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出境医 / 临床实验 / Phase 1 Study of TPX-0022, a MET/CSF1R/SRC Inhibitor, in Patients With Advanced Solid Tumors Harboring Genetic Alterations in MET

Phase 1 Study of TPX-0022, a MET/CSF1R/SRC Inhibitor, in Patients With Advanced Solid Tumors Harboring Genetic Alterations in MET

Study Description
Brief Summary:
A phase 1, first-in-human, open-label study to determine the safety, tolerability, PK, and preliminary efficacy of the novel MET/CSF1R/SRC inhibitor TPX-0022 in adult subjects with advanced solid tumors harboring genetic alterations in MET. The study will proceed in three parts: a dose-escalation, a food effect, and dose-expansion.

Condition or disease Intervention/treatment Phase
Advanced Solid Tumor Metastatic Solid Tumors MET Gene Alterations Drug: TPX-0022 Phase 1

Detailed Description:

Dose Escalation: To evaluate the overall safety profile of TPX-0022, single and multiple dose PK profiles and preliminary efficacy in adults subjects with advanced solid tumors harboring genetic alterations in MET.

Food Effect: To determine the effect of food on PK of TPX-0022 in adult subjects with advanced solid tumors harboring genetic alterations in MET.

Dose Expansion: To evaluate the preliminary efficacy and overall safety profile of TPX-0022 at the RP2D in defined cohorts of adult subjects in advanced solid tumors harboring genetic alterations in MET.

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 120 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1, Open-Label, Multi-Center, First-in-Human Study of the Safety, Tolerability, Pharmacokinetics, and Anti-Tumor Activity of TPX-0022, a Novel MET/CSF1R/SRC Inhibitor, in Patients With Advanced Solid Tumors Harboring Genetic Alterations in MET
Actual Study Start Date : August 20, 2019
Estimated Primary Completion Date : November 2022
Estimated Study Completion Date : November 2023
Arms and Interventions
Arm Intervention/treatment
Experimental: Phase 1 TPX-0022

The dose-escalation part of the study will determine the safety, tolerability, MTD, and RP2D of TPX-0022.

A food-effect sub-study will be conducted once the RP2D has been determined.

The dose-expansion part of the study will determine the safety, tolerability, PK, and preliminary efficacy in specific cohorts.

Dose expansion cohorts: Cohort I (NSCLC, METΔex14, MET Target Therapy Naive), Cohort II (NSCLC, METΔex14, MET Target Therapy Pre-treated), Cohort III (MET-amplified NSCLC, Hepatocellular Carcinoma (HCC), Gastric Cancer, or GEJ, Cohort IV (MET KD Mutations or MET Fusions)

Drug: TPX-0022
Oral TPX-0022 tablets

Outcome Measures
Primary Outcome Measures :
  1. Incidence of first cycle dose-limiting toxicities (DLTs) of TPX-0022 [ Time Frame: Within 28 days of the first TPX-0022 dose for each patient ]
    Evaluate the safety and tolerability of TPX-0022

  2. Define the Recommended Phase 2 Dose [ Time Frame: Approximately 48 months ]
    Determine the maximum tolerated dose (MTD) and/or Recommended Phase 2 Dose (RP2D) of TPX-0022


Secondary Outcome Measures :
  1. Adverse events (AEs) [ Time Frame: Approximately 48 months ]
    Evaluate the overall safety profile of TPX-0022

  2. Cmax (maximum plasma concentration) of TPX-0022 [ Time Frame: Up to 72 hours post-dose ]
    Evaluate the maximum plasma concentration of TPX-0022

  3. AUC (area under plasma concentration time curve) of TPX-0022 [ Time Frame: Up to 72 hours post-dose ]
    Evaluate the AUC of TPX-0022

  4. Cmax (maximum plasma concentration) of TPX-0022 under different food intake conditions [ Time Frame: Up to 72 hours post-dose ]
    Determine the effect of food (specifically, a high-fat, high-calorie meal) on the single-dose PK (Cmax) of TPX-0022 at the RP2D

  5. AUC (area under plasma concentration time curve) of TPX-0022 under different food intake conditions [ Time Frame: Up to 72 hours post-dose ]
    Determine the effect of food (specifically, a high-fat, high-calorie meal) on the single-dose PK (AUC) of TPX-0022 at the RP2D

  6. Preliminary Objective Response Rate (ORR) [ Time Frame: Approximately 48 months ]
    Determine the preliminary objective response rate (ORR) by Blinded Independent Central Review (BICR) of TPX-0022

  7. Clinical benefit rate (CBR) [ Time Frame: Approximately 48 months ]
    Determine the CBR of TPX-0022

  8. Time to response (TTR) [ Time Frame: Approximately 48 months ]
    Determine the TTR of TPX-0022

  9. Duration of Response (DOR) [ Time Frame: Approximately 48 months ]
    Determine the DOR of TPX-0022

  10. Progression free survival (PFS) [ Time Frame: Approximately 48 months ]
    Determine the PFS of TPX-0022

  11. Intracranial tumor response [ Time Frame: Approximately 48 months ]
    Determine the intracranial tumor response in subjects with measurable brain metastases, as determined by BICR

  12. Overall survival (OS) [ Time Frame: Approximately 48 months ]
    Determine efficacy and safety of TPX-0022


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Age ≥ 18 (or age ≥ 20 as required by local regulation).
  2. Histological or cytological confirmation of advanced/metastatic solid tumors harboring the genetic MET alteration(s) including exon 14 deletion (METΔex14), amplification, fusion or activating kinase mutation, who are resistant or intolerant to standard therapy or for whom curative therapy is not available. Subjects must have a genetic MET alteration as determined by fluorescence in situ hybridization (FISH), quantitative polymerase chain reaction (qPCR), or next-generation sequencing (NGS).Local tissue-based or liquid biopsy diagnostic testing will be permitted.
  3. ECOG performance status ≤ 1.
  4. Existence of measurable or evaluable disease (according to Response evaluation criteria in solid tumors [RECIST v1.1] criteria).
  5. Subjects with asymptomatic primary CNS tumors or brain metastases are eligible for the study if they meet protocol specified criteria.
  6. Adequate organ function.
  7. Life expectancy ≥ 12 weeks.

Exclusion Criteria:

  1. Locally advanced solid tumor that is a candidate for curative treatment through radical surgery and/or radiotherapy, or chemotherapy.
  2. Presence or history of any other primary malignancy other than a history of adequately treated basal or squamous cell carcinoma of the skin, or any adequately treated in situ carcinoma.
  3. Major surgery within four weeks of the start of therapy.
  4. Additional exclusion criteria for subjects with NSCLC with MET alterations: known oncogene drivers (ALK, ROS1, or EGFR) conferring sensitivity to targeted therapies.
  5. Additional exclusion criteria for subjects with HCC with MET alterations: liver dysfunction greater than Child-Pugh Class A.
  6. Clinically significant cardiovascular disease (either active or within six months before enrollment): myocardial infarction, unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure (New York Heart Association Classification Class ≥ II), cerebrovascular accident or transient ischemic attack, symptomatic bradycardia, requirement for anti-arrhythmic medication. Ongoing cardiac dysrhythmias of CTCAE version 5.0 grade ≥ 2.
  7. Any of the following cardiac criteria:

    • Mean resting corrected QT interval (ECG interval measured from the onset of the QRS complex to the end of the T wave) for heart rate (QTc) > 470 msec obtained from three ECGs, using the screening clinic ECG machine-derived QTc value
    • Any clinically important 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 > 250 msec)
    • Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, congenital long QT syndrome, family history of long QT syndrome, or any concomitant medication known to prolong the QT interval
  8. Known clinically significant active infections not controlled with systemic treatment (bacterial, fungal, viral including HIV positivity).
  9. Peripheral neuropathy ≥ Grade 2.
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Zach Zimmerman, MD, PhD 858-926-5251 clinical@tptherapeutics.com

Locations
Show Show 22 study locations
Sponsors and Collaborators
Turning Point Therapeutics, Inc.
Investigators
Layout table for investigator information
Study Director: Zach Zimmerman, MD, PhD Turning Point Therapeutics, Inc.
Tracking Information
First Submitted Date  ICMJE June 13, 2019
First Posted Date  ICMJE June 21, 2019
Last Update Posted Date December 29, 2020
Actual Study Start Date  ICMJE August 20, 2019
Estimated Primary Completion Date November 2022   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 19, 2019)
  • Incidence of first cycle dose-limiting toxicities (DLTs) of TPX-0022 [ Time Frame: Within 28 days of the first TPX-0022 dose for each patient ]
    Evaluate the safety and tolerability of TPX-0022
  • Define the Recommended Phase 2 Dose [ Time Frame: Approximately 48 months ]
    Determine the maximum tolerated dose (MTD) and/or Recommended Phase 2 Dose (RP2D) of TPX-0022
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: June 19, 2019)
  • Adverse events (AEs) [ Time Frame: Approximately 48 months ]
    Evaluate the overall safety profile of TPX-0022
  • Cmax (maximum plasma concentration) of TPX-0022 [ Time Frame: Up to 72 hours post-dose ]
    Evaluate the maximum plasma concentration of TPX-0022
  • AUC (area under plasma concentration time curve) of TPX-0022 [ Time Frame: Up to 72 hours post-dose ]
    Evaluate the AUC of TPX-0022
  • Cmax (maximum plasma concentration) of TPX-0022 under different food intake conditions [ Time Frame: Up to 72 hours post-dose ]
    Determine the effect of food (specifically, a high-fat, high-calorie meal) on the single-dose PK (Cmax) of TPX-0022 at the RP2D
  • AUC (area under plasma concentration time curve) of TPX-0022 under different food intake conditions [ Time Frame: Up to 72 hours post-dose ]
    Determine the effect of food (specifically, a high-fat, high-calorie meal) on the single-dose PK (AUC) of TPX-0022 at the RP2D
  • Preliminary Objective Response Rate (ORR) [ Time Frame: Approximately 48 months ]
    Determine the preliminary objective response rate (ORR) by Blinded Independent Central Review (BICR) of TPX-0022
  • Clinical benefit rate (CBR) [ Time Frame: Approximately 48 months ]
    Determine the CBR of TPX-0022
  • Time to response (TTR) [ Time Frame: Approximately 48 months ]
    Determine the TTR of TPX-0022
  • Duration of Response (DOR) [ Time Frame: Approximately 48 months ]
    Determine the DOR of TPX-0022
  • Progression free survival (PFS) [ Time Frame: Approximately 48 months ]
    Determine the PFS of TPX-0022
  • Intracranial tumor response [ Time Frame: Approximately 48 months ]
    Determine the intracranial tumor response in subjects with measurable brain metastases, as determined by BICR
  • Overall survival (OS) [ Time Frame: Approximately 48 months ]
    Determine efficacy and safety of TPX-0022
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Phase 1 Study of TPX-0022, a MET/CSF1R/SRC Inhibitor, in Patients With Advanced Solid Tumors Harboring Genetic Alterations in MET
Official Title  ICMJE A Phase 1, Open-Label, Multi-Center, First-in-Human Study of the Safety, Tolerability, Pharmacokinetics, and Anti-Tumor Activity of TPX-0022, a Novel MET/CSF1R/SRC Inhibitor, in Patients With Advanced Solid Tumors Harboring Genetic Alterations in MET
Brief Summary A phase 1, first-in-human, open-label study to determine the safety, tolerability, PK, and preliminary efficacy of the novel MET/CSF1R/SRC inhibitor TPX-0022 in adult subjects with advanced solid tumors harboring genetic alterations in MET. The study will proceed in three parts: a dose-escalation, a food effect, and dose-expansion.
Detailed Description

Dose Escalation: To evaluate the overall safety profile of TPX-0022, single and multiple dose PK profiles and preliminary efficacy in adults subjects with advanced solid tumors harboring genetic alterations in MET.

Food Effect: To determine the effect of food on PK of TPX-0022 in adult subjects with advanced solid tumors harboring genetic alterations in MET.

Dose Expansion: To evaluate the preliminary efficacy and overall safety profile of TPX-0022 at the RP2D in defined cohorts of adult subjects in advanced solid tumors harboring genetic alterations in MET.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Advanced Solid Tumor
  • Metastatic Solid Tumors
  • MET Gene Alterations
Intervention  ICMJE Drug: TPX-0022
Oral TPX-0022 tablets
Study Arms  ICMJE Experimental: Phase 1 TPX-0022

The dose-escalation part of the study will determine the safety, tolerability, MTD, and RP2D of TPX-0022.

A food-effect sub-study will be conducted once the RP2D has been determined.

The dose-expansion part of the study will determine the safety, tolerability, PK, and preliminary efficacy in specific cohorts.

Dose expansion cohorts: Cohort I (NSCLC, METΔex14, MET Target Therapy Naive), Cohort II (NSCLC, METΔex14, MET Target Therapy Pre-treated), Cohort III (MET-amplified NSCLC, Hepatocellular Carcinoma (HCC), Gastric Cancer, or GEJ, Cohort IV (MET KD Mutations or MET Fusions)

Intervention: Drug: TPX-0022
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: June 19, 2019)
120
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE November 2023
Estimated Primary Completion Date November 2022   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Age ≥ 18 (or age ≥ 20 as required by local regulation).
  2. Histological or cytological confirmation of advanced/metastatic solid tumors harboring the genetic MET alteration(s) including exon 14 deletion (METΔex14), amplification, fusion or activating kinase mutation, who are resistant or intolerant to standard therapy or for whom curative therapy is not available. Subjects must have a genetic MET alteration as determined by fluorescence in situ hybridization (FISH), quantitative polymerase chain reaction (qPCR), or next-generation sequencing (NGS).Local tissue-based or liquid biopsy diagnostic testing will be permitted.
  3. ECOG performance status ≤ 1.
  4. Existence of measurable or evaluable disease (according to Response evaluation criteria in solid tumors [RECIST v1.1] criteria).
  5. Subjects with asymptomatic primary CNS tumors or brain metastases are eligible for the study if they meet protocol specified criteria.
  6. Adequate organ function.
  7. Life expectancy ≥ 12 weeks.

Exclusion Criteria:

  1. Locally advanced solid tumor that is a candidate for curative treatment through radical surgery and/or radiotherapy, or chemotherapy.
  2. Presence or history of any other primary malignancy other than a history of adequately treated basal or squamous cell carcinoma of the skin, or any adequately treated in situ carcinoma.
  3. Major surgery within four weeks of the start of therapy.
  4. Additional exclusion criteria for subjects with NSCLC with MET alterations: known oncogene drivers (ALK, ROS1, or EGFR) conferring sensitivity to targeted therapies.
  5. Additional exclusion criteria for subjects with HCC with MET alterations: liver dysfunction greater than Child-Pugh Class A.
  6. Clinically significant cardiovascular disease (either active or within six months before enrollment): myocardial infarction, unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure (New York Heart Association Classification Class ≥ II), cerebrovascular accident or transient ischemic attack, symptomatic bradycardia, requirement for anti-arrhythmic medication. Ongoing cardiac dysrhythmias of CTCAE version 5.0 grade ≥ 2.
  7. Any of the following cardiac criteria:

    • Mean resting corrected QT interval (ECG interval measured from the onset of the QRS complex to the end of the T wave) for heart rate (QTc) > 470 msec obtained from three ECGs, using the screening clinic ECG machine-derived QTc value
    • Any clinically important 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 > 250 msec)
    • Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, congenital long QT syndrome, family history of long QT syndrome, or any concomitant medication known to prolong the QT interval
  8. Known clinically significant active infections not controlled with systemic treatment (bacterial, fungal, viral including HIV positivity).
  9. Peripheral neuropathy ≥ Grade 2.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Zach Zimmerman, MD, PhD 858-926-5251 clinical@tptherapeutics.com
Listed Location Countries  ICMJE France,   Korea, Republic of,   Spain,   United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03993873
Other Study ID Numbers  ICMJE TPX-0022-01
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Turning Point Therapeutics, Inc.
Study Sponsor  ICMJE Turning Point Therapeutics, Inc.
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Study Director: Zach Zimmerman, MD, PhD Turning Point Therapeutics, Inc.
PRS Account Turning Point Therapeutics, Inc.
Verification Date December 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP