A Study to Assess the Safety and Tolerability of CFT8634 in Locally Advanced or Metastatic SMARCB1-Perturbed Cancers, Including Synovial Sarcoma and SMARCB1-Null Tumors

• ClinicalTrials.gov Identifier: NCT05355753
• Recruitment Status: Recruiting
• First Posted: May 2, 2022
• Last Update Posted: March 22, 2023
• Sponsor: C4 Therapeutics, Inc.
• Information provided by (Responsible Party): C4 Therapeutics, Inc.

Study Description

Brief Summary:

This is an open-label, non-randomized, first-in-human Phase 1/2 study designed to evaluate the safety and tolerability of CFT8634 in subjects with synovial sarcoma and SMARCB1-null tumors who: have received prior systemic therapy; have relapsed/refractory tumors; have unresectable or metastatic disease; and are not candidates for available therapies known to confer clinical benefit. The study will characterize the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary antitumor activity of CFT8634.

Condition or disease	Intervention/treatment	Phase
Synovial Sarcoma; Soft Tissue Sarcoma	Drug: CFT8634	Phase 1; Phase 2

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 110 participants
• Allocation: Non-Randomized
• Intervention Model: Sequential Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Phase 1/2 Open-Label, Multicenter Study to Characterize the Safety and Tolerability of CFT8634 in Subjects With Locally Advanced or Metastatic SMARCB1-Perturbed Cancers, Including Synovial Sarcoma and SMARCB1-Null Tumors
• Actual Study Start Date: March 25, 2022
• Estimated Primary Completion Date: October 2024
• Estimated Study Completion Date: May 2025

Arms and Interventions

Arm	Intervention/treatment
Experimental: Dose Escalation Phase 1/Part1: CFT8634; Up to approximately 40 subjects ≥18 years of age or between ≥16 and <18 years of age and weighing ≥50 kg with locally advanced or metastatic SMARCB1-perturbed cancers, including synovial sarcoma and SMARCB1-null tumors, having received ≥ 1 prior anticancer therapy	Drug: CFT8634; Oral dose of CFT8634
Experimental: Dose Escalation Phase 1/Part 2: CFT8634; Up to approximately 6-12 subjects ≥12 and <16 years of age and weighing ≥40 kg or ≥16 and <18 years of age and weighing ≥40 kg and <50 kg with locally advanced or metastatic SMARCB1-perturbed cancers, including synovial sarcoma and SMARCB1-null tumors	Drug: CFT8634; Oral dose of CFT8634
Experimental: Phase 2 - Arm A: CFT8634; Approximately 30 subjects with locally advanced or metastatic synovial sarcoma at the recommended phase 2 dose (RP2D) having received 1-2 prior anticancer therapies	Drug: CFT8634; Oral dose of CFT8634
Experimental: Phase 2 - Arm B: CFT8634; Approximately 20 subjects with locally advanced or metastatic SMARCB1-null tumors at the RP2D having received ≥1 prior anticancer therapy	Drug: CFT8634; Oral dose of CFT8634

Outcome Measures

Primary Outcome Measures :

1. Frequency and severity of AEs and serious adverse events (SAEs) [ Time Frame: From screening until at least 30 days after completion of study treatment ]
   Phase 1 and Phase 2
2. Number of subjects with changes between baseline and post-baseline safety assessments based on safety laboratory results graded by CTCAE v5.0 [ Time Frame: From screening until at least 30 days after completion of study treatment ]
   Phase 1 and Phase 2
3. Frequency of dose interruptions and dose reductions [ Time Frame: From first dose until end of treatment ]
   Phase 1 and Phase 2
4. Incidence of dose limiting toxicities (DLTs) [ Time Frame: From first dose until 28 days after first dose ]
   Phase 1 only
5. Overall Response Rate (ORR) [ Time Frame: Up to approximately 24 months ]
   Phase 2 only according to RECIST v1.1 criteria

Secondary Outcome Measures :

1. Plasma concentration of CFT8634 to characterize the pharmacokinetics (PK) parameters of CFT8634 [ Time Frame: At multiple time points up to approximately 24 weeks ]
   Plasma concentration of CFT8634 at the scheduled timepoints
2. Asses dose proportionality assessment [ Time Frame: At multiple time points up to approximately 24 weeks ]
   Dose proportionately assessment at the scheduled timepoints
3. Assess the pharmacodynamics by percent reduction from baseline of target protein [ Time Frame: At multiple time points up to approximately 24 weeks ]
   Tumor BRD9 degradation at scheduled timepoints
4. ORR [ Time Frame: Up to approximately 24 months ]
   Phase 1 only according to RECIST v1.1 criteria
5. Duration of Response (DOR) [ Time Frame: Up to approximately 24 months ]
   DOR defined as time from first assessment of PR or CR to follow-on first assessment of progressive disease (PD)
6. Progression Free Survival (PFS) [ Time Frame: Up to approximately 24 months ]
   PFS defined as the time from first treatment received until PD is assessed
7. Overall Survival (OS) [ Time Frame: Up to approximately 48 months ]
   OS is defined as the time from first dose of study treatment to the date of death, irrespective of the cause of death. (Phase 2 only)
8. Time to next treatment [ Time Frame: Up to approximately 8 months ]
   Interval from the date of initiation of a treatment to the date of commencement of the next line of therapy

Eligibility Criteria

• Ages Eligible for Study: 12 Years and older (Child, Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Subject (and legal guardian where applicable) is (are) willing and able to provide signed informed consent (or assent, where applicable) and can follow protocol requirements

2. Subject has histologically or cytologically confirmed synovial sarcoma or SMARCB1-null sold tumor that is relapsed/refractory, and unresectable or metastatic; the subject must not be a candidate for available therapies that are known to confer clinical benefit

   a. Phase 1: subject must have received ≥1 prior line of systemic anticancer therapy considered to be Standard of Care per the Investigator's judgment, in the metastatic or unresectable setting b. Phase 2: i. Arm A: subject must have received only 1-2 prior lines of systemic anticancer therapy considered to be Standard of Care per the Investigator's judgment, in the metastatic or unresectable setting ii. Arm B: subject must have received ≥1 prior line of systemic anticancer therapy considered to be Standard of Care per the Investigator's judgment, in the metastatic or unresectable setting

3. Subject must be:

   • ≥18 years of age (no minimum weight),
   • ≥16 and <18 years old and weighs ≥50 kg,
   • ≥12 and <16 years of age and weighs ≥40kg,
   • or ≥16 and <18 years of age and weighs ≥40kg and <50kg
4. Subject must be able to safely swallow capsules
5. Subject must have measurable disease as defined by RECIST v1.1
6. Subject must have Eastern Cooperative Oncology Group performance status ≤2 or Lansky performance scale (LK scale) ≥ 60

7. Subject must have adequate organ function, defined as:

   1. Bone marrow function: absolute neutrophil count ≥1.0 x 109/L independent of growth factor support for ≤7 days prior to first dose of study drug for granulocyte colony-stimulating factor and ≤14 days prior to first dose of study drug for peg-filgrastim; hemoglobin ≥8 g/dL independent of transfusion support for ≤7 days prior to first dose of study drug; platelet count ≥75 x 109 /L independent of transfusion support for ≤3 days prior to first dose of study drug
   2. Coagulation: Prothrombin time (PT)/international normalized ratio (INR) <1.5x the upper limit of normal (ULN) and activated partial thromboplastin time (aPTT) <1.5x ULN (unless the subject is receiving anticoagulant therapy and INR and partial PT/aPTT are within therapeutic range of intended use of anticoagulants)
   3. Liver function: total bilirubin ≤1.5x ULN (≤3.0x ULN for subjects with Gilbert's syndrome), aminotransferase (ALT) and aspartate aminotransferase (AST) ≤3.0x ULN; except for subjects who have tumor infiltration of the liver, where ALT and AST ≤5x ULN
   4. Renal function: must have a creatinine clearance ≥60 mL/min (via Cockcroft-Gault equation, institutional standard, or measured)
   5. Cardiac function: baseline corrected QT interval using Fredericia's formula ≤470 ms (adolescents 12-17 years of age: ≤450 ms) and a left ventricular ejection fraction ≥50% evaluated via echocardiogram or multi-gated acquisition (MUGA) scan
8. Availability of archival tumor tissue sample or newly obtained core/excisional biopsy of a tumor not previously irradiated
9. A female subject may be eligible to participate if she is not pregnant or planning a pregnancy, not breastfeeding, and following protocol mediated guidance to avoid pregnancy
10. A male subject must have had a prior vasectomy and agree to use a condom during the treatment period and for at least 90 days after the last dose of study treatment
11. A male subject must refrain from donating sperm while taking CFT8634 and for 90 days post-last dose
12. A female subject must refrain from donating ova while taking CFT8634 and for 180 days after discontinuation
13. All subjects must refrain from donating blood and blood products while receiving study drug and for 30 days post-last dose

Exclusion Criteria:

1. Subject has had major surgery within 21 days prior to the planned first dose of CFT8634

   a. Minor surgery (eg, minor biopsy of extracranial site, central venous catheter placement, shunt revision) is permitted within 21 days prior to first dose of CFT8634

2. Subject has received standard of care or investigational systemic anti-neoplastic therapy within 14 days or 5 half-lives, whichever is shorter, prior to the planned first dose of CFT8634
3. Subject has received radiation therapy within 14 days prior to the planned first dose of CFT8634
4. Prior treatment with BRD9 degrader

5. Subject has central nervous system (CNS) involvement (primary tumor or metastatic disease), except in the following circumstances:

   1. Subjects with previously treated brain metastases may be permitted to participate provided they are stable (without evidence of progression by imaging 14 days prior to the first dose of study drug and any neurologic symptoms have stabilized), have no evidence of new or enlarging brain metastases, and if they are taking corticosteroids, they are on stable or tapering doses for at least 7 days prior to first dose of study drug. Antiseizure therapy is permitted provided the medication is not otherwise excluded and seizures have been controlled for at least 28 days since the last antiseizure medication adjustment
   2. Subjects with asymptomatic brain metastases found on Screening magnetic resonance imaging (MRI) may be permitted to be entered into the study without prior radiation therapy to the brain if they do not require immediate surgical or radiation therapy in the opinion of the treating investigator and in the opinion of a radiation therapy or neurosurgical consultant
6. Subject has any evidence of a CNS bleed including intra-tumoral hemorrhage
7. Subject has known bleeding diathesis
8. Subject has impaired cardiac function or clinically significant cardiac disease (i.e. uncontrolled heart disease/hypertension, clinically significant arrythmias, unstable angina/myocardia infarction/stroke within 180 days prior to screening)
9. Subject with presence of inflammatory vascular disease or microangiopathy (eg, thrombotic microangiopathies, hemolytic uremic syndrome [HUS], atypical HUS)

10. Subject with known malignancy, other than study indication, that is progressing or has required treatment within the past 3 years

    a. Subject with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (i.e. breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded

11. Subject has received live, attenuated vaccine within 28 days prior to first dose administration
12. Subject with known history of human immunodeficiency virus (HIV) infection
13. Subject had a venous thrombosis within 14 days prior to first dose of study drug
14. Subject with gastrointestinal absorption issues (e.g., malabsorption syndrome or other illness that could affect oral absorption).
15. Concurrent administration of strong cytochrome P450 (CYP) 3A4 inhibitors and inducers, and multidrug resistance mutation 1 (MDR1) inhibitors.

Contacts and Locations

Contacts

Contact: Chief Medical Officer; (617) 231-0700; clinicaltrials@C4therapeutics.com

Locations

United States, California

City of Hope; Recruiting

Duarte, California, United States, 91010

Principal Investigator: Mark Agulnik, MD

Sarcoma Oncology Research Center; Recruiting

Santa Monica, California, United States, 90403

Principal Investigator: Sant Chawla, MD

United States, Colorado

University of Colorado - Aurora Cancer Center; Recruiting

Aurora, Colorado, United States, 80045

Principal Investigator: Anthony Elias, MD

United States, Florida

Mayo Clinic - Jacksonville; Recruiting

Jacksonville, Florida, United States, 32224

Principal Investigator: Steven Attia, DO

United States, Iowa

University of Iowa Hospital and Clinics; Recruiting

Iowa City, Iowa, United States, 52242

Principal Investigator: Mohammed Milhem, MD

United States, Massachusetts

Massachusetts General Hospital; Recruiting

Boston, Massachusetts, United States, 02114

Principal Investigator: Gregory Cote, MD, PhD

United States, Minnesota

Mayo Clinic - Rochester; Recruiting

Rochester, Minnesota, United States, 55905

Principal Investigator: Thanh Ho, MD

United States, Missouri

Washington University School of Medicine; Recruiting

Saint Louis, Missouri, United States, 63110

Principal Investigator: Brian Van Tine, MD, PhD

United States, New York

David H. Koch Center for Cancer Care at Memorial Sloan Kettering Cancer Center; Recruiting

New York, New York, United States, 10021

Principal Investigator: William Tap, MD

Columbia University; Recruiting

New York, New York, United States, 10027

Principal Investigator: Shaheer Khan, DO

United States, Ohio

Cincinnati Children's Hospital Medical Center; Not yet recruiting

Cincinnati, Ohio, United States, 45229

Principal Investigator: Joseph Pressey, MD

United States, Pennsylvania

University of Pennsylvania Abramson Cancer Center; Not yet recruiting

Philadelphia, Pennsylvania, United States, 19104

United States, Texas

MD Anderson Cancer Center; Recruiting

Houston, Texas, United States, 77030

Principal Investigator: Ravin Ratan, MD

Sponsors and Collaborators

C4 Therapeutics, Inc.

More Information

• Responsible Party: C4 Therapeutics, Inc.
• ClinicalTrials.gov Identifier: NCT05355753
• Other Study ID Numbers: CFT8634-1101
• First Posted: May 2, 2022
• Last Update Posted: March 22, 2023
• Last Verified: February 2023

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by C4 Therapeutics, Inc.:

Synovial Sarcoma; SMARB1-Null Tumors; CFT8634; Soft Tissue Sarcoma; Myoepithelial Carcinoma; Extraskeletal Myxoid Chondrosarcoma; Renal Medullary Carcinoma; Chordoma; Epithelioid Sarcoma

Additional relevant MeSH terms:

Sarcoma; Sarcoma, Synovial; Neoplasms, Connective and Soft Tissue; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Connective Tissue