Study of Bemcentinib Plus Pacritinib In Patients With Advanced Lung Adenocarcinoma

Specific Aim 1. Determine the safety, tolerability and maximum tolerated dose (MTD) of pacritinib in combination with bemcentinib in patients with advanced lung adenocarcinoma. We propose a prospective, open-label, phase Ib trial to evaluate safety, tolerability and MTD of pacritinib (JAK2 inhibitor) in combination with bemcentinib (AXL inhibitor) in patients with treatment refractory lung adenocarcinoma. The primary objectives of the phase Ib study are to determine the maximum tolerated dose (MTD), pharmacokinetics/pharmacodynamics (PK/PD), dose-limiting toxicities (DLTs) and efficacy of oral pacritinib in combination with bemcentinib. This phase Ib part of the study will use a Bayesian Optimal Interval (BOIN)70 design to determine MTD. This Bayesian dose-finding approach combines the ease of implementation of the traditional "3+3" design with the improved performance of more complex model-based designs in terms of accurately identifying the MTD. Compared to the modified probability toxicity interval design, it has a substantially lower risk of overdosing patients and generally has a higher probability of correctly selecting the MTD. In the phase Ib part of the study, subjects with advanced lung adenocarcinoma will be treated with pacritinib in combination with bemcentinib at increasing doses until MTD for combination treatment has been established. Six dose levels of combination treatments will be considered.