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Study of ORIC-944 in Patients With Metastatic Prostate Cancer

Registration Number
NCT05413421
Lead Sponsor
ORIC Pharmaceuticals
Brief Summary

The purpose of this study is to establish recommended Phase 2 dose (RP2D) and/or maximum tolerated dose (MTD) and preliminary antitumor activity of ORIC-944 in patients with metastatic prostate cancer.

Detailed Description

ORIC-944 is a potent, highly selective, allosteric, orally bioavailable, small molecule inhibitor of PRC2 via binding the embryonic ectoderm development (EED) subunit.

This is a first-in-human, open-label, single arm, multicenter, dose escalation followed by dose expansion study to establish the recommended phase 2 dose (RP2D) and/or maximum tolerated dose (MTD) and preliminary antitumor activity of ORIC-944 in patients with metastatic prostate cancer, including those with neuroendocrine and/or small cell features, who have exhausted available treatment options.

The study will begin with dose finding in patients with metastatic prostate cancer (Dose Escalation); additional dose expansion cohorts (Dose Expansion), with specific histology, treatment history, and/or expression of a specific biomarker, may be initiated via protocol amendment The study will evaluate escalating dose levels of ORIC-944 administered orally, once daily in 28-day cycles following an interval 3+3 design.

Recruitment & Eligibility

Status
RECRUITING
Sex
Male
Target Recruitment
42
Inclusion Criteria
  • Patients with metastatic prostate cancer, including those with neuroendocrine prostate cancer (NEPC) and/or small cell features

  • Must have undergone bilateral orchiectomy or be willing to continue GnRH analogue or antagonist to maintain castrate levels of testosterone

  • Any number of prior therapies are allowed, but must have progressed after at least one line of next generation androgen receptor antagonist (abiraterone, enzalutamide, apalutamide, darolutamide) and must not have received more than 2 chemotherapy regimens in the mCRPC setting

  • Evidence of progressive disease by PCWG3 criteria for study entry

    • rising PSA, defined as a minimum of 2 rising values obtained a minimum of one week apart with the latest result being at least 2.0 ng/mL (or 1.0 ng/mL if PSA rise is the only indication of progression), or
    • confirmation of 2 new bone lesions on last systemic therapy, or
    • soft tissue progression per RECIST 1.1
  • Measurable and/or evaluable disease by RECIST 1.1

  • Agreement and ability to undergo on-study punch skin biopsies and core tumor biopsies

  • ECOG performance status of 0 or 1

  • Adequate organ function

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Exclusion Criteria
  • History or presence of CNS metastases, unless previously treated and stable
  • History of class III or IV congestive heart failure or severe non-ischemic cardiomyopathy, unstable or poorly controlled angina, myocardial infarction, or ventricular arrhythmia within the previous 6 months
  • Known, symptomatic human immunodeficiency virus (HIV) infection
  • Active symptomatic Hepatitis B or C infection; patients with well controlled disease are eligible
  • Active gastrointestinal disease (eg, Crohn's disease, ulcerative colitis, short gut syndrome, etc) or other malabsorption syndromes that would reasonably impact drug absorption per investigator judgement
  • Any other condition or circumstance (eg, clinical, psychological, familial, sociological, inability to swallow oral study drug) that, in the opinion of the investigator, may interfere with protocol compliance or contraindicates participation in the study
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Combination Dose EscalationApalutamide (Erleada™) 60 mg or 240 mg tabletsORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combinations with abiraterone, apalutamide, darolutamide, or enzalutamide
Combination Dose OptimizationApalutamide (Erleada™) 60 mg or 240 mg tabletsCohort A and C: ORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combination with apalutamide Cohort B and D: ORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combination with darolutamide Combinations with abiraterone or enzalutamide may be conducted in the future
Combination Dose EscalationDarolutamide (Nubeqa®) 300 mg tabletsORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combinations with abiraterone, apalutamide, darolutamide, or enzalutamide
Combination Dose EscalationEnzalutamide (Xtandi®) 40 mg capsules or 40 mg and 80 mg tabletsORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combinations with abiraterone, apalutamide, darolutamide, or enzalutamide
Single Agent Dose EscalationORIC-944ORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles
Combination Dose EscalationORIC-944ORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combinations with abiraterone, apalutamide, darolutamide, or enzalutamide
Combination Dose EscalationAbiraterone acetate (Zytiga®) 250 mg or 500 mg tabletsORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combinations with abiraterone, apalutamide, darolutamide, or enzalutamide
Combination Dose OptimizationORIC-944Cohort A and C: ORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combination with apalutamide Cohort B and D: ORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combination with darolutamide Combinations with abiraterone or enzalutamide may be conducted in the future
Combination Dose OptimizationDarolutamide (Nubeqa®) 300 mg tabletsCohort A and C: ORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combination with apalutamide Cohort B and D: ORIC-944 dosed orally on a continuous daily dosing regimen in 28-day cycles in combination with darolutamide Combinations with abiraterone or enzalutamide may be conducted in the future
Primary Outcome Measures
NameTimeMethod
Recommended Phase 2 Dose (RP2D)12 months

RP2D as determined by interval 3+3 dose escalation design

Maximum plasma concentration (Cmax)28 Days

PK of ORIC-944 single agent and in combination with an ARPI

Time to maximum observed concentration (Tmax)28 Days

PK of ORIC-944 single agent and in combination with an ARPI

Area under the curve (AUC)28 Days

PK of ORIC-944 single agent and in combination with an ARPI

Apparent plasma terminal elimination half-life (t1/2)28 Days

PK of ORIC-944 single agent and in combination with an ARPI

Secondary Outcome Measures
NameTimeMethod
Clinical benefit rate (CBR)36 months

Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

Objective response rate (ORR)36 months

Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

Duration of response (DOR)36 months

Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

Progression-free survival (PFS)36 months

Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

On-treatment PSA levels and change from baseline36 months

Prostate cancer working group 3 criteria (PCWG3)

Trial Locations

Locations (15)

South Florida Oncology and Hematology

🇺🇸

Plantation, Florida, United States

First Urology

🇺🇸

Jeffersonville, Indiana, United States

University of Washington, Fred Hutchinson Cancer Center

🇺🇸

Seattle, Washington, United States

Marlene & Stewart Greenebaum Comprehensive Cancer Center, University of Maryland

🇺🇸

Baltimore, Maryland, United States

Karmanos

🇺🇸

Detroit, Michigan, United States

Memorial Sloane Kettering Cancer Center

🇺🇸

New York, New York, United States

Levine Cancer Institute

🇺🇸

Charlotte, North Carolina, United States

Keystone Urology Specialists

🇺🇸

Lancaster, Pennsylvania, United States

Urology Clinics of North Texas

🇺🇸

Dallas, Texas, United States

Huntsman Cancer Institute, University of Utah

🇺🇸

Salt Lake City, Utah, United States

Sydney Adventist Health

🇦🇺

Wahroonga, New South Wales, Australia

Bendigo Health

🇦🇺

Bendigo, Victoria, Australia

NEXT Oncology

🇪🇸

Madrid, Spain

Vall d'Hebron Institute of Oncology

🇪🇸

Barcelona, Spain

Royal Marsden NHS Foundation Trust

🇬🇧

Sutton, Surrey, United Kingdom

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