A Study of Avutometinib (VS-6766) + Defactinib (VS-6063) in Recurrent Low-Grade Serous Ovarian Cancer

NCT06072781RecruitingPHASE3INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Verastem, Inc.

Enrollment

270

Start Date

2024-03-18

Completion Date

2028-10-15

Study Type

INTERVENTIONAL

Official Title

A Phase 3, Randomized, Open-Label Study of Combination Therapy With Avutometinib Plus Defactinib Versus Investigator's Choice of Treatment in Patients With Recurrent Low-Grade Serous Ovarian Cancer (LGSOC) (RAMP 301)

Interventions

avutometinibDefactinibPegylated liposomal doxorubicinPaclitaxelLetrozoleAnastrozole

Conditions

Low Grade Serous Ovarian Cancer

Eligibility

Age Range

18 Years+

Sex

FEMALE

Inclusion Criteria:

Patients may be eligible for inclusion in the study if they meet the following criteria:

1. Histologically proven LGSOC (ovarian, fallopian, peritoneal)
2. Documented mutational status of KRAS by a validated tumor-tissue based diagnostic test.
3. Suitable for treatment with at least one of the Investigator's Choice of Treatments:pegylated liposomal doxorubicin, paclitaxel, letrozole, anastrozole.
4. Progression or recurrence of LGSOC after at least one prior systemic therapy for metastatic disease.
5. Measurable disease according to RECIST v1.1.
6. An Eastern Cooperative Group (ECOG) performance status ≤ 1.
7. Adequate organ function.
8. Adequate recovery from toxicities related to prior treatments.
9. For patients with reproductive potential, a negative pregnancy test must be confirmed and agreement to use highly effective method of contraceptive.
10. Willingness to comply with the scheduled visits, treatment plan, laboratory tests and other study procedures.

Exclusion Criteria:

Patients will be excluded from the study if they meet any of the following criteria:

1. Systemic anti-cancer therapy within 4 weeks of the first dose of study therapy.
2. Co-existing high-grade serous ovarian cancer or mixed histology.
3. Prior treatment with avutometinib, defactinib, or other FAK inhibitors.
4. History of prior malignancy with recurrence \<3 years from the time of enrollment.
5. Major surgery within 4 weeks, minor surgery within 1 week, or palliative radiotherapy within 1 week of the first dose of study intervention.
6. Symptomatic brain metastases requiring steroids or other interventions, known leptomeningeal metastases, or spinal cord compression.
7. An active skin disorder that has required systemic therapy within one year of the first dose of study intervention.
8. History of medically significant rhabdomyolysis.
9. For subjects with prior MEK or RAF exposure, Grade 4 toxicity is deemed related to the MEK inhibitor.
10. Symptomatic bowel obstruction within 3 months of the first dose of study intervention
11. Concurrent ocular disorders.
12. Concurrent heart disease or severe obstructive pulmonary disease.
13. Active or past medical history of interstitial lung disease/pneumonitis, including drug-induced or radiation pneumonitis, pulmonary fibrosis, or adult respiratory distress syndrome (ARDS).
14. Subjects with the inability to swallow oral medications.
15. History of hypersensitivity to any of the active agents or ingredients of study intervention: peanut, soya, polyoxyl castor oil, etcetc.). Prior hypersensitivity to anthracyclines or anthracenediones if the use of pegylated liposomal doxorubicin (PLD) is planned.
16. Pregnant or breastfeeding.
17. Active, uncontrolled infection (bacterial, viral, or fungal) requiring systemic therapy.

Outcome Measures

Primary Outcomes

Progression Free Survival (PFS) per blinded independent central review (BICR)

Progression-free survival (PFS) according to RECIST version 1.1, per blinded independent central review (BICR)

Time frame: Up to 24 months

Secondary Outcomes

Overall Survival (OS)

From the time of first dose of study intervention to PD as assessed per RECIST 1.1 or death from any cause

Time frame: Up to 5 years

Progression Free Survival (PFS) per investigator assessment

Progression-free survival (PFS) according to RECIST version 1.1, per blinded independent central review (BICR)

Time frame: 24 months

Objective response rate (ORR)

From the time of first dose of study intervention to PD as assessed per RECIST 1.1 by Investigator or death from any cause

Time frame: 12 months

Duration of Response (DOR)

From the time of first dose of study intervention to PD as assessed per RECIST 1.1 by Investigator or death from any cause

Time frame: 12 months

Disease Control Rate (DCR)

CR+PR+Stable disease

Time frame: 6 months

Frequency and severity adverse events (AEs) and Serious Adverse Events (SAEs)

Count of AE and SAEs by grade, based on the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) grading scale

Time frame: 25 months

Area under the plasma concentration-time curve (AUC) of avutometinib, defactinib and relative metabolites

Area under plasma Concentration (AUC) 0 to t

Time frame: 5 months

Maximum plasma concentration (Cmax) of avutometinib, defactinib and relative metabolites

maximum plasma concentration

Time frame: 5 months

To assess the health-related quality of life and disease based on European Organization for Research and Treatment of Cancer (EORTC) Quality of life Questionnaire Core module C30 (QLQ-C30).

The EORTC QLQ-C30 is a validated questionnaire to assess the quality of life of ovarian cancer patients.

Time frame: 24 months

To assess the health-related quality of life and disease based on European Organization for Research and Treatment of Cancer (EORTC) Quality of life Questionnaire Ovarian Cancer module OV28 (QLQ-OV28).

The EORTC QLQ-OV28 is a validated questionnaire to assess the quality of life of ovarian cancer patients.

Time frame: 24 months

To assess the health-related quality of life and disease based on EuroQol-5 Dimension 5-level (EQ-5D-5L)

The EuroQol-5 Dimension 5-level (EQ-5D-5L) is a validated questionnaire used to measure a patient's overall health.

Time frame: 24 months

Locations

HonorHealth, Phoenix, United States

University of Arkansas, Little Rock, United States

UCLA Health, Los Angeles, United States

UC Davis, Sacramento, United States

University of California, San Francisco, San Francisco, United States

Yale University, New Haven, United States

Florida Cancer Specialists - South, Fort Myers, United States

Mount Sinai, Miami Beach, United States

AdventHealth, Orlando, United States

Moffitt Cancer Center, Tampa, United States

Florida Cancer Specialists Research East, West Palm Beach, United States

Winship Cancer Institute at Emory University, Atlanta, United States

NorthShore University HealthSystem, Evanston, United States

Louisiana State University, New Orleans, United States

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, United States

Karmanos Cancer Center, Detroit, United States

Minnesota Oncology Hematology, Minneapolis, United States

Washington University School of Medicine, St Louis, United States

Roswell Park Cancer Institute, Buffalo, United States

Memorial Sloan Kettering Cancer Center, New York, United States

Atrium Health, Charlotte, United States

Cleveland Clinic Foundation, Cleveland, United States

Ohio State, Hilliard, United States

University of Oklahoma Medical Center, Oklahoma City, United States

Willamette Valley Cancer Institute, Eugene, United States

Northwest Cancer Specialists, Portland, United States

Asplundh Cancer Pavilion | Jefferson Health, Philadelphia, United States

Allegheny Health Network, Pittsburgh, United States

Texas Oncology Central, Austin, United States

Texas Oncology-Fort Worth Cancer Center, Fort Worth, United States

Houston Methodist, Houston, United States

MD Anderson Cancer Center, Houston, United States

Texas Oncology, San Antonio, United States

Texas Oncology, The Woodlands, United States

Texas Oncology, Tyler, United States

Intermountain Medical Center, Murray, United States

University of Virginia Health System, Charlottesville, United States

Virginia Cancer Specialists, PC, Gainesville, United States

Prince of Wales Hospital, Randwick, Australia

Icon Cancer Centre Wesley, Auchenflower, Australia

Cancer Research South Australia, Adelaide, Australia

Peter MacCallum Cancer Centre, Melbourne, Australia

Sir Charles Gairdner Hospital, Nedlands, Australia

UZA, Edegem, Belgium

University Hospital Ghent, Ghent, Belgium

Princess Margaret Cancer Center, Toronto, Canada

Centre Hospitalier de l'Universite de Montreal (CHUM), Montreal, Canada

McGill University Health Centre, Montreal, Canada

British of Columbia, Vancouver, Canada

Aalborg U.H, Aalborg, Denmark

Centre Hospitalier de Besançon, Besançon, France

Site Georges François Leclerc, Dijon, France

Centre Oscar Lambret, Lille, France

Centre Léon Bérard, Lyon, France

Institut Curie, Paris, France

Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany

Charité - Universitätsmedizin Berlin, Berlin, Germany

Universitätsklinikum Carl Gustav Carus, Dresden, Germany

Kliniken Essen-Mitte, Essen, Germany

UMC Hamburg-Eppendorf, Hamburg, Germany

Universitätsklinikum Mannheim GmbH, Mannheim, Germany

Universitätsfrauenkinik Ulm, Ulm, Germany

St. James's Hospital, Dublin, Ireland

Centro di Riferimento Oncologico (CRO), Aviano, Italy

Spedali Civili, Brescia, Italy

AO Cannizzaro, Catania, Italy

San Raffaele Hospital, Milan, Italy

Humanitas San Pio X, Milan, Italy

European Institute of Oncology (IEO), Milan, Italy

Istituto Nazionale dei Tumori, Milan, Italy

INT Napoli Hospital, Naples, Italy

Istituto Oncologico Veneto (IOV), Padua, Italy

IRCCS Gemelli, Roma, Italy

Istituti Fisioterapici Ospitalieri, Rome, Italy

S.C.D.U. Oncologia, Torino, Italy

The Mie University Hospital, Tsu, Japan

Aichi Cancer Center Hospital, Aichi, Japan

Tohoku University Hospital, Miyagi, Japan

Osaka Medical Center, Osaka, Japan

The Jikei University Hospital, Tokyo, Japan

Netherlands Cancer Insitute, Amsterdam, Netherlands

Radboud UMC, Nijmegen, Netherlands

Auckland City Hospital, Auckland, New Zealand

Białostockie Centrum Onkologii, Bialystok, Poland

Gdański Uniwersytet Medyczny, Gdansk, Poland

Siedleckie Centrum Onkologii, Siedlce, Poland

Seoul National University Bundang Hospital, Seongnam, South Korea

Yonsei University Severance Hospital, Seoul, South Korea

Asan Medical Center, Seoul, South Korea

Gangnam Severance Hospital, Seoul, South Korea

Samsung Medical Center, Seoul, South Korea

Clínico Virgen de La Arrixaca, El Palmar, Spain

H. de Donostia, Donostia / San Sebastian, Spain

H. Vall d´ Hebron, Barcelona, Spain

Hospital Universitario Reina Sofía, Córdoba, Spain

H.U. Ramón y Cajal, Madrid, Spain

Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain

Hospital Clínico Universitario de Valencia, Valencia, Spain

Greater Glasgow and Clyde (GGC), Glasgow, United Kingdom

Cambridge University Hospital, Cambridge, United Kingdom

University of Edinburgh Cancer Research Centre, Edinburgh, United Kingdom

Hope Cancer Trials Centre, Leicester, United Kingdom

University College London Hospitals NHS Foundation Trust, London, United Kingdom

Royal Marsden Hospital, London, United Kingdom

The Christie NHS Foundation Trust, Manchester, United Kingdom

Royal Marsden Hospital, Sutton, United Kingdom

Linked Papers

2025-07-11

Efficacy and Safety of Avutometinib ± Defactinib in Recurrent Low-Grade Serous Ovarian Cancer: Primary Analysis of ENGOT-OV60/GOG-3052/RAMP 201

PURPOSE This study evaluated the efficacy and safety of avutometinib (rapidly accelerated fibrosarcoma/mitogen-activated extracellular signal-regulated kinase [MEK] clamp) alone or in combination with defactinib (focal adhesion kinase inhibitor) in patients with recurrent low-grade serous ovarian cancer (LGSOC). METHODS In this phase II, open-label study, patients with recurrent, measurable LGSOC after ≥1 line of platinum chemotherapy were stratified by tumor Kirsten rat sarcoma virus homolog ( KRAS ) mutation status and randomly assigned to oral avutometinib 4.0 mg two times per week monotherapy or avutometinib 3.2 mg two times per week in combination with oral defactinib 200 mg two times per day. The combination was selected as the go-forward regimen for expansion. The primary end point was objective response rate (ORR) by blinded independent central review. RESULTS A total of 115 patients received the go-forward combination regimen. Patients had a median of 3 (range, 1-9) prior lines of therapy, including hormonal (86%), bevacizumab (51%), and MEK inhibitor (22%). Confirmed ORR was 31% (95% CI, 23% to 41%) with a median duration of response of 31.1 months (95% CI, 14.8 to 31.1). ORR was 44% in KRAS- mutant and 17% in KRAS wild-type cohorts. The median progression-free survival was 12.9 months (95% CI, 10.9 to 20.2) overall and 22.0 months (95% CI, 11.1 to 36.6) and 12.8 months (95% CI, 7.4 to 18.4) in KRAS- mutant and wild-type cohorts, respectively. The most frequent grade ≥3 treatment-related adverse events (AEs) were elevated creatine phosphokinase (24%), diarrhea (8%), and anemia (5%). Ten percent of patients discontinued because of AEs. CONCLUSION The efficacy and safety profile of avutometinib in combination with defactinib support this combination as a potential standard of care for recurrent LGSOC. A randomized phase 3 study of avutometinib and defactinib versus investigator's choice of therapy for women with recurrent LGSOC is currently enrolling (RAMP301; ClinicalTrials.gov identifier: NCT06072781 ).

2025-04-19

GOG-3097/ENGOT-ov81/GTG-UK/RAMP 301: a phase 3, randomized trial evaluating avutometinib plus defactinib compared with investigator’s choice of treatment in patients with recurrent low grade serous ovarian cancer

There are no approved treatments specifically for low grade serous ovarian cancer; current standard of care treatment options are limited in efficacy and tolerability. The combination of avutometinib with defactinib has demonstrated efficacy and a consistent safety profile in two clinical trials in recurrent low grade serous ovarian cancer, and a lower discontinuation rate due to adverse events compared with historical rates for standard of care. To compare the progression-free survival of the combination of avutometinib with defactinib versus investigator's choice of treatment in patients with recurrent low grade serous ovarian cancer. Combination treatment with avutometinib-defactinib will significantly improve progression-free survival compared with investigator's choice of treatment in patients with recurrent low grade serous ovarian cancer. GOG-3097/ENGOT-ov81/GTG-UK/RAMP 301 is a phase 3, randomized, international, open-label study designed to compare avutometinib with defactinib versus investigator's choice of treatment in patients with recurrent low grade serous ovarian cancer who have progressed on a previous platinum-based therapy. On confirmation of disease progression using a blinded independent central review, patients on the investigator's choice of treatment arm may cross over to the avutometinib-defactinib arm. Patients must have recurrent low grade serous ovarian cancer (KRAS mutant or wild-type) and have documented progression (radiographic or clinical) or recurrence of low grade serous ovarian cancer after at least one platinum-based chemotherapy regimen. Unlimited additional previous lines of therapy are allowed, including previous MEK/RAF inhibitor. Patients will be excluded if they have co-existing high grade ovarian cancer or had previous treatment with avutometinib, defactinib, or any other FAK inhibitor. Progression-free survival according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, blinded-independent central review. Approximately 270 patients will be randomized in a 1:1 fashion to either the combination avutometinib with defactinib arm (n∼135) or the investigator's choice of treatment arm (n∼135). The estimated primary completion date of RAMP 301 is 2028, and the estimated study completion date is 2031. ClinicalTrials.gov NCT06072781.

Linked Investigators