Description:
AC0010 Maleate Capsules is a new, irreversible, Epidermal Growth Factor Receptor (EGFR)
mutation selective Tyrosine Kinase Inhibitor.Aim at local advanced or metastatic non-small
cell lung cancer patients with EGFR mutation or T790M drug-resistant mutation. The molecular
mechanism: by irreversible combining the EGFR-RTKs ATP binding site of cell, selectively
suppress the activities of EGFR tyrosine kinase phosphorylation, block the sigal signal
transduction system of EGFR, and close the function of ras/raf/MAPK downstream. at last block
the tumor cell growth by EGFR induction, and promotes apoptosis. AC0010 Maleate Capsules has
three characters: 1. Irreversible combination with EGFR; 2.Efficient suppress the EGFR mutant
tumor cell and has no suppression to EGFR wild-type cell; 3. Efficient suppress the EGFR
T790M drug-resistant mutation tumor cell.
Title
- Brief Title: Safety, Tolerability, Pharmacokinetics and Anti-tumour Activity of AC0010 in Advanced Non Small Cell Lung Cancer
- Official Title: Safety, Tolerability, Pharmacokinetics and Anti-tumour Activity of AC0010 in Patients With Advanced Non Small Cell Lung Cancer Who Progressed on Prior Therapy With an Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Agent
Clinical Trial IDs
- ORG STUDY ID:
AC0010-phaseI
- NCT ID:
NCT02274337
Conditions
- Non-Small Cell Lung Cancer
Interventions
Drug | Synonyms | Arms |
---|
AC0010 | | AC0010 |
Purpose
AC0010 Maleate Capsules is a new, irreversible, Epidermal Growth Factor Receptor (EGFR)
mutation selective Tyrosine Kinase Inhibitor.Aim at local advanced or metastatic non-small
cell lung cancer patients with EGFR mutation or T790M drug-resistant mutation. The molecular
mechanism: by irreversible combining the EGFR-RTKs ATP binding site of cell, selectively
suppress the activities of EGFR tyrosine kinase phosphorylation, block the sigal signal
transduction system of EGFR, and close the function of ras/raf/MAPK downstream. at last block
the tumor cell growth by EGFR induction, and promotes apoptosis. AC0010 Maleate Capsules has
three characters: 1. Irreversible combination with EGFR; 2.Efficient suppress the EGFR mutant
tumor cell and has no suppression to EGFR wild-type cell; 3. Efficient suppress the EGFR
T790M drug-resistant mutation tumor cell.
Detailed Description
This study will treat patients with advanced NSCLC who have already received at least one
course of specific anti-cancer treatment but the tumor has started to re-grow following that
treatment. This is the first time that this drug is used or tested in patients, and so it
will help to understand what type of side effects may occur with the drug treatment, it will
measure the levels of drug in the body, it will also measure the anti-cancer activity. By
using these pieces of information together the best dose of this drug to use in further
clinical trials will be selected.
This study is a multicenter, open-label, two-stage phase I clinical trial. Trial including
single-dose and successive-dose tolerance research, single-dose and successive-dose
pharmacokinetic research, food bioavailability study, exploration of different dosing methods
and tentative evaluation for clinical efficacy. Stage one is a dose escalation study, using
the modified Fibonacci methods. 7 dose level are set, respectively are 50mg/d 100mg/d 200mg/d
350mg/d 550mg/d 850mg/d and 1100mg/d. Three patients are enrolled in each dose level, the
observed indicator is dose-limited toxicity. No DLT occurred of all 3 patients, the dose
escalate to next level. 1/3 DLT observed, 3 more patients are enrolled in the level, if no
DLT is observed, the dose escalated to next level, if DLT occurs again, escalation stops. 2/3
DLT are observed, escalation stops. A recommend phase II dose level will acquire by this
method. Stage two is a multicenter, open label, one arm successive dose clinical trial, based
on the dosing level and method acquired in stage one, for further safety evaluation and
tentative evaluation of clinical efficacy.
Trial Arms
Name | Type | Description | Interventions |
---|
AC0010 | Experimental | patients receiving avitinib treatment Qd, at different dose stages | |
Eligibility Criteria
Inclusion Criteria:
- Patients of either gender, aged from 18 years older to 70.
- Histologically or cytologically confirmed metastatic, or unresectable locally
advanced, recurrent NSCLC.
- At least one measurable disease by CT or MRI, according to RECIST Version 1.1.
- Documented evidence of any activating EGFR mutation in the tumor tissue.
- Have undergone or are able to undergo a biopsy of either primary or metastatic tumor
tissue within 28 days of dosing of Avitinib, and have tissue available to send to
central lab for further genetic profiling especially the status of T790M.
- Life expectancy of at least 3 months.
- ECOG performance status of 0 to 1.
- Adequate hematological and physiological functions of heart, lung, liver, and kidney
according to definitions given in Appendix D.
- Disease progression under at least one treatment with current marketed EGFR TKI
therapy for at least 30 days (e.g. Erlotinib, or Gefitinib, or Afatinib) with
intervening treatment after most recent EGFR TKI therapy. The washout period for an
EGFR TKI (Erlotinib, or Gefitinib) is at a minimum of 7 days. The washout period for
an irreversible EGFR inhibitor (Afatinib) and chemotherapy is at a minimum of 14 days.
- Any toxicity related to prior EGFR inhibitor treatment must have resolved to Grade 1
or less.
- NSCLC patients with asymptomatic brain metastasis or drug-controllable brain
metastasis.
- Signed consent on an Independent Ethics Committee-approved Informed Consent Form prior
to any study-specific evaluation.
Exclusion Criteria:
- No pathology confirmation
- History of interstitial lung disease related to prior EGFR inhibitor therapy.
- Symptomatic brain metastases or uncontrollable or unstable brain metastasis.
- Positive to HCV or HIV antibody.
- Treatment with prohibited medications (e.g., concurrent anticancer therapy including
other chemotherapy, radiation, hormonal, or immunotherapy) ≤14 days prior to treatment
with Avitinb.
- Clinically significant abnormal 12-lead ECG, QT interval corrected using Fridericia's
method (QTcF) >450 msec (males) or >470 msec (females).
- Family history of long QT syndrome.
- Treatment with any Category 1 and 2 drugs (See:https://www.crediblemeds.org/ or
www.qtdrug.org).
- Presence of any serious or unstable concomitant systemic disorder incompatible with
the clinical study (e.g., substance abuse, uncontrolled psychiatric condition,
uncontrolled intercurrent illness including active infection, arterial thrombosis, and
symptomatic pulmonary embolism).
- Any other reasons for the investigator to consider the patient should not participate
in the study.
Maximum Eligible Age: | 70 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety, tolerability and ORR of AC0010 |
Time Frame: | Adverse events will be collected from baseline until 28 days after the last dose |
Safety Issue: | |
Description: | Assessed by number and severity of adverse events as recorded on the case report form, vital signs, laboratory variables, physical examination, electrocardiogram, ophthalmic examinations, RECIST1.1, and NCI CTCAE v4.03 |
Secondary Outcome Measures
Measure: | Plasma concentrations and pharmacokinetic parameters of single dose AC0010 |
Time Frame: | Blood samples will be collected from each subject at pre-specified times after the first dose of the study on Day 1 ,4 (pre-dose, 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48hours post dose) |
Safety Issue: | |
Description: | Plasma concentrations of AC0010 and 4 metabolites and pharmacokinetic parameters following single dose with fast in D1 and fed in D4 (Cmax, tmax, AUC, terminal rate constant, clearance, half life, volume of distribution and mean resistance time) |
Measure: | Plasma concentrations and pharmacokinetic parameters of multiple doses AC0010 |
Time Frame: | Blood samples will be collected from each subject at pre-specified times during the multiple dosing cycles (Cycle 1-pre-dose Day 1, 8 ,15 and 22. D28- pre-dose, 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48 hours post dose) |
Safety Issue: | |
Description: | Plasma concentrations of AC0010 and 4 metabolites and pharmacokinetic parameters following multiple doses (steady state Cmax, tmax, Cmin AUC, clearance, accumulation ratio and time dependency) |
Measure: | Efficacy of AC0010 |
Time Frame: | CT or MRI at screening and every 4-8 weeks (from first dose of multiple dosing) until disease progression or withdrawal from study, expected average 6 months |
Safety Issue: | |
Description: | Evaluation of tumour response, duration of response, tumour shrinkage, progression free survival and overall survival as assessed by RECIST 1.1 |
Measure: | Food effect on AC0010's bioavailibility |
Time Frame: | Blood samples will be collected from each subject at pre-specified times after the first dose of the study on Day 4 (pre-dose, 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48hours post dose) |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Unknown status |
Lead Sponsor: | Sun Yat-sen University |
Trial Keywords
- Epidermal Growth Factor Receptor
- Tyrosine Kinase Inhibitor
- T790M mutation
Last Updated
November 23, 2016