Cancerify Logo
Log inSign up
Back to clinical trials
RecruitingInterventionalPhase 2

A Phase 2 Master Protocol to Assess the Efficacy and Safety of FORE8394, an Inhibitor of BRAF Class 1 and Class 2 Alterations, in Participants With Cancer Harboring BRAF Alterations

NCT ID: NCT05503797Sponsor: Fore BiotherapeuticsLast updated: 2026-06-05

Summary

The objective of this Master Protocol is to evaluate the efficacy and safety of plixorafenib in participants with locally advanced or metastatic solid tumors, or recurrent or progressive primary central nervous system (CNS) tumors harboring BRAF fusions, or in participants with rare BRAF V600-mutated solid tumors, melanoma, thyroid, or recurrent primary CNS tumors.

Arms & interventions

  • DrugPlixorafenib

    Oral tablets

Outcome measures

Primary

  • Objective Response Rate (ORR) (Subprotocols A, B and C)

    ORR will be determined by standard tumor response criteria by blinded independent central review (BICR).

    Time frame: Up to approximately 4 years

  • Pharmacokinetics (Subprotocol D)

    Systemic exposure of plixorafenib measured by Cmax and AUC

    Time frame: Up to approximately 4 years

Secondary

  • Duration of Response (DOR) by BICR (Subprotocols A, B and C)

    Time frame: Up to approximately 4 years

  • ORR per Investigator Assessment

    Time frame: Up to approximately 4 years

  • DOR per Investigator Assessment

    Time frame: Up to approximately 4 years

  • Percentage of Participants with DOR at 6 months, 12 months, and 18 months

    Time frame: 6 months, 12 months and 18 months

  • Time to Response by BICR (Subprotocols A, B and C)

    Time frame: Up to approximately 4 years

  • Progression Free Survival (PFS) by BICR (Subprotocols A, B and C)

    Time frame: Up to approximately 4 years

  • PFS per Investigator's Assessment

    Time frame: Up to approximately 4 years

  • Overall Survival

    Time frame: Up to approximately 4 years

  • Percentage of Participants with PFS at 6 months, 12 months and 24 months

    Time frame: 6 months, 12 months and 24 months

  • Disease Control Rate (DCR)

    Time frame: Up to approximately 4 years

  • Number of Participants who Experience Treatment-emergent Adverse Events (TEAEs)

    Time frame: Up to approximately 4 years

  • Plasma Concentrations of Plixorafenib

    Time frame: Up to approximately 4 years

  • Plasma Concentrations of Plixorafenib Metabolites

    Time frame: Up to approximately 4 years

Eligibility criteria

Sex: AllAge: 10 Years and olderHealthy volunteers: No
Inclusion Criteria Subprotocol A: 1. Male and female, ≥10 years of age, and weighing ≥30 kg. 2. Histologic diagnosis of a solid tumor or primary CNS tumor. 3. Documentation of BRAF gene fusion in tumor and/or blood detected by an analytically validated test by DNA sequencing or RNA (transcriptome) sequencing. 4. Have an archival tissue sample available meeting protocol requirements. 5. Consent to provide scan(s) prior to baseline to assess change in tumor trajectory. 6. Received all available standard therapy, is intolerant to available therapies, or the investigator has determined that treatment with standard therapy is not appropriate. 7. All adverse events related to prior therapies (chemotherapy; radiotherapy; surgery) must have resolved to Grade 1 or baseline. Subprotocol B: 1. Male and female, ≥10 years of age, and weighing ≥30 kg. 2. Histological diagnosis of a primary CNS tumor, including but not limited to the following: 1. Adults (≥18 years) with Grade 1-4 glioma or glioneuronal tumor (including glioblastoma, anaplastic astrocytoma, high grade astrocytoma with piloid features, pilocytic astrocytoma, gliosarcoma, anaplastic pleomorphic xanthoastrocytoma, anaplastic oligodendroglioma, anaplastic oligoastrocytoma, not otherwise specified \[NOS\], ganglioglioma, or recurrent LGG). OR 2. Pediatric patients (10-17 years of age) with a Grade 3 or 4 glioma or glioneuronal tumor, including those with a prior, histologically confirmed, diagnosis of a low-grade glioma or glioneuronal tumor and now have radiographic or histopathological findings consistent with WHO \[2021\] Grade 3 or 4 primary CNS tumor. 3. Participants must have unresectable, locally advanced or metastatic disease that: i. Had prior treatment with radiotherapy and/or first-line chemotherapy or concurrent chemoradiation therapy OR * Note: Participants who have a WHO Grade 3 or 4 glioma for whom chemotherapy and/or radiotherapy is not considered standard of care may remain eligible for the study. ii. Is intolerant to available therapies OR iii. The investigator has determined that treatment with standard therapy is not appropriate. 3. Documented BRAF V600E mutation in tumor and/or liquid biopsy detected by an analytically validated test at CLIA or CLIA-equivalent laboratory approved by sponsor or sponsor-designated central test. 4. An archival tissue sample available meeting protocol requirements, or fresh biopsy is required if the archival sample is not available for retrospective confirmation test. 5. Consent to provide scan(s) prior to baseline to assess change in tumor trajectory. 6. Measurable disease based upon specified response criteria, as determined by the radiographic BICR. 7. All adverse events related to prior therapies (eg, chemotherapy, radiotherapy, surgery) must have resolved to Grade 1 or baseline. 8. Participants who are receiving corticosteroid treatment must be on a stable or decreasing dose of ≤8 mg/day of dexamethasone or equivalent corticosteroid treatment for 7 days prior to first dose of study treatments. Subprotocol C: 1. Male and female, ≥10 years of age, and weighing ≥30 kg. 2. Histologic diagnosis of a rare BRAF V600E-mutated solid tumor that is unresectable, locally advanced or metastatic. 3. Measurable disease on CT, MRI, or physical exam 4. Documented BRAF V600E mutation in tumor and/or liquid biopsy detected by an analytically validated test. 5. Have an archival tissue sample available meeting protocol requirements. 6. Consent to provide scan(s) prior to baseline to assess change in tumor trajectory 7. Received all available standard therapy, is intolerant to available therapies, or the investigator has determined that treatment with standard therapy is not appropriate. Subprotocol D: 1. Male and female, 18 - 65 years of age. 2. Histologic diagnosis of a solid tumor harboring a BRAF V600E mutation and not eligible for other subprotocols. 3. Measurable disease on CT, MRI, or physical exam. 4. Evidence of BRAF V600E mutation in tumor and/or blood detected by genomic tests. 5. Consent to provide a tumor biopsy. 6. Willingness to comply with the ECG substudy procedures. 7. All adverse events related to prior therapies (chemotherapy; radiotherapy; surgery) must have resolved to Grade 1 or baseline. Exclusion Criteria: Subprotocol A: 1. Prior treatment with RAF/BRAF inhibitors active for Class 2 BRAF alterations for advanced unresectable or metastatic disease. 2. Prior treatment with a MEK inhibitor. 3. Tyrosine kinase inhibitor(s) and/or targeted therapies are allowed (other than BRAF/MAPK pathway inhibitors per Exclusion Criteria 3 and 4) and will be restricted to no more than the number of lines of therapy that are consistent with standard treatment guidelines. 4. Malignancy with co-occurring activating RAS mutation(s) at any time. 5. Uncontrolled intercurrent illness that would limit compliance with study requirements. 6. HIV infection with exceptions; discuss with treating physician. 7. Have impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral plixorafenib or cobicistat (such as ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, and small bowel resection). 8. Grade ≥2 changes in AST, ALT, GGT, or bilirubin attributed to prior immune checkpoint inhibitor treatment are exclusionary, even if resolved. Subprotocol B: 1. Prior treatment with BRAF, ERK, and/or MEK inhibitor(s). 2. Known or suspected neurofibromatosis-1 (NF-1) and/or RAS related gene alterations. 3. Uncontrolled intercurrent illness that would limit compliance with study requirements. 4. Active infection requiring systemic therapy. 5. HIV infection with exceptions; discuss with treating physician. 6. Have impairment of GI function or GI disease that may significantly alter the absorption of oral plixorafenib (such as ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, small bowel resection). 7. Grade ≥ 2 changes in AST, ALT, gamma-glutamyl transaminase (GGT), or bilirubin attributed to prior immune checkpoint inhibitor treatment are exclusionary, even if resolved. Subprotocol C: 1. Diagnosis of colorectal adenocarcinoma or pancreatic ductal adenocarcinoma (neuroendocrine or acinar tumors are eligible). 2. Diagnosis of BRAF V600E-mutated cutaneous melanoma, papillary thyroid cancer, or NSCLC. 3. Participant has CNS metastases. 4. Prior treatment with BRAF, ERK, and/or MEK inhibitor(s), unless otherwise specified for specific tumor types (i.e. low grade serous or borderline ovarian cancer). 5. Known or suspected neurofibromatosis-1 (NF-1) and/or RAS related gene alterations. 6. Participants with prostate, breast, or gynecologic cancers with known activating mutations that lead to constitutive hormone receptor activation (AR-V7, ESR1). 7. Uncontrolled intercurrent illness that would limit compliance with study requirements. 8. Active infection requiring systemic therapy. 9. HIV infection with exceptions; discuss with treating physician. Subprotocol D: 1. Known or suspected neurofibromatosis-1 (NF-1) and/or RAS related gene alterations or other co-occurring driver mutations. 2. Participant has a non-CNS solid tumor with CNS metastases. 3. Uncontrolled intercurrent illness that would limit compliance with study requirements. 4. Active infection requiring systemic therapy. 5. HIV infection with exceptions; discuss with treating physician. 6. Use or anticipate the need for medications with known risk for QT-prolonging potential and Torsades de Pointes. 7. History of acute or chronic cardiovascular disease or surgery, hypertension, with systolic blood pressure \>160mm HG, history of QTc abnormalities, or clinical significantly ECG abnormalities.

Study locations (30)

Precision NextGen Oncology & Research Center

Beverly Hills, California, 90210

Recruiting

UCSF Helen Diller Family Comprehensive Cancer Center

San Francisco, California, 94143

Recruiting

University of California Los Angeles Rheumatology

Westwood, Los Angeles, California, 90095-6984

Recruiting

Norwalk Hospital

Norwalk, Connecticut, 06856

Recruiting

University of Miami Hospital and Clinics

Miami, Florida, 33136

Recruiting

The John Hopkins Hospital

Baltimore, Maryland, 21287

Recruiting

Maryland Oncology Hematology- Columbia

Rockville, Maryland, 20850

Recruiting

Tufts Medical Center

Boston, Massachusetts, 02111

Recruiting

Massachusetts General Hospital

Boston, Massachusetts, 02214

Recruiting

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215

Not Yet Recruiting

St. Luke's Hospital

Duluth, Minnesota, 55805

Recruiting

Mosaic Life Care at Saint Joseph - Medical Center

Saint Joseph, Missouri, 64506

Recruiting

Nebraska Cancer Specialists - Midwest Cancer Center - Legacy

Omaha, Nebraska, 68130

Recruiting

Overlook Medical Center

Summit, New Jersey, 07901

Recruiting

Columbia University Irving Medical Center

New York, New York, 10032

Recruiting

Memorial Sloan Kettering Cancer Center

New York, New York, 10065

Recruiting

Atrium Health Wake Forest Baptist - Comprehensive Cancer Center

Winston-Salem, North Carolina, 27157

Recruiting

Nationwide Children's Hospital

Columbus, Ohio, 43205

Recruiting

The Ohio State University Comprehensive Cancer Center (OSUCCC) - The James Cancer Hospital and Solove Research Institute

Columbus, Ohio, 43221

Recruiting

Taylor Cancer Research Center

Maumee, Ohio, 43537

Recruiting

Toledo Clinic Cancer Center

Toledo, Ohio, 43623

Completed

Thomas Jefferson University

Philadelphia, Pennsylvania, 19107

Recruiting

Lifespan Cancer Institute - Rhode Island Hospital

Providence, Rhode Island, 02903

Recruiting

SCRI - TriStar Medical Group Children's Specialists

Nashville, Tennessee, 37203

Recruiting

SCRI Oncology Partners

Nashville, Tennessee, 37203

Recruiting

Baylor Scott & White Research Institute

Dallas, Texas, 75246

Recruiting

University of Texas MD Anderson Cancer Center

Houston, Texas, 77030

Recruiting

Baylor Scott & White Medical Center

Temple, Texas, 43205

Recruiting

University of Washington School of Medicine

Seattle, Washington, 98109

Recruiting

West Virginia University Health Sciences Campus

Morgantown, West Virginia, 26506

Recruiting