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The goal of the Dose Escalation phase of the study is to evaluate the safety, tolerability, pharmacokinetics (PK) and preliminary anti-tumor activity to determine the preliminary recommended dose for expansion (RDE) of NKT3964 in adults with advanced or metastatic solid tumors. The goal of the Expansion phase of the study is to evaluate the preliminary anti-tumor activity of NKT3964 at the RDE based on objective response rate (ORR) and determine the preliminary recommended Phase 2 dose (RP2D).
Inclusion Criteria:
- Must have a pathologically confirmed, advanced and unresectable or metastatic solid tumor listed below with documented disease progression on last standard treatment.
For Part 1 only: Patients must be refractory to, or intolerant of existing therapy(ies) known to provide clinical benefit for their condition.
Part 1 Dose Escalation and Food Effect Sub-study:
Part 2 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 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) 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.
Exclusion Criteria:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose Escalation | Experimental | Dose escalation will assess the safety, efficacy, and PK/PD data of oral dosing NKT3964 at increasing dosage levels to determine the MTD and/or preliminary RDEs. |
|
| Dose Expansion | Experimental | Dose expansion will include the RDE selected to determine the preliminary antitumor activity and the RP2D. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NKT3964 | Drug | Oral CDK2 Degrader |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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 | 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 | 1 Year |
| Measure | Description | Time Frame |
|---|---|---|
| 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. | 2 Year |
| Duration of Response (DOR) |
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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:
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.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sponsor Contact | Contact | (302) 596-8654 | clinicaltrials@nikangtx.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Arkansas Medical School | Recruiting | Little Rock | Arkansas | 72205 | United States |
IPD are not planned to be shared at this time
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Dose Escalation and Dose Expansion
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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.
| 2 Year |
| Disease control rate | Disease control rate defined as CR + PR + stable disease [SD] for at least 8 weeks | 1 Year |
| Overall Survival (OS) | OS defined as the time from the date the participant started study drug to death for any reason. | 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. | 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. | 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 | 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) | 1 Month |
| Observed trough concentration of NKT3964 (Ctrough) | Observed trough concentration of NKT3964 (Ctrough) | 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 | 1 Month |
| Apparent clearance (CL/F) of NKT3964 | Apparent clearance (CL/F) | 1 Month |
| Apparent volume of distribution (V/F) of NKT3964 | Apparent volume of distribution (V/F) | 1 Month |
| Half-life (t1/2) of NKT3964 | Half-life (t1/2) | 1 Month |
| Accumulation ratio (AR) of NKT3964 | Accumulation ratio (AR) | 1 Month |
| University of California - Los Angeles | Not yet recruiting | Los Angeles | California | 90095 | United States |
|
| UCSF | Withdrawn | San Francisco | California | 94158 | United States |
| SCRI at HealthOne | Recruiting | Denver | Colorado | 80218 | United States |
|
| Florida Cancer Specialists & Research Institute | Terminated | Lake Mary | Florida | 32746 | United States |
| AdventHealth Cancer Institute | Recruiting | Orlando | Florida | 32804 | United States |
|
| Emory Winship Cancer Institute | Recruiting | Atlanta | Georgia | 30322 | United States |
|
| Augusta University | Not yet recruiting | Augusta | Georgia | 30912 | United States |
|
| University of Kansas | Withdrawn | Fairway | Kansas | 66205 | United States |
| Dana Farber Cancer Institute | Recruiting | Boston | Massachusetts | 02215 | United States |
|
| John Theurer Cancer Center at Hackensack UMC | Recruiting | Hackensack | New Jersey | 07601 | United States |
|
| Sidney Kimmell Cancer Center - Jefferson Health | Recruiting | Philadelphia | Pennsylvania | 19107 | United States |
|
| UPMC | Withdrawn | Pittsburgh | Pennsylvania | 15213 | United States |
| Sarah Cannon Research Institute (SCRI) | Recruiting | Nashville | Tennessee | 37203 | United States |
|
| NEXT Oncology | Recruiting | Austin | Texas | 78758 | United States |
|
| UT Southwestern | Recruiting | Dallas | Texas | 75235 | United States |
|
| Intermountain Health | Recruiting | Salt Lake City | Utah | 84145 | United States |
|
| University of Virginia | Recruiting | Charlottesville | Virginia | 22903 | United States |
|
| NEXT Virginia | Recruiting | Fairfax | Virginia | 22031 | United States |
|
| ID | Term |
|---|---|
| D009362 | Neoplasm Metastasis |
| D010051 | Ovarian Neoplasms |
| D016889 | Endometrial Neoplasms |
| D014591 | Uterine Diseases |
| D064726 | Triple Negative Breast Neoplasms |
| D013274 | Stomach Neoplasms |
| D055752 | Small Cell Lung Carcinoma |
| ID | Term |
|---|---|
| D009385 | Neoplastic Processes |
| D009369 | Neoplasms |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D004701 | Endocrine Gland Neoplasms |
| D009371 | Neoplasms by Site |
| D010049 | Ovarian Diseases |
| D000291 | Adnexal Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D005833 | Genital Neoplasms, Female |
| D014565 | Urogenital Neoplasms |
| D000091662 | Genital Diseases |
| D004700 | Endocrine System Diseases |
| D006058 | Gonadal Disorders |
| D014594 | Uterine Neoplasms |
| D001943 | Breast Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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