A Phase Ib/II Trial of Zunsemetinib in Combination With Capecitabine in Patients With Hormone Receptor-Positive and HER2-Negative Metastatic Breast Cancer With Bone Metastasis

Status: Recruiting
Location: See all (3) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

This is a phase Ib/II study evaluating the safety and efficacy of zunsemetinib (ATI-450) with capecitabine in patients with hormone receptor-positive and HER2-negative (HR+/HER2-) metastatic breast cancer (MBC).

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

• Hormone receptor-positive, HER2-negative metastatic breast cancer.

• Measurable or non-measurable but evaluable disease by RECIST v1.1.

• Candidate for capecitabine treatment per physician decision. See below phase-specific eligibility criteria for further guidance.

• No more than one prior chemotherapy for metastatic disease.

• Patient must have received prior endocrine therapy with CDK4/6 inhibitor.

• If patient is on denosumab or zoledronic acid prior to enrollment, patient must have been on the regimen for at least 6 months prior to study. However, a washout of 3 weeks is required prior to C1D1.

• At least 18 years of age.

• ECOG performance status 0, 1, or 2

• Life expectancy of at least 12 weeks.

• Adequate bone marrow and organ function as defined below:

‣ Leukocytes ≥ 3 K/cumm

⁃ Absolute neutrophil count (ANC) ≥ 1.5 K/cumm

⁃ Platelets ≥ 100 K/cumm

⁃ Total bilirubin ≤ 1.5 x IULN (or total bilirubin ≤ 3 mg/dL if patient has known Gilbert Syndrome)

⁃ AST(SGOT)/ALT(SGPT) ≤ 3.0 x IULN

⁃ Creatinine clearance \> 60 mL/min by Cockcroft-Gault

⁃ Calcium within normal limits

• Women of childbearing potential and men who are heterosexually active must agree to use adequate contraception as specified in the protocol. Contraception should continue for 6 months (for women) or 3 months (for men) after the end of treatment. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately.

• Ability to understand and willingness to sign an IRB approved written informed consent document.

• Patients must have archival tissue sample available from prior metastatic biopsy. If no tissue is available, patient may still be able to enroll with PI approval.

• Presence of bone metastasis is not required.

• Candidate for, or currently on stable doses of capecitabine, defined as capecitabine: 1000 mg/m\^2 BID, 14 days on and 7 days off. A stable dose of capecitabine is defined as no more than grade 1 AEs related to capecitabine on the 1000 mg/m\^2 BID, 14 days on and 7 days off dose for at least 1 cycle. Capecitabine is not counted as a prior chemotherapy regimen in these patients.

• Progressive bone metastasis per the most recent tumor imaging studies by RECIST 1.1 or clinical progression (such as worsening bone pain, elevation of tumor marker) per treating physician.

Locations
United States
Kansas
The University of Kansas Cancer Center
NOT_YET_RECRUITING
Westwood
Minnesota
Mayo Clinic
NOT_YET_RECRUITING
Rochester
Missouri
Washington University School of Medicine
RECRUITING
St Louis
Contact Information
Primary
Cynthia X Ma, M.D., Ph.D.
cynthiaxma@wustl.edu
314-362-8903
Time Frame
Start Date: 2025-01-30
Estimated Completion Date: 2032-05-31
Participants
Target number of participants: 152
Treatments
Experimental: Phase Ib: Zunsemetinib + Capecitabine
Patients will receive zunsemetinib by mouth (PO) twice per day (BID) at an assigned dose along with capecitabine (1000 mg/m\^2 PO BID on Days 1-14 an every 21-day cycle). For patients enrolled in phase Ib, capecitabine is dosed on days 2-15 during cycles 1-2. Dose escalation of zunsemetinib will utilize a 3+3 design. A maximum of 3 dose levels of zunsemetinib will be tested, and the two highest dose levels which did not lead to more than 1 of 6 patients with DLT in cycle 1 will be chosen as the RP2D-L1 and RP2D-L2 for Phase II. If only one dose level of zunsemetinib was found tolerable, then only one RP2D will be chosen for Phase II.
Active_comparator: Phase II Arm 1: Standard of care anti-resorptive + Capecitabine
Standard of care anti-resorptives will consist of bisphosphonate (zoledronic acid) is to be administered every 4-12 weeks, or denosumab is to be administered every 4-6 weeks, as per physician choice and institutional practice. In general, capecitabine will be taken twice daily at a dose of 1000 mg/m\^2 on Days 1 through 14 of every 21-day cycle. The first 4 patients enrolling to phase II will take capecitabine on a different schedule for PK purposes in Cycles 1 and 2 ONLY. Patients will take capecitabine at a dose of 1000mg/m\^2 on Days 2 through 15 of Cycles 1 and 2, and then on Days 1 through 14 starting with Cycle 3.
Experimental: Phase II Arm 2: Zunsemetinib (RP2D-L1) + Capecitabine
Patients will receive zunsemetinib by mouth (PO) twice per day (BID) at an assigned dose. In general, capecitabine will be taken twice daily at a dose of 1000 mg/m\^2 on Days 1 through 14 of every 21-day cycle. The first 4 patients enrolling to phase II will take capecitabine on a different schedule for PK purposes in Cycles 1 and 2 ONLY. Patients will take capecitabine at a dose of 1000mg/m\^2 on Days 2 through 15 of Cycles 1 and 2, and then on Days 1 through 14 starting with Cycle 3.
Experimental: Phase II Arm 3: Zunsemetinib (RP2D-L2) + Capecitabine
Patients will receive zunsemetinib by mouth (PO) twice per day (BID) at an assigned dose. In general, capecitabine will be taken twice daily at a dose of 1000 mg/m\^2 on Days 1 through 14 of every 21-day cycle. The first 4 patients enrolling to phase II will take capecitabine on a different schedule for PK purposes in Cycles 1 and 2 ONLY. Patients will take capecitabine at a dose of 1000mg/m\^2 on Days 2 through 15 of Cycles 1 and 2, and then on Days 1 through 14 starting with Cycle 3. If only one dose level of zunsemetinib plus capecitabine was found tolerable in phase Ib testing, the phase II trial will proceed with 2:1 two-arm randomization with Arm 2 of capecitabine plus zunsemetinib and Arm 1 of capecitabine plus standard of care anti-resorptive agent.
Related Therapeutic Areas
Sponsors
Leads: Washington University School of Medicine
Collaborators: United States Department of Defense, Aclaris Therapeutics, Inc.

This content was sourced from clinicaltrials.gov

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