1. < Pancreatic Cancer

Anyone participate in RMC9805 and RMC6236 clinical trials?

Posted by gnest @gnest, Dec 29, 2024

My mom is fighting pancreatic cancer. She had 12 rounds of FOLFIRINOX, followed by 15 fractions of chemoradiation in a hope to have a Whipple surgery. Unfortunately the surgery was aborted due to discovering liver metastases.
After that she had 3 bi-weekly GemAbrax, bur it didn't work, so her oncologist switch to FOLFIRI with liposomal irinotecan. She had 7 cycles of FOLFIRI. Recently her CA19-9 skyrocketed and her oncologist suggested to enroll in the clinical trail RMC9805 / RMC6236 (targeted KRASG12D) .
If anyone participates in this trail, what is your experience (disease control, side effects, etc.)?
Also, has anyone done histotripsy for liver metastases? If yes, what was your experience?
Thank you

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mimimmx | @mimimmx | Feb 12 12:06am
In reply to @dodooya "Thank you for your sharing! I would like to ask whether 6236 should be taken all..." + (show)
@dodooya

Thank you for your sharing! I would like to ask whether 6236 should be taken all the time or will it rest for a period of time after 21 days?

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It is take daily in pill form. No rests.

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1 reply
gamaryanne | @gamaryanne | Feb 12 9:53am
In reply to @dodooya "Thank you for your sharing! I would like to ask whether 6236 should be taken all..." + (show)
@dodooya

Thank you for your sharing! I would like to ask whether 6236 should be taken all the time or will it rest for a period of time after 21 days?

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The medicine is taken every day. There is no "rest period". The lab is required to evaluate you each 21 days and with acceptable blood tests, etc will issue the next 21 day dose. Scans are about every 6 weeks.
There are many cohorts now for Revolution Medicine KRAS drugs. Monotherapy 6236 (the panKRAS drug) is in phase 3, available to pcan patients but also colon cancer and perhaps other types. The drugs have now been named as well. I have had small progression now, and my CA19-9 has risen from normal range to 145. Next scans will tell whether I am allowed to stay on the drugs or will need to look elsewhere and possibly resort to targetted radiation - which I have been avoiding.

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1 reply
mefiu1985 | @mefiu1985 | Feb 12 1:17pm

Carolina BioOncology in NC wrote to me that patients who have so far received a maximum of one line of treatment are eligible for RMC9805/6236 treatment. What is it like for you or for people you know who take these medications?

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1 reply
dodooya | @dodooya | Feb 13 9:54am
In reply to @mimimmx "It is take daily in pill form. No rests." + (show)
@mimimmx

It is take daily in pill form. No rests.

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Thank you very much!Wish you better and better🙏🏻❤️

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dodooya | @dodooya | Feb 13 10:07am
In reply to @gamaryanne "The medicine is taken every day. There is no "rest period". The lab is required to..." + (show)
@gamaryanne

The medicine is taken every day. There is no "rest period". The lab is required to evaluate you each 21 days and with acceptable blood tests, etc will issue the next 21 day dose. Scans are about every 6 weeks.
There are many cohorts now for Revolution Medicine KRAS drugs. Monotherapy 6236 (the panKRAS drug) is in phase 3, available to pcan patients but also colon cancer and perhaps other types. The drugs have now been named as well. I have had small progression now, and my CA19-9 has risen from normal range to 145. Next scans will tell whether I am allowed to stay on the drugs or will need to look elsewhere and possibly resort to targetted radiation - which I have been avoiding.

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Thank you very much for your detailed sharing. I'm sorry to hear about your ca199 rebound. May I take the liberty of asking you, how long you have been using RMC6236? I wish you all the best.❤️❤️

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dodooya | @dodooya | Feb 13 10:32am
In reply to @mefiu1985 "Carolina BioOncology in NC wrote to me that patients who have so far received a maximum..." + (show)
@mefiu1985

Carolina BioOncology in NC wrote to me that patients who have so far received a maximum of one line of treatment are eligible for RMC9805/6236 treatment. What is it like for you or for people you know who take these medications?

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There are only people around me who use 6236. As far as I know, the effect of 6236 is very nice, and the side effects are tolerable, but the pfs is limited.

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plum1 | @plum1 | 3 days ago

I am on 9805/6236 but at lower dose - 900/100. Only side effect is mouth sores on and off. Started in August and by October ca19-9 was down to 38 from 16000. However got sepsis and ca19-9 went up to 830. This is third episode of sepsis since whipple surgery and they’re trying to figure out source. Anyone else had this problem? Ca19-9 Came down a little last time and scan shows no progression. Doctor doesn’t seem worried about the ca19/9 level.

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wulijingjing | @wulijingjing | 3 days ago
In reply to @mimimmx "Yes. I am on the RMC trial combo for 6236/9805. I just completed my 4th cycle..." + (show)
@mimimmx

Yes. I am on the RMC trial combo for 6236/9805. I just completed my 4th cycle (every cycle is 3 weeks). I have had an excellent early response with the 1.6cm lesion in my liver and 1.5 cm lesion in my abdomen near my left adrenal gland are too small to measure as of yesterday’s CT scan. My doctor said this is an unusually good response. The side effects are challenging (facial rash that bleeds, scalp sores, mouth sores, diarrhea) but not nearly as difficult as the folfirinox side effects. Doctor has made clear it is not a cure but could extend my life by some time. Let me know if I can answer any other questions.

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@mimimmx Is RMC-6236 a gastric-soluble or enteric-soluble formulation?

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1 reply
lillious | @lillious | 2 days ago
In reply to @gamaryanne "I am also on the trial, cycle 10! My cohort is 1200mg RM 9805-KRAS G12D (the..." + (show)
@gamaryanne

I am also on the trial, cycle 10! My cohort is 1200mg RM 9805-KRAS G12D (the max dose) and as of this cycle, 200 mg RM 6236 (pan KRAS). Skin nuisances, mostly on my face but also randomly on fingers. Basically, it really dries your scalp so some little sores appeared there. The face is more irritating, because it creates tiny white blisters. Doxycline doesn't help me much, but I do try to use the gel twice/day. It dries everything up which creates more issues. So I use Vitamin C/E oil and some serums. Basically, a little nausea for about 30 min after taking it then life as normal. The side effects are FAR different than the chemos we all know.

I am in phase 1b which has select dosing requirements different than the other cohorts. RM6236 is getting tons of attention and it looks to be moving rapidly into phase 3. Some sites are administering it to first line patients with Gem/Abraxane.

Revolution Medicine will be of very little help, if at all. Call the sites listed as hosting their trials for details about which cohort they may be registering. Feel free to reach out to me, also, if I can answer any questions. I am in trial at Carolina BioOncology in NC.

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My husband has an appointment next week at Carolina BioOncology and if possible plans to participate in the trial with both arms. Having you share your experiences is so very helpful. I hope you have continued success! Thank you again for all the information!

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mimimmx | @mimimmx | 2 days ago
In reply to @wulijingjing "@mimimmx Is RMC-6236 a gastric-soluble or enteric-soluble formulation?" + (show)
@wulijingjing

@mimimmx Is RMC-6236 a gastric-soluble or enteric-soluble formulation?

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Apologies, but I don’t know the answer to your question.

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