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A Study of Avelumab, Binimetinib and Talazoparib in Patients With Locally Advanced or Metastatic RAS-mutant Solid Tumors

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ClinicalTrials.gov Identifier: NCT03637491
Recruitment Status : Recruiting
First Posted : August 20, 2018
Last Update Posted : November 17, 2020
Sponsor:
Information provided by (Responsible Party):
Pfizer

Study Description
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Brief Summary:
This Phase 1b/2 study will examine the effects of the study drugs, avelumab, binimetinib and talazoparib when given in a 2 (doublet) or 3 (triplet) drug combination, in patients with locally advanced or metastatic RAS-mutant solid tumors. The Phase 1b part of the study will assess if the different study drugs can be given together safely and which doses to use for further research. Phase 2 will test if the study treatments have an effect on tumor size and growth, and gather more information about potential side effects.

Condition or disease Intervention/treatment Phase
Pancreatic Cancer Drug: Avelumab Drug: Binimetinib Drug: Talazoparib Phase 1 Phase 2

Detailed Description:

This is a Phase 1b/2, open label, multi-center, safety, clinical activity, pharmacokinetic (PK), and pharmacodynamics (PD) study of combinations of avelumab, binimetinib and talazoparib in adult patients with metastatic pancreatic ductal adenocarcinoma and other locally advanced or metastatic KRAS- or NRAS-mutant solid tumors.

The Phase 1b part of this study will initially assess doublet drug combinations to determine a recommended dose for further investigation. Following this, the recommended dose for the combination of avelumab, binimetinib and talazoparib (triplet) will be determined. The recommended doses for the doublet and triplet combinations will be used in the Phase 2 part of the study, which will assess the safety and preliminary anti-tumor activity of the study treatments.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 122 participants
Allocation: Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A PHASE 1B/2 STUDY TO EVALUATE SAFETY AND CLINICAL ACTIVITY OF COMBINATIONS OF AVELUMAB, BINIMETINIB AND TALAZOPARIB IN PATIENTS WITH LOCALLY ADVANCED OR METASTATIC RAS-MUTANT SOLID TUMORS
Actual Study Start Date : August 15, 2018
Estimated Primary Completion Date : November 29, 2023
Estimated Study Completion Date : November 28, 2024

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Avelumab and binimetinib
Open label
 Drug: Avelumab
IV treatment
Other Name: MSB0010718C

Drug: Binimetinib
Oral treatment
Other Names:
  • MEK162
  • ARRY-438162
Experimental: Avelumab, binimetinib and talazoparib
Open label
 Drug: Avelumab
IV treatment
Other Name: MSB0010718C

Drug: Binimetinib
Oral treatment
Other Names:
  • MEK162
  • ARRY-438162

Drug: Talazoparib
Oral treatment
Other Name: MDV3800, BMN 673
Experimental: Binimetinib and talazoparib.
Open label.
 Drug: Binimetinib
Oral treatment
Other Names:
  • MEK162
  • ARRY-438162

Drug: Talazoparib
Oral treatment
Other Name: MDV3800, BMN 673


Outcome Measures
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Primary Outcome Measures :
  1. Dose Limiting Toxicity (DLT) [ Time Frame: Cycle 1 (days 1-28 of study treatment) ]
    Phase 1: DLT during the primary DLT evaluation period (Cycle 1)

  2. Confirmed Objective Response (OR) [ Time Frame: From start date (date of randomization for randomized cohorts and first dose of study treatment for non-randomized cohorts) until the date of first documentation of progressive disease or death due to any cause assessed up to approximately 24 months. ]
    Phase 2: Confirmed OR, defined as a complete response (CR) or partial response (PR) per RECIST v1.1. Both CR and PR must be confirmed by repeat assessments performed no less than 4 weeks after the criteria for response are first met.


Secondary Outcome Measures :
  1. Concentration of avelumab in blood [ Time Frame: Day 1, Day 8 and Day 15 of Cycle 1 (each cycle is 28 days); Day 1 and Day 15 of Cycle 2; and Day 1 of Cycles 3, 5, 9 and 12. ]
    Pharmacokinetic parameters: pre-dose/trough concentrations (Ctrough)

  2. Concentration of avelumab in blood [ Time Frame: Day 1, Day 8 and Day 15 of Cycle 1 (each cycle is 28 days); Day 1 and Day 15 of Cycle 2; and Day 1 of Cycles 3, 5, 9 and 12. ]
    Pharmacokinetic parameters: post dose concentrations (Cmax)

  3. Avelumab ADA levels [ Time Frame: Day 1, Day 8 and Day 15 of Cycle 1 (each cycle is 28 days); Day 1 and Day 15 of Cycle 2; and Day 1 of Cycles 3, 5, 9 and 12. ]
    Immunogenicity assessment of avelumab

  4. Neutralizing antibodies (nAb) against avelumab. [ Time Frame: Day 1, Day 8 and Day 15 of Cycle 1 (each cycle is 28 days); Day 1 and Day 15 of Cycle 2; and Day 1 of Cycles 3, 5, 9 and 12. ]
    Immunogenicity assessment of avelumab

  5. Concentration of binimetinib in plasma [ Time Frame: Pre-dose on Day 1, Day 8 and Day 15 of Cycle 1 (each cycle is 28 days). Day 1 of Cycle 2 and 3 ]
    Pharmacokinetic parameters: pre-dose/trough concentrations (Ctrough)

  6. Concentration of binimetinib in plasma [ Time Frame: Day 1, Day 8 and Day 15 of Cycle 1 (each cycle is 28 days). Day 1 of Cycle 2 and Cycle 3. ]
    Pharmacokinetic parameters: post dose concentrations (Cmax).

  7. Concentration of talazoparib in plasma [ Time Frame: Pre-dose on Day 1, 8 and Day 15 of Cycle 1 (each cycle is 28 days), and on Day 1 of Cycle 2 and 3 ]
    Pharmacokinetic parameters: pre-dose/trough concentrations (Ctrough)

  8. Biomarker Tumor Mutational Burden [ Time Frame: Baseline ]
    Tumor mutational burden in baseline tumor tissue

  9. Biomarker PD-L1 [ Time Frame: Baseline ]
    PD-L1 expression level in baseline tumor tissue.

  10. Biomarker DNA Damage Repair [ Time Frame: Baseline ]
    DDR gene alterations in baseline tumor tissue.

  11. Objective Response [ Time Frame: From the start of treatment until disease progression/recurrence up to approximately 24 months. ]
    Phase 1b: Confirmed OR based on Investigator assessment per RECIST v1.1.

  12. Time to Tumor Response (TTR) [ Time Frame: Baseline up to approximately 24 months ]
    TTR is defined, for patients with an OR, as the time from the 'start date' to the first documentation of objective response (CR or PR) which is subsequently confirmed

  13. Duration of Response (DR) [ Time Frame: Baseline up to approximately 24 months ]
    DR is defined, for patients with OR, as the time from the first documentation of objective response (CR or PR) to the date of first documentation of PD or death due to any cause

  14. Overall Survival (OS) [ Time Frame: Baseline up to approximately 24 months ]
    OS is defined as the time from time from the 'start date' to the date of death due to any cause. Patients without an event (death) will be censored at the date of last contact

  15. Progression Free Survival [ Time Frame: Baseline up to approximately 24 months ]
    PFS is defined as the time from 'start date' to the date of PD by RECIST v1.1 or death due to any cause, whichever occurs first


Eligibility Criteria
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Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histological diagnosis of locally advanced (primary or recurrent) or metastatic solid tumors that are not amenable for treatment with curative intent as follows:

    1. Metastatic pancreatic ductal adenocarcinoma; or
    2. Phase 2 only: Stage IIIb/IV NSCLC or other advanced solid tumors with documented positive KRAS or NRAS mutation as determined using a validated test performed in a CAP/CLIA-certified laboratory (or other comparable local or regional certification).
  • Have had disease progression during or following at least 1 and not more than 2 prior lines of treatment for advanced or metastatic disease.
  • Patients with NSCLC must have previously received treatment with an anti-PD-1 or anti-PD-L1 agent for advanced disease.
  • Measurable disease as per RECIST v1.1 criteria.
  • Provision of a baseline tumor sample.
  • Age ≥18 years (Japanese patients must be ≥20 years old)
  • Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0 or 1.
  • Adequate bone marrow, renal and liver functions.
  • Adequate cardiac function.
  • Informed consent provided.

Exclusion Criteria:

  • Prior treatment with avelumab, a PARP inhibitor or MEK inhibitor.
  • Prior systemic anti-cancer therapy within 2 weeks prior to study enrollment.
  • Persisting toxicity related to prior therapy.
  • Current use of immunosuppressive medication.
  • Known history of immune-mediated colitis, inflammatory bowel disease, pneumonitis, pulmonary fibrosis, uveitis or iritis.
  • Active or prior autoimmune disease that might deteriorate when receiving an immunostimulatory agent.
  • Diagnosis of myelodysplastic syndrome (MDS).
  • Known symptomatic brain metastases requiring steroids.
  • Known history of testing positive for HIV or hepatitis.
  • Clinically significant (ie, active) cardiovascular disease.
  • History of thromboembolic or cerebrovascular events.
  • Current or anticipated use of a P-gp inhibitor, inducer, or inhibitor of breast cancer resistance protein (BCRP)
  • Uncontrolled hypertension.
  • Concurrent neuromuscular disorder that is associated with the potential of elevated creatinine kinase.
  • Known history of Gilbert's syndrome.
  • History or current evidence of retinal degenerative disease, retinal vein occlusion (RVO) or current risk factors for RVO.
  • Other acute or chronic medical or psychiatric condition.
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03637491


Contacts
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Contact: Pfizer CT.gov Call Center 1-800-718-1021 ClinicalTrials.gov_Inquiries@pfizer.com

Locations
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Sponsors and Collaborators
Pfizer
Investigators
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Study Director: Pfizer CT.gov Call Center Pfizer
More Information
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Additional Information:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Pfizer
ClinicalTrials.gov Identifier: NCT03637491    
Other Study ID Numbers: B9991033
2018-000124-34 ( EudraCT Number )
First Posted: August 20, 2018    Key Record Dates
Last Update Posted: November 17, 2020
Last Verified: November 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Pfizer:
KRAS
NRAS
PDAC
Pancreatic Cancer
Additional relevant MeSH terms:
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Pancreatic Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Endocrine Gland Neoplasms
Digestive System Diseases
Pancreatic Diseases
 Endocrine System Diseases
Talazoparib
Poly(ADP-ribose) Polymerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents