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Study of Ulixertinib for Patients With Advanced Malignancies Harboring MEK or Atypical BRAF Alterations

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ClinicalTrials.gov Identifier: NCT04488003
Recruitment Status : Recruiting
First Posted : July 27, 2020
Last Update Posted : May 28, 2021
Sponsor:
Information provided by (Responsible Party):
BioMed Valley Discoveries, Inc

Brief Summary:
This BVD-523-ABC study builds on the safety and clinical activity experience of previous studies that have evaluated ulixertinib as a novel targeted cancer treatment in cohorts of patients with specific genetic alterations and tumor histologies that result in aberrant MAPK pathway signaling. Early clinical data have demonstrated anti-tumor activity with ulixertinib treatment and have identified specific groups of patients for whom additional development is warranted.

Condition or disease Intervention/treatment Phase
Advanced Solid Tumor BRAF Gene Mutation BRAF Gene Alteration MEK Mutation MEK Alteration MAP2K1 Gene Mutation MAP2K1 Gene Alteration MAP2K2 Gene Mutation MAP2K2 Gene Alteration Drug: Ulixertinib Drug: Physician's Choice Phase 2

Expanded Access : An investigational treatment associated with this study is available outside the clinical trial.   More info ...

Detailed Description:

This multi-center, phase II study will be conducted in two parts and assess the clinical benefit, safety, pharmacokinetics, and pharmacodynamics of ulixertinib (BVD-523) in patients with advanced malignancies.

Part A (tumor histology agnostic) will be open label and enroll patients to one of six groups based on their tumor alteration.

  • Group 1: Patients with tumors, other than colorectal cancer (CRC), having a BRAF alteration that results in an amino acid change at positions G469, L485, or L597.
  • Group 2: Patients with tumors, other than CRC, having a defined Class 2 BRAF alteration (see Appendix 2 of protocol).
  • Group 3: Patients with tumors, other than CRC, having an atypical BRAF alteration (non V600) that is not specified in Group 1 or Group 2.
  • Group 4: Patients with CRC having any atypical BRAF alteration.
  • Group 5: Patients with tumors, other than CRC, harboring alterations in MEK1/2.
  • Group 6: Patients with CRC harboring alterations in MEK1/2.

Part B (tumor histology specific) will randomly enroll patients with one of up to three specified tumor histologies to receive either ulixertinib or the physician's choice of treatment in a 2:1 ratio. Tumors must harbor a specified MEK or atypical BRAF alteration. If a patient progresses on physician's choice of treatment, crossover to the ulixertinib arm is permitted.The specific histologies to be included in this part will be selected based on available data and discussion with the clinical investigators, the medical monitor, and the sponsor.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 528 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Two-Part, Phase II, Multi-center Study of the ERK Inhibitor Ulixertinib (BVD-523) for Patients With Advanced Malignancies Harboring MEK or Atypical BRAF Alterations
Actual Study Start Date : November 3, 2020
Estimated Primary Completion Date : August 1, 2023
Estimated Study Completion Date : August 1, 2023

Arm Intervention/treatment
Experimental: Part A: Ulixertinib
Oral, 600 mg, twice daily, for 28-days in each treatment cycle
Drug: Ulixertinib
Oral, 600 mg, twice daily, for 28-days in each treatment cycle
Other Name: BVD-523, BVD523

Experimental: Part B: Ulixertinib
Oral, 600 mg, twice daily, for 28-days in each treatment cycle
Drug: Ulixertinib
Oral, 600 mg, twice daily, for 28-days in each treatment cycle
Other Name: BVD-523, BVD523

Experimental: Part B: Physician's choice of treatment
Physician's choice will be restricted to two approved (not off-label) treatments for each tumor histology (agents targeting BRAF or MEK kinases and experimental agents are not permitted as physician choice). If a patient progresses on physician's choice of treatment, crossover to the ulixertinib arm is permitted.
Drug: Physician's Choice
Physician's choice will be restricted to two approved (not off-label) treatments for each tumor histology (agents targeting BRAF or MEK kinases and experimental agents are not permitted as physician choice)).




Primary Outcome Measures :
  1. Part A: Overall Response Rate (ORR) according to RECIST 1.1 [ Time Frame: Up to 30 months ]
    ORR will be defined as the percentage of patients achieving a Best Overall Response (BOR) of confirmed Complete Response (CR) and/or Partial Response (PR). Patients will be evaluated at baseline & at periodic follow-up visits through the time their participation in the study is complete.The best responses will occur at different time points for each patient.

  2. Part B: Progression Free Survival (PFS) according to RECIST 1.1 [ Time Frame: 18 months ]
    PFS will be defined as time from first day of study drug to disease progression as adjudicated by the independent review committee or death. Patients with no event will be censored at the last available tumor assessment.


Secondary Outcome Measures :
  1. Part A: Duration of Response (DOR) according to RECIST 1.1 [ Time Frame: Up to 30 months ]
    Time from first response to disease progression (DP) or death; assessed until DP, death, or initiation of subsequent anticancer therapy. Patients with no event will be censored at the last available tumor assessment.

  2. Part A: Progression Free Survival (PFS) according to RECIST 1.1 [ Time Frame: 18 months ]
    PFS will be defined as time from first day of study drug to disease progression or death. Patients with no event will be censored at the last available tumor assessment. This analysis will be based on investigator assessment.

  3. Part A: Overall Survival (OS) according to RECIST 1.1 [ Time Frame: 18 months ]
    OS will be defined as time from first day of study drug to death. Patients with no event will be censored at the last date the patient is known to be alive.

  4. Part A: Cmax of BVD-523 at steady state [ Time Frame: Single time point drawn at Visit 4/approximately day 15 (or whenever the patient reaches steady state). ]
    Single time point taken prior to taking study drug (trough) at steady state. Steady state is defined as patients who have received at least 5 days, or 10 consecutive doses, of study drug.

  5. Part B: Overall Survival (OS) of ulixertinib compared to physician's choice of treatment [ Time Frame: 18 months ]
    OS will be defined time from first day of study drug to death. Patients with no event will be censored at the last date the patient is known to be alive.

  6. Part B: Overall Response Rate (ORR) of ulixertinib compared to physician's choice of treatment, according to RECIST 1.1 [ Time Frame: Up to 30 months ]
    ORR will be defined as the percentage of patients achieving a Best Overall Response (BOR) of confirmed Complete Response (CR) and/or Partial Response (PR). Patients will be evaluated at baseline & at periodic follow-up visits through the time their participation in the study is complete.The best responses will occur at different time points for each patient.

  7. Part B: Duration of Response (DOR) of ulixertinib compared to physician's choice of treatment, according to RECIST 1.1 [ Time Frame: Up to 30 months ]
    Time from first response to disease progression or death; assessed until DP, death, or initiation of subsequent anticancer therapy. Patients with no event will be censored at the last available tumor assessment.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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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:

  • Patients with a locally advanced or metastatic malignancy, that has progressed following systemic therapy for their disease, if available, or for which the patient is not a candidate or refuses.
  • Tumors harboring a MEK or atypical BRAF alteration.
  • Provide signed and dated informed consent prior to initiation of any study-related procedures that are not considered standard of care (SoC).
  • Male or female patients aged ≥18 years.
  • Patients must have measurable disease by RECIST version 1.1.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 2.
  • Adequate renal function [creatinine ≤1.5 times ULN (upper limit of normal)] or a glomerular filtration rate (GFR) of ≥50 mL/min (using Cockcroft-Gault).
  • Adequate hepatic function [total bilirubin ≤1.5 times ULN; AST (aspartate transaminase) and ALT (alanine transaminase) ≤3 times ULN or ≤5 times ULN if the elevation is due to liver involvement by tumor].
  • Adequate bone marrow function (hemoglobin ≥9.0 g/dL; platelets ≥100 x 109 cells/L; absolute neutrophil count ≥1.5 x 109 cells/L).
  • Adequate cardiac function: Left ventricular ejection fraction (LVEF) of >50% as assessed by multi-gated acquisition (MUGA) or ultrasound/echocardiography (ECHO); and a corrected QT interval (QTc) <480ms by the Fridericia method (QTcF).
  • Contraception - women: Negative pregnancy test for females of child-bearing potential; must be surgically sterile, postmenopausal (no menstrual cycle for at least 12 consecutive months), or compliant with a medically approved contraceptive regimen during and for 3 months after the last administration of study drug. Abstinence is not considered an adequate contraceptive regimen.
  • Contraception - men: Must be surgically sterile, or compliant with a medically approved contraceptive regimen during and for 3 months after the last administration of study drug.
  • Willing and able to participate in the trial and comply with all trial requirements.
  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational agent may be included after consultation with the medical monitor.

Exclusion Criteria:

  • Gastrointestinal (GI) condition that could impair absorption of study medication (specific cases e.g., remote history of GI surgery, may be enrolled after discussion with the medical monitor) or inability to ingest study medication.
  • Uncontrolled or severe intercurrent medical condition.
  • Known uncontrolled brain metastases. Stable brain metastases either treated or being treated with a stable dose of steroids/anticonvulsants, with no dose change in the previous 4 weeks, can be allowed.
  • Having received any cancer-directed therapy (chemotherapy, hormonal therapy, biologic or immunotherapy, etc.) within 28 days or 5 half-lives (whichever is shorter) prior to the first dose of study drug. Patients previously treated with radiotherapy must have recovered from the acute toxicities associated with such treatment.
  • Major surgery within 4 weeks prior to first dose.
  • Any use of an investigational drug within 28 days or 5 half-lives (whichever is shorter) prior to the first dose of study drug. A minimum of 10 days between termination of the prior investigational drug and administration of study drug is required. In addition, any drug-related toxicity except alopecia should have recovered to Grade 1 or less.
  • Prior therapy with any ERK inhibitor (e.g. LY3214996, LTT462).
  • Groups 1-4: Prior therapy with any BRAF and/or MEK inhibitor (e.g. encorafenib, dabrafenib, vemurafenib, binimetinib, trametinib, cobimetinib) is excluded. Prior BRAF and/or MEK inhibitor therapy is permitted for Groups 5 and 6.
  • For Part B, agents targeting BRAF or MEK kinases and experimental agents are not permitted as physician's choice
  • Pregnant or breast-feeding women.
  • Any evidence of serious active infections. Patients are allowed to enroll if they have been fever-free for at least 48 hours and are on an active treatment that is not prohibited in Appendix 1 of the protocol.
  • Any important medical illness or abnormal laboratory finding that would increase the risk of participating in this study (based on the investigator's judgment).
  • A history or current evidence/risk of retinal vein occlusion (RVO) or central serous retinopathy (CSR).
  • Concurrent therapy with any other investigational agent.
  • Concurrent therapy with drugs known to be strong inhibitors or inducers of CYP1A2, CYP2D6, and CYP3A4.

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): NCT04488003


Contacts
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Contact: BioMed Valley Discoveries, Inc 816.960.6600 ERK@biomed-valley.com

Locations
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United States, Arizona
Mayo Clinic Recruiting
Phoenix, Arizona, United States, 85054
Contact: Clinical Trials Referral Office    855-776-0015      
Principal Investigator: Tanios (Tony) Bekaii-Saab, MD         
United States, Delaware
Christiana Care Health Services / Helen F. Graham Cancer Center Recruiting
Newark, Delaware, United States, 19713
Contact: Denise DeMaio    302-623-4500    Denise.A.DeMaio@christianacare.org   
Principal Investigator: Michael Guarino, MD         
United States, Florida
University of Florida Recruiting
Gainesville, Florida, United States, 32610
Contact: Marlene Sarmiento, RN       msarmien@ufl.edu   
Principal Investigator: Thomas J George Jr., MD         
Mayo Clinic Recruiting
Jacksonville, Florida, United States, 32224
Contact: Clinical Trials Referral Office    855-776-0015      
Principal Investigator: Jeremy Jones, MD         
United States, Massachusetts
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02114
Contact: Ryan Sullivan, MD    617-724-4000    rsullivan7@mgh.harvard.edu   
Principal Investigator: Ryan Sullivan, MD         
United States, Minnesota
Mayo Clinic Recruiting
Rochester, Minnesota, United States, 55905
Contact: Clinical Trials Referral Office    855-776-0015      
Principal Investigator: Wen Wee Ma, MBBS         
Metro-Minnesota Community Oncology Research Consortium (MMCORC) Recruiting
Saint Louis Park, Minnesota, United States, 55416
Contact: Justin Eklund    952-993-1555    justin.eklund@parknicollet.com   
Principal Investigator: Daniel Anderson, MD         
United States, North Carolina
Duke University Medical Center / Duke Cancer Institute Recruiting
Durham, North Carolina, United States, 27710
Contact: Jeremy Jenkins    919-684-6342    jeremy.jenkins@duke.edu   
Principal Investigator: Niharika Mettu, MD         
United States, Ohio
Kettering Cancer Center Recruiting
Kettering, Ohio, United States, 45429
Contact: Terri VanZant-Marvin       Terri.vanzant-marvin@ketteringhealth.org   
Principal Investigator: Brandon Cutler, DO         
United States, South Dakota
Avera Cancer Institute Recruiting
Sioux Falls, South Dakota, United States, 57105
Contact: Martha Lang       MedoncResearch@avera.org   
Principal Investigator: Heidi McKean, MD         
United States, Texas
MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: Anjali Raina    713-792-3238    araina@mdanderson.org   
Principal Investigator: Filip Janku, MD, PhD         
United States, Virginia
Virginia Cancer Specialists, PC Recruiting
Fairfax, Virginia, United States, 22031
Contact: Carrie Friedman    703-208-3192    Carrie.Friedman@usoncology.com   
Principal Investigator: Alexander Spira, MD         
United States, Wisconsin
University of Wisconsin Clinical Science Center Recruiting
Madison, Wisconsin, United States, 53792
Contact    800-622-8922    clinicaltrials@cancer.wisc.edu   
Principal Investigator: Mark Burkard, MD         
Sponsors and Collaborators
BioMed Valley Discoveries, Inc
Additional Information:
Publications:
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Responsible Party: BioMed Valley Discoveries, Inc
ClinicalTrials.gov Identifier: NCT04488003    
Other Study ID Numbers: BVD-523-ABC
First Posted: July 27, 2020    Key Record Dates
Last Update Posted: May 28, 2021
Last Verified: May 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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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 BioMed Valley Discoveries, Inc:
atypical BRAF, non-V600
Additional relevant MeSH terms:
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Neoplasms