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Testen der Zugabe des Krebsmedikaments ZEN003694 zur üblichen Chemotherapie, Cetuximab plus Encorafenib, bei Darmkrebs

29. Oktober 2026 aktualisiert von: National Cancer Institute (NCI)

Eine Phase-1-Studie zu ZEN003694 (ZEN-3694) in Kombination mit Cetuximab und Encorafenib bei Patienten mit refraktärem metastasiertem BRAF V600E-Darmkrebs

This phase I trial tests the safety, best dose, and effectiveness of ZEN003694 in combination with cetuximab and encorafenib in treating patients with colorectal cancer that has not responded to previous treatment (refractory), that has come back after a period of improvement (relapsed), and that has spread from where it first started (primary site) to other places in the body (metastatic). ZEN003694 is a protein inhibitor that binds to BET proteins. When ZEN003694 binds to BET proteins, it disrupts gene expression. Preventing the expression of certain growth-promoting genes may inhibit proliferation of tumor cells that over-express BET proteins. Immunotherapy with monoclonal antibodies, such as cetuximab, may help the body's immune system attack the tumor, and may interfere with the ability of tumor cells to grow and spread. Encorafenib is an enzyme inhibitor. It inhibits pathways that are responsible for controlling cell proliferation and survival, which may lead to a decrease in tumor cell proliferation. Both cetuximab and encorafenib have been approved to treat cancer. Adding ZEN003694 to cetuximab and encorafenib may be more effective at treating patients with refractory metastatic colorectal cancer than giving the usual treatment (cetuximab and encorafenib) alone.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

PRIMARY OBJECTIVES:

I. To define the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of BET bromodomain inhibitor ZEN-3694 (ZEN003694) when used in combination with cetuximab and encorafenib.

II. To define the safety profile of combination of ZEN003694, encorafenib, and cetuximab.

SECONDARY OBJECTIVES:

I. To observe and record anti-tumor activity. II. To evaluate clinical response signals of the combination. III. To assess the pharmacodynamic (PD) profile of the combination as defined by MAPK inhibition.

IV. To assess the pharmacokinetics (PK) of ZEN003694 in combination with encorafenib.

EXPLORATORY OBJECTIVE:

I. To characterize pharmacodynamics and potential mechanisms of resistance to therapy via whole exome sequencing (WES), ribonucleic acid sequencing (RNAseq), and assay for transposase-accessible chromatin with sequencing (ATACseq)/HiSeq 4000 or NovaSeq following progression on treatment.

OUTLINE: This is a dose-escalation study of ZEN003694 followed by a dose-expansion study.

Patients receive ZEN003694 orally (PO) once daily (QD) on days 1-28 of each cycle, cetuximab intravenously (IV) over 120 minutes on days 1 and 15 of each cycle, and encorafenib PO QD on days 1-28 of each cycle. NOTE: In the dose-expansion study, patients receive encorafenib on days 2-28 of cycle 1 and then on days 1-28 of cycles thereafter. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo echocardiography (ECHO) or multi-gated acquisition scan (MUGA), computed tomography (CT) or magnetic resonance imaging (MRI), and collection of blood samples throughout the trial. Patients may also undergo biopsy at screening and on study.

After completion of study treatment, patients are followed up every 2 months.

Studientyp

Interventionell

Einschreibung (Geschätzt)

30

Phase

  • Phase 1

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

    • California
      • Costa Mesa, California, Vereinigte Staaten, 92627
        • Rekrutierung
        • UC Irvine Health Cancer Center-Newport
        • Hauptermittler:
          • Farshid Dayyani
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 877-827-8839
      • Irvine, California, Vereinigte Staaten, 92612
        • Rekrutierung
        • UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
        • Kontakt:
        • Hauptermittler:
          • Farshid Dayyani
      • Los Angeles, California, Vereinigte Staaten, 90033
        • Rekrutierung
        • USC / Norris Comprehensive Cancer Center
        • Hauptermittler:
          • Heinz-Josef Lenz
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 323-865-0451
      • Los Angeles, California, Vereinigte Staaten, 90033
        • Suspendiert
        • Los Angeles General Medical Center
      • Orange, California, Vereinigte Staaten, 92868
        • Rekrutierung
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
        • Kontakt:
        • Hauptermittler:
          • Farshid Dayyani
    • Colorado
      • Aurora, Colorado, Vereinigte Staaten, 80045
        • Rekrutierung
        • UCHealth University of Colorado Hospital
        • Kontakt:
          • Site Public Contact
          • Telefonnummer: 720-848-0650
        • Hauptermittler:
          • Alexis D. Leal
    • Kansas
      • Fairway, Kansas, Vereinigte Staaten, 66205
        • Aktiv, nicht rekrutierend
        • University of Kansas Clinical Research Center
      • Kansas City, Kansas, Vereinigte Staaten, 66160
        • Aktiv, nicht rekrutierend
        • University of Kansas Cancer Center
      • Overland Park, Kansas, Vereinigte Staaten, 66211
        • Aktiv, nicht rekrutierend
        • University of Kansas Hospital-Indian Creek Campus
      • Westwood, Kansas, Vereinigte Staaten, 66205
        • Aktiv, nicht rekrutierend
        • University of Kansas Hospital-Westwood Cancer Center
    • Louisiana
      • New Orleans, Louisiana, Vereinigte Staaten, 70121
        • Aktiv, nicht rekrutierend
        • Ochsner Medical Center Jefferson
    • Ohio
      • Columbus, Ohio, Vereinigte Staaten, 43210
        • Rekrutierung
        • Ohio State University Comprehensive Cancer Center
        • Hauptermittler:
          • Shafia Rahman
        • Kontakt:
    • Oklahoma
      • Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
        • Rekrutierung
        • University of Oklahoma Health Sciences Center
        • Kontakt:
        • Hauptermittler:
          • Susanna V. Ulahannan
    • Texas
      • Houston, Texas, Vereinigte Staaten, 77030
        • Rekrutierung
        • UT MD Anderson Cancer Center
        • Kontakt:
        • Hauptermittler:
          • Salvador Alonso Martinez
    • Virginia
      • Charlottesville, Virginia, Vereinigte Staaten, 22908
      • Richmond, Virginia, Vereinigte Staaten, 23298
        • Rekrutierung
        • VCU Massey Comprehensive Cancer Center
        • Hauptermittler:
          • Khalid Matin
        • Kontakt:

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Patients must have histologically confirmed and radiographically measurable metastatic colorectal adenocarcinoma with known BRAF V600E mutation, confirmed in a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory with at least one tumor measurable as defined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and for which standard curative or palliative measures do not exist or are no longer effective
  • Age ≥ 18 years. Because no dosing or adverse event data are currently available on the use of ZEN003694 in combination with cetuximab and encorafenib in patients < 18 years of age, children are excluded from this study
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 (Karnofsky ≥ 60%)
  • Absolute neutrophil count ≥ 1,500/mcL
  • Platelets ≥ 100,000/mcL
  • Hemoglobin (Hb) ≥ 9 mg/dl
  • Total bilirubin ≤ 1.5 mg/dl (excluding Gilbert's disease)
  • Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 3 x institutional upper limit of normal (ULN)
  • Creatinine clearance (CrCL) glomerular filtration rate (GFR) ≥ 50 mL/min/1.73 m^2
  • Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
  • For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
  • Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
  • Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of progression
  • Patients with new or progressive brain metastases (active brain metastases) or leptomeningeal disease are eligible if the treating physician determines that immediate CNS specific treatment is not required and is unlikely to be required during the first cycle of therapy
  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
  • Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. Patients should be New York Heart Association Functional Classification of class II or better
  • Patients must have progressed after at least 1 prior systemic treatment for incurable advanced or metastatic disease
  • Patients must have received prior treatment with the combination of encorafenib and cetuximab. They must have tolerated the combination at doses planned for the study
  • For the dose expansion phase, patients must have discontinued encorafenib at least 2 weeks prior to starting study treatment
  • The effects of ZEN003694 on the developing human fetus are unknown. For this reason and because BRD and BET inhibitor agents as well as other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for at least 4 months following the last dose of study drug. Women must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [HCG]) within 72 hours prior to the start of investigational product. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately
  • Ability to understand and the willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants

Exclusion Criteria:

  • Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities > grade 1) with the exception of alopecia
  • Patients who are receiving any other investigational agents
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to ZEN003694 or other agents used in study
  • Patients with uncontrolled intercurrent illness including, but not limited to, active bleeding diatheses, poorly controlled infection/disorders, or nonmalignant medical illnesses that are uncontrolled or whose control may be jeopardized by the treatment with the study therapy
  • Patients receiving any medications or substances that are strong inhibitors or inducers of CYP3A4 or substrates of CYP1A2 with narrow therapeutic windows are ineligible. Strong inhibitors or inducers of CYP3A4 must be discontinued at least 7 days prior to the first dose of ZEN003694. As proton pump inhibitors (PPIs), H2 receptor antagonists, and antacids may alter the pharmacokinetics of ZEN003694 by reducing ZEN003694 exposure, patients receiving proton pump inhibitors are ineligible. If H2 blockers or other acid reducing agents are used concomitantly with ZEN003694, a staggered dosing schedule should be used, either dose ZEN003694 2 hours before the H2 blocker or 10-12 hours after an H2 blocker. Because the lists of these agents are constantly changing, it is important to regularly consult a frequently-updated medical reference. As part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product
  • Pregnant women are excluded from this study because ZEN003694 is BRD and BET inhibitor agent with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ZEN003694, breastfeeding should be discontinued if the mother is treated with ZEN003694. These potential risks may also apply to other agents used in this study

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: N / A
  • Interventionsmodell: Einzelgruppenzuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Treatment (ZEN003694, cetuximab, encorafenib)

Patients receive ZEN003694 PO QD on days 1-28 of each cycle, cetuximab IV over 120 minutes on days 1 and 15 of each cycle, and encorafenib PO QD on days 1-28 of each cycle. NOTE: In the dose-expansion study, patients receive encorafenib on days 2-28 of cycle 1 and then on days 1-28 of cycles thereafter. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo ECHO or MUGA, CT or MRI, and collection of blood samples throughout the trial. Patients may also undergo biopsy at screening and on study.

Undergo CT

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT

Undergo ECHO

Andere Namen:
  • Echokardiographie
  • EG

Undergo MUGA

Andere Namen:
  • Blutpool-Scan
  • Gleichgewichts-Radionuklid-Angiographie
  • Gated Blood Pool Imaging
  • MUGA
  • Radionuklid-Ventrikulographie
  • RNVG
  • SYMA-Scannen
  • Synchronisiertes Multigated Acquisition Scanning
  • MUGA-Scan
  • Multi-Gated Acquisition Scan
  • Radionuklid-Ventrikulogramm-Scan
  • Gated Heart Pool-Scan
  • RNV-Scan

Undergo biopsy

Andere Namen:
  • Bx
  • BIOPSY_TYPE
  • Biopsie

Undergo collection of blood samples

Andere Namen:
  • Biologische Probensammlung
  • Bioprobe gesammelt
  • Probenentnahme
  • Beispielsammlung

Given IV

Andere Namen:
  • C225
  • Erbitux
  • IMC-C225
  • Cetuximab-Biosimilar CDP-1
  • Cetuximab-Biosimilar CMAB009
  • Cetuximab-Biosimilar KL 140
  • Chimärer monoklonaler Anti-EGFR-Antikörper
  • Chimärer MoAb C225
  • Chimärer monoklonaler Antikörper C225
  • C-225
  • C 225
  • Cetuximab-cetu
  • Cetuxa
  • ENZ 124
  • ENZ-124
  • ENZ124

Given PO

Andere Namen:
  • BETi ZEN-3694
  • ZEN3694
  • ZEN-3694
  • ZEN003694

Given PO

Andere Namen:
  • Braftovi
  • LGX818
  • LGX-818

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Maximum tolerated dose (dose escalation cohort)
Zeitfenster: Up to completion of dose escalation phase

Will be determined based on the number of grade 3 or 4 adverse events in patients who participate on the study. Toxicities will be graded according to Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v 5.0).

Up to completion of dose escalation phase
Recommended phase 2 dose (dose escalation cohort)
Zeitfenster: Up to completion of dose escalation phase

Will be determined based on the number of grade 3 or 4 adverse events in patients who participate on the study. Toxicities will be graded according to CTCAE v 5.0.

Up to completion of dose escalation phase

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Time to progression
Zeitfenster: Time between consent onto study and progression, withdraw, or death, assessed up to 3 years

Will be estimated according to Kaplan-Meier analysis.

Time between consent onto study and progression, withdraw, or death, assessed up to 3 years
Time to death
Zeitfenster: Time between consent onto study and death, assessed up to 3 years

Will be estimated according to Kaplan-Meier analysis.

Time between consent onto study and death, assessed up to 3 years
Overall survival (OS)
Zeitfenster: Up to 3 years

Median OS will be estimated according to Kaplan-Meier analysis.

Up to 3 years
Progression-free survival (PFS)
Zeitfenster: From start of treatment to time of progression or death, whichever occurs first, assessed up to 3 years

Median PFS will be estimated according to Kaplan-Meier analysis.

From start of treatment to time of progression or death, whichever occurs first, assessed up to 3 years
MAPK inhibition
Zeitfenster: Baseline and cycle 1 day 14 (C1D14)

MAPK inhibition, measured by phosphorylated ERK pharmacodynamic profiling, will be evaluated to determine efficacy of the combination.

Baseline and cycle 1 day 14 (C1D14)
Pharmacokinetic profile of ZEN003694 when combined with encorafenib
Zeitfenster: Prior to ZEN003694 administration on C1D1, C1D2 and C1D15, as well as 0.5, 1, 1.5, 2, 3, 4, 6, and 8 hours post ZEN003694 administration on C1D1 and C1D15

Plasma concentration-time curves will be analyzed by noncompartmental methods using routines supplied.

Prior to ZEN003694 administration on C1D1, C1D2 and C1D15, as well as 0.5, 1, 1.5, 2, 3, 4, 6, and 8 hours post ZEN003694 administration on C1D1 and C1D15

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Presence or absence of a given gene mutation
Zeitfenster: At pre-treatment and post-progression

The presence or absence of a given gene mutation will be evaluated by next-generation sequencing.

At pre-treatment and post-progression

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

  • Hauptermittler: Salvador Alonso Martinez, University of Texas MD Anderson Cancer Center LAO

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

5. Juni 2024

Primärer Abschluss (Geschätzt)

30. Januar 2027

Studienabschluss (Geschätzt)

30. Januar 2027

Studienanmeldedaten

Zuerst eingereicht

25. Oktober 2023

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

25. Oktober 2023

Zuerst gepostet (Tatsächlich)

26. Oktober 2023

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

30. Oktober 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

29. Oktober 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • NCI-2023-08787
  • UM1CA186688 (US NIH Stipendium/Vertrag)
  • 10605 (Andere Kennung: CTEP)
  • NCI-2023-08787 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))
  • 2024-0120
  • 10605 (Andere Kennung: University of Texas MD Anderson Cancer Center LAO)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Ja

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Produkt, das in den USA hergestellt und aus den USA exportiert wird

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .