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A Phase 1/2, Study Evaluating the Safety, Tolerability, PK, and Efficacy of Sotorasib (AMG 510) in Subjects With Solid Tumors With a Specific KRAS Mutation (CodeBreaK 100)

Phase 1
Active, not recruiting
Conditions
KRAS p.G12C Mutant Advanced Solid Tumors
Interventions
Registration Number
NCT03600883
Lead Sponsor
Amgen
Brief Summary

Evaluate the safety and tolerability of sotorasib in adult subjects with KRAS p.G12C mutant advanced solid tumors.

Estimate the maximum tolerated dose (MTD) and/or a recommended phase 2 dose (RP2D) in adult subjects with KRAS p.G12C mutant advanced solid tumors.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
713
Inclusion Criteria
  • Men or women greater than or equal to 18 years old.
  • Pathologically documented, locally-advanced or metastatic malignancy with, KRAS p.G12C mutation identified through molecular testing.

Exclusion Criteria

  • Active brain metastases from non-brain tumors.
  • Myocardial infarction within 6 months of study day 1.
  • Gastrointestinal (GI) tract disease causing the inability to take oral medication.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Phase 1 Dose Exploration Part 1 monotherapysotorasibCohorts with food effect and alternative dosing regimens Enrollment into the dose exploration cohorts may be from any eligible solid tumor type. Dose escalation will begin with 2-4 subjects treated at the lowest planned dose level of 180 mg. If no DLT is observed, dose escalation will continue to the next planned dose cohort
Phase 1 Dose Expansion Part 2 monotherapysotorasibUpon completing the dose exploration part of the study, dose expansion may proceed with 3 groups consisting of subjects with KRAS p.G12C mutant advanced solid tumors. Dose expansion in these 3 groups may be done concurrently
Phase 1 combination arm with sotorasib and anti PD-1/L1sotorasibAdditional subjects will be enrolled into the combination arm with sotorasib in combination with an anti (PD-1/L1)
Phase 1 combination arm with sotorasib and anti PD-1/L1Anti PD-1/L1Additional subjects will be enrolled into the combination arm with sotorasib in combination with an anti (PD-1/L1)
Phase 1 monotherapy treatment naive advanced NSCLCsotorasibSeparate cohort of part 1 dose expansion subjects to evaluate the safety and clinical activity of sotorasib administered orally once daily in subjects with previously untreated advanced non-small cell lung cancer (NSCLC). Drug-drug interaction will be evaluated in 6 of the subjects enrolled in the treatment naive cohort by adding Midazolam alone on Day -1 and in combination with sotorasib on Day 15 of Cycle 1, where each cycle is 21 days.
Phase 1 monotherapy treatment naive advanced NSCLCMidazolamSeparate cohort of part 1 dose expansion subjects to evaluate the safety and clinical activity of sotorasib administered orally once daily in subjects with previously untreated advanced non-small cell lung cancer (NSCLC). Drug-drug interaction will be evaluated in 6 of the subjects enrolled in the treatment naive cohort by adding Midazolam alone on Day -1 and in combination with sotorasib on Day 15 of Cycle 1, where each cycle is 21 days.
Phase 2 monotherapy dose comparisonsotorasibSubjects with NSCLC will be enrolled in a dose comparison study evaluating safety and efficacy
Phase 1 Does escalation and Expansion monotherapy BIDsotorasibBID 2L+solid tumors (fed state)
Primary Outcome Measures
NameTimeMethod
Primary: Number of subjects with serious adverse events24 Months

Serious adverse events will be a primary outcome measure in the following group:

- Phase 2 monotherapy dose comparison

Primary: Number of subjects with adverse events of interest24 Months

Adverse events of interest will be a primary outcome measure in the following group:

- Phase 2 monotherapy dose comparison

Primary: Number of subjects with treatment-emergent adverse events24 Months

Treatment-emergent adverse events will be a primary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

* Phase 2 monotherapy dose comparison

Primary: Number of subjects with clinically significant changes in physical examination resultsBaseline to 24 Months

Physical examinations will be a primary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

Primary: Number of subjects with clinically significant changes on electrocardiograms (ECGs)Baseline to 24 Months

ECGs will be a primary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

Primary: Number of subjects with treatment-related adverse events24 Months

Treatment-related adverse events will be a primary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

Primary: Number of subjects with grade ≥3 treatment-emergent adverse events24 Months

Grade ≥3 treatment-emergent adverse events will be a primary outcome measure in the following group:

- Phase 2 monotherapy dose comparison

Primary: Number of subjects with clinically significant changes in vital signsBaseline to 24 Months

Vital signs will be a primary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

Primary: Duration of response (DOR) as assessed by RECIST 1.1 criteria24 Months

DOR will be a primary outcome measure in the following group:

- Phase 1 monotherapy treatment naïve advanced NSCLC

Primary: Number of subjects with dose-limiting toxicities (DLTs)21 Days

DLTs will be a primary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

Primary: Number of subjects with clinically significant changes in clinical laboratory valuesBaseline to 24 Months

Abnormal clinical laboratory values will be a primary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

Primary: Objective response rate (ORR) as assessed by RECIST 1.1 criteria24 Months

ORR will be a primary outcome measure in the following group:

* Phase 1 monotherapy treatment naïve advanced NSCLC

* Phase 2 monotherapy

* Phase 2 monotherapy dose comparison

Primary: Disease control as assessed by RECIST 1.1 criteria24 Months

Disease control will be a primary outcome measure in the following group:

- Phase 1 monotherapy treatment naïve advanced NSCLC

Primary: Duration of stable disease (SD) as assessed by RECIST 1.1 criteria24 Months

Duration of SD will be a primary outcome measure in the following group:

- Phase 1 monotherapy treatment naïve advanced NSCLC

Primary: Time to response (TTR) as assessed by RECIST 1.1 criteria24 Months

TTR will be a primary outcome measure in the following group:

- Phase 1 monotherapy treatment naïve advanced NSCLC

Secondary Outcome Measures
NameTimeMethod
Secondary: Terminal half-life (t1/2) of midazolam16 Days

t1/2 of midazolam will be a secondary outcome measure for the subgroup of subjects who were administered midazolam in the following group:

- Phase 1 monotherapy treatment naïve advanced NSCLC

Secondary: Objective response rate (ORR) as assessed by RECIST 1.1 criteria24 Months

ORR will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

Secondary: Duration of response (DOR) as assessed by RECIST 1.1 criteria24 Months

DOR will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 2 monotherapy dose comparison

Secondary: Disease control as assessed by RECIST 1.1 criteria24 Months

DOR will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 2 monotherapy dose comparison

Secondary: Progression-free survival (PFS) as assessed by RECIST 1.1 criteria24 Months

PFS will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 2 monotherapy dose comparison

* Phase 1 monotherapy treatment naïve advanced NSCLC

Secondary: Duration of stable disease (SD) as assessed by RECIST 1.1 criteria24 Months

Duration of SD will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

Secondary: Depth of response (best percentage change from baseline in lesion sum diameters) as assessed by RECIST 1.1 criteriaBaseline to 24 Months

Depth of response will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Time to response (TTR) as assessed by RECIST 1.1 criteria24 Months

DOR will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 2 monotherapy dose comparison

Secondary: Overall survival (OS)24 Months

OS will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 2 monotherapy dose comparison

* Phase 1 monotherapy treatment naïve advanced NSCLC

Secondary: sotorasib exposure and QTc interval relationship24 Months

sotorasib exposure and QTc interval relationship will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

Secondary: Progression-free survival (PFS) at 6 months6 Months

PFS at 6 months will be a secondary outcome measure for the following group:

- Phase 2 monotherapy

Secondary: Progression-free survival (PFS) at 12 months12 Months

PFS at 12 months will be a secondary outcome measure for the following group:

- Phase 2 monotherapy

Secondary: Overall survival (OS) at 12 months12 Months

OS at 12 months will be a secondary outcome measure for the following group:

- Phase 2 monotherapy

Secondary: Number of subjects with treatment-emergent adverse events24 Months

Treatment-emergent adverse events will be a secondary outcome measure for the following group:

- Phase 2 monotherapy

Secondary: Number of subjects with grade ≥3 treatment-emergent adverse events24 Months

Grade ≥3 treatment-emergent adverse events will be a secondary outcome measure for the following group:

- Phase 2 monotherapy

Secondary: Impact of treatment on disease-related symptoms and health related quality of life (HRQOL) as assessed by EORTC QLQ-C3024 Months

Impact of treatment on disease-related symptoms and HRQOL will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Impact of treatment on disease-related symptoms and HRQOL as assessed by disease-specific modules Quality-of-Life Questionnaire Lung Cancer Module (QLQ LC13)24 Months

Impact of treatment on disease-related symptoms and HRQOL will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Impact of treatment on disease-related symptoms and HRQOL as assessed by non-small cell lung cancer symptom assessment questionnaire (NSCLC SAQ) for NSCLC24 Months

Impact of treatment on disease-related symptoms and HRQOL will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Impact of treatment on disease-related symptoms and HRQOL as assessed by Patient Global Impression of Severity (PGIS)24 Months

Impact of treatment on disease-related symptoms and HRQOL will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Impact of treatment on disease-related symptoms and HRQOL as assessed by Patient Global Impression of Change (PGIC) in cough, dyspnea and chest pain for NSCLC24 Months

Impact of treatment on disease-related symptoms and HRQOL will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Treatment-related symptoms and impact on the subject as assessed by EORTC QLQ-C3024 Months

Treament related symptoms and impact on the subject will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Treatment-related symptoms and impact on the subject as assessed by selected questions from the Patient-reported Outcome of the Common Terminology Criteria for Adverse Events (PRO-CTCAE library)24 Months

Treatment-related symptoms and impact on the subject will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Treatment-related symptoms and impact on the subject as assessed by a single item about symptom bother, item GP5 of the Functional Assessment of Cancer Therapy - General (FACT-G)24 Months

Treatment-related symptoms and impact on the subject will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Change from baseline in physical function as assessed by EORTC QLQ-C30Baseline to 24 Months

Treatment-related symptoms and impact on the subject will be a secondary outcome measure for the following group:

- Phase 2 monotherapy dose comparison

Secondary: Plasma concentration (Cmax) of sotorasib15 Weeks

Cmax will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

* Phase 2 monotherapy dose comparison

Secondary: Plasma concentration (Cmax) of midazolam16 Days

Cmax of midazolam will be a secondary outcome measure for the subgroup of subjects who were administered midazolam in the following group:

- Phase 1 monotherapy treatment naïve advanced NSCLC

Secondary: Time to achieve Cmax (Tmax) of sotorasib15 Weeks

Tmax will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

Secondary: Area under the plasma concentration-time curve (AUC) of sotorasib15 Weeks

AUC will be a secondary outcome measure for the following groups:

* Phase 1 Dose Exploration Part 1 monotherapy

* Phase 1 Dose Expansion Part 2 monotherapy

* Phase 2 monotherapy

* Phase 1 combination arm with sotorasib and anti PD-1/L1

* Phase 1 monotherapy treatment naïve advanced NSCLC

* Phase 2 monotherapy dose comparison

Secondary: Area under the plasma concentration-time curve (AUC) of midazolam16 Days

AUC of midazolam will be a secondary outcome measure for the subgroup of subjects who were administered midazolam in the following group:

- Phase 1 monotherapy treatment naïve advanced NSCLC

Secondary: Clearance of midazolam from the plasma16 Days

Clearance of midazolam from the plasma will be a secondary outcome measure for the subgroup of subjects who were administered midazolam in the following group:

- Phase 1 monotherapy treatment naïve advanced NSCLC

Trial Locations

Locations (133)

City of Hope National Medical Center

🇺🇸

Duarte, California, United States

University of California Los Angeles

🇺🇸

Los Angeles, California, United States

University of California at SF

🇺🇸

San Francisco, California, United States

Sarcoma Oncology Research Center LLC

🇺🇸

Santa Monica, California, United States

Rocky Mountain Cancer Centers

🇺🇸

Denver, Colorado, United States

Sarah Cannon Research Institute at HealthONE

🇺🇸

Denver, Colorado, United States

Smilow Cancer Hospital at Yale New Haven

🇺🇸

New Haven, Connecticut, United States

Medical Oncology Hematology Consultants Helen F Graham Cancer Center

🇺🇸

Newark, Delaware, United States

University of Florida Health

🇺🇸

Gainesville, Florida, United States

AdventHealth Orlando Infusion Center

🇺🇸

Orlando, Florida, United States

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City of Hope National Medical Center
🇺🇸Duarte, California, United States

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