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

PHASE3RECRUITING

This study will assess the safety and efficacy of avutometinib (VS-6766) in combination with defactinib versus Investigator's choice of treatments (ICT) in subjects with recurrent LGSOC who have progressed on a prior platinum-based therapy.

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Study details:

This international, randomized, open-label, Phase 3 study will compare the investigational combination of avutometinib plus defactinib versus Investigator's Choice of Treatments (ICT) in patients with recurrent LGSOC who have progressed on a prior platinum-based therapy. Avutometinib and defactinib are both types of drugs called kinase inhibitors. Kinase inhibitors block cancer cell growth.

The study will compare the progression-free survival (PFS) of the combination of avutometinib plus defactinib versus ICT. The study will also evaluate the effect of the combination on safety, overall survival, other efficacy endpoints, and health-related quality of life and disease related symptoms. The study is being conducted by gynecological cancer specialists.

Patients who are eligible and agree to participate in this study will be treated with either a combination of avutometinib with defactinib, or with one of four standard of care NCCN and ESMO treatment recommendations for recurrent LGSOC, and then with subsequent follow up appointments. Patients who originally received one of the standards of care treatments who are determined to have progressive disease may be eligible to crossover to receive the investigational combination avutometinib plus defactinib. Avutometinib and defactinib are investigational drugs that have not been approved by the U.

S. Food and Drug Administration (FDA).

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Eligibility criteria

Researchers look for people who fit a certain description, called eligibility criteria. See if you qualify.

Inclusion criteria

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

  • Systemic anti-cancer therapy within 4 weeks of the first dose of study therapy.
  • Co-existing high-grade serous ovarian cancer or mixed histology.
  • Prior treatment with avutometinib, defactinib, or other FAK inhibitors.
  • History of prior malignancy with recurrence <3 years from the time of enrollment.
  • Major surgery within 4 weeks, minor surgery within 1 week, or palliative radiotherapy within 1 week of the first dose of study intervention.
  • Symptomatic brain metastases requiring steroids or other interventions, known leptomeningeal metastases, or spinal cord compression.
  • An active skin disorder that has required systemic therapy within one year of the first dose of study intervention.
  • History of medically significant rhabdomyolysis.
  • For subjects with prior MEK or RAF exposure, Grade 4 toxicity is deemed related to the MEK inhibitor.
  • Symptomatic bowel obstruction within 3 months of the first dose of study intervention
  • Concurrent ocular disorders.
  • Concurrent heart disease or severe obstructive pulmonary disease.
  • Active or past medical history of interstitial lung disease/pneumonitis, including drug-induced or radiation pneumonitis, pulmonary fibrosis, or adult respiratory distress syndrome (ARDS).
  • Subjects with the inability to swallow oral medications.
  • 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.
  • Pregnant or breastfeeding.
  • Active, uncontrolled infection (bacterial, viral, or fungal) requiring systemic therapy.
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    Eligibility

    Age eligible for study : 18 and older

    Healthy volunteers accepted : No

    Gender eligible for study: Female

    Things to know

    Study dates

    Study start: 2024-03-18

    Primary completion: 2028-10-15

    Study completion finish: 2031-02-09

    study type

    Study type

    TREATMENT

    phase

    Phase

      PHASE3

    trial

    Trial ID

    NCT06072781

    Intervention or treatment

    DRUG: avutometinib

    DRUG: Defactinib

    DRUG: Pegylated liposomal doxorubicin

    DRUG: Paclitaxel

    DRUG: Letrozole

    DRUG: Anastrozole

    Conditions

    • Low Grade Serous Ovarian Cancer

    Find a site

    Closest Location:

    Prince of Wales Hospital

    Research sites nearby

    Select from list below to view details:

    • Prince of Wales Hospital

      Randwick, New South Wales, Australia

    • Icon Cancer Centre Wesley

      Auchenflower, Queensland, Australia

    • Cancer Research South Australia

      Adelaide, South Australia, Australia

    • Peter MacCallum Cancer Centre

      Melbourne, Victoria, Australia

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    Study Plan

    This section provides details of the study plan, including how the study is designed and what the study is measuring.

    How is the study designed?

    Participant Group/ArmIntervention/Treatment
    EXPERIMENTAL: avutometinib + defactinib
    • Avutometinib 3.2 mg, PO, twice weekly for 21 days on, 7 days off in a 28-day (4 weeks) cycle in combination with defactinib 200 mg, PO, twice daily for 21 days on, 7 days off in a 28-day(4 week) cycle.
    DRUG: avutometinib
    • Avutometinib: administered orally
    ACTIVE_COMPARATOR: Investigator Choice of Treatment (ICT)
    • Patients will receive one of the following therapies as determined by the Investigator:
    • * Pegylated liposomal doxorubicin: 40 mg/m2 IV on Day 1 of each 28-day (4 week) cycle.
    • * Paclitaxel: 80 mg/m2 IV on Days 1, 8, and 15 of each 28-day (4 week) cycle.
    • * Anastrozole: 1 mg, PO, once daily of each 28-day (4 week) cycle.
    • * Letrozole: 2.5 mg, PO, once daily of each 28-day (4 week) cycle.
    DRUG: Pegylated liposomal doxorubicin
    • administered intravenously

    What is the study measuring?

    Primary outcome

    Primary Outcome MeasurePrimary Outcome DescriptionPrimary Outcome Time Frame
    Progression Free Survival (PFS) per blinded independent central review (BICR)Confirmed overall response rate per RECIST 1.1 per blinded independent central review (BICR)Up to 24 months

    Secondary outcome

    Secondary Outcome MeasureSecondary Outcome DescriptionSecondary Outcome Time Frame
    Overall Survival (OS)From the time of first dose of study intervention to PD as assessed per RECIST 1.1 or death from any causeUp to 5 years
    Progression Free Survival (PFS) per investigator assessmentFrom the time of first dose of study intervention to PD as assessed per RECIST 1.1 by Investigator or death from any cause24 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 cause12 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 cause12 months
    Disease Control Rate (DCR)CR+PR+Stable disease6 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 scale25 months
    Area under the plasma concentration-time curve (AUC) of avutometinib, defactinib and relative metabolitesArea under plasma Concentration (AUC) 0 to t5 months
    Maximum plasma concentration (Cmax) of avutometinib, defactinib and relative metabolitesmaximum plasma concentration5 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.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.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.24 months

    Frequently Asked Questions

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    References

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

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