PRIMARY OBJECTIVE:~I. Assess the effects of CBX-12 on biomarkers of DDR in biopsy specimens from patients with advanced solid tumors at baseline and 24-30 hours post-first dose to establish the degree and duration of CBX-12 target engagement.~SECONDARY OBJECTIVES:~I. Assess the effects of CBX-12 on tumor TOP1 molecular response at baseline and 24-30 hours post-first dose.~II. Determine any association between tumor TOP1 and DDR modulation and plasma exatecan concentrations.~III. Evaluate the effects of CBX-12 on CD8 T cell infiltration and activation in tumor.~EXPLORATORY OBJECTIVES:~I. Measure the effects of CBX-12 on molecular markers of apoptosis. II. Examine any genomic or gene expression characteristics in tumor that may be associated with sensitivity or resistance to CBX-12.~III. Examine any genomic alterations in circulating tumor deoxyribonucleic acid (DNA) (ctDNA) that may be associated with sensitivity or resistance to CBX-12.~IV. Measure changes in levels of any anti-drug antibodies that may develop during CBX-12 therapy (Cybrexa assay).~V. Examine the molecular context of drug sensitivity or resistance (e.g., SLFN11 expression).~OUTLINE:~Patients receive CBX-12 intravenously (IV) on study. Patients undergo tumor biopsy and computed tomography (CT) scans on study and undergo blood sample collection throughout the trial.
This phase I trial studies how well CBX-12 works in treating patients with solid tumors that have spread from where they first started (primary site) to started to nearby tissue, lymph nodes, or distant parts of the body (advanced) or other places in the body (metastatic). CBX-12 works by binding to a protein called TOP1 that is present inside the cells. This allows CBX-12 to kill the cancer cells by damaging their DNA, resulting in cancer cell death. This trial is being done to find out if this approach is better or worse than the usual approach for advanced cancers.