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NCT05315700PHASE1, PHASE2Recruiting

Study of ORIC-114 in Patients With Advanced Solid Tumors Harboring an EGFR or HER2 Alteration

ORIC Pharmaceuticals

Start Date

3/10/2022

Completion Date

9/1/2027

Summary

The purpose of this study is to establish the recommended Phase 2 dose (RP2D) and/or maximum tolerated dose (MTD), safety, pharmacokinetics (PK), pharmacodynamics (PD), and antitumor activity of ORIC-114 as a Single Agent or in Combination with Chemotherapy when administered to patients with advanced solid tumors harboring an EGFR or HER2 alteration.

Detailed Description

ORIC-114 is a brain penetrant, selective, orally bioavailable, irreversible small molecule inhibitor designed to target EGFR and HER2 alterations, making it a promising therapeutic candidate for development in patients whose tumors harbor these alterations, including those with CNS metastases. This is a first-in-human, open-label, single arm, multicenter, dose escalation study of ORIC-114 as a single agent (Part I), followed by dose optimization (Part II) to establish the recommended phase 2 dose (RP2D) and antitumor activity of ORIC-114 in patients with advanced solid tumors harboring an EGFR or HER2 alteration who have exhausted available treatment options. After the optimal RP2D has been determined, Phase 2 will be initiated via protocol amendment to add one or more expansion cohorts of patients with specific tumor types, treatment history, and/or expression of a specific biomarker to evaluate the antitumor activity of ORIC-114. After completion of Part I dose escalation, Part III, a dose escalation study of ORIC-114 in combination with chemotherapy (carboplatin-pemetrexed) may be initiated to establish the RP2D and/or MTD and antitumor activity for the combination (US sites only).

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Histologically or cytologically confirmed locally advanced or metastatic solid tumor with a documented EGFR or HER2 exon 20 insertion mutation or atypical EGFR mutation as determined by any nucleic acid-based diagnostic testing method, or HER2 amplification/overexpression as determined by an immunohistochemistry (IHC) or an in situ hybridization (ISH) test 1. Part I Dose Escalation (CLOSED) Any solid tumor with * EGFR exon 20 insertion mutation * HER2 exon 20 insertion mutation * Atypical EGFR mutations (NSCLC only) (Appendix 8) * HER2 amplification or overexpression (HER2+) * Previously received and progressed on or after available standard therapies and for whom additional standard therapy is considered unsuitable or intolerable 2. Part I Extension (ONGOING) * Cohort IA: Patients with HER2+ breast cancer previously received and progressed on or after available standard therapies and for whom additional standard therapy is considered unsuitable or intolerable * Cohort IB: NSCLC patients with EGFR exon 20 insertion mutation previously treated with chemotherapy and amivantamab * Cohort IC: Treatment-naïve NSCLC patients with EGFR exon 20 insertion mutation * Cohort ID: Treatment-naïve NSCLC patients with EGFR atypical mutations 3. Part II Dose Optimization (ONGOING): NSCLC patients with * Cohort IIA: EGFR exon 20 insertion mutation, patients must have received platinum-based chemotherapy or other chemotherapy regimen if platinum- based chemotherapy was contraindicated. Additionally, patients must be naïve to an EGFR exon 20 targeted agent, ie, must have declined or be ineligible for all available exon 20 targeted therapies with proven benefit * Cohort IIB: HER2 exon 20 insertion mutation, patients must have received platinum-based chemotherapy or other chemotherapy regimen if platinum- based chemotherapy was contraindicated. Additionally, patients must be naïve to a HER2 exon 20 targeted TKI * Cohort IIC: Atypical EGFR mutation, patients may have received a prior EGFR TKI * Agreement and ability to undergo pretreatment biopsy * Measurable disease according to RECIST 1.1 * CNS involvement, which is either previously treated and controlled, or untreated and asymptomatic * ECOG performance status of 0 or 1 * Adequate organ function Exclusion Criteria: * Known EGFR T790M mutation * Leptomeningeal disease and spinal cord compression \-- Except if LMD has been reported radiographically on baseline MRI, but is not suspected clinically by the Investigator; the subject must be free of neurological symptoms of LMD * History of class III or IV congestive heart failure or severe non-ischemic cardiomyopathy, unstable or poorly controlled angina, myocardial infarction, or ventricular arrhythmia within the previous 6 months * Past medical history of interstitial lung disease (ILD), drug induced ILD, radiation pneumonitis which required steroid treatment, or any evidence of clinically active ILD * Known, symptomatic human immunodeficiency virus (HIV) infection * Known active infection requiring treatment or history of hepatitis B virus (HBV) or hepatitis C virus (HCV). Patients positive for HBsAg but normal HBV DNA level are allowed. * Active gastrointestinal disease (eg, Crohn's disease, ulcerative colitis, or short gut syndrome) or other malabsorption syndromes * Any other concurrent serious uncontrolled medical, psychological, or addictive conditions

Interventions

DRUG

ORIC-114

DRUG

Chemotherapy drug

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Conditions

Solid Tumors

Locations

City of Hope

Duarte, California 91010

United States

City of Hope

Huntington Beach, California 90813

United States

City of Hope

Irvine, California 92618

United States

City of Hope

Long Beach, California 90813

United States

University of California, San Francisco

San Francisco, California 94122

United States

Yale Cancer Center

New Haven, Connecticut 06510

United States

Georgetown University

Washington D.C., District of Columbia 20007

United States

Mayo Clinic

Jacksonville, Florida 32224

United States

Moffitt Cancer Center

Tampa, Florida 33612

United States

Northwestern University

Chicago, Illinois 60611

United States

Dana Farber Cancer Institute

Boston, Massachusetts 02215

United States

Mayo Clinic

Rochester, Minnesota 55905

United States

NYU Langone Health Perlmutter Cancer Center

New York, New York 10016

United States

Duke Cancer Institute

Durham, North Carolina 27710

United States

University of Pennsylvania

Philadelphia, Pennsylvania 19104

United States

Spartanburg Regional Healthcare System

Spartanburg, South Carolina 29303

United States

Next Oncology

Fairfax, Virginia 22031

United States

Chris O'Brien Lifehouse

Camperdown,

Australia

Peter MacCallum Cancer Centre

Melbourne,

Australia

One Clinical Research, Hollywood Medical Centre

Nedlands,

Australia

Sydney Adventist Health

Sydney,

Australia

Princess Margaret Cancer Centre

Toronto, Ontario M5G 2C4

Canada

The Chinese University of Hong Kong

Shatin,

Hong Kong

Sultan Ahmad Shah Medical Centre at International Islamic University Malaysia (IIUM)

Kuantan, Pahang

Malaysia

Pulau Pinang Hospital

George Town, Pulau Pinang

Malaysia

Sarawak General Hospital (SGH)

Kuching, Sarawak

Malaysia

Hospital Kuala Lumpur

Kuala Lumpur,

Malaysia

University of Malaya Medical Center (UMMC)

Kuala Lumpur,

Malaysia

Medical University of Gdańsk

Gdansk,

Poland

Chungbuk University Hospital

Cheongju-si,

South Korea

National Cancer Center

Goyang-si,

South Korea

Catholic University of Korea, St, Vincent Hospital

Gyeonggi-do,

South Korea

Gachon University Hospital

Incheon,

South Korea

Seoul National Bundang Hospital

Seongnam-si,

South Korea

Asan Medical Center

Seoul,

South Korea

Samsung Medical Center

Seoul,

South Korea

Severance Hospital, Yonsei University Health System

Seoul,

South Korea

NEXT Oncology - Barcelona

Barcelona,

Spain

Vall d'Hebron Institute of Oncology (VHIO)

Barcelona,

Spain

NEXT Oncology - Madrid

Madrid,

Spain

National Taiwan University Hospital

Taipei,

Taiwan

The Christie NHS Foundation Trust

Manchester, England

United Kingdom