A Phase 2 Study of Defactinib and Avutometinib, in Combination With Nivolumab for Patients With Anti-PD1 Refractory LKB1-Mutant Advanced Lung Adenocarcinoma

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Investigational drug late phase More information Active drug More information High burden on patient More information

Trial Details

Sponsor: Emory University (other)

Phase: 2

Start date: July 31, 2024

Planned enrollment: 50

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Investigational Drug AI Analysis

chevron Show for: Defactinib (PF-04554878, VS-6063)

chevron Show for: Avutometinib (RO-5126766, CKI-27, CH-5126766, R-7304, RG-7304, VS-6766)

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Trial ID: NCT06495125
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More trial details at ClinicalTrials.gov More info

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Goal: To evaluate the efficacy and safety of combining defactinib and avutometinib with nivolumab in patients with anti-PD1 refractory, LKB1-mutant advanced lung adenocarcinoma.

Patients: This trial is enrolling adults with advanced, unresectable, or metastatic non-small cell lung adenocarcinoma harboring LKB1 mutations who are refractory to prior anti-PD1 therapy (nivolumab or similar agents) and first line chemotherapy. A subset of patients will also have KRAS mutations. Eligible patients must have good performance status (ECOG 0-1) and adequate organ function.

Design: This is a single-arm, open-label phase 2 study with no randomization. Up to 50 patients will be treated with the combination regimen and followed for efficacy and safety outcomes.

Treatments: Patients receive oral defactinib twice daily on days 1-21 of each 28-day cycle, oral avutometinib twice weekly for 21 days per cycle, and intravenous nivolumab on day 1 of every cycle. Avutometinib is a dual RAF/MEK inhibitor that allosterically inhibits both kinases and induces dominant-negative complexes to prevent MEK phosphorylation; in early trials, avutometinib combined with defactinib has shown encouraging disease control rates and manageable toxicity in ovarian cancer. Defactinib is a FAK/Pyk2 inhibitor that disrupts tumor cell signaling; it has shown modest activity as monotherapy in KRAS-mutant NSCLC and is currently being investigated primarily in combination approaches. Nivolumab is an anti-PD1 monoclonal antibody approved for use in several cancers including NSCLC.

Outcomes: The primary outcome is progression free survival (PFS) rate at 6 months. Secondary endpoints include overall response rate, median PFS, overall survival, duration of response, and incidence of adverse events (graded by CTCAE v5.0). Exploratory biomarker analyses will be conducted on archival and on-treatment tumor samples and blood samples.

Burden on patient: The study involves a moderate patient burden. Patients will require frequent clinic visits for IV nivolumab administration, regular oral dosing of defactinib and avutometinib, serial tumor imaging (CT or PET), and protocol-mandated tumor biopsies and blood sampling for biomarker studies. This exceeds the standard of care due to the addition of investigational agents and serial tissue collection.

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Sites (3)

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Emory University Hospital Midtown

Atlanta, Georgia, 30308, United States

[email protected] / No phone

Status: Not yet recruiting

Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia, 30322, United States

[email protected] / 404-778-5378

Status: Recruiting

Emory Saint Joseph's Hospital

Atlanta, Georgia, 30342, United States

[email protected] / No phone

Status: Recruiting

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