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RecruitingInterventionalPhase 1/Phase 2

First-in-Human Study of STX-478, a Mutant-Selective PI3Kα Inhibitor as Monotherapy and in Combination With Other Antineoplastic Agents in Participants With Advanced Solid Tumors

NCT ID: NCT05768139Sponsor: Eli Lilly and CompanyLast updated: 2026-06-04

Summary

Study STX-478-101 (LY4064809) is a multipart, open-label, phase 1/2 study evaluating the safety, tolerability, pharmacokinetics (PK), and preliminary antitumor activity of STX-478 (LY4064809) in participants with advanced solid tumors with P13Ka mutations. Part 1 will evaluate STX-478 as monotherapy in participants with advanced solid tumors. Part 2 will evaluate STX-478 therapy as combination therapy with fulvestrant in participants with hormone receptor positive (HR+) breast cancer. Part 3 will evaluate STX-478 as combination therapy with endocrine therapy (aromatase inhibitors, fulvestrant, tamoxifen, or imlunestrant) and a CDK4/6 Inhibitor (either Ribociclib, Palbociclib or Abemaciclib) in participants with HR+ breast cancer. Each study part will include a 28-day screening period, followed by treatment with STX-478 monotherapy or combination therapy.

Arms & interventions

  • DrugSTX-478

    STX-478 is a mutant-selective PI3Kα inhibitor

  • DrugFulvestrant

    Fulvestrant

  • DrugRibociclib

    Ribociclib

  • DrugPalbociclib

    Palbociclib

  • DrugLetrozole

    Letrozole

  • DrugAnastrozole

    Anastrozole

  • DrugExemestane

    Exemestane

  • DrugTamoxifen

    Tamoxifen

  • DrugAbemaciclib

    Abemaciclib

  • DrugImlunestrant

    Imlunestrant

  • DrugMetformin

    Metformin

Outcome measures

Primary

  • Number of participants who experience at least 1 Dose Limiting Toxicity (DLT)

    Time frame: First 28 days of treatment

  • Proportion of participants who experience at least 1 DLT during the first 28 days of treatment

    Time frame: First 28 days of treatment

  • Objective response rate (ORR) defined as the percentage of participants with partial response or complete response based on RECIST 1.1

    Time frame: 12 months

  • Incidence of TEAEs/SAEs ≥ grade 2

    Time frame: 12 months

  • Frequency of TEAEs according to CTCAE v5.0 criteria

    Time frame: 12 months

Secondary

  • Cmax of STX-478

    Time frame: 12 months

  • AUC(0-inf) of STX-478

    Time frame: 12 months

  • AUC(0-t) of STX-478

    Time frame: 12 months

  • AUC(0-τ) of STX-478

    Time frame: 12 months

  • Change from baseline in ctDNA levels

    Time frame: 12 months

  • Changes in circulating markers of glucose metabolism as assessed by changes in circulating glycosylated hemoglobin (HbA1c)

    Time frame: 12 months

  • Changes in circulating markers of glucose metabolism as assessed by circulating fasting plasma glucose

    Time frame: 12 months

  • Changes in circulating markers of glucose metabolism as assessed by circulating C-peptide

    Time frame: 12 months

  • Change in ECOG performance status

    Time frame: 12 months

  • Disease Control Rate (DCR) per RECIST v1.1, measured as percentage of participants with Complete Response

    Time frame: 12 months

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Key Inclusion Criteria: * Has an advanced or refractory solid tumor malignancy that is metastatic or locally advanced and unresectable (as specified by Cohort) * Has a new or recent tumor biopsy (collected at screening, if feasible) or will provide an adequate tissue sample prior to screening * Has a tumor that harbors a documented PI3Kα mutation (cohort specific criterion for cohort-specific mutation types) * Is ≥18 years of age at the time of signing the ICF * Has an ECOG performance status score of 0 or 1 at screening * Has adequate organ function as defined per protocol Key Exclusion Criteria: * Has history (within ≤2 years before screening) of a solid tumor or hematological malignancy that is histologically distinct from the cancers being studied * Has symptomatic brain or spinal metastases * Has an established diagnosis of uncontrolled diabetes mellitus (defined as HbA1c ≥8% and/or FBG ≥140 mg/dL \[7.7 mmol/L\] and/or requiring or required insulin). * Has had prior treatment with PI3K/AKT/mTOR inhibitor(s), except in certain circumstances * Has had treatment with any local or systemic antineoplastic therapy or investigational anticancer agent within 14 days or 4 half-lives, whichever is longer, prior to the initiation of study treatment up to a maximum washout period of 28 days. Endocrine therapy does not require a washout period if the patient is enrolling in a cohort with the same combination endocrine therapy. * Has toxicities from previous anticancer therapies that have not resolved to baseline levels or CTCAE grade ≤1, with the exception of alopecia and peripheral neuropathy. * Has had radiotherapy within 14 days before the initiation of study treatment

Study locations (28)

Ellison Clinic at Saint John's

Los Angeles, California, 90064

Recruiting
Reva Basho · Principal Investigator

UCSF Medical Center at Mission Bay

San Francisco, California, 94143

Recruiting
Varun Monga · Principal Investigator

University of Colorado Cancer Center

Aurora, Colorado, 80045

Recruiting
Anthony Elias · Principal Investigator

Yale-New Haven Hospital

New Haven, Connecticut, 06510

Completed

Florida Cancer Specialists ORLANDO/DDU

Lake Mary, Florida, 32746

Completed

Moffitt Cancer Center

Tampa, Florida, 33612

Recruiting
Aixa Soyano · Principal Investigator

Winship Cancer Institute, Emory University

Atlanta, Georgia, 30322

Recruiting
Manali Bhave · Principal Investigator

University of Iowa

Iowa City, Iowa, 52242

Recruiting
Mark Burkard · Principal Investigator

Louisiana State University Health Sciences Center

New Orleans, Louisiana, 70112

Recruiting
Shou-Ching Tang · Principal Investigator

Massachusetts General Hospital

Boston, Massachusetts, 02115

Recruiting
Dejan Juric · Principal Investigator

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215

Recruiting
Antonio Giordano · Principal Investigator

Barbara Ann Karmanos Cancer Institute

Detroit, Michigan, 48201

Terminated

START Midwest

Grand Rapids, Michigan, 49546

Recruiting
Manish Sharma · Principal Investigator

Saint Luke's Cancer Institute

Kansas City, Missouri, 64111-3220

Recruiting
Timothy Pluard · Principal Investigator

Washington University

St Louis, Missouri, 63110

Recruiting
Cynthia Ma · Principal Investigator

Memorial Sloan Kettering Cancer Center

New York, New York, 10065

Recruiting
Komal Jhaveri · Principal Investigator

UH Cleveland Medical Center

Cleveland, Ohio, 44106

Recruiting
Alberto Montero · Principal Investigator

Stefanie Spielman Comprehensive Breast Center

Columbus, Ohio, 43212

Recruiting
Robert Wesolowski · Principal Investigator

Providence Cancer Institute Franz Clinic

Portland, Oregon, 97213

Recruiting
David Page · Principal Investigator

The West Clinic, PLLC dba West Cancer Center

Germantown, Tennessee, 38138

Recruiting
Gregory Vidal · Principal Investigator

Sarah Cannon Research Institute

Nashville, Tennessee, 37203

Recruiting
SMO Sarah Cannon Research Inst. · Principal Investigator

Mary Crowley Cancer Research Center

Dallas, Texas, 75230

Completed

Texas Oncology-Baylor Charles A. Sammons Cancer Center

Dallas, Texas, 75246-2092

Recruiting
Joyce O'Shaughnessy · Principal Investigator

University of Texas Southwestern

Dallas, Texas, 75390

Not Yet Recruiting
Nisha Unni · Principal Investigator

University of Texas MD Anderson Cancer Center

Houston, Texas, 77030

Recruiting
Jordi Rodon Ahnert · Principal Investigator

START San Antonio

San Antonio, Texas, 78229

Recruiting
Amita Patnaik · Principal Investigator

START Mountain Region

West Valley City, Utah, 84119

Recruiting
William McKean · Principal Investigator

USO-Virginia Cancer Specialists, PC

Fairfax, Virginia, 22031

Recruiting
Alexander Spira · Principal Investigator