Description:
CVM-1118 is a new small molecule chemical entity being developed as a potential anti-cancer
therapeutic by TaiRx, Inc. CVM-1118 is a potent anti-cancer agent in numerous human cancer
cell lines. The safety of administrating CVM-1118 on human is evaluated from the phase 1
study. The objectives of the phase 2 study is to further investigate the efficacy of CVM-1118
with sorafenib for subjects with advanced hepatoma.
Title
- Brief Title: CVM-1118 and Sorafenib Combination in Subjects With Advanced Hepatocellular Carcinoma
- Official Title: A Phase 2, Open-Label Study With Orally Administered CVM-1118 and Sorafenib in Subjects With Advanced Hepatocellular Carcinoma
Clinical Trial IDs
- ORG STUDY ID:
CVM-004
- NCT ID:
NCT03582618
Conditions
- Hepatocellular Carcinoma
- Advanced Cancer
Interventions
Drug | Synonyms | Arms |
---|
Sorafenib | Nexavar | Sorafenib + CVM-1118 |
CVM-1118 | TRX-818 | Sorafenib + CVM-1118 |
Purpose
CVM-1118 is a new small molecule chemical entity being developed as a potential anti-cancer
therapeutic by TaiRx, Inc. CVM-1118 is a potent anti-cancer agent in numerous human cancer
cell lines. The safety of administrating CVM-1118 on human is evaluated from the phase 1
study. The objectives of the phase 2 study is to further investigate the efficacy of CVM-1118
with sorafenib for subjects with advanced hepatoma.
Detailed Description
Sorafenib is a multi-kinase inhibitor that inhibits tumor growth and angiogenesis. Although
sorafenib is the first-line treatment of advanced hepatocellular cancer (HCC), patients
developing resistance to sorafenib have been reported.
To meet the medical need, TaiRx, Inc. develops a new small molecule drug, CVM-1118 targeting
the formation of vasculogenic mimicry (VM). VM has been associated with tumor metastasis and
poor clinical outcomes. VM is reported to be particularly active in tumor under hypoxia state
when patients are treated with the potent vascular endothelial growth factor (VEGF) inhibitor
like sorafenib. Hence, the ability of inhibiting the VM network make CVM-1118 a potential
good combination drug with sorafenib for advanced diseases.
The safety profile of CVM-1118 dosing has been established in the phase 1 study. The analysis
of metabolism pathways further showed that the potential of CVM-1118 and sorafenib drug-drug
interactions are very low.
Based on the mechanism of actions and the safety analysis of sorafenib and CVM-1118, the
design of phase 2 trial with the combination therapy might have great potential for the
patients with advanced HCC.
Trial Arms
Name | Type | Description | Interventions |
---|
Sorafenib + CVM-1118 | Experimental | Cycle 0 (at least 3 weeks): sorafenib tolerability assessment period (sorafenib alone)
400mg BID daily (starting dose); The subject will be assessed for the need for a dose reduction in sorafenib during this period.
Cycle 1+ (28-day cycles): combination period (sorafenib+CVM-1118)
Tolerable dose of sorafenib and CVM-1118 150 (starting dose) or 200 mg BID will be administered continuously for a 28-day cycle until progressive disease, unacceptable toxicity, or consent withdrawal. | |
Eligibility Criteria
Inclusion Criteria:
1. Signed, informed consent
2. Age 18 or older (for all treatment locations with exception of Taiwan), or age 20 or
older (Taiwan only)
3. Pathologically or cytologically-confirmed, advanced-stage hepatocellular carcinoma
without prior systemic treatment except for prior immunotherapy and Child-Pugh liver
function class A appropriate for treatment with sorafenib
4. Measurable disease according to modified Response Evaluation Criteria in Solid Tumors
criteria (mRECIST)
5. Eastern Cooperative Oncology Group (ECOG) performance status: 0 to 1
6. Adequate laboratory parameters including:
1. Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) ≤ 3.0 x
upper limit of normal (ULN), or AST and ALT ≤ 5.0 x ULN if liver function
abnormalities are due to underlying malignancy
2. Total serum bilirubin ≤ 2.0 x ULN (except for subjects with documented Gilbert's
syndrome who have a limit of ≤ 3.0 x ULN)
3. Absolute neutrophil count (ANC):1500/µL
4. Platelets: 90,000/µL
5. Hemoglobin: 9.0 g/dL
6. Serum creatinine ≤ 2.0 x ULN or creatinine clearance of ≥ 50 mL/min
7. Serum albumin ≥ 3.0 g/dL
8. International normalized ratio (INR) ≤ 1.4
9. Prothrombin Time (PT)/ Activated Partial Thromboplastin Time (aPTT) ≤ 1.2 x ULN
7. QTc interval (using Fridericia correction) of ≤ 470 msec (QTc interval may be derived
from up to 3 separate EKGs performed at least 5 minutes apart)
8. Willingness to participate in collection of pharmacokinetic and other exploratory
blood collection as defined in the protocol
9. Willingness to use adequate contraception throughout study and for a period of 3
months after last dose of CVM-1118
Exclusion Criteria:
1. Major surgery (other than diagnostic surgery) or radiation therapy within 28 days of
starting study treatment
2. Prior systemic immunotherapy for hepatoma within 28 days of starting study treatment
3. Systemic anticancer therapy (e.g., chemotherapy, hormonal, investigational, biological
therapies) within 28 days (or fewer than 5 half-lives, whichever is shorter) of
starting study treatment except for ongoing hormonal therapy administered for control
of a second cancer (e.g., breast or prostate cancer)
4. Receipt of a CYP3A4 inducer less than 28 days or 5 half-lives of the CYP3A4 inducer
prior to the first day of sorafenib administration
5. Other known active cancer(s) likely to require treatment in the next two (2) years or
likely to impact the assessment of any study endpoints
6. Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic
therapy (e.g., subjects with known HBV or HCV infections controlled on antivirals are
allowed)
7. Known Central Nervous system (CNS) metastases unless appropriately treated and
neurologically stable for ≥ 4 weeks off steroids
8. Pregnant or currently breast-feeding
9. Known HIV-positive
10. Patients with impaired gastrointestinal (GI) diseases that may significantly alter the
absorption of oral medications
11. Psychiatric illness/social situations that would interfere with compliance with study
requirements
12. History of clinically significant cardiovascular abnormalities such as uncontrolled
hypertension, congestive heart failure (New York Heart Association classification ≥
2), unstable angina, poorly controlled arrhythmias, myocardial infarction within 6
months of study entry
13. Other severe acute or chronic medical or psychiatric conditions or laboratory
abnormalities that would impart, in the judgement of the PI and/or Sponsor, excess
risk associated with study participation or study drug administration, which would
make the subject inappropriate for entry into this study
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Objective Response Rate (ORR) |
Time Frame: | 24 weeks after the last subject starts CVM-1118 |
Safety Issue: | |
Description: | Assessment by modified RECIST criteria |
Secondary Outcome Measures
Measure: | Overall survival (OS) |
Time Frame: | 24 weeks after the last subject starts CVM-1118 and up to 1 year after the last-dose |
Safety Issue: | |
Description: | Overall survival (OS) is defined as time from first dose of study drug to death |
Measure: | Progression-free survival (PFS) |
Time Frame: | 24 weeks after the last subject starts CVM-1118 and up to 1 year after the last-dose |
Safety Issue: | |
Description: | Progression-free survival (PFS) is defined as time from the first dose of study drug to the time of progression or death |
Measure: | Time to progression (TTP) |
Time Frame: | 24 weeks after the last subject starts CVM-1118 and up to 1 year after the last-dose |
Safety Issue: | |
Description: | Time to progression (TTP) is defined as the time from the first dose of study drug to the time of progression |
Measure: | Duration of response (DoR) |
Time Frame: | 24 weeks after the last subject starts CVM-1118 and up to 1 year after the last-dose |
Safety Issue: | |
Description: | Duration of response (DoR) is defined as time from the first documentation of response to the time of progression |
Measure: | Disease control rate (DCR) |
Time Frame: | 24 weeks after the last subject starts CVM-1118 and up to 1 year after the last-dose |
Safety Issue: | |
Description: | Disease control rate (DCR) is defined as the sum of complete response (CR), partial response (PR), and stable disease rate (SD) as assessed by modified RECIST criteria |
Measure: | Rate of Adverse event (AE) and Serious Adverse Event (SAE) |
Time Frame: | During the course of trial and within 28 days following the last dose of CVM-1118 or prior to the start of new treatment, whichever comes first |
Safety Issue: | |
Description: | Rate of Adverse event (AE) and Serious Adverse Event (SAE) are assessed using Common Terminology Criteria for Adverse Events v5 (CTCAE) criteria |
Measure: | Assessed the baseline and out-of-range vital signs_ body temperature, blood pressure, heart rate, and respiratory rate by CTCAE v4.03 |
Time Frame: | During the course of trial and within 28 days following the last dose of CVM-1118 or prior to the start of new treatment, whichever comes first |
Safety Issue: | |
Description: | A list of all laboratory normal ranges will also be provided. Values with CTCAE v4.03 Grade ≧ 3 will be identified with flags. |
Measure: | Assessed the baseline and out-of range laboratory parameters_hematology, chemistry, coagulation, and urinalysis by CTCAE v4.03 |
Time Frame: | During the course of trial and within 28 days following the last dose of CVM-1118 or prior to the start of new treatment, whichever comes first |
Safety Issue: | |
Description: | A list of all laboratory normal ranges will also be provided. Values with CTCAE v4.03 Grade ≧ 3 will be identified with flags. |
Measure: | Abnormalities in electrocardiography (ECG) |
Time Frame: | During the course of trial and within 28 days following the last dose of CVM-1118 or prior to the start of new treatment, whichever comes first |
Safety Issue: | |
Description: | a 12-lead (with a 10-second rhythm strip) tracing, with a capacity to calculate the standard intervals automatically, will be used. |
Measure: | Maximum Plasma Concentration [Cmax] of sorafenib, CVM-1118, and its metabolite CVM-1125 after CVM-1118 dosing |
Time Frame: | During Cycle 1 and Cycle 2 (each cycle is 28 days) |
Safety Issue: | |
Description: | Maximum Plasma Concentration [Cmax] of sorafenib, CVM-1118, and its metabolite CVM-1125 will be measured to see maximum exposure after CVM-1118 dosing |
Measure: | Area Under the Curve [AUC] of sorafenib, CVM-1118, and its metabolite CVM-1125 after CVM-1118 dosing |
Time Frame: | During Cycle 1 and Cycle 2 (each cycle is 28 days) |
Safety Issue: | |
Description: | Area Under the Curve [AUC] of sorafenib, CVM-1118, and its metabolite CVM-1125 will be measured to see drug exposure after CVM-1118 dosing |
Measure: | Pharmacodynamics analysis for the relationship of Cmax and ORR |
Time Frame: | During Cycle 1 and Cycle 2 (each cycle is 28 days) |
Safety Issue: | |
Description: | Relationship between Cmax and ORR will be evaluated |
Measure: | Pharmacodynamics analysis for the relationship of AUC and ORR |
Time Frame: | During Cycle 1 and Cycle 2 (each cycle is 28 days) |
Safety Issue: | |
Description: | Relationship between AUC and ORR will be evaluated |
Measure: | Pharmacodynamics analysis for the relationship of Cmax and Adverse Event (AE) |
Time Frame: | During Cycle 1 and Cycle 2 (each cycle is 28 days) |
Safety Issue: | |
Description: | Relationship between Cmax and AE will be evaluated |
Measure: | Pharmacodynamics analysis for the relationship of AUC and Adverse Event (AE) |
Time Frame: | During Cycle 1 and Cycle 2 (each cycle is 28 days) |
Safety Issue: | |
Description: | Relationship between AUC and AE will be evaluated |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | TaiRx, Inc. |
Trial Keywords
- Oncology
- Hepatocellular Carcinoma (HCC)
- Sorafenib
- Hepatoma
Last Updated
April 1, 2021