Clinical Trials /

A Phase 1 Study Evaluating CB-5083 in Subjects With Advanced Solid Tumors

NCT02243917

Description:

This is a multicenter, open-label, Phase 1 study of orally administered CB-5083 in adult subjects with advanced metastatic solid tumors. The study will be conducted in 2 parts: an initial Dose Escalation Phase (Phase 1a) of CB-5083 in subjects with advanced metastatic solid tumors who have progressed or are non-responsive to available therapies and for which no standard therapy exists, followed by a Dose Expansion Phase (Phase 1b) which will include 1 to 4 arms: one arm in subjects with RAS mutated mCRC; optionally, at sponsors discretion, 3 additional arms may be added for subjects with advanced RCC, advanced pNET, or solid tumors with mutations in the RAS-MAPK pathway.

Related Conditions:
  • Malignant Solid Tumor
Recruiting Status:

Terminated

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Phase 1 Study Evaluating CB-5083 in Subjects With Advanced Solid Tumors
  • Official Title: A Phase 1, Open-Label, Dose Escalation and Dose Expansion Study Evaluating the Safety, Pharmacokinetics, Pharmacodynamics, and Clinical Effects of Orally Administered CB-5083 in Subjects With Advanced Solid Tumors

Clinical Trial IDs

  • ORG STUDY ID: CLC-101
  • NCT ID: NCT02243917

Conditions

  • Advanced Solid Tumors

Interventions

DrugSynonymsArms
CB-5083Dose Escalation Stage - CB-5083

Purpose

This is a multicenter, open-label, Phase 1 study of orally administered CB-5083 in adult subjects with advanced metastatic solid tumors. The study will be conducted in 2 parts: an initial Dose Escalation Phase (Phase 1a) of CB-5083 in subjects with advanced metastatic solid tumors who have progressed or are non-responsive to available therapies and for which no standard therapy exists, followed by a Dose Expansion Phase (Phase 1b) which will include 1 to 4 arms: one arm in subjects with RAS mutated mCRC; optionally, at sponsors discretion, 3 additional arms may be added for subjects with advanced RCC, advanced pNET, or solid tumors with mutations in the RAS-MAPK pathway.

Detailed Description

      The objectives of the Dose Escalation Phase are to determine the safety, tolerability, PK and
      pharmacodynamic profiles, the MTD and/or RP2D, and the effect of fed vs. fasted state on the
      bioavailability of orally administered CB-5083. The objectives of the dose expansion phase
      are to confirm the safety and tolerability of the RP2D, to further assess the PK and
      pharmacodynamic profiles and to evaluate the preliminary anti-tumor activity of CB-5083 in
      subjects with tumors for which there is biologic plausibility of unique sensitivity to
      CB-5083 mechanism of action (MOA) based on pre-clinical data. The objectives of the Food
      Effect Stage is to determine the effect of fed vs. fasted state on the bioavailability of
      orally administered CB-5083.
    

Trial Arms

NameTypeDescriptionInterventions
Dose Escalation Stage - CB-5083ExperimentalCB-5083 will be orally administered daily, 4 days on and 3 days off, for 28 day cycles; subjects who have completed at least one cycle may optionally participate in a food effect week, wherein CB-5083 will be orally administered once daily, on days 1 and 4, and thereafter return to the original dosing schedule
  • CB-5083
Dose Expansion Stage - CB-5083ExperimentalCB-5083 will be orally administered daily, 4 days on and 3 days off, for 28 day cycles
  • CB-5083
Food Effect Stage - CB-5083ExperimentalCB-5083 will be orally administered once daily, on days 1 and 4 of week 1, cycle 1, and orally administered daily, 4 days on and 3 days off, for the remaining 3 weeks of cycle 1; for subsequent 28 day cycles, CB-5083 will be orally administered daily, 4 days on and 3 days off
  • CB-5083

Eligibility Criteria

        Inclusion Criteria - All Phases:

          1. Males and females ≥18 years of age;

          2. Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤1

          3. Acceptable bone marrow and organ function at screening as described below:

               1. ANC ≥ 1,500/µL;

               2. Platelet count ≥ 100,000/µL;

               3. Total bilirubin ≤ 1.5 × ULN or ≤ 3.0 × ULN for subjects with hereditary benign
                  hyperbilirubinemia;

               4. AST (SGOT) ≤ 3 × ULN (≤ 5 × ULN if liver metastases are present);

               5. ALT (SGPT) ≤ 3 × ULN (≤ 5 × ULN if liver metastases are present);

               6. Serum creatinine ≤ 1.5 mg/dL or a measured creatinine clearance ³ 60 mL/min
                  according to Cockcroft-Gault formula

          4. Left ventricular ejection fraction informed (LVEF) ≥ 55%;

          5. Ability to swallow and retain oral medications;

          6. Negative serum beta-human Chorionic Gonadotropin (β-hCG) test in women of childbearing
             potential (WOCBP); Note, subject must agree to use dual barrier contraceptive methods;
             and

          7. Willing and able to provide written informed consent and comply with the requirements
             of the study;

          8. Phase 1a Dose Escalation only - Histologically confirmed advanced solid tumor for
             which standard therapy does not exist or is no longer effective

          9. Food Effect Stage - willing and able to ingest a standard meal

         10. Phase 1b All Expansion Cohorts - Evidence of measurable disease per RECIST, v1.1.
             Measurable disease is defined as a lesion that can be accurately measured in at least
             1 dimension (longest diameter to be recorded) with a minimum size of 10 mm by computed
             tomography (CT) scan;

         11. Phase 1b All Expansion Cohorts - Prior treatment with embolization or ablative
             therapies is allowed if measurable disease remains outside of the treated area or if
             there is definitive progression in the treated lesions. There is no limit on the
             number of prior procedures;

         12. Phase 1b Dose Expansion RAS Mutated mCRC Arm only - Histologically confirmed
             colorectal cancer with a K-RAS or N-RAS mutation in exons 2,3 and 4 that is metastatic
             or unresectable;

         13. Phase 1b Dose Expansion RAS Mutated mCRC Arm only - At least 2 prior systemic
             therapies for the treatment of metastatic colorectal cancer. Neo-adjuvant and adjuvant
             therapies may not be counted as part of the prior therapy requirements. At least 7
             subjects should be naïve to treatment with regorafenib;

         14. Phase 1b Optional Dose Expansion Advanced RCC Arm only - Histologically confirmed
             metastatic renal cell carcinoma;

         15. Phase 1b Optional Dose Expansion Advanced RCC Arm only - Must have received 2 prior
             therapies for metastatic RCC, including a vascular endothelial growth factor receptor
             (VEGFR) tyrosine kinase inhibitor (TKI) and an immune checkpoint inhibitor (ie
             anti-PD-1) (if approved and available for commercial use in the local country). At
             least 7 subjects should be naïve to treatment with prior inhibitors of mammalian
             target of rapamycin (mTOR) (eg. everolimus);

         16. Phase 1b Optional Dose Expansion pNET Arm only - Histologically confirmed low-grade or
             intermediate-grade, unresectable or metastatic pNET tumor for which standard therapy
             does not exist or is no longer effective. Functional and non-functional tumors can be
             included;

         17. Phase 1b Optional Dose Expansion RAS-MAPK Pathway Mutation Arm only - Histologically
             confirmed malignancy with a RAS-MAPK pathway mutation that is metastatic or
             unresectable and for which standard therapy does not exist or is no longer effective.
             At least 10 subjects with non-small cell lung cancer (NSCLC) are to be enrolled in
             this arm.

        Exclusion Criteria - All Phases

          1. Any prior treatment (with the exception of somatostatin analogues, which are allowed
             before and during the study in pNET subjects at the investigator discretion in pNET
             subjects) such as chemotherapy, immunomodulatory drug therapy, anti-neoplastic
             hormonal therapy (unless dose has been stable for 3 months prior to Baseline and will
             remain stable during the study), immunosuppressive therapy, or corticosteroids (unless
             administered to prevent contrast material reactions during radiographic procedures)
             received within the past 28 days or 5 half-lives, whichever is shorter;

          2. Presence of an acute or chronic toxicity resulting from prior chemotherapy, with the
             exception of alopecia, that has not resolved to ≤ grade 1, as determined by NCI CTCAE
             v 4.0 (http://evs.nci.nih.gov/ftp1/CTCAE/About.html);

          3. Received radiotherapy within the last 21 days (limited palliative radiation is allowed
             if ≥ 14 days prior);

          4. Subjects with primary brain tumors or known central nervous system (CNS) metastases;

          5. Major surgery < 28 days from the start of treatment (major surgery is defined as a
             procedure requiring general anesthesia);

          6. Minor surgery <14 days from the start of treatment (insertion of a vascular access
             device is not considered major or minor surgery);

          7. Active infection requiring systemic therapy;

          8. Known to be human immunodeficiency virus (HIV) positive or have an acquired
             immunodeficiency syndrome-related illness;

          9. Uncontrolled congestive heart failure, angina, myocardial infarction, cerebrovascular
             accident, coronary/peripheral artery bypass graft surgery, transient ischemic attack,
             or pulmonary embolism within 3 months prior to initiation of study drug;

         10. History of or ongoing cardiac dysrhythmias requiring treatment, atrial fibrillation of
             any grade, or persistent prolongation of the QTc (Fridericia) interval to > 450 msec
             for males or > 470 msec for females;

         11. History of esophageal bleeding due to varices;

         12. Gastrointestinal disease that may interfere with the absorption of orally-administered
             drugs;

         13. History of inflammatory bowel disease or other illness resulting in chronic diarrhea;

         14. Known achlorhydria or history of gastrointestinal surgery that could reduce the
             acidity of the stomach;

         15. Acute pancreatitis or cholecystitis within 6 months prior to Baseline;

         16. Cirrhosis with severe liver dysfunction (Child-Pugh Class B or C);

         17. Previous or concomitant malignancy, except for basal-cell or squamous cell carcinoma
             of the skin or carcinoma-in-situ of the uterine cervix. Subjects with other
             malignancies are eligible if they have remained disease free for at least 2 years
             prior to study entry;

         18. Any severe, acute, or chronic medical or psychiatric condition, or laboratory
             abnormality that may increase the risk associated with study participation or study
             drug administration, may interfere with the informed consent process and/or with
             compliance with the requirements of the study, or may interfere with the
             interpretation of the study results and, in the Investigator's opinion, would make the
             subject inappropriate for entry into this study;

         19. Use of any investigational agents within 28 days or 5 half-lives (whichever is
             shorter) prior to Baseline;

         20. A condition that is expected to require concomitant use of any medication listed as
             prohibited while on study;

         21. Pregnant or lactating female;

         22. Women of childbearing potential, or men who partner with a woman of childbearing
             potential, unless they agree to use dual barrier contraceptive methods which, in the
             Investigator's opinion, are effective and adequate for that subject's circumstances
             while on study drug and for 3 months afterward;

         23. Grade 3 or 4 eye disorder at study entry, unless stable and longstanding (>3 months)
             and unlikely to interfere with protocol-required ophthalmology assessments;

         24. Phase 1b Optional Dose Expansion pNET Arm only - Poorly differentiated pNET;

         25. Phase 1b Optional Dose Expansion RAS-MAPK Pathway Mutation Arm only - Subjects with
             primary pancreatic cancer or primary RAS mutated colorectal cancer.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Dose Escalation Stage - the dose limiting toxicities (DLTs), using NCI CTCAE v4.0, of oral CB-5083 in subjects with advanced tumors
Time Frame:the first 28 days of treatment with CB-5083
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Dose Escalation Stage - the pharmacodynamic (PD)effects of CB-5083 through the measurement of polyubiquitin accumulation (PUA) in peripheral blood mononuclear cells (PBMCs)
Time Frame:day 1 through day 5 of Cycle 1
Safety Issue:
Description:
Measure:Dose Expansion Stage - PK and PD profiles of CB-5083; PK parameters to include AUC, Cmax, Tmax and T1/2; PD effects through the measurement of PUA in PBMCs
Time Frame:day 1 through day 5 of Cycle 1; day 1 and day 2 of Cycle 2 (PK only)
Safety Issue:
Description:
Measure:Dose Expansion Stage - anti-tumor activity in certain subjects, using the Response Evaluation Criteria in Solid Tumors (RECIST), v1.1
Time Frame:from the pre-study visit though the end of the last cycle on treatment, an expected average of 14 weeks
Safety Issue:
Description:
Measure:Food Effect Stage - safety and tolerability of oral CB-5083 in subjects with advanced solid tumors using NCI CTCAE v4.0, of oral CB-5083
Time Frame:From day 1 of Cycle 1 through 28 days after the subjects's last treatment
Safety Issue:
Description:

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Terminated
Lead Sponsor:Cleave Biosciences, Inc.

Last Updated

February 27, 2018