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NCT Number: NCT05396833

Study of Tuvusertib (M1774) in Combination With DNA Damage Response Inhibitor or Immune Checkpoint Inhibitor (DDRiver Solid Tumors 320)

This is an open-label, multicenter, clinical study conducted in multiple parts to establish the safety, tolerability, Pharmacokinetic/Pharmacodynamic (PK/PD) profile, maximum tolerated dose (MTD) combinations (if observed) and recommended dose for expansion (RDE) combination for tuvusertib in combination with lartesertib (in Part A1), food effect on the PK of lartesertib as monotherapy followed by treatment with tuvusertib in combination with lartesertib in participants with specific tumor types (in Part A1.1), relative bioavailability of a tuvusertib tablet formulation vs capsule formulation followed by treatment with tuvusertib (capsule) in combination with lartesertib in participants with specific tumor types (in Part A1.2), safety/tolerability and early signs of clinical activity of tuvusertib (capsule)and lartesertib in combination in participants with prostate cancer harboring loss of function (LoS) mutation in the gene ATM based on historic data collected prior to prescreening in circulating tumor (ct) DNA (liquid biopsies) or tumor biopsies (in Part A2), safety/tolerability and early signs of clinical activity of tuvusertib and lartesertib in combination in participants with endometrial cancer harboring LoS mutation(s) in the gene ARID1A based on historic data collected prior to prescreening in ctDNA (liquid biopsies) or tumor biopsies (in Part A3), the relative bioavailability of a tuvusertib tablet formulation (TF1, test) compared to a capsule formulation (reference) will also be investigated (in Part A2/A3), and identify a potential set of MTD combinations, and establish the RDE for the combination of tuvusertib and avelumab in participants with metastatic or locally advanced unresectable solid tumors (in Part B1).

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Royal North Shore Hospital, St Leonards, Australia

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Parts A1, A1.1, A1.2, A2, A3, and A2/3: Participants with metastatic or locally advanced unresectable solid tumors refractory to standard therapy or for which no standard therapy is judged appropriate by the Investigator, which may convey clinical benefit, or who cannot tolerate standard of care treatment
  • Parts A1.1 and A1.2: Triple negative breast cancer, epithelial ovarian cancer, castrate resistant prostate cancer, urothelial cancer, endometrial cancer, and colorectal cancer independent of mutation status.
  • Part A2: Participants with advanced prostate cancer whose tumor carries a genetic loss of function (LoF) mutation(s) in the gene ataxia telangiectasia mutated (ATM). No more than 3 prior lines of therapy for castrate resistant disease. Prior therapy must have included a taxane and a novel antiandrogen (example [e.g.] enzalutamide).
  • Part A3: Participants with advanced endometrial cancer whose tumor carries a genetic LoF mutation(s) in the gene AT-rich interaction domain 1A (ARID1A). Prior therapy must have included a platinum agent. Prior therapy must also have included a checkpoint inhibitor if the participant has mismatch repair (MMR)-deficient endometrial cancer. Note for Parts A2/A3: Participants with ATM LoF mutated prostate cancer and ARID1A LoF mutated endometrial cancer should be prioritized to the respective expansion arms instead of being enrolled in Part A1.1. The presence of ATM and ARID1A LoF mutations will be determined according to historic data collected prior to prescreening, generated by an assay with appropriate regulatory status, in either tumor or liquid biopsy. The Sponsor will confirm that mutations certified by historic data fulfil this definition.
  • Participants with eastern Cooperative Oncology Group (ECOG) performance status 0 or 1, with estimated life expectancy of at least 3 months
  • Adequate hematological, hepatic, and renal function as defined in the protocol
  • Other protocol defined inclusion criteria could apply

Exclusion criteria

  • Participants with any condition, including any uncontrolled disease state other than with metastatic or locally advanced unresectable solid tumors, that in the Investigator's opinion constitutes an inappropriate risk or a contraindication for participation in the study or that could interfere with the study objectives, conduct, or evaluation
  • Participants with a known additional malignancy that is progressing and/or requires active treatment
  • Participants with carcinomatous meningitis are excluded regardless of clinical stability
  • Participants with serious gastrointestinal bleeding within 3 months, refractory nausea and vomiting, uncontrolled diarrhea, known malabsorption, significant small bowel resection or gastric bypass surgery, use of feeding tubes, other chronic gastrointestinal disease, and/or other situations that may preclude adequate absorption of oral medications
  • Participants with organ transplantation, including allogeneic stem cell transplant
  • Other protocol defined exclusion criteria could apply

Treatment and study plan

Tuvusertib

Drug

Tuvusertib will be administered orally once daily over a defined period of time in Part A1, A1.1, A1.2, A2, A3, A2/A3, and Part B1 until disease progression, death, discontinuation, or end of study.

Other names: M1774

Lartesertib

Drug

Lartesertib will be administered orally once daily over a defined period of time in Part A1, A1.1, A1.2, A2, A3, A2/A3, until disease progression, death, discontinuation, or end of study.

Other names: M4076

Avelumab

Drug

Avelumab will be administered by intravenous infusion once a day over a defined period of time in Part B1 until disease progression, death, discontinuation, or end of study.

Primary outcomes

  1. Part A1: Number of Participants With Dose-Limiting Toxicities (DLTs) During the DLT Evaluation Period

    Time frame: Day 1 up to Day 28

  2. Part A1: Number of Participants With Adverse Events (AEs) and Treatment-Related AEs

    Time frame: Baseline up to 18 months

  3. Part B1: Number of Participants with Dose-Limiting Toxicities (DLTs) During the DLT Evaluation Period

    Time frame: Day 1 up to Day 28

  4. Part B1: Number of Participants with AEs and Treatment-Related AEs

    Time frame: Baseline up to 18 months

  5. Part A1: Change From Baseline in Pharmacodynamic (PD) Biomarker

    Time frame: Pre-dose up to approximately 1 month

    The PD biomarker of histone variant will be measured by flow cytometry.

  6. Part B1: Change From Baseline in PD Biomarker

    Time frame: Pre-dose up to approximately 1 month

    The PD biomarker of histone variant will be measured by flow cytometry.

  7. Part A1.1: PK Plasma Concentration of Lartesertib Under Fed and Fasted Conditions

    Time frame: Day -1 up to Period 1 Day 1

  8. Part A2/A3: Objective Response according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 as assessed by Investigator

    Time frame: Up to 18 months after first dose administration

  9. Part A2/A3: Number of Participants With AEs and Treatment-Related AEs

    Time frame: Baseline up to 18 months

  10. Part A1.2: Relative Bioavailability Based on Area Under the Plasma Concentration Curve From Time Zero Extrapolated to Infinity [Frel(AUC0-inf)] of Tuvusertib Test Treatment Compared to Tuvusertib Reference Treatment

    Time frame: Day -4 up to Period 1 Day 1

  11. Part A1.2: Relative Bioavailability Based on Area Under the Plasma Concentration Curve From Time Zero to Last Quantifiable Concentration [Frel(AUC0-t)] of Tuvusertib Test Treatment Compared to Tuvusertib Reference Treatment

    Time frame: Day -4 up to Period 1 Day 1

  12. Part A1.2: Ratio Maximum Observed Plasma Concentration (Ratio[Cmax]) of Tuvusertib Test Treatment Compared to Tuvusertib Reference Treatment

    Time frame: Day -4 up to Period 1 Day 1

  13. Part A2/A3: Relative Bioavailability Based on Area Under the Plasma Concentration Curve From Time Zero Extrapolated to Infinity [Frel(AUC0-inf)] of Tuvusertib Test Treatment Compared to Tuvusertib Reference Treatment

    Time frame: Day -4 up to Period 1 Day 1

  14. Part A2/A3: Relative Bioavailability Based on Area Under the Plasma Concentration Curve From Time Zero to Last Quantifiable Concentration [Frel(AUC0-t)] of Tuvusertib Test Treatment Compared to Tuvusertib Reference Treatment

    Time frame: Day -4 up to Period 1 Day 1

  15. Part A2/A3: Ratio Maximum Observed Plasma Concentration (Ratio[Cmax]) of Tuvusertib Test Treatment Compared to Tuvusertib Reference Treatment

    Time frame: Day -4 up to Period 1 Day 1

Secondary outcomes

  1. Part A1: Pharmacokinetic (PK) Plasma Concentration of Tuvusertib and Lartesertib

    Time frame: Pre-dose up to approximately 6 months

  2. Parts A1.2 and B1: Pharmacokinetic (PK) Plasma Concentration of Tuvusertib

    Time frame: Pre-dose up to approximately 6 months

  3. Part B1: Pharmacokinetic (PK) Serum Concentration of Avelumab

    Time frame: Pre-dose up to approximately 18 months

  4. Part A1 and B1: Number of Participants with Clinically Significant Abnormalities in Digital Electrocardiogram (ECG) Measures

    Time frame: Baseline up to 18 months

  5. Part A1 and B1: Objective Response (OR) According to Response Evaluation Criteria in Solid Tumor (RECIST) v1.1

    Time frame: Up to 18 months after first dose administration

  6. Part B1: Number of Participants with Any Positive Anti-Drug Antibody (ADA) of Avelumab

    Time frame: Baseline up to 18 months

  7. Parts A1.1, A1.2 and A2/3: Number of Participants With AEs and Treatment-Related AEs

    Time frame: Baseline up to 18 months

  8. Part A1.1: PK Plasma and Urine Concentration of Lartesertib Under Fed and Fasted Conditions

    Time frame: Day -1 up to Period 1 Day 1

  9. Part A2/A3: Time to Reach Maximum Plasma Concentration (tmax) of Tuvusertib

    Time frame: Day -4 up to Period 1 Day 1

  10. Part A2/A3: Duration of Response according to RECIST v1.1

    Time frame: Up to 18 months after first dose administration

  11. Part A2/A3: Clinical benefit (either OR or stable disease for 6 months or more) according to RECIST v1.1.

    Time frame: Up to 18 months after first dose administration

  12. Part A2/A3: Progression Free Survival according to RECIST v1.1 modified according to the Prostate Cancer Working Group 3 (PCWG-3), assessed by Investigator

    Time frame: Up to 18 months after first dose administration

Sponsors and collaborators

Lead sponsor

EMD Serono Research & Development Institute, Inc.

Industry

Collaborators

  • Merck KGaA, Darmstadt, Germany

Registry information

Official study title

An Open-label, Multicenter Phase Ib Study of the Safety, Tolerability, and Pharmacokinetic/Pharmacodynamic Profile of the ATR Inhibitor Tuvusertib (M1774) in Combination With DNA Damage Response Inhibitors or Immune Checkpoint Inhibitors in Patients With Metastatic or Locally Advanced Unresectable Solid Tumors (DDRiver Solid Tumors 320)

Important dates

Study start
2022
Primary completion
2027
Study completion
2027
First posted
May 31, 2022
Registry last updated
May 28, 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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