A phase 1, open-label, dose escalation and dose expansion study to evaluate the safety, tolerability, pharmacokinetics, and antitumor activity of PF-07799933 (ARRY-440) as a single agent and in combination therapy in participants 16 years and older with advanced solid tumors with BRAF alterations.

Authors

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J. Thaddeus Thaddeus Beck

Highlands Oncology Group, Springdale, AR

J. Thaddeus Thaddeus Beck , Meredith McKean , Shirish M. Gadgeel , Daniel W. Bowles , Rizwan Haq , Rona Yaeger , Matthew H. Taylor , Arnab K. Maity , Stefanie Drescher , Colleen Oliver , Ann Marie Huelskamp , Gang Feng , Keren Sturtz

Organizations

Highlands Oncology Group, Springdale, AR, Sarah Cannon Research Institute, Tennessee Oncology, Nashville, TN, Henry Ford Cancer Institute, Henry Ford Health, Detroit, MI, University of Colorado, Aurora, CO, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, Memorial Sloan Kettering Cancer Center, New York, NY, Providence Cancer Institute, Portland, OR, Pfizer Inc., San Diego, CA, Pfizer Inc., Boulder, CO, Pfizer, Inc., Boulder, CO, Pfizer, Inc., Cambridge, MA

Research Funding

Pharmaceutical/Biotech Company
Pfizer

Background: Approved BRAF inhibitors (BRAFi) are inactive against RAF dimers. Accordingly, the acquisition of BRAF dimers (e.g., through drug-acquired splice variants or BRAF amplification) may lead to therapy resistance. Non-V600 (class II and III) BRAF alterations that occur de novo in diverse tumor types also signal as dimers and therefore have no approved targeted therapeutic options. Additional liabilities of approved BRAFi include toxicity from paradoxical activation of wild-type (WT) RAF and limited brain penetration, a common primary and metastatic site for BRAF-altered cancers. In contrast to approved agents, investigational BRAFi inhibit WT and mutant RAF proteins (A, B, and C-RAF, monomers, dimers), and therefore may be limited by on-target toxicity from “pan-RAF” inhibition. PF-07799933 is an oral selective ATP-competitive small-molecule RAF kinase inhibitor that suppresses BRAF signaling in BRAF V600-mutant and non-V600-BRAF mutant tumors. It displays significantly less paradoxical activation than approved BRAFi and is not “pan RAF” as it spares non-BRAF-containing RAF dimers. We describe here the Phase 1 study of PF-07799933 as monotherapy or in combination with binimetinib or cetuximab in participants with BRAF-altered advanced solid tumors. Methods: The purpose of this first-in-human study is to investigate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics, and potential clinical benefits of PF-07799933 administered as a single agent and in combination in participants with BRAF Class I, II and III mutated solid tumors with or without brain involvement. Part 1 (monotherapy dose escalation) and Part 2 (combination dose escalation) will enroll participants with BRAF V600 mutation who have progressed on a approved BRAFi or with de novo Class II or III alterations who have progressed on standard of care therapy. The primary objective of Part 1 is to determine monotherapy MTD/RDE of PF-07799933. Participants in Part 1 will be allowed to add on rational combination with either binimetinib or cetuximab at the time of disease progression. Once PK measurements indicate the potential for significant BRAF inhibition in the brain, participants with untreated and symptomatic brain metastases will be allowed to enroll. The primary objective of Part 2 is combination MTDc/RDEc of PF-07799933 with binimetinib or cetuximab. The primary objective of Part 3 is efficacy in defined cohorts (total ~120 participants): Cohort 1-2: BRAF V600 mutant melanoma; Cohort 3: BRAF Class II altered melanoma; Cohorts 4-5: BRAF V600 and Class II altered CRC; Cohort 6: other BRAF V600, Class II/III altered solid tumor not qualifying for Cohorts 1-5. Clinical trial information: NCT05355701.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology

Track

Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology

Sub Track

Small Molecules

Clinical Trial Registration Number

NCT05355701

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr TPS3164)

DOI

10.1200/JCO.2023.41.16_suppl.TPS3164

Abstract #

TPS3164

Poster Bd #

356b

Abstract Disclosures