Description:
The purpose of this study is to assess the safety and tolerability of ASP8273 and to
determine the maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D). This study
will also determine the pharmacokinetics (PK) of ASP8273, evaluate the potential inhibition
of CYP3A4 by ASP8273 and the antitumor activity of ASP8273 as well as determine the effect of
food on the bioavailability of ASP8273.
Title
- Brief Title: A Dose Escalation Study of ASP8273 in Subjects With Non-Small-Cell Lung Cancer (NSCLC) Who Have Epidermal Growth Factor Receptor (EGFR) Mutations
- Official Title: An Open-label, Phase 1 Dose Escalation Study of Oral ASP8273 in Subjects With Non-Small-Cell Lung Cancer (NSCLC) Who Have Epidermal Growth Factor Receptor (EGFR) Mutations
Clinical Trial IDs
- ORG STUDY ID:
8273-CL-0102
- NCT ID:
NCT02113813
Conditions
- Non-Small-Cell Lung Cancer (NSCLC)
- Epidermal Growth Factor Receptor Mutations
Interventions
Drug | Synonyms | Arms |
---|
naquotinib | ASP8273 | ASP8273 Dose Escalation cohort (part 1) |
midazolam | | ASP8273 and Midazolam RP2D Expansion cohort (part 2) |
Purpose
The purpose of this study is to assess the safety and tolerability of ASP8273 and to
determine the maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D). This study
will also determine the pharmacokinetics (PK) of ASP8273, evaluate the potential inhibition
of CYP3A4 by ASP8273 and the antitumor activity of ASP8273 as well as determine the effect of
food on the bioavailability of ASP8273.
Detailed Description
This study is composed of 2 parts: part 1 is the dose escalation phase and part 2 is the
recommended Phase 2 dose (RP2D) phase, Food Effect (FE) cohort and Exon 20 cohort.
Trial Arms
Name | Type | Description | Interventions |
---|
ASP8273 Dose Escalation cohort (part 1) | Experimental | oral | |
ASP8273 Response Expansion cohort (part 1) | Experimental | oral | |
ASP8273 and Midazolam RP2D Expansion cohort (part 2) | Experimental | oral | |
Food Effect Fasted cohort (part 2) | Experimental | oral | |
Food Effect Fed cohort (part 2) | Experimental | oral | |
Exon 20 Cohort (part 2) | Experimental | oral | |
Eligibility Criteria
Inclusion Criteria:
- Non-child bearing potential or able to follow birth control requirements
- Eastern Cooperative Oncology Group (ECOG) ≤ 1
- Life expectancy ≥ 12 weeks
- Laboratory criteria as:
- Neutrophil count ≥ 1,500/mm3
- Platelet count ≥ 7.5 x 104 /mm3
- Hemoglobin ≥ 9.0 g/dL
- Lymphocyte count ≥ 500/mm3
- Serum creatinine < 1.5 x institutional Upper Limit of Normal (ULN) or an
estimated glomerular filtration rate (eGFR) of > 50 ml/min as calculated by the
Modification of Diet in Renal Disease (MDRD) equation
- Total bilirubin < 1.5 x ULN (except for subjects with documented Gilbert's
syndrome)
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3.0 x ULN
- Dose escalation subjects: Epidermal Growth Factor Receptor (EGFR) activating mutation
by local testing: exon 18 G719X, exon 19 deletion, exon 21 L861Q, exon 21 L858R or
exon 20 insertion; and received prior treatment with EGFR Tyrosine Kinase Inhibitor
(TKI)
- Response expansion/RP2D expansion/ FE Cohort subjects: disease progression on or was
intolerant to prior EGFR TKI; activating mutation as above AND T790M mutation; tumor
sample subsequent to EGFR TKI is available for central testing; at least one
measurable lesion per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
Inclusion Criteria for Exon 20 cohort:
- Subject on any line of treatment and has an EGFR exon 20 insertion mutation on
examination of an NSCLC tissue or cellular specimen. Local testing may determine
eligibility and a tumor sample should also be sent for central testing.
- Subjects must have at least 1 measurable lesion based on RECIST version 1.1.
Exclusion Criteria:
- Any ongoing toxicity ≥ Grade 2 attributable to prior Non-Small-Cell Lung Cancer
(NSCLC) treatment
- Prior EGFR inhibitor within 6 days; received prior treatment with any other agent with
antitumor activity chemotherapy, radiotherapy, or immunotherapy within 14 days; any
investigational therapy within 28 days or 5 half-lives, whichever is shorter; blood
transfusion or hemopoietic factor within 14 days; major surgery within 14 days; any
strong CYP3A4 inhibitors within 7 days
- Positive hepatitis B surface antigen (HBsAg) or hepatitis C antibody (anti-HCV) or
Human Immunodeficiency Virus (HIV)
- Symptomatic Central Nervous System (CNS) metastasis
- Active infection requiring systemic therapy within 14 days
- Severe or uncontrolled systemic diseases including uncontrolled hypertension
- History of or active interstitial lung disease
- Screening QTcF >450 msec or current medication known to prolong QT
- ≥ Grade 2 cardiac arrhythmia or uncontrolled atrial fib of any grade; Class 3 or 4 New
York Heart Association congestive heart failure; history of severe/unstable angina,
myocardial infarction or cerebrovascular accident within 6 months
- History of gastrointestinal ulcer or bleeding within 3 months; any digestive tract
dysfunction
- Concurrent corneal disorder or ophthalmologic condition making subject unsuitable
- RP2D cohort subjects: contraindications to midazolam, any other midazolam within 7
days, or any medications or supplements known to be strong CYP3A inhibitors within 7
days or inducers within 12 days
- Any other malignancy requiring treatment
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety and tolerability as assessed by Dose Limiting Toxicities (DLTs) |
Time Frame: | up to 18 months |
Safety Issue: | |
Description: | A DLT is defined as any pre-determined toxicity that is related to study drug per the investigator and which occurs during Cycle 0 and Cycle 1 using NCI CTCAE v4.03. |
Secondary Outcome Measures
Measure: | Composite of pharmacokinetics of ASP8273 concentration and its metabolites (plasma): Cmax, tmax, AUClast, AUCinf, t1/2, CL/F, and Vz/F |
Time Frame: | Cycle 0: Dose Escalation Days 1-2, FE Days 1-6; Cycle 1: Dose Escalation/Response Expansion/RP2D/FE Days 1,8,15, RP2D Day 21, Exon 20 Days 8,15; Cycle 2 & 3: Dose Escalation/Response Expansion/RP2D Days 1,2, FE Day 1; Exon 20 days 1, 2 & Cycle 3 |
Safety Issue: | |
Description: | Maximum concentration (Cmax), the time after dosing when Cmax occurs (tmax), area under the concentration - time curve from time 0 up to the last quantifiable concentration (AUClast), area under the concentration - time curve from time 0 extrapolated to infinity (AUCinf), apparent terminal elimination half-life (t1/2), apparent oral systemic clearance (CL/F), Apparent volume of distribution (Vz/F) |
Measure: | Composite of pharmacokinetics of midazolam concentration and its metabolites (plasma): Cmax, tmax, AUClast, AUCinf, t1/2, CL/F, and Vz/F |
Time Frame: | Day -1 and Day 1 of cycle 1; Day 1 and Day 2 of cycle 2 |
Safety Issue: | |
Description: | |
Measure: | Best overall response rate |
Time Frame: | Up to 18 months |
Safety Issue: | |
Description: | Defined as proportion of subjects whose best overall response is Complete Response (CR) or Partial Response (PR) among all analyzed subjects. |
Measure: | Disease control rate |
Time Frame: | Up to 18 months |
Safety Issue: | |
Description: | Defined as the proportion of subjects whose best overall response is rated as CR, PR or Stable Disease (SD) among all analyzed subjects. |
Measure: | Progression free survival |
Time Frame: | Up to 18 months |
Safety Issue: | |
Description: | Defined as the time from the start of the study treatment until death from any cause or radiographic disease progression assessed according to RECIST 1.1, whichever occurs first. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | Astellas Pharma Global Development, Inc. |
Trial Keywords
- irreversible EGFR inhibitor
- Non-Small-Cell Lung Cancer
- Midazolam
- T790M resistance mutation
- EGFR
- NSCLC
- naquotinib
- Epidermal Growth Factor Receptor mutations
- ASP8273
Last Updated
January 18, 2020