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The study consists of 2 parts. Part 1 is dose escalation and will first administer SY-5609 alone to participants with select advanced solid tumors and then in combination with fulvestrant to participants with HR positive, HER2-negative breast cancer. Part 2 is a dose expansion and will first administer SY-5609 in combination with gemcitabine and then SY-5609 in combination with gemcitabine and nab-paclitaxel in participants with pancreatic ductal adenocarcinoma (PDAC) .
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1: Single Agent Dose Escalation | Experimental | Dose escalation phase to explore maximum tolerated dose of SY-5609 given as a single agent. |
|
| Group 2: SY-5609 + Fulvestrant | Experimental | Participants with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2) negative advanced or metastatic breast cancer (BC) that has progressed following prior treatment with a cyclin-dependent kinase (CDK)4/6 inhibitor in combination with hormonal therapy will receive SY-5609 in combination with fulvestrant. |
|
| Group 3: SY-5609 + Gemcitabine | Experimental | Participants with PDAC will receive SY-5609 in combination with gemcitabine in Safety Lead-in to identify a recommended combination dose for the expansion. The expansion part will assess the safety, tolerability, and preliminary clinical activity of SY-5609 in combination with gemcitabine at the recommended combination dose. |
|
| Group 4: SY-5609 + Gemcitabine + Nab-paclitaxel | Experimental | Participants with PDAC will receive SY-5609 in combination with gemcitabine plus nab-paclitaxel in Safety Lead-in to identify a recommended combination dose for the expansion. The expansion part will assess the safety, tolerability, and preliminary clinical activity of SY-5609 in combination with gemcitabine plus nab-paclitaxel at the recommended combination dose. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SY-5609 | Drug | An oral CDK7 Inhibitor |
|
| Measure | Description | Time Frame |
|---|---|---|
| Groups 1 and 2: Dose-Limiting Toxicity of SY-5609 | Up to 28 days after first administration | |
| Groups 1 and 2: Number of Participants With Treatment Emergent Adverse Events | From Baseline up to 30 days after last dose of study drug (up to 1 year) | |
| Groups 3 and 4 (Safety Lead-ins): Number of Participants With Dose-Limiting Toxicity | Up to 28 days after first administration | |
| Groups 3 and 4 (Safety Lead-ins): Number of Participants With TEAEs | From Baseline up to 30 days after last dose of study drug (up to 1 year) | |
| Groups 3 and 4 (Expansions): Progression Free Survival | Up to 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Groups 1 and 2: Area Under The Concentration Versus Time Curve of SY-6509 | Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days) | |
| Groups 1 and 2: Apparent Clearance of SY-5609 |
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Inclusion Criteria:
Exclusion Criteria:
Chemotherapy or limited field radiotherapy within 2 weeks, wide field radiotherapy within 4 weeks, or nitrosoureas or mitomycin C within 6 weeks before entering the study
Major surgery within 2 weeks before starting the study treatment, or not recovered to baseline status from the effects of surgery received > 2 weeks prior
Received any other investigational agents within 4 weeks before enrollment, or < 5 half-lives since completion of previous investigational therapy, whichever is shorter
Received previous noncytotoxic, US Food and Drug Administration-approved anticancer agent within previous 2 weeks, or < 5 half-lives since completion of previous therapy, whichever is shorter
Known brain metastases or carcinomatous meningitis
Immunocompromised participants with increased risk of opportunistic infections
Participants with known active or chronic hepatitis B or active hepatitis C infection. Participants with a history of hepatitis C virus (HCV) infection who have completed curative therapy for HCV at least 12 weeks before Screening and have a documented undetectable viral load at Screening are eligible for enrollment.
Baseline QT interval corrected (QTc) with Fridericia's method > 480 milliseconds
• NOTE: criterion does not apply to participants with a right or left bundle branch block (QTc interval)
Female participants who are pregnant or breastfeeding
History of clinically significant cardiac disease or clinically relevant uncontrolled cardiac risk factors
Uncontrolled intercurrent illness.
Poorly controlled ascites requiring paracentesis within 1 month prior to entering the study. (Groups 3 and 4 only)
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Banner MD Anderson Cancer Center | Gilbert | Arizona | 85234 | United States | ||
| Cedars-Sinai Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34726887 | Derived | Marineau JJ, Hamman KB, Hu S, Alnemy S, Mihalich J, Kabro A, Whitmore KM, Winter DK, Roy S, Ciblat S, Ke N, Savinainen A, Wilsily A, Malojcic G, Zahler R, Schmidt D, Bradley MJ, Waters NJ, Chuaqui C. Discovery of SY-5609: A Selective, Noncovalent Inhibitor of CDK7. J Med Chem. 2022 Jan 27;65(2):1458-1480. doi: 10.1021/acs.jmedchem.1c01171. Epub 2021 Nov 2. | |
| 32385714 |
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|
| Fulvestrant | Drug | Estrogen receptor antagonist |
|
| Gemcitabine | Drug | Nucleoside metabolic inhibitor |
|
| Nab-paclitaxel | Drug | Taxane-type chemotherapy |
|
| Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days) |
| Groups 1 and 2: Apparent Volume of Distribution of SY-5609 | Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days) |
| Groups 1 and 2: Elimination Half-Life of SY-5609 | Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days) |
| Groups 1 and 2: Maximum Plasma Concentration (Cmax) of SY-5609 | Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days) |
| Groups 1 and 2: Time of Maximum Plasma Concentration (Tmax) of SY-5609 | Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days) |
| Groups 1 and 2: Minimum or Trough Plasma Concentration (Cmin) of SY-5609 | Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days) |
| Groups 1 and 2: Time of Minimum or Trough Plasma Concentration (Tmin) of SY-5609 | Predose, 0.5, 1, 2, 4, 6, 8 hours postdose on Day 1 and 4 or 15 of Cycle 1; 24 hours predose on Day 2 and 5 of Cycle 1; 24 hours predose on Day 1 of Cycle 2, 3 and 4 (Each Cycle=28 days) |
| Groups 3 and 4 (Safety Lead-ins): Progression Free Survival | Up to 1 year |
| Groups 3 and 4 (Safety Lead-ins): Objective Response Rate (ORR) | ORR is defined as the proportion of participants who achieve complete response (CR) and partial remission (PR) (as determined by the investigator). | Up to 1 year |
| Groups 3 and 4 (Safety Lead-ins): Complete Response/Remission (CR) Rate | CR rate is defined as proportion of participants who achieve CR (as determined by the investigator). | Up to 1 year |
| Groups 3 and 4 (Safety Lead-ins): Disease Control Rate | Up to 1 year |
| Groups 3 and 4 (Safety Lead-ins): Time to Response | Time to response is defined as the duration from the date of randomization to the date of the first documented evidence of response as determined by the investigator. | Up to 1 year |
| Groups 3 and 4 (Safety Lead-ins): Duration of Response | Duration of response is defined as duration from the date of first documented evidence of response to the date of relapse of disease (as determined by the investigator), or death due to any cause, whichever occurs first. | Up to 1 year |
| Groups 3 and 4 (Expansions): Objective Response Rate | ORR is defined as the proportion of participants who achieve CR and partial remission (PR) (as determined by the investigator). | Up to 1 year |
| Groups 3 and 4 (Expansions): Complete Response Rate | CR rate is defined as proportion of participants who achieve CR (as determined by the investigator). | Up to 1 year |
| Groups 3 and 4 (Expansions): Disease Control Rate | Up to 1 year |
| Groups 3 and 4 (Expansions): Time to Response | Time to response is defined as the duration from the date of randomization to the date of the first documented evidence of response as determined by the investigator. | Up to 1 year |
| Groups 3 and 4 (Expansions): Duration of Response | Duration of response is defined as duration from the date of first documented evidence of response to the date of relapse of disease (as determined by the investigator), or death due to any cause, whichever occurs first. | Up to 1 year |
| Los Angeles |
| California |
| 90048 |
| United States |
| University of California Los Angeles | Los Angeles | California | 90095 | United States |
| Orlando Health Cancer Institute | Orlando | Florida | 32806 | United States |
| Emory University | Atlanta | Georgia | 30322 | United States |
| The University of Iowa | Iowa City | Iowa | 52242 | United States |
| Johns Hopkins University | Baltimore | Maryland | 21205 | United States |
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
| Dana Farber Cancer Institute | Boston | Massachusetts | 02215 | United States |
| University of Michigan | Ann Arbor | Michigan | 48109 | United States |
| START Midwest, LLC | Grand Rapids | Michigan | 49546 | United States |
| Duke University | Durham | North Carolina | 27705 | United States |
| Stephenson Cancer Center | Oklahoma City | Oklahoma | 73104 | United States |
| Sidney Kimmel Cancer Center | Philadelphia | Pennsylvania | 19107 | United States |
| Sarah Cannon Research Institute - Tennessee Oncology | Nashville | Tennessee | 37203 | United States |
| South Texas Accelerated Research Theraputics (START), LLC | San Antonio | Texas | 78229 | United States |
| Sava GP, Fan H, Coombes RC, Buluwela L, Ali S. CDK7 inhibitors as anticancer drugs. Cancer Metastasis Rev. 2020 Sep;39(3):805-823. doi: 10.1007/s10555-020-09885-8. |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D055752 | Small Cell Lung Carcinoma |
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D004067 | Digestive System Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
| D004066 | Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| C000722587 | SY-5609 |
| D000077267 | Fulvestrant |
| D000093542 | Gemcitabine |
| C520255 | 130-nm albumin-bound paclitaxel |
| ID | Term |
|---|---|
| D004958 | Estradiol |
| D004963 | Estrenes |
| D004962 | Estranes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D045166 | Estradiol Congeners |
| D012739 | Gonadal Steroid Hormones |
| D042341 | Gonadal Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D006571 | Heterocyclic Compounds |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
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