Brief Title: Milademetan in Advanced/Metastatic Solid Tumors

PRIMARY OUTCOMES

Primary Outcome 1 - Measure: Overall Response Rate (ORR) of treatment with milademetan, as defined as the percentage of patients who have achieved confirmed complete response (CR) or Partial Response (PR) according to RECIST v1.1 criteria

Primary Outcome 1 - Timeframe: 3 years

CONDITION

• Solid Tumors
• Head and Neck Carcinoma
• Cholangiocarcinoma
• Sarcoma
• Lung Adenocarcinoma
• Bladder Urothelial Carcinoma
• Stomach Adenocarcinoma
• Breast Cancer Invasive
• Ovarian Carcinoma
• Cervical Cancer
• Non Small Cell Lung Cancer
• Gastric Cancer
• Biliary Tract Cancer
• Melanoma
• Pancreas Cancer
• MDM2 Gene Amplification
• Testicular Germ Cell Tumor
• Adrenocortical Carcinoma

ELIGIBILITY

Inclusion Criteria:
Histologically and/or cytologically confirmed diagnosis of a cancer that is a locally advanced or metastatic solid tumor

- Measurable tumor lesion(s) in accordance with RECIST v1.1

- Received all standard therapy appropriate for their tumor type and stage of disease or, in the opinion of the Investigator, would be unlikely to tolerate or derive clinically meaningful benefit from appropriate standard-of-care therapy

- Resolution of any clinically relevant toxic effects of prior chemotherapy, surgery, radiotherapy, or hormonal therapy

- Presence of WT TP53 and MDM2 gene amplification by tumor tissue/blood testing, defined as ≥ 8 copies in tumor tissue by central laboratory or ≥ 8 copies or 4-fold increase in tumor tissue or blood by local testing
Prescreening for TP53 and MDM2 at a Central Laboratory:
MDM2 amplification: CN unknown and where CN cannot be derived for documentation by interpretation of reported results

- MDM2 amplification: CN 6 to 7.9

- MDM2 amplification: 3-3.9-fold increase

- MDM2 amplification with CN ≥ 8 and with equivocal TP53 mutation upon discussion with Sponsor's Medical Monitor

- ECOG performance status of 0 or 1
Adequate bone marrow function:
Platelet count ≥ 100 × 10^9/L

- Hemoglobin ≥ 9.0 g/dL

- Absolute neutrophil count ≥ 1.5 × 10^9/L
Adequate renal function
Creatinine clearance ≥ 30mL/min, as calculated using the modified Cockcroft-Gault equation
Adequate hepatic function
Alanine aminotransferase and aspartate aminotransferase ≤ 3 × upper limit of normal (ULN) if no liver metastases are present; ≤ 5 × ULN if liver metastases are present

- Total bilirubin ≤ 1.5 × ULN, or ≤ 3 x ULN in the presence of liver metastases
Exclusion Criteria:
Prior treatment with a mouse double minute 2 (MDM2) inhibitor

- Well-differentiated/dedifferentiated liposarcoma or intimal sarcoma/cardiac sarcoma

- Primary malignancies that required systemic antineoplastic treatment within the previous 2 years, except for localized cancers that have apparently been cured

- Has a primary malignant brain tumor of any grade or histology

- Untreated brain metastases

- Gastrointestinal conditions that could affect the absorption of milademetan, in the opinion of the Investigator

- Known HIV infection or active hepatitis B or C infection

- Major surgery ≤ 3 weeks of the first dose of milademetan

- Curative-intent radiation therapy ≤ 4 weeks or palliative radiation therapy
Uncontrolled or significant cardiovascular disease
QTcF at rest, where the mean QTcF interval is > 480 milliseconds

- Myocardial infarction within 6 months

- Uncontrolled angina pectoris within 6 months

- New York Heart Association Class 3 or 4 congestive heart failure

- Uncontrolled hypertension

Gender: All

Minimum Age: 18 Years

Maximum Age: N/A

Healthy Volunteers: No

OFFICIAL INFORMATION

Name: N/A

Role: N/A

Affiliation: N/A

Overall Contact

Name: N/A

Phone: 5109535559

Email: rain3202@rainoncology.com

LOCATION