Saracatinib in the Treatment of Idiopathic Pulmonary Fibrosis

Prior treatment

• Listed for lung transplantation
• Treatment with another investigational drug or other intervention within 8 weeks
• Major surgery within the past 2 months
• Previous lung transplantation
• Previous acute exacerbation of IPF requiring hospitalization and/or antibiotics within 90 days before the first dose of the investigational product
• Chronic oral corticosteroids at doses greater than prednisone 10 mg/day (or equivalent)
• Refer to 6.5 Concomitant Therapy for exclusions based on co-medications

Other illness

• Active infection at screening or randomization
• Known active or latent hepatitis B or C
• Life expectancy for disease other than IPF \< 2.5 years (Investigator assessment)
• Known allergic reactions to components of saracatinib
• Advanced hematologic, renal, hepatic, any lung disease determined by the investigator to be non-IPF related or metabolic disease that, in the opinion of the investigator, would make it unsafe for the person to receive study drug.
• History of malignancy in the past two years, other than squamous or basal cell skin cancer
• Known pulmonary hypertension (PH) requiring PH-specific treatment

Lab values

• Liver function test results ≥3× upper limit of normal (ULN) liver isoform of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), or alkaline phosphatase (ALP) or ≥2×ULN total bilirubin (excepting documentation of benign hereditary cause). An isolated total bilirubin elevation (ie, no significant concomitant elevation in ALT or AST) at baseline of ≤ 2xULN is permitted. If there is concomitant elevation in ALT or AST to ≤3xULN, then the threshold for total bilirubin is ≤1.5xULN.
• Creatinine clearance \<30 mL/min calculated by Cockcroft-Gault formula

Other

• Requirement for supplemental oxygen \> 4 L/min at rest to maintain saturation \> 90%
• Taking pirfenidone or nintedanib in the last 4 weeks
• Pregnancy or lactation
• Current smoker or tobacco use within 4 months
• Inability to attend scheduled study visits
• Inability to give informed consent
• Inability to perform pulmonary function testing

• IPF of any duration, confirmed or diagnosed by ILD center or expert according to Fleischner Guidelines (33). Subjects with a probable or indeterminant CT scan who otherwise meet the Fleischner criteria for IPF are eligible to be included in the study after a multidisciplinary evaluation. A positive Envisia genomic classifier score (34) on a lung biopsy specimen will be considered as strong evidence for a diagnosis of IPF. Subjects with a positive invisia genomic classifier score in conjunction with a probable or indeterminant CT scan are eligible to be included in the study after a multidisciplinary evaluation.
• Women or men \>40 years of age at the time of screening
• FVC%\>45% of predicted value (GLI-2012)
• Single breath DLCO% ≥ 30 - inclusive of predicted (without bronchodilator and uncorrected for hemoglobin GLI-2017)
• FEV1/FVC\>70 (GLI-2012)
• Provision of signed/dated written informed consent prior to any study-specific procedures
• Females must be of nonchildbearing potential (defined as surgically sterilized \[i.e., bilateral tubal ligation, bilateral oophorectomy or complete hysterectomy\] or postmenopausal \[defined as 12 months with no menses without an alternative medical cause\] with a follicle-stimulating hormone \[FSH\] \> 25.8 IU/L) or use a highly effective method of contraception (defined as combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation; progestogen only hormonal contraception associated with inhibition of ovulation; intrauterine device (IUD); intrauterine hormone-releasing system (IUS) for the duration of the study (from the time they sign consent) and for 3 months after the last dose of drug/matching placebo
• Male subjects must be surgically sterile or using an acceptable method of contraception (defined as barrier methods in conjunction with spermicides) for the duration of the study (from the time they sign consent) and for 3 months after the last dose of drug/matching placebo to prevent pregnancy in a partner. Male subjects must not donate or bank sperm for the duration of the study (from the time they sign consent) and for 3 months after the last dose of drug/matching placebo.