Clinical Trials Search at Vanderbilt-Ingram Cancer Center

Inclusion Criteria:

Diagnosis of advanced or recurrent, histologically or cytologically confirmed, measurable by RECIST 1.1 metastatic or unresectable solid tumor

Patient must have progressed on, be intolerant of, decline, or be ineligible for, all available standard of care therapies

Part 2: locally advanced or metastatic NSCLC with KEAP1, NFE2L2 and/or STK11 mutation ; Patients must have received at least a platinum doublet chemotherapy and an anti-PD-(L)1 antibody; Received up to 3 lines of systemic anticancer therapy in the recurrent or metastatic setting

Part 3 and 4 - DRP-104 + atezolizumab Prior exposure to any checkpoint inhibitor (anti-PD-1, anti-PD-L1, anti-PDL2, and/or anti-CTLA-4 antibody)

ECOG performance 0 or 1

Patient must consent to allow acquisition of existing FFPE tumor tissue; If unavailable, patient must consent to new pre-treatment tumor biopsy

All SCCHN patient, all NSCLC patients and all patients treated with combination of DRP-104 and atezolizumab will be required to undergo pre-treatment and post-treatment core or excisional biopsies.

Pre-treatment and post-treatment core or excisional biopsies are optional for all remaining patients

Adequate baseline organ function as defined by: Absolute neutrophil count 1.5 109/L (1500/L); Hemoglobin 9 g/dL (patients that require transfusion or growth factors need to demonstrate stable hemoglobin of 9 g/dL over at least a 7-day period after the last transfusion/growth factor injection prior to screening labs to meet eligibility) ; Platelets 75 109/L (75,000/L); Hepatic Total bilirubin 1.5 upper limit of normal (ULN): PT/INR and PTT 1.5 ULN, unless treated with warfarin; AST(SGOT)/ALT(SGPT) 3 ULN or 5 ULN for patients with liver metastases; Creatinine clearance 60 ml/min/1.73m2 measured or calculated

Cardiac QTc (Fridericia)
Women of child-bearing potential and men who are sexually active must agree to use one highly effective method of contraception



Exclusion Criteria:

Patients with primary central nervous system tumors and hepatocellular carcinoma

Patients with progressive or symptomatic brain metastases or leptomeningeal disease

Patients who have not recovered to grade 1 or baseline from adverse events (CTCAE v 5.0) related to prior therapy excluding alopecia, peripheral neuropathy and ototoxicity, which are excluded if grade 3.

Lymphopenia grade 3 is allowed if not related to prior anticancer therapy. If related to prior anticancer therapy, lymphopenia must resolve to grade 1 or baseline.

Spinal cord compression not definitively treated with surgery and/or radiation

Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage

Prior glutaminase inhibitor use

Prior systemic anticancer treatment (i.e., chemotherapy, biologic therapy, monoclonal antibodies, investigational agents) within 21 days or 5 half-lives, whichever is shorter

Anti-androgen therapies for prostate cancer, such as bicalutamide, within 4 weeks prior to enrollment

Patients must have recovered from all AEs due to previous therapies to CTCAE v 5.0 grade 1 or baseline, excluding, alopecia, peripheral neuropathy and ototoxicity, which must be at least grade 2 or baseline

Prior small port palliative radiotherapy within 14 days of start of Cycle 1

Any major surgery within 21 days from start of Cycle 1

Secondary malignancy that is progressing or has required active treatment within the past 3 years, except basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy

Has a known history of HIV or HBV

Gastrointestinal (GI) function impairment or GI disease

Significant, uncontrolled heart disease and/or cardiac repolarization abnormality

Exclusion specific to only Part 3 and 4 (DRP-104 combined with atezolizumab):

History of severe allergic, anaphylactic to chimeric or humanized antibodies or fusion proteins

Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells

Prior anti-PD-1, anti-PD-L1 and/or anti CTLA4- agent, patient must not have had a serious (> Grade 3) immune-related AE requiring treatment

History of autoimmune disease except hypothyroidism on thyroid replacement hormone therapy, idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis

Patients with underlying condition requiring systemic corticosteroids (>10 mg daily prednisone equivalents) or other immunosuppressive medications or other systemic immunosuppressant medications may be enrolled in the study after approval by the Medical Monitor

History of organ transplantation and/or hematopoietic stem cell transplantation

Evidence or history of active or latent tuberculosis infection

Administration of a live, attenuated vaccine within 4 weeks before Cycle 1 Day 1