RECRUITING

Testing the Combination of Two Anti-cancer Drugs, Peposertib (M3814) and M1774 for Advanced Solid Tumors

Conditions

Advanced Malignant Solid Neoplasm Metastatic Malignant Solid Neoplasm Unresectable Malignant Solid Neoplasm

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase I trial tests the safety, side effects and best dose of peposertib (M3814) in combination with tuvusertib (M1774) in treating patients with solid tumors that have spread to other places in the body (advanced). Peposertib and tuvusertib stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Official Title

A Molecularly Driven Phase 1b Dose Escalation and Dose Expansion Study of the DNA-PK Inhibitor Peposertib (M3814) in Combination With the ATR Inhibitor M1774

Quick Facts

Study Start:2024-06-07

Study Completion:2026-08-31

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT05687136

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Patients must have histologically confirmed solid malignancy that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective. * For the dose escalation and dose expansion phases, patients must have genomic evidence of inactivating ATM mutations, amplification of MYC, mutation of FBXW7, CCNE1 amplification, SWI/SNF member mutation (ARID1A, PBRM1, SMARCA4, ARID2, ARID1b, SMARCA2, SS18), and ATRX/DAXX. Other SWI/SNF mutations may be considered after discussion with the principal investigator (PI). * Progression on at least one prior standard therapy. * Age \>= 18 years. Because no dosing or adverse event data are currently available on the use of peposertib (M3814) in combination with M1774 in patients \< 18 years of age, children are excluded from this study. * Life expectancy \> 3 months. * Eastern cooperative oncology group (ECOG) performance status =\< 2 (Karnofsky \>= 60%). * Measurable disease by response evaluation criteria in solid tumors (RECIST) 1.1 (RECIST) 1.1 non-measurable disease permitted for the dose escalation portion). * Hemoglobin \>= 9 g/dL. * Absolute neutrophil count \>= 1,500/mcL. * Platelets \>= 1000,000/mcL. * Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN). * Asparate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\]/alanine aminotransferase (ALT)(serum glutamic pyruvic transaminase \[SGPT\]) =\< 3 × institutional ULN or =\< 5.0X the ULN if liver metastases are present. * Glomerular filtration rate (GFR) \>= 60 mL/min/1.73m\^2. * Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial. Anti-retroviral therapy agents must be considered for potential drug-drug interactions per exclusion. * For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated. * Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load. * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial. * Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better. * Able to swallow whole capsules or tablets. * Willing to undergo paired biopsies (expansion arm). * Female patients of childbearing potential must have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of study medication. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. * Female patients of childbearing potential must be willing to use an adequate method of contraception for the course of the study through 6 months after the last dose of study medication. * Male patients of reproductive potential must agree to avoid impregnating a partner while receiving study drug and for 3 months after the last dose of study drug by complying with adequate methods of contraception. * Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the patient. * Ability to understand and the willingness to sign a written informed consent document. Participants with impaired decision-making capacity who have a legally-authorized representative (LAR) and/or family member available will also be eligible.	* Patients who have received immunotherapy within 21 days of Cycle 1 Day 1. * Patients who have received therapeutic radiation therapy within 21 days, or palliative radiation therapy within 7 days, of Cycle 1 Day 1. * Patients who have undergone major surgery within 21 days of Cycle 1 Day 1. * Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities \> Grade 1) with the exception of alopecia, controlled endocrine toxicity (e.g., hypothyroidism), and cutaneous toxicity which will be permitted at Grade 2. * Patients who are receiving any other investigational agents. * Patients with new or progressive brain metastases (active brain metastases) or leptomeningeal disease are eligible if the treating physician determines that immediate central nervous system (CNS) specific treatment is not required and is unlikely to be required during the first cycle of therapy. * History of allergic reactions attributed to compounds of similar chemical or biologic composition to peposertib (M3814) and M1774. * Patients who cannot discontinue concomitant medications or herbal supplements that are strong inhibitors or strong inducers of cytochrome P450 (CYP) isoenzymes CYP3A4/5, CYP2C19, and CYP2C9. Concomitant use of CYP3A4/5 substrates with a narrow therapeutic index are also excluded. Concomitant administration of sensitive substrates of P-gp, BCRP, OCT1, OATP1B1, and OATP1B3 should be avoided (if the use is unavoidable, carefully monitor patients for signs of increased toxicity). Patients may confer with the study doctor to determine if alternative medications can be used. The following categories of medications and herbal supplements must be discontinued for at least the specified period of time before the patient can be treated: * Strong inducers of CYP3A4/5,CYP2C19, and CYP2C9: \>= 3 weeks prior to study treatment. * Strong inhibitors of CYP3A4/5, CYP2C19, and CYP2C9: \>= 1 week prior to study treatment. * Substrates of CYP3A4/5, , P-gp, BCRP, OCT1, OATP1B1, and OATP1B3 with a narrow therapeutic index: \>= 1 day prior to study treatment. * Patients who cannot discontinue proton-pump inhibitors (PPIs). H-2-receptor antagonist should be held during the 2 weeks of concurrent dosing with M1774. There is no H-2-receptor antagonist restriction during the off weeks without M1774/peposertib (M3814) dosing. * Patients who received hematopoietic growth factor (e.g., granulocyte colony-stimulating factor, erythropoietin) within 14 days prior to the first dose of study intervention. * Patients with uncontrolled intercurrent illness including, but not limited to: ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or chronic indwelling drains. * QTcF (using the Fridericia correction calculation) of \> 470 msec * Pregnant women and women who are breastfeeding are excluded from this study because the effects of the study drugs on the developing fetus are unknown. * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen as assessed by the treating investigator may be included with the approval of the sponsor-investigator.

Inclusion Criteria

Exclusion Criteria

* Patients must have histologically confirmed solid malignancy that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective.
* For the dose escalation and dose expansion phases, patients must have genomic evidence of inactivating ATM mutations, amplification of MYC, mutation of FBXW7, CCNE1 amplification, SWI/SNF member mutation (ARID1A, PBRM1, SMARCA4, ARID2, ARID1b, SMARCA2, SS18), and ATRX/DAXX. Other SWI/SNF mutations may be considered after discussion with the principal investigator (PI).
* Progression on at least one prior standard therapy.
* Age \>= 18 years. Because no dosing or adverse event data are currently available on the use of peposertib (M3814) in combination with M1774 in patients \< 18 years of age, children are excluded from this study.
* Life expectancy \> 3 months.
* Eastern cooperative oncology group (ECOG) performance status =\< 2 (Karnofsky \>= 60%).
* Measurable disease by response evaluation criteria in solid tumors (RECIST) 1.1 (RECIST) 1.1 non-measurable disease permitted for the dose escalation portion).
* Hemoglobin \>= 9 g/dL.
* Absolute neutrophil count \>= 1,500/mcL.
* Platelets \>= 1000,000/mcL.
* Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN).
* Asparate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\]/alanine aminotransferase (ALT)(serum glutamic pyruvic transaminase \[SGPT\]) =\< 3 × institutional ULN or =\< 5.0X the ULN if liver metastases are present.
* Glomerular filtration rate (GFR) \>= 60 mL/min/1.73m\^2.
* Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial. Anti-retroviral therapy agents must be considered for potential drug-drug interactions per exclusion.
* For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.
* Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.
* Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.
* Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better.
* Able to swallow whole capsules or tablets.
* Willing to undergo paired biopsies (expansion arm).
* Female patients of childbearing potential must have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of study medication. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
* Female patients of childbearing potential must be willing to use an adequate method of contraception for the course of the study through 6 months after the last dose of study medication.
* Male patients of reproductive potential must agree to avoid impregnating a partner while receiving study drug and for 3 months after the last dose of study drug by complying with adequate methods of contraception.
* Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the patient.
* Ability to understand and the willingness to sign a written informed consent document. Participants with impaired decision-making capacity who have a legally-authorized representative (LAR) and/or family member available will also be eligible.

* Patients who have received immunotherapy within 21 days of Cycle 1 Day 1.
* Patients who have received therapeutic radiation therapy within 21 days, or palliative radiation therapy within 7 days, of Cycle 1 Day 1.
* Patients who have undergone major surgery within 21 days of Cycle 1 Day 1.
* Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities \> Grade 1) with the exception of alopecia, controlled endocrine toxicity (e.g., hypothyroidism), and cutaneous toxicity which will be permitted at Grade 2.
* Patients who are receiving any other investigational agents.
* Patients with new or progressive brain metastases (active brain metastases) or leptomeningeal disease are eligible if the treating physician determines that immediate central nervous system (CNS) specific treatment is not required and is unlikely to be required during the first cycle of therapy.
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to peposertib (M3814) and M1774.
* Patients who cannot discontinue concomitant medications or herbal supplements that are strong inhibitors or strong inducers of cytochrome P450 (CYP) isoenzymes CYP3A4/5, CYP2C19, and CYP2C9. Concomitant use of CYP3A4/5 substrates with a narrow therapeutic index are also excluded. Concomitant administration of sensitive substrates of P-gp, BCRP, OCT1, OATP1B1, and OATP1B3 should be avoided (if the use is unavoidable, carefully monitor patients for signs of increased toxicity). Patients may confer with the study doctor to determine if alternative medications can be used. The following categories of medications and herbal supplements must be discontinued for at least the specified period of time before the patient can be treated:
* Strong inducers of CYP3A4/5,CYP2C19, and CYP2C9: \>= 3 weeks prior to study treatment.
* Strong inhibitors of CYP3A4/5, CYP2C19, and CYP2C9: \>= 1 week prior to study treatment.
* Substrates of CYP3A4/5, , P-gp, BCRP, OCT1, OATP1B1, and OATP1B3 with a narrow therapeutic index: \>= 1 day prior to study treatment.
* Patients who cannot discontinue proton-pump inhibitors (PPIs). H-2-receptor antagonist should be held during the 2 weeks of concurrent dosing with M1774. There is no H-2-receptor antagonist restriction during the off weeks without M1774/peposertib (M3814) dosing.
* Patients who received hematopoietic growth factor (e.g., granulocyte colony-stimulating factor, erythropoietin) within 14 days prior to the first dose of study intervention.
* Patients with uncontrolled intercurrent illness including, but not limited to: ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or chronic indwelling drains.
* QTcF (using the Fridericia correction calculation) of \> 470 msec
* Pregnant women and women who are breastfeeding are excluded from this study because the effects of the study drugs on the developing fetus are unknown.
* Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen as assessed by the treating investigator may be included with the approval of the sponsor-investigator.

Contacts and Locations

Principal Investigator

Gregory M Cote

PRINCIPAL_INVESTIGATOR

Dana-Farber - Harvard Cancer Center LAO

Study Locations (Sites)

National Cancer Institute Developmental Therapeutics Clinic

Bethesda, Maryland, 20892

United States

National Institutes of Health Clinical Center

Bethesda, Maryland, 20892

United States

Massachusetts General Hospital Cancer Center

Boston, Massachusetts, 02114

United States

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215

United States

NYU Langone Hospital - Long Island

Mineola, New York, 11501

United States

Laura and Isaac Perlmutter Cancer Center at NYU Langone

New York, New York, 10016

United States

Collaborators and Investigators

Sponsor: National Cancer Institute (NCI)

Gregory M Cote, PRINCIPAL_INVESTIGATOR, Dana-Farber - Harvard Cancer Center LAO

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2024-06-07

Study Completion Date2026-08-31

Study Record Updates

Study Start Date2024-06-07

Study Completion Date2026-08-31

Terms related to this study

Additional Relevant MeSH Terms

Advanced Malignant Solid Neoplasm
Metastatic Malignant Solid Neoplasm
Unresectable Malignant Solid Neoplasm