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NCT06995677PHASE2Recruiting

Efficacy and Safety of TYRA-300 in Participants With FGFR3 Altered Low Grade, Intermediate Risk Non-Muscle Invasive Bladder Cancer

Tyra Biosciences, Inc

Start Date

6/27/2025

Completion Date

9/1/2028

Summary

Phase 2 Study of TYRA-300 in FGFR3 Altered Low Grade, Intermediate Risk NMIBC

Detailed Description

A Phase 2 Multicenter, Open-Label Study Evaluating the Efficacy and Safety of TYRA-300 in Participants with FGFR3 Altered Low Grade, Intermediate Risk Non-Muscle Invasive Bladder Cancer

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Participants age 18 and over of informed consent and willing and able to comply with all requires study procedures * Able to understand and given written informed consent * Participants with histologically confirmed low-grade NMIBC within 6 weeks prior to randomization with prior diagnostic biopsy/TURBT to confirm stage and grade and with at least 3 mm and no more than 12 mm total (1/2 a resectoscope loop to 2 loops, refer to Section 8.1.5) residual visible tumor as a marker lesion(s) left behind: 1. Ta low grade 2. T1 low grade * Participants must have intermediate risk NMIBC, defined as having any of the following characteristics (AUA Guidelines, 2024) 1. Recurrence within 1 year, LG Ta 2. Solitary LG Ta \>3cm 3. LG Ta, multifocal 4. LG T1 * Documented activating FGFR3 mutation or fusion (Appendix 4) * Have undergone bladder mapping and identification of visible marker lesion(s) within 6 weeks prior to randomization (refer to Inclusion Criterion #3) * No evidence of urothelial carcinoma of the upper urinary tract (confirmed by imaging) or prostatic urethra within 6 months of randomization * No prior BCG administration within 1 year of date of consent. * No intravesical chemotherapy within 8 weeks prior to C1D1. * ECOG 0-1 * Pathology consistent with pure urothelial carcinoma; if mixed histology, ensure that at least 80% of the sample is urothelial * Adequate bone marrow, liver, and renal function: b. Bone marrow function: i. Absolute neutrophil count (ANC) \> or = 1,500/mm3 ii. Platelet count \> or = 75,000/mm3 iii. /hemoglobin \> or = 10.0 g/dL e. Liver function: i.Total bilirubin \< or = ULN ii. Alanine aminotransferase (ALT) \< or = ULN iii. Aspartate aminotransferase (AST) \< or = ULN f. Renal function: i. estimated glomerular filtration rate \>60 mL/min calculated using the modification of diet in renal disease equation or CKD-EPI formula ii. Serum Phosphate level \< or = ULN prior to starting treatment g. Coagulation i. International normalized ratio (INR) \< or = 1.5 x ULN * Ability to swallow tablets * Participants (male and female) of child-bearing potential (including females who are post-menopausal for less than 1 year) must be willing to practice effective contraception while on treatment and be willing and able to continue contraception for 3 months (males) and 6 months (females) after the last dose of study treatment. Potential male participants should consider the potential impact of TYRA-300 on their ability to father a child and discuss options with the site study staff. * Potential participants who are positive for human immunodeficiency virus (HIV) must have a viral load below the limits of detection and on stable antiretroviral therapy for at least 3 months prior to C1D1. NOTE: some of the compounds in antiretroviral therapy may be on the prohibited medications list. Allowances will be made to ensure the participant's HIV treatment continues uninterrupted following a discussion with the Sponsor's medical monitor. A discussion of the impact of the antiretroviral therapy on TYRA- 300 needs to be discussed with the potential participant prior to C1D1. * Potential participants with chronic hepatitis B virus (HBV) infection with active disease should be on a suppressive antiviral therapy prior to C1D1. * Potential participants patients with a history of hepatitis C virus (HCV) infection should have completed curative antiviral treatment and must have a HCV viral load below the limit of quantification. * Potential participants with a history of HCV infection and on current treatment must have a HCV viral load below the limit of quantification Exclusion Criteria: * Presence of tumor in ureter or prostatic urethra: * Current or previous history of muscle invasive bladder cancer * Current or previous history of lymph node positive and/or metastatic bladder cancer * Evidence of pure squamous cell carcinoma, pure adenocarcinoma or pure undifferentiated carcinoma of the bladder * Currently receiving systemic cancer therapy (cytotoxic, immunotherapy, targeted) * Currently receiving treatment with a prohibited therapy (refer to Section 6.7.1) * Current or prior history of pelvic external beam radiotherapy * Current or history of receiving a prior FGFR inhibitor * Systemic immunotherapy within 6 months prior to randomization * Treatment with an investigational agent within 30 days or 5 half-lives from randomization, whichever is shorter; compounds with an unknown half-life will default to the 30 days. * Prior treatment with an intravesical agent within 8 weeks prior to C1D1 * Current ongoing toxicity from previous therapy * Had major surgery within 4 weeks prior to C1D1 * Any reason that in the view of the investigator, would substantially impair the ability of the participant to comply with study procedures and/or risk to the participant (i.e., uncontrolled diabetes) * Females who are pregnant, breastfeeding or planning to become pregnant within 6 months after the last dose of TYRA-300 and males who plan to father a child while enrolled in this study or within 3 months after the last dose of TYRA-300 * Has impaired wound healing capacity * Serum phosphate levels above the upper limit of normal during screening * Any ocular condition likely to increase the risk of eye toxicity * Current evidence of central serous retinopathy or retinal pigmented epithelial detachment of any grade at time of baseline examination. * History of or current uncontrolled cardiovascular disease * Gastrointestinal disorders that will affect oral administration or absorption of TYRA-300 * Known history of HIV infection, or active hepatitis B or C * History of a second primary malignancy within 3 years of signing ICF, except for nonmelanoma skin cancer and cured and active surveillance malignancies (i.e., prostate, breast) . * Known allergy to TYRA-300 or any excipients of the formulated product * Participants taking strong inhibitors and/or inducers of CYP3A4 enzyme * History of prolonged QT syndrome or baseline heart rate-corrected QT interval using Fridericia formula (QTcF) interval \>470 ms

Interventions

DRUG

TYRA-300 60mg

DRUG

TYRA-300 50mg

DRUG

TYRA-300 Dose TBD

Interested in This Trial?

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Conditions

Low-grade NMIBCFGFR Gene AmplificationFGFR Gene AlterationsFGFR3 Gene AlterationFGFR3 Gene MutationFGFR3 Gene Fusions

Locations

Urology Centers of Alabama

Homewood, Alabama 35209

United States

Arkansas Urology

Little Rock, Arkansas 72211

United States

Tri Valley Urology - Murrieta

Murrieta, California 92562

United States

Eisenhower Medical Associates

Rancho Mirage, California 92270

United States

Om Research LLC

San Diego, California 92123

United States

Associated Urological Specialists

Chicago Ridge, Illinois 60415

United States

Duly Health and Care

Lisle, Illinois 60532

United States

Urology of Indiana

Greenwood, Indiana 46143

United States

First Urology

Jeffersonville, Indiana 47130

United States

University of Kansas Medical Center (KUMC)

Kansas City, Kansas 66160

United States

Johns Hopkins University

Baltimore, Maryland 21205

United States

Greater Boston Urology

Plymouth, Massachusetts 02360

United States

Specialty Clinical Research of St. Louis

St Louis, Missouri 63141

United States

Atlantic Health System

Morristown, New Jersey 07960

United States

New Jersey Urology, LLC (Summit Health - Washington Township)

Voorhees Township, New Jersey 08043

United States

NYU Langone Health

New York, New York 10016

United States

Memorial Sloan Kettering Cancer Center - Sidney Kimmel Center for Prostate and Urologic Cancers

New York, New York 10065

United States

Associated Medical Professionals of NY

Syracuse, New York 13210

United States

State University of New York (SUNY) Upstate Medical University

Syracuse, New York 13210

United States

The Bronx Veterans Medical Research Foundation, Inc.

The Bronx, New York 10468

United States

Duke Cancer Institute

Durham, North Carolina 27705

United States

Associate Urologist of North Carolina

Raleigh, North Carolina 27612

United States

The James at Brain and Spine Hospital (OSU)

Columbus, Ohio 43210

United States

Oregon Urology Institute

Springfield, Ohio 97477

United States

MidLantic Urology

Bala-Cynwyd, Pennsylvania 19004

United States

Keystone Urology Specialists

Lancaster, Pennsylvania 17604

United States

Medical University of South Carolina

Charleston, South Carolina 29425

United States

Carolina Urologic Research Center

Myrtle Beach, South Carolina 29572

United States

Lowcounty Urology Clinics, P.A.

North Charleston, South Carolina 29406

United States

Conrad Pearson-Memphis

Germantown, Tennessee 38138

United States

Urology Associates PC

Nashville, Tennessee 37209

United States

Urology Austin

Austin, Texas 78759

United States

Urology Clinics of North Texas

Dallas, Texas 75231

United States

Baylor College of Medicine

Houston, Texas 77030

United States

Urology San Antonio

San Antonio, Texas 78229

United States

Epworth Freemasons-Victoria Parade

Richmond, Victoria 3121

Australia

Istituti Fisioterapici Ospitalieri (IFO)

Rome, Italy

Italy

Istituto Europeo di Oncologia

Milan, 20141

Italy

Azienda Ospedaliero Universitaria Pisana - Ospedale Santa Chiara

Pisa, 56126

Italy

ASL Napoli 2 Nord - Ospedale Santa Maria delle Grazie

Pozzuoli, 80078

Italy

Hospital del Mar

Barcelona, Spain 08003

Spain

Hospital Clínico San Carlos

Madrid, Spain 28040

Spain

Hospital Universitario 12 de Oc

Madrid, Spain 28041

Spain

Hospital Quirón Barcelona

Barcelona, 08908

Spain

MD Anderson Cancer Center - Madrid

Madrid, 28003

Spain

Hospital Universitario Ramón y Cajal

Madrid, 28034

Spain

Hospital Universitario Marqués de Valdecilla

Santander, 39008

Spain