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A Study to Test Different Doses of BI 1823911 Alone and Combined With Other Medicines in People With Different Types of Advanced Cancer With KRAS Mutation

Phase 1
Active, not recruiting
Conditions
Solid Tumors, KRAS Mutation
Interventions
Drug: BI 1823911
Drug: BI 1701963
Drug: Midazolam
Registration Number
NCT04973163
Lead Sponsor
Boehringer Ingelheim
Brief Summary

This study is open to adults with different types of advanced or metastatic cancer (including lung cancer, colorectal cancer, pancreatic cancer, and bile duct cancer). This study is for people for whom previous treatment was not successful or no treatment exists.

People who have a tumour with a KRAS mutation can participate in the study. A KRAS mutation makes tumours grow faster. BI 1823911 and BI 1701963 are medicines that may turn off KRAS, each in a different way. In this study, BI 1823911 is given to people for the first time.

The purpose of this study is to find the highest dose of BI 1823911 that people can tolerate when taken alone and together with BI 1701963. The most suitable dose is used to find out whether BI 1823911 alone and in combination with BI 1701963 can make tumours shrink.

Participants can stay in the study as long as they benefit from treatment and can tolerate it.

During this time, participants take tablets of BI 1823911 alone or in combination with BI 1701963 once a day. The doctors regularly monitor the size of the tumour. Doctors also regularly record any unwanted effects and check participant's health.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Pathologically confirmed diagnosis of locally advanced or metastatic solid tumours, e.g. adenocarcinoma of the lung, colorectal cancer, pancreatic cancer or cholangiocarcinoma. Non-small cell lung cancer (NSCLC) patients with mixed histology are eligible if adenocarcinoma is the predominant histology.

  • Documented disease progression despite appropriate prior standard therapies or for whom no standard therapy exists for their tumour type and disease stage.

  • KRAS mutation status: Kirsten rat sarcoma virus homolog (KRAS) glycine-to-cysteine (G12C) mutation in tumour tissue or blood based on previously performed local testing using a validated test.

  • Provision of archival tumour tissue, if available, to confirm retrospectively KRAS G12C mutation status and for biomarker assessment.

  • At least one target lesion that can be measured per Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1 (radiated lesions do not qualify as target lesions). In patients who only have one target lesion, and a biopsy of the lesion is required, the baseline imaging must be performed before the biopsy or at the earliest two weeks after the biopsy.

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

  • Adequate organ function as follows:

    • Absolute neutrophil count (ANC) ≥1.5 x 10^9/L (equivalent values: ≥ 1.5 x 10³/μL or ≥ 1500/mm³); hemoglobin ≥9.0 g/dL (equivalent values: ≥ 90 g/L or ≥ 5.6 mmol/L); platelets ≥100 x 10^9/L (equivalent values: ≥ 100 x 10³/μL or ≥ 100 x 10³/mm³) without the use of haematopoietic growth factors.
    • Total bilirubin ≤1.5 times the upper limit of normal (ULN), or ≤4 x ULN for patients who are known to have Gilbert's syndrome.
    • Creatinine ≤1.5 x ULN. If creatinine is >1.5 x ULN, patient is eligible if concurrent creatinine clearance ≥50 mL/min (equivalent value: 0.84mL/s) (measured or calculated by Cockcroft-Gault formula).
    • Aspartate transaminase (AST) and alanine transaminase (ALT) ≤3 x ULN, for patients with liver metastases ≤5 x ULN.
  • Age ≥18 years of age, or over the legal age of consent as required by local legislation.

Further inclusion criteria apply.

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Exclusion Criteria
  • Previous anticancer chemotherapy within 3 weeks of the first administration of trial drug. Previous anticancer hormonal treatment or anticancer immunotherapy within 2 weeks of the first administration of trial drug.
  • Previous treatment with Rat Sarcoma (RAS), Mitogen-activated protein kinase (MAPK) or Son of sevenless 1 (SOS1) targeting agents (only for monotherapy Parts A, B, and C).
  • Radiotherapy within 2 weeks prior to start of treatment, provided recovery from related toxicity.
  • Major surgery (major according to the investigator's assessment) performed within 4 weeks prior to start of treatment or planned during the projected course of the trial, e.g. hip replacement.
  • Previous treatment with any investigational agent(s) or targeted treatment within 28 days prior to start of treatment or 5 half-lives, whichever is shorter.
  • Known history of hypersensitivity to any of the excipients of BI 1823911 tablets, or any contraindication to Midazolam (for Monotherapy Part B only).
  • History or presence of cardiovascular abnormalities such as congestive heart failure New York Heart Association (NYHA) classification of ≥3, unstable angina or poorly controlled arrhythmia which are considered clinically relevant by the Investigator. Myocardial infarction within 6 months prior to start of treatment. Uncontrolled hypertension defined as: Blood pressure (BP) measured in a rested and relaxed condition, where systolic BP >=140 mmHg, or diastolic BP >= 90 mmHg, with or without medication.
  • Left ventricular ejection fraction (LVEF) <50%. Further exclusion criteria apply.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Monotherapy ArmBI 1823911Each arm consists of three parts (dose escalation (A), dose confirmation (B), and dose expansion (C).
Combination Therapy ArmBI 1823911Will be started after confirmation of safety in the Monotherapy Arm. Each arm consists of three parts (dose escalation (A), dose confirmation (B), and dose expansion (C).
Combination Therapy ArmBI 1701963Will be started after confirmation of safety in the Monotherapy Arm. Each arm consists of three parts (dose escalation (A), dose confirmation (B), and dose expansion (C).
Monotherapy ArmMidazolamEach arm consists of three parts (dose escalation (A), dose confirmation (B), and dose expansion (C).
Primary Outcome Measures
NameTimeMethod
Dose confirmation (Part B) and expansion (Part C) - Monotherapy and combination therapy: Objective response (OR) defined as best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR)up to 39 months

BOR is determined according to Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1.

BOR will consider all tumour assessments from first treatment administration until the earliest of disease progression, death, or last evaluable tumour assessment before start of subsequent anti-cancer therapy, loss to follow-up, or withdrawal of consent.

Dose escalation (Part A) - Monotherapy and combination therapy: Number of patients experiencing Dose limiting toxicities (DLTs) during the Maximum tolerated dose (MTD) evaluation period for BI 1823911 in monotherapy and in each combinationup to 28 days

DLTs are graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

Secondary Outcome Measures
NameTimeMethod
All study parts, BI 1701963: Maximum concentration (Cmax)up to 24 hours
Dose confirmation (Part B) and expansion (Part C) - Monotherapy and combination therapy: Objective response (OR)up to 39 months

OR is defined as best overall response (BOR) of complete response (CR) or partial response (PR), both regardless of confirmation.

BOR is determined according to RECIST version 1.1. BOR will consider all tumour assessments from first treatment administration until the earliest of disease progression, death, or last evaluable tumour assessment before start of subsequent anti-cancer therapy, loss to follow-up, or withdrawal of consent.

Dose confirmation (Part B) and expansion (Part C) - Monotherapy and combination therapy: Progression-free survival (PFS) rateat month 6

PFS is defined as the time from first treatment administration until tumour progression according to RECIST version 1.1 or death from any cause, whichever occurs earlier.

All study parts, BI 1823911: Maximum concentration (Cmax)up to 24 hours
All study parts, BI 1823911: Area under the plasma concentration-time curve from time zero to time t (AUCτ)up to 24 hours
All study parts, BI 1701963: Area under the plasma concentration-time curve at steady state (AUCss)up to 24 hours
Dose confirmation (Part B) and expansion (Part C) - Monotherapy and combination therapy: Tumour shrinkage (in millimetres)up to 39 months

Tumour shrinkage is defined as the difference between the minimum post-baseline sum of diameters of target lesions (longest for non-nodal lesions, short axis for nodal lesions) and the baseline sum of longest diameters of the same set of target lesions.

All study parts, BI 1701963: Steady state concentration (Css)up to 24 hours
Dose escalation (Part A) - Monotherapy and combination therapy: Number of patients experiencing DLTs during all treatment cycles for BI 1823911 in monotherapy and in each combinationup to 39 months
Dose confirmation (Part B) and expansion (Part C) - Monotherapy and combination therapy: Duration of ORup to 39 months

Duration of OR is defined as the time from first documented CR or PR until disease progression or death (whichever occurs first) among patients with OR.

All study parts: Number of patients with adverse events during the on-treatment periodup to 39 months
All study parts, BI 1823911: Area under the plasma concentration-time curve at steady state (AUCss)up to 24 hours
All study parts, BI 1701963: Area under the plasma concentration-time curve from time zero to time t (AUCτ)up to 24 hours
All study parts, BI 1823911: Steady state concentration (Css)up to 24 hours

Trial Locations

Locations (8)

Mary Crowley Cancer Research Center

🇺🇸

Dallas, Texas, United States

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Edegem - UNIV UZ Antwerpen

🇧🇪

Edegem/Antwerpen, Belgium

UNIV UZ Gent

🇧🇪

Gent/Oost-Vlaanderen, Belgium

Brussels - HOSP Jules Bordet

🇧🇪

Anderlecht/Brussels-Capital, Belgium

UZ Leuven

🇧🇪

Leuven/Vlaams-Brabant, Belgium

Hospital Vall d'Hebron

🇪🇸

Barcelona, Spain

The Christie Hospital

🇬🇧

Manchester, United Kingdom

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