Tests NST-628 tablets in adults with advanced solid tumors carrying MAPK pathway changes

Trial details

Who runs it

Nested Therapeutics, Inc

Trial code

NCT06326411

Record updated

20 April 2026

Original description

This is a two-part Phase 1, open label, multi-center, single arm, non-randomized, multiple dose, safety, pharmacokinetic (PK) and preliminary efficacy study of single agent NST-628 in adult patients with MAPK pathway mutated/dependent advanced solid tumors who have exhausted standard treatment options.Read full original descriptionShow less

A Phase I, Open Label Single-arm Two-part Study to Investigate Safety, Pharmacokinetics, and Preliminary Efficacy of Pan-RAF/MEK Glue NST-628 Oral Tablets in Subject With Solid Tumors Harboring Genetic Alterations in the MAPK Pathway and With Other Solid Tumors

This is a two-part Phase 1, open label, multi-center, single arm, non-randomized, multiple dose, safety, pharmacokinetic (PK) and preliminary efficacy study of single agent NST-628 in adult patients with MAPK pathway mutated/dependent advanced solid tumors who have exhausted standard treatment options.

Inclusion: Subjects are eligible to be included in the study only if all of the following criteria apply:; Subjects must be ≥18 years old (or of legal age of consent in the country in which the study is taking place) at the time of signing the informed consent; Subjects who have a histologically or cytologically documented metastatic or locally advanced solid tumor, for which standard of care (SoC) therapy does not exist, no longer provides benefit, or is not tolerated by the subject, or the subject has been assessed by the Investigator as not being suitable for SoC therapy; Part A: Subjects with any solid tumor with genetic alteration of or evidence of tumor dependence upon the RAS/MAPK pathway (subject to additional restrictions specified in the study protocol); Part B: Subjects must be diagnosed with one of the following solid tumors harboring specified genetic alterations based on a validated local test:; Melanoma Cohorts:; Activating NRAS mutations; Select BRAF alterations; Non-Melanoma Cohorts:; Solid tumors with NRAS activating mutations; Solid tumors with KRAS activating mutations; Solid tumors with select BRAF alterations; Glioma with BRAF alterations; Newly obtained or archived tumor tissue is required; Part B: measurable disease as defined by RECIST Version 1.1 or by other disease assessment tool standard for a given tumor type (if RECIST v. 1.1 is not standard); Performance status; Solid tumors other than glioma: ECOG 0 or 1; Glioma: Karnofsky ≥ 70 and ECOG 0 or 1; Have adequate organ function; Understand and voluntarily sign an Institutional Review Board/Independent Ethics Committee-approved informed consent form prior to any study-specific evaluation; Life expectancy ≥ 12 weeks.

Exclusion: Part B: prior treatment with any MEK or BRAF inhibitor; Presence of any serious or unstable concomitant systemic disorder incompatible with the clinical study; Conditions interfering with oral intake of NST-628; Conditions interfering with intestinal absorption of an orally administered drug; Current or history within 6 months of planned Cycle 1 Day 1 of pneumonitis or interstitial lung disease (ILD); Chemotherapy, radiation, gene therapy, vaccine therapy, or anti-cancer antibodies / ADCs within 28 days of Cycle 1 Day 1; Subjects are excluded from the study if any of the following criteria apply:; A history or current evidence of significant retinal pathology leading to increased risk of RVO; A history or evidence of cardiovascular risk; Untreated or symptomatic central nervous system (CNS) metastases; Targeted small molecule agents within 14 days or 5 half-lives of Cycle 1 Day 1; Females who are pregnant or breastfeeding; For fertile patients (female able to become pregnant or male able to father a child), refusal to use effective contraception during the period of the trial and for 6 months after the last dose of NST-628.

ClinicalTrials.gov NCT06326411