A Study With NKT3964 for Adults With Advanced/Metastatic Solid Tumors

NCT06586957RecruitingPHASE1INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

NiKang Therapeutics, Inc.

Enrollment

150

Start Date

2024-09-19

Completion Date

2029-01-01

Study Type

INTERVENTIONAL

Official Title

A Phase 1, First-in-human, Open-label Study to Evaluate the Safety, Tolerability, PK, and Preliminary Anti-tumor Activity of the Novel Oral CDK2 Degrader NKT3964 in Adults With Advanced/Metastatic Solid Tumors

Interventions

NKT3964

Conditions

Solid TumorAdvanced Solid TumorSolid TumorAdultMetastatic TumorOvarian CancerOvarian NeoplasmsOvarian CarcinomaMetastatic Ovarian CarcinomaEndometrial NeoplasmsEndometrial DiseasesMetastatic Endometrial CancerTriple Negative Breast CancerMetastatic Endometrial CarcinomaAdvanced Endometrial CarcinomaAdvanced Ovarian CarcinomaGastric CancerAdvanced Gastric CarcinomaMetastatic Gastric CancerMetastatic Gastric CarcinomaSmall Cell Lung CancerSmall Cell Lung CarcinomaTriple Negative Breast NeoplasmsPlatinum-resistant Ovarian CancerPlatinum-refractory Ovarian CarcinomaCCNE1 AmplificationHormone Receptor Negative Breast CarcinomaHuman Epidermal Growth Factor 2 Negative Carcinoma of BreastProgesterone-receptor-positive Breast Cancer

Eligibility

Age Range

18 Years+

Sex

ALL

Inclusion Criteria:

\- Must have a pathologically confirmed advanced and unresectable or metastatic solid tumor listed below with documented disease progression on last standard treatment. Part 1 only: subjects must be refractory to, or intolerant of existing therapy(ies) known to provide clinical benefit for their condition.

Dose Escalation:

1. Ovarian cancer
2. Endometrial cancer (only endometrioid subtype will require CCNE1 amplification)
3. Gastric, gastroesophageal junction (GEJ) or esophageal adenocarcinoma with CCNE1 amplification
4. Small cell lung cancer (SCLC)
5. Triple-negative breast cancer (TNBC; HER2, estrogen receptor and progesterone receptor negative)
6. HR+ (includes estrogen-receptor or progesterone-receptor) and HER2- breast cancer (must have progressed following treatment with a CDK4/6 inhibitor, and is not suitable for endocrine therapy \[ET\])
7. Other solid tumors with CCNE1 amplification

Dose Expansion:

Part 2A: HR+ and HER2- breast cancer that is locally advanced and unresectable (Stage III) or metastatic (Stage IV); previously treated with ≥1 line of standard of care (SOC) including CDK4/6 inhibitor plus ET and not suitable for further ET. Subjects must have progressed after receiving therapy for ≥3 months in the metastatic setting or for ≥6 months in the adjuvant setting. Subjects must have received ≤2 lines of systemic cytotoxic therapy (chemotherapy or cytotoxic antibody drug conjugate \[ADC\]) in the metastatic setting..

Part 2B: Advanced platinum-based-chemotherapy resistant or refractory epithelial ovarian/fallopian/primary peritoneal carcinoma or clear cell ovarian cancer (defined as recurrence ≤6 months after completing platinum-based regimen) with progression on at least one platinum containing therapy and previously treated with ≤4 prior lines of systemic therapy administered for advanced/metastatic disease and with CCNE1 amplification.

Part 2C: Advanced unresectable or metastatic gastric, GEJ or esophageal adenocarcinoma with progression on at least one systemic therapy and previously treated with ≤3 prior lines of systemic therapy administered for advanced/metastatic disease, with CCNE1 amplification as determined by NGS by local liquid or tissue test.

Part 2D: Advanced endometrial adenocarcinoma or uterine papillary serous carcinoma previously treated with ≤4 prior lines of systemic therapy administered for advanced/metastatic disease with CCNE1 amplification.

Part 2E: Advanced/recurrent uterine carcinosarcoma previously treated with 1 prior platinum-based chemotherapy regimen and ≤3 prior lines of systemic therapy. Prior bevacizumab or PARP inhibitors are allowed and must be at least 3 weeks prior to the start of study drug.

* Have adequate organ function
* Subjects with female reproductive organs must be surgically sterile, post-menopausal, or must be willing to use highly effective method(s) of contraception
* Ability to swallow oral medications.
* Consent to provide archived tumor tissues and paired tumor biopsy at pretreatment

Exclusion Criteria:

* Locally advanced solid tumor that is a candidate for curative treatment through radical surgery and/or radiotherapy, or chemotherapy.
* History of another malignancy with exceptions
* History of lymphohistiocytic or lymphoid hyperplasia; hemophagocytic lymphohistiocytosis.
* Failed to recover from effects of prior anticancer treatment therapy to baseline or Grade ≤ 1 severity (per CTCAE)
* Clinically significant cardiovascular event within 6 months prior to start of NKT3964 treatment
* Known active CNS metastases and/or carcinomatous meningitis
* Active interstitial lung disease currently requiring treatment
* History of uveitis, retinopathy or other clinically significant retinal disease
* Active or chronic corneal disorders, other active ocular conditions requiring ongoing therapy, or any clinically significant corneal disease
* Active wound healing from major surgery within 1 month or minor surgery within 10 days before the first dose of NKT3964.
* Known human immunodeficiency virus (HIV), active hepatitis B or C infection
* Prior investigative treatment with a selective or nonselective CDK2 inhibitor or degrader
* Childs-Pugh class B or C cirrhosis or any other clinically significant liver disorder
* Palliative radiation therapy within 14 days or other radiation therapy within 4 weeks prior to C1D1

Outcome Measures

Primary Outcomes

Number of Participants with Dose Limiting Toxicity (DLT) events

DLTs graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0

Time frame: 28 Days

Objective Response Rate (ORR)

ORR defined as the percentage of participants with a confirmed complete response (CR) or partial response (PR) by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as determined by the Investigator

Time frame: 1 Year

Secondary Outcomes

Progression-free survival (PFS)

PFS defined as the time from the date the participant started study drug to the date the participant experiences an event of disease progression or death.

Time frame: 2 Year

Duration of Response (DOR)

Duration of overall response is defined as the time from the date of first confirmed CR or PR, assessed by investigator and based on RECIST v. 1.1, to the documented date of progressive disease (PD) including clinical progression, or death due to any cause, or the start of subsequent anticancer therapy, whichever occurred first.

Time frame: 2 Year

Disease control rate

Disease control rate defined as CR + PR + stable disease \[SD\] for at least 8 weeks

Time frame: 1 Year

Overall Survival (OS)

OS defined as the time from the date the participant started study drug to death for any reason.

Time frame: 2 Year

Time to Response (TTR)

TTR is defined as the time from first dose to the first documented CR or PR which is subsequently confirmed.

Time frame: 1 Year

Number of Participants with Adverse Events

An adverse event (AE) is defined as any untoward medical occurrence in a patient and which does not necessarily have a causal relationship with this treatment. The investigator assessed the relationship of each event to the use of study drug as either probably related, possibly related, probably not related or not related.

Time frame: 2 Year

Maximum observed plasma concentration (Cmax) of NKT3964 with and without a high-fat and/or low-fat meal

Maximum observed plasma concentration (Cmax) of NKT3964

Time frame: 1 Month

Time to maximum observed plasma concentration of NKT3964 (Tmax) with and without a high-fat and/or low-fat meal

Time to maximum observed plasma concentration of NKT3964 (Tmax)

Time frame: 1 Month

Observed trough concentration of NKT3964 (Ctrough)

Observed trough concentration of NKT3964 (Ctrough)

Time frame: 88 Weeks

Area under the plasma concentration-time curve (AUC0-t) of NKT3964 with and without a high-fat and/or low-fat meal

Area under the plasma concentration-time curve (AUC0-t) of NKT3964

Time frame: 1 Month

Apparent clearance (CL/F) of NKT3964

Apparent clearance (CL/F)

Time frame: 1 Month

Apparent volume of distribution (V/F) of NKT3964

Apparent volume of distribution (V/F)

Time frame: 1 Month

Half-life (t1/2) of NKT3964

Half-life (t1/2)

Time frame: 1 Month

Accumulation ratio (AR) of NKT3964

Accumulation ratio (AR)

Time frame: 1 Month

Locations

University of Arkansas Medical School, Little Rock, United States

University of California - Los Angeles, Los Angeles, United States

UCSF, San Francisco, United States

SCRI at HealthOne, Denver, United States

Florida Cancer Specialists & Research Institute, Lake Mary, United States

AdventHealth Cancer Institute, Orlando, United States

Emory Winship Cancer Institute, Atlanta, United States

Augusta University, Augusta, United States

University of Kansas, Fairway, United States

Dana Farber Cancer Institute, Boston, United States

John Theurer Cancer Center at Hackensack UMC, Hackensack, United States

Sidney Kimmell Cancer Center - Jefferson Health, Philadelphia, United States

UPMC, Pittsburgh, United States

Sarah Cannon Research Institute (SCRI), Nashville, United States

NEXT Oncology, Austin, United States

UT Southwestern, Dallas, United States

Intermountain Health, Salt Lake City, United States

University of Virginia, Charlottesville, United States

NEXT Virginia, Fairfax, United States

A Study With NKT3964 for Adults With Advanced/Metastatic Solid Tumors