On April 11, 2024 Boundless Bio (Nasdaq: BOLD), a clinical-stage oncology company interrogating extrachromosomal DNA (ecDNA) biology to deliver transformative therapies to patients with previously intractable oncogene amplified cancers, reported that the first patient has been dosed with BBI-825 in a first-in-human, Phase 1/2 clinical trial for patients with locally advanced or metastatic cancer with resistance gene amplifications (NCT06299761) (Press release, Boundless Bio, APR 11, 2024, View Source [SID1234642023]). ecDNA are a key driver of high copy number amplification in cancer, and Boundless has validated multiple drug targets that are essential for ecDNA function in cancer cells. BBI-825, the Company’s second ecDNA-directed therapy (ecDTx) to enter clinical trials, is a novel, selective, oral small molecule inhibitor of ribonucleotide reductase (RNR), a rate-limiting enzyme responsible for the de novo synthesis of deoxyribonucleotides, the building blocks of DNA. Boundless has identified an essential role for RNR in ecDNA assembly and repair and in the survival of certain oncogene amplified cancer cells.
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"We are excited to announce dosing of the first patient in our first-in-human study of BBI-825, our second program to enter the clinic," said Klaus Wagner, M.D., Ph.D., Chief Medical Officer at Boundless Bio. "BBI-825 represents a new approach in the potential treatment of oncogene amplifications, particularly in resistance associated with targeted therapy treatment of MAPK pathway-activated cancers."
"Rapid resistance is a major limitation for targeted therapies, particularly in colorectal cancer, as patients with colorectal cancer often progress within about 6 months of initiating targeted treatment," said Rona Yaeger, M.D., Gastrointestinal Oncologist and Early Drug Development Specialist at Memorial Sloan Kettering Cancer Center. "We have observed firsthand that tumors in patients treated with KRASG12C or BRAFV600E targeted therapies develop resistance via MAPK pathway and receptor tyrosine kinase gene amplifications, and those with pre-existing amplifications have an overall worse outcome. There remains an incredible need for therapies that can prevent amplification-driven resistance or treat patients that have already acquired such resistance."
"Advancing our second ecDTx into clinical development is an important milestone for Boundless Bio and underscores the power of our Spyglass platform to identify synthetic lethal targets essential to ecDNA formation and function in oncogene amplified cancers," said Zachary Hornby, President and Chief Executive Officer at Boundless Bio. "We are excited to enroll patients in this first-in-human Phase 1/2 study, focused initially on patients with KRASG12C and BRAFV600E mutated colorectal cancer with resistance gene amplifications. If data are supportive, we may have the opportunity to expand into broader patient populations, including pan-tumor, pan-RAS, and pan-RAF indications, potentially addressing these populations of cancer patients with very high unmet need."
About the STARMAP Trial
STARMAP ("Study Treating Acquired Resistance: MAPK Amplifications") is an open-label, non-randomized, three-part Phase 1/2 clinical trial to evaluate the safety, pharmacokinetics, pharmacodynamic biomarkers, preliminary antitumor activity, and identify the maximum tolerated dose and recommended Phase 2 dose (RP2D) of BBI 825 administered as a single agent or in combination with select targeted therapies (NCT06299761). Part 1 is a dose escalation of BBI-825 as a monotherapy in patients with solid tumors. Part 2 is a combination dose escalation of BBI-825 and targeted therapies, encorafenib and cetuximab, or adagrasib and cetuximab, in patients with advanced or metastatic colorectal cancer with BRAFV600E or KRASG12C mutations, respectively, and co-occurring resistance gene amplifications. Part 3 is a combination dose expansion to evaluate preliminary anti-tumor activity at the RP2D of BBI-825 and each targeted therapy combination from Part 2.