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A Dose Escalation and Expansion Study of ASP4132 to Subjects With Advanced Refractory Tumors and Lymphoma

Primary Purpose

Lymphoma, Refractory Solid Tumors, Advanced Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ASP4132
Sponsored by
Astellas Pharma Global Development, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma focused on measuring Pharmacokinetics, ASP4132, Lymphoma, Refractory Solid Tumors

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject has a life expectancy of more than 3 months
  • Subject agrees not to participate in another interventional study while on treatment.
  • Subject has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
  • Female subject must be either:

    1. Of non-child bearing potential:

      • post-menopausal (defined as at least 1 year without any menses) prior to Screening,
      • or, documented surgically sterile or status post hysterectomy
    2. Or, if of childbearing potential,

      • agree not to try to become pregnant during the study and for 90 days after the final study drug administration;
      • if heterosexually active must use two forms of birth control
  • Male subject and their female spouse/partners who are of childbearing potential must be using highly effective contraception consisting of two forms of birth control (one of which must be a barrier method) starting at Screening and continue throughout the study period and for 90 days after the final study drug administration.
  • Subject must have advanced and/or metastatic, histologically or cytologically documented cancer or lymphomas, for whom there is no available standard therapy shown to provide clinical benefit.

Exclusion Criteria:

  • Subject has absolute neutrophil count < 1000/μL, platelet count < 75,000/μL, and hemoglobin < 8 g/dL (< 5 mmol/L) at Screening
  • Subject has total serum bilirubin ≥1.5 times the upper limit of normal (ULN),serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) > 3 times ULN, or albumin ≤ 3.0 g/dL at Screening.
  • Subject has any abnormalities in serum sodium, potassium, chloride, calcium and magnesium levels ≥ Grade 2 at screening (CTCAE Version 4.03).
  • Subject has a known elevation in serum lactate at screening ˃ 2x institutional ULN
  • Subject has an estimated glomerular filtration rate (eGFr) of < 60ml/min as calculated by the modification of diet Renal disease (MDRD) Equation.
  • Subject with a QTcF of > 450 msec in male subjects and > 470 msec in female subjects on the screening 12 lead ECG.
  • Subject has Neuropathy ≥ Grade 2 at Screening.
  • Subject has Type 1 Diabetes Mellitus or Type 2 Diabetes Mellitus and currently being treated with insulin or sulfonylureas.
  • Subject has concomitant active second malignancies unless remission was achieved at least 3 years prior to study entry and subject is no longer on therapy for the malignancy.
  • Subject has a significant cardiovascular disease
  • Subject has a known history of acute or chronic hepatitis B (HBV), HIV or hepatitis C (HCV) infection.
  • Subject has serious/active bacterial, viral or fungal infection requiring systemic treatment.
  • Subject has significant gastrointestinal abnormalities, including ulcerative colitis, chronic diarrhea associated with intestinal malabsorption, Crohn's disease, and/or prior surgical procedures affecting absorption or requirement for intravenous (IV) alimentation.
  • Subject has active central nervous system (CNS) metastases not controlled by prior surgery or radiotherapy (subjects must be off steroids). Subjects with signs or symptoms suggestive of brain metastasis are not eligible unless brain metastases are ruled out by brain MRI/CT.
  • Subject has concurrent severe or uncontrolled medical disease or organ system dysfunction which, in the opinion of the Investigators, would limit life expectancy to < 3 months.
  • Subject has psychiatric disorder or altered mental status that would preclude an understanding of the informed consent process and/or completion of the necessary study procedures.
  • Subject has difficulty swallowing large pills.
  • Subject currently being treated with biguanides or other agents known to increase risk of lactic acidosis.
  • Subject has unavoidable concomitant treatment with any drug known for causing Torsades de Pointes.
  • Subject has had radiotherapy or surgery within the 4 weeks prior to treatment with ASP4132.
  • Subject has not discontinued all previous systemic therapies for cancer including chemotherapy, immunotherapy, or biological therapies for at least 14 days prior to the initiation of ASP4132.
  • Subject has not fully recovered from the acute toxicities (except alopecia) of any prior anti-cancer therapy.
  • Subject requiring concomitant use of strong CYP3A4 inhibitors or inducers.

Sites / Locations

  • Site US10001
  • Site US10004
  • Site US10002
  • Site US10003
  • Site US10005

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

ASP4132 dose escalation

ASP4132 dose expansion

Arm Description

Subjects will receive a single dose of the study drug on Day -4 (Single-Dose Period), followed by PK sampling prior to Multiple-Dose Period where they will receive the same dose as they received in the Single-Dose Period on one of four schedules: Continuous - daily dosing for 28 days, Intermittent: Schedule A: 3 days on / 4 days off; Schedule B: 1 days on / 6 days off; Schedule C: 3 days on / 11 days off.

Subjects in Part 2 will be treated with ASP4132 at the MTD and dosing schedule identified from Part 1.

Outcomes

Primary Outcome Measures

Safety as assessed by adverse events
Safety as assessed by clinical laboratory tests
Safety as assessed by vital signs
Safety as assessed by electrocardiograms (ECG)

Secondary Outcome Measures

Objective response rate to ASP4132
Duration of response to ASP4132
Disease control rate to ASP4132
Maximum concentration (Cmax) of ASP4132
Time of the maximum concentration (Tmax) of ASP4132
Area under the concentration-time curve from time of dosing to the last measurable concentration (AUClast) of ASP4132
AUC from the time of dosing to 24 hours (AUC24) of ASP4132
AUC from the time of dosing extrapolated to time infinity (AUCinf) of ASP4132
Apparent terminal elimination half-life (T1/2) of ASP4132
Accumulation ratio of ASP4132
Apparent total systemic clearance after single or multiple extravascular dosing (CL/F) of ASP4132
Apparent volume of distribution during the terminal elimination phase after single or multiple extravascular dosing (Vz/F) of ASP4132
Progression-free survival

Full Information

First Posted
March 4, 2015
Last Updated
May 31, 2019
Sponsor
Astellas Pharma Global Development, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02383368
Brief Title
A Dose Escalation and Expansion Study of ASP4132 to Subjects With Advanced Refractory Tumors and Lymphoma
Official Title
An Open-Label, Dose-Escalation/Expansion Phase 1 Study of ASP4132 Given Orally to Patients With Advanced Refractory Solid Tumors and Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2019
Overall Recruitment Status
Completed
Study Start Date
March 23, 2015 (Actual)
Primary Completion Date
April 27, 2018 (Actual)
Study Completion Date
April 27, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Astellas Pharma Global Development, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and tolerability of ASP4132 and to determine the maximum tolerated dose and recommended phase 2 dose of ASP4132. The study will also determine the pharmacokinetics (PK) of ASP4132 and evaluate the preliminary antitumor activity.
Detailed Description
The study consists of two parts and these will be conducted sequentially: Part 1 (dose escalation) and Part 2 (dose expansion). Subjects will participate in Part 1 or Part 2.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma, Refractory Solid Tumors, Advanced Cancer
Keywords
Pharmacokinetics, ASP4132, Lymphoma, Refractory Solid Tumors

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
39 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ASP4132 dose escalation
Arm Type
Experimental
Arm Description
Subjects will receive a single dose of the study drug on Day -4 (Single-Dose Period), followed by PK sampling prior to Multiple-Dose Period where they will receive the same dose as they received in the Single-Dose Period on one of four schedules: Continuous - daily dosing for 28 days, Intermittent: Schedule A: 3 days on / 4 days off; Schedule B: 1 days on / 6 days off; Schedule C: 3 days on / 11 days off.
Arm Title
ASP4132 dose expansion
Arm Type
Experimental
Arm Description
Subjects in Part 2 will be treated with ASP4132 at the MTD and dosing schedule identified from Part 1.
Intervention Type
Drug
Intervention Name(s)
ASP4132
Intervention Description
oral
Primary Outcome Measure Information:
Title
Safety as assessed by adverse events
Time Frame
up to 39 months
Title
Safety as assessed by clinical laboratory tests
Time Frame
up to 39 months
Title
Safety as assessed by vital signs
Time Frame
up to 39 months
Title
Safety as assessed by electrocardiograms (ECG)
Time Frame
up to 39 months
Secondary Outcome Measure Information:
Title
Objective response rate to ASP4132
Time Frame
Week 16
Title
Duration of response to ASP4132
Time Frame
Week 16
Title
Disease control rate to ASP4132
Time Frame
Week 16
Title
Maximum concentration (Cmax) of ASP4132
Time Frame
up to 43 days
Title
Time of the maximum concentration (Tmax) of ASP4132
Time Frame
up to 43 days
Title
Area under the concentration-time curve from time of dosing to the last measurable concentration (AUClast) of ASP4132
Time Frame
up to 43 days
Title
AUC from the time of dosing to 24 hours (AUC24) of ASP4132
Time Frame
up to 43 days
Title
AUC from the time of dosing extrapolated to time infinity (AUCinf) of ASP4132
Time Frame
up to 43 days
Title
Apparent terminal elimination half-life (T1/2) of ASP4132
Time Frame
up to 43 days
Title
Accumulation ratio of ASP4132
Time Frame
up to 43 days
Title
Apparent total systemic clearance after single or multiple extravascular dosing (CL/F) of ASP4132
Time Frame
up to 43 days
Title
Apparent volume of distribution during the terminal elimination phase after single or multiple extravascular dosing (Vz/F) of ASP4132
Time Frame
up to 43 days
Title
Progression-free survival
Time Frame
up to 39 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject has a life expectancy of more than 3 months Subject agrees not to participate in another interventional study while on treatment. Subject has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2. Female subject must be either: Of non-child bearing potential: post-menopausal (defined as at least 1 year without any menses) prior to Screening, or, documented surgically sterile or status post hysterectomy Or, if of childbearing potential, agree not to try to become pregnant during the study and for 90 days after the final study drug administration; if heterosexually active must use two forms of birth control Male subject and their female spouse/partners who are of childbearing potential must be using highly effective contraception consisting of two forms of birth control (one of which must be a barrier method) starting at Screening and continue throughout the study period and for 90 days after the final study drug administration. Subject must have advanced and/or metastatic, histologically or cytologically documented cancer or lymphomas, for whom there is no available standard therapy shown to provide clinical benefit. Exclusion Criteria: Subject has absolute neutrophil count < 1000/μL, platelet count < 75,000/μL, and hemoglobin < 8 g/dL (< 5 mmol/L) at Screening Subject has total serum bilirubin ≥1.5 times the upper limit of normal (ULN),serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) > 3 times ULN, or albumin ≤ 3.0 g/dL at Screening. Subject has any abnormalities in serum sodium, potassium, chloride, calcium and magnesium levels ≥ Grade 2 at screening (CTCAE Version 4.03). Subject has a known elevation in serum lactate at screening ˃ 2x institutional ULN Subject has an estimated glomerular filtration rate (eGFr) of < 60ml/min as calculated by the modification of diet Renal disease (MDRD) Equation. Subject with a QTcF of > 450 msec in male subjects and > 470 msec in female subjects on the screening 12 lead ECG. Subject has Neuropathy ≥ Grade 2 at Screening. Subject has Type 1 Diabetes Mellitus or Type 2 Diabetes Mellitus and currently being treated with insulin or sulfonylureas. Subject has concomitant active second malignancies unless remission was achieved at least 3 years prior to study entry and subject is no longer on therapy for the malignancy. Subject has a significant cardiovascular disease Subject has a known history of acute or chronic hepatitis B (HBV), HIV or hepatitis C (HCV) infection. Subject has serious/active bacterial, viral or fungal infection requiring systemic treatment. Subject has significant gastrointestinal abnormalities, including ulcerative colitis, chronic diarrhea associated with intestinal malabsorption, Crohn's disease, and/or prior surgical procedures affecting absorption or requirement for intravenous (IV) alimentation. Subject has active central nervous system (CNS) metastases not controlled by prior surgery or radiotherapy (subjects must be off steroids). Subjects with signs or symptoms suggestive of brain metastasis are not eligible unless brain metastases are ruled out by brain MRI/CT. Subject has concurrent severe or uncontrolled medical disease or organ system dysfunction which, in the opinion of the Investigators, would limit life expectancy to < 3 months. Subject has psychiatric disorder or altered mental status that would preclude an understanding of the informed consent process and/or completion of the necessary study procedures. Subject has difficulty swallowing large pills. Subject currently being treated with biguanides or other agents known to increase risk of lactic acidosis. Subject has unavoidable concomitant treatment with any drug known for causing Torsades de Pointes. Subject has had radiotherapy or surgery within the 4 weeks prior to treatment with ASP4132. Subject has not discontinued all previous systemic therapies for cancer including chemotherapy, immunotherapy, or biological therapies for at least 14 days prior to the initiation of ASP4132. Subject has not fully recovered from the acute toxicities (except alopecia) of any prior anti-cancer therapy. Subject requiring concomitant use of strong CYP3A4 inhibitors or inducers.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Astellas Pharma Global Development, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Site US10001
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520
Country
United States
Facility Name
Site US10004
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Site US10002
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Site US10003
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Site US10005
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Access to anonymized individual participant level data will not be provided for this trial as it meets one or more of the exceptions described on www.clinicalstudydatarequest.com under "Sponsor Specific Details for Astellas."
Citations:
PubMed Identifier
33830407
Citation
Janku F, LoRusso P, Mansfield AS, Nanda R, Spira A, Wang T, Melhem-Bertrandt A, Sugg J, Ball HA. First-in-human evaluation of the novel mitochondrial complex I inhibitor ASP4132 for treatment of cancer. Invest New Drugs. 2021 Oct;39(5):1348-1356. doi: 10.1007/s10637-021-01112-7. Epub 2021 Apr 8.
Results Reference
derived
Links:
URL
https://astellasclinicalstudyresults.com/study.aspx?ID=316
Description
Link to results on the Astellas Clinical Study Results website

Learn more about this trial

A Dose Escalation and Expansion Study of ASP4132 to Subjects With Advanced Refractory Tumors and Lymphoma

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