Primary Outcome Measures:
- Assess biomarker responses to VS-6063 in tumor tissue [ Time Frame: From Baseline to 12 days (+/- 2 days) post-treatment ] [ Designated as safety issue: No ]
- To determine biomarker responses to the Focal Adhesion Kinase (FAK) inhibitor, VS-6063 (defactinib), in Malignant Pleural Mesothelioma (MPM).
Secondary Outcome Measures:
- Evaluate the safety of VS-6063 (defactinib) [ Time Frame: Start of treatment through 30 days after the end of treatment, expected average of 6 weeks ] [ Designated as safety issue: Yes ]
- Adverse events will be graded by the CTCAE (Common Terminology Criteria for Adverse Events) 4.0 and summarized according to the worst grade observed since the first treatment dose.
- Evaluate the pharmacokinetics of VS-6063 (defactinib) [ Time Frame: Day 11 and Day 12 (+/-2) days post-treatment ] [ Designated as safety issue: No ]
- PK (pharmacokinetic) parameters will include but not limited to peak and trough concentrations and AUC (area under curve), clearance, and elimination half-life will be characterized by average and variation summaries in the population.
- To evaluate the tumor response to VS-6063 (defactinib) [ Time Frame: Baseline and 12 (+/-2) days post-treatment ] [ Designated as safety issue: No ]
- Tumor response will be assessed by Recist 1.1 modified for mesothelioma. The response rate will be reported with 95% exact confidence intervals based on the exact binomial distribution.
Eligibility Criteria
- Inclusion Criteria:
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- Histologically confirmed malignant pleural mesothelioma that is not metastatic or unresectable
- Eligible to undergo excisional surgery such as extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/DC) or any other mesothelioma surgery.
- Localized disease. The malignancy is confined to one affected hemithorax. Mediastinal N2 lymph nodes via cervical mediastinoscopy or EBUS (endobronchial ultrasound) must be negative in order to be eligible
- Grossly normal pulmonary, cardiac function, renal, hepatic hematologic and performance functions
- Male or non-pregnant female
- Age ≥ 18 years of age
- Tissue is required prior to enrollment. If patient was diagnosed outside and tumor tissue is not available, a pleural biopsy for frozen tissue collection is required.
- Exclusion Criteria:
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- Participants who have had chemotherapy or radiotherapy any time prior to entering the study or at any prior time for mesothelioma. Patients receiving chemotherapy type drugs for benign conditions can participate in this trial
- History of upper gastrointestinal bleeding, ulceration, or perforation within 12 months prior to the first dose of study drug
- Known history of Gilbert’s Syndrome or any current hyperbilirubinemia of any cause
- Known history of stroke or cerebrovascular accident within 6 months prior to the first dose of study drug
- Subjects with known infection with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS)
- Subjects with confirmed Hepatitis A, B or C
- Subjects being actively treated for a secondary malignancy or any malignancy within the last 5 years, with the exception of non-melanomatous skin cancer or localized, definitively treated cervical cancer
- Uncontrolled or severe cardiovascular disease, including myocardial infarct or unstable angina within 6 months prior to study treatment, New York Heart Association (NYHA) Class II or greater congestive heart failure, serious arrhythmias requiring medication for treatment, clinically significant pericardial disease, or cardiac amyloidosis
- Known history of malignant hypertension
- Uncontrolled intercurrent illness including symptomatic congestive heart failure, cardiac arrhythmia, or psychiatric illness/social situations which in the opinion of the study investigators would be associated with undue risk of participation in the study