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대장암에 대한 일반적인 화학요법 치료법인 Cetuximab Plus Encorafenib에 항암제 ZEN003694를 추가하여 테스트

2026년 10월 29일 업데이트: National Cancer Institute (NCI)

불응성 BRAF V600E 전이성 대장암 환자를 대상으로 Cetuximab 및 Encorafenib과 병용한 ZEN003694(ZEN-3694)에 대한 1상 연구

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.

연구 개요

상태

모병

정황

개입 / 치료

상세 설명

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.

연구 유형

중재적

등록 (추정된)

30

단계

  • 1단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

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

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

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

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 해당 없음
  • 중재 모델: 단일 그룹 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 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

다른 이름들:
  • CT
  • 고양이
  • 고양이 스캔
  • 컴퓨터 축 단층 촬영
  • 전산화 단층 촬영
  • CT 스캔
  • 단층 촬영
  • 컴퓨터 축 단층 촬영(시술)
  • 컴퓨터 단층촬영(CT) 스캔
  • 진단 CAT 스캔
  • 진단 CAT 스캔 서비스 유형

Undergo MRI

다른 이름들:
  • MRI
  • 자기 공명
  • 자기공명영상 스캔
  • 의료영상, 자기공명 / 핵자기공명
  • 씨
  • MR 이미징
  • MRI 검사
  • NMR 이미징
  • NMRI
  • 핵자기공명영상
  • 자기공명영상(MRI)
  • SMRI
  • 자기공명영상(시술)
  • 구조적 MRI

Undergo ECHO

다른 이름들:
  • 심초음파
  • EC

Undergo MUGA

다른 이름들:
  • 혈액 풀 스캔
  • 평형 방사성핵종 혈관조영술
  • 게이티드 혈액 풀 이미징
  • 무가
  • 방사성핵종 뇌실조영술
  • RNVG
  • SYMA 스캐닝
  • 동기화된 다중 게이트 수집 스캐닝
  • 무가 스캔
  • 다중 게이트 획득 스캔
  • 방사성핵종 뇌실도 스캔
  • 게이트 하트 풀 스캔
  • RNV 스캔

Undergo biopsy

다른 이름들:
  • 비엑스
  • 생검_유형
  • 생검

Undergo collection of blood samples

다른 이름들:
  • 생물학적 샘플 수집
  • 생체 표본 수집
  • 표본 수집
  • 샘플 수집

Given IV

다른 이름들:
  • C225
  • 얼비툭스
  • IMC-C225
  • 세툭시맙 바이오시밀러 CDP-1
  • 세툭시맙 바이오시밀러 CMAB009
  • 세툭시맙 바이오시밀러 KL 140
  • 키메라 항-EGFR 단클론항체
  • 키메라 MoAb C225
  • 키메라 단클론항체 C225
  • C-225
  • Cetuximab-cetu
  • Cetuxa
  • ENZ 124
  • ENZ-124
  • ENZ124

Given PO

다른 이름들:
  • BETi ZEN-3694
  • 젠 3694
  • 젠-3694
  • 젠003694

Given PO

다른 이름들:
  • 브라프토비
  • LGX 818
  • LGX-818
  • LGX818

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Maximum tolerated dose (dose escalation cohort)
기간: 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)
기간: 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

2차 결과 측정

결과 측정
측정값 설명
기간
Time to progression
기간: 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
기간: 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)
기간: Up to 3 years

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

Up to 3 years
Progression-free survival (PFS)
기간: 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
기간: 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
기간: 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

기타 결과 측정

결과 측정
측정값 설명
기간
Presence or absence of a given gene mutation
기간: 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

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

수사관

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

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2024년 6월 5일

기본 완료 (추정된)

2027년 1월 30일

연구 완료 (추정된)

2027년 1월 30일

연구 등록 날짜

최초 제출

2023년 10월 25일

QC 기준을 충족하는 최초 제출

2023년 10월 25일

처음 게시됨 (실제)

2023년 10월 26일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 10월 30일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 10월 29일

마지막으로 확인됨

2026년 9월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • NCI-2023-08787
  • UM1CA186688 (미국 NIH 보조금/계약)
  • 10605 (기타 식별자: CTEP)
  • NCI-2023-08787 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
  • 2024-0120
  • 10605 (기타 식별자: University of Texas MD Anderson Cancer Center LAO)

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

예

IPD 계획 설명

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.

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

예

미국 FDA 규제 기기 제품 연구

아니

미국에서 제조되어 미국에서 수출되는 제품

아니

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