Clinical Trials /

A Study Evaluating the Safety, Pharmacokinetics and Early Efficacy of AVA6000 in Solid Tumours

NCT04969835

Description:

This open-label, First-into-Human (FIH) study will evaluate the safety, tolerability, pharmacokinetics (PK) and early efficacy of AVA6000, a FAP-activated pro-drug of doxorubicin, in patients with locally advanced and/or metastatic solid tumours. In Phase Ia, using a 3+3 design, escalating doses of AVA6000 will be administered to patients with a range of solid tumour types to determine the maximum tolerated dose (MTD) and/or recommended Phase II dose (RP2D). In Phase 1b, the selected RP2D dose will be assessed in one to three tumour types.

Related Conditions:
  • Bladder Carcinoma
  • Breast Carcinoma
  • Colorectal Carcinoma
  • Head and Neck Squamous Cell Carcinoma
  • Non-Small Cell Lung Carcinoma
  • Ovarian Carcinoma
  • Pancreatic Carcinoma
  • Soft Tissue Sarcoma
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Study Evaluating the Safety, Pharmacokinetics and Early Efficacy of AVA6000 in Solid Tumours
  • Official Title: A Phase 1, Open Label, Dose-Escalation and Expansion Study to Evaluate the Safety, Pharmacokinetics and Initial Therapeutic Activity of AVA6000, a Novel FAP-activated Doxorubicin Prodrug Administered Intravenously in Patients With Locally Advanced or Metastatic Selected Solid Tumours

Clinical Trial IDs

  • ORG STUDY ID: ALS-6000-101
  • NCT ID: NCT04969835

Conditions

  • Pancreatic Cancer
  • Colorectal Cancer
  • Non-small Cell Lung Cancer
  • Breast Cancer
  • Head and Neck Cancer
  • Soft Tissue Sarcoma
  • Ovarian Cancer
  • Bladder Cancer

Interventions

DrugSynonymsArms
AVA6000AVA6000 Phase 1a

Purpose

This open-label, First-into-Human (FIH) study will evaluate the safety, tolerability, pharmacokinetics (PK) and early efficacy of AVA6000, a FAP-activated pro-drug of doxorubicin, in patients with locally advanced and/or metastatic solid tumours. In Phase Ia, using a 3+3 design, escalating doses of AVA6000 will be administered to patients with a range of solid tumour types to determine the maximum tolerated dose (MTD) and/or recommended Phase II dose (RP2D). In Phase 1b, the selected RP2D dose will be assessed in one to three tumour types.

Detailed Description

      This study is a first-in-human (FIH), Phase 1, open-label, multicentre, dose-escalation study
      investigating AVA6000 monotherapy administered intravenously (IV) in patients with locally
      advanced (unresectable) and/or metastatic solid tumours.

      The study will be conducted in two parts: Phase 1a (Dose Escalation) and Phase 1b (Dose
      Expansion):

      Phase 1a (Dose Escalation): The dose-escalation phase is designed to evaluate the safety,
      tolerability and MTD and/or RP2D of AVA6000, administered as monotherapy

      Phase 1b (Dose Expansion): The dose-expansion phase will comprise 1 to 3 expansion arms in
      specific tumour types to evaluate the safety and tolerability of AVA6000 at the MTD or RP2D
      when administered as monotherapy. The tumour types to be explored in Phase 1b, will be
      determined based on evaluation of the Phase 1a data and the protocol will be amended
      accordingly.
    

Trial Arms

NameTypeDescriptionInterventions
AVA6000 Phase 1aExperimentalPatients in Phase Ia will receive escalating doses of AVA6000 following a 3+3 design, commencing with a starting dose of 80mg/m2, once every 3 weeks (Q3W) starting on Cycle 1, Day 1 (C1D1), until disease progression, unacceptable toxicities, withdrawal from treatment for other reasons, reaching maximum lifetime cumulative exposure to doxorubicin (or other anthracyclines), or death, whichever occurs first.
  • AVA6000
AVA6000 Phase 1bExperimentalPatients in Phase Ib will receive the RP2D dose of AVA6000, once every 3 weeks (Q3W) starting on Cycle 1, Day 1 (C1D1), until disease progression, unacceptable toxicities, withdrawal from treatment for other reasons, reaching maximum lifetime cumulative exposure to doxorubicin (or other anthracyclines), or death, whichever occurs first. One to three tumour types will be selected based on the assessment of Phase 1a data.
  • AVA6000

Eligibility Criteria

        Key Inclusion Criteria:

          1. Willing and able to give written informed consent

          2. Male or female patients, ≥18 years of age

          3. Histological or cytological confirmation of a locally advanced (unresectable) and/or
             metastatic pancreatic, CRC, NSCLC, SCCHN, ovarian, breast, soft tissue sarcoma and
             bladder cancer, who have either relapsed or progressed on SoC treatment or are
             intolerant or nonamenable to SoC treatment

          4. In Phase 1b part of the study only: At least 1 lesion, not previously irradiated, that
             can be accurately measured at baseline as ≥10mm in the largest diameter (except lymph
             nodes, which must have a short axis ≥15 mm) with CT or MRI scan and that is suitable
             for accurate repeated measurements.

          5. Life expectancy of greater than 12 weeks, in the opinion of the investigator

          6. Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1

          7. Recovered from all acute toxic effects of any prior radiotherapy, chemotherapy, or
             surgical procedure (must have resolved to CTCAE grade ≤1 or returned to baseline,
             except alopecia and peripheral neuropathy, which can be up to CTCAE grade 2)

          8. Adequate haematological function (applies only to patients not receiving therapeutic
             anticoagulation; patients receiving therapeutic anticoagulation should be on a stable
             dose):

               1. Neutrophil count of ≥1.5× 10^9 cells/L

               2. Haemoglobin ≥9g/dL (with or without transfusion support)

               3. Platelet count of ≥75,000/μL (without transfusion within 2 weeks prior to Cycle
                  1, Day 1)

               4. International normalised ratio (INR) and activated partial thromboplastin time
                  (aPTT) ≤1.5 times the upper limit of normal (ULN)

          9. Adequate liver function:

               1. Total bilirubin ≤1.5 × ULN (in patients with Gilbert's Syndrome, <3 × ULN is
                  allowed)

               2. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 × ULN
                  (in patients with liver metastases, <5 × ULN is allowed)

               3. Alkaline phosphatase (ALP) <5 × ULN (patients with documented liver or bone
                  metastases only)

         10. Adequate renal function:

             a. Serum creatinine ≤1.5 × ULN (in patients for whom, in the Investigator's judgment,
             serum creatinine levels do not adequately reflect renal function, creatinine clearance
             by Cockcroft-Gale formula ≥ 50 mL/min may be used)

         11. Women of childbearing potential (WOCBP) and women who have ≤ 2 years amenorrhea after
             start of menopause: has a negative serum pregnancy test within 7 days prior to Cycle
             1, Day 1

         12. Contraception requirements:

               1. Female patients of childbearing potential must agree to remain abstinent (refrain
                  from heterosexual intercourse) or use a highly effective contraceptive method
                  (Pearl Index failure rate <1% per year) during the treatment period and for at
                  least 6 months after the last dose of study drug

               2. Male patients with female partners of childbearing potential must agree to use 2
                  acceptable methods of contraception (Pearl Index failure rate <1% per year),
                  including a barrier method (with or without spermicide) during the treatment
                  period and for at least 6 months after the last dose of study drug

        Key Exclusion Criteria:

          1. Received trastuzumab within 7 months of the planned Cycle 1, Day 1 AVA6000 infusion

          2. Received a prior total cumulative anthracycline dose of >350mg/m^2 doxorubicin
             hydrochloride (or equivalent anthracycline dose)

          3. Clinically significant or untreated central nervous system (CNS) metastases requiring
             treatment, as determined by the Investigator.

          4. Has leptomeningeal disease

          5. Any history of an active (requiring treatment) other malignancy (except any in-situ
             carcinoma, non-melanoma skin carcinoma and early prostate cancer with a normal PSA)
             within 2 years of study entry

          6. Has a significant, uncontrolled, concomitant disease that could affect compliance with
             the protocol

          7. Has uncontrolled hypertension (systolic blood pressure [SBP] >150 mmHg and/or
             diastolic [DBP] >100 mm Hg), unstable angina, congestive heart failure (New York Heart
             Association (NYHA) Class >II), left ventricular ejection fraction (LVEF) <55% or the
             low limit of institutional normal limit (whichever is lower) by echocardiogram (ECHO),
             serious cardiac arrhythmia requiring treatment (exceptions include atrial
             fibrillation, paroxysmal supraventricular tachycardia), history of myocardial
             infarction within 6 months prior to Cycle 1, Day 1; history of uncontrolled
             cardiovascular disease or high-sensitivity troponin above normal at baseline

          8. Screening baseline mean QTcF interval (Fridericia's) of >470 msec, obtained from 3
             electrocardiograms (ECGs). Has any clinically significant abnormalities in rhythm,
             conduction, or morphology of resting ECG (e.g., complete left bundle branch block,
             third-degree heart block, second-degree heart block, PR interval >250msec). Has any
             factors that increase the risk of QTc prolongation or risk of arrhythmic events such
             as heart failure, hypokalaemia, congenital long QT syndrome, known family history of
             long QT syndrome or unexplained sudden death under 40 years of age in first degree
             relatives or any concomitant medication known to prolong the QT interval, a baseline
             resting bradycardia <45 beats/min or a baseline resting tachycardia of >100 beats/min

          9. Known uncontrolled HIV infection

         10. Active hepatitis B (HBV) or hepatitis C (HCV) infection:

               1. Positive hepatitis B surface antigen (HBsAG) test at Screening. Patients with a
                  past or resolved HBV infection (defined as having a negative HBsAG test and a
                  positive antibody to hepatitis B core antigen [antiHBc] antibody test) are
                  eligible.

               2. Patients positive for HCV antibody are eligible only if PCR is negative for HCV
                  RNA

         11. Severe infection(requiring IV treatment)within 21 days prior to Cycle 1, Day 1
             including, but not limited to, hospitalisation for complications of infection,
             bacteraemia, or severe pneumonia

         12. Any other clinically significant active disease, metabolic dysfunction, physical
             examination finding, clinical laboratory finding, or reasonable suspicion of a disease
             or condition that would contraindicate the use of an investigational drugin the
             opinion of the investigator.

         13. Major surgery within 21 days prior to Cycle 1, Day 1 (excluding biopsies) or
             anticipates the need for major surgery during study treatment

         14. Has dementia or altered mental status that in the opinion of the investigator would
             preclude providing informed consent

         15. Pregnant or breastfeeding woman

         16. Known hypersensitivity to any of the components of AVA6000 or any excipient related to
             the product

         17. Received prior investigational therapy (defined as a treatment for which there is no
             Regulatory Authority-approved indication) within 21 or 42 days of Cycle 1 Day 1, for
             small molecule and biologic investigational therapies, respectively.

         18. Received any approved anticancer therapy, including chemotherapy or hormonal therapy,
             within 28 days prior to Cycle 1, Day 1, with the following exceptions:

               1. Hormone-replacement therapy or oral contraceptives

               2. Tyrosine kinase inhibitors (TKIs) that have been discontinued more than 7 days
                  prior to Cycle1, Day 1

         19. Is planned for on study treatment or has received within 21 days prior to Cycle 1, Day
             1: St John's Wort, any strong inhibitor or inducer of CYP3A4, CYP2D6, narrow
             therapeutic index CYP1A2, CYP2B6, or P-glycoprotein (PGP) ̧ or any moderate OATP1B3
             inhibitor (will include statins)

         20. Received systemic immunosuppressive medication (for any indication) at doses of >10mg
             prednisolone (or equivalent) within 28 days prior to Cycle 1, Day 1.

         21. Received radiotherapy within 28 days prior to Cycle 1, Day 1, except for limited field
             palliative radiotherapy. Patients who have received prior or concomitant radiotherapy
             to the mediastinal area are also excluded.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of participants with dose-limiting toxicities (DLTs)
Time Frame:Cycle 1, 21 days
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Maximum drug concentration (Cmax) of AVA6000 & Doxorubicin
Time Frame:Cycle 1 and Cycle 2, 0-72 hours post dose (Dose Escalation)
Safety Issue:
Description:Cmax (maximum plasma concentration) of AVA6000 and Doxorubicin after administration after Cycle 1 and 2 for 72 hours post-dose.
Measure:Area under the concentration versus time curve (AUC) of AVA6000 & Doxorubicin
Time Frame:Cycle 1 and Cycle 2, 0-72 hours post dose (Dose Escalation)
Safety Issue:
Description:AUC (Area under the concentration versus time curve) of AVA6000 and Doxorubicin after administration after Cycle 1 and 2 for 72 hours post-dose.
Measure:Elimination half-life (t1/2) of AVA6000 & Doxorubicin
Time Frame:Cycle 1 and Cycle 2, 0-72 hours post dose (Dose Escalation)
Safety Issue:
Description:t1/2 (Elimination half-life) of AVA6000 and Doxorubicin after administration after Cycle 1 and 2 for 72 hours post-dose.
Measure:Renal clearance (CLr) of AVA6000 & Doxorubicin
Time Frame:Cycle 1 and Cycle 2, 0-72 hours post dose (Dose Escalation)
Safety Issue:
Description:CLr (Renal clearance) of AVA6000 and Doxorubicin after administration after Cycle 1 and 2 for 72 hours post-dose.
Measure:Objective response rate (ORR)
Time Frame:Up to one year
Safety Issue:
Description:ORR is defined as the proportion of patients achieving a best overall response of confirmed partial responses (PR) or complete response (CR), per Response Evaluation Criteria in Solid Tumors (RECIST 1.1).
Measure:Duration of Response (DoR)
Time Frame:Up to one year
Safety Issue:
Description:DoR is defined as the duration of time from date of first response to date of disease progression, as per RECIST v1.1
Measure:Progression-free-survival (PFS)
Time Frame:Up to one year
Safety Issue:
Description:PFS is defined as the time from the date of the first dose to the date of the first documentation of confirmed disease progression or death, whichever occurs first, as per RECIST v1.1
Measure:Overall survival (OS)
Time Frame:Up to one year
Safety Issue:
Description:Overall survival (OS), defined as the date of first dose) to the occurrence of death from any cause

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Avacta Life Sciences Ltd

Last Updated

July 22, 2021