FOG-001 in Locally Advanced or Metastatic Solid Tumors

Clinicaltrials.gov ID: NCT05919264
db-list-check Status RECRUITING
b-loader Phase PHASE1, PHASE2
b-people Age ≥ 18 Years
b-bullseye-arrow Enrollments 480

Conditions

Cancer, Colorectal Cancer, Solid Tumor, Locally Advanced Solid Tumor, Metastatic Cancer, WNT Pathway, β-catenin, Beta-catenin, Adenomatous Polyposis Coli, APC, HCC, Desmoid, Microsatellite Stable Colorectal Cancer, Metastatic Castration-resistant Prostate Cancer, FAP, Endometrial Carcinoma, Prostate Cancer, Microsatellite Instability-High Colorectal Cancer, CTNNB1, Adamantinomatous Craniopharyngioma

Drugs

FOG-001, mFOLFOX-6, Nivolumab, Trifluridine/tipiracil, Bevacizumab

Summary

The goal of this clinical trial is to determine if FOG-001 is safe and effective in participants with locally advanced or metastatic cancer.

Detailed Description

This is a FIH, Phase 1/2, multicenter, open-label, non-randomized, dose escalation and dose expansion study to evaluate the safety, tolerability, PK, pharmacodynamics, and antitumor activity of FOG-001 as monotherapy and in combination with other anticancer agents in participants with advanced or metastatic solid tumors likely or known to have a Wnt pathway activating mutation (WPAM).

Locations

9 locations Found with status Recruiting

Status

  • RECRUITING

Contact Person

  • Sunil Sharma, MD
  • 480-323-1350

Study Chair

  • Marie Nguyen, MD

Status

  • RECRUITING

Contact Person

  • Michael Cecchini, MD
  • 415-302-7807

Study Chair

  • Marie Nguyen, MD

Status

  • RECRUITING

Contact Person

  • Samuel Klempner, MD
  • 617-724-4000

Study Chair

  • Marie Nguyen, MD

Status

  • RECRUITING

Contact Person

  • Moh'd Khushman, MD
  • 314-362-9115

Study Chair

  • Marie Nguyen, MD

Status

  • RECRUITING

Contact Person

  • Rona Yaeger, MD
  • 646-888-5109

Study Chair

  • Marie Nguyen, MD

Status

  • RECRUITING

Contact Person

  • Shivaani Kummar, MD
  • 503-494-8534

Study Chair

  • Marie Nguyen, MD

Status

  • RECRUITING

Contact Person

  • Meredith S Pelster, MD
  • 615-329-6862

Study Chair

  • Marie Nguyen, MD

Status

  • RECRUITING

Contact Person

  • Jordi Rodon Ahnert, MD/PhD
  • 713-792-5603

Study Chair

  • Marie Nguyen, MD

Status

  • RECRUITING

Contact Person

  • Kyriakos Papadopoulos, MD
  • 210-593-5255

Study Chair

  • Marie Nguyen, MD

Eligibility Criteria

Inclusion Criteria:

* Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
* Adequate organ and marrow function.

Additional Inclusion Criteria for Dose Escalation Cohorts (Part 1a and Part 1e):

* Diagnosis of treatment-refractory advanced/metastatic solid tumor that is non-MSI-H or non-dMMR colorectal cancer (CRC) or any other solid tumor with documented WNT- pathway activating mutations (WPAMs).

Additional Inclusion Criteria for Dose Escalation Cohorts (Part 1b):

* Diagnosis of treatment-refractory advanced/metastatic non-MSI-H or non-dMMR CRC.
* At least one lesion that is suitable for a core needle biopsy.

Additional Inclusion Criteria for Dose Escalation and Dose Expansion Cohorts (Part 1c and Part 2c):

* Diagnosis of HCC with a documented WPAM (by local testing) in APC or CTNNB1. HCC that is radiographically confirmed without tissue biopsy may be enrolled with a documented CTNNB1 mutation (e.g., by ctDNA).

Additional Inclusion Criteria for Dose Escalation and Dose Expansion Cohorts (Part 1d and Part 2d):

* Desmoid tumor (aggressive fibromatosis) with a documented WPAM (by local testing) in APC or CTNNB1.

Additional Inclusion Criteria for Dose Escalation and Dose Expansion Cohorts (Part 1f-1 and Part 2f-1) FOG-001 + FOLFOX + Bevacizumab:

* Diagnosis of locally advanced or metastatic non-MSI-H or non-dMMR CRC
* Participants with tumors known to be negative for APC LoF mutations or CTNNB1 GoF mutations (per NGS tests) are not eligible.

Additional Inclusion Criteria for Dose Escalation and Dose Expansion Cohorts (Part 1f-2 and Part 2f-2): FOG-001 + Nivolumab

* Non-MSI-H or non-dMMR (by local testing) CRC with or without liver metastases.
* MSI-H CRC or solid tumors that are WPAM and resistant to a-PD-1/PD-L1
* Participants with tumors known to be negative for APC LoF mutations or CTNNB1 GoF mutations (per NGS tests) are not eligible

Additional Inclusion Criteria for Dose Escalation and Dose Expansion Cohorts (Part 1f-3 and Part 2f-3): FOG-001 + Trifluridine/Tipiracil + Bevacizumab

* Diagnosis of locally advanced or metastatic non-MSI-H or non-dMMR (by local testing) CRC
* Participants with tumors known to be negative for APC LoF mutations or CTNNB1 GoF mutations (per NGS tests) are not eligible.

Additional Inclusion Criteria for Dose Expansion Cohort (Part 2a):

* Diagnosis of locally advanced or metastatic non-MSI-H or non-dMMR (by local testing) CRC

Additional Inclusion Criteria for Dose Expansion Cohort (Part 2b):

* Diagnosis of advanced or metastatic solid tumors with a documented WPAM (by local testing) or equivalent evidence

Exclusion Criteria:

* Known history of bone metastasis. Bone metastasis are allowed for patients with mCRPC.
* Evidence of vertebral compression fracture or non-traumatic bone fracture within the past 12 months and who are not receiving antiresorptive therapy.
* Osteoporosis, which is defined as a T-score of ≤-2.5 at the lumbar spine (L1 - L4), left (or right) femoral neck or left (or right) total hip as determined by DXA scan.
* Inflammatory bowel disease (i.e., ulcerative colitis or Crohn's disease) that is recently active or requires therapy currently.
* Unstable/inadequate cardiac function.
* Has known meningeal carcinomatosis, leptomeningeal carcinomatosis, spinal cord compression, or symptomatic or unstable brain metastases.
* Pregnant, lactating, or planning to become pregnant.

Study Plan

Part 1a

EXPERIMENTAL

Solid Tumors with any WNT-Pathway Activating Mutation (WPAM) or Microsatellite Stable (MSS) Colorectal Cancer (CRC), irrespective of WPAM status

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 1b

EXPERIMENTAL

MSS CRC (known WPAM negative participants are not eligible)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 1c

EXPERIMENTAL

Hepatocellular Carcinoma (documented WPAM in APC or CTNNB1 required)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 1d

EXPERIMENTAL

Desmoid Tumors (documented WPAM in APC or CTNNB1 required)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 1e-1

EXPERIMENTAL

Solid Tumors with documented WPAM or MSS CRC, irrespective of WPAM status

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 1e-2

EXPERIMENTAL

Solid Tumors with documented WPAM or MSS CRC, irrespective of WPAM status

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 1f-1

EXPERIMENTAL

MSS CRC (known WPAM negative participants are not eligible)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days
  • DRUG:

    mFOLFOX-6

    Description:

    mFOLFOX-6 will be administered per the prescribing information in combination with FOG-001
  • DRUG:

    Bevacizumab

    Description:

    Bevacizumab will be administered per the prescribing information in combination with FOG-001

Part 1f-2

EXPERIMENTAL

Solid Tumors with documented WPAM or MSS CRC (known WPAM negative participants are not eligible)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days
  • DRUG:

    Nivolumab

    Description:

    Nivolumab will be administered per the prescribing information in combination with FOG-001

Part 1f-3

EXPERIMENTAL

MSS CRC (known WPAM negative participants are not eligible)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days
  • DRUG:

    Trifluridine/tipiracil

    Description:

    Trifluridine/tipiracil will be administered per the prescribing information in combination with FOG-001
  • DRUG:

    Bevacizumab

    Description:

    Bevacizumab will be administered per the prescribing information in combination with FOG-001

Part 2a

EXPERIMENTAL

MSS CRC, irrespective of WPAM status

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 2b

EXPERIMENTAL

Solid Tumors with documented WPAM

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 2c

EXPERIMENTAL

Hepatocellular Carcinoma (documented WPAM in APC or CTNNB1 required)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 2d

EXPERIMENTAL

Desmoid Tumors (documented WPAM in APC or CTNNB1 required)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 2e

EXPERIMENTAL

Metastatic Castration-Resistant Prostate Cancer (documented WPAM in APC or CTNNB1 required)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days

Part 2f-1

EXPERIMENTAL

MSS CRC (known WPAM negative participants are not eligible)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days
  • DRUG:

    mFOLFOX-6

    Description:

    mFOLFOX-6 will be administered per the prescribing information in combination with FOG-001
  • DRUG:

    Bevacizumab

    Description:

    Bevacizumab will be administered per the prescribing information in combination with FOG-001

Part 2f-2

EXPERIMENTAL

Solid Tumors with documented WPAM or MSS CRC (known WPAM negative participants are not eligible)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days
  • DRUG:

    Nivolumab

    Description:

    Nivolumab will be administered per the prescribing information in combination with FOG-001

Part 2f-3

EXPERIMENTAL

MSS CRC (known WPAM negative participants are not eligible)

  • DRUG:

    FOG-001

    Description:

    FOG-001 will be administered IV at assigned doses in continuous cycles of 28 days
  • DRUG:

    Trifluridine/tipiracil

    Description:

    Trifluridine/tipiracil will be administered per the prescribing information in combination with FOG-001
  • DRUG:

    Bevacizumab

    Description:

    Bevacizumab will be administered per the prescribing information in combination with FOG-001

Outcome Measures

Primary Outcome Measures

During dose escalation and dose expansion measure incidence and severity of treatment emergent adverse events by CTCAE v5.0

Time Frame: Through study completion, an average of 10 months

During dose escalation characterize dose-limiting toxicities (DLTs)

Time Frame: 1 treatment cycle (28 days)

During dose expansion describe the Overall Response Rate using RECIST v1.1

Time Frame: Every 63 days until study completion, approximately 10 months on average

During dose expansion describe the Disease Control Rate using RECIST v1.1 (Part 2a only)

Time Frame: 4 months

During dose expansion describe the PSA30 response rate for participants with prostate cancer

Time Frame: Baseline, weekly during the first 2 cycles (56 days), bi-weekly during the Cycle 3 (28 days), and then monthly (up to approximately 7 months)

Secondary Outcome Measures

Maximum observed plasma concentration (Cmax) of FOG-001 and associated metabolites

Time Frame: During first 2 cycles (56 days)

Time to achieve Cmax (Tmax) of FOG-001 and associated metabolites in plasma

Time Frame: During first 2 cycles (56 days)

Area under the plasma concentration-time curve (AUC) of FOG-001 and associated metabolites

Time Frame: During first 2 cycles (56 days)

Plasma trough concentration (Ctrough) of FOG-001 and associated metabolites

Time Frame: During first 2 cycles (56 days)

Clearance (CL) of FOG-001 from the plasma

Time Frame: During first 2 cycles (56 days)

Volume of distribution of FOG-001

Time Frame: During first 2 cycles (56 days)

During dose escalation select the preliminary recommended Phase 2 dose and dosing schedule of study drug Rate of DLTs across dose levels

Time Frame: During Cycle 1 (28 days)

During dose escalation Part 1b to evaluate the pharmacodynamic activity in tumors

Time Frame: During first 2 cycles (56 days)

During dose escalation and expansion to describe Best Overall Response Rate using RECIST v1.1

Time Frame: Every 63 days until study completion, approximately 10 months on average

During dose escalation and expansion to describe Duration of Response using RECIST v1.1

Time Frame: Every 63 days until study completion, approximately 10 months on average

During dose escalation and expansion describe Progression Free Survival

Time Frame: From date of randomization until the date of first disease progression, an average of 10 months

During dose escalation and expansion describe the Disease Control Rate using RECIST v1.1

Time Frame: Every 63 days until study completion, approximately 10 months on average

During dose escalation and expansion describe the Time To Progression using RECIST v1.1

Time Frame: From date of randomization until the date of first disease progression, an average of 10 months

During dose escalation and expansion describe radiographic Progression Free Survival for participants with prostate cancer

Time Frame: From date of randomization until the date of first disease progression, an average of 10 months

Timeline

  • Last Updated
    December 17, 2024
  • Start Date
    June 26, 2023
  • Today
    May 12, 2025
  • Completion Date ( Estimated )
    August 31, 2027

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