Description:
This is a first-in-human Phase 1a/1b, multicenter, open-label, dose-escalation, dose and
schedule optimization, and expansion study of TPST-1495 to determine its maximum tolerated
dose (MTD) and or recommended Phase 2 dose (RP2D), safety, tolerability, pharmacokinetics,
pharmacodynamics and preliminary anti-tumor activity in subjects with advanced solid tumors.
Subjects with all histologic types of solid tumors are eligible for the study. However, the
preferred tumor types for enrollment are colorectal cancer (CRC), non-small cell lung cancer
(NSCLC), squamous cell carcinoma of the head and neck (SCCHN), urothelial cancer, endometrial
cancer, and gastroesophageal junction (GEJ) or gastric adenocarcinoma.
Title
- Brief Title: Phase 1a/1b Study of TPST-1495 in Subjects With Solid Tumors
- Official Title: Phase 1a/1b Open Label Dose-escalation and Expansion Study of TPST-1495 as a Single Agent in Subjects With Solid Tumors
Clinical Trial IDs
- ORG STUDY ID:
TPST-1495-001
- NCT ID:
NCT04344795
Conditions
- Solid Tumor
- Colorectal Cancer
- Non Small Cell Lung Cancer
- Squamous Cell Carcinoma of Head and Neck
- Urothelial Carcinoma
- Endometrial Cancer
- Gastroesophageal Junction Adenocarcinoma
- Gastric Adenocarcinoma
Interventions
Drug | Synonyms | Arms |
---|
TPST-1495 twice daily | | TPST-1495 monotherapy dose escalation |
TPST-1495 once daily or on intermittent schedule | | TPST-1495 monotherapy dose and schedule optimization |
Purpose
This is a first-in-human Phase 1a/1b, multicenter, open-label, dose-escalation, dose and
schedule optimization, and expansion study of TPST-1495 to determine its maximum tolerated
dose (MTD) and or recommended Phase 2 dose (RP2D), safety, tolerability, pharmacokinetics,
pharmacodynamics and preliminary anti-tumor activity in subjects with advanced solid tumors.
Subjects with all histologic types of solid tumors are eligible for the study. However, the
preferred tumor types for enrollment are colorectal cancer (CRC), non-small cell lung cancer
(NSCLC), squamous cell carcinoma of the head and neck (SCCHN), urothelial cancer, endometrial
cancer, and gastroesophageal junction (GEJ) or gastric adenocarcinoma.
Detailed Description
This is a first-in-human Phase 1a/1b, multicenter, open-label, dose-escalation, dose and
schedule optimization, and expansion study of TPST-1495 to determine its MTD, safety,
tolerability, pharmacokinetics (PD), pharmacodynamics (PK) and preliminary anti-tumor
activity in subjects with advanced solid tumors. Subjects with all histologic types of solid
tumors are eligible for the study. However, the preferred tumor types for enrollment are
colorectal cancer (CRC), non-small cell lung cancer (NSCLC), squamous cell carcinoma of the
head and neck (SCCHN), urothelial cancer, endometrial cancer, and gastroesophageal junction
(GEJ) or gastric adenocarcinoma. Tumor prostaglandin production and downstream signaling in
both tumor cells and other cell types, including immune suppressive cell population in the
tumor microenvironment, is thought to be a principal driver of progression in each of these
selected malignancies. To be eligible, subjects must have no remaining standard therapy known
to confer clinical benefit.
The study is composed of 3 stages. The Dose-Escalation stage will determine the MTD of
single-agent TPST-1495 administered twice a day (BID). The Schedule and Dose Optimization
stage will evaluate alternative TPST-1495 administration schedules and determine an RP2D for
the selected schedule. The Expansion stage will evaluate the activity of TPST-1495 at the
selected schedule and dose in disease-specific cohorts.
Trial Arms
Name | Type | Description | Interventions |
---|
TPST-1495 monotherapy dose escalation | Experimental | Subjects will receive escalating doses of TPST-1495 administered orally twice daily until maximum tolerated dose is reached or until disease progression | |
TPST-1495 monotherapy dose and schedule optimization | Experimental | Subjects will receive alternative TPST-1495 administration schedules until RP2D for the selected schedule is determined or until disease progression. | - TPST-1495 once daily or on intermittent schedule
|
TPST-1495 monotherapy dose expansion | Experimental | Subjects will receive selected dose regimen from dose and schedule optimization stage until disease progression | - TPST-1495 once daily or on intermittent schedule
|
Eligibility Criteria
Subjects must meet all the following inclusion criteria to be eligible:
1. Subjects must have a histologically-confirmed malignancy that is metastatic or
unresectable for which there is no remaining standard therapy known to confer clinical
benefit. While all solid tumor types are eligible for the study, there is a preference
to enroll patients with colorectal cancer, squamous cell carcinoma of the head and
neck, urothelial cancer, endometrial cancer, NSCLC, and gastric or gastroesophageal
junction adenocarcinoma.
2. Subjects must have a tumor that is at least 1 cm in a single dimension and is
radiographically apparent on CT or MRI.
3. Eastern Cooperative Oncology Group performance status of 0 or 1 at treatment
initiation.
4. Life expectancy estimated to be ≥ 12 weeks
5. Adequate organ and marrow function (subjects must not have received transfusions or
growth factor support within 1 month prior to first dose of investigational product)
as defined below:
- Albumin ≥ 3.0 g/dL
- Hemoglobin ≥ 10.0 g/dL
- Absolute neutrophil count ≥ 1,000/mm3
- Platelet count ≥ 100,000/mm3
- Bilirubin ≤ 1.5 × institutional upper limit of normal (ULN); for subjects with
documented/suspected Gilbert's disease, bilirubin should be ≤ 2 × ULN.
- Aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 × ULN; for
subjects with liver metastases, AST or ALT ≤ 5 × ULN
- Creatinine ≤ 1.5×ULN OR calculated creatinine clearance (CrCl) ≥ 60 mL/min for
subjects with creatinine levels > 1.5× ULN.
Subjects who meet any of the following exclusion criteria will not be eligible to receive
investigational product:
1. Concurrent enrollment in another clinical study, unless it is an observational (non
interventional) clinical study, a specimen-collection study or the follow-up period of
an interventional study.
2. Received more than 4 doses of nonsteroidal anti-inflammatory drugs or COX-2 inhibitors
within 2 weeks prior to study treatment initiation.
3. History of allergy or hypersensitivity, GI bleed, or ulceration secondary to
nonsteroidal anti-inflammatory drugs or COX-2 inhibitors.
4. History of GI ulcer within 1 year of treatment initiation or history of untreated
helicobacter pylori infection. Subjects with history of treated helicobacter pylori
infection with confirmation of eradication are eligible
5. History of diverticulitis or any GI bleed within 2 years of treatment initiation.
6. Receipt of any anticancer therapy within the following windows:
- Small molecule tyrosine kinase inhibitor (TKI) therapy (including
investigational) within 2 weeks or 5 half-lives prior to treatment initiation,
whichever is longer
- Any type of anti-cancer antibody or cytotoxic chemotherapy within 4 weeks prior
to treatment initiation
- Radiation therapy for bone metastasis within 2 weeks, any other external
radiation therapy within 4 weeks before treatment initiation. Patients with
clinically relevant ongoing complications from prior radiation therapy are not
eligible
- Other investigational therapy within 2 weeks or 5 half-lives prior to dosing,
whichever is longer
7. Subjects with active or untreated central nervous system (CNS) metastases
8. New York Heart Association Classification II, III or IV.
9. Baseline QTcF > 470 milliseconds
10. Receipt of live attenuated vaccines within 30 days prior to the first dose of
investigational product. (Killed virus or other non-live vaccines are allowed
(including most seasonal influenza vaccines, streptococcus pneumonia vaccines, and
newly approved COVID-19 vaccines).
11. Active autoimmune disease or inflammatory disorders including inflammatory bowel
disease (e.g., ulcerative colitis or Crohn's disease) requiring systemic treatment
(i.e., with use of disease modifying agents, systemic corticosteroids or
immunosuppressive drug) within 2 years prior to treatment initiation.
12. Known human immunodeficiency virus (HIV) infection, active Hepatitis B (HBV), or
hepatitis C (HCV). Active HBV is defined as a known positive HBsAg result. Active HCV
is defined by a known positive HCV antibody result and known quantitative HCV RNA
results greater than the lower limits of detection of the assay. Patients receiving
antiviral therapy for Hepatitis B or C also are not eligible
13. Uncontrolled intercurrent illness, including but not limited to, ongoing or active
infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable
angina pectoris, cardiac arrhythmia, serious chronic gastrointestinal conditions
associated with diarrhea, or psychiatric illness/social situations including a history
of substance abuse that would limit compliance with study requirement, substantially
increase risk of incurring AEs or compromise the ability of the patient to give
written informed consent.
14. Subjects who are receiving anti-coagulant therapy or who are considered to be at
increased risk of bleeding (i.e bleeding disorder or coagulopathy).
15. Administration of the following substrates for drug transporters OATP1B1 and OATP1B3
is prohibited while on study or within 7 days of treatment initiation: glyburide,
digoxin, docetaxel, paclitaxel, pitavastatin, rosuvastatin, simvastatin or saquinavir
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Determination of maximum tolerated dose and/or recommended Phase 2 dose (RP2D) and optimum dose schedule for TPST-1495 |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Determination of maximum tolerated dose and/or recommended Phase 2 dose (RP2D) and optimum dose schedule for TPST-1495 based on dose limiting toxicities |
Secondary Outcome Measures
Measure: | Incidence of adverse events and serious adverse events as assessed by NCI-CTCAE v.5.0 |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Incidence of treatment-emergent adverse events and serious adverse events for TPST-1495 |
Measure: | Assess pharmacokinetics: maximum serum concentration (Cmax) |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Maximum serum concentration (Cmax) of TPST-1495 |
Measure: | Assess pharmacokinetics: area under the serum concentration-time curve (AUC) |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Area under the serum concentration-time curve (AUC) of TPST-1495 |
Measure: | Assess pharmacokinetics: Clearance (CL) |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Clearance (CL) of TPST-1495 |
Measure: | Assess pharmacokinetics: terminal elimination half-life (t 1/2) |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Terminal elimination half-life (t 1/2) of TPST-1495 |
Measure: | Overall response rate (ORR) using RECIST version 1.1 |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Preliminary efficacy of TPST-1495 as a single agent and in combination with pembrolizumab as assessed by overall response rate (ORR) using RECIST version 1.1 |
Measure: | Progression free survival (PFS) |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Preliminary efficacy of TPST-1495 as a single agent and in combination with pembrolizumab as assessed by progression free survival (PFS) |
Measure: | Duration of response (DoR) |
Time Frame: | From start of treatment to treatment termination visit, up to 24 months |
Safety Issue: | |
Description: | Preliminary efficacy of TPST-1495 as a single agent and in combination with pembrolizumab as assessed by duration of response (DoR) |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Tempest Therapeutics |
Trial Keywords
- TPST-1495
- EP2 antagonist
- EP4 antagonist
- prostaglandin E2 (PGE2)
Last Updated
April 22, 2021