The primary Phase 1 purpose of this study was to assess overall safety, tolerability and
recommended Phase 2 dose (RP2D) of APL-101.
The Phase 2 portion will assess efficacy of the dose determined in Phase 1 in individuals
with Non-Small Cell Lung Cancer with c-Met EXON 14 Skip Mutations; individuals with cancers
associated with c-Met amplifications; individuals with cancers associated with c-Met fusion
This is a Phase 1/2, multi-center, global, open-label, 2-part study with a Dose Escalation
Segment and Dose and Disease Expansion Cohorts study of APL-101, a c-MET inhibitor, to
determine the recommended Phase 2 dose (RP2D) and dose limiting toxicities for APL-101, and
to obtain preliminary efficacy and target engagement data, in subjects with NSCLC and
advanced malignancies with c-Met dysregulation.
c-MET dysregulation will be determined from historical results by molecular pre-screening
evaluations to determine eligibility of enrollment for both the Dose Escalation Segment
(Phase 1) and Dose and Disease Expansion Cohorts (Phase 2).
Dose escalation will occur until a protocol defined dose limited toxicity (DLT) occurs and a
tentative maximum tolerated dose (MTD) is determined.
Once dose is determined, five cohort groups will be further evaluated:
- Cohort A-1: NSCLC EXON 14 skip mutation (c-Met naïve, 1L)
- Cohort A-2: NSCLC EXON 14 skip mutation (c-Met naïve, 2/3L),
- Cohort B: NSCLC EXON 14 skip mutation (c-Met experienced; progressed on prior c-Met
inhibitor),
- Cohort C: basket of tumor types (with c-Met high-level amplifications),
- Cohort D: basket of tumor types (with c-Met fusions)
Major Inclusion Criteria:
- Able to understand and comply with study procedures, understand the risks involved,
and provide written informed consent.
- For Phase 1, histologically and / or cytological confirmed unresectable or metastatic
solid malignancy, refractory to standard therapies with no more than three prior lines
of therapy.
- For Phase 2, five cohorts will be enrolled: Cohort A-1: NSCLC EXON 14 skip mutation
(c-Met naïve) for first line treatment, Cohort A-2: NSCLC EXON 14 skip mutation (c-Met
naïve) pretreated subjects with no more than 3 lines of prior therapy, Cohort B: NSCLC
EXON 14 skip mutation (c-Met experienced; radiographic progression on prior c-Met
inhibitor), Cohort C: basket of tumor types with c-Met high level amplification (NSCLC
EXON 14 skip mutation excluded), Cohort D: basket of tumor type with c-Met fusions.
- Local/archival result (tissue and/or plasma) of a positive c-Met dysregulation is
required (except in Cohort A-1 in the US).
- Measurable disease according to RECIST v1.1. (or relevant criteria per tumor type).
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
- For all prior anticancer treatment, including radiotherapy, chemotherapy or targeted
agents or hormonal therapy, a duration of more than 30 days or 5 half-lives of the
agents used, whichever is shorter, must have elapsed, and any encountered toxicity
must have resolved to levels meeting all the other eligibility criteria prior to the
first dose of study treatment.
- No planned major surgery within 4 weeks of first dose of APL-101
Major Exclusion Criteria:
- Hypersensitivity to APL-101, excipients of the drug product, or other components of
the study treatment regimen.
- Known actionable mutation/gene rearrangement of EGFR (except for Cohort C), ALK, ROS1,
RET, NTRK, KRAS, and BRAF.
- Unstable angina or myocardial infarction within 1 year prior to first dose of APL-101,
symptomatic or unstable arrhythmia requiring medical therapy, history of congenital
prolonged QT syndrome, prolonged QT interval corrected by Fridericia formula (QTcF) at
screening (> 450 msec based on the average of 3 measurements), or concurrent treatment
with a medication that is a known risk for prolonging the QT interval.
- Unable to swallow orally administered medication whole.
- Impairment of gastrointestinal function or gastrointestinal disease that may
significantly alter drug absorption (e.g., Crohn's, ulcerative colitis, active
inflammatory bowel disease, uncontrolled nausea, vomiting, diarrhea, or malabsorption
syndrome).
- Women who are breastfeeding.
