Clinical trial NCT02857270: A Study of LY3214996 Administered Alone or in Combination With Other Agents in Participants With Advanced/Metastatic Cancer
Official title: A Phase 1 Study of an ERK1/2 Inhibitor (LY3214996) Administered Alone or in Combination With Other Agents in Advanced Cancer
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Advanced Cancer
Metastatic Melanoma
Metastatic Non-small Cell Lung Cancer
Colorectal Cancer
Keywords: MAPK
RAS
BRAF
Lead sponsor: Eli Lilly and Company
Sponsor class: INDUSTRY
First posted: 2016-08-05
Enrollment: 210
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief 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 criteria: Inclusion Criteria:

* Have advanced or metastatic cancer (solid tumors) and be an appropriate candidate for experimental therapy.

  * Part B (No Longer Enrolling Participants): Have advanced or metastatic cancer with an activating mitogen-activated protein kinase pathway alteration, BRAF mutant metastatic melanoma refractory to or relapsed after treatment with RAF and/or MEK inhibitors, metastatic melanoma with a NRAS mutation, or BRAF mutant NSCLC.
  * Part C: Advanced, unresectable cancer (dose escalation) and advanced, unresectable, or metastatic non-small cell lung cancer with a BRAF or RAS mutation, or NRAS mutant melanoma (dose expansion).
  * Part D (No Longer Enrolling Participants): Have metastatic pancreatic ductal adenocarcinoma (dose escalation and dose expansion).
  * Part E: Metastatic BRAF V600E colorectal cancer.
* 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.
* Part C: have serious and/or uncontrolled preexisting medical condition(s) that, in the judgment of the investigator, would preclude participation in this study, including interstitial lung disease (ILD) or severe dyspnea at rest or requiring oxygen therapy.
* Part C4 NRAS Melanoma: have previously completed or withdrawn from a study investigating a MEK inhibitor.

Primary outcomes:
measure: Number of Participants with LY3214996 Dose Limiting Toxicities (DLTs)
timeFrame: Cycle 1 (21 Days)
Secondary outcomes:
measure: Pharmacokinetics (PK): Area Under the Concentration-Time Curve (AUC) of LY3214996 Administered as Monotherapy and when Administered in Combination with Nab-Paclitaxel Plus Gemcitabine, Abemaciclib and Encorafenib Plus Cetuximab
timeFrame: Cycle 1 Day 1 through Cycle 2 Day 1 (up to 28 Day Cycles)
measure: PK: AUC of Gemcitabine when Administered with LY3214996
timeFrame: Cycle 1 Day 1 through Cycle 1 Day 15 (28 Day Cycles)
measure: PK: AUC of Nab-Paclitaxel when Administered with LY3214996
timeFrame: Cycle 1 Day 1 through Cycle 1 Day 15 (28 Day Cycles)
measure: PK: AUC of Abemaciclib and its Metabolites when Administered with LY3214996
timeFrame: Cycle 1 Day 1 through Cycle 2 Day 1 (up to 22 Day Cycles)
measure: PK: AUC of Encorafenib when Administered with LY3214996
timeFrame: Cycle 1 Day 1 through Cycle 2 Day 1 (up to 22 Day Cycles)
measure: PK: AUC of Cetuximab when Administered with LY3214996
timeFrame: Cycle 1 Day 1 through Cycle 2 Day 1 (up to 22 Day Cycles)
measure: PK: AUC of Midazolam and its 1'-Hydroxymidazolam Metabolite when Administered Alone and in Combination with LY3214996
timeFrame: Cycle 1 Day 1 through Cycle 1 Day 16 (21 Day Cycles)
measure: Objective Response Rate (ORR): Percentage of Participants With a Complete (CR) or Partial Response (PR)
timeFrame: Baseline to Measured Progressive Disease or Start of New Anti-Cancer Therapy (Estimated up to 6 Months)
measure: Duration of Response (DoR)
timeFrame: Date of Complete Response (CR) or Partial Response (PR) to Date of Objective Disease Progression or Death Due to Any Cause (Estimated up to 12 Months)
measure: Time to First Response (TTR)
timeFrame: Baseline to Date of CR or PR (Estimated up to 6 Months)
measure: Progression Free Survival (PFS)
timeFrame: Baseline to Progressive Disease or Death of Any Cause (Estimated up to 12 Months)
measure: Disease Control Rate (DCR): Percentage of Participants who Exhibit Stable Disease (SD), CR or PR
timeFrame: Baseline through Measured Progressive Disease (Estimated up to 6 Months)
measure: Overall Survival (OS) (Dose Expansion Arms Only)
timeFrame: Baseline to Date of Death from Any Cause (Estimated up to 2 Years)
Other outcomes:
Locations:
city: Washington
country: United States
facility: Georgetown University Medical Center
state: District of Columbia
city: Sarasota
country: United States
facility: Florida Cancer Specialists
state: Florida
city: Boston
country: United States
facility: Massachusetts General Hospital
state: Massachusetts
city: Lebanon
country: United States
facility: Dartmouth Hitchcock Medical Center
state: New Hampshire
city: Pittsburgh
country: United States
facility: UPMC Hillman Cancer Center
state: Pennsylvania
city: Nashville
country: United States
facility: Sarah Cannon Cancer Center
state: Tennessee
city: Nashville
country: United States
facility: Tennessee Oncology PLLC
state: Tennessee
city: Houston
country: United States
facility: University of Texas MD Anderson Cancer Center
state: Texas
city: Sydney
country: Australia
facility: St Vincent's Hospital
state: New South Wales
city: Nedlands
country: Australia
facility: Linear Clinical Research Ltd
state: Western Australia
city: Villejuif Cedex
country: France
facility: Gustave Roussy
city: Sunto-Gun
country: Japan
facility: Shizuoka Cancer Center
state: Shizuoka
city: Chuo-ku
country: Japan
facility: National Cancer Center Hospital
state: Tokyo
Study officials:
affiliation: Eli Lilly and Company
name: Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST)
role: STUDY_DIRECTOR
References:
citation: Bhagwat SV, McMillen WT, Cai S, Zhao B, Whitesell M, Shen W, Kindler L, Flack RS, Wu W, Anderson B, Zhai Y, Yuan XJ, Pogue M, Van Horn RD, Rao X, McCann D, Dropsey AJ, Manro J, Walgren J, Yuen E, Rodriguez MJ, Plowman GD, Tiu RV, Joseph S, Peng SB. ERK Inhibitor LY3214996 Targets ERK Pathway-Driven Cancers: A Therapeutic Approach Toward Precision Medicine. Mol Cancer Ther. 2020 Feb;19(2):325-336. doi: 10.1158/1535-7163.MCT-19-0183. Epub 2019 Nov 19.