RecruitingPhase 1NCT07114601

A Study of LY4257496 in Participants With Cancer (OMNIRAY)

A Phase 1a/b Multicenter, Open-Label Trial to Evaluate Safety, Tolerability, and Dosimetry of LY4257496, a GRPR-Targeted Radioligand Therapy, in Adults With GRPR-Positive Advanced Solid Tumors (OMNIRAY)


Sponsor

Eli Lilly and Company

Enrollment

421 participants

Start Date

Aug 6, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The main purpose of this study is to evaluate safety, tolerability, and efficacy of LY4257496 alone and as part of relevant standard of care (SOC) combination therapy in participants with Gastrin-releasing Peptide Receptor (GRPR)-positive advanced breast, colorectal, prostate, and endometrial cancer. The study will also evaluate the safety, tolerability, and efficacy of LY4257529 to identify cancer with high levels of a protein called GRPR. This is a 2-part study. Participation could last up to 36 weeks or until your tumor progresses.


Eligibility

Min Age: 18 Years

Inclusion Criteria17

  • Must have histologically or cytologically proven diagnosis of locally advanced, unresectable, or metastatic cancer.
  • Must be assessed by computed tomography (CT)/magnetic resonance imaging (MRI) to confirm at least 1 of the following:
  • At least 1 measurable target lesion per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
  • If only bone lesions are present without a soft-tissue component, a bone scan or MRI must confirm at least 2 detectable lesions considered to represent active metastases
  • Must have GRPR-positive disease, defined by investigator assessment of GRPR imaging.
  • Must have the following histologically or cytologically confirmed diagnosis:
  • Estrogen receptor (ER+)/human epidermal growth factor receptor 2 (HER2-) breast cancer
  • ER+/HER2+ breast cancer
  • Colorectal carcinoma
  • Metastatic castration-resistant prostate cancer
  • Endometrial carcinoma. Carcinosarcoma is eligible. Uterine leiomyosarcoma, adenosarcoma, or endometrial stromal sarcoma is not eligible.
  • Other GRPR-positive solid tumor
  • For participants with breast cancer diagnosis, where possible, ER and HER2 status should be assessed from the most recent tissue biopsy taken at the time of presentation with recurrent or metastatic disease.
  • To fulfill the requirement for ER+ disease by local testing, a tumor must express the ER immunohistochemistry, as defined in the relevant American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines.
  • HER2 status should be determined by local testing, as defined in the relevant ASCO/CAP Guidelines.
  • Must have an Eastern Cooperative Oncology Group (ECOG) performance status of less than or equal to 1.
  • Must be able to comply with outpatient treatment, laboratory monitoring, imaging, and required clinic visits for the duration of trial participation.

Exclusion Criteria21

  • Phase 1a (Cohort A1 and A2) only: Previously received radiopharmaceutical or radioligand therapy. For participants with metastatic castration-resistant prostate cancer (mCRPC), prior ¹⁷⁷Lu-prostate-specific membrane antigen (PSMA)-617 is permitted.
  • Has a history of ongoing acute pancreatitis within 1 year of screening.
  • Previously received any prior hemi-body or whole-body radiotherapy, or prior external beam radiation therapy (EBRT) to greater than 25% of the bone marrow.
  • A bone superscan, defined as a bone scan that demonstrates markedly increased skeletal radioisotope uptake relative to soft tissues in association with absent or faint genitourinary tract activity.
  • Has evidence of ongoing and untreated urinary tract obstruction or unmanageable urinary incontinence.
  • Have known active hepatitis B virus (HBV) defined as positive for hepatitis B surface antigen (HBsAg) or Polymerase Chain Reaction (PCR) positive for HBV deoxyribonucleic acid (DNA) . Exception: Individuals with chronic HBV if they:
  • Have positive HBsAg
  • Are on suppressive antiviral therapy, as allowed per local regulations prior to C1D1
  • Remain on the same antiviral treatment throughout study, and should follow local standards for continuation of therapy after completion of trial therapy.
  • Have undetectable HBV DNA ≤14 days of C1D1.
  • Have known active hepatitis C virus (HCV) defined as positive for anti-HCV antibodies. Exception: Individuals previously treated for HCV if they:
  • Completed curative antiviral therapy.
  • Have an HCV viral load below the limit of quantification ≤14 days of C1D1 and.
  • Are positive for anti-HCV antibodies and negative for HCV ribonucleic acid (RNA) before randomization.
  • Have untreated human immunodeficiency virus (HIV) infection. Exception: Individuals who have well-controlled HIV infection/disease and they:
  • Are on a stable and permitted antiretroviral therapy (ART) regimen without changes in drug or dose, for at least 4 weeks prior to C1D1
  • Have a viral load of \<400 copies/mL ≤14 days of C1D1.
  • Have a CD4+ T-cell count ≥350 cells/mL ≤14 days of C1D1.
  • Have not had an opportunistic infection within the past 12 months.
  • Has an active second malignancy unless in remission with life expectancy greater than 2 years.
  • Has known hypersensitivity to any component or excipient of LY4257496.

Interventions

DRUGLY4257496

Administered IV

DRUGStandard of Care Anticancer Therapies

Fulvestrant, Imlunestrant, Aromatase Inhibitors, Capecitabine, Abemaciclib

DIAGNOSTIC_TESTLY4257529

Administered IV at select sites


Locations(25)

City of Hope

Duarte, California, United States

University of California, Los Angeles (UCLA)

Los Angeles, California, United States

Stanford University Medical Center

Stanford, California, United States

Biogenix Molecular, LLC

Miami, Florida, United States

Moffitt

Tampa, Florida, United States

Emory University School of Medicine - Winship Cancer Institute

Atlanta, Georgia, United States

Massachusetts General Hospital

Boston, Massachusetts, United States

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Barbara Ann Karmanos Cancer Institute

Detroit, Michigan, United States

BAMF Health Inc.

Grand Rapids, Michigan, United States

Washington University

St Louis, Missouri, United States

David H. Koch Center for Cancer Care at Memorial Sloan Kettering Cancer Center

New York, New York, United States

Texas Oncology - DFW (Sammons CC)

Dallas, Texas, United States

MD Anderson Cancer Center

Houston, Texas, United States

Juravinski Cancer Centre

Hamilton, Canada

Lady Davis Institute for Medical Research Jewish General Hospital

Montreal, Canada

Sunnybrook Health Sciences Centre

Toronto, Canada

Princess Margaret Hospital

Toronto, Canada

Institut Curie

Paris, France

Institut de Cancerologie de l'Ouest - site St-Herblain

Saint-Herblain, France

Universitaetsklinikum Erlangen

Erlangen, Germany

Universitaetsklinikum Essen

Essen, Germany

LMU Klinikum Muenchen-Campus Grosshadern

München, Germany

Klinikum der Technischen Universitaet Muenchen (TUM Klinikum)

München, Germany

Hospital Universitari Quiron Dexeus Barcelona

Barcelona, Spain

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