Unknown Cancer NIHR-supported project Lungs & Breathing

PRT3789-02 - A Phase 2, Safety and Efficacy Study of PRT3789 in Combination with Pembrolizumab in Patients with Advanced or Metastatic Solid Tumors with a SMARCA4 Mutation

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AI plain-English summary

A drug that targets a specific genetic mutation is being tested in combination with an existing immunotherapy to treat advanced oesophageal and lung cancers. Around 10% of non-small cell lung cancers and a subset of oesophageal cancers carry a mutation in the SMARCA4 gene, which helps regulate how DNA is packaged inside cells. When this gene stops working, tumours often become resistant to standard treatments, including PD-L1 inhibitors. This trial is testing whether adding PRT3789—a drug that blocks a protein called PRMT5, which these cancer cells rely on to survive—can restore or enhance the effectiveness of pembrolizumab, a widely used immunotherapy. If the combination proves safe and shows signs of shrinking tumours, it could offer a new treatment option for patients whose cancers have stopped responding to existing therapies. The study first tests the drug pairing in a small group of patients with any solid tumour, then expands to roughly 40 patients specifically with SMARCA4-mutant oesophageal or non-small cell lung cancer. Success would mean that a genetic test could identify which patients might benefit from this targeted approach, moving beyond one-size-fits-all chemotherapy.

View original technical description
This is an open-label, multi-center, Phase 2 study to determine the safety, tolerability, efficacy, pharmacokinetics, pharmacodynamics, and anti-tumor activity of PRT3789 in combination with pembrolizumab in patients with advanced, recurrent or metastatic solid tumors with a SMARCA4 mutation. This study has 2 parts: Part 1 is a safety run-in and will establish the dose of PRT3789 to be used in combination with pembrolizumab in Part 2, the main study. In Part 1, an initial 6 to 10 patients with any type of solid tumor and any type of SMARCA4 mutation, and have previously received standard of care therapy, including in most cases antiprogrammed cell death ligand 1 (PD-L1)therapy, will be enrolled to receive PRT3789 376 mg intravenously (IV) weekly in combination with pembrolizumab 200 mg IV every 3 weeks. Part 2, the main study will enroll up to approximately 40 patients with advanced, recurrent, or metastatic esophageal or non-small cell lung cancer (NSCLC) with a deleterious (loss of function) SMARCA4 mutation. Patients in Part 2 will receive the recommended PRT3789 dose from Part 1 to be used in combination with pembrolizumab 200 mg IV every 3 weeks.

Researchers

John Bridgewater (Principal Investigator)

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A Phase 2, Safety and Efficacy Study of PRT3789 in Combination with Pembrolizumab in Patients with Advanced or Metastatic Solid Tumors with a SMARCA4 Mutation
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