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145 active trials for Advanced Solid Tumors

A Study to Learn How Safe the Study Drug BAY 2416964 (AhR Inhibitor) in Combination With the Treatment Pembrolizumab is, How This Combination Affects the Body, the Maximum Amount That Can be Given, How it Moves Into, Through and Out of the Body and Its Action Against Advanced Solid Cancers in Adults

Researchers are looking for a better way to treat advanced solid cancers including head and neck cancer, lung cancer and bladder cancer. In some people with cancer a protein called Aryl Hydrocarbon Receptor (AhR) can prevent immune cells from fighting tumor cells. The study drug, BAY 2416964, is a small molecule which blocks the AhR allowing the body to use its immune response against the cancer cells. Researchers think that BAY 2416964 given together with a cancer treatment called pembrolizumab may help shrink tumors in people with cancer. The main aims of this study are to find for BAY 2416964 in combination with pembrolizumab, how safe this drug combination is how it affects the body (also referred to as tolerability) the highest amount of BAY 2416964 that can be given in combination with pembrolizumab without too many side effects. The researchers will also study the action of BAY 2416964 in combination with pembrolizumab against the cancer. The participants in this study will get BAY 2416964 and pembrolizumab. BAY 2416964 will be given in tablet form by mouth. Pembrolizumab will be given as an intravenous (IV) infusion. An IV infusion is given through a needle into a vein. This study will have two parts. The first part will help find the most appropriate dose that can be given in the second part. Each participant of the first, so called dose escalation part, will be assigned to one specific dose group for BAY 2416964. The amount of BAY 2416964 that is given increases step-wise from one group to the next. The dose of pembrolizumab will always be the same. The participants of the second, so called dose expansion part, will receive the most appropriate dose of BAY 2416964 found in the first part. During the study, the participants will receive the treatment in 3-week periods called cycles. In each cycle, the participants will in general get pembrolizumab once and BAY 2416964 in a daily schedule. These 3-week cycles will be repeated throughout the trial. The participants can take the study treatment until their cancer gets worse, until they have medical problems, or until they leave the trial. Participants will have around 4 visits in each cycle. Some of the visits can also be done via phone. During the study, the study doctors and their team will: take blood and urine samples check if the participants' cancer has spread using computed tomography scans or magnetic resonance imaging scans of the participants' tumors check the participants' overall health ask the participants questions about how they are feeling and what adverse events they are having. An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events that happen in studies, even if they do not think the adverse events might be related to the study treatments.

Milano, LombardiaStart: August 2021
A Phase I/II Study of Sacituzumab Govitecan Plus Berzosertib in Small Cell Lung Cancer and Homologous Recombination-Deficient Cancers Resistant to PARP Inhibitors

Background: Several small molecule poly-(ADP)-ribose polymerase inhibitors (PARPi) have been approved by the FDA for multiple cancers with homologous recombination (HR) deficiencies. Despite their measurable initial benefit, PARPi resistance is a major problem in the clinic. There are no established standards for care of patients who have disease progression after PARPi. Small cell lung cancer (SCLC) is an aggressive cancer with poor prognosis. Despite being chemo-sensitive initially, the tumors are invariably chemo-resistant at recurrence. Currently available therapies for patients who have disease progression after chemotherapy yield limited benefit, and most patients die within months of relapse. In preclinical studies, ataxia telangiectasia and Rad3-related protein (ATR) inhibition can overcome PARPi/chemotherapy-resistance in tumors with restored HR or restored fork protection. However, combinations of DNA damage response inhibitors and chemotherapy may be challenging in clinic due to overlapping toxicities, specifically myelosuppression. To mitigate some of the overlapping toxicities relating to myelosuppression, we have proposed a strategy that incorporates tumor targeted DNA-damaging chemotherapy delivery (using approaches such as antibody drug conjugates) and dose scheduling of ATR inhibitors. Sacituzumab govitecan is an antibody-drug conjugate, comprising a topoisomerase-I inhibiting camptothecin, SN-38, linked to a humanized antibody targeting trophoblastic cell-surface antigen 2 (Trop-2), and is FDA approved as Trodelvy for triple-negative breast cancer patients who have received at least two prior therapies for metastatic disease. Berzosertib is a potent and selective kinase inhibitor of ATR in phase I and II clinical trials as a single agent and in combination with chemotherapy, radiation and other anticancer agents. We hypothesize that a combination of berzosertib with sacituzumab govitecan will provide an effective therapeutic option for patients with PARPi resistant tumors and chemotherapy-resistant SCLCs. Primary objectives: Phase I: To identify the maximum tolerated dose (MTD) of sacituzumab govitecan in combination with berzosertib. Phase II HRD cohort: To assess the efficacy with respect to objective response rate (ORR) of the combination of sacituzumab govitecan and berzosertib in previously treated participants with HRD. Phase II SCLC cohort: To assess the efficacy with respect to ORR of the combination of sacituzumab govitecan and berzosertib in previously treated participants with SCLC. Eligibility: All phases: Subjects must be greater than or equal to 18 years of age and have a performance status (ECOG) less than or equal to 2. Phase I: Adult participants with advanced solid tumors with progression on at least one prior chemotherapy. Phase II HRD cohort: Known HRD cancer and documented evidence of germline or somatic BRCA mutation or other HRD germline mutation, or tumor is HRD positive; progressive disease while taking a PARPi as a previous therapy or within 6 months of completing PARPi therapy. Phase II SCLC cohort: Recurrent SCLC after at least one prior platinum-based therapy. Design: This is a Phase I/II, open label clinical trial identifying the maximum tolerated dose (MTD) of sacituzumab govitecan in combination with berzosertib in a phase I trial, and assessing the efficacy with respect to clinical response rate of a combination of sacituzumab govitecan and berzosertib as treatment of subjects with recurrent SCLC and HRD positive tumors in a phase II trial. The accrual ceiling will be set to 70 for this study. Participants will receive sacituzumab govitecan on days 1 and 8 and berzosertib on days 2 and 9, administered every 21 days (1 cycle), until disease progression or development of intolerable side effects. Blood, hair follicles, and tumor will be collected at various time points to support the exploratory objectives. The Phase I will follow a 3+3 design: dose will be escalated in cohorts of 3-6 participants each with the individual dose of berzosertib and sacituzumab govitecan increased in successive dose levels. The phase II HRD cohort and phase II SCLC cohort will be conducted using a Simon two-stage Minimax design in order to rule out an unacceptably low 5% response rate (p0=0.05) for HRD and 10% (p=0.10) response rate for SCLC in favor of a targeted response rate of 20% (p1=0.20) and 30% (p1=0.30), respectively.

Bethesda, MarylandStart: September 2021
Metarrestin (ML-246) in Subjects With Metastatic Solid Tumors

Background: Metastasis is the spread of cancer from one organ to a nonadjacent organ. It causes 90% of cancer deaths. No treatment specifically prevents or reduces metastasis. Researchers hope a new drug can help. It stops cancer cells from growing and spreading further and possibly shrink cancer lesions in distant organs. Objective: To find a safe dose of metarrestin and to see if this dose shrinks tumors. Eligibility: Adults age 18 and older with pancreatic cancer, breast cancer, or a solid tumor that has not been cured by standard therapies. Also, children age 12-17 with a solid tumor (other than a muscle tumor) with no standard therapy options. Design: Participants will be screened with: blood tests physical exam documentation of disease confirmation or tumor biopsy electrocardiogram to evaluate the heart review of their medicines and their ability to do their normal activities Participants will take metarrestin by mouth until they cannot tolerate it or stop to benefit from it. They will keep a medicine diary. Participants will visit the Clinical Center. During the first month there are two brief hospital stays required with visits weekly or every other week thereafter. They will repeat some of the screening tests. They will fill out questionnaires. They will have tests of their cognitive function. They will have an electroencephalogram to record brain activity. They will have a computed tomography (CT) scan or magnetic resonance imaging (MRI). A CT is a series of X-rays of the body. An MRI uses magnets and radio waves to take pictures of the body. Adult participants may have tumor biopsies. Participants will have a follow-up visit 30 days after treatment ends. Then they will have follow-up phone calls or emails every 6 months for the rest of their life or until the study ends.

Bethesda, MarylandStart: October 2020