protocole Servier: BDTX-4933-101 Sponsor: Institut de Recherches Internationales Servier Identifiant Clinicaltrials.gov: NCT05786924 Numéro de l'essai UE (CTIS): 2025-523474-16-00

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Comment participer à cette étude
Si vous pensez être éligible pour cette étude (voir
critères d'éligibilité
ci-dessous), vous pouvez identifier le site le plus proche de chez vous et le contacter directement. Si vous ne trouvez pas de site près de chez vous, veuillez contacter l'Institut de Recherches Internationales Servier (I.R.I.S.).
Nom: Institut de Recherches Internationales Servier, Département des études cliniques
Numéro de téléphone: +33 1 55 72 60 00
L'étude a 11 centres

Description de l'étude

BDTX-4933-101 is a first-in-human, open-label, Phase 1/2 dose escalation, dose optimization and expansion study designed to evaluate the safety and tolerability of S241656 as monotherapy and in combination with other anti-cancer therapies in participants with selected advanced malignancies. The study population for the Dose Escalation part of the study comprises adults with recurrent advanced/metastatic non-small cell lung cancer (NSCLC), Gastrointestinal (GI) cancers, and other solid tumors harboring KRAS, HRAS, NRAS, BRAF, and/or CRAF (Rapidly Accelerated Fibrosarcoma (RAF1)) mutations or alterations. A dose optimization part in adults with NSCLC may follow the dose escalation phase if the sponsor, in consultation with the safety review committee, decides it is necessary to further characterize the optimal dose. However, the study may also proceed directly to the expansion phase. The study population for the Dose Expansion part of the study comprises adults with advanced/metastatic NSCLC with KRAS and/or BRAF mutations, and with Pancreatic Ductal AdenoCarcinoma (PDAC), ColoRectal Cancer (CRC), and Biliary Tract Cancer (BTC) with KRAS, HRAS, NRAS, BRAF, and/or CRAF (RAF1) mutations and alterations. All patients will self-administer S241656 orally in 28-day cycles until disease progression, toxicity, withdrawal of consent, or termination of the study.
Titre officiel: A Phase 1/2, Open-label Study of Oral S241656 (BDTX-4933) as Monotherapy and in Combination With Other Anti-Cancer Therapies in Patients With KRAS, BRAF and Other Selected RAS/MAPK Mutation-Positive Malignancies
Indications
Non-small Cell Lung Cancer Histiocytic Neoplasm Histiocytosis BRAF Gene Mutation BRAF V600E BRAF V600 Mutation BRAF Mutation-Related Tumors BRAF Metastatic Lung Non-Small Cell Carcinoma Metastatic Lung Cancer Recurrent Lung Cancer Recurrent Lung Non-Small Cell Carcinoma NSCLC Solid Tumor Solid Carcinoma KRAS G12D KRAS G12V KRAS Mutation-Related Tumors NRAS Gene Mutation Thyroid Cancer Thyroid Carcinoma Colorectal Cancer Colorectal Carcinoma Recurrent Histiocytic and Dendritic Cell Neoplasm Brain Metastases Recurrent NSCLC KRAS G13C Acquired Resistance to KRAS G12C Inhibitor KRAS G12A KRAS G12F KRAS G12R KRAS G13D
Interventions / Traitements
  • S241656
  • FOLFOX6/FOLFOX7
  • FOLFIRI
  • Cetuximab
  • Panitumumab
  • Gemcitabine
  • Nab-paclitaxel
Autres numéros d'identification
  • BDTX-4933-101

Critères d'éligibilité

Age éligible pour l’étude

18 ans et plus (Adulte, Adulte plus âgé)

Sexe

Homme/Femme

Accepte les volontaires en bonne santé

Non

  • * Life expectancy of ≥ 12 weeks in the opinion of the investigator.
  • * Histologically or cytologically confirmed recurrent locally advanced (unresectable) or metastatic solid tumors with documented RAS or RAF mutations or alterations.
  • * Adequate bone marrow and organ function.
  • * Recovered from toxicity to prior anti-cancer therapy.
  • Part 1 Dose Escalation cohort ONLY:
  • * Part 1A: Advanced/metastatic NSCLC with KRAS non-G12C, HRAS, NRAS, BRAF or CRAF (RAF1) mutations or alterations
  • * Part 1B: Advanced/metastatic GI tumors (e.g., PDAC, CRC, and BTC) with KRAS, HRAS, NRAS, BRAF, and/or CRAF (RAF1) mutations or alterations
  • * Part 1C: Advanced/metastatic PDAC with KRAS, HRAS, NRAS, BRAF, and/or CRAF (RAF1) mutations or alterations
  • * Part 1D: Colorectal adenocarcinoma with KRAS, HRAS, NRAS, BRAF, and/or CRAF (RAF1) mutations or alterations
  • * Part 1E: Other advanced/metastatic non-GI, non-NSCLC solid tumors with KRAS, HRAS, NRAS, BRAF, CRAF (RAF1) mutations or alterations
  • Part 2 Dose Optimization and Expansion cohorts ONLY:
  • * Part 2A: Advanced/metastatic NSCLC with KRAS non-G12C mutations and/or BRAF mutations
  • * Part 2A1: Advanced/metastatic NSCLC with KRAS non-G12C mutations
  • * Part 2A2: Advanced/metastatic NSCLC with BRAF mutations
  • * Part 2A3: Advanced/metastatic NSCLC with KRAS non-G12C or BRAF mutations or alterations and active CNS metastatic disease
  • * Part 2A4: Advanced/metastatic NSCLC with a KRAS G12C mutation
  • * Part 2B1: Advanced/metastatic PDAC with KRAS, HRAS, NRAS, BRAF, and/or CRAF (RAF1) mutations or alterations
  • * Part 2B2: Advanced/metastatic CRC with KRAS, HRAS, NRAS, BRAF, and/or CRAF (RAF1) mutations or alterations
  • * Part 2B3: Advanced/metastatic BTC (adenocarcinoma) with KRAS, HRAS, NRAS, BRAF, and/or CRAF (RAF1) mutations or alterations

  • * Cancer that has a known MEK1/2 mutation.
  • * Known allergy/hypersensitivity to excipients of S241656 or to any of the registered IMPs administered in combination.
  • * Any contra-indication, to use of any of the combination chemotherapy or anti-EGFR therapy partners administered as part of this trial.
  • * Major surgery within 4 weeks of study entry or planned during study.
  • * Ongoing anticancer therapy.
  • * Ongoing radiation therapy.
  • * Uncontrolled or active clinically relevant bacterial, fungal, or specific viral infection requiring systemic therapy.
  • * Clinically significant cardiovascular disease.
  • * Symptomatic spinal cord compression.
  • * Evidence of active malignancy (other than study-specific malignancies) requiring systemic therapy within the next 2 years.
  • * History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO.
  • * Females who are pregnant or breastfeeding.
  • * Actively receiving systemic treatment or direct medical intervention on another therapeutic clinical study.
  • * Prior use of experimental agents that target the KRAS/BRAF/MEK/ERK pathway.

Comment l'étude est-elle conçue ?

Allocation
Non randomisé
Modèle d'étude interventionnelle
Séquentiel
Groupe de participants / Bras de traitement
Expérimental: Part 1A: Dose Escalation NSCLC
S241656 will be administered as a monotherapy at escalating dose levels until the biologically effective dose (BED) range is determined.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 1B: Dose Escalation GI Tumors
S241656 will be administered as a monotherapy at escalating dose levels until the BED range is determined.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 1C: Dose Escalation PDAC
S241656 will be administered in combination with gemcitabine/nab-paclitaxel at escalating dose levels until the BED range is determined.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Traitement: Gemcitabine
Used as a combination therapy and administered intravenously
Traitement: Nab-paclitaxel
Used as a combination therapy and administered intravenously
Groupe de participants / Bras de traitement
Expérimental: Part 1D: Dose Escalation CRC
S241656 will be administered in combination with FOLFOX6/FOLFOX7 or FOLFIRI, and panitumumab or cetuximab at escalating dose levels until the BED range is determined.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Traitement: FOLFOX6/FOLFOX7
Used as a combination therapy and administered intravenously
Traitement: FOLFIRI
Used as a combination therapy and administered intravenously
Traitement: Cetuximab
Used as a combination therapy and administered intravenously
Traitement: Panitumumab
Used as a combination therapy and administered intravenously
Groupe de participants / Bras de traitement
Expérimental: Part 1E: Dose Escalation Other Solid Tumors
S241656 will be administered as a monotherapy at escalating dose levels until the BED range is determined.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2A: Dose Optimization NSCLC
S241656 will be administered to further characterize the optimal dose.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2A1: Dose Expansion NSCLC with KRAS non-G12C mutations
S241656 will be administered as a monotherapy in the BED range.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2A2: Dose Expansion NSCLC with BRAF mutations
S241656 will be administered as a monotherapy in the BED range.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2A3: Dose Expansion NSCLC with KRAS non-G12C or BRAF mutations/alterations
S241656 will be administered as a monotherapy in the BED range. Participants must also have active CNS metastatic disease
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2A4: Dose Expansion NSCLC with a KRAS G12C mutation
S241656 will be administered as a monotherapy in the BED range. Participants must have received and progressed upon G12C targeted therapy
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2B1: Dose Expansion PDAC
S241656 will be administered as a monotherapy in the BED range.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2B2: Dose Expansion CRC
S241656 will be administered as a monotherapy in the BED range.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2B3: Dose Expansion BTC
S241656 will be administered as a monotherapy in the BED range.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2C1: Dose Expansion PDAC
S241656 will be administered in combination with anti-cancer therapies in the BED range. The combination therapies to be used will be determined in the future.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2D1: Dose Expansion CRC
S241656 will be administered in combination with anti-cancer therapies in the BED range. The combination therapies to be used will be determined in the future.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations
Groupe de participants / Bras de traitement
Expérimental: Part 2F: Exploratory Food Effect
S241656 will be administered as a monotherapy.
Intervention / Traitement
Traitement: S241656
RAF inhibitor targeting all classes of oncogenic BRAF alterations (Classes I, II, and III) and constitutively active CRAF, KRAS or NRAS mutations

Mots clés

Fournis par Servier
BRAF Class I BRAF Class II BRAF Class III KRAS Intolerant histiocytic neoplasm BDTX-4933 Phase 1 dose escalation dose expansion MAPK mitogen-activated protein kinase RAS RAF Upstream oncogenic alterations RAF inhibitor intracranial disease CRAF NRAS RAF fusions
Autres termes
Carcinoma, Non-Small-Cell Lung Histiocytosis Lung Neoplasms Thyroid Neoplasms Colorectal Neoplasms Brain Neoplasms