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RecruitingNCT07176689Updated Sep 14, 2026

Nirogacestat in Premenopausal Females With Desmoid Tumor/Aggressive Fibromatosis (DT/AF)

A Phase 4 interventional study of Nirogacestat in Desmoid Tumor and Aggressive Fibromatosis, sponsored by SpringWorks Therapeutics, Inc., a healthcare company of Merck KGaA, Darmstadt, Germany. Recruiting at 23 sites in 6 countries. Open to female participants aged 18 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-09-14.

Sponsored by SpringWorks Therapeutics, Inc., a healthcare company of Merck KGaA, Darmstadt, Germany · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
50
Allocation
Not applicable
Ages
18 Years to 40 Years
Sex
Female
01

Study summary

This study is being conducted to study how nirogacestat may affect the ovarian function of adult premenopausal women with progressing desmoid tumors/aggressive fibromatosis.

Read the detailed description

Desmoid tumors, also referred to as aggressive fibromatosis, are rare, locally invasive, slow growing soft tissue tumors. Although considered benign because of their inability to metastasize, desmoid tumors can cause significant morbidity and occasionally mortality in patients.

Nirogacestat is a tumor inhibitor that works by slowing or stopping the growth of tumor cells. Nirogacestat is a tablet taken by mouth and has been approved in the USA for adult patients with progressing desmoid tumors who require systemic treatment.

This is an open-label study to characterize the incidence and ovarian function recovery rates of ovarian toxicity (OT) events and to evaluate the efficacy, safety, and tolerability of nirogacestat in postpubertal and premenopausal females with desmoid tumors (DT).

02

Conditions studied

  • Desmoid Tumor
  • Aggressive Fibromatosis

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Keywords

  • Nirogacestat
  • PF-03084014
  • GSI
  • gamma secretase inhibitor
  • notch pathway
  • Ogsiveo
03

Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Participant is female, postpubertal aged ≥18 and ≤40 years of age at the time of signing the informed consent and premenopausal at baseline. Premenopausal is defined as meeting all of the following: Estradiol >30 pg/mL. Follicle-stimulating hormone (FSH) \<40 IU/L. Regular menses (e.g., menstrual cycle length of 21 to 35 days) for at least 3 menstrual cycles prior to signing informed consent
  • Participant uses 1 highly effective non-hormonal contraceptive method, has a negative pregnancy test prior to first dose of study treatment), is not breastfeeding, agrees to not harvest or donate eggs for at least 90 days prior to and during the study
  • Participant has histologically confirmed DT/AF with symptomatic or progressive disease requiring systemic treatment
  • Participant has an Eastern Cooperative Oncology Group (ECOG) performance status ≤2 at screening
  • Participant has adequate organ and bone marrow function.

Exclusion criteria

Exclusion Criteria:

  • Participant has known malabsorption syndrome or preexisting gastrointestinal conditions that may impair absorption of nirogacestat
  • Participant has experienced any of the following within 6 months of signing informed consent: clinically significant cardiac disease (New York Heart Association Class III or IV), myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident, transient ischemic attack, or symptomatic pulmonary embolism.
  • Participant has had lymphoma, leukemia, or any malignancy within the past 5 years at the time of informed consent, except for any locally recurring cancer that has been treated curatively (e.g., resected basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of the cervix or breast), with no evidence of metastatic disease for 3 years at the time of informed consent.
  • Participant has known hepatic impairment
  • Participant previously received or is currently receiving gamma secretase inhibitors or anti-Notch antibody therapy
  • Participant is currently using any treatment for DT/AF including tyrosine kinase inhibitors (TKIs) or any investigational treatment 28 days (or 5 half-lives, whichever is longer) prior to the first dose of study treatment
  • Participant is currently using or anticipates using food or drugs that are known strong/moderate cytochrome P450 (CYP) 3A4 inhibitors, or strong CYP3A inducers within 14 days prior to the first dose of study treatment.
  • Participant has a history of polycystic ovary syndrome, hypothalamic amenorrhea, severe endometriosis involving ovaries, family history of primary ovarian insufficiency, any chromosomal abnormality, mutation, gene variant or medical condition associated with early/premature menopause, including a history of OT while on a TKI
  • Participant is currently using or has used hormonal contraception or ovarian suppression within 90 days prior to first dose of study treatment
  • Participant has a history of heavy tobacco smoking (≥20 pack years) or is a current smoker (>1 pack per day)
  • Participant has experienced other severe acute or chronic medical or psychiatric conditions within 1 year of signing informed consent.
  • Participant is unable to comply with study related procedures (including, but not limited to, the completion of a menstrual diary and electronic patient-reported outcomes and ability to return to clinic for hormone level blood draws timed to the menstrual cycle (days 1-5)
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
50 participants (estimated)

Study arms

  • Experimental
    Nirogacestat

    Nirogacestat 150 mg by mouth, twice daily

    Drug: Nirogacestat

Interventions

  • DrugNirogacestat

    Nirogacestat oral tablet

    Also known as: PF-03084014, Ogsiveo

05

What researchers measure

Primary outcomes

  1. Ovarian function recovery rate of ovarian toxicity (OT) treatment-emergent adverse events (TEAEs)

    Ovarian function recovery is defined as achieving the resumption of ≥2 consecutive menstrual periods and an FSH level \<30 mIU/mL with concomitant estradiol \<80 pg/mL OR resumption of ≥2 consecutive menstrual periods and AMH level within normal range adjusted for age and pretreatment baseline OR a positive serum β-HCG pregnancy test.

    Time frame: Up to 24 cycles (each cycle is 28 days) of treatment and up to 2 years in the Clinical Follow-up Period

Secondary outcomes

  1. Incidence of OT TEAEs

    OT is any new onset amenorrhea lasting ≥3 consecutive menstrual periods, FSH level ≥30 mIU/mL and a negative β-HCG pregnancy test.

    Time frame: Up to 24 cycles (each cycle is 28 days) of treatment and up to 2 years in the Clinical Follow-up Period

  2. Time to ovarian function recovery in participants with a TEAE of OT

    Time to ovarian function recovery is evaluated in participants who had a TEAE of OT and is defined as the time it takes to resolve.

    Time frame: Up to 24 cycles (each cycle is 28 days) of treatment and up to 2 years in the Clinical Follow-up Period

  3. The incidence of adverse events (AEs) according to toxicities graded by National Cancer Institute (NCI) Common Technology Criteria for Adverse Events (CTCAE) Version 5

    Time frame: Up to 24 cycles (each cycle is 28 days) of treatment and up to 2 years in the Clinical Follow-up Period

Other outcomes

  1. Objective Response Rate (ORR)

    Proportion of participants with Complete Response (CR) and Partial Response (PR) using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria

    Time frame: First day of every 3 cycles (each cycle is 28 days) for up to 24 cycles of treatment and up to 1 year in the Clinical Follow-up Period

  2. Duration of Response (DoR) for participants whose best response is CR or PR

    DoR is defined as the duration from the time of first assessment of CR or PR response (per RECIST v1.1) to the first date of disease progression or death (whichever comes first).

    Time frame: First day of every 3 cycles (each cycle is 28 days) until disease progression is observed or death, whichever comes first, up to 24 cycles of treatment and up to 1 year in the Clinical Follow-up Period

  3. Disease Control Rate (DCR) for participants whose best response is CR, PR or Stable Disease (SD)

    DCR is defined as the proportion of participants who have a best response of CR, PR, or SD.

    Time frame: First day of every 3 cycles (each cycle is 28 days) for up to 24 cycles of treatment and up to 1 year in the Clinical Follow-up Period

  4. Duration of Disease Control (DoDC) for participants whose best response is CR, PR or SD

    DoDC is defined as the duration from the start of study treatment until first date of disease progression or death (whichever comes first).

    Time frame: First day of every 3 cycles (each cycle is 28 days) until disease progression is observed or death, whichever comes first, up to 24 cycles of treatment and up to 1 year in the Clinical Follow-up Period

  5. Progression Free Survival (PFS)

    PFS is defined at the start of study treatment until the date of assessment of progression or death by any cause. Progression will be determined radiographically using RESIST v1.1 performed by a local radiologist.

    Time frame: First day of every 3 cycles (each cycle is 28 days) until disease progression is observed or death, whichever comes first, up to 24 cycles of treatment and up to 1 year in the Clinical Follow-up Period

  6. Changes in tumor volume from baseline assessed by MRI volumetric analysis performed locally

    Time frame: First day of every 3 cycles (each cycle is 28 days) up to 24 cycles and up to 1 year in the Clinical Follow-up Period

  7. Change in T2 hyperintensity baseline assessed by MRI analysis performed locally

    Time frame: First day of every 3 cycles (each cycle is 28 days) up to 24 cycles and up to 1 year in the Clinical Follow-up Period

  8. Characterization of serum nirogacestat concentrations assessed in sparse pharmacokinetic (PK) sampling (pre-dose and 1-hour post dose at Cycle 1 Day 1 only) and trough PK sampling (pre-dose at treatment period visits after Cycle 1 Day 1

    Time frame: First day of every 3 cycles (each cycle is 28 days) up to 24 cycles of treatment

  9. Pain severity using Brief Pain Index - Short Form (BPI-SF), question #3

    BPI question #3 will measure worst pain in the last 24 hours using an 11-point numeric scale from 0 (no pain) to 10 (pain as bad as you can imagine)

    Time frame: From 7 days prior to date of first dose of treatment through end of Cycle 2 (each cycle is 28 days), assessed up to 9 weeks

  10. Patient experience of desmoid tumors and nirogacestat

    Two (2) optional 60-minute qualitative interviews using open-ended exploratory questions to elicit spontaneous responses will be transcribed and analyzed in an inductive/deductive method to identify themes in the data

    Time frame: One interview will occur following treatment completion (on average approximately 2 years after study entry) and a second interview will occur at study completion (on average approximately 3 years after study entry)

06

Study locations

23 of 23 sites recruiting
  • Cliniques Universitaires Saint-Luc (CUSL)
    Brussels, 1200, Belgium
    Recruiting
  • Universitaetsmedizin Mannheim
    Mannheim, 68167, Germany
    Recruiting
  • IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" - IRST S.r.l.
    Meldola, Forli-Cesena 47014, Italy
    Recruiting
  • La Fondazione e l'Istituto di Candiolo
    Candiolo, Torino 10060, Italy
    Recruiting
  • IRCCS Azienda Ospedaliero-Universitaria di Bologna - Policlinico di Sant Orsola
    Bologna, 40138, Italy
    Recruiting
  • IRCCS Istituto Ortopedico Rizzoli di Bologna
    Bologna, 40138, Italy
    Recruiting
  • Fondazione IRCCS Istituto Nazionale dei Tumori Milano
    Milan, 20133, Italy
    Recruiting
  • Istituto Nazionale Tumori I.R.C.C.S- Fondazione G. Pascale
    Naples, 80131, Italy
    Recruiting
  • Policlinico Universitario Campus Bio-Medico
    Roma, 00128, Italy
    Recruiting
  • Nederlands Kanker Instituut - Antoni van Leeuwenhoek Ziekenhuis (NKI-AVL)
    Amsterdam, 1066 CX, Netherlands
    Recruiting
  • Academisch Ziekenhuis Leiden
    Leiden, 2333 ZA, Netherlands
    Recruiting
  • Hospital de la Santa Creu i Sant Pau
    Barcelona, 08041, Spain
    Recruiting
  • Institut Catala d'Oncologia
    Barcelona, 08907, Spain
    Recruiting
  • Hospital General Universitario Gregorio Maranon
    Madrid, 28007, Spain
    Recruiting
  • Hospital Fundacion Jimenez Diaz
    Madrid, 28040, Spain
    Recruiting
  • Hospital Universitario 12 de Octubre
    Madrid, 28041, Spain
    Recruiting
  • Hospital Universitario La Paz
    Madrid, 28046, Spain
    Recruiting
  • Hospital Universitari i Politecnic La Fe de Valencia
    Valencia, 46026, Spain
    Recruiting
  • Hospital Universitario Miguel Servet
    Zaragoza, 50009, Spain
    Recruiting
  • Cambridge University - Addenbrooke's Hospital
    Cambridge, CB2 0QQ, United Kingdom
    Recruiting
  • University College London Hospital
    London, NW1 2PG, United Kingdom
    Recruiting
  • The Royal Marsden NHS Foundation Trust
    London, SW3 6JJ, United Kingdom
    Recruiting
  • The Christie NHS Foundation Trust
    Manchester, M20 4BX, United Kingdom
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes — IPD supporting publicly available results will be evaluated for sharing.

Supporting information: Study protocol, Sap, Csr, Analytic code

08

Registry details

Key details

Study ID
NCT07176689
Lead sponsor
SpringWorks Therapeutics, Inc., a healthcare company of Merck KGaA, Darmstadt, Germany
Responsible party
Sponsor
First posted
Sep 16, 2025
Start date
Sep 17, 2025
Primary completion
Feb 26, 2031 (estimated)
Completion
Feb 26, 2031 (estimated)
Last update
Sep 14, 2026

Study contacts

US Medical Information
Contact
eMediUSA@emdserono.com
888-275-7376
Medical Responsible
study director · SpringWorks Therapeutics, Inc., a healthcare company of Merck KGaA, Darmstadt, Germany

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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