Study of Lunresertib Alone or in Combination With RP-3500 or Debio 0123 in Patients With Advanced Solid Tumors

Official title

Phase 1/1b Study of the Safety, Pharmacokinetics, Pharmacodynamics and Preliminary Clinical Activity of Lunresertib Alone or in Combination With RP-3500 or Debio 0123 in Patients With Advanced Solid Tumors

Overview

The primary purpose of this study is to assess the safety and tolerability of lunresertib alone and in combination with RP-3500 or in combination with Debio 0123 in patients with eligible advanced solid tumors, determine the maximum tolerated dose (MTD) and assess preliminary anti-tumor activity.

Detailed description

Phase 1/1b, multi-center, open-label, dose-escalation study to:

* Evaluate the safety profile and MTD of lunresertib alone and in combination with RP-3500 or in combination with Debio 0123 when administered orally to establish the recommended Phase 2 dose and schedule * Characterize the PK and pharmacodynamics of lunresertib alone and in combination with RP-3500 or in combination with Debio 0123 * Assess preliminary anti-tumor activity associated with lunresertib alone and in combination with RP-3500 or in combination with Debio 0123

This study was previously posted by Repare Therapeutics. In September 2025, sponsorship of the trial was transferred to Debiopharm International S.A

Expanded Access Status: There is no expanded access program available for the investigational products in this study at this time.

Interventions

• Drug Lunresertib
  Oral PKMYT1 Inhibitor
• Drug RP-3500
  Oral ATR Inhibitor
• Drug Debio0123
  Oral WEE1 Inhibitor

Primary outcome measures

• Safety and Tolerability of lunresertib either in monotherapy or in combination with RP-3500 or with Debio 0123 in patients with eligible advanced solid tumors [Time frame: Up to 90 days after last administration of study intervention]
• To define the MTD of lunresertib monotherapy, and determine a recommended Phase 2 dose (RP2D) and preferred schedule [Time frame: Up to 90 days after last administration of study intervention]
• To define the MTD of lunresertib in combination with RP-3500 or in combination with Debio 0123, and determine a recommended Phase 2 dose (RP2D) and preferred schedule [Time frame: Up to 90 days after last administration of study intervention]
• The relative bioavailability of lunresertib capsule formulation as compared to lunresertib tablet formulation in the fasted state [Time frame: Time 0 (time of dosing) to 72 hours post-dose for each treatment condition]
• The effect of food on the PK of tablet formulation of lunresertib when administered in fed conditions compared to administration under fasted conditions [Time frame: Time 0 (time of dosing) to 72 hours post-dose for each treatment condition]
• To assess the safety and tolerability of lunresertib tablets in combination with RP-3500, confirm the MTD of lunresertib tablets in combination with RP-3500, and determine a RP2D and preferred schedule [Time frame: Up to 90 days after last administration of study intervention]

Secondary outcome measures (6)

• The plasma concentrations of lunresertib monotherapy (capsule formulation) in the fasted and fed states [Time frame: Up to 90 days after last administration of study intervention]
• To assess the relationship between pharmacodynamic biomarkers and PK of lunresertib at different dose levels and/or schedules [Time frame: Up to 90 days after last administration of study intervention]
• The plasma concentrations of lunresertib and RP-3500 when dosed in combination [Time frame: Up to 90 days after last administration of study intervention]
• To assess preliminary anti-tumor activity achieved with lunresertib monotherapy, lunresertib in combination with RP-3500 or lunresertib in combination with Debio 0123 [Time frame: Through Study Completion, an average of 1 year]
• To assess the safety and anti-tumor effects of lunresertib capsule + RP-3500 [Time frame: Through Study Completion, an average of 1 year]
• To further characterize the PK of lunresertib tablets and assess preliminary anti-tumor [Time frame: Through Study Completion, an average of 1 year]

Eligibility criteria

Inclusion criteria

• Male or female and ≥12 years-of-age at the time of informed consent.
• Lansky performance status ≥50% for patients ≤16 years of age, or ECOG score of 0, 1, (or 2 for module 1) for patients >16 years of age.
• Locally advanced or metastatic resistant or refractory solid tumors.
• Patients <18 years of age must weigh at least 40 kg.
• Submission of available tumor tissue at screening or willingness to have a biopsy performed if safe and feasible
• Next generation sequencing (NGS) report obtained in a CLIA-certified or equivalent laboratory demonstrating eligible tumor biomarker.
• CCNE1 amplification (non-equivocal) as determined by either a tumor or plasma NGS test, or FISH
• FBXW7 deleterious mutations identified by either a tumor or plasma NGS test
• PPP2R1A deleterious mutations identified by either a tumor or plasma NGS test
• Measurable disease as per RECIST v1.1. For certain modules, patients with prostate cancer or ovarian cancer that have non-measurable disease but have elevated tumor markers (PSA or CA-125, respectively) can also be eligible
• Ability to swallow and retain oral medications.
• Acceptable hematologic and organ function at screening.
• Negative pregnancy test (serum) for women of childbearing potential (WOCBP) at Screening.
• Resolution of all toxicities of prior therapy or surgical procedures.
• Any prior radiation must have been completed at least 7 days prior to the start of study drugs, and patients must have recovered from any acute adverse effects prior to the start of study treatment.

Exclusion criteria

• Chemotherapy or small molecule antineoplastic agent given within 21 days or <5 half-lives, whichever is shorter, prior to first dose of study drug.
• History or current condition, therapy, or laboratory abnormality that might confound the study results or interfere with the patient's participation for the full duration of the study treatment.
• Patients who are pregnant or breastfeeding.
• Life-threatening illness, medical condition, active uncontrolled infection, or organ system dysfunction or other reasons which, in the investigator's opinion, could compromise the participating patient's safety.
• Major surgery within 4 weeks prior to first dose of lunresertib.
• Uncontrolled, symptomatic brain metastases.
• Uncontrolled hypertension.
• Certain prior anti-cancer therapy
• Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol and/or follow-up procedures outlined in the protocol.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

United States · 17 centers

• # 1019, UCLA, Westwood Cancer Center — Los Angeles
• #1025, University of California San Francisco — San Francisco
• #1012, Yale — New Haven
• #1017, Mayo Clinic — Jacksonville
• #1002, Dana Farber Cancer Institute — Boston
• #1023, START Midwest — Grand Rapids
• #1016, Mayo Clinic — Rochester
• #1011, Washington University — St Louis
• … and 9 more centers

Canada · 3 centers

• #2002, The Hospital for Sick Children — Toronto
• #2001, Princess Margaret Cancer Centre — Toronto
• #2003, The Research Institute of the McGill University Health Centre — Montreal

Denmark · 1 center

• #4001, Rigshospitalet - Blegdamsvej — Copenhagen

United Kingdom · 1 center

• #3003, Sarah Cannon Research Institute — London

Identifiers

NCT: NCT04855656 · Debio 0123-106 · RP-6306-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗