A phase 1a/1b study of aurora kinase A inhibitor VIC-1911 as monotherapy and in combination with sotorasib for the treatment of KRAS G12C-mutant non–small-cell lung cancer.

Authors

null

Sarah B. Goldberg

Yale Cancer Center, Yale School of Medicine, New Haven, CT

Sarah B. Goldberg , Salman Rafi Punekar , Vamsidhar Velcheti , Jonathan W. Riess , Katherine Ann Scilla , Jennifer W Carlisle , Katerina A. Politi , Jong Woo Lee , Thomas J. Myers , Linda J. Paradiso , Barbara Burtness

Organizations

Yale Cancer Center, Yale School of Medicine, New Haven, CT, NYU Langone-Laura and Isaac Perlmutter Cancer Center, New York, NY, University of California Davis Comprehensive Cancer Center, Sacramento, CA, University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, Winship Cancer Institute of Emory University, Atlanta, GA, VITRAC Therapeutics, LLC, Natick, MA

Research Funding

Pharmaceutical/Biotech Company
VITRAC Therapeutics, LLC

Background: Activity of direct covalent KRASG12C inhibitors in NSCLC is limited by mutational and adaptive resistance. AURKA has roles in centrosome maturation and cytokinesis. AURKA amplification/overexpression is reported in multiple tumors, including NSCLC, and AURKA signaling may mediate adaptive resistance to KRAS inhibition. VIC-1911 is a highly selective, orally active small molecule inhibitor of AURKA. VIC-1911 demonstrated monotherapy activity in vitro in KRASG12C-mutant human NSCLC cells with intrinsic and acquired resistance to the KRASG12C inhibitor sotorasib, and combination VIC-1911 and sotorasib showed synergy in the same cell lines. Combination VIC-1911 and sotorasib delayed the emergence of adaptive resistance in vitro. These findings suggest that 1) AURKA activation is present in both intrinsic and acquired resistance to sotorasib in KRASG12C-mutant NSCLC and 2) the combination of VIC-1911 and sotorasib is a potential therapeutic approach for KRASG12C-mutant NSCLC with intrinsic or acquired resistance to sotorasib monotherapy. In addition, in vivo data suggest both sotorasib and adagrasib are synergistic in combination with VIC-1911 in human KRASG12C-mutant NSCLC cell line xenograft models. Methods: A non-randomized, open-label Phase 1a/1b study of VIC-1911, an aurora kinase A inhibitor, administered as monotherapy and in combination with sotorasib for the treatment of advanced KRASG12C-mutant NSCLC is in progress. Participants ≥18 years, with locally advanced or metastatic KRASG12C-mutant NSCLC, prior treatment with at least 1 line of PD-1/PD-L1 inhibitor therapy with or without platinum-based chemotherapy and have adequate organ function are eligible. Both KRASG12C inhibitor naïve and experienced patients are eligible. VIC-1911 monotherapy is given at oral doses of 25 – 90 mg twice daily in dose escalation and at the VIC-1911 maximum tolerated dose (MTD) in the expansion cohort in patients who are refractory/relapsed on prior KRASG12C inhibitor therapy. The combination regimen includes dose escalation with VIC-1911 at oral doses of 75, 150 or 200 mg twice daily on days 1-4, 8-11 and 15-18 every 28-day cycle plus sotorasib 960 mg daily in patients who are refractory/relapsed or naïve to prior KRASG12C inhibitor therapy. In dose escalation, a 3+3 schema is followed with dose limiting toxicity (DLT) criteria for toxicity and a sample size ≤ 36. For expansion cohorts, the sample size is based on Simon 2-stage optimal design, with a sample size ≤ 104. VIC-1911 and sotorasib dose modification criteria are provided. Supportive medications are allowed and early stopping rules for toxicity will be followed. VIC-1911 pharmacokinetics will be assessed. Pharmacodynamics will be determined from ctDNA and tumor biomarker analysis. Clinical trial information: NCT05374538.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT05374538

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr TPS9140)

DOI

10.1200/JCO.2023.41.16_suppl.TPS9140

Abstract #

TPS9140

Poster Bd #

127b

Abstract Disclosures