Phase 2 Study of AUY922 in NSCLC Patients With Exon 20 Insertion Mutations in EGFR

This research study is a Phase II clinical trial, which tests the safety and effectiveness of an investigational drug to learn whether the drug works in treating a specific cancer. "Investigational" means that the drug is being studied. It also means that the FDA has not yet approved the drug for your type of cancer or for any use outside of research studies. It has been found that some people with NSCLC have a change (mutation) in a certain gene called the EGFR gene. This mutated gene helps cancer cells grow. The majority of NSCLC patients with EGFR mutations achieve good outcomes with erlotinib or other EGFR inhibitor therapies, with a high response rate, prolonged progression-free survival and possibly improved overall survival from therapy. However, the 4% of EGFR mutant patients that harbor an exon 20 insertion mutation historically have reaped little benefit from EGFR-directed therapy due to the low affinity of this mutation for direct EGFR inhibitors, especially erlotinib and gefitinib (see Yasuda et al, Lancet Oncol 2011). This group of patients is ideal for studying other targeted therapeutic strategies that could affect the oncogene mutation in EGFR via alternative mechanisms. AUY922 is an investigational drug that may stop cancer cells from growing abnormally. This drug has been used in other research studies. Information from those other research studies suggests that AUY922 may be effective in killing cancer cells in patients with exon 20 insertion mutations in EGFR. The purpose of this study is to test the safety of AUY922 and determine how well AUY922 works for participants with advanced NSCLC and exon 20 insertion mutations in EGFR.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Histologically or cytologically confirmed stage IV or recurrent NSCLC
* Measurable disease by RECIST 1.0
* Must have received at least one prior line of therapy for advanced lung cancer (no maximum number)
* Life expectancy of at least 12 weeks

Exclusion Criteria:

* Pregnant or breastfeeding
* Radiation within 2 weeks
* Cytotoxic chemotherapy or monoclonal antibodies within 4 weeks
* EGFR tyrosine kinase inhibitor within 2 weeks
* Other small molecule inhibitor within 2 weeks
* Experimental treatment within 30 days
* Prior treatment with any HSP90 or HDAC inhibitor compound
* Known and untreated brain metastases
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to AUY922
* Unresolved diarrhea greater than or equal to CTCAE version 4, grade 1
* Major surgery within 2 weeks of starting study drug or have not recovered from side effects of surgery
* Known disorders due to a deficiency in bilirubin glucuronidation
* Requiring use of therapeutic doses of warfarin (Coumadin)
* History of long QT syndrome
* History of clinically manifest ischemic heart disease, heart failure or left ventricular dysfunction
* Clinically significant ECG abnormalities
* Other clinically significant heart disease
* Currently receiving treatment with any medication which has a relative risk of prolonging the QTc interval or inducing Torsades de Pointes
* On a cardiac pacemaker
* Concurrent malignancies or invasive cancers diagnosed within 3 years except for adequately treated basal cell cancer of the skin or in situ cancer of the cervix
* Known to be HIV positive

• DERIVEDPiotrowska Z, Costa DB, Oxnard GR, Huberman M, Gainor JF, Lennes IT, Muzikansky A, Shaw AT, Azzoli CG, Heist RS, Sequist LV. Activity of the Hsp90 inhibitor luminespib among non-small-cell lung cancers harboring EGFR exon 20 insertions. Ann Oncol. 2018 Oct 1;29(10):2092-2097. doi: 10.1093/annonc/mdy336. PMID 30351341