a Study to Evaluate the Safety and Efficacy of D-1553 Combined With IN10018 in KRAS G12C Mutant Solid Tumors

Phase 1

Recruiting

• Conditions: Solid Tumor
• Interventions: Drug: D1553; Drug: IN10018（Ifebemtinib）

• Registration Number: NCT06166836
• Lead Sponsor: InxMed (Shanghai) Co., Ltd.

Brief Summary

This is a phase 1b/II, open-label study to evaluate the safety, tolerability, pharmacokinetics and antitumor activities of D-1553 in combination with IN10018 in subjects with locally advanced or metastatic solid tumor with KRAS G12C mutation.

Detailed Description

This study includes 2 phases: Phase Ib-Dose Escalation and Phase II-Dose Expansion. Phase Ib-Dose Escalation part will enroll at least 6 subjects to identify the safety and RP2D of D1553 in combination with IN10018 in KRAS G12C mutant solid tumors. Phase II-Dose Expansion part contains 3 cohorts with cohort A to enroll advanced colorectal cancer (CRC) with KRAS G12C mutation, cohort B to enroll advanced non-small cell lung cancer (NSCLC) with KRAS G12C mutation, and cohort C to enroll other advanced solid tumors with KRAS G12C mutation. Phase II study is to evaluate the safety and antitumor activities of D-1553 in combination with IN10018 in KRAS G12C mutant solid tumors. The sample size in each cohort is estimated per Simon's 2-stage design. In Cohort A, when Simon's 2-stage study achieved statistical hypothesis, an open-label, randomized study will be conducted for factorial analysis to evaluate the contribution of IN10018 in the combination regimen.

Study Timeline

• Study Start: 2022-10-12
• Study First Submitted: 2023-12-04
• Study First Submitted QC: 2023-12-04
• Study First Posted: 2023-12-12
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-28
• Last Update Posted: 2025-04-30
• Primary Completion: 2025-12-31
• Study Completion: 2026-12-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 140

Inclusion Criteria

1. Men or women aged ≥ 18 years at the time of signing the informed consent form.
2. Subjects with pathologically confirmed locally advanced or metastatic solid tumors.
3. Confirmed positive KRAS G12C mutation in tumor tissue or other biospecimens (only for phase1b) containing cancer cells or DNA.
4. Tumor types in different phases and cohorts: 1) Phase 1b: subjects with locally advanced or metastatic solid tumors who have progressed on or failed in standard therapy, and no standard treatment is available. 2) Phase II Cohort A: subjects with locally advanced or metastatic CRC. 3) Phase II Cohort B: subjects with locally advanced or metastatic NSCLC. 4) Phase 2 Cohort C: subjects with other locally advanced or metastatic solid tumors.
5. Has measurable lesions at baseline according to RECIST 1.1 criteria.
6. Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
7. Adequate bone marrow, liver, renal, and coagulation function within 7 days prior to the first dose.

Exclusion Criteria

1. Prior KRAS G12C inhibitors treatment.
2. Have known symptoms of spinal cord compression, instable or symptomatic central nervous system (CNS) metastases, and/or carcinomatous meningitis.
3. Have a history of stroke or other serious cerebrovascular diseases within 12 months prior to the first dose.
4. Have had interstitial lung disease or any active infection requiring systemic treatment within 14 days prior to the first dose.
5. Has a history of severe cardiovascular disease such as acute myocardial infarction, severe/unstable angina, QTc prolongation, or poorly controlled hypertension.
6. Haven't recovered from toxicity due to prior antitumor therapy
7. Pregnant or lactating women.
8. Malignant neoplasms other than study disease within 5 years prior to enrollment.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Phase II Cohort A-previously-treated CRC with KRAS G12C mutation（Treatmnt Group）	IN10018（Ifebemtinib）	To evaluate the safety and antitumor efficacy of D-1553 in combination with IN10018 in previously-treated CRCs with KRAS G12C mutation.
Phase II Cohort C-other previously-treated solid tumors with KRAS G12C mutation	IN10018（Ifebemtinib）	To evaluate the safety and antitumor efficacy of D-1553 in combination with IN10018 in other solid tumors with KRAS G12C mutation
Phase 1b-Dose Escalation Part	D1553	To evaluate the safety and Recommended Phase 2 dose (RP2D) of D-1553 in combination with IN10018 in previously-treated solid tumors.
Phase II Cohort A-previously-treated CRC with KRAS G12C mutation (Control Group)	D1553	To evaluate the safety and antitumor efficacy of D-1553 in previously-treated CRCs with KRAS G12C mutation.
Phase 1b-Dose Escalation Part	IN10018（Ifebemtinib）	To evaluate the safety and Recommended Phase 2 dose (RP2D) of D-1553 in combination with IN10018 in previously-treated solid tumors.
Phase II Cohort B-treatment-naïve or previously-treated NSCLC with KRAS G12C mutation	IN10018（Ifebemtinib）	To evaluate the safety and antitumor efficacy of D-1553 in combination with IN10018 in advanced NSCLCs with KRAS G12C mutation.
Phase II Cohort B-treatment-naïve or previously-treated NSCLC with KRAS G12C mutation	D1553	To evaluate the safety and antitumor efficacy of D-1553 in combination with IN10018 in advanced NSCLCs with KRAS G12C mutation.
Phase II Cohort A-previously-treated CRC with KRAS G12C mutation（Treatmnt Group）	D1553	To evaluate the safety and antitumor efficacy of D-1553 in combination with IN10018 in previously-treated CRCs with KRAS G12C mutation.
Phase II Cohort C-other previously-treated solid tumors with KRAS G12C mutation	D1553	To evaluate the safety and antitumor efficacy of D-1553 in combination with IN10018 in other solid tumors with KRAS G12C mutation

Primary Outcome Measures

Name	Time	Method
Objective Response Rate (ORR) of D1553 in combination with IN10018 in solid tumors with KRAS G12C mutation	Through study completion, approximately 3 years	Defined as the proportion of subjects with complete response (CR) or partial response (PR).
Recommended phase II dose (RP2D) of D1553 in combination with IN10018 in solid tumors with KRAS G12C mutation	Through study completion, approximately 3 years	Evaluate the number of patients with dose-limited toxicities (DLTs); Determine the RP2D of D1553 in combination with IN10018 in solid tumors with KRAS G12C mutation.

Secondary Outcome Measures

Name	Time	Method
Progression-free Survival (PFS) of D1553 in combination with IN10018 in solid tumors with KRAS G12C mutation	Through study completion, approximately 3 years	Defined as the time from the first dose of study treatment to first documentation of disease progression or to death due to any cause, whichever comes first.
Overall survival (OS) of D1553 in combination with IN10018 in solid tumors with KRAS G12C mutation	Through study completion, approximately 3 years	Defined as the time from the first dose of study treatment to the date of death due to any cause.
Number of subjects with adverse event	Through study completion, approximately 3 years	The number of subjects who experienced AEs is presented.
PK:t1/2 of D-1553 and IN10018	Through study completion, approximately 3 years	Elimination half-life (t1/2).
Disease Control Rate (DCR) of D1553 in combination with IN10018 in solid tumors with KRAS G12C mutation	Through study completion, approximately 3 years	Defined as the proportion of patients with CR, PR, or stable disease (SD).
PK: Cmax of D-1553 and IN10018	Through study completion, approximately 3 years	Maximum concentration (Cmax)
PK: Cmin of D-1553 and IN10018	Through study completion, approximately 3 years	Minimum concentration (Cmin)
PK: AUC of D-1553 and IN10018	Through study completion, approximately 3 years	Area under the concentration-time curve (AUC)
Duration of Response (DoR) of D1553 in combination with IN10018 in solid tumors with KRAS G12C mutation	Through study completion, approximately 3 years	Defined as the time from start of the first documentation of CR or PR to the first documentation of disease progression or to death due to any cause, whichever comes first.
PK:CL/F of D-1553 and IN10018	Through study completion, approximately 3 years	apparent clearance (CL/F)
PK:Vd/F of D-1553 and IN10018	Through study completion, approximately 3 years	Apparent volume of distribution (Vd/F)
Plasma concentrations of D-1553 and IN10018 in solid tumors with KRAS G12C mutation	Through study completion, approximately 3 years	Plasma concentrations of D-1553 and IN10018

Trial Locations

Locations (10)

General Hospital Of Eastern Theater Command; 🇨🇳 Nanjing, China

Renmin Hospital of Wuhan University; 🇨🇳 Wuhan, China

Hunan Cancer Hospital; 🇨🇳 Changsha, China

Xuzhou Central Hospital; 🇨🇳 Xuzhou, China

The first Affiliated Hospital of Zhengzhou University; 🇨🇳 Zhengzhou, China

First Affiliated Hospital of Bengbu Medical College; 🇨🇳 Bengbu, China

Zhejiang Cancer Hospital; 🇨🇳 Hangzhou, Zhejiang, China

Henan Cancer Hospital; 🇨🇳 Zhengzhou, China

First Affiliated Hospital of Gannan Medical University; 🇨🇳 Ganzhou, China

Fujian Cancer Hospital; 🇨🇳 Fuzhou, China