Anyone familiar with the clinical trial RMC-6236? Or how to enroll?

Sorry, 5127

I did RM 9805 (KRAS G12D Target) with RM 6236 (pan KRAS). I am stage IV-ie its roaming around in my bloodstream. Ultimately I did have some progression, but I really think when it is combined with the right chemo it’s going to be a winner. Hopefully a resolution to the side effects to the skin have been resolved.
It worked for me for about 6 months. Great time to get my bloodwork back to normal and be ready for whatever could be next. For me, it’s Naliri right now. Maybe SBRT again.
Travelling for a second opinion this week. Best of luck with the trial. If I can help on the skin issues, don’t hesitate to reach out.

I'm very glad to hear your effects from Naliri are minimal. Is it lowering your ca19-9. I'm doing very bad now. Naliri affected me horribly; particularly my breathing. I have to take a breathing treatment a day now just to be able to breathe, in addition to my inhaler which I typically use 2x per day, anyway. It gave me a horrible heart arrhythmia and the nausea was out of this world. I won't take it again. I went 1 month with no chemo and my cancer spread like crazy. Several lesions in my liver and a lesion that was 0.5 to now 0.7cm bext to lesion that was radiated last October. I'm very curious his this could happen. Was it that the margins radiated in October were too small? @stageivsurvivor please chime in on this. I too am wondering if histotripsy is now an option and I see exactly what your drs are saying. My cancer is very systemic now and very aggressive. It went from about 324 to almost 3000 in the 1 month I had no chemo. All the lesions in liver are new so I asked the place where u had planned to get histotripsy if was worthwhile now if there was any point now to get it and they said they had already gotten the appointment approved but I'm wondering are they really doing this for my benefit and my gut feeling is no. Originally, I had 1 suspected lesion in liver too small to be seen in scans, but activity visible in a PET scan. Do this disease has spread to the peritoneum now. Several nodules all across the abdomen. Pain intensity and frequency are increasing more and more everyday. I feel much more sick like this disease has finally got me now. I wonder 1 month ago had I been given the gemzar I requested at city of Hope would i be in this position? The dr didn't want to give it to me; I had refused the Naliri because I had read about it's potential to cause interstitial lung disease and wanted more info. My dr at Hope denied knowing anything about those potential side effects - I didn't believe him because he was a very learned dr. He wouldn't give me gemzar that day because it said it was no longer working. Not true in my opinion! It couldn't decimate cancer by itself, but it kept my numbers from climbing so fast. I told this to the PA but dr refused. I let drs know about the breathing g issues but I have heard anything back about an alternative plan to Naliri. This is a systemic disease and those with aggressive mutations need aggressive treatment which includes chemo. Your drs are probably right about histotripsy being nit the best option for you. In my humble opinion, it's a life extender for those that don't have lesions or nodules in any other place and only have 1 or 2 in liver. With all my garbage in the abdominal peritoneum now, I believe it would be a waste of time for me at this point. Best wishes to you dale. It sounds like you have a good team.

RMC-6236 is showing consistently promising results. There are a number of trials for this pan-KRAS inhibitor with a good safety profile and the progression-free survival encouraging. I too would prefer entering a phase II trial as the safety profile is already established and everyone in the trial receives the drug at the dosage established in the phase I trial. I’d only consider a phase III trial when there was no other option but a remaining standard of care.

I was in a phase II trial eleven years ago and here I am 13 years later after a diagnosis of stage IV and considered cured. I can say plenty about enrolling in a phase II trial.

@mnewland99
Marie I'm so sorry to hear of your problems! Can you look into getting on an RMC-6236 trial? It is systemic and all my doctors are recommending it. Do you know what kind of KRAS G12 mutation you have?

Is nalari part of the folforinox treatment where you wear the pump for.48 hours? Husband is on gem abraxine now next step nalari I think.

KRAS 12D, but I think it's the ATM (VUS) that's causing the aggressive behavior. I just live the input @stageivsurvivor gave about stage2 versus stage 3. I didn't even know you could get a stage 2 trial, if stage 3 is going on; doesnt make sense to me.

There are three stages of trails starting with stage I which is dose escalation of the investigational new drug (IND) to determine the “therapeutic” dose to administer and in expanded phase III trials which often times are randomized, double blinded. The same trial does not have all three of these phases at the same time. When phase I finished and meets the objective, it goes to phase II. When the objectives are met successfully, it the is expanded to stage III.

It is possible that an IND can be used in different trials where it may be tested alone as monotherapy, in combination with another IND, or combined with a standard of care. This is the case with RMC-6236 and why you will find it in various phases. You will not find it standing alone in three different phases. You will have to see what is available in how it is configured and in what phase, research it for the benefits and risks in that phase and make an informed decision.

Yes Naliri is similar to Folfirinox, but no Oxaliplatin, and the irinitocan is liposomal, supposed to stick to the cancer cells better than plain irinitocan. There is Naliri-Fox as well that does have the platinum based as well, but none of my doctors thought it was worth it on account of the neuropathy that I already have from Folfirinox. Yes I have to wear the pump for 46 hours.

RMC 9806 is targeted against KRAS G12D, I think someone on this forum has had experience with this?