Patient case: 63-year-old female with melanoma; genetic feature: NRAS (Q61R)

Clinical trial: A Study of LY3214996 Administered Alone or in Combination With Other Agents in Participants With Advanced/Metastatic Cancer

Summary: The purpose of this study is to determine the safety of an extracellular signal regulated kinase (ERK1/2) inhibitor LY3214996 administered alone or in combination with other agents in participants with advanced cancer.


Eligibility: Inclusion Criteria:
  -  Have advanced or metastatic cancer (solid tumors) and be an appropriate candidate for experimental therapy.
  -  Part B2: Have advanced/metastatic cancer carrying activating mitogen-activated protein kinase (MAPK) pathway alteration
  -  Part B3: Have metastatic melanoma carrying BRAF mutation, refractory/relapsed after treatment with Raf and/or MEK inhibitors
  -  Part B4: Have metastatic melanoma carrying NRAS mutation
  -  Part C: Have advanced unresectable cancer (dose escalation) and advanced/unresectable/metastatic NSCLC carrying BRAF or RAS mutation and colorectal cancer carrying RAS mutation (dose expansion)
  -  Part D: Have metastatic pancreatic ductal adenocarcinoma (dose escalation and dose expansion)
  -  Have discontinued previous treatments for cancer and have resolution, except where otherwise stated in the inclusion criteria, of all clinically significant toxic effects of prior chemotherapy, surgery, or radiotherapy to Grade ≤1 by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0.
  -  Have adequate organ function.
  -  Have a performance status of 0 to 1 on the Eastern Cooperative Oncology Group (ECOG) scale.
  Exclusion Criteria:
  -  Have serious preexisting medical conditions.
  -  Have a known human immunodeficiency virus (HIV) infection or known activated/reactivated hepatitis A, B, or C.
  -  Have symptomatic central nervous system malignancy or metastasis.
  -  Have current hematologic malignancies, acute or chronic leukemia.
  -  Have a second primary malignancy that in the judgment of the investigator or Lilly may affect the interpretation of results.
  -  Have prior malignancies. Participants with carcinoma in situ of any origin and participants with prior malignancies who are in remission and whose likelihood of recurrence is very low, as judged by the Lilly clinical research physician, are eligible for this study.
  -  Have a mean QT interval corrected for heart rate (QTc) of ≥470 milliseconds on screening electrocardiogram (ECG) as calculated using the Bazett's formula at several consecutive days of assessment.
  -  Have participated, within the last 28 days in a clinical trial involving an investigational product or are currently enrolled in a clinical trial involving an investigational product or any other type of medical research judged not to be scientifically or medically compatible with this study.
  -  Have previously completed or withdrawn from this study or any other study investigating an ERK1/2 inhibitor.
  -  If female, is pregnant, breastfeeding, or planning to become pregnant.
  -  Have history or findings of central or branch retinal artery or venous occlusion with significant vision loss or other retinal diseases that cause current visual impairment or would likely cause visual impairment over the time period of the study.
  -  Currently using concomitant medications that are strong inhibitors or inducers of CYP3A4.

Relevance to patient case: definitely relevant