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临床试验/NCT06299839
NCT06299839招募中1 期

A Phase 1 Open-label Study to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of PAS-004, a MEK (1/2) Inhibitor, in Patients With MAPK Pathway-driven Advanced Solid Tumors With a Documented RAS, NF1, or RAF Mutation or Patients Who Have Failed BRAF/MEK Inhibition

Pasithea Therapeutics Corp.4 个研究点 分布在 3 个国家目标入组 48 人开始时间: 2024年2月29日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
1 期
状态
招募中
入组人数
48
试验地点
4
主要终点
Evaluation of dose limiting toxicities (DLTs)

研究概览

简要总结

The main purpose of this clinical trial is to test PAS-004 in people with advanced solid tumors with rat sarcoma virus (RAS), neurofibromatosis type I (NF1), or rapidly accelerated fibrosarcoma (RAF) mutations. The main questions it aims to answer are:

  • How well participants are able tolerate different doses of PAS-004, and
  • What side effects PAS-004 might have.

Study participants will have regular visits to the study doctor and be asked to have tests and exams done to check on their health and safety. Everyone participating in the study will take PAS-004 by mouth as a single dose, followed by one week observation, then once a day during the study, in 28-day cycles. Participants will continue on daily PAS-004 for up to 2 years, or until:

  • They decide to withdraw from the study, or
  • They experience unacceptable side effects, or
  • Their disease progresses, or another illness interferes with taking the study drug, or
  • The sponsors stops the study.

研究设计

研究类型
Interventional
分配方式
Non Randomized
干预模型
Sequential
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Capable of giving signed informed consent which includes compliance with the requirements, prohibitions and restrictions listed in the informed consent form (ICF).
  • Patient has been informed both verbally and in writing about the objectives of the clinical study, the methods, the anticipated benefits, the potential risks, and the discomfort to which they may be exposed and has given written consent to participation in the study prior to study start and any study-related procedure.
  • Patient must be at least 18 years of age at the time of signing the ICF.
  • Patient must be able to swallow oral medication.
  • Patient with histologically or cytologically diagnosed mitogen-activated protein kinase (MAPK) pathway driven advanced solid tumors with all of the following characteristics:
  • Tumor cannot be surgically resected
  • Patient has failed or is ineligible for standard of care therapy
  • Patient has no available treatment options with known clinical benefit
  • Documented evidence of rat sarcoma virus (RAS), neurofibromatosis type I (NF1), and/or rapidly accelerated fibrosarcoma (RAF) mutations. Patients with RAF mutations must have previously failed v-Raf murine sarcoma viral oncogene homolog B (BRAF) / MEK inhibition.
  • Prior to enrollment, patients must agree to provide tumor tissue via biopsy (paraffin section or fresh tissue specimens) that will be sent for analysis to confirm eligibility, if no genetic test data or an adequate tumor tissue sample is available from within the 12 months prior to ICF signature.
  • Patient must have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 (Appendix B).
  • Patient must have an estimated life expectancy of at least 12 weeks in the opinion of the Investigator at the time of informed consent.
  • Patient must have adequate organ function at screening as indicated by the following laboratory value ranges:
  • Serum total bilirubin ≤ 1.5 × upper limit normal (ULN) (Serum total bilirubin can be ≤ 3.0 × ULN if patients have hemolysis or congenital hemolytic diseases)
  • Aspartate aminotransferase (AST) ≤ 2.5 × ULN or 5 × ULN for patient with liver metastases
  • Alanine aminotransferase (ALT) ≤ 2.5 × ULN or 5 × ULN for patient with liver metastases
  • Albumin ≥2 mg/dL
  • Creatinine clearance ≥ 45 mL/min (as calculated per Cockcroft-Gault)
  • Absolute neutrophil count (ANC) ≥ 1.5×109/L
  • Platelets ≥ 100×109/L
  • Hemoglobin ≥ 90 g/L (Note: Criteria must be met without a transfusion within 2 weeks of obtaining the sample)
  • Patient must agree to maintain abstinence (no heterosexual intercourse) or use a highly effective form of contraception during study treatment and for at least 90 days after the last dose of IP. Male patients must agree not to donate sperm while receiving IP and for at least 90 days after the last dose of IP.

排除标准

  • Participation in another therapeutic clinical trial within 4 weeks of enrollment.
  • Having received chemotherapy, radiotherapy, major surgery, targeted therapy, immunotherapy, or other antitumor treatment within 4 weeks of enrollment.
  • Known or active central nervous system metastases.
  • Patients with untreated brain metastases ≤ 30 mm that are asymptomatic, do not have significant edema, and do not require steroids or anti-seizure medications are eligible after discussion with the Medical Monitor.
  • Patients with previously treated brain metastases may participate provided they are stable after treatment and without evidence of progression by imaging for at least 4 weeks prior to the first dose of IP administration and are not using corticosteroids for at least 7 days prior to IP administration.
  • Patients with confirmed leptomeningeal disease are to be excluded.
  • Unresolved toxicity from prior antitumor therapy defined as AEs > Grade 2 according to Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0, except for alopecia; neurotoxicity AEs of patients who have received prior chemotherapy needs to be restored to Grade 2 or below. Patients with ≥ Grade 3 bleeding within 4 weeks of first study treatment dose should be excluded.
  • Taken a medication that is a strong cytochrome P450 (CYP3A) inhibitor or inducer within 14 days of initiation of study therapy dosing.
  • Taken a corrected QT (QTc) interval prolongating medication within 7days of initiation or longer if the half-life of the QTc prolonging medication is such that the drug is not cleared from the body within 7 days (5 half-lives) of initiation of study therapy dosing.
  • Active dysphagia, digestive system disease, malabsorption syndrome, or other conditions affecting PAS-004 absorption.
  • Previous or current retinal vein stenosis, retinal detachment, central retinal vein occlusion, or glaucoma.
  • Active interstitial pneumonia, including clinically significant radiation pneumonitis.
  • Impaired cardiac function or cardiac disease as indicated by:
  • Average QTc interval > 470 ms as calculated according to the QTc formula of the instrument at the research center where electrocardiogram (ECG) measurements are performed.
  • Grade ≥ 3 congestive heart failure per New York Heart Association (NYHA) guidelines.
  • Clinically significant arrhythmias, including but not limited to, complete left bundle branch conduction abnormalities and 2nd degree atrioventricular block.
  • Pregnant or lactating female patients.
  • Known allergy or hypersensitivity to the investigational product (IP), including excipients, or history of severe adverse reaction to any drug, or sensitivity to components of the IP.
  • Clinically active bacterial, fungal, or viral infections, hepatitis B (hepatitis B virus surface antigen positive and hepatitis B virus DNA over 1000 IU/ml) or hepatitis C (hepatitis C virus RNA positive), human immunodeficiency virus infection (HIV positive).

研究组 & 干预措施

PAS-004 Capsules

Experimental

Sequential dose escalation: 2 mg, 4 mg, 8 mg, 15 mg, 22 mg, 30 mg, 37 mg, and 45 mg

干预措施: PAS-004 Capsules (Drug)

PAS-004 Tablets

Experimental

A single cohort at the 4mg dose using tablet formulation of PAS-004

干预措施: PAS-004 Tablets (Drug)

结局指标

主要结局

Evaluation of dose limiting toxicities (DLTs)

时间窗: Day 1 through Day 35 (Cycle 1)

Pre-defined DLTs will be assessed for dose escalation and expansion determinations.

Evaluation of adverse events (AEs)

时间窗: Screening through Day 1 through Day 35 (Cycle 1), and 30 days after discontinuation of study drug

The number and severity of AEs will be evaluated for dosing cohorts to inform dose escalation and expansion decisions, and support selection of a preliminary recommended phase 2 dose (RP2D).

Evaluation of hematology laboratory parameters

时间窗: Screening through Day 1 through Day 35 (Cycle 1), and 30 days after discontinuation of study drug

Lab parameters will be evaluated for to assess the safety profile of the study drug, and support selection of a preliminary recommended phase 2 dose (RP2D).

Evaluation of AEs leading to discontinuation of investigational product (IP), PAS-004.

时间窗: Screening through Day 1 through Day 35 (Cycle 1), and 30 days after discontinuation of study drug

The number and severity of AEs leading to discontinuation of study drug will be evaluated for dosing cohorts to inform dose escalation and expansion decisions, and support selection of a preliminary recommended phase 2 dose (RP2D).

Evaluation of clinical chemistry laboratory parameters

时间窗: Screening through Day 1 through Day 35 (Cycle 1), and 30 days after discontinuation of study drug

Lab parameters will be evaluated for to assess the safety profile of the study drug, and support selection of a preliminary recommended phase 2 dose (RP2D).

次要结局

  • Evaluation of overall survival (OS)(Cycle 1 Day 1 to date of death, up to 13 months from last participant enrolled)
  • Peak Plasma Concentration (Cmax)(Cycle 1: Day 1 and Day 22 (predose, and 30 min, 1 hr, 2 hr, 3 hr, 5 hr, 8 hr and 24 hr post-dose), Day 4, 8, 15, 29 and 35 (predose))
  • Plasma predose or trough concentration (Ctau/Ctrough)(Cycle 1: Day 22 (predose, and 30 min, 1 hr, 2 hr, 3 hr, 5 hr, 8 hr and 24 hr post-dose), Day 8, 15, 29 and 35 (predose))
  • Time of maximum plasma concentration (Tmax)(Cycle 1: Day 1 and Day 22 (predose, and 30 min, 1 hr, 2 hr, 3 hr, 5 hr, 8 hr and 24 hr post-dose), Day 4, 8, 15, 29 and 35 (predose))
  • Area under the concentration versus time curve from time zero to the last sampling time with quantifiable analyte (AUC0-t)(Cycle 1: Day 1 (predose, and 30 min, 1 hr, 2 hr, 3 hr, 5 hr, 8 hr and 24 hr post-dose), Day 4)
  • Area under the concentration versus time curve from time zero extrapolated to infinity if possible (AUC0-∞)(Cycle 1: Day 1 (predose, and 30 min, 1 hr, 2 hr, 3 hr, 5 hr, 8 hr and 24 hr post-dose), Day 4)
  • Apparent terminal elimination half-life (t1/2) in Plasma(Cycle 1: Day 1 and Day 22 (predose, and 30 min, 1 hr, 2 hr, 3 hr, 5 hr, 8 hr and 24 hr post-dose), Day 4, 8, 15, 29 and 35 (predose))
  • Area under the concentration versus time curve for the dosing interval, assuming steady state has been reached and duplicating the predose concentration for the 24 hour postdose concentration (AUC0-tau)(Cycle 1: Day 22 (predose, and 30 min, 1 hr, 2 hr, 3 hr, 5 hr, 8 hr and 24 hr post-dose), Day 8, 15, 29 and 35 (predose))
  • Apparent total plasma clearance if possible (CL/F)(Cycle 1: Day 1 (predose, and 30 min, 1 hr, 2 hr, 3 hr, 5 hr, 8 hr and 24 hr post-dose), Day 4, and 8 (predose))
  • Evaluation of the percentage of extracellular signal-regulated kinase phosphorylation (pERK) inhibition from baseline(Day 1 through Day 35 (Cycle 1))
  • Evaluation of the objective response rate (ORR)(Screening, Day 35 (Cycle 1), and every 9 weeks thereafter)
  • Evaluation of progression-free survival (PFS)(Cycle 1 Day 1 to date of death, up to 25 months from last participant enrolled)

研究者

申办方类型
Industry
责任方
Sponsor

研究点 (4)

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相关资讯

Pasithea Therapeutics Secures $60 Million Funding to Advance MEK Inhibitor for Neurofibromatosis Treatment- Pasithea Therapeutics completed a $60 million public offering led by prominent healthcare investors to fund development of PAS-004, a next-generation MEK inhibitor. - The company is currently testing PAS-004 in Phase 1 clinical trials for advanced cancer patients and Phase 1/1b trials for neurofibromatosis type 1-associated plexiform neurofibromas. - The funding extends Pasithea's cash runway through at least the first half of 2028, supporting ongoing clinical development and research activities. - PAS-004 represents a novel macrocyclic oral MEK inhibitor designed to treat RASopathies, MAPK pathway-driven tumors, and other related diseases.9 months agoPasithea Therapeutics Receives $1 Million ALS Association Grant to Advance PAS-004 MEK Inhibitor in Phase 1 ALS Trial- The ALS Association awarded Pasithea Therapeutics approximately $1 million through its Hoffman Clinical Trial Awards Program to study PAS-004, a next-generation macrocyclic MEK inhibitor, in ALS patients. - The Phase 1 study will evaluate PAS-004 in twelve ALS patients across three sequential dose cohorts over approximately 28 weeks, marking the first clinical trial of this MEK inhibitor in ALS. - PAS-004 targets MAPK and MEK enzymes involved in TDP-43-related neurodegeneration and neuroinflammation, with promising preclinical results in the SOD mouse model of ALS. - The trial will assess safety and tolerability while measuring changes in ALS Functional Rating Scale-Revised scores and neurofilament light chain levels as potential biomarkers of clinical activity.9 months agoPasithea's PAS-004 Shows Strong Target Engagement with 91% pERK Inhibition in Phase 1 Cancer Trial- Pasithea Therapeutics' Phase 1 trial of PAS-004 demonstrated up to 91% inhibition of pERK, confirming substantial target engagement in advanced cancer patients at doses as low as 8mg. - The MEK inhibitor has shown a favorable safety profile with no dose-limiting toxicities or rash observed in the first 19 patients, a significant advantage over competitor drugs that typically cause rash in over 80% of patients. - A stage 4 pancreatic cancer patient with KRAS G12R mutation achieved tumor volume reduction of 9.8% and maintained stable disease for over 5 months, suggesting promising clinical activity.last yearPasithea Therapeutics Expands PAS-004 Clinical Trial to Europe, Completes Dosing in Cohort 4A- Pasithea Therapeutics has broadened its Phase 1 clinical trial for PAS-004 by opening new sites in Romania and Bulgaria, actively recruiting patients. - The trial is evaluating PAS-004, a next-generation MEK inhibitor, for advanced solid tumors with specific MAPK pathway mutations. - Initial dosing has been completed for Cohort 4A (15mg capsule), with ongoing recruitment for Cohort 4B (4mg tablet) participants. - Interim safety and pharmacokinetic data from Cohorts 4A and 4B are anticipated in Q1 2025, offering insights into PAS-004's efficacy.last yearPAS-004 Shows Favorable Safety and Early Efficacy in MAPK-Driven Solid Tumors- PAS-004, a next-generation MEK inhibitor, demonstrates a tolerable safety profile in early phase 1 trial cohorts of patients with advanced MAPK-driven cancers. - The trial observed no drug-related serious adverse effects or dose interruptions at 2 mg and 4 mg doses, with no reports of rash, gastrointestinal, or ocular toxicities. - Pharmacokinetic data reveals a long half-life of approximately 70 hours and a flat pharmacokinetic curve at steady-state, potentially enabling constant target inhibition. - Early signs of efficacy were observed in a heavily pretreated patient with BRAF K601E-mutated colorectal cancer, showing prolonged stable disease during treatment.last year