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A Phase 1/2 Trial of SRA737 in Subjects With Advanced Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02797964
Recruitment Status : Active, not recruiting
First Posted : June 14, 2016
Last Update Posted : March 7, 2019
Sponsor:
Information provided by (Responsible Party):
Sierra Oncology, Inc.

Tracking Information
First Submitted Date  ICMJE May 23, 2016
First Posted Date  ICMJE June 14, 2016
Last Update Posted Date March 7, 2019
Actual Study Start Date  ICMJE July 2016
Estimated Primary Completion Date September 2019   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 2, 2017)
  • Number of subjects with adverse events as assessed by CTCAE 4.03 [ Time Frame: Up to 30 days after last dose of SRA737 ]
  • Maximum tolerated dose of SRA737 [ Time Frame: Cycle 1 (28 days) in the Dose Escalation Phase ]
  • Recommended Phase 2 dose of SRA737 [ Time Frame: Up to 30 days after last dose of SRA737 ]
  • Objective response rate of SRA737 [ Time Frame: From date of first dose until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 32 months ]
Original Primary Outcome Measures  ICMJE
 (submitted: June 13, 2016)
  • Safety and Tolerability of CCT245737 assessed as the incidence, severity and causality of adverse events [ Time Frame: Up to 28 days after last dose of CCT245737. ]
  • The highest dose at which ≤33% of patients have a dose limiting toxicity (DLT) in a cohort of up to 6 patients of CCT245737 [ Time Frame: Up to 28 days after last dose of CCT245737 ]
    A recommended safe dose of CCT245737 for evaluation in Phase II trials as defined by a dose at which no more than one patient out of up to six patients at the same dose level experience a highly probably or probably drug-related dose limiting toxicity (DLT).
Change History Complete list of historical versions of study NCT02797964 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE
 (submitted: June 13, 2016)
  • Assessment of plasma levels of CCT245737 to define the maximum observed plasma concentration (Cmax) [ Time Frame: 48 hrs after CCT245737 dose 1, C1D15 or C1D22 ]
    PK profiling will be measured over a 48 hour time course after the first dose of CCT2456737 and again for 48 hours after dosing on Cycle 1 Day 15 or 22.
  • Assessment of plasma levels of CCT245737 to define the time to reach Cmax (Tmax) [ Time Frame: 48 hrs after CCT245737 dose 1, C1D15 or C1D22 ]
    PK profiling will be measured over a 48 hour time course after the first dose of CCT2456737 and again for 48 hours after dosing on Cycle 1 Day 15 or 22.
  • Assessment of plasma levels of CCT245737 to define the area under the curve (AUC) [ Time Frame: 48 hrs after CCT245737 dose 1, C1D15 or C1D22 ]
    PK profiling will be measured over a 48 hour time course after the first dose of CCT2456737 and again for 48 hours after dosing on Cycle 1 Day 15 or 22.
  • Assessment of plasma levels of CCT245737 to define the terminal elimination half-life (T1/2) [ Time Frame: 48 hrs after CCT245737 dose 1, C1D15 or C1D22 ]
    PK profiling will be measured over a 48 hour time course after the first dose of CCT2456737 and again for 48 hours after dosing on Cycle 1 Day 15 or 22.
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE A Phase 1/2 Trial of SRA737 in Subjects With Advanced Cancer
Official Title  ICMJE A Phase 1/2 Trial of SRA737 (a Chk1 Inhibitor) Administered Orally in Subjects With Advanced Cancer
Brief Summary The purpose of this clinical study is to establish the safety profile, determine the maximum tolerated dose (MTD) and recommend a Phase 2 dose and schedule of SRA737; and to evaluate the efficacy of SRA737 in prospectively-selected subjects with genetically-defined tumors that harbor genomic alterations linked to increased replication stress and that are hypothesized to be more sensitive to checkpoint kinase 1 (Chk1) inhibition via synthetic lethality. Specific cancer indications that frequently harbor these genetic mutations will be studied.
Detailed Description

SRA737 is a potent, highly selective, orally bioavailable small molecule inhibitor of Chk1, a key regulator of cell cycle progression and the DNA Damage Response (DDR) replication stress response. In cancer cells, intrinsic replication stress (RS) is induced by factors such as oncogenes (e.g., CCNE1 or MYC), genetic mutations in DNA repair machinery (e.g. BRCA1 or FANCA), genetic mutations leading to a dysregulated cell cycle (e.g., TP53 or RAD50) or other genomic alterations. This replication stress results in persistent DNA damage and genomic instability, leading to an increased dependency on Chk1 for survival. Targeted inhibition of Chk1 by SRA737 may therefore be synthetically lethal to cancer cells with elevated intrinsic RS.

This study has been designed to: establish the safety profile; determine the pharmacokinetic profile; identify the optimal dose, schedule, and MTD; obtain preliminary evidence of activity; and evaluate SRA737's efficacy in prospectively-selected subjects with tumors that harbor genomic alterations linked to increased replication stress and that are hypothesized to be more sensitive to Chk1 inhibition via synthetic lethality.

This clinical study consists of two phases, a Dose Escalation Phase 1 portion and a Cohort Expansion Phase 2 portion.

In the Dose Escalation Phase 1 portion, cohorts consisting initially of a single subject will receive escalating doses of SRA737, administered orally on a continuous daily dosing schedule in 28-day cycles. Once an SRA737-related Grade 2 toxicity is observed in a dose escalation cohort during Cycle 1, that cohort will be expanded to 3 to 6 subjects, and subsequent dose level cohorts will follow a rolling 6 design until the MTD has been identified.

In the Cohort Expansion Phase 2 portion, subjects with genetically-defined tumors that harbor genomic alterations linked to increased replication stress and that are hypothesized to be more sensitive to Chk1 inhibition will be prospectively enrolled into six indication-specific cohorts to explore the preliminary efficacy of SRA737. Subjects must have advanced or metastatic disease of one of the following types:

  • castration-resistant prostate cancer (mCRPC);
  • high grade serous ovarian cancer (HGSOC) without CCNE1 gene amplification;
  • HGSOC with CCNE1 gene amplification (or alternative genetic alteration with similar functional effect);
  • non-small cell lung cancer (NSCLC);
  • head and neck squamous cell carcinoma (HNSCC) or squamous cell carcinoma of the anus (SCCA); and
  • colorectal cancer (mCRC).

To qualify for enrolment in the Cohort Expansion Phase 2 portion, the subject's tumor must have a confirmed combination of mutations which are expected to confer sensitivity to Chk1 inhibition, determined by the Sponsor's review of genetic abnormalities detected in the following categories:

  • Oncogenic drivers such as CCNE1 or MYC, etc.
  • Genes involved in the DNA repair process including BRCA1, BRCA2, FANC genes, mismatch repair (MMR) genetic alterations and/or high microsatellite instability.
  • Key tumor suppressor genes regulating G1 cell cycle progression/arrest such as TP53, RAD50, etc. For patients with HNSCC or SCCA, positive human papilloma virus (HPV) status is also considered for eligibility.
  • Genetic indicators of replicative stress such as gain of function/amplification of CHEK1, ATR or other related genes.

Tumor genetics will be prospectively determined using Next-Generation Sequencing.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Phase 2
Study Design  ICMJE Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Advanced Solid Tumors or Non-Hodgkin's Lymphoma (NHL)
Intervention  ICMJE Drug: SRA737
SRA737 will be administered orally on each day of a 28-day cycle. Subjects will receive a single dose of SRA737 between 4 to 7 days prior to starting the first cycle for PK profiling. Subjects can continue taking SRA737 if they are receiving clinical benefit and able to safely take the drug and follow the requirements of the study.
Study Arms  ICMJE Experimental: Open label
Intervention: Drug: SRA737
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Active, not recruiting
Actual Enrollment  ICMJE
 (submitted: March 6, 2019)
112
Original Estimated Enrollment  ICMJE
 (submitted: June 13, 2016)
40
Estimated Study Completion Date  ICMJE April 2020
Estimated Primary Completion Date September 2019   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Key Inclusion Criteria:

  1. For Dose Escalation Only: any locally advanced or metastatic, histologically or cytologically proven solid tumor or NHL, relapsed after or progressing despite conventional treatment
  2. Life expectancy of at least 12 weeks
  3. World Health Organization (WHO) performance status of 0-1
  4. Must meet select hematological and biochemical laboratory indices
  5. Archival tumor tissue or accessible tumor and willingness to consent to a biopsy

Expansion Only:

  1. Any locally advanced or metastatic malignancy of the following types for which no other conventional therapy is considered appropriate:

    • Metastatic Colorectal Cancer (CRC)
    • Platinum-resistant or intolerant High Grade Serious Ovarian Cancer (HGSOC)
    • Advanced Non-Small Cell Lung Cancer (NSCLC)
    • Metastatic Castration-Resistant Prostate Cancer (mCRPC)
    • Head and Neck Squamous Cell Carcinoma (HNSCC) or squamous cell carcinoma of the anus (SCCA).
    • Eligibility may be further restricted by the select number of prior regimens specific to each indication
  2. Measurable disease per RECIST v1.1, or for mCRPC, evaluable disease per any of the following:

    • Measurable disease per RECIST v1.1
    • Increasing PSA
    • Circulating tumor cell (CTC) count of 5 or more cells per 7.5 ml of blood
  3. Tumor tissue or ctDNA evidence that subject's tumor harbors a combination of mutations which are expected to confer sensitivity to Chk1 inhibition. Eligibility will be determined by the Sponsor's review of genetic abnormalities detected in genes in the following categories:

    • Oncogenic drivers such as MYC, CCNE1, etc.
    • Key tumor suppressor genes regulating G1 cell cycle progression/arrest such as RAD50, TP53, etc. For patients with NHSCC or SCCA, positive HPV status is also considered for eligibility.
    • The DDR pathway including BRCA1, BRCA2 and FANC. For patients with CRC, MMR genetic alterations and/or high microsatellite instability are also considered for eligibility.
    • Genetic indicators of replicative stress such as gain of function/amplification of Chk1 or ATR or other related gene.

Key Exclusion Criteria:

  1. Received the following prior or current anticancer therapy:

    • Radiotherapy within the last 6 weeks
    • Endocrine therapy during the previous 4 weeks
    • Chemotherapy during the previous 4 weeks
    • Immunotherapy during the previous 6 weeks
    • Nitrosoureas or Mitomycin C during the previous 6 weeks
    • Other Investigational Medicinal Product during the 4 weeks before treatment
    • Any prior treatment with a Chk1 inhibitor or prior treatment with an ATR inhibitor within 6 months prior to receiving SRA737
  2. Other malignancy within the past 2 years, except for adequately treated tumors
  3. Ongoing toxic manifestations of previous treatments greater than NCI-CTCAE Grade 1
  4. For Dose Escalation: new or progressing brain metastases. For Cohort Expansion: present or prior brain metastases
  5. High medical risk because of nonmalignant systemic disease
  6. Serologically positive for hepatitis B, hepatitis C or HIV
  7. Serious cardiac condition, left ventricular ejection fraction < 45% at baseline, history of cardiac ischemia within the past 6 months, or prior history of cardiac arrhythmia requiring treatment
  8. Prior bone marrow transplant or extensive radiotherapy to greater than 25% of bone marrow within 8 weeks
  9. Peanut allergy
  10. QTcF> 450 msec in adult males and > 470 msec in adult females
  11. Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of SRA737
  12. Inability to swallow capsules without chewing or crushing
  13. Is a participant or plans to participate in another interventional clinical trial
  14. Any other condition which in the Investigator's opinion would not make the subject a good candidate
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United Kingdom
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT02797964
Other Study ID Numbers  ICMJE SRA737-01
Has Data Monitoring Committee No
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Sierra Oncology, Inc.
Study Sponsor  ICMJE Sierra Oncology, Inc.
Collaborators  ICMJE Not Provided
Investigators  ICMJE Not Provided
PRS Account Sierra Oncology, Inc.
Verification Date March 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP