Clinical Trials /

Phase 1a/1b Study of TPST-1495 in Subjects With Solid Tumors

NCT04344795

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.

Related Conditions:
  • Malignant Solid Tumor
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

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

DrugSynonymsArms
TPST-1495 twice dailyTPST-1495 monotherapy dose escalation
TPST-1495 once daily or on intermittent scheduleTPST-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

NameTypeDescriptionInterventions
TPST-1495 monotherapy dose escalationExperimentalSubjects will receive escalating doses of TPST-1495 administered orally twice daily until maximum tolerated dose is reached or until disease progression
  • TPST-1495 twice daily
TPST-1495 monotherapy dose and schedule optimizationExperimentalSubjects 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 expansionExperimentalSubjects 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