Clinical Trials /

Study of MTB-9655, an Inhibitor of ACSS2, in Patients With Advanced Solid Tumors

NCT04990739

Description:

MetaboMed is developing MTB-9655, an orally bioavailable, first-in-class small molecule inhibitor of the human Acetyl coenzyme A (Acyl-CoA) synthetase short chain family member 2 (ACSS2) enzyme, as a potential treatment for patients with cancer. This study is a Phase 1,First-in-Human (FIH), open-label dose-escalation study of MTB-9655 given daily as a single oral (PO) agent. Up to 30 patients with locally advanced, unresectable and/or metastatic solid tumor(s) are expected to be enrolled in the dose-escalation portion (Part A). The study will be conducted at 1 to 2 sites in the United States and Israel.

Related Conditions:
  • Malignant Solid Tumor
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Study of MTB-9655, an Inhibitor of ACSS2, in Patients With Advanced Solid Tumors
  • Official Title: A Phase 1 Open Label, Multicenter Study of MTB-9655, an Inhibitor of ACSS2, in Patients With Advanced Solid Tumors

Clinical Trial IDs

  • ORG STUDY ID: MTB-9655-101
  • NCT ID: NCT04990739

Conditions

  • Advanced Solid Tumor

Interventions

DrugSynonymsArms
MTB-9655Part A Dose-Escalation and Part B RP2D Dose-Expansion

Purpose

MetaboMed is developing MTB-9655, an orally bioavailable, first-in-class small molecule inhibitor of the human Acetyl coenzyme A (Acyl-CoA) synthetase short chain family member 2 (ACSS2) enzyme, as a potential treatment for patients with cancer. This study is a Phase 1,First-in-Human (FIH), open-label dose-escalation study of MTB-9655 given daily as a single oral (PO) agent. Up to 30 patients with locally advanced, unresectable and/or metastatic solid tumor(s) are expected to be enrolled in the dose-escalation portion (Part A). The study will be conducted at 1 to 2 sites in the United States and Israel.

Detailed Description

      This Phase 1 First-in-Human (FIH) study is to initiate clinical development of MTB-9655 in
      patients with advanced solid tumors who have failed or refused standard treatment, or who
      have a tumor for which no therapy of proven efficacy exists. This study of MTB-9655 may
      consist of 2 parts: a dose-escalation part to establish a safe and tolerable dose of MTB-9655
      in patients with advanced or metastatic solid tumors for which no standard therapy is
      available or standard therapy has failed (Part A), and a dose expansion phase (Part B) which
      may be initiated at the Sponsor's discretion after the maximum tolerated dose (MTD) (or
      recommended Phase 2 dose [RP2D]) has been determined in the dose-escalation (Part A), and
      with approval of an amendment to the protocol. This study will be the basis for future
      studies. The study will identify the safety and tolerability of MTB-9655 when administered on
      a continuous dosing schedule (given by mouth on a 21-day schedule).
    

Trial Arms

NameTypeDescriptionInterventions
Part A Dose-Escalation and Part B RP2D Dose-ExpansionExperimentalStudy has two parts: Part A Dose-Escalation will evaluate MTB-9655 monotherapy administered in 21 days cycle,and will be conducted in 2 stages (accelerated titration and dose-escalation). The first stage will consist of accelerated titration in single-patient cohorts for the initial two dose levels. In the second stage, a conventional 3+3 schema using a modified Fibonacci dose titration strategy will be implemented. The first dose at every dose level and in every patient will be administered under close medical supervision, and the patients will be hospitalized for approximately 24 hours. Up to 30 participants will participate in this dose escalation arm. Part B dose-expansion will further explore the safety, PK and preliminary efficacy of MTB-9655 at the RP2D. The RP2D level will be no higher than the MTD identified in Part A.
  • MTB-9655

Eligibility Criteria

        Inclusion Criteria:

          1. Signed written informed consent.

          2. Patient is at least 18 years-of-age at the time of signature of the informed consent
             form (ICF).

          3. Patient has an Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0
             or 1.

          4. Patient must have a confirmed diagnosis of locally advanced, unresectable and/or
             metastatic solid tumor(s), have failed standard treatment, or refuse standard
             treatment, or have a tumor for which no therapy of proven efficacy exists, or a tumor
             that is not amenable to standard therapies.

          5. Patient has measurable disease on imaging based or non-measurable disease.

          6. Patient will be requested to provide a fresh pre-treatment biopsy specimen, otherwise
             they are required to provide an archival diagnostic tumor sample that is <1 year old.

          7. Patient has a life expectancy ≥3 months according to the Investigator's judgment.

          8. Women of child-bearing potential (WOCBP) must have a negative serum pregnancy test at
             screening within 72 hours of first dose of MTB-9655. In addition, WOCBP are required
             to use two forms of acceptable contraception.

          9. Male patients with WOCBP partners must agree to use highly effective contraceptive
             measures throughout the study starting with screening visit through 120 days after the
             last dose.

        Exclusion Criteria:

        Patients who meet any of the following criteria will be excluded from study entry:

          1. Treatment with any of the following:

               -  Any systemic anti-cancer chemotherapy, small molecule, biologic, or hormonal
                  agent from a previous treatment regimen or clinical study within 28 days or 5
                  half-lives (whichever is shorter) prior to the first dose of study drug. At least
                  10 days must have elapsed between the last dose of such agent and the first dose
                  of study drug.

               -  Wide-field radiotherapy administered ≤28 days or limited field radiation for
                  palliation ≤7 days prior to starting study drug.

               -  Major surgery(excluding placement of vascular access) within 3 weeks of first
                  dose of study drug.

               -  Prior treatment with other drug with the same mechanism of action (directed to
                  ACSS2).

               -  Receiving systemic corticosteroid therapy 1 week prior to the first dose of study
                  drug or receiving any other form of systemic immunosuppressive medication for
                  medically significant acute or chronic conditions.

          2. Persistent toxicity of National Cancer Institute Common Terminology Criteria for
             Adverse Events (NCI CTCAE) Grade >1 severity that is related to prior therapy.

          3. Central nervous system tumor, metastasis(es), and/or carcinomatous meningitis
             identified either on the baseline brain imaging obtained during the screening period
             or identified prior to consent.

          4. Active infection requiring treatment.

          5. Out-of-range laboratory values defined as:

               -  Absolute neutrophil count (ANC) <1.5 × 10^9/L

               -  Hemoglobin <9 g/dL

               -  Platelets <100 × 10^9/L)

               -  Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) >2.5 × the
                  upper limit of normal (ULN) or ≥5 × ULN with liver involvement

               -  Total bilirubin >1.5 × ULN

               -  Serum creatinine >1.5 × ULN or creatinine clearance (CrCl≤60mL/min, measured or
                  calculated using the Cockcroft-Gault Method

               -  International Normalized Ratio (INR) or prothrombin time (PT) >1.5 × ULN and
                  activated partial thromboplastin time (aPTT) >1.5 × ULN (unless patient is
                  receiving anticoagulant therapy)

          6. Inability to swallow oral medications or presence of active gastrointestinal disease
             or other condition that will interfere significantly with the absorption,
             distribution, metabolism, or excretion of MTB-9655 (e.g., ulcerative disease,
             uncontrolled nausea, vomiting, diarrhea Grade ≥2, malabsorption syndrome).

          7. Any of the following cardiac criteria:

               -  Known history of marked prolongation of QT/corrected QT(QT/QTc) interval.

               -  Clinically significant cardiovascular disease, including cerebral vascular
                  accident/stroke or myocardial infarction within 6 months of enrollment, unstable
                  angina, congestive heart failure,or serious uncontrolled cardiac arrhythmia
                  requiring medication.

               -  History of additional risk factors for Torsade de Pointes (including heart
                  failure, hypokalemia, family history of long QT syndrome, and use of concomitant
                  medications that prolong the QT/QTc interval.

               -  Patients with a left ventricular ejection fraction (LVEF) <50%.

          8. History of concomitant malignancy with recurrence <3 year from enrolment.

          9. Expected to require any other form of systemic or localized antineoplastic therapy
             while on trial.

         10. Significant liver cirrhosis defined as Child-Pugh Class B or C.

         11. History of hemolytic disorders.

         12. Active infection with human immunodeficiency virus (HIV).

         13. History or current evidence of any condition, therapy, or laboratory abnormality that
             might confound the results of the study, interfere with the patient's participation
             for the full duration of the study, or is not in the best interest of the patient to
             participate, in the opinion of the treating Investigator.

         14. Pregnant or breastfeeding.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Part A: Number of participants with dose limiting toxicities (DLTs) from MTB-9655 monotherapy in patients with locally advanced or metastatic solid tumors.
Time Frame:21 days
Safety Issue:
Description:DLTs are defined as adverse events (graded according to NCI CTCAE v5.0) during first 21 days of treatment that are related to MTB-9655 monotherapy

Secondary Outcome Measures

Measure:Pharmacokinetic Analysis single dose : maximum plasma concentration (Cmax) for MTB-9655
Time Frame:22 days ,from Cycle 0 to Cycle 2 Day1. Each cycle is 21 days.
Safety Issue:
Description:Blood samples will be collected for calculation of pharmacokinetic (PK) parameters.
Measure:Pharmacokinetic Analysis (multiple dose): Time to maximum plasma concentration at steady state (tmax ss) for MTB-9655
Time Frame:22 days -from Cycle 0 to Cycle 2 Day1. Each cycle is 21 days.
Safety Issue:
Description:Blood samples analyzed by biochemical assays at initial dose drug levels and steady -state drug levels.
Measure:Overall response rate in participants receiving MTB-9655
Time Frame:Every 6 weeks from Cycle 1 Day1 for 24 weeks, then every 12 weeks up to 24 months (each cycle is 21 days)
Safety Issue:
Description:Overall response rate is defined as the proportion of patients who have a best response of either complete response (CR) or partial response (PR) based on RECIST v1.1
Measure:Duration of response based on RECIST 1.1
Time Frame:Every 6 weeks from Cycle 1 Day 1 for 24 weeks, then every 12 weeks until disease progression or death or up to 1 year
Safety Issue:
Description:Duration of response will be defined for patients with a Best Overall Response of CR/PR as the time from the date of first documented response until date of documented progression (by RECIST v1.1), or death in the absence of disease progression.
Measure:Disease control rate based on RECIST 1.1
Time Frame:Every 6 weeks from Cycle 1 Day 1 for 24 weeks, then every 12 weeks until disease progression or death or up to 1 year
Safety Issue:
Description:Disease control rate is defined as the proportion of patients with CR, PR, or SD based on RECIST v1.1
Measure:Progression free survival based on RECIST 1.1
Time Frame:Every 6 weeks from Cycle 1 Day 1 for 24 weeks, then every 12 weeks until disease progression or death or up to 1 year
Safety Issue:
Description:Progression free survival is defined as the time from the start of study treatment until the earliest objective disease progression defined( by RECIST v1.1),or death by any cause in the absence of progression.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:MetaboMed Inc

Trial Keywords

  • metastatic
  • ACSS2 inhibitor

Last Updated

August 4, 2021