Phase I Study to Evaluate Safety, Tolerability, Pharmacokinetics and Anti-Tumor Activity of WSD0922-FU

Who is this study for? Patients with brain and spinal cord cancers
What treatments are being studied? WSD0922-FU
Status: Recruiting
Location: See all (3) locations...
Intervention Type: Procedure, Drug
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

This phase I trial studies the side effects and best dose of WSD0922-FU for the treatment of glioblastoma, anaplastic astrocytoma, or non-small cell lung cancer that has spread to the central nervous system (central nervous system metastases). WSD0922-FU is a targeted treatment which blocks the EGFR protein - a strategy that has led to a lot of benefit in patients with many different cancers. WSD0922-FU may also be able to get into cancers in the brain and spinal cord and help patients with brain and spinal cord cancers.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Pre-Registration - Inclusion Criteria Specific to Dose Escalation Cohort

‣ Histolopathological and/or molecular confirmation of either glioblastoma, IDH wildtype (GBM), (as defined by either the 2016 or 2021 World Health Organization \[WHO\] classifications) anaplastic astrocytoma, IDH wildtype (AA) (as defined by the 2016 WHO classification) or non-small cell lung cancer (NSCLC)

⁃ EGFR Status:

• GBM/AA must either EGFR amplification and/or any activating EGFR mutation (e.g. A289T, EGFRvIII , etc.)

∙ NSCLC must have a confirmed activating EGFR mutation (e.g. Del19, L858R, EGFRvIII, G719A, L861Q, T790M, C797S, etc.)

• Pre-Registration - Inclusion Criteria Specific to Dose Expansion Cohorts

‣ Glioblastoma, IDH wildtype/Anaplastic astrocytoma, IDH wildtype (GBM/AA) Cohort:

• Diagnosis: Histological or molecular confirmation of either glioblastoma, IDH wildtype (GBM) (as defined by either the 2016 or 2021 WHO classifications) or anaplastic astrocytoma, IDH wildtype (AA) (as defined by the 2016 WHO classification)

∙ EGFR status: GBM/AA must have EGFRvIII mutation

⁃ Brain Tumor Penetration (BTP) Cohort:

• Diagnosis: Histopathological or molecular confirmation of either glioblastoma, IDH wildtype (GBM) (as defined by either the 2016 or 2021 WHO classifications) or anaplastic astrocytoma, IDH wildtype (AA) (as defined by the 2016 WHO classification)

∙ EGFR status: GBM/AA must have been previously demonstrated to have either EGFR amplification and/or any activating EGFR mutation based on any prior resection

⁃ Non-Small Cell Lung Cancer (NSCLC) cohort:

• Diagnosis: Histological confirmation of non-small cell lung cancer (NSCLC)

∙ EGFR status: NSCLC must have confirmed activating EGFR mutation. Following protocol amendment 7, NSCLC must have EGFR C797S mutation.

• Registration -Inclusion Criteria Specific to Dose Escalation Cohort

‣ Previous treatments:

• Patients with GBM/AA must have been previously treated with radiation and temozolomide

∙ Patients with NSCLC must have been previously treated with at least one line of single-agent therapy with an EGFR TKI e.g. gefitinib, erlotinib, afatinib, or osimertinib)

⁃ Radiographic progression:

• Patients with GBM/AA must have radiographic progression based on RANO criteria

∙ Patients with NSCLC must have new or radiographic progression in the central nervous system (brain metastases and/or leptomeningeal metastases). Positive confirmation of CSF cytology is both necessary and sufficient to define the presence of leptomeningeal metastases for patients in this study. Patients with positive CSF cytology and brain metastases will be categorized as leptomeningeal metastases.

⁃ Measurable disease

⁃ Eastern Cooperative Oncology Group (ECOG) 0 or 1. For patients with NSCLC with leptomeningeal metastases, ECOG 2 is also acceptable

• Registration - Inclusion Criteria Specific to Dose Expansion Cohorts

‣ Glioblastoma, IDH wildtype/Anaplastic astrocytoma, IDH wildtype (GBM/AA) Cohort:

• Previous treatments: Patients must have been previously treated with radiation and temozolomide. First recurrence only (no additional systemic therapies have been administered for recurrent disease)

∙ Radiographic progression: Patients with GBM/AA must have radiographic progression based on RANO criteria

∙ Patients remain eligible for enrollment if the recurrent disease has been surgically removed

∙ Performance status: ECOG 0 or 1

⁃ Brain Tumor Penetration (BTP) Cohort:

• Previous treatments: Patients must have been previously treated with radiation and temozolomide

∙ Radiographic progression: Patients with GBM/AA must have radiographic progression based on RANO criteria

∙ Therapeutic surgical resection of GBM/AA required as part of routine clinical care

∙ Performance status: ECOG 0 or 1

⁃ Non-Small Cell Lung Cancer (NSCLC) cohort:

• Previous treatments: No limitations

∙ Radiographic progression: Patients must have radiographic progression based on RECIST 1.1 criteria.

∙ Measurable Disease

∙ Performance Status: ECOG 0 or 1

• Registration - Inclusion Criteria Common to Dose Escalation and Dose Expansion Cohorts:

‣ Age \>= 18 years old

⁃ Ability to understand and the willingness to sign a written informed consent document

⁃ Hemoglobin \>= 9.0 g/dL (obtained =\< 14 days prior to registration)

⁃ Leukocytes \>= 3.0 x 10\^9/L (obtained =\< 14 days prior to registration)

⁃ Absolute neutrophil count \>= 1.5 x 10\^9/L (obtained =\< 14 days prior to registration)

⁃ Platelets \>= 100 x 10\^9/L (obtained =\< 14 days prior to registration)

⁃ International normalized ratio (INR) =\< 1.5 x upper limit of normal (ULN) (obtained =\< 14 days prior to registration)

• Patients on a stable dose of anti-coagulation therapy will be allowed to participate if they have no signs of bleeding or clotting and the INR/prothrombin time (PT) and partial thromboplastin time (PTT)/activated (a)PTT results are compatible with an acceptable risk-benefit ratio as per the investigator's discretion

⁃ aPTT =\< 1.5 x ULN (obtained =\< 14 days prior to registration)

• Patients on a stable dose of anti-coagulation therapy will be allowed to participate if they have no signs of bleeding or clotting and the INR/PT and PTT/aPTT results are compatible with an acceptable risk-benefit ratio as per the investigator's discretion

⁃ Total bilirubin =\< 1.5 x ULN and =\< 3 mg/dL for patients with Gilbert's disease (obtained =\< 14 days prior to registration)

⁃ Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 3 x ULN or =\< 5 x ULN if due to liver involvement by tumor (obtained =\< 14 days prior to registration)

⁃ Creatinine =\< 1.5 x ULN or estimated glomerular filtration rate (estimated glomerular filtration rate \[eGFR\]) \>= 60 mL/minute (obtained =\< 14 days prior to registration)

⁃ Negative pregnancy test done =\< 7 days prior to registration, for persons of childbearing potential only

⁃ Provision of signed and dated written informed consent prior to any study specific procedures, sampling, and analyses

⁃ Willingness to provide mandatory blood specimens for correlative research

⁃ Willingness to return to enrolling institution for follow-up (during the active monitoring phase of the study i.e., active treatment and clinical follow-up)

⁃ Male and female patients of child bearing potential must be willing to use contraception, (i.e., condoms, birth control) while on study and until 3 months after the last dose of study drug is taken

⁃ Must be willing to take light-protective measures during the study and for 2 weeks after their last dose of WSD0922-FU

⁃ Must have a minimum life expectancy of \>= 3 months

⁃ Must be stable on no more than 2 mg of dexamethasone (or equivalent steroids) per day. Steroid dose adjustments should be minimized during cycle 1 of therapy. Patients enrolling to the BTP expansion cohort do not have any restrictions on current steroid/dexamethasone dosing.

⁃ Must not take enzyme-inducing anticonvulsants treatment for at least 2 weeks prior to enrollment. Patients on enzyme-inducing anticonvulsants will be changed to non-enzyme inducing anticonvulsants

⁃ Strong inducers and strong inhibitors of CYP3A should be discontinued at least 14 days prior to registration

⁃ Willingness to provide mandatory tissue specimens for correlative research (BTP cohort only)

Locations
United States
Arizona
Mayo Clinic in Arizona
RECRUITING
Scottsdale
Florida
Mayo Clinic in Florida
RECRUITING
Jacksonville
Minnesota
Mayo Clinic in Rochester
RECRUITING
Rochester
Contact Information
Primary
Clinical Trials Referral Office
mayocliniccancerstudies@mayo.edu
855-776-0015
Time Frame
Start Date: 2019-12-20
Estimated Completion Date: 2025-12-20
Participants
Target number of participants: 55
Treatments
Experimental: Dose escalation (WSD0922-FU)
Patients receive WSD0922-FU PO QD or BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT, MRI, and blood sample collection on study. Patients with NSCLC with LM also undergo collection of CSF samples on study.
Experimental: Dose expansion Cohort I (WSD0922-FU)
Patients with GBM/AA receive WSD0922-FU PO on days 1 and 4 of cycle 0. Patients then receive WSD0922-FU PO BID on days 1-28 of subsequent cycles. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo MRI during screening and on study, as well as blood sample collection on study. Patients may undergo additional optional blood sample collection on study.
Experimental: Dose expansion Cohort II (WSD0922-FU, surgery)
Patients with BTP receive a single dose of WSD0922-FU prior to surgery. Patients then undergo surgical resection of brain tumor. After surgery, patients receive WSD0922-FU PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo MRI during screening and on study, as well as blood sample collection on study.
Experimental: Dose expansion Cohort III (WSD0922-FU)
Patients with NSCLC receive WSD0922-FU PO BID on days 1-28 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo MRI and CT during screening and on study, as well as blood sample collection on study. Patients with LM also undergo collection of CSF samples on study. Patients may also undergo optional blood sample collection on study.
Sponsors
Leads: Mayo Clinic
Collaborators: National Cancer Institute (NCI)

This content was sourced from clinicaltrials.gov