SpringWorks Therapeutics initiates phase 3 trial of Nirogacestat in desmoid tumors

SpringWorks Therapeutics, a clinical-stage biopharmaceutical company focused on developing life-changing medicines for patients with severe rare diseases and cancer, today announced that the first patient has been dosed in the Phase 3 “DeFi” (Desmoid/Fibromatosis) trial evaluating nirogacestat, an oral, selective, small molecule gamma-secretase inhibitor, in adult patients with progressing desmoid tumors.

Desmoid tumors are rare and often debilitating and disfiguring soft-tissue tumors that can aggressively invade surrounding healthy tissues, including joints, muscles, blood vessels, nerves and internal organs. Depending on their size and location, desmoid tumors can cause significant morbidities, including severe pain, disfigurement, internal bleeding, debilitating loss of range of motion, and, in rare cases, desmoid tumors can be fatal.

It is estimated that 1,000 to 1,500 new cases of desmoid tumors are diagnosed each year in the United States. There are currently no therapies approved by the U.S. Food and Drug Administration (FDA) for the treatment of desmoid tumors.

“For patients living with these debilitating tumors, the DeFi trial marks a meaningful step forward in what we hope will result in the first approved treatment for this underserved patient community,” said Saqib Islam, Chief Executive Officer of SpringWorks Therapeutics.

“I am grateful for the persistence of our partners, colleagues and the patient advocacy community, whose collective efforts made it possible for SpringWorks to advance nirogacestat into our Phase 3 DeFi trial. We look forward to enrolling patients to confirm the clinical benefits of nirogacestat for people with desmoid tumors.”

In June 2018, the FDA granted Orphan Drug designation for nirogacestat for the treatment of desmoid tumors, and in November 2018, the FDA granted Fast Track designation for nirogacestat for the treatment of adult patients with progressive, unresectable, recurrent or refractory desmoid tumors or deep fibromatosis.

The DeFi trial is a global, randomized, double-blind, placebo-controlled Phase 3 trial to evaluate the efficacy, safety and tolerability of nirogacestat in adult patients with progressing desmoid tumors.

The study will enroll approximately 100 adult patients, who will receive 150 mg of nirogacestat or placebo twice daily. Key eligibility criteria include tumor progression by ≥20% as measured by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) within 12 months prior to the first dose of study treatment.

The primary endpoint is progression-free survival (PFS), defined as the time from randomization until the date of assessment of progression or death by any cause using RECIST 1.1. Secondary endpoints include safety and tolerability measures, as well as overall response rate, tumor volume changes as assessed by MRI, and changes in baseline in patient-reported outcomes.

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