IACS-6274 With or Without Pembrolizumab for the Treatment of Advanced Solid Tumors

  • STATUS
    Recruiting
  • End date
    May 29, 2026
  • participants needed
    36
  • sponsor
    M.D. Anderson Cancer Center
Updated on 4 October 2022
cancer
monoclonal antibodies
carcinoma
neutrophil count
tumor cells
cancer chemotherapy

Summary

This phase I trial tests the safety, side effects, and best dose of IACS-6274 with or without pembrolizumab in treating patients with solid tumors that have spread to other places in the body (advanced). IACS-6274 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving IACS-6274 with or without pembrolizumab may help to control the disease.

Description

PRIMARY OBJECTIVES:

I. To assess the safety and tolerability of oral glutaminase inhibitor IPN60090 (IACS-6274) as monotherapy (Part A) and in combination therapy with pembrolizumab (Part B).

II. To determine the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) of IACS-6274 in combination therapy with pembrolizumab (Part B). (For Dose Escalation Only)

SECONDARY OBJECTIVES:

I. To assess the preliminary antitumor activity of IACS-6274 as monotherapy (Part A) and in combination with pembrolizumab (Part B) in patients with or without biomarker selected tumor types.

II. To characterize the pharmacokinetics (PK) and pharmacodynamic (PD) profile of IACS-6274 as a monotherapy (Part A) and in combination with pembrolizumab (Part B).

III. To evaluate biomarkers of patient stratification and correlate them with clinical outcome.

EXPLORATORY OBJECTIVE:

I. To collect biobank samples for potential future analysis of biomarkers (optional, informed consent required).

OUTLINE: This is a dose-escalation study of IACS-6274 followed by a dose-expansion study. Patients are assigned to 1 of 2 parts.

PART A: Patients receive IACS-6274 orally (PO) twice daily (BID) on days 1-21. Cycles repeat every 21 days for 2 years in the absence of disease progression or unacceptable toxicity.

PART B: Patients receive IACS-6274 PO BID on days 1-21 and pembrolizumab intravenously (IV) over 30 minutes on day 1. Cycles repeat every 21 days for 2 years in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 30 days. Part B patients are also followed up at 60 and 90 days.

Details
Condition Advanced Endometrial Carcinoma, Advanced Head and Neck Squamous Cell Carcinoma, Advanced Malignant Solid Neoplasm, Advanced Melanoma, Advanced Ovarian Clear Cell Adenocarcinoma, Chondrosarcoma, Clinical Stage III Cutaneous Melanoma AJCC v8, Clinical Stage IV Cutaneous Melanoma AJCC v8, Pathologic Stage III Cutaneous Melanoma AJCC v8, Pathologic Stage IIIA Cutaneous Melanoma AJCC v8, Pathologic Stage IIIB Cutaneous Melanoma AJCC v8, Pathologic Stage IIIC Cutaneous Melanoma AJCC v8, Pathologic Stage IIID Cutaneous Melanoma AJCC v8, Pathologic Stage IV Cutaneous Melanoma AJCC v8, Refractory Endometrial Carcinoma, Refractory Head and Neck Squamous Cell Carcinoma, Refractory High Grade Ovarian Serous Adenocarcinoma, Refractory Melanoma, Refractory Ovarian Clear Cell Adenocarcinoma, Stage III Ovarian Cancer AJCC v8, Stage III Uterine Corpus Cancer AJCC v8, Stage IIIA Ovarian Cancer AJCC v8, Stage IIIA Uterine Corpus Cancer AJCC v8, Stage IIIA1 Ovarian Cancer AJCC v8, Stage IIIA2 Ovarian Cancer AJCC v8, Stage IIIB Ovarian Cancer AJCC v8, Stage IIIB Uterine Corpus Cancer AJCC v8, Stage IIIC Ovarian Cancer AJCC v8, Stage IIIC Uterine Corpus Cancer AJCC v8, Stage IIIC1 Uterine Corpus Cancer AJCC v8, Stage IIIC2 Uterine Corpus Cancer AJCC v8, Stage IV Ovarian Cancer AJCC v8, Stage IV Uterine Corpus Cancer AJCC v8, Stage IVA Ovarian Cancer AJCC v8, Stage IVA Uterine Corpus Cancer AJCC v8, Stage IVB Ovarian Cancer AJCC v8, Stage IVB Uterine Corpus Cancer AJCC v8
Treatment Pembrolizumab, Glutaminase Inhibitor IPN60090
Clinical Study IdentifierNCT05039801
SponsorM.D. Anderson Cancer Center
Last Modified on4 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Provision of written informed consent prior to any study related procedures
Patients >= 18 years of age at the time of study entry who agree to participate by giving written informed consent prior to participation in any study related activities
Histologically or cytologically confirmed advanced solid tumors, specifically
Dose Escalation and Dose Expansion may include
Patients with tumors with actionable KEAP1/NFE2L2/STK11/NF1 mutations
Patients with low ASNS expression levels (high-grade serous ovarian carcinoma [HGSOC] or endometrial cancer)
Post-immunotherapy (IO) melanoma (minimum treatment duration of prior PD-1 or PD-L1-containing regimen is 12 weeks [or equivalent of 2 response evaluations])
Dose Escalation may also include
Patients with post-platinum HNSCC
Patients with chondrosarcoma
Patients with ARID1A mutant clear cell ovarian cancer Note: all biomarker mutations/expression levels must be confirmed prior to study treatment
Patients must have received at least one line of therapy for advanced stage disease
and be refractory or ineligible to available existing therapy(ies) known to
Prior treatment with chemotherapy, radiotherapy, immunotherapy or any investigational therapies must have been completed at least 3 weeks or at least five half-lives, whichever is shorter, before the study drug administration, and all adverse events (AEs) (excluding alopecia and peripheral neuropathy) have either returned to =< grade 1 or stabilized
Fresh and/or archival tumor tissue from the biopsy obtained between the completion of the most recent line of treatment until study entry must be available for mutation and biomarker analysis. Patients should not be put at undue risk to obtain fresh tumor biopsy. If available, archival tumor tissue from time of initial diagnosis will be collected in addition to the most recent biopsy (archival and/or fresh)
provide clinical benefit for their condition
Measurable or non-measurable evaluable disease as defined per the Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1 (or immune-related RECIST [iRECIST] for Part B only)
Eastern Cooperative Oncology Group (ECOG) performance status =< 1
Absolute neutrophil count (ANC) >= 1500/mL
Platelets >= 100,000/mL
Hemoglobin >= 9 g/dL
Serum creatinine =< 1.5 x upper limit of normal (ULN) and/or creatinine clearance > 40 mL/min. Actual body weight should be used for calculating creatinine clearance using the Cockroft-Gault equation (except for patients with body mass index > 30 kg/m^2 when the lean body weight should be used)
Serum total bilirubin =< 1.5 x ULN (with the exception of patients with known Gilbert's syndrome: serum total bilirubin must be < 3 x ULN in these patients)
Aspartate aminotransferase (serum glutamic oxaloacetic transaminase) and alanine aminotransferase (serum glutamic pyruvic transaminase) =< 2.5 x ULN or =< 5 x ULN for patients with liver metastases)
Left ventricular ejection fraction >= 50%
Female patients are eligible to enter and participate in the study if they are of
Non-childbearing potential (physiologically incapable of becoming pregnant), including any female who
Has had a hysterectomy, OR
Has had a bilateral oophorectomy, OR
Has had a bilateral salpingectomy, OR
Is postmenopausal (total cessation of menses for >= 2 years, or follicle-stimulating hormone >= 50 IU/L)
Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (for example oral, intravaginal, transdermal)
Childbearing potential, but with a negative serum pregnancy test at screening
Progestogen-only hormonal contraception associated with inhibition of ovulation (for example oral, implantable, injectable)
(within 7 days of the first investigational medicinal product [IMP]
Intrauterine device
Intrauterine hormone-releasing system
administration), is not breastfeeding, and uses highly effective contraception
Bilateral tubal occlusion
at study entry and throughout the study until 90 days after the last
Male partner has had a vasectomy
administration. Highly effective contraceptive methods include
Male patients are eligible to enter and participate in the study if they agree to use
effective methods of contraception during the study treatment period and for
at least 90 days after the last dose of investigational product

Exclusion Criteria

Prior malignancy within the previous 2 years except for locally curable cancers that have been cured, such as basal or squamous cell skin cancer, or carcinoma in situ of the cervix, breast or bladder
Known primary central malignancy or symptomatic central nervous system metastasis(es)
Note: Patients with stable, previously treated brain metastases may participate if neurologic symptoms have resolved, patients have been off steroids for at least 7 days, and there is no evidence of disease progression by imaging for at least 2 weeks before the first dose of study treatment
Uncontrolled, significant intercurrent or recent illness including, but not limited to, the following cardiac conditions
Any unstable cardiac arrhythmia within 6 months prior to enrolment
Prolongation of the Fridericia corrected QT (QTcF) interval defined as > 450 ms for males and > 470 ms for females
History of any of the following cardiovascular conditions within 6 months of
enrolment
Cardiac angioplasty or stenting, myocardial infarction, unstable angina, coronary artery
Bypass graft surgery, symptomatic peripheral vascular disease, class III or IV congestive heart failure, as defined by the New York Heart Association
Major surgical intervention within 28 days before study drug administration
Patients should be excluded if they have a condition requiring systemic treatment with
Significant acute or chronic infections
either corticosteroids (> 10 mg daily prednisone equivalents) or other
immunosuppressive medications within 2 weeks of the first dose of study drug
Any psychiatric condition that would prohibit the understanding or rendering of informed consent
Treatment with strong cytochrome P450 (CYP450) subtype 3A4 (CYP3A4) inducers (including St John's wort) and inhibitors (including grapefruit juice) within 7 days of the first dose of study drug
Treatment with strong CYP450 subtype 2D6 (CYP2D6) inhibitors within 7 days of the first dose of study drug
Radiotherapy within 4 weeks prior to the start of study drug. Palliative radiotherapy for symptomatic control is acceptable if completed at least 2 weeks prior to study drug administration and no additional radiotherapy for the same lesion is planned
Underlying medical conditions that, in the investigator's opinion, will make the administration of study drug hazardous or obscure the interpretation of toxicity determination or AEs
History of allergic reactions attributed to compounds of similar chemical or biological composition to any of the compounds in the study
Known alcohol or drug abuse
Legal incapacity or limited legal capacity
Inability to swallow oral medications (capsules and tablets) without chewing, breaking, crushing, opening or otherwise altering the product formulation. Patients should not have gastrointestinal illnesses that would preclude the absorption of IACS-6274, which is an oral agent
Patients unwilling to comply with protocol requirements related to the assigned part
PART B (DOSE ESCALATION AND DOSE EXPANSION) SPECIFIC EXCLUSION CRITERIA
Autoimmune disease that might deteriorate when receiving an immune-stimulatory agent, or immunodeficiencies
Known severe hypersensitivity reactions to monoclonal antibodies, any history of anaphylaxis, or uncontrolled asthma (that is, three or more features of partially controlled asthma)
Prior organ transplantation, including allogeneic stem cell transplantation
Patient has received a live vaccine within 30 days prior to the first dose of study drug. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette-Guerin and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist) are live attenuated vaccines and are not allowed
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