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A Phase 1a, Dose Escalation, Safety and Tolerability Study of NX-1607, a Casitas B-lineage Lymphoma Proto-oncogene (CBL-B) Inhibitor, in Adults With Advanced Malignancies, With Phase 1b Expansion in Select Tumor Types

INTRODUCTION

  • Org Study ID: NX-1607-101
  • Secondary ID: N/A
  • NTC ID: NCT05107674
  • Sponsor: Nurix Therapeutics, Inc.

BRIEF SUMMARY

This is a first-in-human Phase 1a/1b multicenter, open-label oncology study designed to evaluate the safety and anti-cancer activity of NX-1607 in patients with advanced malignancies.

DETAILED DESCRIPTION

Phase 1a is a dose escalation to evaluate the safety and tolerability of NX-1607 in adult patients with advanced solid tumors for which standard therapy with proven clinical benefit does not exist, is no longer effective, or is not appropriate. Indications include platinum resistant epithelial ovarian cancer (EOC), gastric/gastroesophageal junction (GEJ) cancer, squamous cell carcinoma of the head and neck (HNSCC), recurrent and either metastatic or unresectable melanoma, non-small cell lung cancer (NSCLC), metastatic castration-resistant prostate cancer (mCRPC), malignant pleural mesothelioma (MPM), triple-negative breast cancer (TNBC), locally advanced or metastatic urothelial cancer, cervical cancer, and microsatellite stable colorectal cancer (MSS CRC).

Phase 1b will investigate the efficacy of NX-1607 at the dose selected in Phase 1a in up to 8 cohorts of patients with select advanced malignancies for which standard therapy, including immunotherapy, with proven clinical benefit does not exist, is no longer effective, or is not appropriate. Indications include:

Platinum-resistant EOC, including primary peritoneal and fallopian tube carcinoma
Advanced gastric/GEJ cancer
HNSCC
Recurrent and either metastatic or unresectable melanoma
Advanced NSCLC
mCRPC
Mixed solid tumor cohort indications consisting of patients with MPM, TNBC, locally advanced or metastatic urothelial cancer, cervical cancer, or MSS CRC
Diffuse large cell B-cell lymphoma (DLBCL), including patients with Richter transformation (DLBCL-RT)

  • Overall Status
    Recruiting
  • Start Date
    September 29, 2021
  • Phase
    Phase 1
  • Study Type
    Interventional

PRIMARY OUTCOMES

Primary Outcome 1 - Measure: Incidence of treatment-emergent adverse events (TEAEs), including Grade ≥ 3 TEAEs, treatment-emergent serious adverse events (SAEs), TEAEs leading to study drug discontinuation, and deaths due to TEAEs

Primary Outcome 1 - Timeframe: 16 months

Primary Outcome 2 - Measure: Incidence of immune-related AEs (irAEs), all deaths, and dose-limiting toxicities (DLTs)

Primary Outcome 2 - Timeframe: Up to 2 Years

Primary Outcome 3 - Measure: Objective Response Rate (ORR) per disease-specific response criteria as assessed by the Investigator

Primary Outcome 3 - Timeframe: Up to 3 Years

CONDITION

  • Ovarian Cancer
  • Epithelial
  • Gastric Cancer
  • GastroEsophageal Junction (GEJ) Cancer
  • Head and Neck Squamous Cell Carcinoma
  • Metastatic or Unresectable Melanoma
  • Non-small Cell Lung Cancer (NSCLC)
  • Metastatic Castration-resistant Prostate Cancer (mCRPC)
  • Malignant Pleural Mesothelioma (MPM)
  • Triple Negative Breast Cancer (TNBC)
  • Metastatic Urothelial Carcinoma
  • Cervical Cancer
  • Colorectal Cancer Metastatic
  • CLL Transformation
  • Diffuse Large B Cell Lymphoma (DLBCL)
  • Richter Transformation

ELIGIBILITY

Key Inclusion Criteria:
Age ≥ 18 years.

- Measurable disease per disease-specific response criteria.

- Patients must have disease that is metastatic or unresectable and have received standard treatment options, are not candidates for standard treatment options, or will otherwise be prevented from receiving any standard treatment options.

- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

- Minimum of 3 weeks or 5 half-lives (whichever is shorter) since last dose of systemic cancer therapy (unless otherwise specified) or minimum of 2 weeks since last radiotherapy, or minimum of 6 weeks since last systemic therapy with nitrosoureas, antibody-drug conjugate, or radio immuno-conjugate therapy.

- Adequate organ and bone marrow function, in the absence of growth factors, as defined by laboratory parameters.

- Patients of child-bearing potential must use adequate contraceptive measures to avoid pregnancy for the duration of the study as defined in the protocol.

- Patient must be willing and able to adhere to the prohibitions and restrictions specified in the protocol.

- Each patient must sign an informed consent form (ICF).

- Histological or cytological diagnosis of platinum-resistant EOC, including primary peritoneal and fallopian tube carcinoma; gastric/GEJ cancer; HNSCC; metastatic or unresectable melanoma; NSCLC; mCRPC; MPM; TNBC; locally advanced or metastatic urothelial cancer; cervical cancer; MSS CRC; or DLBCL (including DLBCL-RT) (Phase 1b only).

- Accessible tumor or lymph node (e.g., DLBCL) for biopsy (Phase 1b only).
Key Exclusion Criteria:
Active untreated brain metastases.
Patient has any of the following:
Uncontrolled intercurrent illness including, but not limited to, poorly controlled hypertension or diabetes, or ongoing active infection requiring systemic therapy.

- Psychiatric illness or social situation that would limit compliance with study requirements.

- Prior treatment with a CPI (anti-PD-1, PD-L1, CTLA-4, etc.) within 3 weeks prior to the first dose of NX-1607.

- History of CAR-T therapy within 100 days prior to the first dose of NX-1607. Must have evidence of B-cell recovery if prior CAR-T therapy.

- Toxicities from previous anti-cancer therapies that have not resolved to baseline levels or to Grade 1 or less except for Grade 2 alopecia and Grade 2 peripheral neuropathy.

- Patients who experienced Grade 3 or higher irAEs with prior immunotherapy.

- History of uveitis, or an active autoimmune disease that has required systemic treatment in the past 2 years (i.e., with use of disease modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed.

- Unable to swallow capsules or has malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel or ulcerative colitis, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction likely to interfere with the delivery, absorption, or metabolism of NX-1607.

- Known allergies, hypersensitivity, or intolerance to components of NX-1607.

- Pregnant, breastfeeding, or planning to become pregnant while enrolled in this study or within 6 months after the last dose of NX-1607.

- Patient is a man who plans to father a child while enrolled in this study or within 3 months after the last dose of NX-1607.

- Patient has had major surgery (e.g., requiring general anesthesia) within 4 weeks before the planned first dose of NX-1607, or will not have fully recovered from surgery, or has surgery planned during the time the patient is expected to participate in the study or within 4 weeks after the last dose of NX-1607. Note: Patients with minor planned surgical procedures to be conducted under local anesthesia may participate.

- Vaccinated with a live vaccine within 28 days (with the exception of the annual inactivated influenza vaccine) prior to the first dose of NX-1607.
Active known second malignancy with the exception of any of the following:
Adequately treated basal cell carcinoma, squamous cell carcinoma of the skin, or in situ cervical cancer.

- Adequately treated Stage I cancer from which the patient is currently in remission and has been in remission for ≥ 2 years.

- Low-risk prostate cancer with Gleason score < 7 and PSA < 10 ng/mL. - Any other cancer from which the patient has been disease-free for ≥ 2 years. - Infection with human immunodeficiency virus (HIV)-1 or HIV-2. Exception: Patients with well controlled HIV (e.g., CD4 > 350/mm3 and undetectable viral load) are eligible.

- Current active liver disease from any cause, including hepatitis A (hepatitis A virus immunoglobulin M [IgM] positive), hepatitis B (hepatitis B virus [HBV] surface antigen positive), or hepatitis C (hepatitis C virus [HCV] antibody positive, confirmed by HCV RNA). Patients with HCV with undetectable virus after treatment are eligible. Patients with prior exposure to HBV may be entered if quantitative PCR is negative.

- Use of systemic corticosteroids (> 20 mg prednisone or equivalent) within 15 days (except for prophylaxis for radio diagnostic contrast reactions), or other immunosuppressive drugs within 30 days, prior to the first dose of NX-1607.

- Use of biotin (i.e., Vitamin B7) or supplements containing biotin higher than the daily adequate intake of 30 µg [NIH 2020] (Note: Patients who switch from a high dose to a dose of 30 µg/day or less at least 1 day prior to Screening assessments are eligible for study entry).

- Receipt of an investigational product (IP) or has been treated with an investigational device within 3 weeks or 5 half-lives (whichever is shorter) prior to the first dose of NX-1607.
Any of the following within 6 months prior to the first dose of NX-1607:
Myocardial infarction

- Unstable angina

- Unstable symptomatic ischemic heart disease

- New York Heart Association Class III or IV heart failure

- Thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism, or symptomatic cerebrovascular events)

- Any other significant cardiac condition (e.g., pericardial effusion, restrictive cardiomyopathy, severe untreated valvular stenosis, or severe congenital heart disease)

- Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating Investigator

- Use, within 14 days prior to the first dose of NX-1607, or the need for concomitant treatment with, a potent or moderate inhibitor or inducer of CYP3A4 or a sensitive substrate of CYP3A4

- The need for concomitant treatment with a sensitive substrate of P-gp or BCRP.

Gender: All

Minimum Age: 18 Years

Maximum Age: N/A

Healthy Volunteers: No

OFFICIAL INFORMATION

Name: Katherine Jameson

Role: Study Director

Affiliation: Nurix Therapeutics, Inc.

Overall Contact

Name: Katherine Jameson

Phone: 4152307815

Email: nx1607101@nurixtx.com

LOCATION

Facility Status Contact
Facility: University of North Carolina
Chapel Hill, North Carolina 27599
United States
Status: Recruiting Contact: N/A
Facility: MD Anderson Cancer Center
Houston, Texas 77030
United States
Status: Recruiting Contact: N/A
Facility: Royal Marsden Hospital NHS Foundation Trust
Sutton, Surrey SM2 5PT
United Kingdom
Status: Recruiting Contact: N/A
Facility: University College London Hospitals NHS Foundation Trust
Bloomsbury, W1T 7HA
United Kingdom
Status: Recruiting Contact: N/A
Facility: Addenbrookes Cambridge University Hospital
Cambridge, CB2 0QQ
United Kingdom
Status: Recruiting Contact: N/A
Facility: Beatson West of Scotland Cancer Centre
Glasgow, G12 0YN
United Kingdom
Status: Recruiting Contact: N/A
Facility: Sarah Cannon Research Institute
London, W1G 6AD
United Kingdom
Status: Recruiting Contact: N/A
Facility: The Christie NHS Foundation Trust
Manchester, M20 4BX
United Kingdom
Status: Recruiting Contact: N/A
Facility: Northern Centre for Cancer Care
Newcastle, NE7 7DN
United Kingdom
Status: Recruiting Contact: N/A
Facility: Churchill Hospital
Oxford, OX3 7LE
United Kingdom
Status: Recruiting Contact: N/A