A Phase 1 interventional study of Plixorafenib and Cobicistat in Healthy Participants, sponsored by Fore Biotherapeutics. Completed at 1 site in United States. Open to participants aged 18 Years to 55 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-03-27.
Sponsored by Fore Biotherapeutics · Phase 1, Interventional, and Basic science
The primary goal of this phase 1 study is to evaluate the effect of food and cobicistat on the pharmacokinetics of plixorafenib in healthy participants. Healthy male and female participants between the ages of 18 and 55 will be enrolled into this study. This study is looking to examine the following in two parts:
Part A
Part B
Part A is an open-label, randomized, single dose, 3-treatment, 3-period, crossover design. On Day 1 of each period (Days 1, 8, and 15 of the confinement), participants will receive a single oral dose of plixorafenib administered either with or without cobicistat, under fasting conditions or following a standardized high-fat/high-calorie meal. PK blood and urine samples will be collected at pre-dose and at several post-dose time points. There will be a washout period between doses. Participants will be confined for total of 19 days.
Part B is an open-label, randomized, single dose, 4-treatment, 3-period, crossover design. On Day 1 of each period (Days 1, 8, and 15 of the confinement), participants will receive a single oral dose of plixorafenib administered without cobicistat, under fasting conditions, following a standardized high-fat/high-calorie meal without cobicistat, or following a low-fat meal with or without cobicistat. PK blood and urine samples will be collected at pre-dose and at several post-dose time points. There will be a washout period between doses. participants will be confined for total of 19 days.
Healthy male or non-pregnant, non-lactating female participants aged 18 to 55 years, inclusive, with a BMI of 18 kg/m2 or greater, but less than 30 kg/m2. The participant is considered by the investigator to be in good general health status as determined by physical examination, vital signs, temperature, medical history, no clinically significant abnormalities at investigator's discretion in laboratory and urine analyses, and with normal organ function as defined below:
Healthy female participants must be:
Documented to be surgically sterile (surgical methods inclusive of hysterectomy, bilateral salpingectomy, and/or bilateral oophorectomy) or postmenopausal (amenorrhea for ≥24 months without an alternative medical cause and FSH ≥30 mIU/mL).
OR
Exclusion Criteria:
Treatment 1: 900 mg plixorafenib (6 × 150 mg tablets) administered after overnight fast (fasted state).
Drug: Plixorafenib
Treatment 2: 900 mg plixorafenib (6 × 150 mg tablets) + cobicistat (1 × 150 mg tablet) administered after overnight fast (fasted state).
Drug: Plixorafenib · Drug: Cobicistat
Treatment 3: 900 mg plixorafenib (6 × 150 mg tablets) + cobicistat (1 × 150 mg tablet) administered following a high fat, high caloric meal (fed state).
Drug: Plixorafenib · Drug: Cobicistat
Treatment A: 900 mg plixorafenib administered after overnight fast (fasted state).
Drug: Plixorafenib
Treatment B: 900 mg plixorafenib administered following a high-fat high caloric meal (fed state-high fat meal).
Drug: Plixorafenib
Treatment C: 900 mg plixorafenib administered following a low-fat meal (fed state-low-fat meal).
Drug: Plixorafenib
Treatment D: 900 mg plixorafenib administered with 150 mg cobicistat following a low-fat meal (fed state-low-fat meal).
Drug: Plixorafenib · Drug: Cobicistat
Oral Tablet
Also known as: FORE8394
Oral Tablet
Also known as: Tybost
Number of Participants With Treatment Emergent Adverse Events (TEAEs).
Number of Participants with at least one reported Treatment Emergent Adverse Events (TEAEs).
Time frame: First dose of Plixorafenib to day 19 (Treatment Period 3).
Area Under the Plasma Concentration Versus Time Curve (AUC) From Time 0 to the Last Quantifiable Concentration (AUC0-t).
Area under the concentration versus time curve from time 0 to the last quantifiable concentration within the dosing interval.
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
AUC From Time 0 Extrapolated to Infinity (AUC0-inf).
Area under the concentration versus time curve from time 0 extrapolated to infinity calculated as AUC0-t + Clast/λz, where Clast is the last quantifiable concentration and lambda z is the terminal rate constant.
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
Maximum Observed Plasma Concentration (Cmax).
Maximum observed concentration, obtained by inspection.
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
Time to Maximum Observed Plasma Concentration (Tmax).
Time at which the maximum concentration was observed, obtained by inspection.
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
Terminal Elimination Rate Constant (λz).
Terminal rate constant calculated from the terminal slope of the natural log-linear regression of concentration with time.
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
Terminal Phase Half-life (t1/2).
Terminal half-life, calculated as ln (2)/λz.
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
Apparent Oral Clearance (CL/F).
Oral clearance, calculated as Dose/AUC0 inf.
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
Apparent Volume of Distribution (Vz/F).
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
Lag Time of Absorption or the Time Delay Between Time 0 and the First Observed Quantifiable Concentration, Obtained by Inspection.
Time frame: Predose (0 hours) and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 24, 32, 48, 72, and 96 hours after dosing in each treatment period.
Cumulative Amount of Plixorafenib Excreted in Urine(Ae)
The cumulative amount of plixorafenib in urine from 0 to 48 hours, Ae,48, was calculated for the Part A participants only as the sum between 0 and 48 hours of the product of the urine concentration and the urine volume for each collection interval by participant for each treatment.
Time frame: Predose (0 hours) and at intervals 0-4, 4-8, 8-12, 12-24 and 24-48 hours after dosing in each treatment period.
Percent of Dose Excreted in Urine in 48 Hours.
The percent of the dose excreted in urine in 48 hours (fe,48%) was calculated as Ae,48\*100/Dose.
Time frame: Predose (0 hours) and at intervals 0-4, 4-8, 8-12, 12-24 and 24-48 hours after dosing in each treatment period.
1 Clinical site located in the United States.
| Milestone | Part A: Sequence 1 | Part A: Sequence 2 | Part A: Sequence 3 | Part A: Sequence 4 | Part A: Sequence 5 | Part A: Sequence 6 | Part B: Sequence 1 | Part B: Sequence 2 | Part B: Sequence 3 | Part B: Sequence 4 |
|---|---|---|---|---|---|---|---|---|---|---|
| Started | 2 | 2 | 2 | 2 | 2 | 2 | 4 | 4 | 4 | 4 |
| Completed | 2 | 2 | 2 | 2 | 2 | 2 | 4 | 4 | 4 | 4 |
| Not completed | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Number of Participants with at least one reported Treatment Emergent Adverse Events (TEAEs).
| Participants | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Any treatment Emergent Adverse Events (TEAE) | 1 | 1 | 1 | 2 | 3 | 4 | 1 |
| Related to Plixorafenib | 1 | 1 | 1 | 1 | 1 | 0 | 0 |
| Related to Cobicistat | 0 | 1 | 1 | 0 | 0 | 0 | 0 |
| Grade ≥3 TEAE | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Serious Adverse Event (SAE) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| TEAE Leading to Early Study Discontinuation | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Adverse Event of Special Interest (AESI) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Death | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Area under the concentration versus time curve from time 0 to the last quantifiable concentration within the dosing interval.
| h*µg/mL | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Area Under the Plasma Concentration Versus Time Curve (AUC) From Time 0 to the Last Quantifiable Concentration (AUC0-t). | 49.02 ± 25.387 | 168.31 ± 90.7189 | 513.686 ± 115.459 | 72.36 ± 41.4522 | 120.376 ± 44.2094 | 173.517 ± 65.8967 | 474.421 ± 155.6191 |
Area under the concentration versus time curve from time 0 extrapolated to infinity calculated as AUC0-t + Clast/λz, where Clast is the last quantifiable concentration and lambda z is the terminal rate constant.
| h*µg/mL | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| AUC From Time 0 Extrapolated to Infinity (AUC0-inf). | 46.588 ± 24.1108 | 169.316 ± 91.6553 | 514.824 ± 115.8643 | 74.02 ± 42.9613 | 121.883 ± 45.6913 | 173.964 ± 66.1065 | 474.967 ± 155.8864 |
Maximum observed concentration, obtained by inspection.
| µg/mL | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Maximum Observed Plasma Concentration (Cmax). | 11.481 ± 6.6171 | 23.272 ± 11.8014 | 49 ± 17.228 | 12.416 ± 4.2213 | 24.61 ± 8.007 | 28.13 ± 13.914 | 66.12 ± 14.655 |
Time at which the maximum concentration was observed, obtained by inspection.
| h | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Time to Maximum Observed Plasma Concentration (Tmax). | 2.668 ± 0.7772 | 3.3 ± 0.87 | 6.2 ± 1.8 | 2.935 ± 1.3348 | 2.676 ± 0.7972 | 3.443 ± 1.0918 | 3.679 ± 0.6283 |
Terminal rate constant calculated from the terminal slope of the natural log-linear regression of concentration with time.
| 1/h | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Terminal Elimination Rate Constant (λz). | 0.05129 ± 0.020593 | 0.06208 ± 0.036737 | 0.06057 ± 0.024043 | 0.04381 ± 0.031688 | 0.04046 ± 0.019789 | 0.05121 ± 0.020887 | 0.05538 ± 0.02338 |
Terminal half-life, calculated as ln (2)/λz.
| h | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Terminal Phase Half-life (t1/2). | 15.603 ± 6.1525 | 21.036 ± 23.4608 | 14.285 ± 9.4796 | 23.976 ± 17.1641 | 22.909 ± 14.0374 | 17.009 ± 10.3003 | 16.868 ± 11.8901 |
Oral clearance, calculated as Dose/AUC0 inf.
| L/h | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Apparent Oral Clearance (CL/F). | 25.521 ± 14.6921 | 7.211 ± 4.166 | 1.837 ± 0.4374 | 15.868 ± 7.5778 | 8.301 ± 2.8639 | 5.628 ± 1.402 | 2.123 ± 0.8305 |
| L | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Apparent Volume of Distribution (Vz/F). | 631.925 ± 519.1238 | 208.855 ± 307.5796 | 36.971 ± 22.4434 | 442.143 ± 222.1673 | 237.592 ± 87.5592 | 124.526 ± 53.1671 | 45.258 ± 23.8247 |
| h | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Lag Time of Absorption or the Time Delay Between Time 0 and the First Observed Quantifiable Concentration, Obtained by Inspection. | 0 ± 0 | 0 ± 0 | 0 ± 0 | 0 ± 0 | 0 ± 0 | 0 ± 0 | 0 ± 0 |
The cumulative amount of plixorafenib in urine from 0 to 48 hours, Ae,48, was calculated for the Part A participants only as the sum between 0 and 48 hours of the product of the urine concentration and the urine volume for each collection interval by participant for each treatment.
| mg | Treatment 1 | Treatment 2 | Treatment 3 |
|---|---|---|---|
| Cumulative Amount of Plixorafenib Excreted in Urine(Ae) | 0.11749 ± 0.057749 | 0.46969 ± 0.229764 | 1.82134 ± 0.865302 |
The percent of the dose excreted in urine in 48 hours (fe,48%) was calculated as Ae,48\*100/Dose.
| percent | Treatment 1 | Treatment 2 | Treatment 3 |
|---|---|---|---|
| Percent of Dose Excreted in Urine in 48 Hours. | 0.01305 ± 0.006417 | 0.05219 ± 0.025529 | 0.20237 ± 0.096145 |
Collected over Patients were monitored on a daily basis for changes in vital signs, collection of adverse events and clinical labs for the duration of 20 days for Part A and Part B each.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Treatment 1 | 0/12 (0%) | 0/12 (0%) | 1/12 (8.3%) |
| Treatment 2 | 0/12 (0%) | 0/12 (0%) | 1/12 (8.3%) |
| Treatment 3 | 0/12 (0%) | 0/12 (0%) | 1/12 (8.3%) |
| Treatment A | 0/12 (0%) | 0/12 (0%) | 2/12 (16.7%) |
| Treatment B | 0/12 (0%) | 0/12 (0%) | 3/12 (25%) |
| Treatment C | 0/12 (0%) | 0/12 (0%) | 4/12 (33.3%) |
| Treatment D | 0/12 (0%) | 0/12 (0%) | 1/12 (8.3%) |
| Event | Treatment 1 | Treatment 2 | Treatment 3 | Treatment A | Treatment B | Treatment C | Treatment D |
|---|---|---|---|---|---|---|---|
| Abdominal PainGastrointestinal disorders | 0/12 | 0/12 | 0/12 | 1/12 | 2/12 | 0/12 | 0/12 |
| DizzinessNervous system disorders | 1/12 | 0/12 | 0/12 | 0/12 | 0/12 | 0/12 | 0/12 |
| DysgeusiaNervous system disorders | 0/12 | 1/12 | 0/12 | 0/12 | 0/12 | 0/12 | 0/12 |
| AlopeciaSkin and subcutaneous tissue disorders | 0/12 | 0/12 | 1/12 | 0/12 | 0/12 | 0/12 | 0/12 |
| VertigoEar and labyrinth disorders | 0/12 | 0/12 | 0/12 | 0/12 | 1/12 | 0/12 | 0/12 |
| DiarrhoeaGastrointestinal disorders | 0/12 | 1/12 | 0/12 | 0/12 | 1/12 | 0/12 | 0/12 |
| NauseaGastrointestinal disorders | 0/12 | 0/12 | 0/12 | 0/12 | 1/12 | 0/12 | 0/12 |
| Medical device site dermatitisGeneral disorders | 0/12 | 0/12 | 0/12 | 0/12 | 0/12 | 1/12 | 0/12 |
| Non-cardiac chest painGeneral disorders | 0/12 | 0/12 | 0/12 | 0/12 | 1/12 | 0/12 | 0/12 |
| Viral upper respiratory tract infectionInfections and infestations | 0/12 | 0/12 | 0/12 | 1/12 | 0/12 | 0/12 | 0/12 |
| Age, Categorical(Participants) | Part A: Sequence 1 | Part A: Sequence 2 | Part A: Sequence 3 | Part A: Sequence 4 | Part A: Sequence 5 | Part A: Sequence 6 | Part B: Sequence 1 | Part B: Sequence 2 | Part B: Sequence 3 | Part B: Sequence 4 | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 2 | 2 | 2 | 2 | 2 | 2 | 4 | 4 | 4 | 4 | 28 |
| >=65 years | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Sex: Female, Male(Participants) | Part A: Sequence 1 | Part A: Sequence 2 | Part A: Sequence 3 | Part A: Sequence 4 | Part A: Sequence 5 | Part A: Sequence 6 | Part B: Sequence 1 | Part B: Sequence 2 | Part B: Sequence 3 | Part B: Sequence 4 | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Female | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 2 | 4 | 2 | 10 |
| Male | 2 | 2 | 2 | 2 | 1 | 1 | 4 | 2 | 0 | 2 | 18 |
| Race/Ethnicity, Customized(Participants) | Part A: Sequence 1 | Part A: Sequence 2 | Part A: Sequence 3 | Part A: Sequence 4 | Part A: Sequence 5 | Part A: Sequence 6 | Part B: Sequence 1 | Part B: Sequence 2 | Part B: Sequence 3 | Part B: Sequence 4 | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Black or African American | 2 | 1 | 1 | 0 | 1 | 1 | 2 | 2 | 3 | 3 | 16 |
| White | 0 | 1 | 1 | 2 | 1 | 1 | 2 | 2 | 1 | 1 | 12 |
| Region of Enrollment(participants) | Part A: Sequence 1 | Part A: Sequence 2 | Part A: Sequence 3 | Part A: Sequence 4 | Part A: Sequence 5 | Part A: Sequence 6 | Part B: Sequence 1 | Part B: Sequence 2 | Part B: Sequence 3 | Part B: Sequence 4 | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| United States | 2 | 2 | 2 | 2 | 2 | 2 | 4 | 4 | 4 | 4 | 28 |
| Height(centimeters) | Part A: Sequence 1 | Part A: Sequence 2 | Part A: Sequence 3 | Part A: Sequence 4 | Part A: Sequence 5 | Part A: Sequence 6 | Part B: Sequence 1 | Part B: Sequence 2 | Part B: Sequence 3 | Part B: Sequence 4 | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean | 185.55 ± 3.748 | 174.65 ± 3.323 | 177.30 ± 4.808 | 184.4 ± 13.294 | 166.10 ± 9.192 | 166.40 ± 4.808 | 176.48 ± 7.121 | 165.55 ± 7.059 | 174.25 ± 5.482 | 170.38 ± 9.404 | 168.12 ± 30.40 |
| Weight(kilograms) | Part A: Sequence 1 | Part A: Sequence 2 | Part A: Sequence 3 | Part A: Sequence 4 | Part A: Sequence 5 | Part A: Sequence 6 | Part B: Sequence 1 | Part B: Sequence 2 | Part B: Sequence 3 | Part B: Sequence 4 | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean | 98.75 ± 5.728 | 83.55 ± 2.475 | 83.00 ± 0.849 | 91.95 ± 21.001 | 70.70 ± 9.334 | 73.50 ± 11.597 | 83.35 ± 11.148 | 74.95 ± 4.664 | 82.03 ± 10.136 | 72.65 ± 9.941 | 80.53 ± 11.03 |
| Body Mass Index (BMI)(kg/m2) | Part A: Sequence 1 | Part A: Sequence 2 | Part A: Sequence 3 | Part A: Sequence 4 | Part A: Sequence 5 | Part A: Sequence 6 | Part B: Sequence 1 | Part B: Sequence 2 | Part B: Sequence 3 | Part B: Sequence 4 | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean | 28.65 ± 0.495 | 27.40 ± 1.838 | 26.40 ± 1.131 | 26.80 ± 2.263 | 25.55 ± 0.495 | 26.45 ± 2.616 | 26.83 ± 3.746 | 27.40 ± 1.903 | 26.90 ± 1.780 | 24.94 ± 2.450 | 26.68 ± 2.098 |
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Fore Biotherapeutics