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Completed

NCT Number: NCT04526106

REFOCUS: A First-in-Human Study of Highly Selective FGFR2 Inhibitor, RLY-4008, in Patients With ICC and Other Advanced Solid Tumors

This is a Phase 1/2, open-label, FIH study designed to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PDy), and antineoplastic activity of RLY-4008, a potent and highly selective FGFR2 inhibitor, in patients with unresectable or metastatic cholangiocarcinoma (CCA) and other solid tumors. The study consists of 4 parts: a dose escalation (Part 1), a dose expansion (Part 2), and an extension (Part 3) and a rollover (Part 4).

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

St. Vincent's Hosptial Sydney, Darlinghurst, Australia

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Key Inclusion Criteria

  • Histologically or cytologically confirmed unresectable or metastatic solid tumor
  • Documented FGFR2 gene fusion, mutation, or amplification per local testing of blood and/or tumor
  • Patient must have measurable disease per RECIST v1.1
  • Patient has ECOG performance status of 0-1
  • Patient must have disease that is refractory to standard therapy, disease that has not adequately responded to standard therapy, disease for which standard or curative therapy does not exist, or the patient must be intolerant to or have declined standard therapy
  • Part 2 dose expansion patients with Cholangiocarcinoma:
  • Group 1: CCA patients with an FGFR2 fusion previously treated with an FGFRi
  • Group 2: CCA patients with an FGFR2 fusion with prior chemotherapy but not previously treated with an FGFRi
  • Group 6: CCA patients with an FGFR2 fusion with no prior chemotherapy and not previously treated with an FGFRi. Prior adjuvant/neo-adjuvant treatment completed >6 months before enrollment is acceptable. Up to 2 cycles of palliative chemotherapy are allowed during screening
  • Group 7: CCA patients with an FGFR2 mutation or amplification and not previously treated with an FGFRi. Note: For Group 7, patients with confirmed diagnosis of unresectable or metastatic CCA with an FGFR2 fusion are not eligible.
  • Part 2 dose expansion patients with other solid tumors (NOT Cholangiocarcinoma):
  • Group 3: Non-CCA patients with an FGFR2 fusion and not previously treated with an FGFRi.
  • Group 4: Non-CCA patients with an FGFR2 amplification and not previously treated with an FGFRi.
  • Group 5: Non-CCA patients with an FGFR2 mutation and not previously treated with an FGFRi
  • Part 3 extension:

o CCA patients with an FGFR2 fusion with prior chemotherapy but not previously treated with an FGFRi

  • Part 4:
  • Patient is receiving RLY-4008 on RLY-4008-101 study and benefiting from treatment as assessed by the investigator.

Key Exclusion Criteria

  • Parts 1, 2, and 3
  • Ongoing, clinically significant FGFRi-induced retinal detachment or an ongoing clinically significant corneal or retinal disorder
  • Patient does not have adequate organ function (defined in protocol)
  • Patient has active infection, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), and/or hepatitis C virus (HCV) (defined in protocol). Patients with well-controlled HBV are eligible (defined in protocol).
  • QT interval corrected using Fridericia's formula (QTcF) > 480 msec or history of prolonged QT syndrome, Torsades de pointes or familial history of prolonged QT syndrome
  • Clinically significant, uncontrolled cardiovascular disease
  • CNS metastases or primary CNS tumor that is associated with progressive neurologic symptoms
  • Part 4:
  • Patient has permanently discontinued treatment with RLY-4008 for any reason before enrolling into Part 4.

Treatment and study plan

RLY-4008

Drug

RLY-4008 is an oral inhibitor of FGFR2

Primary outcomes

  1. Part 1 and Part 4: Number of patients with adverse events and serious adverse events

    Time frame: Every cycle (4-week cycles) until study discontinuation, approximately 24 months

  2. Part 1: Determination of maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) of RLY-4008

    Time frame: Cycle 1 (4-week cycle) of treatment for MTD and at the end of every cycle (4-week cycles) for RP2D until study discontinuation, approximately 24 months

  3. Part 2 and Part 3: Objective Response Rate (ORR) assessed by Independent Review Committee per RECIST v1.1

    Time frame: Approximately every 8 weeks during treatment and every 12 weeks after the last dose in the absence of progressive disease, approximately 36 months

  4. Part 4: Number of patients with dose interruptions

    Time frame: Every 28-day cycle until end of treatment, approximately 24 months.

  5. Part 4: Number of patients with dose reductions

    Time frame: Every 28-day cycle until end of treatment, approximately 24 months.

  6. Part 4: Number of patients with dose discontinuations

    Time frame: Every 28-day cycle until end of treatment, approximately 24 months.

Secondary outcomes

  1. Part 1: FGFR2 gene status in plasma circulating tumor deoxyribonucleic acid (ctDNA) and tumor tissue

    Time frame: Every cycle (4-week cycles) through Cycle 3 and every other cycle thereafter until study discontinuation, approximately 24 months

  2. Part 1: Duration of Response (DOR) assessed by Investigator per RECIST v1.1

    Time frame: Approximately every 8 weeks during treatment and every 12 weeks after the last dose in the absence of progressive disease, approximately 36 months

  3. Part 1: Disease Control Rate (DCR) as assessed by Investigator per RECIST v1.1

    Time frame: Approximately every 8 weeks during treatment and every 12 weeks after the last dose in the absence of progressive disease, approximately 36 months

  4. Part 1, Part 2, and Part 3: Objective Response Rate (ORR) as assessed by Investigator per RECIST v1.1

    Time frame: Approximately every 8 weeks during treatment and every 12 weeks after the last dose in the absence of progressive disease, approximately 36 months

  5. Pharmacokinetic parameters including maximum plasma drug concentration (Cmax)

    Time frame: Approximately every 2 weeks in Cycle 1 (4-week cycle) and every cycle through Cycle 4 (4-week cycles)

  6. Pharmacokinetic parameters including area under the plasma concentration versus time curve (AUC)

    Time frame: Approximately every 2 weeks in Cycle 1 (4-week cycle) and every cycle through Cycle 4 (4-week cycles)

  7. Pharmacokinetic parameters including half-life (t1/2)

    Time frame: Approximately every 2 weeks in Cycle 1 (4-week cycle) and every cycle through Cycle 4 (4-week cycles)

  8. Part 1: Pharmacodynamic parameters including changes in fibroblast growth factor 23 (FGF-23)

    Time frame: Approximately every 2 weeks in Cycle 1 (4-week cycle) and every other cycle (4-week cycles) from Cycle 3, approximately 24 months

  9. Part 1: Pharmacodynamic parameters including changes in carcinoembryonic antigen (CEA)

    Time frame: Approximately every 2 weeks in Cycle 1 (4-week cycle) and every other cycle (4-week cycles) from Cycle 3, approximately 24 months

  10. Part 1: Pharmacodynamic parameters including changes in cancer antigen 19-9 (CA 19-9)

    Time frame: Approximately every 2 weeks in Cycle 1 (4-week cycle) and every other cycle (4-week cycles) from Cycle 3, approximately 24 months

  11. Part 2 and Part 3: Duration of response (DOR) assessed by Investigator and Independent Review Committee per RECIST v1.1

    Time frame: Approximately every 8 weeks during treatment and every 12 weeks after the last dose in the absence of progressive disease, approximately 36 months

  12. Part 2 and Part 3: Progression-free survival (PFS) assessed by Investigator and Independent Review Committee per RECIST v1.1

    Time frame: Approximately every 8 weeks during treatment and every 12 weeks after the last dose in the absence of progressive disease, approximately 36 months

  13. Part 2 and Part 3: Disease control rate (DCR) assessed by Investigator and Independent Review Committee per RECIST v1.1

    Time frame: Approximately every 8 weeks during treatment and every 12 weeks after the last dose in the absence of progressive disease, approximately 36 months

  14. Part 2 and Part 3:Overall survival (OS)

    Time frame: Up to approximately 36 months.

  15. Part 2 and Part 3:Change from baseline in quality of life as assessed by EORTC QLQ-C30

    Time frame: Approximately every 4 weeks during treatment, approximately 24 months

  16. Part 2 and Part 3:Dose intensity

    Time frame: Every 28-day cycle until end of treatment, approximately 24 months.

  17. Part 2 and Part 3: Number of patients with dose interruptions

    Time frame: Every 28-day cycle until end of treatment, approximately 24 months.

  18. Part 2 and Part 3: Number of patients with dose reductions

    Time frame: Every 28-day cycle until end of treatment, approximately 24 months.

  19. Part 2 and Part 3: Number of patients with dose discontinuations

    Time frame: Every 28-day cycle until end of treatment, approximately 24 months.

  20. Part 2 and Part 3: Correlation between FGFR2 genotype by central tissue assessment and antitumor response, as measured by ORR

    Time frame: Approximately every 8 weeks during treatment and every 12 weeks after the last dose in the absence of progressive disease, approximately 36 months

Sponsors and collaborators

Lead sponsor

Elevar Therapeutics

Industry

Registry information

Official study title

A First-in-Human Study of Highly Selective FGFR2 Inhibitor, RLY-4008, in Patients With Intrahepatic Cholangiocarcinoma (ICC) and Other Advanced Solid Tumors

Important dates

Study start
2020
Primary completion
2025
Study completion
2025
First posted
Aug 25, 2020
Registry last updated
Feb 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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