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出境医 / 临床实验 / Phase 1, First in Human, Open-Label, Dose-Escalation Study of 609A

Phase 1, First in Human, Open-Label, Dose-Escalation Study of 609A

Study Description
Brief Summary:
Phase 1, First in Human, Open-Label, Dose-Escalation Study of 609A in the Patients with Locally advanced/Metastatic Solid Tumors

Condition or disease Intervention/treatment Phase
Solid Tumors Drug: 609A Phase 1

Detailed Description:
This is a first-in-human (FIH), open-label, phase 1 dose-escalation study of 609A, a recombinant monoclonal anti-PD-1 antibody product, in subjects with Locally advanced/Metastatic Solid Tumors, who must have received, or be intolerant to all available approved or standard therapies known to confirm clinical benefit, or for whom no standard therapy exits.
Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 24 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A First-in-Human, Open-label, Phase 1 Dose-Escalation Study of 609A in Subjects With Locally Advanced / Metastatic Solid Tumors
Actual Study Start Date : May 1, 2019
Estimated Primary Completion Date : October 24, 2020
Estimated Study Completion Date : May 24, 2022
Arms and Interventions
Arm Intervention/treatment
Experimental: 609A group
Dose escalation will be conducted using a traditional 3+3 design. Dose Escalation Level cohort 1. Dose 1 mg/kg, Q3W, IV. Subjects 3-6; Dose Escalation Level cohort 2. Dose 3 mg/kg, Q3W, IV. Subjects 3-6; Dose Escalation Level cohort 3. Dose 200mg, Q3W, IV. Subjects 3-6; Dose Escalation Level cohort 4. Dose 10 mg/kg, Q3W, IV. Subjects 3-6;
Drug: 609A
609A is a recombinant anti-PD-1 humanized IgG4 kappa antibody that targets the human PD-1

Outcome Measures
Primary Outcome Measures :
  1. Treatment-Emergent Adverse Events [ Time Frame: for 90 Days ]
    To monitor adverse events (AEs) per the NCI CTCAE 5.0.

  2. The MTD [ Time Frame: for 90 Days ]
    Maximum Tolerated Dose, if any, and RP2D (s) for 609A will be determined.


Secondary Outcome Measures :
  1. AUC [ Time Frame: for 90 Days ]
    Area Under the Curve of 609A

  2. Cmax [ Time Frame: for 90 Days ]
    Maximum Plasma Concentration of 609A

  3. t½ [ Time Frame: for 90 Days ]
    Half life of 609A in blood

  4. CL [ Time Frame: for 90 Days ]
    Plasma clearance of 609A

  5. ORR [ Time Frame: for 1 Year ]
    the rate of completely response [CR] and partial response [PR] patients

  6. DCR [ Time Frame: for 1 Year ]
    disease control rates of the patients with 609A

  7. PFS [ Time Frame: for 1 Year ]
    Progression-free survival of the patients with 609A

  8. DOR [ Time Frame: for 1 Year ]
    Duration of response of the patients with 609A

  9. OS [ Time Frame: for 1 Year ]
    overall survival of the patients with 609A

  10. Immunogenicity [ Time Frame: for 1 Year ]
    the presence of anti-609A antibody will be assessed


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:

Subjects must meet all the following inclusion criteria to be eligible for participation in this study:

  • Able to understand and willing to sign the Informed Consent Form(ICF).
  • Male or female ≥ 18years.
  • Subjects with histologically or cytologically confirmed advanced-stage or metastatic tumor must have received, or be intolerant to all available approved or standard therapies known to confirmed clinical benefit, or for whom standard therapy does not exist.
  • Must have adequate organ function, prior to start of 609A, including the following:

    1. Bone marrow reserve: absolute neutrophil count (ANC) ≥ 1.0 ×109/L; platelet count≥ 100 × 109/L; hemoglobin ≥ 9 g/dL or ≥ 5.6 mmol/L;
    2. Hepatic: total bilirubin ≤ 1.5 times the upper limit of normal (ULN), aspartate transaminase (AST) and/or alanine aminotransferase (ALT) ≤ 3 × ULN (≤5 × ULN if with liverinvolvement)
    3. Renal: serum creatinine ≤1.5 times the ULN or estimated creatinineclearance

      ≥50mL/min (Cockroft and Gault formula [http://www.mdcalc.com/creatinine-clearance-cockcroft-gault-equation/]).

    4. Coagulation tests INR≤ 2 (Exception: INR 2 to ≤ 3 is acceptable for subjects onWarfarin anticoagulation), activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN
  • Regarding prior anti-tumortherapy:

    1. Subjects who have received any anticancer drugs approved or investigational, including chemotherapy, immune therapy, hormonal therapy (Exceptions: hormone-replacement therapy, testosterone or oral contraceptives), biologic therapy, must have stopped treatment at least 3 weeks, or five half-lives, whichever is shorter, before first dose of 609A.
    2. Generalized radiation therapy must have stopped 3 weeks before first dose of 609A, or local radiotherapy or radiation therapy for bone metastases must have stopped 2 weeks before first dose of 609A. No therapeutic radiopharmaceuticals are taken within 8 weeks before first dose of 609A.
    3. Subjects who have received prior immunotherapies targeting T cell stimulation such as (e.g. anti-PD-1, anti- PD-L1 or anti-CTLA-4) must have stopped treatment for at least 4 weeks before first dose of 609A.
  • Female patient with fertility or male patient whose partner has fertility should use one or more contraceptive methods for contraception from the screening period to five half-lives after the last treatment. These measures include, but are not limited to, oral or implantable injections of hormonal contraceptives; intrauterine birth control ring or placement of intrauterine system (IUS) hormone-releasing intrauterine device; or use of barrier methods such as condoms or septum and spermicide products. Women of childbearing potential must have a negative pregnancy test ≤ 72 hours prior to the first dose of study drug.

Postmenopausal women must have been amenorrhoeic for at least 12 months to be considered of non-childbearing potential.

  • According to RECIST1.1, the subject should have an assessable lesion (target lesion or non- target lesion)
  • According to RECIST1.1, the subject should have an assessable lesion (target lesion or non- target lesion) ECOG score 0, 1 or 2 point.

Exclusion Criteria:

  • Subjects who meet any of the following criteria cannot be enrolled: Life expectancy < 3 months.
  • Any remaining AEs > grade 1 from prior anti-tumor treatment as per CTCAE v5. 0, with exception of the residual hair loss;
  • Any remaining AEs > grade 1 from prior anti-tumor treatment as per CTCAE v5. 0, with exception of the residual hair loss; Any involvement of CNS excluded except: Based on screening brain magnetic resonance imaging (MRI), patients must have one of the following:

    1. No evidence of brain metastases or has to be clinically stable for at least 4 weeks
    2. Untreated brain metastases not needing immediate localtherapy
  • Pregnant or nursing females
  • Subjects who have had major surgery within the 21-days from the screening;
  • Subjects with history of interstitial lung disease or idiopathic pulmonary fibrosis or unresolved active or chronic inflammatory pulmonary disease are excluded. Subjects with a history of radiation pneumonitis which has resolved areeligible.
  • HIV infection.
  • Active hepatitis B or C. HBV carriers without active disease (HBV DNA titer< 1000 cps/mL or 200 IU/mL) or cured Hepatitis C (negative HCV RNA test) may been rolled.
  • History of primary immunodeficiency, stem cell or organ transplant, or previous clinical diagnosis of tuberculosisdisease.
  • History of life-threatening hypersensitivity or known to be allergic to protein drugs or recombinant proteins or excipients in 609A drug formulation.
  • Acute or chronic uncontrolled renal disease, pancreatitis or liver disease (per investigator assessment).
  • Subjects with any type of primary immunodeficiencies will be excluded from thestudy.
  • Subjects with condition requiring systemic treatment with either corticosteroids (>15 mg/day prednisone or equivalent) or other immunosuppressive medications within 14 days before the planned first dose of study drug. Inhaled or topical steroids, and adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent are permitted in the absence of activeautoimmune disease. Ophthalmologic, nasal and intra-articular injections of steroids areacceptable.
  • Subjects who experienced immunotherapy-related adverse events (irAE) grade ≥ 3, or who had to discontinue prior anti-PD-1, anti-PD-L1, or CTL4 treatment due to irAEs of any grade.
  • Severe or uncontrolled cardiac disease requiring treatment, congestive heart failure NYHA III or IV, unstable angina pectoris even if medically controlled, history of myocardial infarction during the last 6 months, ECG QTcF (Fridericia)≥450 msec for male or QTcF (Fridericia)≥470 msec for female, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia).
  • Hypertension (defined as sustained systolic blood pressure> 160 mm Hg and / or post- diastolic blood pressure with antihypertensive drugs> 100 mmHg;
  • Any other serious underlying medical (e.g. uncontrolled diabetes mellitus, active uncontrolled infection, active gastric ulcer, uncontrolled seizures, cerebrovascular incidents, gastrointestinal bleeding, severe signs and symptoms of clotting disorders), psychiatric, psychological, familial or geographical condition that, in the judgment of the investigator, may interfere with the planned staging, treatment and follow-up, affect subject compliance or place the subject at high risk from treatment-related complications.
  • Has received a live and attenuated vaccine within 28 days prior to the first dose of study drug.
  • Patients who had received treatment with any herbal or alternative therapies or Chinese prepared medicine within 7 days prior to the first dose of the studydrug.
  • Subjects with active autoimmune diseases or history of autoimmune diseases should be excluded; these include but are not limited to subjects with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain- Barre syndrome, myasthenia gravis, systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease including Crohn's disease and ulcerative colitis, hepatitis, toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or antiphospholipidsyndrome.
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Anthony Tolcher, MD 210-595-5670 atolcher@nextsat.com

Locations
Layout table for location information
United States, Texas
NEXT Oncology Business Office Recruiting
San Antonio, Texas, United States, 78229
Contact: Aracely Cavazos, BBA         
Sponsors and Collaborators
Sunshine Guojian Pharmaceutical (Shanghai) Co., Ltd.
Tracking Information
First Submitted Date  ICMJE May 13, 2019
First Posted Date  ICMJE May 15, 2019
Last Update Posted Date April 3, 2020
Actual Study Start Date  ICMJE May 1, 2019
Estimated Primary Completion Date October 24, 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 14, 2019)
  • Treatment-Emergent Adverse Events [ Time Frame: for 90 Days ]
    To monitor adverse events (AEs) per the NCI CTCAE 5.0.
  • The MTD [ Time Frame: for 90 Days ]
    Maximum Tolerated Dose, if any, and RP2D (s) for 609A will be determined.
Original Primary Outcome Measures  ICMJE
 (submitted: May 13, 2019)
  • the safety of 609A [ Time Frame: for 90 Days ]
    The safety of 609A will be assessed throughout the study by monitoring adverse events (AEs) per the NCI CTCAE 5.0.
  • The MTD [ Time Frame: for 90 Days ]
    Maximum Tolerated Dose, if any, and RP2D (s) for 609A will be determined.
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: May 13, 2019)
  • AUC [ Time Frame: for 90 Days ]
    Area Under the Curve of 609A
  • Cmax [ Time Frame: for 90 Days ]
    Maximum Plasma Concentration of 609A
  • t½ [ Time Frame: for 90 Days ]
    Half life of 609A in blood
  • CL [ Time Frame: for 90 Days ]
    Plasma clearance of 609A
  • ORR [ Time Frame: for 1 Year ]
    the rate of completely response [CR] and partial response [PR] patients
  • DCR [ Time Frame: for 1 Year ]
    disease control rates of the patients with 609A
  • PFS [ Time Frame: for 1 Year ]
    Progression-free survival of the patients with 609A
  • DOR [ Time Frame: for 1 Year ]
    Duration of response of the patients with 609A
  • OS [ Time Frame: for 1 Year ]
    overall survival of the patients with 609A
  • Immunogenicity [ Time Frame: for 1 Year ]
    the presence of anti-609A antibody will be assessed
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, First in Human, Open-Label, Dose-Escalation Study of 609A
Official Title  ICMJE A First-in-Human, Open-label, Phase 1 Dose-Escalation Study of 609A in Subjects With Locally Advanced / Metastatic Solid Tumors
Brief Summary Phase 1, First in Human, Open-Label, Dose-Escalation Study of 609A in the Patients with Locally advanced/Metastatic Solid Tumors
Detailed Description This is a first-in-human (FIH), open-label, phase 1 dose-escalation study of 609A, a recombinant monoclonal anti-PD-1 antibody product, in subjects with Locally advanced/Metastatic Solid Tumors, who must have received, or be intolerant to all available approved or standard therapies known to confirm clinical benefit, or for whom no standard therapy exits.
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 Solid Tumors
Intervention  ICMJE Drug: 609A
609A is a recombinant anti-PD-1 humanized IgG4 kappa antibody that targets the human PD-1
Study Arms  ICMJE Experimental: 609A group
Dose escalation will be conducted using a traditional 3+3 design. Dose Escalation Level cohort 1. Dose 1 mg/kg, Q3W, IV. Subjects 3-6; Dose Escalation Level cohort 2. Dose 3 mg/kg, Q3W, IV. Subjects 3-6; Dose Escalation Level cohort 3. Dose 200mg, Q3W, IV. Subjects 3-6; Dose Escalation Level cohort 4. Dose 10 mg/kg, Q3W, IV. Subjects 3-6;
Intervention: Drug: 609A
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: May 13, 2019)
24
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE May 24, 2022
Estimated Primary Completion Date October 24, 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

Subjects must meet all the following inclusion criteria to be eligible for participation in this study:

  • Able to understand and willing to sign the Informed Consent Form(ICF).
  • Male or female ≥ 18years.
  • Subjects with histologically or cytologically confirmed advanced-stage or metastatic tumor must have received, or be intolerant to all available approved or standard therapies known to confirmed clinical benefit, or for whom standard therapy does not exist.
  • Must have adequate organ function, prior to start of 609A, including the following:

    1. Bone marrow reserve: absolute neutrophil count (ANC) ≥ 1.0 ×109/L; platelet count≥ 100 × 109/L; hemoglobin ≥ 9 g/dL or ≥ 5.6 mmol/L;
    2. Hepatic: total bilirubin ≤ 1.5 times the upper limit of normal (ULN), aspartate transaminase (AST) and/or alanine aminotransferase (ALT) ≤ 3 × ULN (≤5 × ULN if with liverinvolvement)
    3. Renal: serum creatinine ≤1.5 times the ULN or estimated creatinineclearance

      ≥50mL/min (Cockroft and Gault formula [http://www.mdcalc.com/creatinine-clearance-cockcroft-gault-equation/]).

    4. Coagulation tests INR≤ 2 (Exception: INR 2 to ≤ 3 is acceptable for subjects onWarfarin anticoagulation), activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN
  • Regarding prior anti-tumortherapy:

    1. Subjects who have received any anticancer drugs approved or investigational, including chemotherapy, immune therapy, hormonal therapy (Exceptions: hormone-replacement therapy, testosterone or oral contraceptives), biologic therapy, must have stopped treatment at least 3 weeks, or five half-lives, whichever is shorter, before first dose of 609A.
    2. Generalized radiation therapy must have stopped 3 weeks before first dose of 609A, or local radiotherapy or radiation therapy for bone metastases must have stopped 2 weeks before first dose of 609A. No therapeutic radiopharmaceuticals are taken within 8 weeks before first dose of 609A.
    3. Subjects who have received prior immunotherapies targeting T cell stimulation such as (e.g. anti-PD-1, anti- PD-L1 or anti-CTLA-4) must have stopped treatment for at least 4 weeks before first dose of 609A.
  • Female patient with fertility or male patient whose partner has fertility should use one or more contraceptive methods for contraception from the screening period to five half-lives after the last treatment. These measures include, but are not limited to, oral or implantable injections of hormonal contraceptives; intrauterine birth control ring or placement of intrauterine system (IUS) hormone-releasing intrauterine device; or use of barrier methods such as condoms or septum and spermicide products. Women of childbearing potential must have a negative pregnancy test ≤ 72 hours prior to the first dose of study drug.

Postmenopausal women must have been amenorrhoeic for at least 12 months to be considered of non-childbearing potential.

  • According to RECIST1.1, the subject should have an assessable lesion (target lesion or non- target lesion)
  • According to RECIST1.1, the subject should have an assessable lesion (target lesion or non- target lesion) ECOG score 0, 1 or 2 point.

Exclusion Criteria:

  • Subjects who meet any of the following criteria cannot be enrolled: Life expectancy < 3 months.
  • Any remaining AEs > grade 1 from prior anti-tumor treatment as per CTCAE v5. 0, with exception of the residual hair loss;
  • Any remaining AEs > grade 1 from prior anti-tumor treatment as per CTCAE v5. 0, with exception of the residual hair loss; Any involvement of CNS excluded except: Based on screening brain magnetic resonance imaging (MRI), patients must have one of the following:

    1. No evidence of brain metastases or has to be clinically stable for at least 4 weeks
    2. Untreated brain metastases not needing immediate localtherapy
  • Pregnant or nursing females
  • Subjects who have had major surgery within the 21-days from the screening;
  • Subjects with history of interstitial lung disease or idiopathic pulmonary fibrosis or unresolved active or chronic inflammatory pulmonary disease are excluded. Subjects with a history of radiation pneumonitis which has resolved areeligible.
  • HIV infection.
  • Active hepatitis B or C. HBV carriers without active disease (HBV DNA titer< 1000 cps/mL or 200 IU/mL) or cured Hepatitis C (negative HCV RNA test) may been rolled.
  • History of primary immunodeficiency, stem cell or organ transplant, or previous clinical diagnosis of tuberculosisdisease.
  • History of life-threatening hypersensitivity or known to be allergic to protein drugs or recombinant proteins or excipients in 609A drug formulation.
  • Acute or chronic uncontrolled renal disease, pancreatitis or liver disease (per investigator assessment).
  • Subjects with any type of primary immunodeficiencies will be excluded from thestudy.
  • Subjects with condition requiring systemic treatment with either corticosteroids (>15 mg/day prednisone or equivalent) or other immunosuppressive medications within 14 days before the planned first dose of study drug. Inhaled or topical steroids, and adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent are permitted in the absence of activeautoimmune disease. Ophthalmologic, nasal and intra-articular injections of steroids areacceptable.
  • Subjects who experienced immunotherapy-related adverse events (irAE) grade ≥ 3, or who had to discontinue prior anti-PD-1, anti-PD-L1, or CTL4 treatment due to irAEs of any grade.
  • Severe or uncontrolled cardiac disease requiring treatment, congestive heart failure NYHA III or IV, unstable angina pectoris even if medically controlled, history of myocardial infarction during the last 6 months, ECG QTcF (Fridericia)≥450 msec for male or QTcF (Fridericia)≥470 msec for female, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia).
  • Hypertension (defined as sustained systolic blood pressure> 160 mm Hg and / or post- diastolic blood pressure with antihypertensive drugs> 100 mmHg;
  • Any other serious underlying medical (e.g. uncontrolled diabetes mellitus, active uncontrolled infection, active gastric ulcer, uncontrolled seizures, cerebrovascular incidents, gastrointestinal bleeding, severe signs and symptoms of clotting disorders), psychiatric, psychological, familial or geographical condition that, in the judgment of the investigator, may interfere with the planned staging, treatment and follow-up, affect subject compliance or place the subject at high risk from treatment-related complications.
  • Has received a live and attenuated vaccine within 28 days prior to the first dose of study drug.
  • Patients who had received treatment with any herbal or alternative therapies or Chinese prepared medicine within 7 days prior to the first dose of the studydrug.
  • Subjects with active autoimmune diseases or history of autoimmune diseases should be excluded; these include but are not limited to subjects with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain- Barre syndrome, myasthenia gravis, systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease including Crohn's disease and ulcerative colitis, hepatitis, toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or antiphospholipidsyndrome.
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: Anthony Tolcher, MD 210-595-5670 atolcher@nextsat.com
Listed Location Countries  ICMJE United States
Removed Location Countries Armenia
 
Administrative Information
NCT Number  ICMJE NCT03950297
Other Study ID Numbers  ICMJE SSGJ-609-UND-US-I-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 Sunshine Guojian Pharmaceutical (Shanghai) Co., Ltd.
Study Sponsor  ICMJE Sunshine Guojian Pharmaceutical (Shanghai) Co., Ltd.
Collaborators  ICMJE Not Provided
Investigators  ICMJE Not Provided
PRS Account Sunshine Guojian Pharmaceutical (Shanghai) Co., Ltd.
Verification Date May 2019

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