ARQ 092 (Miransertib) in Proteus Syndrome

• Status: Not yet recruiting
• Trial end date: 2026-05-01
• Target enrollment: 0
• Participant gender: All

Summary

Background:

Proteus syndrome is a rare overgrowth disorder. Most people begin to have symptoms between 6 months and 2 years of age. There are very few living adults with this disease. There is also no known treatment for it. Researchers want to see if a new drug can slow down or stop overgrowth in people with Proteus syndrome.

Objective:

The learn if miransertib is a safe and effective treatment for Proteus syndrome.

Eligibility:

People ages 3 and older with Proteus syndrome

Design:

Participants will be screened with a medical checkup. They will answer questions about their medical history and current health. They will have a physical exam with vital signs. They will have an electrocardiogram to measure their heartbeat. They will give blood and urine samples. They will repeat the screening tests during the study.

Participants will take a miransertib pill once a day. They will bring their empty pill bottles with them to the NIH when they visit. If they can t swallow a pill, researchers will try to find other ways for them to take the drug.

Participants will have X-rays, ultrasounds, and imaging scans. Photos may be taken of their feet and other parts of the body that have or develop signs of Proteus syndrome.

Participants will have lung function tests to measure how much and how fast air moves out of their lungs.

Participants will complete surveys about their levels of pain, physical functioning, and quality of life.

Participants may have additional tests performed to assess their individual disease. They may have consultations with other specialists.

Participation lasts about 4 years. Participants will have 20 30 visits at the NIH.

...

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: National Human Genome Research Institute (NHGRI)

Criteria

• INCLUSION CRITERIA:

All participants in all Cohorts must meet the criteria below:

• Signed informed consent, and when applicable, signed assent

• Have a molecular diagnosis of Proteus syndrome with documented somatic AKT1 mutation from a CLIA-certified laboratory.

• Have progressive and measurable disease (e.g., a measurable manifestation of Proteus syndrome with evidence or report of worsening of manifestation(s)/ in the last 12 months)

• Adequate organ function as indicated by the following laboratory values:

Hematological:

• Hemoglobin (Hgb) depending on age:

• 2-5 years male and female: greater than or equal to 10.0 g/Dl

• 6-9 years male and female: greater than or equal to 11.5 g/dL

• 10-17 years female: greater than or equal to 11.0 g/dL

• 10-17 years male: greater than or equal to 11.5 g/dL

• >17 years male and female: greater than or equal to 10.0 g/dL

• Glycated hemoglobin (HbA1c): less than or equal to 8% (less than or equal to 64 mmol/mol)

• Absolute neutrophil count (ANC): greater than or equal to 1.5 x 10^9/L

• Platelet count greater than or equal to 150 x 10^9/L

Hepatic:

• Total bilirubin less than or equal to 1.5 x upper limit of normal (ULN)/L

• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than or equal to x ULN

Renal:

-Serum creatinine depending on age:

• 2-5 years male and female: less than or equal to 0.50 mg/dL

• 6-10 years male and female: less than or equal to 0.59 mg/dL

• 11-15 years male and female: less than or equal to 1.2 mg/dL

• >15 years male and female: less than or equal to 1.5 mg/dL

Metabolic (lipids):

• Cholesterol: less than or equal to 400 mg/dL (less than or equal to 10.34 mmol/L)

• Triglyceride: less than or equal to 500 mg/dL (less than or equal to 5.7 mmol/L)

• If a female is of child-bearing potential, documentation of a negative pregnancy test is required prior to enrollment. Sexually active participants (male and female) must agree to use double-barrier contraceptive measures, oral contraception, or avoidance of intercourse while on study and for up to 90 days after ending treatment

• Ability to complete the questionnaires by the participant and/or his/her caregiver

The following specific criteria will be used to assign participants to Cohorts:

Cohort 1 (Proteus syndrome with plantar CCTN) specific criteria:

• Have at least one plantar CCTN that can accurately be measured by standardized photography. The CCTN is defined as a nevus with at least two gyri and three sulci affecting 10% - 70% of the total surface area of the foot.

• Male or female participants age greater than or equal to 3 and less than or equal to 16 years old and BSA of greater than or equal to 0.33 m^2

Cohort 2 (Proteus syndrome without plantar CCTN) specific criteria:

• Does not meet the eligibility criteria for Cohorts 1 or 3

• Male or female participants age greater than or equal to 3 years old and BSA of greater than or equal to 0.33 m^2

Cohort 3 (Proteus syndrome previously treated with miransertib) specific criteria:

• Participants previously treated with miransertib or currently receiving miransertib under Compassionate Use/Expanded Access or an existing trial (i.e., 16-HG-0014)

• Male or female participants greater than or equal to 3 years old and BSA of greater than or equal to 0.33 m^2

Note: All participants must meet Cohort-related age criteria by/on the date of the first dose, Cycle 1 Day 1

EXCLUSION CRITERIA:

An individual who meets any of the following criteria will be excluded from participation in this study:

• History of Type 1 or Type 2 uncontrolled diabetes mellitus requiring regular medication (other than metformin or other oral hypoglycemic agents) or fasting glucose greater than or equal to 160 mg/dL ( if >12 years old) and greater than or equal to 180 mg/dL (if less than or equal to 12 years old) at the baseline/screening visit

• History of significant cardiac disorders:

• Myocardial infarction (MI) or congestive heart failure defined as Class II-IV per the New York Heart Association (NYHA) classification within six months of the first dose of miransertib (MI occurring >6 months of the first dose of miransertib will be permitted)

• Grade 2 (per National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] current version) or worse conduction defect (e.g., right or left bundle branch block).

• Major surgery, radiotherapy, or immunotherapy within four weeks of the first dose of miransertib

• Any experimental systemic therapy for the purpose of treating Proteus syndrome (e.g., sirolimus, everolimus, high dose steroids, alpelisib) within two weeks of the first dose of miransertib, except for participants who were previously or are currently treated with miransertib under a Compassionate Use/Expanded Access program or existing protocol

--Participants who were previously treated with or currently are receiving miransertib will be enrolled and treated according to the Schedule of Assessments/Study Visits defined in this protocol

• Intolerance of, or severe toxicity attributed to, AKT inhibitors (e.g., miransertib, uprosertib, afuresertib, ipatasertib)

• Concurrent severe uncontrolled illness not related to Proteus syndrome

• Ongoing or active infection

• Known human immunodeficiency virus (HIV) infection malabsorption syndrome

• Psychiatric illness/substance abuse/social situation that would limit compliance with study requirements

• Pregnant or breastfeeding (contraception requirements can be found above and in the informed consent form)

• Inability to comply with study evaluations or to follow drug administration guidelines

• Concomitant use of a prohibited medication

• Regular tobacco use and/or use of cannabidiol/tetrahydrocannabidiol (CBD/THC), and/or vaping products