A Phase 2 Study of Avelumab in Combination With ATR Inhibitor M1774 in Patients With ARID1A-mutated Recurrent Endometrial Cancer Who Have Received Prior Immunotherapy

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Investigational drug late phase More information Active drug More information Moderate burden on patient More information

Trial Details

Sponsor: Panagiotis Konstantinopoulos, MD, PhD (other)

Phase: 2

Start date: Nov. 14, 2024

Planned enrollment: 25

Trial ID: NCT06518564
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More trial details at ClinicalTrials.gov More info

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Investigational Drug AI Analysis

chevron Show for: Tuvusertib (M1774, VXc-400, VRT-1363004, MSC2584415A, VR-1363004, ATR inhibitor 1)

TrialFetch AI Analysis

Goal: Assess the efficacy and safety of combining avelumab with the ATR inhibitor M1774 in patients with ARID1A loss-of-function mutated recurrent endometrial cancer previously treated with PD-1/PD-L1 immunotherapy.

Patients: Adults (≥18 years) with recurrent endometrial cancer harboring ARID1A loss-of-function mutations confirmed by a CLIA-certified assay, measurable disease by RECIST 1.1, ECOG 0–2, adequate organ function, and prior exposure to PD-1/PD-L1 inhibitors in any setting. Unlimited prior lines allowed with at least one prior chemotherapy regimen. Key exclusions include uncontrolled CNS disease (meningeal carcinomatosis excluded), active autoimmune disease requiring immunosuppression, significant cardiovascular disease, severe GI conditions, strong CYP3A4/CYP1A2 inhibitor/inducer use, PPIs, and pregnancy/breastfeeding.

Design: Non-randomized, open-label, two-stage phase 2 study with an initial safety lead-in (dose de-escalation for M1774 based on DLTs). Planned enrollment of 25 participants; treatment up to 2 years with follow-up to 3–5 years depending on endpoint.

Treatments: Avelumab plus M1774. Avelumab is an anti–PD-L1 human IgG1 monoclonal antibody approved in other indications; here it is combined with M1774 to potentially enhance antitumor immunity and exploit DNA damage response vulnerabilities in ARID1A-mutant tumors. M1774 (tuvusertib) is an investigational, oral ATR kinase inhibitor that disrupts DNA damage response signaling and replication stress tolerance. In a first-in-human phase 1 monotherapy study in advanced solid tumors, M1774 showed molecular responses (including in ARID1A, ATRX, DAXX) and an unconfirmed partial response in platinum/PARP-resistant ovarian cancer; common grade ≥3 AEs included anemia, neutropenia, and lymphopenia. An intermittent dosing schedule (e.g., 180 mg once daily, 2 weeks on/1 week off) demonstrated improved tolerability relative to continuous dosing. In this trial, cycles are 42 days with M1774 on days 1–14 and 22–35 and avelumab on days 1, 15, and 29.

Outcomes: Primary: 6-month progression-free survival rate (PFS6) by RECIST 1.1, and objective response rate (CR+PR) by RECIST 1.1. Secondary: median PFS, median overall survival, immune-related ORR and immune-related PFS by irRECIST, and rate of grade 3–5 treatment-related adverse events per CTCAE v5.0.

Burden on patient: Moderate. Participants undergo screening, baseline assessments, and provision of archival tissue or slides; no mandatory fresh biopsy is specified. On-study requirements include clinic visits every 2 weeks during 42-day cycles for avelumab infusions and safety labs, oral M1774 dosing on an intermittent schedule, ECGs, and CT/MRI imaging every 12 weeks. The infusion schedule and safety monitoring increase visit frequency beyond typical standard-of-care for recurrent endometrial cancer, but the imaging cadence is standard. No intensive pharmacokinetic sampling is described, reducing additional burden; however, medication restrictions (e.g., CYP3A4/CYP1A2 modulators, PPIs, herbal products) and contraception requirements add logistical considerations.

Last updated: Oct 2025

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Sites (2)

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Brigham and Women's Hospital

Boston, Massachusetts, 02215, United States

[email protected] / 617-632-5269

Status: Recruiting

Dana-Farber Cancer Institute

Boston, Massachusetts, 02115, United States

[email protected] / 617-632-5269

Status: Recruiting

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