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NCT06445062PHASE1, PHASE2Recruiting

Study of RAS(ON) Inhibitors in Patients With Gastrointestinal Solid Tumors

Revolution Medicines, Inc.

Start Date

5/24/2024

Completion Date

7/15/2027

Summary

The purpose of this platform study is to evaluate the safety, tolerability, pharmacokinetics (PK), and preliminary antitumor activity of novel RAS(ON) inhibitors combined with Standard(s) of Care (SOC) or with novel agents. The current subprotocols include the following: Subprotocol A: RMC-6236 + 5-fluorouracil-based regimens Subprotocol B: RMC-6236 + cetuximab with or without mFOLFOX6 Subprotocol C: RMC-6236 + gemcitabine + nab-paclitaxel Subprotocol D: RMC-9805 with or without RMC-6236 + 5-fluorouracil-based regimens Subprotocol E: RMC-9805 with or without RMC-6236 + cetuximab with or without mFOLFOX6 Subprotocol F: RMC-9805 with or without RMC-6236 + gemcitabine + nab-paclitaxel

Detailed Description

The platform study design allows combinations of RAS(ON) inhibitors with other anticancer agents to be evaluated in patients with RAS-mutated solid tumors with a focus on GI cancers. This is an open-label platform study to evaluate the safety, tolerability, pharmacokinetics (PK), and preliminary antitumor activity of novel RAS(ON) inhibitors combined with Standard of Care (SOC) or with novel agents, and to define the Recommended Phase 2 Dose and Schedule (RP2DS). Enrollment of patients with RAS mutations will be specified in each subprotocol. Subprotocol A is an open-label, multicenter study of RMC-6236 in combination with 5-fluorouracil-based regimens in patients with treatment-naïve unresectable or metastatic colorectal cancer or treatment-naïve metastatic pancreatic ductal adenocarcinoma. Subprotocol B is an open-label, multicenter study of RMC-6236 in combination with cetuximab with or without mFOLFOX6 in patients with unresectable or metastatic colorectal cancer or patients with previously treated or treatment-naïve metastatic pancreatic ductal adenocarcinoma. Subprotocol C is an open-label, multicenter study of RMC-6236 in combination with gemcitabine and nab-paclitaxel in patients with treatment-naïve metastatic pancreatic ductal adenocarcinoma. Subprotocol D is an open-label, multicenter study of RMC-9805 with or without RMC-6236 in combination with 5-fluorouracil-based regimens in patients with RAS G12D-mutant unresectable or metastatic colorectal cancer or metastatic pancreatic ductal adenocarcinoma. Subprotocol E is an open-label, multicenter study of RMC-9805 with or without RMC-6236 in combination with cetuximab-based therapies with or without mFOLFOX6 in patients with RAS G12D-mutant unresectable or metastatic colorectal cancer or metastatic pancreatic ductal adenocarcinoma. Subprotocol F is an open-label, multicenter study of RMC-9805 with or without RMC-6236 in combination with gemcitabine and nab-paclitaxel in patients with RAS G12D-mutant metastatic pancreatic ductal adenocarcinoma. Each subprotocol consists of two parts: Part 1 - Dose Exploration and Part 2 - Dose Expansion.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: All Patients (unless otherwise noted): * ≥ 18 years of age * ECOG PS is 0 to 1 * Adequate organ function as outlined by the study * Pathologically or cytologically documented pancreatic carcinoma or poorly differentiated pancreatic carcinoma with metastatic disease or RAS-mutated, histologically or cytologically confirmed colorectal adenocarcinoma with documented unresectable or metastatic disease (Subprotocol A, B, and C) * Presence of RAS G12D mutation (Subprotocol D, E, F) Exclusion Criteria: All Patients: * Primary central nervous system (CNS) tumors * Impaired gastrointestinal (GI) function that may significantly alter the absorption of RMC drugs * Major surgery within 28 days of first dose Other inclusion/exclusion criteria may apply.

Interventions

DRUG

RMC-6236

DRUG

mFOLFOX6 regimen

DRUG

bevacizumab

DRUG

mFOLFIRINOX regimen

DRUG

cetuximab

DRUG

gemcitabine

DRUG

nab-paclitaxel

DRUG

RMC-9805

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Conditions

Colorectal CancerCRCPancreatic Ductal AdenocarcinomaPDACGastrointestinal CancerMetastatic Pancreatic Ductal Adenocarcinoma

Locations

Ironwood Cancer and Research Centers

Chandler, Arizona 85224

United States

Mayo Clinic Hospital

Phoenix, Arizona 85054

United States

HonorHealth Research Institute

Scottsdale, Arizona 85258

United States

UC San Diego Moores Cancer Center

La Jolla, California 92093

United States

Cedars-Sinai Cancer at Cedars-Sinai Medical Center

Los Angeles, California 90048

United States

UCLA Hematology/Oncology- Santa Monica

Los Angeles, California 90404

United States

University of Colorado Hospital-Anschutz Cancer Pavilion

Aurora, Colorado 88045

United States

Yale-New Haven Hospital-Yale Cancer Center

New Haven, Connecticut 06520

United States

Mayo Clinic Cancer Center

Jacksonville, Florida 32224

United States

Moffitt Cancer Center

Tampa, Florida 33612

United States

The University of Kansas Clinical Research Center

Westwood, Kansas 66205

United States

The Sidney Kimmel Comprehensive Cancer Center at John Hopkins

Baltimore, Maryland 21287

United States

Massachusetts General Hospital

Boston, Massachusetts 02114

United States

Dana Farber Cancer Institute

Boston, Massachusetts 02215

United States

Mayo Clinic

Rochester, Minnesota 55905

United States

Nebraska Cancer Specialists

Omaha, Nebraska 68130

United States

University of Nebraska Medical Center

Omaha, Nebraska 68198

United States

Atlantic Health System

Morristown, New Jersey 07960

United States

Northwell Health / RJ Zuckerberg Cancer Center

Lake Success, New York 11042

United States

Columbia University Medical Center

New York, New York 10032

United States

Memorial Sloan Kettering Cancer Center Main Campus

New York, New York 10065

United States

Duke University Medical Center

Durham, North Carolina 27710

United States

University of Cincinnati Medical Center

Cincinnati, Ohio 45267

United States

Stephenson Cancer Center

Oklahoma City, Oklahoma 73104

United States

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania 19104

United States

SCRI Oncology Partners

Nashville, Tennessee 37203

United States

Baylor College of Medicine

Houston, Texas 77030

United States

The University of Texas MD Anderson Cancer Center

Houston, Texas 77030

United States

NEXT Oncology Dallas

Irving, Texas 75039

United States

Huntsman Cancer Institute, University of Utah

Salt Lake City, Utah 84112

United States

Virginia Cancer Specialists

Fairfax, Virginia 22314

United States

Fred Hutchinson Cancer Center

Seattle, Washington 98109

United States