Clinical trial • Phase I/II • Oncology

1-{6-[(4M)-4-(5-CHLORO-6-METHYL-1H -INDAZOL-4-YL)-5-METHYL-3-(1-METHYL-1H -INDAZOL-5-YL)-1H -PYRAZOL-1-YL]-2-AZASPIRO[3.3]HEPTAN-2-YL}PROP-2-EN-1-ONE for KRAS G12C-mutant advanced solid tumors | Non-small cell lung cancer | Colorectal cancer

Phase I/II trial of 1-{6-[(4M)-4-(5-CHLORO-6-METHYL-1H -INDAZOL-4-YL)-5-METHYL-3-(1-METHYL-1H -INDAZOL-5-YL)-1H -PYRAZOL-1-YL]-2-AZASPIRO[3.3]HEPTAN-2-YL}…

Overview

Trial Therapeutic Area
Oncology
Trial Disease
KRAS G12C-mutant advanced solid tumors | Non-small cell lung cancer | Colorectal cancer
Trial Stage
Phase I/II
Drug Modality
Small molecule|Monoclonal antibody

Key dates

Initial CTIS Submission Date
02-08-2024
First CTIS Authorization Date
02-09-2024

Trial design

Randomised, open-label, no placebo or external active comparator specified. arms include jdq443 single agent, jdq443 + tno155, jdq443 + tislelizumab, and jdq443 + tno155 + tislelizumab; a jdq443 dose-randomization group is included (different jdq443 dose levels vs each other) — specific comparator drug doses/schedules not specified in available data.-controlled, adaptive Phase I/II trial across 19 sites in Germany, Netherlands, Belgium and others.

Randomised
Yes
Open Label
Yes
Comparator
No placebo or external active comparator specified. Arms include JDQ443 single agent, JDQ443 + TNO155, JDQ443 + tislelizumab, and JDQ443 + TNO155 + tislelizumab; a JDQ443 dose-randomization group is included (different JDQ443 dose levels vs each other) — specific comparator drug doses/schedules not specified in available data.
Adaptive
True, dose-escalation/adaptive design to identify maximum tolerated dose (MTD) and/or recommended dose/regimen; DLT evaluation during first cycle guides escalation decisions; includes dose expansion and a dose-randomization subgroup.
Biomarker Stratified
True, KRAS G12C mutation
Single Multiple Or Escalation Dose Combined
Yes
Target Sample Size
282

Eligibility

Recruits 282 Vulnerable population selected. Study documents include adult ICFs and specific follow-up/ICF documents for pregnant participants and for pregnant partners/parent legal guardians. Consent is obtained via adult informed consent forms; no paediatric consent/assent procedures are described in the available materials..

Vulnerable Population
Vulnerable population selected. Study documents include adult ICFs and specific follow-up/ICF documents for pregnant participants and for pregnant partners/parent legal guardians. Consent is obtained via adult informed consent forms; no paediatric consent/assent procedures are described in the available materials.

Inclusion criteria

  • {"criterion_text":"- Dose Escalation: • Patients with advanced (metastatic or unresectable) KRAS G12C mutant solid tumors who have received standard of care therapy or are intolerant or ineligible to approved therapies.\n- Dose Expansion: • Patients with advanced (metastatic or unresectable) KRAS G12C mutant non-small cell lung cancer who have received a platinum-based chemotherapy regimen and immune checkpoint inhibitor therapy, unless patient was ineligible to receive such therapy. Treatment with a prior KRAS G12C inhibitor is not allowed.\n- Dose Expansion: • Patients with advanced (metastatic or unresectable) KRAS G12C mutant non-small cell lung cancer who have received a platinum-based chemotherapy regimen and immune checkpoint inhibitor therapy, unless patient was ineligible to receive such therapy, and one treatment line of a direct KRAS G12C inhibitor given as a single agent and discontinued within 6 months of the first day of study treatment.\n- Dose Expansion: • Patients with advanced (metastatic or unresectable) KRAS G12C mutant NSCLC who have received a platinum-based chemotherapy regimen and an immune checkpoint inhibitor therapy either in combination or in sequence, unless patient was ineligible to receive such therapy. The patient must have at least one untreated brain metastasis. Treatment with a prior KRAS G12C inhibitor is not allowed.\n- Dose Expansion: • Patients with advanced (metastatic or unresectable) KRAS G12C mutant colorectal cancer who have received standard-of-care therapy, including a fluropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, unless patient was ineligible to such therapy. Treatment with a prior KRAS G12C inhibitor is not allowed.\n- Dose Expansion: • Patients with advanced (metastatic or unresectable) KRAS G12C mutant solid tumors other than NSCLC or CRC who have received standard of care therapy or are intolerant or ineligible to approved therapies. Treatment with a prior KRAS G12C inhibitor is not allowed.\n- All Patients: • ECOG performance status of 0 or 1.\n- All Patients: • Patients must have a site of disease amenable to biopsy and be a candidate for tumor biopsy according to the institution's own guidelines and requirements for such procedures."}

Exclusion criteria

  • {"criterion_text":"- Tumors harboring driver mutations that have approved targeted therapies, with the exception of KRAS G12C mutations.\n- Prior treatment with a KRAS G12C inhibitor is excluded for patients in the single agent dose escalation arm and a subset of groups in dose expansion.\n- Prior treatment with a SHP2 or SOS1 inhibitor is not allowed for NSCLC patients enrolled into the dose expansion parts of the JDQ443 single agent and JDQ443 plus TNO155 expansion arms.\n- Untreated brain metastases (applicable to all patients except the brain metastasis group), symptomatic brain metastases (applicable to all patients), or known leptomeningeal disease (applicable to all patients), or known leptomeningeal disease (applicable to all patients).\n- Clinically significant cardiac disease or risk factors at screening\n- Insufficient bone marrow, hepatic or renal function at screening"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Dose Escalation: - Safety: Incidence and severity of dose limiting toxicities (DLTs) during the first cycle of monotherapy or combination treatment during the dose escalation part. Incidence and severity of adverse events (AEs) and serious adverse events (SAEs), including changes in laboratory values, electrocardiograms (ECGs), and vital signs by treatment","definition_or_measurement_approach":"DLTs observed during the first cycle; AEs/SAEs graded and recorded including lab values, ECGs and vital signs by treatment arm."}
  • {"endpoint_text":"- Dose Escalation: - Tolerability: Frequency of dose interruptions, reductions, and dose intensity, by treatment","definition_or_measurement_approach":"Frequency and incidence of dose interruptions, dose reductions and calculated dose intensity per treatment arm."}
  • {"endpoint_text":"- Dose Expansion: - ORR per RECIST 1.1 (all groups except the brain metastasis group)","definition_or_measurement_approach":"Overall response rate assessed per RECIST 1.1 criteria."}
  • {"endpoint_text":"- Dose Expansion: - OIRR per mRANO-BM (brain metastasis group only)","definition_or_measurement_approach":"Overall intracranial response rate assessed using modified RANO-BM (mRANO-BM) criteria."}
  • {"endpoint_text":"- Dose Expansion: - Safety: Incidence and severity of AEs and SAEs, including changes in laboratory values, ECGs, and vital signs","definition_or_measurement_approach":"Incidence and severity of AEs/SAEs captured and graded; laboratory, ECG and vital signs changes monitored."}
  • {"endpoint_text":"- Dose Expansion: - Tolerability: Frequency of dose interruptions, reductions, and dose intensity","definition_or_measurement_approach":"Recording frequency of dose interruptions/reductions and dose intensity by treatment."}
  • {"endpoint_text":"- Dose Expansion: - Efficacy: ORR* per RECIST 1.1 (JDQ443 dose randomization group only)","definition_or_measurement_approach":"ORR measured per RECIST 1.1 in the JDQ443 dose-randomized subgroup."}

Secondary endpoints

  • {"endpoint_text":"- Dose Escalation: • ORR, DCR, Best Overall Response (BOR), Progression-free survival (PFS) and Duration of Response (DOR) per RECIST 1.1; and Overall Survival (OS)","definition_or_measurement_approach":"Efficacy endpoints assessed per RECIST 1.1 (ORR, DCR, BOR, PFS, DOR) and OS recorded."}
  • {"endpoint_text":"- Dose Escalation: • Plasma or serum concentration vs time profiles and derived PK parameters (i.e. AUC, Cmax, Cmin, Tmax, half-life) of JDQ443 and its metabolite HZC320, TNO155 and tislelizumab.","definition_or_measurement_approach":"PK sampling to derive concentration-time profiles and calculate AUC, Cmax, Cmin, Tmax, half-life for JDQ443, HZC320, TNO155 and tislelizumab."}
  • {"endpoint_text":"- Dose Escalation: • Antidrug antibody (ADA) incidence by treatment","definition_or_measurement_approach":"Incidence of anti-drug antibodies (ADA) measured for relevant biologic treatments (tislelizumab) by treatment arm."}
  • {"endpoint_text":"- Dose Expansion: - ORR, DCR, BOR, PFS, and DOR per RECIST 1.1; and OS","definition_or_measurement_approach":"Efficacy outcomes per RECIST 1.1 and overall survival recorded."}
  • {"endpoint_text":"- Dose Expansion: - IDCR, BOIR, IPFS and DOIR per mRANO-BM (brain metastasis group only)","definition_or_measurement_approach":"Intracranial efficacy endpoints (IDCR, BOIR, IPFS, DOIR) assessed per mRANO-BM in brain metastasis subgroup."}
  • {"endpoint_text":"- Dose Expansion: - Safety: Incidence and severity of dose limiting toxicities (DLTs) during the first cycle of monotherapy or combination treatment. Incidence and severity of AEs and SAEs, including changes in laboratory values, ECGs, and vital signs by treatment","definition_or_measurement_approach":"DLTs in first cycle and AE/SAE monitoring including labs, ECGs and vitals by treatment."}
  • {"endpoint_text":"- Dose Expansion: - Tolerability: Frequency of dose interruptions, reductions, and dose intensity, by treatment","definition_or_measurement_approach":"Frequency of dose interruptions/reductions and dose intensity assessed by treatment."}
  • {"endpoint_text":"- Dose Expansion: - Plasma or serum concentration vs time profiles and derived PK parameters (i.e. AUC, Cmax, Cmin, Tmax, half-life) of JDQ443 and its metabolite HZC320, TNO155, and tislelizumab","definition_or_measurement_approach":"PK profiles and derived parameters for JDQ443, metabolite HZC320, TNO155 and tislelizumab."}
  • {"endpoint_text":"- Dose Expansion: - Incidence of anti-tislelizumab antibodies by treatment","definition_or_measurement_approach":"Incidence of anti-tislelizumab antibodies measured by treatment arm."}

Recruitment

Planned Sample Size
282
Recruitment Window Months
66
Consent Approach
Informed consent obtained from adult participants via country-specific Main ICFs. Multiple language ICFs are provided (English, German, Dutch, Spanish, French, Italian as seen in document listings). Additional ICFs/info sheets exist for molecular pre-screening, pregnant participants, pregnant partners and data protection; consent is completed by the adult participant (or relevant legal guardian for specified follow-up forms). No paediatric assent processes are described.

Geography

Total Number Of Sites
19
Total Number Of Participants
359

Germany

Earliest CTIS Part Ii Submission Date
28-08-2024
Latest Decision Or Authorization Date
02-09-2024
Processing Time Days
5
Number Of Sites
4
Number Of Participants
5

Sites

Site Name
Universitaetsklinikum Carl Gustav Carus Dresden an der Technischen Universitaet Dresden AöR
Department Name
#1101: Universitätskrebszentrum Innere Medizin, Hämatologie und Onkologie
Contact Person Name
Martin Wermke
Site Name
Medical Center - University Of Freiburg
Department Name
#1104: Klinik für Innere Medizin! Hämatologie, Onkologie und Stammzelltransplantation
Contact Person Name
Justyna Rawluk
Site Name
Universitaetsklinikum Essen AöR
Department Name
#1100: Westdeutsches Tumorzentrum, Innere Klinik (Tumorforschung)
Contact Person Name
Martin Schuler
Contact Person Email
Martin.schuler@uk-essen.de
Site Name
University Hospital Cologne AöR
Department Name
#1102: Klinik I für Innere Medizin-LCGC
Contact Person Name
Jürgen Wolf
Contact Person Email
Jurgen.wolf@uk-koeln.de

Netherlands

Earliest CTIS Part Ii Submission Date
28-08-2024
Latest Decision Or Authorization Date
02-09-2024
Processing Time Days
5
Number Of Sites
1
Number Of Participants
45

Sites

Site Name
Netherlands Cancer Institute
Department Name
1300:Clinical Research Unit
Contact Person Name
Neeltje Steeghs
Contact Person Email
n.steeghs@nki.nl

Belgium

Earliest CTIS Part Ii Submission Date
28-08-2024
Latest Decision Or Authorization Date
02-09-2024
Processing Time Days
5
Number Of Sites
1
Number Of Participants
16

Sites

Site Name
UZ Leuven
Department Name
#7000 : Pneumology
Contact Person Name
Christophe Dooms
Contact Person Email
christophe.dooms@uzleuven.be

Spain

Earliest CTIS Part Ii Submission Date
28-08-2024
Latest Decision Or Authorization Date
09-09-2024
Processing Time Days
12
Number Of Sites
6
Number Of Participants
37

Sites

Site Name
Complexo Hospitalario Universitario De Santiago
Department Name
#1404: Oncología
Contact Person Name
Neus / Luis Angel Steeghs
Site Name
Hospital Universitario Virgen De La Victoria
Department Name
#1405: Oncología
Contact Person Name
Javier Garcia Corbacho
Contact Person Email
jgcorbacho@ibima.eu
Site Name
Hospital Universitari Vall D Hebron
Department Name
#1400: Oncología
Contact Person Name
Enriqueta Felip Font
Contact Person Email
efelip@vhio.net
Site Name
Institut Catala D'oncologia
Department Name
#1402: Oncología
Contact Person Name
Jose Carlos Ruffinelli Rodriguez
Contact Person Email
jruffinelli@iconcologia.net
Site Name
Hospital Clinico Universitario De Valencia
Department Name
#1403: Oncología
Contact Person Name
Valentina Gambardella
Contact Person Email
Valen.gambardella@gmail.com
Site Name
Hospital Universitario Hm Sanchinarro
Department Name
#1401: Oncología
Contact Person Name
Ramón Yarza Barrio
Contact Person Email
Ramon.Yarza@startmadrid.co

Italy

Earliest CTIS Part Ii Submission Date
28-08-2024
Latest Decision Or Authorization Date
23-09-2024
Processing Time Days
26
Number Of Sites
3
Number Of Participants
151

Sites

Site Name
Fondazione IRCCS Istituto Nazionale Dei Tumori
Department Name
#1200: S.C. Oncologia Medica 1
Contact Person Name
Filippo De Braud
Site Name
ASST Grande Ospedale Metropolitano Niguarda
Department Name
#1201: S.C. Oncologia Medica FALCK Niguarda Cancer Center
Contact Person Name
Salvatore Siena
Site Name
Azienda Socio Sanitaria Territoriale Degli Spedali Civili Di Brescia
Department Name
#1203: U.O. Oncologia Medica
Contact Person Name
Salvatore Grisanti
Contact Person Email
grisanti.salvatore@gmail.com

France

Earliest CTIS Part Ii Submission Date
28-08-2024
Latest Decision Or Authorization Date
03-09-2024
Processing Time Days
6
Number Of Sites
3
Number Of Participants
28

Sites

Site Name
Institut Paoli Calmettes
Department Name
#:9003 Medical Oncology
Contact Person Name
Cecile Vicier
Contact Person Email
VICIERC@ipc.unicancer.fr
Site Name
Centre Leon Berard
Department Name
#:9000 Medical Oncology
Contact Person Name
Philippe Cassier
Site Name
Institut Gustave Roussy
Department Name
#:9001 Medical Oncology
Contact Person Name
Fabrice Barlesi

Denmark

Earliest CTIS Part Ii Submission Date
28-08-2024
Latest Decision Or Authorization Date
10-09-2024
Processing Time Days
13
Number Of Sites
1
Number Of Participants
77

Sites

Site Name
Rigshospitalet
Department Name
#8000: Phase 1 unit
Contact Person Name
Kristoffer Rohrberg

Sponsor

Primary sponsor

Full Name
Novartis Pharma AG
Organisation Type
Pharmaceutical company
Country Of Registered Address
Switzerland

Contract research organisations

Name
Parexel International (IRL) Limited
Responsibilities
code:12 (as listed in sponsorDuties)
Name
Icon Clinical Research Limited
Responsibilities
code:1 (as listed in sponsorDuties)
Name
IQVIA Limited
Responsibilities
code:3 (as listed in sponsorDuties)
Name
Syneos Health Inc.
Responsibilities
code:1 (as listed in sponsorDuties)
Name
Icon Laboratory Services Inc.
Responsibilities
code:4 (as listed in sponsorDuties)

Third parties

  • {"country":"United States","full_name":"Foundation Medicine Inc.","duties_or_roles":"code:4","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Xenobiotic Laboratories Inc.","duties_or_roles":"code:4","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Perceptive Informatics Inc.","duties_or_roles":"code:15 - central imaging (calyx)","organisation_type":"Pharmaceutical company"}
  • {"country":"Ireland","full_name":"Parexel International (IRL) Limited","duties_or_roles":"code:12","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"CellCarta","duties_or_roles":"code:4","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Ireland","full_name":"Icon Clinical Research Limited","duties_or_roles":"code:1","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Eresearchtechnology Inc.","duties_or_roles":"code:15 - ECG analysis/review","organisation_type":"Pharmaceutical company"}
  • {"country":"China","full_name":"Wuxi Apptec Co. Ltd.","duties_or_roles":"code:4","organisation_type":"Pharmaceutical company"}
  • {"country":"Italy","full_name":"Opis S.r.l.","duties_or_roles":"code:15 - TMF archive","organisation_type":"Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Q Squared Solutions Limited","duties_or_roles":"code:4","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"IQVIA Limited","duties_or_roles":"code:3","organisation_type":"Pharmaceutical company"}
  • {"country":"United Kingdom (Northern Ireland)","full_name":"Almac Diagnostic Services Limited","duties_or_roles":"code:4","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Syneos Health Inc.","duties_or_roles":"code:1","organisation_type":"Pharmaceutical company"}
  • {"country":"France","full_name":"SGS France","duties_or_roles":"code:4","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Icon Laboratory Services Inc.","duties_or_roles":"code:4","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"India","full_name":"Veeda Clinical Research Limited","duties_or_roles":"code:4","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
JDQ443
Active Substance
1-{6-[(4M)-4-(5-CHLORO-6-METHYL-1H -INDAZOL-4-YL)-5-METHYL-3-(1-METHYL-1H -INDAZOL-5-YL)-1H -PYRAZOL-1-YL]-2-AZASPIRO[3.3]HEPTAN-2-YL}PROP-2-EN-1-ONE
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
ORAL
Authorisation Status
Authorised
Investigational Product Name
TNO155
Active Substance
BATOPROTAFIB
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
ORAL
Authorisation Status
Authorised
Investigational Product Name
VDT482/ BGB-A317
Active Substance
TISLELIZUMAB
Modality
Monoclonal antibody
Routes Of Administration
INTRAVENOUS USE
Route
INTRAVENOUS
Authorisation Status
Authorised
Combination Treatment
Yes

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