FORAGER-1: A Phase 1, Open-Label, Multicenter Study of LOXO-435 (LY3866288) in Locally Advanced or Metastatic Solid Tumors Including Urothelial Cancer with FGFR3 Alterations
Investigation of an Investigational Medication for Advanced Solid Tumors with FGFR3 Alterations
Tareq Salous
Primary Investigator
Brief description of study
This is an open-label, multi-center, phase 1a/b study in participants with FGFR3-altered advanced solid tumors, including metastatic urothelial cancer (UC). The main purpose of this study is to learn more about the safety, side effects, and effectiveness of LOXO-435. LOXO-435 may be used to treat cancer of the cells that line the urinary system and other solid tumor cancers that have a change in a particular gene (known as the FGFR3 gene). Participation could last up to 30 months (2.5 years) and possibly longer if the disease does not get worse.
Detailed description of study
The study will be conducted in 2 phases: Dose escalation and dose optimization (1a) and dose expansion (1b). Phase 1a will include up to 2 cohorts to assess safety, tolerability, and pharmacokinetics of LOXO-435 to determine the recommended phase 2 dose (RP2D) (or optimal dose). Phase 1b will include 4 dose expansion cohorts of participants with prespecified activating FGFR3 alterations to evaluate the efficacy and safety of LOXO-435 at the RP2D. Cohort B will enroll pts with metastatic UC and includes three cohorts to evaluate LOXO-435 as monotherapy (B1, B2) and in combination with pembrolizumab (B3). Cohort C will enroll pts with non-UC advanced solid tumors and includes a cohort to evaluate LOXO-435 as monotherapy (C1).
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Neoplasm Metastasis, Ureteral Neoplasms, Urinary Bladder Neoplasms, Metastatic urothelial cancer
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Age: 18 years - 100 years
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Gender: All
Inclusion Criteria:
- Have solid tumor cancer with an FGFR3 pathway alteration on molecular testing in tumor or blood sample that is deemed as actionable.
- Cohort A1 (Dose Escalation): Presence of an alteration in FGFR3 or its ligands.
- Cohort A2 (Dose Optimization): Histological diagnosis of urothelial cancer (UC) that is locally advanced or metastatic with a qualifying FGFR3 alteration.
- Cohorts B1, B2 and B3 (Dose Expansion): Histological diagnosis of urothelial cancer that is locally advanced or metastatic with a prespecified activating FGFR3 alteration.
- Cohort C (Dose Expansion): Must have histological diagnosis of a non-urothelial solid tumor malignancy that is locally advanced or metastatic with a prespecified activating FGFR3 alteration.
- Measurability of disease:
- Cohort A1: Measurable or non-measurable disease as defined by Response Evaluation Criteria in Solid Tumors v 1.1 (RECIST v1.1)
- Cohorts A2, B1, B2, B3, and C1: Measurable disease required as defined by RECIST v1.1
- Have adequate archival tumor tissue sample available or undergo a screening biopsy if allowed per country-specific regulations.
- Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Prior Systemic Therapy Criteria:
- Cohort A1/C1: Participant has received all standard therapies for which the participant was deemed to be an appropriate candidate by the treating Investigator; OR the participant is refusing the remaining most appropriate standard of care treatment; OR there is no standard therapy available for the disease. There is no restriction on number of prior therapies.
- Cohort A2/B1/B2/B3: Participants must have received at least one prior regimen in the advanced or metastatic setting. There is no restriction on number of prior therapies.
- FGFR inhibitor specific requirements:
- Cohort A1/A2: Prior FGFR inhibitor treatment is permitted, but not required.
- Cohort B1: Participants must have been previously treated with a FGFR inhibitor.
- Cohort B2, B3, C1: Participants must be FGFR inhibitor naïve.
Exclusion Criteria:
- Participants with primary central nervous system (CNS) malignancy.
- Known or suspected history of uncontrolled CNS metastases.
- Current evidence of corneal keratopathy or retinal disorder.
- Have a history and/or current evidence of extensive tissue calcification.
- Any serious unresolved toxicities from prior therapy.
- Significant cardiovascular disease.
- Prolongation of the QT interval corrected for heart rate using Fridericia's formula (QTcF).
- Active uncontrolled systemic infection or other clinically significant medical conditions.
- Participants who are pregnant, lactating, or plan to breastfeed during the study or within 6 months of the last dose of study treatment. Participants who have stopped breastfeeding may be enrolled.
This study investigates the safety, side effects, and effectiveness of an investigational medication in treating advanced solid tumors with FGFR3 alterations, including metastatic urothelial cancer. FGFR3 is a gene that, when altered, can contribute to the growth of cancer cells. The purpose of this study is to understand how the investigational medication works in people with these genetic changes.
Participants in this study will undergo various procedures, including dose escalation and dose expansion phases. The study will assess the safety and tolerability of the investigational medication and determine the optimal dose for further testing. Participants with urothelial cancer will receive the investigational medication alone or in combination with another treatment, while those with non-urothelial cancers will receive it as monotherapy.
- Who can participate: Adults with advanced solid tumors that have an FGFR3 alteration can participate. Key eligibility factors include having measurable disease and adequate tumor tissue samples.
- Study details: Participants will receive the investigational medication, possibly alongside another treatment, to assess its effects on cancer growth. The study will include different cohorts, focusing on safety and effectiveness.
- Study timelines: The study will last 30 months.
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