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A Study of Select Drug Combinations in Adult Patients With Advanced/Metastatic BRAF V600 Colorectal Cancer

Registration Number
NCT04294160
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

A phase Ib, open-label platform study of select drug combinations chosen in order to characterize safety and tolerability of each treatment arm tested and to identify recommended doses and regimens for future studies.

Detailed Description

This is a phase Ib, multi-center, open-label study with multiple treatment arms in adult patients with advanced or metastatic BRAF V600 (E, D, or K) in order to characterize safety and tolerability of each treatment arm tested and to identify recommended doses and regimens for future studies. The open platform design of this study is adaptive to allow removal of combination treatment arm(s) based on emerging data and facilitate introduction of new candidate combinations. The study is comprised of a dose escalation part and may be followed by a dose expansion part for any combination treatment arm.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
122
Inclusion Criteria
  • Patients must have a site of disease amenable to biopsy, and be a candidate for tumor biopsy according to the treating institution's guidelines. Patients must be willing to undergo a new tumor biopsy at baseline and during on study therapy. Exceptions may be considered after documented discussion with Novartis.
  • All patients must have a BRAF V600 mutation confirmed by local assessment.
  • Patients with unresectable advanced/metastatic BRAF V600 cancer of the colon or rectum with measurable disease as determined by RECIST v1.1
  • Patients must have documented disease progression following, or are intolerant to, 1 or 2 lines of chemotherapy for advanced/metastatic disease

Key

Exclusion Criteria
  • Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy, or in-situ cervical cancer, or other tumors that will not affect life expectancy
  • Impairment of gastrointestinal function or gastrointestinal disease that may signficantly alter the absorption of study drugs
  • History of or current evidence/risk of retinal verin occlusion or serous retinopathy
  • History of or current interstitial lung disease or non-infectious pneumonitis
  • Patients with a known history of testing positive for HIV
  • Clinically significant cardiac disease at screening
  • Any medical condition that would, in the investigator's judgment, prevent the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures.
  • Pregnant or lactating women

Other protocol-defined inclusion/exclusion may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dabrafenib + LTT462 backbone arm 1LTT462dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + trametinib triplet arm 1LTT462dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + LXH254 triplet arm 2LXH254dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer - Arm is closed for further enrollment.
Dabrafenib + LTT462 + TNO155 triplet arm 3TNO155dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + spartalizumab triplet arm 4LTT462dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer - Arm is closed for further enrollment.
Dabrafenib + trametinib + TNO155 triplet arm 5TNO155dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + Tislelizumab triplet arm 6LTT462dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + LXH254 triplet arm 2LTT462dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer - Arm is closed for further enrollment.
Dabrafenib + LTT462 + TNO155 triplet arm 3LTT462dose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + trametinib triplet arm 1Dabrafenibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 backbone arm 1Dabrafenibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + trametinib triplet arm 1Trametinibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + LXH254 triplet arm 2Dabrafenibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer - Arm is closed for further enrollment.
Dabrafenib + LTT462 + TNO155 triplet arm 3Dabrafenibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + spartalizumab triplet arm 4Dabrafenibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer - Arm is closed for further enrollment.
Dabrafenib + trametinib + TNO155 triplet arm 5Dabrafenibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + spartalizumab triplet arm 4Spartalizumabdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer - Arm is closed for further enrollment.
Dabrafenib + trametinib + TNO155 triplet arm 5Trametinibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + Tislelizumab triplet arm 6Dabrafenibdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Dabrafenib + LTT462 + Tislelizumab triplet arm 6Tislelizumabdose escalation to determine maximum tolerated dose (MTD)/ Recommended dose (RD) in adult patients with advanced or metastatic BRAF V600 colorectal cancer
Primary Outcome Measures
NameTimeMethod
Incidence and nature of dose limiting toxicities (DLTs) in the first cycle30 months

To characterize safety and tolerability of each treatment arm tested and identify recommended doses (RD) and regimens for future studies

Incidence and severity of AEs and SAEs, including changes in laboratory values, vital signs, and ECGs34 months

To characterize safety and tolerability of each treatment arm tested and identify recommended doses and regimens for future studies

Frequency of dose interruptions30 months

To characterize safety and tolerability of each treatment arm tested and identify recommended doses and regimens for future studies

Frequency of dose reductions30 months

To characterize safety and tolerability of each treatment arm tested and identify recommended doses and regimens for future studies

Dose intensity30 months

To characterize safety and tolerability of each treatment arm tested and identify recommended doses and regimens for future studies

Secondary Outcome Measures
NameTimeMethod
AUClast derived from Serum/plasma concentration of individual investigational drugs within combination treatments30 months

To characterize the PK of each investigational drug within each treatment arm

Best overall response (BOR)34 months

To evaluate preliminary anti-tumor activity of each treatment arm per RECIST v1.1.

Progression free survival (PFS)34 months

To evaluate preliminary anti-tumor activity of each treatment arm per RECIST v1.1.

Overall response rate (ORR)34 months

To evaluate preliminary anti-tumor activity of each treatment arm per RECIST v1.1.

Duration of response (DOR)34 months

To evaluate preliminary anti-tumor activity of each treatment arm per RECIST v1.1.

Disease control rate (DCR)34 months

To evaluate preliminary anti-tumor activity of each treatment arm per RECIST v1.1.

Change from baseline of the PD marker DUSP6 in tumor tissue (dose escalation only)30 months

To evaluate PD effect in their respective combinations in tumor

AUCtau derived from Serum/plasma concentration of individual investigational drugs within combination treatments30 months

To characterize the PK of each investigational drug within each treatment arm

Cmax derived from Serum/plasma concentration of individual investigational drugs within combination treatments30 months

To characterize the PK of each investigational drug within each treatment arm

Tmax derived from Serum/plasma concentration of individual investigational drugs within combination treatments30 months

To characterize the PK of each investigational drug within each treatment arm

Trial Locations

Locations (5)

University of California LA Santa Monica Location

🇺🇸

Los Angeles, California, United States

Massachusetts General Hospital Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Sarah Cannon Research Institute SC

🇺🇸

Nashville, Tennessee, United States

Uni Of TX MD Anderson Cancer Cntr

🇺🇸

Houston, Texas, United States

Novartis Investigative Site

🇬🇧

Manchester, United Kingdom

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