FOG-001 in Locally Advanced or Metastatic Solid Tumors
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 CraniopharyngiomaDrugs
FOG-001, mFOLFOX-6, Nivolumab, Trifluridine/tipiracil, BevacizumabSummary
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-001Description:
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-001Description:
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-001Description:
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-001Description:
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-001Description:
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-001Description:
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-001Description:
FOG-001 will be administered IV at assigned doses in continuous cycles of 28 daysDRUG:
mFOLFOX-6Description:
mFOLFOX-6 will be administered per the prescribing information in combination with FOG-001DRUG:
BevacizumabDescription:
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-001Description:
FOG-001 will be administered IV at assigned doses in continuous cycles of 28 daysDRUG:
NivolumabDescription:
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-001Description:
FOG-001 will be administered IV at assigned doses in continuous cycles of 28 daysDRUG:
Trifluridine/tipiracilDescription:
Trifluridine/tipiracil will be administered per the prescribing information in combination with FOG-001DRUG:
BevacizumabDescription:
Bevacizumab will be administered per the prescribing information in combination with FOG-001
Part 2a
EXPERIMENTAL
MSS CRC, irrespective of WPAM status
DRUG:
FOG-001Description:
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-001Description:
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-001Description:
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-001Description:
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-001Description:
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-001Description:
FOG-001 will be administered IV at assigned doses in continuous cycles of 28 daysDRUG:
mFOLFOX-6Description:
mFOLFOX-6 will be administered per the prescribing information in combination with FOG-001DRUG:
BevacizumabDescription:
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-001Description:
FOG-001 will be administered IV at assigned doses in continuous cycles of 28 daysDRUG:
NivolumabDescription:
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-001Description:
FOG-001 will be administered IV at assigned doses in continuous cycles of 28 daysDRUG:
Trifluridine/tipiracilDescription:
Trifluridine/tipiracil will be administered per the prescribing information in combination with FOG-001DRUG:
BevacizumabDescription:
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
During dose escalation characterize dose-limiting toxicities (DLTs)
During dose expansion describe the Overall Response Rate using RECIST v1.1
During dose expansion describe the Disease Control Rate using RECIST v1.1 (Part 2a only)
During dose expansion describe the PSA30 response rate for participants with prostate cancer
Secondary Outcome Measures
Maximum observed plasma concentration (Cmax) of FOG-001 and associated metabolites
Time to achieve Cmax (Tmax) of FOG-001 and associated metabolites in plasma
Area under the plasma concentration-time curve (AUC) of FOG-001 and associated metabolites
Plasma trough concentration (Ctrough) of FOG-001 and associated metabolites
Clearance (CL) of FOG-001 from the plasma
Volume of distribution of FOG-001
During dose escalation select the preliminary recommended Phase 2 dose and dosing schedule of study drug Rate of DLTs across dose levels
During dose escalation Part 1b to evaluate the pharmacodynamic activity in tumors
During dose escalation and expansion to describe Best Overall Response Rate using RECIST v1.1
During dose escalation and expansion to describe Duration of Response using RECIST v1.1
During dose escalation and expansion describe Progression Free Survival
During dose escalation and expansion describe the Disease Control Rate using RECIST v1.1
During dose escalation and expansion describe the Time To Progression using RECIST v1.1
During dose escalation and expansion describe radiographic Progression Free Survival for participants with prostate cancer
Timeline
Last Updated
December 17, 2024Start Date
June 26, 2023Today
May 12, 2025Completion Date ( Estimated )
August 31, 2027
Sponsors of this trial
Lead Sponsor
Parabilis Medicines, Inc.