KEAPSAKE: A Study of Telaglenastat (CB-839) With Standard-of-Care Chemoimmunotherapy in 1L KEAP1/NRF2-Mutated Nonsquamous NSCLC

  • STATUS
    Recruiting
  • days left to enroll
    40
  • participants needed
    120
  • sponsor
    Calithera Biosciences, Inc
Updated on 19 February 2024
folic acid
measurable disease
metastasis
carboplatin
pembrolizumab
pemetrexed
stage iv non-small cell lung cancer
systemic therapy
adjuvant therapy
ros1
liquid biopsy
proto-oncogene tyrosine-protein kinase ros
adjuvant
BRAF
EGFR
NTRK
vitamin b12 level

Summary

This is a Phase 2, randomized, multicenter, double-blind study of the glutaminase inhibitor telaglenastat with standard-of-care pembrolizumab and chemotherapy versus placebo with standard-of-care pembrolizumab and chemotherapy for first line treatment of metastatic disease in patients with KEAP1/NRF2-mutated, stage IV, nonsquamous, non-small cell lung cancer (NSCLC). The study primary endpoints are PFS per RECIST v. 1.1 and safety. KEAP1/NRF2 mutation status (for eligibility) and STK11/LKB1 status (for stratification) will be determined by next generation sequencing. A commercial liquid biopsy (circulating tumor DNA) NGS test will be provided to study participants free of charge.

Details
Condition Non-Small Cell Lung Cancer, Non-Small Cell Lung Cancer, Non-squamous Non-small-cell Lung Cancer, Non-Squamous Non-Small Cell Neoplasm of Lung, KEAP1 Gene Mutation, NRF2 Gene Mutation, NFE2L2 Gene Mutation
Age 18-100 years
Treatment Placebo, Telaglenastat, Carboplatin Chemotherapy, Pemetrexed Chemotherapy, Pembrolizumab Immunotherapy, Folic acid 400 -1000 μg, Vitamin B12 1000 μg, Dexamethasone 4 mg
Clinical Study IdentifierNCT04265534
SponsorCalithera Biosciences, Inc
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

b'Histologically or cytologically documented nonsquamous NSCLC'
b'Stage IV (M1a-c, AJCC 8th Edition) disease not previously treated with systemic'
b'therapy for metastatic NSCLC'
b'a. Patients who received adjuvant or neoadjuvant therapy (with or without'
b'immunotherapy) for localized NSCLC are eligible if all adjuvant/neoadjuvant therapy'
b'(including immunotherapy) was completed at least 6 months prior to the development of'
b'metastatic disease.'
b'No known actionable mutation in EGFR, ALK, ROS1, BRAF, NTRK or other known actionable'
b'mutation for which there is approved therapy.'
b'Measurable disease per RECIST 1.1.'
b'Life expectancy of at least 3 months.'
b'Mutation in KEAP1 or NRF2 documented by NGS from a CAP-accredited and/or'
b'CLIA-certified laboratory and STK11/LKB1 mutation status is known for the purpose of'
b'tratification.'
b'Adequate hepatic, renal, cardiac and hematologic function.'
b'Willingness to use adequate contraception as defined in the study protocol'

Exclusion Criteria

b'Squamous cell histology and mixed histology tumors with any small-cell component'
b'(other mixed histology and large cell neuroendocrine histology is allowed).'
b'Known history of malignancy within the past three years except for adequately treated'
b'basal cell or squamous cell skin cancer, carcinoma in situ of the cervix or other'
b'neoplasm that, in the opinion of the principal investigator and with the agreement of'
b'the medical monitor, will not interfere with study-specific endpoints.'
b'Had radiation therapy to the lung > 30 Gy within 6 months prior to randomization.'
b'Has active autoimmune disease that has required systemic treatment in past 2 years.'
b'Is currently receiving chronic systemic steroids and/or immunosuppressive drugs.'
b'Is unable to interrupt aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs),'
b'other than an aspirin dose \\u22641.3 g per day, for a 5-day period (8-day period for'
b'long-acting agents, such as piroxicam).'
b'Unable to swallow oral medications.'
b'Previously had a severe hypersensitivity reaction to treatment with another monoclonal'
b'antibody (mAb).'
b'Known positivity for Hepatitis B or C.'
b'Is unable or unwilling to take folic acid or vitamin B12 supplementation.'
b'Interstitial lung disease or a history of pneumonitis that required oral or'
b'intravenous glucocorticoid treatment.'
b'Unable or unwilling to discontinue proton pump inhibitors (PPI) at least 5 days before'
b'randomization.'
b'Major surgery within 3 weeks of randomization.'
b'Symptomatic ascites or pleural effusion.'
b'Any condition that may preclude adequate absorption of oral study drug.'
b'Patients with active and/or untreated central nervous system metastasis including'
b'carcinomatous meningitis (leptomeningeal disease) are not eligible. Patients with'
b'previously treated brain metastases are eligible if they meet the following criteria:'
b'Received definitive treatment with stereotactic radiosurgery (SRS) or surgery to'
b'all known central nervous system (CNS) lesions (whole brain radiotherapy is not'
b'an eligible modality)'
b'Are at least 7 days post SRS and 4 weeks post-surgical resection of CNS disease,'
b'ymptomatically stable and off steroids before randomization'
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