Study to Assess the Safety and Efficacy of Evexomostat (SDX-7320) in Combination With A PI3K or Akt Inhibitor Plus Fulvestrant in Patients With HR+, HER2-, Metastatic Breast Cancer With PI3K Pathway Alteration(s)
SynDevRx, Inc.
Summary
This is a Phase 1b/2, open-label, parallel-arms pilot study in men and post-menopausal women with hormone receptor positive (HR+), HER2- advanced or metastatic breast cancer with an alteration in the PI3K pathway, including a mutation of the PIK3CA gene, PTEN loss, or AKT1 mutation, designed to determine the safety of evexomostat (SDX-7320) plus standard of care treatment alpelisib (BYL-719) or capivasertib and fulvestrant (each combined, the 'triplet therapy'), to measure the severity and number of hyperglycemic events, and to assess clinical, anti-tumor benefit of the triplet therapy. The purpose of this study is: * to characterize the safety of the triplet drug combination consisting of either alpelisib or capivasertib (per the treating oncologist's choice) and fulvestrant plus evexomostat, * to test whether evexomostat, when given in combination with either alpelisib or capivasertib and fulvestrant will reduce the number and severity of hyperglycemic events and/or reduce the number or dose of anti-diabetic medications needed to control the hyperglycemia for metabolically normal patients and those deemed at risk for capivasertib and alpelisib-induced hyperglycemia (insulin resistance, as measured by HOMA-IR, baseline elevated HbA1c or well-controlled type 2 diabetes), and * to assess preliminary anti-tumor efficacy for each combination and changes in key biomarkers and quality of life in this patient population.
Description
Phosphoinositide 3-kinase (PI3K) pathway alterations frequently occur in breast cancer, conferring growth advantages to cancer cells via increased catalytic activity of various related proteins, such as protein kinase B (AKT) or via the loss of function of the negative regulator phosphatase and tensin homolog (PTEN) (He 2021). Of these alterations, the PIK3CA gene is most frequently mutated, leading to disease aggressiveness and patient mortality. Currently approved treatments targeting this pathway include alpelisib, a small molecule that inhibits the activity of the PIK3CA gene product PI3Kα…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion: 1. Patient is an adult male or postmenopausal female ≥18 years old at the time of informed consent(s) and has signed informed consent(s) before any trial related activities and according to local guidelines. 2. Patient with histologically and/or cytologically confirmed diagnosis of HR+, HER2- breast cancer, as determined by the local laboratory. 3. Patient has identified PI3K pathway alteration, defined as a PIK3CA mutation or PTEN loss or an AKT1 mutation using a Food and Drug Administration (FDA)-approved test, as determined either during Screening or was previously determined to…
Interventions
- DrugEvexomostat
Evexomostat (SDX-7320) is a synthetic copolymer-drug conjugate of a novel MetAP2 inhibitor.
Locations (10)
- Loma Linda University Cancer CenterLoma Linda, California
- Hoag Memorial Hospital PresbyterianNewport, California
- SHARP HealthcareSan Diego, California
- Miami Cancer Institute at Baptist HealthMiami, Florida
- Hope and Healing Cancer ServicesHinsdale, Illinois
- Trinity HealthYpsilanti, Michigan