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A Study to Assess Naporafenib (ERAS-254) Administered With Trametinib in Patients With RAS Q61X Mutations

Phase 1
Recruiting
Conditions
Advanced or Metastatic Solid Tumors
Interventions
Registration Number
NCT05907304
Lead Sponsor
Erasca, Inc.
Brief Summary

To evaluate the efficacy of naporafenib administered with trametinib in patients with rat sarcoma viral oncogene (RAS) Q61X solid tumors

* To evaluate the safety and tolerability of naporafenib administered with trametinib in patients with RAS Q61X solid tumors

* To characterize the pharmacokinetic (PK) profile of naporafenib and trametinib when administered to patients with RAS Q61X solid tumors

Detailed Description

SEACRAFT-1 is an open-label study to assess the safety and efficacy of naporafenib administered with trametinib in previously treated patients with locally advanced unresectable or metastatic RAS Q61X solid tumor malignancies. The study will enroll a total of approximately 100 adult patients; a sub-study will enroll approximately 15 adolescent patients ≥12 and \<18 years for a total sample size of approximately 115. Patients with a locally advanced unresectable or metastatic solid tumor malignancy that is not responsive to standard therapies or for which there is no standard therapy are eligible. Patients with primary central nervous system (CNS) tumors are not eligible. Documentation of a RAS Q61X mutation in tumor tissue prior to the first dose of study treatment is required.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
115
Inclusion Criteria
  1. Willing and able to provide written informed consent
  2. Age ≥ 12 years
  3. A locally advanced or metastatic tumor who has progressed on or for which no standard therapy exists. Patients who are intolerant to standard therapy or who are not a candidate for standard therapy (in the opinion of the Investigator) or who decline standard therapy are also eligible.
  4. Documentation of a RAS Q61X mutation (tumor tissue or blood) prior to first dose of study treatment as determined locally with an analytically validated assay in a certified testing laboratory.
  5. Archival tumor tissue collected within 5 years prior to enrollment must be confirmed to be available at the time of Screening, which may be submitted before or after enrollment for exploratory biomarker analysis.
  6. ECOG performance status 0, 1 or 2
  7. Presence of at least 1 measurable lesion according to RECIST v1.1
  8. Able to swallow oral medication.
Exclusion Criteria
  1. Prior therapy with an ERK-, MEK-, RAF-, or RAS-inhibitor
  2. Impairment of GI function or gastrointestinal (GI) disease that may significantly alter the absorption of study treatment (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, small bowel resection)
  3. History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndrome)
  4. Corrected QT interval using Fridericia's formula (QTcF) at Screening >450 ms based on triplicate average NOTE: criterion does not apply to patients with a right or left bundle branch block
  5. LVEF <50%
  6. All primary CNS tumors
  7. Symptomatic CNS metastases that are neurologically unstable. Patients with controlled CNS metastases are eligible.
  8. Patients receiving treatment with medications that are known to be strong inhibitors and/or inducers of cytochrome P450 (CYP)3A; substrates of CYP2C8, CYP2C9, and CYP3A with a narrow therapeutic index and sensitive substrates of CYP3A;
  9. Are pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Naporafenib + TrametinibNaporafenibNaporafenib (ERAS-254) 200 mg twice daily (BID) Trametinib 1 mg once daily (QD)
Naporafenib + TrametinibTrametinibNaporafenib (ERAS-254) 200 mg twice daily (BID) Trametinib 1 mg once daily (QD)
Primary Outcome Measures
NameTimeMethod
To evaluate the efficacy of naporafenib administered with trametinib in patients with rat sarcoma viral oncogene (RAS) Q61X solid tumorsAssessed up to 24 months from time of first dose

Based on assessment of Objective response rate (ORR) per RECIST version 1.1

Secondary Outcome Measures
NameTimeMethod
Plasma concentration (Cmax)Study Day 1 up to Day 29

Maximum plasma concentration of ERAS-254 and trametinib

Time to achieve Cmax (Tmax)Study Day 1 up to Day 29

Time to achieve maximum plasma concentration of ERAS-254 and trametinib

Area under the curve (AUC)Study Day 1 up to Day 29

Area under the plasma concentration-time curve

Adverse EventsAssessed up to 24 months from time of first dose

Incidence and severity of treatment-emergent AEs and serious AEs

Duration of Response (DOR)Assessed up to 24 months from time of first dose

Based on assessment of radiographic imaging per RECIST version 1.1

Overall survivalAssessed up to 24 months from time of first dose

Survival Status

Time to Response (TTR)Assessed up to 24 months from time of first dose

Based on assessment of radiographic imaging per RECIST version 1.1

Progression Free Survival (PFS)Assessed up to 24 months from time of first dose

Based on assessment of radiographic imaging per RECIST version 1.1

Disease Control Rate (DCR)Assessed up to 24 months from time of first dose

Based on assessment of radiographic imaging per RECIST version 1.1

Trial Locations

Locations (30)

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Inova Schar Cancer Institute

🇺🇸

Fairfax, Virginia, United States

University of Alabama

🇺🇸

Birmingham, Alabama, United States

NEXT Virginia

🇺🇸

Fairfax, Virginia, United States

University of California, San Francisco

🇺🇸

San Francisco, California, United States

Yale Cancer Center

🇺🇸

New Haven, Connecticut, United States

Florida Cancer Specialists - St. Petersburg

🇺🇸

Saint Petersburg, Florida, United States

Florida Cancer Specialists - Sarasota

🇺🇸

Sarasota, Florida, United States

Emory University School of Medicine

🇺🇸

Atlanta, Georgia, United States

Henry Ford Health System

🇺🇸

Detroit, Michigan, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Comprehensive Cancer Center of Nevada (CCCN)

🇺🇸

Las Vegas, Nevada, United States

Oregon Health & Science University

🇺🇸

Portland, Oregon, United States

SCRI Oncology Partners (formerly Tennessee Oncology)

🇺🇸

Nashville, Tennessee, United States

University of Wisconsin

🇺🇸

Madison, Wisconsin, United States

Macquarie University

🇦🇺

Macquarie Park, New South Wales, Australia

St. Vincent's Hospital

🇦🇺

Melbourne, Victoria, Australia

Linear Clinical Research, LTD

🇦🇺

Perth, Australia

Cross Cancer Institute- Alberta Health Services (AHS)

🇨🇦

Edmonton, Alberta, Canada

British Columbia Cancer Agency

🇨🇦

Vancouver, British Columbia, Canada

London Regional Cancer Center

🇨🇦

London, Ontario, Canada

Princess Margaret Cancer Centre

🇨🇦

Toronto, Ontario, Canada

Inje University Haeundae Paik Hospital

🇰🇷

Busan, Busan Gwang'yeogsi, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Seoul Teugbyeolsi, Korea, Republic of

National Cancer Center

🇰🇷

Goyang-si, Korea, Republic of

Seoul National University Hospital Bundang

🇰🇷

Gyeonggi-do, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

The Catholic University Hospital

🇰🇷

Seoul, Korea, Republic of

Sarah Cannon Research Institute - HCA Healthcare

🇬🇧

City Of London, London, United Kingdom

Beatson West of Scotland Cancer Center

🇬🇧

Glasgow, United Kingdom

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