Clinical Trials /

Dose-escalation Study of APG-1387 and Toripalimab in Solid Tumors

NCT04284488

Description:

An ascending dose study in patients with solid tumors to evaluate the safety, tolerability, pharmacodynamics and efficacy of APG-1387 in combination with toripalimab. A phase II study of 3 cohorts will be included.

Related Conditions:
  • Colorectal Carcinoma
  • Malignant Solid Tumor
  • Nasopharyngeal Carcinoma
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Dose-escalation Study of APG-1387 and Toripalimab in Solid Tumors
  • Official Title: A Phase Ib/II Clinical Study to Evaluate the Efficacy and Safety of APG-1387 in Combination With Toripalimab in Patients With Advanced Solid Tumors

Clinical Trial IDs

  • ORG STUDY ID: APG1387XC101
  • NCT ID: NCT04284488

Conditions

  • Advanced Solid Tumor

Interventions

DrugSynonymsArms
APG-1387 for InjectionAPG-1387 in combination with Toripalimab
ToripalimabJS001APG-1387 in combination with Toripalimab

Purpose

An ascending dose study in patients with solid tumors to evaluate the safety, tolerability, pharmacodynamics and efficacy of APG-1387 in combination with toripalimab. A phase II study of 3 cohorts will be included.

Detailed Description

      This study will be conducted in two phases. In phase Ib, the safety and efficacy of different
      dose levels of APG-1387 in combination with 240 mg toripalimab will be explored to determine
      the recommended Phase 2 dose (RP2D) of APG-1387 in combination therapy, both administered as
      a 30-minute intravenous (IV) infusion. The following proposed doses of APG-1387 are to be
      evaluated: 20,30, or 12mg (in case no DLT occur in high dose levels, 12mg may be initiated
      for further exploration to determine RP2D comprehensively.) The Phase II portion, will
      compromise 3 cohorts of 29-31 patients.

      The 3 cohorts will include the following:

        -  Colorectal cancer

        -  Nasopharyngeal carcinoma

        -  Non-small cell lung cancer A Simon's 2-stage design will be used for each of the cohorts
           in colorectal cancer, nasopharyngeal carcinoma and non-small cell lung cancer. A
           predefined analysis will be performed in the first stage, and failure to achieve the
           prespecified efficacy will halt enrollment to avoid futile treatment.
    

Trial Arms

NameTypeDescriptionInterventions
APG-1387 in combination with ToripalimabExperimental
  • APG-1387 for Injection
  • Toripalimab

Eligibility Criteria

        Inclusion Criteria:

          1. Histopathologically confirmed advanced solid tumors

               1. For phase II CRC group only: Patients with histologically confirmed
                  microsatellite stable (detected by immunohistochemistry, PCR or NGS methods)
                  advanced colorectal cancer.

               2. For phase II NPC group only: Patients with histologically or cytologically
                  confirmed advanced NPC.

               3. For phase II NSCLC group only: Patients with histologically confirmed or
                  cytologically confirmed advanced non-small cell lung cancer together with
                  wild-type EGFR/ALK/ROS1 (first or second-generation sequencing results are
                  allowed).

          2. Patients who have failed standard antitumor therapy.

          3. At least one evaluable lesion according to RECIST 1.1 criteria.

          4. Age greater than 18 years, both men and women.

          5. ECOG: 0 to 1.

          6. Expected survival ≥ 3 months.

          7. The function of vital organs meets the following criteria (no blood components and
             cell growth factors are allowed 2 weeks before the start of study treatment):

               1. Absolute neutrophil count (ANC) ≥ 1.5 × 109/L;

               2. Platelets ≥ 90 × 109/L;

               3. Hemoglobin ≥ 90 g/L;

               4. Serum albumin ≥ 30 g/L;

               5. Total bilirubin ≤ 1.5 x the upper limit of normal(ULN), ALT and AST ≤ 2.5 x ULN;
                  if there is liver metastasis, ALT and AST ≤ 5 x ULN;

               6. Serum creatinine ≤ 1.5 x ULN or 24-hour creatinine clearance ≥ 50 mL/min
                  (calculated according to Cockcroft-Gault formula);

          8. Patients with asymptomatic brain metastases (not requiring pharmacological control) or
             brain metastases that have been stable for more than 28 days after treatment.

          9. Patients must have recovered to Grade 1 or less from adverse reactions resulting from
             prior antineoplastic therapy (except alopecia and sensory neuropathy not exceeding
             Grade 2).

         10. Males, women of childbearing potential (postmenopausal women who must have been
             postmenopausal for at least 12 months to be considered of non-childbearing potential)
             and their partners voluntarily use contraception deemed effective by the investigator
             during treatment and for at least three months after the last dose of study drug.

         11. Able to understand and voluntarily sign a written informed consent form, which must be
             signed prior to the performance of any trial-specified study procedures.

         12. Patients must be voluntary and able to complete study procedures and follow-up
             examinations.

        Exclusion Criteria:

          1. Cytotoxic chemotherapy, radiation therapy, surgery (except minor surgery), anticancer
             therapy with hormone therapy (except hormone for hypothyroidism or estrogen
             replacement therapy (ERT)), or any clinical study treatment within 28 days prior to
             the first dose of study drug; or clinically significant tumor embolism or tumor lysis
             syndrome (TLS).

          2. Immunotherapy or biologic therapy within 28 days or 5 half-lives (whichever is
             shorter) prior to receiving the first dose of study drug.

          3. Patients who have received targeted therapy within 28 days prior to first dose of
             study drug.

          4. Prior treatment with anti PD-1, anti PD-L1, or anti PD-L2 agents (Phase II only).

          5. Use of anti-TNFa therapy within 28 days prior to first dose.

          6. Patients have an immunodeficiency diagnosis or are receiving chronic systemic steroid
             therapy (daily dose of more than 10 mg prednisone equivalent) or any form of
             immunosuppressive therapy 7 days prior to the first dose of trial treatment.

          7. Patients have any active autoimmune disease or a history of autoimmune disease (such
             as interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, vasculitis,
             myocarditis, nephritis, hyperthyroidism, decreased thyroid function (can be included
             if hormone replacement therapy is effective); patients with vitiligo or asthma that
             has been completely relieved in childhood and does not require any intervention after
             adulthood can be included, and patients with asthma requiring bronchodilators for
             medical intervention cannot be included.

          8. Patient has an active infection or unexplained fever > 38.5。C within 2 weeks prior to
             the first dose (subjects may be enrolled due to tumor generated fever as judged by the
             investigator).

          9. Any evidence of a past history of interstitial lung disease, drug-induced interstitial
             lung disease, radiation pneumonitis requiring steroids, or clinically active
             interstitial lung disease.

         10. Hepatic decompensation.

         11. Evidence of any severe or uncontrolled systemic disease; various chronic active
             infections such as hepatitis B (evidence of hepatitis activity such as HBV-DNA ≥ 104
             copies/mL or 2000 IU/mL), hepatitis C, and HIV.

         12. Any of the following cardiac criteria: Mean QTcB > 470 msec at rest during screening;
             Any clinically important abnormality in rhythm, conduction, or morphology of the
             resting electrocardiogram (ECG) (e.g., complete left bundle branch block, third degree
             heart block, second degree heart block); Congenital long QT syndrome or family history
             of long QT syndrome.

         13. Uncontrolled hypertension (requiring 2 or more medications to control blood pressure);
             Unstable cardiac pain; Angina pectoris within 3 months of study entry; Congestive
             heart failure (NYHA class II or higher); Previous myocardial infarction (NSTEMI or
             STEMI) within 6 months of study entry; Serious cardiac arrhythmia requiring medical
             attention; Serious hepatic, renal, gastrointestinal, or metabolic disease.

         14. History of allergic reactions attributed to compounds of similar chemical or biologic
             composition to APG-1387 or toripalimab or their constituents.

         15. Have received a live vaccine within 28 days prior to the first dose of investigational
             product. Live vaccines include but are not limited to the following: measles, mumps,
             rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacille Calmette-Guérin
             vaccine (BCG) and typhoid. Injectable seasonal influenza vaccines are usually
             inactivated viral vaccines and are therefore allowed; however, intranasal influenza
             vaccines (e.g., FluMist) are live attenuated vaccines and are not allowed.

         16. Patients who have not sufficiently recovered after surgical treatment as judged by the
             investigator. Patients with major surgery within 28 days prior to the first dose of
             study drug and minor surgery within 7 days prior to the start of the study.

         17. Pregnant or lactating female patients.

         18. The subject has other factors that may cause the subject to be forced to terminate the
             study, such as suffering from other serious diseases (including mental illness)
             requiring concomitant treatment, severe abnormalities in laboratory tests, family or
             social factors, conditions that may affect the safety of the subject or the collection
             of trial data, etc.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Recommended Phase 2 dose(RP2D) (Applicable for: phase I stage in various solid tumor types).
Time Frame:21 days.
Safety Issue:
Description:Recommended phase 2 dose(RP2D) of APG-1387 in combination with toripalimab in subjects with solid tumors.

Secondary Outcome Measures

Measure:Overall Response (Applicable for: phase I stage in various solid tumor types)
Time Frame:18-24months.
Safety Issue:
Description:Evaluated using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
Measure:Incidence of Treatment-Emergent Adverse Events (safety and tolerability) (Applicable for: phase II)
Time Frame:18-24months.
Safety Issue:
Description:Patients treatment related adverse events (AEs) and severe adverse events (SAEs) will be assessed according NCI CTCAE Version 5.0.

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Not yet recruiting
Lead Sponsor:Ascentage Pharma Group Inc.

Last Updated

February 23, 2020