CLINICAL TRIAL / NCT05200442
A Study of VS-6766 and Cetuximab in Patients With Advanced Colorectal Cancer
- Interventional
- Recruiting
- NCT05200442
Contact Information
A Phase 1b/2 Study of AVUTOMETINIB and Cetuximab in Participants With Advanced KRAS Mutated Colorectal Cancer
Doctors leading this study hope to learn about the safety of combining the study drug VS-6766 with another drug called cetuximab in colorectal cancer. This study is for individuals who have advanced colorectal cancer and their cancer has progressed while getting previous treatment or individuals who cannot take/tolerate previous treatments. If you choose to participate, your time in this research will last up to 24 months.
The purpose of this research is to gather information on the safety and effectiveness of
VS-6766 in combination with cetuximab. Doctors leading this study want to find out if
combining two medications (cetuximab and VS-6766) is better or worse than the usual
approach for the treatment of colorectal cancer. The usual approach for treating
colorectal cancer after it progresses involves chemotherapies like Fluorouracil (5-FU),
oxaliplatin, irinotecan and possibly a medication like bevacizumab. This study will
instead combine cetuximab and VS-6766 to find out if the two medications can help people
living with advanced colorectal cancers with certain mutations (differences) called KRAS
mutations.
Gender
All
Age Group
18 Years and up
Accepting Healthy Volunteers
No
Inclusion Criteria:
- Must be able to show documentation of disease: Participants must have metastatic
colorectal adenocarcinoma with kirsten rat sarcoma viral oncogene homolog (KRAS)
mutations, detected by any Clinical Laboratory Improvement Amendments-certified
method (tumor or ct-DNA), for which curable treatment modalities are not an option.
- Participants with the following KRAS mutations can be included in the study. These
eligible KRAS mutations will be confirmed by the Study Chair, Dr. Shergill. Please
contact Dr. Shergill for all other mutations that you feel may benefit from this
treatment.
- Must have measurable disease per Response Evaluation Criteria in Solid Tumors
(RECIST 1.1).
- Must have had progression of disease on 5-FU or capecitabine, oxaliplatin,
irinotecan and bevacizumab therapy or any other approved anti-VEGF therapy or must
have a scientifically justifiable reason for not having had these therapies prior to
trial. If participant has high levels of MicroSatellite Instability (MSI-H), they
must have had recommended immunotherapy agent(s) i.e anti- programmed death ligand 1
(L)1 with or without anti-CTLA4 agents.
- No prior Lonsurf or regorafenib treatment is allowed.
- Must have not had any treatment with prior MEK (mitogen-activated protein kinase
kinase) inhibitor, anti-EGFR (antineoplastic epidermal growth factor receptor),
KRAS, SOS1 ( Son of sevenless 1) and SHP2 (Src homology-2 domain-containing protein
tyrosine phosphatase-2) inhibitor therapy.
- Participants should not have had chemotherapy, radiotherapy, or major surgery within
2 weeks prior to entering the study.
- Participants should not be receiving any other study agents concurrently with the
study drugs.
- Not pregnant and not nursing, because this study involves an investigational agent
whose genotoxic, mutagenic and teratogenic effects on the developing fetus and
newborn are unknown. Therefore, for women of childbearing potential only, a negative
pregnancy test done ≤ 7 days prior to registration is required. Negative serum
pregnancy test is required for all female patients of child bearing potential within
7 days of cycle 1 day. All patients should agree to use highly effective method of
contraceptive: female patient up to 2 months after 30 days of the last dose and male
pts up to 90 days of the last dose.
- Must be 18 years old or older.
- Must have Eastern Cooperative Oncology Group Performance status of 0-1
- Must meet required clinical laboratory values set by study doctor to show
participant's health and organ function meets requirements to be in study.
- Must have adequate cardiac function as clinically confirmed by study doctor.
- Participants with human immunodeficiency virus (HIV)-infected who are on effective
anti-retroviral therapy with undetectable viral load within 6 months are eligible
for this trial.
- For participants with a history of chronic hepatitis B virus infection, the
hepatitis B virus (HBV) viral load must be undetectable on suppressive therapy, if
indicated.
- Participants with a history of hepatitis C (HCV) infection must have been treated
and cured. For participants with HCV infection who are currently on treatment, they
are eligible if they have an undetectable HCV viral load.
- Participants with known untreated Central Nervous System (CNS) metastases are
excluded. Patients with a history of CNS metastases are permitted to enroll if they
have been treated, and systemic steroids have been tapered to physiologic doses (10
milligrams (mg) or less of prednisone or equivalent), and CNS disease has been
stable for a minimum of one month on imaging and clinically. Exceptions for
participants with asymptomatic sub-centimeter metastases that, in the opinion of the
treating investigator, do not require intervention may be possible following
discussion and agreement with the overall Study Chair.
Exclusion criteria:
- Participants with uncontrolled intercurrent illness including, but not limited to:
ongoing or active infection requiring systemic treatment, symptomatic congestive
heart failure, cardiac arrhythmia, psychiatric illness/social situations that would
limit compliance with study requirements, hypertension, defined as systolic blood
pressure > 160 mmHg despite medical management, myocardial infarction, unstable
angina, coronary artery bypass grafting, coronary angioplasty, or stenting < 12
months prior to screening.
- Participants with clinically relevant coronary artery disease or history of
myocardial infarction in last 12 months or high risk of uncontrolled arrhythmia or
uncontrolled cardiac insufficiency, or those with uncontrolled or poorly controlled
hypertension (>180 millimeters of mercury (mmHg) systolic or >130 mmHG diastolic
pressures) may not receive cetuximab.
- Participants with history of corrected QT interval (QTc) prolongation, Brugada
syndrome, known history of QTc prolongation, or Torsades de Pointes.
- Participants with known COVID-19 infection within 28 days prior to first dose of
therapy are excluded. History of Gilbert's syndrome.
- Participants with history of recent rhabdomyolysis within last 3 months.
- Participants with active skin disorder that has requested systemic therapy within
past 12 months.
- Participants with a history of neuromuscular disorders that are associated with
elevated creatine phosphokinase (CPK) (e.g. inflammatory myopathies, muscular
dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy).
- History of other malignancy which could affect compliance with the protocol or
interpretation of results.
- History of curatively treated basal or squamous cell carcinoma of the skin or in
situ carcinoma of the cervix are allowed. Subjects with a malignancy that has been
treated with curative intent will also be allowed if the malignancy has been in
remission without treatment for ≥ 2 years prior to Cycle 1, Day 1. Subjects with
localized prostate cancer that has been treated with curative intent will be
allowed.
- Participants planning to embark on a new strenuous exercise regimen after the first
dose of study treatment (e.g. running or bicycling > 10 mph) due to risk of CPK
elevation.
- Participants with history of a malabsorption syndrome or uncontrolled nausea,
vomiting, or diarrhea that may interfere with the absorption of oral study
medication in the opinion of the treating study doctor.
- Participants with evidence of visible retinal pathology or retinal degenerative
disease on screening ophthalmologic examination that places the participant at an
unacceptable risk for ocular events. Related to their vision and eye health,
patients must also:
- Not have history of glaucoma, history of retinal vein occlusion (RVO),
predisposing factors for RVO, including uncontrolled hypertension, uncontrolled
diabetes.
- Not have history of retinal pathology or evidence of visible retinal pathology
that is considered a risk factor for RVO as measured by tonometry, or other
significant ocular pathology, such as anatomical abnormalities that increase
the risk for RVO
- Patients must not have history of corneal erosion (instability of corneal
epithelium), corneal degeneration, active or recurrent keratitis, and other
forms of serious ocular surface inflammatory conditions.
- Patients must not have history of retinal degenerative disease.
- Patient must not have presence of neurosensory retinal detachment, or
neovascular macular degeneration on screening ophthalmologic exam.
- Patients with Impairment of gastrointestinal function or gastrointestinal disease
(e.g., active ulcerative disease, uncontrolled nausea, vomiting, diarrhea,
malabsorption syndrome, small bowel resection) are excluded.
- Participants should not have history of bowel perforation or intestinal fistulas in
the last 6 months.
- Participants with current Grade 3 or higher neuropathy are excluded.
- No prior allogeneic stem cell or solid organ transplantation. Patients may not have
had prior stem cell or solid organ transplantation. Women who are pregnant or
breastfeeding are excluded.
- History of allergic reactions attributed to compounds of chemical or biologic
composition similar to those of cetuximab, or if the patient had red meat
allergy/tick bite history.
- The participant is on any medications that conflict with the drugs administered in
study.
- Participants with known or suspected allergy or hypersensitivity to VS-6766 or any
of the inactive ingredients which include, but is not limited to,
hydroxypropylmethylcellulose, mannitol, magnesium stearate.
- If the participant has a history of allergic reactions attributed to compounds of
chemical or biologic composition similar to those of cetuximab, or if the
participant had red meat allergy/tick bite history they must be excluded.
- Chronic concomitant treatment with strong inhibitors of Cytochrome P450 3A4 (CYP3A4)
is not allowed on this study. Patients on strong CYP3A4 inhibitors must discontinue
the drug for 14 days prior to registration on the study. See Section 8.1.9 for more
information.
- Chronic concomitant treatment with strong CYP3A4 inducers is not allowed. Patients
must discontinue the drug 14 days prior to the start of study treatment.
- Participants must avoid grapefruit, grapefruit juice, St. John's Wort and other
medications (with or without prescriptions), supplements, herbal remedies or foods
that are strong inhibitors or inducers of CYP3A4 while on VS-6766.