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Clinical Trials/NCT04497116
NCT04497116
Completed
Phase 1

Phase 1/2a Study of the Safety, Pharmacokinetics, Pharmacodynamics and Preliminary Clinical Activity of RP-3500 Alone or in Combination With Talazoparib or Gemcitabine in Advanced Solid Tumors With ATR Inhibitor Sensitizing Mutations (TRESR Study)

Repare Therapeutics13 sites in 4 countries276 target enrollmentJuly 22, 2020

Overview

Phase
Phase 1
Intervention
RP-3500 (camonsertib)
Conditions
Advanced Solid Tumor
Sponsor
Repare Therapeutics
Enrollment
276
Locations
13
Primary Endpoint
Frequency of Treatment-Related Adverse Event of CTCAE Grade 3 and Above
Status
Completed
Last Updated
6 months ago

Overview

Brief Summary

The primary purpose of this study is to define the maximum tolerated dose (MTD) and determine a recommended Phase 2 dose (RP2D) and schedule of orally-administered RP-3500 (camonsertib) alone or in combination with talazoparib, a PARP inhibitor, or Gemcitabine in patients with advanced solid tumors with ATR inhibitor-sensitizing mutations. This study will also evaluate the safety and tolerability of RP-3500 (camonsertib) alone or in combination with talazoparib or gemcitabine, examine both the pharmacokinetics (PK)and pharmacodynamics (PD)and investigate its anti-tumor activity in solid tumors.

Detailed Description

This is a first-in-human, Phase 1/2a, multi-center, open-label, dose-escalation and expansion study to: * Evaluate the safety profile and MTD of RP-3500 (camonsertib) when administered orally, alone and in combination with talazoparib or gemcitabine, to establish the dose and schedule recommended for the Phase 2 * Characterize the PK profile of RP-3500 (camonsertib) alone or in combination with talazoparib or gemcitabine * Identify anti-tumor activity associated with RP-3500 (camonsertib) given alone or in combination with talazoparib or gemcitabine The initial cohorts will test RP-3500 (camonsertib) as monotherapy. Additional cohorts will enroll with RP-3500 (camonsertib) in combination with talazoparib or gemcitabine. After the RP2D and schedule is determined, expansion cohort(s) for RP-3500 (camonsertib) will be enrolled to study the anti-tumor effect, and further examine the safety and PK of RP-3500 (camonsertib) at the RP2D

Registry
clinicaltrials.gov
Start Date
July 22, 2020
End Date
June 13, 2025
Last Updated
6 months ago
Study Type
Interventional
Study Design
Sequential
Sex
All

Investigators

Responsible Party
Sponsor

Eligibility Criteria

Inclusion Criteria

  • Written informed consent, according to local guidelines, signed and dated by the patient or legal guardian prior to the performance of any study-specific procedures, sampling, or analyses.
  • Male or female and ≥ 18 years-of-age at the time of signature of the consent.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or
  • Histologically confirmed solid tumors resistant or refractory to standard treatment and/or patients who are intolerant to standard therapy.
  • Measurable disease as per RECIST v1.1
  • Existing biomarker profile (tumor tissue or plasma) reported from a local test obtained in a certified lab per institutional guidelines:
  • Available tumor tissue
  • Ability to comply with the protocol and study procedures detailed in the Schedule of Assessments.
  • Ability to swallow and retain oral medications.
  • Acceptable organ function at screening

Exclusion Criteria

  • Chemotherapy, small molecule anticancer or biologic anticancer therapy given within 14 days prior to first dose of study drug.
  • History or current condition (such as transfusion dependent anemia or thrombocytopenia), therapy, or laboratory abnormality that might confound the study results, or interfere with the patient's participation for the full duration of the study treatment.
  • Prior therapy with an ATR or DNA-dependent protein kinase (DNA-PK) inhibitor.
  • Known hypersensitivity to any of the ingredients of RP-3500 (camonsertib).
  • Life-threatening illness, medical condition, active uncontrolled infection, or organ system dysfunction or other reasons which, in the investigator's opinion, could compromise the patient's safety.
  • Uncontrolled, symptomatic brain metastases.
  • Uncontrolled high blood pressure
  • Patients with active, uncontrolled bacterial, fungal, or viral infection, including hepatitis B virus (HBV), hepatitis C virus (HCV), known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) related illness.
  • Moderate or severe hepatic impairment (ie, Child-Pugh class B or C).
  • History or presence of an abnormal ECG that is clinically significant in the investigator's opinion.

Arms & Interventions

RP-3500 (camonsertib) alone

Phase 1: Multiple doses of RP-3500 (camonsertib) for oral administration alone

Intervention: RP-3500 (camonsertib)

Expansion cohorts with RP-3500 (camonsertib)

Phase 2: Expansion cohorts with RP-3500 (camonsertib)

Intervention: RP-3500 (camonsertib)

RP-3500 (camonsertib) with Talazoparib or Gemcitabine

Phase 1: Multiple doses of RP-3500 (camonsertib) for oral administration in combination with talazoparib or gemcitabine

Intervention: RP-3500 (camonsertib)

RP-3500 (camonsertib) with Talazoparib or Gemcitabine

Phase 1: Multiple doses of RP-3500 (camonsertib) for oral administration in combination with talazoparib or gemcitabine

Intervention: Talazoparib

RP-3500 (camonsertib) with Talazoparib or Gemcitabine

Phase 1: Multiple doses of RP-3500 (camonsertib) for oral administration in combination with talazoparib or gemcitabine

Intervention: Gemcitabine Injection

Outcomes

Primary Outcomes

Frequency of Treatment-Related Adverse Event of CTCAE Grade 3 and Above

Time Frame: Start of treatment to 30 days post last dose, up to 1 year

Treatment-emergent adverse events (TEAEs) are those events that occur or worsen on or after the first dose of study drug up through 30 days post the last dose (or cross over to a different module) or the start of subsequent anticancer therapy. AEs are considered related to treatment if the relationship to camonsertib or the other combination drug (in the study regimen) is "Related" (include unknown relationship) as indicated on the AE eCRF page based on investigator's assessment.

Frequency of Dose Limiting Toxicity (DLT)

Time Frame: Either 21 days or 28 days (1 cycle) from the initiation of the study treatment.

Toxicity were assessed using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. A toxicity was considered dose-limiting if it occurred during the first cycle and was deemed at least possibly related to study treatment. If multiple toxicities occurred, the most severe toxicity was used in the assessment. The DLT Evaluable population consists of patients who received at least 80% of planned total doses of camonsertib , 80% of planned total doses of camonsertib and talazoparib, or 80% of planned total doses of camonsertib and 100% of gemcitabine; complete all required safety evaluations and are observed through the end of Cycle 1; or patients who experience a DLT qualifying event in the first cycle of treatment.

Study Sites (13)

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Camonsertib Shows Promise in ATM-Deficient Advanced Solid Tumors• Repare Therapeutics presented Phase 1/2 TRESR trial data on camonsertib monotherapy at ESMO 2024, highlighting its potential in advanced solid tumors with ATM loss-of-function. • The study (NCT04497116) evaluated safety, pharmacokinetics, and anti-tumor activity of camonsertib, a potential leading ATR inhibitor, in patients with various solid tumors. • Early data suggests camonsertib monotherapy demonstrates preliminary anti-tumor activity in this patient population, warranting further investigation. • The oral presentation included detailed findings from Module 1 of the TRESR trial, focusing on dose escalation and expansion to determine the recommended Phase 2 dose.Repare Therapeutics' ATR Inhibitor Camonsertib Shows Promise in DNA Repair-Deficient Cancers- Camonsertib, a selective ATR inhibitor developed by Repare Therapeutics in partnership with Roche, demonstrated significant clinical activity in DNA damage response-deficient solid tumors with results published in Nature Medicine. - The Phase 1/2 TRESR trial showed camonsertib combinations with PARP inhibitors achieved a 48% clinical benefit rate across tumor types, with particularly compelling results in ovarian cancer patients showing 32% overall response and 58% clinical benefit rate. - Early circulating tumor DNA molecular responses were observed in 66% of evaluable patients, confirming antitumor activity and providing mechanistic validation for the synthetic lethality approach in heavily pretreated patients.