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This is a multicenter, open-label, Phase 1/2 study of orally administered VMD-928 monotherapy and in combination with pembrolizumab in adult subjects with advanced solid tumors or lymphoma that have progressed or are non responsive to available therapies and for which no standard or available curative therapy exists
This is an open-label, dose-escalation (Phase 1) and expansion (Phase 2) multi-center study conducted in five parts to identify the safe and pharmacologically active doses (MTD and/orRP2D) and regimen for oral VMD-928 monotherapy and in combination with a PD-1 inhibitor, pembrolizumab in cancer patients. An immunohistochemistry (IHC) assay specific for detecting TrkA protein in tumor tissue samples has been validated and is being used to detect TrkA protein expressions in patient tumor tissue samples at Pre-screening. The study is currently focusing on the top 5 solid tumor with the highest TrkA protein overexpression are: Head and Neck Cancers (HNC), Esophageal cancer, Lung cancers, Mesothelioma, and Pancreatic Cancer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| VMD-928 monotherapy | Experimental | VMD-928 tablet monotherapy |
|
| Combination Therapy | Experimental | VMD-928 tablet in combination with fixed dose of pembrolizumab 200 mg once-very-21-day (per cycle) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| VMD-928 100 mg Tablet | Drug | Taken orally once daily for 21 days per 21-day cycle |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number and severity of treatment-emergent Adverse Events (Phase 1) | TEAE | First cycle (21 days per cycle) |
| To determine the recommended Phase 2 dose for VMD-928 (Phase 1) | RP2D of monotherapy | First cycle (21 days per cycle) |
| To determine the RP2D of VMD-928 in combination with pembrolizumab (Phase 1) | RP2D of combination therapy | First cycle (21 days per cycle) |
| Antitumor activity of VMD-928 in subjects with TrkA-driven tumors (Phase 2) | Antitumor efficacy signal for monotherapy | Up to 18 months |
| Antitumor activity of VMD-928 in combination with pembrolizumab in subjects with TrkA-driven tumors (Phase 2) | Antitumor efficacy signal for combination therapy | Up to 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Area under the plasma concentration versus time curve (AUC) of VMD-928. | AUC | On Day 1 and Day 15 of Cycle 1 (each cycle is 21 days) |
| Peak plasma concentration (Cmax) of VMD-928. | Cmax |
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Key Inclusion Criteria:
#. Histologically or cytologically confirmed diagnosis of any type of solid tumor malignancy or lymphoma:
Phase 1 Dose Escalation only: Subjects with
(A) any advanced solid tumors of
Or,
(B) any NTRK1 gene fusion positive ("NTRK1+") solid tumors or lymphomas, that is relapsed, refractory or intolerant (R/R/I) to standard of care (SOC) and for which there is no approved or curative therapy. Additionally, patients must not be candidates for or have exhausted regimens known to provide clinical benefit, including hematopoietic stem cell transplantation in lymphoma patients if they are deemed transplant eligible.
Phase 2 Monotherapy and Combination with Pembrolizumab only:
Subjects must have
Key Inclusion Criteria:
Eastern Cooperative Oncology Group (ECOG) Performance Status: 0 or 1.
Able to swallow and retain oral medication.
Subjects must either have available archival tumor tissue samples, or consent to tumor tissue sampling prior to the first dose.
Adequate organ system function as defined as follows:
Key Exclusion Criteria:
Received chemotherapy having delayed toxicity within the last 14 days (six weeks for prior nitrosourea or mitomycin C).
Received anticancer therapy with radiation, immunotherapy, and a biologic, surgery and/or tumor embolization within the past 2 weeks.
Received an investigational anticancer drug within 14 days or 5 half-lives of the investigational agent, whichever is longer, prior to the first dose of VMD-928. Any exceptions to the above must be approved by the Sponsor Medical Monitor.
Unresolved toxicity from previous anticancer therapy > CTCAE Grade 1 (except alopecia or anemia) unless agreed to by both the Sponsor Medical Monitor and the Investigator.
Known active infections including HIV disease.
Currently pregnant, nursing, or planning to become pregnant during the course of the study.
QTcF interval ≥ 480 msec.
Class II, III, or IV heart failure as defined by the New York Heart Association (NYHA) functional classification system.
Acute coronary syndromes (including unstable angina), coronary angioplasty, or stenting within the past 24 weeks.
Unstable or uncompensated respiratory, hepatic, renal, or cardiac disease that would compromise the patient's safety or interfere with assessment of the drug.
Psychological, familial, sociological, geographical, or other concurrent conditions that would interfere with safety evaluation, limit the patient's ability to follow the procedures in the protocol or otherwise jeopardize compliance with the protocol. Patients with uncontrolled major depression, bipolar disorder, or severe anxiety disorder are excluded.
Patient has had or is currently having other malignant tumors within 3 years.
Patients have multiple factors that affect their oral medication.
Patients have long-term unhealed wounds or fractures.
Patients have uncontrolled pleural effusion, pericardial effusion, or ascites that still require repeated drainage.
Patients are taking the following drugs and can't stop them during the study:
Epstein-Barr virus (EBV) negative nasopharyngeal carcinoma.
For Phase 2 only:
For combination therapy with Pembrolizumab only:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jay Wu, PhD | Contact | 1-510-270-2790 | 101 | OM@VMOncology.com |
| Name | Affiliation | Role |
|---|---|---|
| Clinical Development | VM Oncology | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Providence Medical Foundation (site 209) | Recruiting | Santa Rosa | California | 95403 | United States |
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Tablet formulation and in Combination with Pembrolizumab:
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| VMD-928 Tablet and Pembrolizumab (200 mg) | Drug | VMD-928 tablet (oral) starting at 300 mg daily for 21 days of 21-day cycle. Pemprolizumab at fixed intravenous dose of 200 mg once-every-21 days (per cycle) for max. 6 cycles. |
|
|
| On Day 1 and Day 15 of Cycle 1 (each cycle is 21 days) |
| Incidence of Dose Limiting Toxicities. | # of DLTs | During the Cycle 1 (each cycle is 21 days) |
| Correlation between clinical antitumor and TrkA protein expression. | Relationship of TrkA vs. efficacy | Up to the end of the Cycle 2 (each cycle is 21 days) |
| Hartford Hospital (site 210) | Recruiting | Hartford | Connecticut | 06102 | United States |
|
| The George Washington University Cancer Center (site 212) | Recruiting | Washington D.C. | District of Columbia | 20037 | United States |
|
| Holy Cross Hospital (site 213) | Recruiting | Fort Lauderdale | Florida | 33308 | United States |
|
| Memorial Cancer Institute at Memorial Healthcare Systems (site 132) | Recruiting | Pembroke Pines | Florida | 33028 | United States |
|
| Englewood Hospital and Medical Center (site 202) | Recruiting | Englewood | New Jersey | 07631 | United States |
|
| Summit Medical Group (site 205) | Recruiting | Florham Park | New Jersey | 07932 | United States |
|
| Atlantic Health System, Morristown Medical Center (site 124) | Recruiting | Morristown | New Jersey | 07962 | United States |
|
| Presbyterian Kaseman Hospital (site 208) | Recruiting | Albuquerque | New Mexico | 87110 | United States |
|
| Weill Cornell Medicine, Cornell University (site 126) | Recruiting | New York | New York | 10065 | United States |
|
| Taylor Cancer Research Center (site 204) | Recruiting | Maumee | Ohio | 43537 | United States |
|
| Cancer Care Associates of York (site 206) | Recruiting | York | Pennsylvania | 17403 | United States |
|
| The University of Texas MD Anderson Cancer Center (site 127) | Recruiting | Houston | Texas | 77030 | United States |
|
| Utah Cancer Specialists (site 203) | Recruiting | Salt Lake City | Utah | 84106 | United States |
|
| PanOncology Trials, Hospital Oncologico - Puerto Rico Medical Center, Río Piedras (site 200) | Recruiting | San Juan | 00935 | Puerto Rico |
|
| ID | Term |
|---|---|
| D003528 | Carcinoma, Adenoid Cystic |
| D008175 | Lung Neoplasms |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D010190 | Pancreatic Neoplasms |
| D008654 | Mesothelioma |
| D004938 | Esophageal Neoplasms |
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| D055752 | Small Cell Lung Carcinoma |
| D009362 | Neoplasm Metastasis |
| D006258 | Head and Neck Neoplasms |
| D012468 | Salivary Gland Neoplasms |
| D007818 | Laryngeal Diseases |
| D014133 | Tracheal Diseases |
| ID | Term |
|---|---|
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
| D004066 | Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
| D000236 | Adenoma |
| D018301 | Neoplasms, Mesothelial |
| D005770 | Gastrointestinal Neoplasms |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D002294 | Carcinoma, Squamous Cell |
| D009385 | Neoplastic Processes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009062 | Mouth Neoplasms |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D012466 | Salivary Gland Diseases |
| D010038 | Otorhinolaryngologic Diseases |
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| ID | Term |
|---|---|
| D013607 | Tablets |
| C582435 | pembrolizumab |
| D003131 | Combined Modality Therapy |
| ID | Term |
|---|---|
| D004304 | Dosage Forms |
| D004364 | Pharmaceutical Preparations |
| D013812 | Therapeutics |
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