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A Study of AMG 193 in Participants With Advanced MTAP-null Solid Tumors (MTAPESTRY 101)

Phase 1
Recruiting
Conditions
Advanced MTAP-null Solid Tumors
Interventions
Drug: Comparator AMG 193 Test Tablet
Registration Number
NCT05094336
Lead Sponsor
Amgen
Brief Summary

The primary objective of Parts 1 and 2 of this study is to evaluate the safety, tolerability, and to determine the maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D) of AMG 193 alone and in combination with docetaxel in adult participants with metastatic or locally advanced methylthioadenosine phosphorylase (MTAP)-null solid tumors.

The primary objective of Part 3 of this study is to evaluate the efficacy of AMG 193 in adult participants with metastatic or locally advanced MTAP-null solid tumors.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
649
Inclusion Criteria
  • Participant has provided informed consent/assent before initiation of any study specific activities/procedures.
  • Age ≥ 18 years.
  • Evidence of homozygous loss of cyclin dependent kinase inhibitor 2A (CDKN2A) (null) (Parts 1a, 1j, 1k, and 2a only) and/or methylthioadenosine phosphorylase (MTAP) (null) in the tumor tissue or blood (Parts 1a to 1k, Parts 2a and 2b) or lost MTAP expression in the tumor tissue (Parts 1a to 1k, Parts 2a and 2b).
  • Histologically confirmed metastatic or locally advanced solid tumor not amenable to curative treatment with surgery and/or radiation.
  • Able to swallow and retain orally (PO) administered study treatment and willing to record daily adherence to investigational product.
  • Disease measurable as defined by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1). Note: except participants enrolling to Part 1m.

Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.

  • Adequate hematopoietic function per local laboratory
  • Adequate renal function per local laboratory
  • Adequate glucose control per local laboratory (Part 1 only)
  • Adequate liver function per local laboratory
  • Adequate coagulation parameters
  • Adequate pulmonary function
  • Adequate cardiac function
  • Minimum life expectancy of 12 weeks as per investigator judgement.
  • Archived tumor tissue (formalin-fixed, paraffin-embedded [FFPE] sample collected within 5 years) or an archival block must be available.
  • For Part 1f (MTAP-null or lost MTAP expression HNSCC): Must be willing to undergo tumor biopsy.
  • For Part 1a: Must be willing to undergo tumor biopsy, before start of treatment (archival sample acceptable if obtained with 6 months of enrollment and subject has not received any other treatment since sample was obtained) and while on treatment.
  • For DSPS study (Part 1j): Must be willing to participate in DSPS substudy (US sites only).

Food Effect Substudy (Part 1k): Specific Inclusion Criteria

  • Subject able and willing to eat a standardized high-fat, high-caloric meal
  • Subject able and willing to fast for ≥ 6 hours

Specific Inclusion Criteria for subjects with glioma (Part 1m only)

  • Disease measurable as defined per Modified Response Assessment in Neuro-Oncology Criteria 2.0 (mRANO 2.0)
Exclusion Criteria
  • Spinal cord compression or untreated brain metastases or leptomeningeal disease.
  • History of other malignancy within the past 2 years
  • Any evidence of current interstitial lung disease
  • Active infection
  • Evidence of active severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infection.
  • History of arterial thrombosis
  • Myocardial infarction and/or symptomatic congestive heart failure.
  • Gastrointestinal tract disease
  • History of bowel obstruction, abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess
  • History of solid organ transplant.
  • Diagnosis of Congenital Short QT Syndrome.
  • Major surgery
  • Anti-tumor therapy within 28 days of study day 1.
  • Prior treatment with an methionine adenosyltransferase 2α (MAT2A) inhibitor or a protein arginine methyltransferase 5 (PRMT5) inhibitor.
  • Prior treatment with docetaxel (Part 2 only)
  • Prior irradiation to 25% of the bone marrow.
  • Therapeutic or palliative radiation therapy within 2 weeks of study day 1.
  • Live vaccine therapy within 4 weeks before study drug administration.
  • Use of therapeutic anti-coagulation for treatment of active thromboembolic events.
  • Use of prescription medications that are known strong inducers of cytochrome P450 3A4 (CYP3A4) within 14 days or 5 half-lives (whichever is longer) before study day 1
  • Unresolved toxicity from prior anti-cancer therapy
  • Currently receiving treatment in another investigational device or drug study.
  • Known positive test for Human Immunodeficiency Virus (HIV).
  • Positive hepatitis B surface antigen
  • positive hepatitis C virus ribonucleic acid (RNA) by polymerase chain reaction (PCR)
  • Female participants of childbearing potential unwilling to use protocol specified method of contraception

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Part 1a, Phase 1: AMG 193 Monotherapy Dose ExplorationAMG 193Participants with MTAP-null solid tumors will receive escalating doses of AMG 193 to estimate the MTD and/or the RP2D.
Part 1c, Phase 1: AMG 193 Monotherapy Dose ExpansionAMG 193Participants will receive the identified MTD/RP2D of AMG 193 in the following cohort: MTAP-null NSCLC.
Part 2a, Phase 1: AMG 193 Dose Exploration + DocetaxelAMG 193Participants with MTAP-null NSCLC will receive escalating doses of AMG 193 + a fixed dose of docetaxel to estimate the MTD/RP2D of the combination.
Part 2a, Phase 1: AMG 193 Dose Exploration + DocetaxelDocetaxelParticipants with MTAP-null NSCLC will receive escalating doses of AMG 193 + a fixed dose of docetaxel to estimate the MTD/RP2D of the combination.
Part 2b, Phase 1: AMG 193 + Docetaxel Dose ExpansionAMG 193Participants with MTAP-null NSCLC will receive the identified MTD/RP2D of AMG 193 + docetaxel.
Part 2b, Phase 1: AMG 193 + Docetaxel Dose ExpansionDocetaxelParticipants with MTAP-null NSCLC will receive the identified MTD/RP2D of AMG 193 + docetaxel.
Part 3: AMG 193 Phase 2AMG 193Participants with MTAP-null solid tumors will receive AMG 193.
Part 1e, Phase 1: AMG 193 Monotherapy Dose ExpansionAMG 193Participants will receive the identified selected dose/MTD of AMG 193 in the following cohort: MTAP-null BTC.
Part 1f, Phase 1: AMG 193 Monotherapy Dose ExpansionAMG 193Participants will receive the identified selected dose/MTD of AMG 193 in the following cohort: MTAP-null head and neck squamous cell carcinoma (HNSCC).
Part 1g, Phase 1: AMG 193 Monotherapy Dose ExpansionAMG 193Participants will receive the identified selected dose/MTD of AMG 193 in the following cohort: MTAP-null pancreatic adenocarcinoma.
Part 1h, Phase 1: AMG 193 Monotherapy Dose ExpansionAMG 193Participants will receive the identified selected dose/MTD of AMG 193 in the following cohort: MTAP-null or lost MTAP expression solid tumors (other than lymphoma or primary brain tumor).
Part 1i, Phase 1: AMG 193 Dose OptimizationAMG 193Participants will receive a randomized dose optimization evaluation of AMG 193.
Part 1j, Phase 1: AMG 193 DSPS Substudy (US Sites Only)AMG 193Participants will receive doses of AMG 193 and comparator AMG 193 test tables at different times in a fasted state.
Part 1j, Phase 1: AMG 193 DSPS Substudy (US Sites Only)Comparator AMG 193 Test TabletParticipants will receive doses of AMG 193 and comparator AMG 193 test tables at different times in a fasted state.
Part 1k, Phase 1: AMG 193 Food Effect Substudy (US Sites Only)AMG 193Participants will receive AMG 193 once on a fasted state and once after eating a standardized high-fat, high calorie meal.
Part 1l, Phase 1: AMG 193 Monotherapy Dose ExpansionAMG 193Participants will receive the identified selected dose/MTD of AMG 193 in the following cohort: MTAP-null esophageal/gastric cancer.
Part 1m, Phase 1: AMG 193 Monotherapy Dose ExpansionAMG 193Participants will receive the identified selected dose/MTD of AMG 193 in the following cohort: MTAP-null glioma.
Primary Outcome Measures
NameTimeMethod
Parts 1 and 2: Number of Participants Who Experience a Treatment-emergent Adverse Event (TEAE)Up to approximately 2 years

Adverse events (AEs) are defined as any untoward medical occurrence in clinical study participant irrespective of a causal relationship with the study treatment. TEAEs are any event that occurs after the participant has received study treatment. Any clinically significant changes in vital signs, electrocardiograms (ECGs) and clinical laboratory tests will be recorded as TEAEs.

Serious AEs (SAEs) are defined as any event that meets at least 1 of the following serious criteria:

* Results in death (fatal)

* Requires in-patient hospitalization or prolongation of existing hospitalization

* Results in persistent or significant disability/incapacity

* Is a congenital anomaly/birth defect

* Other medically important serious event

Parts 1 and 2: Number of Participants Who Experience a Dose-Limiting Toxicity (DLT)28 days
Part 3: Objective Response Rate (ORR)Up to approximately 2 years
Secondary Outcome Measures
NameTimeMethod
Part 2 Only: Maximal Plasma Concentration (Cmax) of DocetaxelCycle 1 Day 1 to Pre-Dose Cycle 5 Day 1 (Cycle =21 days)
Part 2 Only: Time to Achieve Maximal Plasma Concentration (Tmax) of DocetaxelCycle 1 Day 1 to Pre-Dose Cycle 5 Day 1 (Cycle =21 days)
Part 2 Only: Area Under the Plasma Concentration Versus Time Curve (AUC) of DocetaxelCycle 1 Day 1 to Pre-Dose Cycle 5 Day 1 (Cycle =21 days)
Part 1a Only: Time to Achieve Maximal Plasma Concentration (Tmax) of AMG 193Cycle 2 Day 1 to pre-dose on Cycle 2 Day 2 (Cycle = 28 days)
Parts 1 and 2: Maximal Plasma Concentration (Cmax) of AMG 193Cycle 1 Day 1 to Pre-Dose Cycle 5 Day 1 (Part 1 Cycle = 28 days, Part 2 Cycle =21 days)
Parts 1, 2 and 3: Progression-Free Survival (PFS)Up to approximately 2 years
Part 1k Only: Cmax of AMG 193 during fasted stateCycle 2 day 1 pre-dose up to 24 hours post-dose (Cycle = 28 days)
Part 1k Only: Tmax of AMG 193 during fasted stateCycle 2 day 1 pre-dose up to 24 hours post-dose (Cycle = 28 days)
Part 1k Only: AUC of AMG 193 during fasted stateCycle 2 day 1 pre-dose up to 24 hours post-dose (Cycle = 28 days)
Parts 1, 2 and 3: Time to Response (TTR)Up to approximately 2 years
Parts 1 and 2: Area Under the Plasma Concentration Versus Time Curve (AUC) of AMG 193Cycle 1 Day 1 to Pre-Dose Cycle 5 Day 1 (Part 1 Cycle = 28 days, Part 2 Cycle =21 days)
Parts 1, 2 and 3: Duration of Response (DoR)Up to approximately 2 years
Parts 1, 2 and 3: Duration of Disease Control (DC)Up to approximately 2 years
Part 3 Only: Number of Participants Who Experience TEAEUp to approximately 2 years

AEs are defined as any untoward medical occurrence in clinical study participant irrespective of a causal relationship with the study treatment. TEAEs are any event that occurs after the participant has received study treatment. Any clinically significant changes in vital signs, ECGs and clinical laboratory tests will be recorded as TEAEs.

SAEs are defined as any event that meets at least 1 of the following serious criteria:

* Results in death (fatal)

* Requires in-patient hospitalization or prolongation of existing hospitalization

* Results in persistent or significant disability/incapacity

* Is a congenital anomaly/birth defect

* Other medically important serious event

Part 1a Only: Maximal Plasma Concentration (Cmax) of AMG 193Cycle 2 Day 1 to pre-dose on Cycle 2 Day 2 (Cycle = 28 days)
Parts 1 and 2: Time to Achieve Maximal Plasma Concentration (Tmax) of AMG 193Cycle 1 Day 1 to Pre-Dose Cycle 5 Day 1 (Part 1 Cycle = 28 days, Part 2 Cycle =21 days)
Parts 1 and 2: ORRUp to approximately 2 years
Parts 1, 2 and 3: Disease Control Rate (DCR)Up to approximately 2 years
Parts 1, 2 and 3: Overall Survival (OS)Up to approximately 2 years
Part 1a Only: Area Under the Plasma Concentration Versus Time Curve (AUC) of AMG 193Cycle 2 Day 1 to pre-dose on Cycle 2 Day 2 (Cycle = 28 days)
Part 1a Only: Maximal Plasma Concentration (Cmax) of Comparator AMG 193 Test TabletCycle 2 Day 2 to pre-dose on Cycle 2 Day 3 (Cycle = 28 days)
Part 1a Only: Time to Achieve Maximal Plasma Concentration (Tmax) of Comparator AMG 193 Test TabletCycle 2 Day 2 to pre-dose on Cycle 2 Day 3 (Cycle = 28 days)
Part 1a Only: Area Under the Plasma Concentration Versus Time Curve (AUC) of Comparator AMG 193 Test TabletCycle 2 Day 2 to pre-dose on Cycle 2 Day 3 (Cycle = 28 days)
Part 1k Only: Cmax of AMG 193 during fed stateCycle 2 day 2 pre-dose up to 24 hours post-dose (Cycle = 28 days)
Part 1k Only: AUC of AMG 193 during fed stateCycle 2 day 2 pre-dose up to 24 hours post-dose (Cycle = 28 days)
Part 1k Only: Tmax of AMG 193 during fed stateCycle 2 day 2 pre-dose up to 24 hours post-dose (Cycle = 28 days)

Trial Locations

Locations (74)

City of Hope National Medical Center

🇺🇸

Duarte, California, United States

California Research Institute

🇺🇸

Glendale, California, United States

Fomat Medical Research

🇺🇸

Oxnard, California, United States

University of California at SF

🇺🇸

San Francisco, California, United States

D and H Cancer Research Center

🇺🇸

Margate, Florida, United States

Boca Raton Clinical Research Medical Center Inc

🇺🇸

Tamarac, Florida, United States

Goshen Health Systems

🇺🇸

Goshen, Indiana, United States

Indiana University

🇺🇸

Indianapolis, Indiana, United States

Community Health Network MD Anderson Cancer Center - North

🇺🇸

Indianapolis, Indiana, United States

University of Maryland Medical Center

🇺🇸

Baltimore, Maryland, United States

American Oncology Partners, PA

🇺🇸

Bethesda, Maryland, United States

Henry Ford Cancer Detroit (Brigitte Harris Cancer Pavilion)

🇺🇸

Detroit, Michigan, United States

Washington University

🇺🇸

Saint Louis, Missouri, United States

Rutgers Cancer Institute of NJ

🇺🇸

New Brunswick, New Jersey, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Northwell Health Monter Cancer Center

🇺🇸

Lake Success, New York, United States

New York University Grossman School of Medicine and New York University Langone Hospitals

🇺🇸

New York, New York, United States

Duke University

🇺🇸

Durham, North Carolina, United States

University Hospitals Cleveland Medical Center

🇺🇸

Cleveland, Ohio, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

University of Pittsburgh Medical Center

🇺🇸

Pittsburgh, Pennsylvania, United States

Sanford Oncology Clinic and Pharmacy

🇺🇸

Sioux Falls, South Dakota, United States

Mary Crowley Cancer Research

🇺🇸

Dallas, Texas, United States

Center for Oncology and Blood Disorders

🇺🇸

Houston, Texas, United States

University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Lumi Research

🇺🇸

Kingwood, Texas, United States

South Texas Accelerated Research Therapeutics

🇺🇸

San Antonio, Texas, United States

University of Virginia Cancer Center

🇺🇸

Charlottesville, Virginia, United States

Virginia Cancer Specialists PC

🇺🇸

Fairfax, Virginia, United States

Chris OBrien Lifehouse

🇦🇺

Camperdown, New South Wales, Australia

Epworth Healthcare

🇦🇺

East Melbourne, Victoria, Australia

Peter MacCallum Cancer Centre

🇦🇺

Parkville, Victoria, Australia

Medizinische Universitaet Graz

🇦🇹

Graz, Austria

Landeskrankenhaus Salzburg

🇦🇹

Salzburg, Austria

Universite Catholique de Louvain Cliniques Universitaires Saint Luc

🇧🇪

Bruxelles, Belgium

Universitair Ziekenhuis Antwerpen

🇧🇪

Edegem, Belgium

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

Jessa Ziekenhuis - Campus Virga Jesse

🇧🇪

Hasselt, Belgium

Universitair Ziekenhuis Leuven - Campus Gasthuisberg

🇧🇪

Leuven, Belgium

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

Princess Margaret Cancer Centre

🇨🇦

Toronto, Ontario, Canada

Chongqing University Cancer Hospital

🇨🇳

Chongqing, Chongqing, China

Fujian Cancer Hospital

🇨🇳

Fuzhou, Fujian, China

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Mengchao Hepatobiliary hospital of Fujian Medical University

🇨🇳

Fuzhou, Fujian, China

Shanghai East Hospital

🇨🇳

Shanghai, Shanghai, China

Shanghai Pulmonary Hospital

🇨🇳

Shanghai, Shanghai, China

Centre Georges Francois Leclerc

🇫🇷

Dijon, France

Centre Oscar Lambret

🇫🇷

Lille, France

Gustave Roussy

🇫🇷

Villejuif, France

Universitaetsklinikum Halle - Saale

🇩🇪

Halle (Saale), Germany

Universitaetsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

Universitaetsklinikum Ulm

🇩🇪

Ulm, Germany

Universitaetsklinikum Wuerzburg

🇩🇪

Wuerzburg, Germany

Queen Mary Hospital, The University of Hong Kong

🇭🇰

Hong Kong, Hong Kong

Prince of Wales Hospital, Chinese University of Hong Kong

🇭🇰

Shatin, New Territories, Hong Kong

Aichi Cancer Center

🇯🇵

Nagoya-shi, Aichi, Japan

National Cancer Center Hospital East

🇯🇵

Kashiwa-shi, Chiba, Japan

National Cancer Center Hospital

🇯🇵

Chuo-ku, Tokyo, Japan

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Gyeonggi-do, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Severance Hospital Yonsei University Health System

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Istituto Oncologico della Svizzera Italiana

🇨🇭

Bellinzona, Switzerland

Inselspital Bern

🇨🇭

Bern, Switzerland

Hopitaux Universitaires de Geneve

🇨🇭

Geneve 14, Switzerland

Kantonsspital St Gallen

🇨🇭

Sankt Gallen, Switzerland

Universitaetsspital Zuerich

🇨🇭

Zuerich, Switzerland

National Cheng Kung University Hospital

🇨🇳

Tainan, Taiwan

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

Linkou Chang Gung Memorial Hospital of Chang Gung Medical Foundation

🇨🇳

Taoyuan, Taiwan

Sarah Cannon Research Institute UK

🇬🇧

London, United Kingdom

Royal Marsden Hospital

🇬🇧

Sutton, United Kingdom

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