A Study Evaluates the Safety, Pharmacokinetics and Efficacy of WX-0593 in Advanced Solid Tumor Patients
Primary Purpose
Advanced Solid Tumor, Non-small Cell Lung Cancer
Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
WX-0593 Tablets
Sponsored by

About this trial
This is an interventional treatment trial for Advanced Solid Tumor, Non-small Cell Lung Cancer
Eligibility Criteria
Inclusion Criteria:
- 18 to 70 years, inclusive.
- Female or male
- Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1.
- Life expectancy of at least 12 weeks.
- At least one measurable lesion (according to RECIST v1.1)
Histologically or cytologically confirmed diagnosis of advanced solid tumor malignancy with ALK/ROS1+ (For the expansion phase, patients must have NSCLC with ALK+ ):
- Patients with advanced tumor (eg. NSCLC, lymphoma, inflammatory myofibroblastic tumor) who failed in standard treatment (eg. resistant of ALK inhibitors or chemotherapy)
- Patients with advanced NSCLC who cannot accept chemotherapy or intolerance with chemotherapy.
- Advanced NSCLC patients who could not afford ALK inhibitor treatment.
- Patients with treated or untreated asymptomatic Central Nervous System(CNS) metastases may be allowed to enroll.
- Patients must have normal function as defined: ANC≥1.5*10^9/L PLT≥100*10^9/L, Total Bilirubin (TBIL)≤1.5*Upper Limit of Normal(ULN) ( Gilbert's Syndrome TBIL ≤3.0*ULN and DBIL≤1.5*ULN ),Alanine Transaminase (ALT)and Aspartate Aminotransferase(AST)≤2.5*ULN. For liver metastasis patients, ALT and AST≤5*ULN, Cr≤1.5*ULN, LVEF≥50%.
- Any surgery or radiation (expect for palliative radiation) must have been completed at least 4 weeks prior to first dosing. Palliative radiation must have been completed at least 48 hours prior to first dosing.
- All related adverse events from previous anti-cancer therapies must have recovered to ≤ Grade 1 (except for alopecia).
- Patients must be able to understand and volunteer to sign the informed consent.
Exclusion Criteria:
- Clinically significant cardiovascular disease within 3 months prior to first dosing.
- Ongoing cardiac dysrhythmias, or any grade of uncontrolled atrial fibrillation, or prolonged QT interval (QTc > 480 ms).
- Patients need medications that may prolong QT interval or induce torsades de pointes within 14 days prior to the first dosing or during the study.
- Peripheral neuropathy ≥ Grade 3 according to CTCAE 4.03.
- Patients who received continuous use of steroids for more than 30 days, or who need long-term use of steroid hormones or other immunosuppressive agents.
- History of extensive disseminated/bilateral pulmonary interstitial fibrosis, interstitial fibrosis or interstitial lung disease of Grade 3/4 .
- Presence of active gastrointestinal (GI) disease or other condition that will interfere significantly with the absorption, distribution, metabolism, or excretion of WX-0593.
- Patients who are receiving warfarin sodium (Coumadin) or any other coumadin-derived anticoagulants,and patients with coagulation disturbance and bleeding tendency.
- Patient has received other investigational drug within 1 month.
- Patients with acute or chronic infectious medical conditions, including active hepatitis (Hepatitis A、 Hepatitis B、 Hepatitis C ) or HIV infection.
- Patients who received prior anti-cancer therapy within 2 weeks (t1/2 ≤ 3 days) or within 4 weeks (3 days < t1/2). Patients previously treated with crizotinib could start WX-0593 dosing after 1 week from the last dosing.
- Patients who could not discontinue therapy with potent CYP3A4 inhibitors or inducers within 1 week prior first dosing, or patients who need therapy with CYP3A4 inhibitors or inducers during the study.
- Patients received medications known to be metabolized by CYP3A4 and with narrow therapeutic indices, who could not discontinue within 1 week prior to the start of WX-0593 administration. Patients who need therapy with those medications during the study.
- Females who are pregnant or breastfeeding.
- Patients with childbearing potential must agree to use adequate contraception for the duration of treatment and for 6 months after the study.
- Drug abusers and alcoholics.
- History of definite nerves or psychosis diseases including epilepsy or dementia.
- History of other malignancy.
- Concurrent condition that in the investigator's opinion would jeopardize compliance with the protocol or would impart excessive risk associated with study participation that would make it inappropriate for the patient to be enrolled.
Sites / Locations
- Cancer Institute and Hospital, Chinese Academy of Medical SciencesRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
WX-0593 Tablets
Arm Description
The first part is a dose-escalation design in patients with ALK/ROS1-positive solid tumor. The second part is an expansion in non-small cell lung Cancer (NSCLC) characterized by abnormalities in ALK expression.
Outcomes
Primary Outcome Measures
Maximum tolerated dose(MTD)
The MTD is determined by the number of the participants in cohort who suffer a dose-limiting toxicity (DLT). The MTD is defined as the former dose at which more than one third of the participants develop a DLT. If no DLTs are observed, the MTD is not reached.
Secondary Outcome Measures
Tmax of WX-0593
Pharmacokinetics of WX-0593 by assessment of time to Cmax
Cmax of WX-0593
Pharmacokinetics of WX-0593 by assessment of maximum plasma WX-0593 concentration.
Cmin of WX-0593
Pharmacokinetics of WX-0593 by assessment of minimum plasma WX-0593 concentration.
AUC of WX-0593
Pharmacokinetics of WX-0593 by assessment of area under the plasma concentration time curve from zero to infinity
tl/2 of WX-0593
Pharmacokinetics of WX-0593 by assessment of the terminal half-life
Cssmin of WX-0593
Cmin of WX-0593 at steady state
Cssmax of WX-0593
Cmax of WX-0593 at steady state
Css-av of WX-0593
Mean plasma concentration of WX-0593 at steady state
AUCss of WX-0593
area under the curve of WX-0593 at steady state
DF of WX-0593
Pharmacokinetics of WX-0593 by assessment of degree of fluctuation
Vz of WX-0593
volume of distribution during terminal phase after WX-0593 administration
CLs of WX-0593
total plasma,serum or blood clearance of WX-0593 after administration
Objective Response Rate (ORR)
Primary efficacy endpoint is a change in the proportion of subjects showing overall objective response rate (ORR) from baseline to final tumor assessment point after treatment. As Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria, the percentage of subjects indicating PR (partial response) and CR (complete response) will be calculated.
According to RECIST 1.1 criteria, complete response (CR) - the disappearance of all target lesions and partial response ( PR ) - at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter.
Progression-free survival (PFS)
PFS defined as the time from baseline to first observed disease progression or death from any cause.
Disease Control Rate (DCR)
DCR is the percentage of patients with best response of CR, PR or Stable Disease (SD).
SD was defined as neither sufficient shrinkage to qualify for a PR nor sufficient increase to qualify for PD, taking as reference the smallest sum of the longest diameter.
Duration of Response (DOR) and so on
The DOR is defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date on which progressive disease (PD) is first noted or date of death.
Full Information
NCT ID
NCT03389815
First Posted
December 6, 2017
Last Updated
December 26, 2017
Sponsor
Qilu Pharmaceutical Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT03389815
Brief Title
A Study Evaluates the Safety, Pharmacokinetics and Efficacy of WX-0593 in Advanced Solid Tumor Patients
Official Title
The Dose-escalation Study Followed by an Extension Phase Evaluating the Safety, Pharmacokinetics and Efficacy of WX-0593 in Advanced Solid Tumor Patients With Anaplastic Lymphoma Kinase(ALK)/Receptor Tyrosine Kinase(ROS1) Positive
Study Type
Interventional
2. Study Status
Record Verification Date
December 2017
Overall Recruitment Status
Unknown status
Study Start Date
September 14, 2017 (Actual)
Primary Completion Date
June 2020 (Anticipated)
Study Completion Date
December 2020 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Qilu Pharmaceutical Co., Ltd.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of the study is to evaluate safety, pharmacokinetics and efficacy of WX-0593 alone in the treatment of advanced cancer.
Detailed Description
The first part is a single-arm, phase 1, open label, dose-escalation design in patients with anaplastic lymphoma kinase(ALK)/receptor tyrosine kinase(ROS1) Positive ALK/ROS1-positive solid tumor. The second part is an expansion in non-small cell lung Cancer (NSCLC) characterized by abnormalities in anaplastic lymphoma kinase(ALK) expression.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Tumor, Non-small Cell Lung Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
48 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
WX-0593 Tablets
Arm Type
Experimental
Arm Description
The first part is a dose-escalation design in patients with ALK/ROS1-positive solid tumor. The second part is an expansion in non-small cell lung Cancer (NSCLC) characterized by abnormalities in ALK expression.
Intervention Type
Drug
Intervention Name(s)
WX-0593 Tablets
Other Intervention Name(s)
FL-006
Intervention Description
tablets, dosage ranged from 30 mg to 300 mg, quaque die(QD)
Primary Outcome Measure Information:
Title
Maximum tolerated dose(MTD)
Description
The MTD is determined by the number of the participants in cohort who suffer a dose-limiting toxicity (DLT). The MTD is defined as the former dose at which more than one third of the participants develop a DLT. If no DLTs are observed, the MTD is not reached.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Tmax of WX-0593
Description
Pharmacokinetics of WX-0593 by assessment of time to Cmax
Time Frame
28 days
Title
Cmax of WX-0593
Description
Pharmacokinetics of WX-0593 by assessment of maximum plasma WX-0593 concentration.
Time Frame
28 days
Title
Cmin of WX-0593
Description
Pharmacokinetics of WX-0593 by assessment of minimum plasma WX-0593 concentration.
Time Frame
28 days
Title
AUC of WX-0593
Description
Pharmacokinetics of WX-0593 by assessment of area under the plasma concentration time curve from zero to infinity
Time Frame
28 days
Title
tl/2 of WX-0593
Description
Pharmacokinetics of WX-0593 by assessment of the terminal half-life
Time Frame
28 days
Title
Cssmin of WX-0593
Description
Cmin of WX-0593 at steady state
Time Frame
28 days
Title
Cssmax of WX-0593
Description
Cmax of WX-0593 at steady state
Time Frame
28 days
Title
Css-av of WX-0593
Description
Mean plasma concentration of WX-0593 at steady state
Time Frame
28 days
Title
AUCss of WX-0593
Description
area under the curve of WX-0593 at steady state
Time Frame
28 days
Title
DF of WX-0593
Description
Pharmacokinetics of WX-0593 by assessment of degree of fluctuation
Time Frame
28 days
Title
Vz of WX-0593
Description
volume of distribution during terminal phase after WX-0593 administration
Time Frame
28 days
Title
CLs of WX-0593
Description
total plasma,serum or blood clearance of WX-0593 after administration
Time Frame
28 days
Title
Objective Response Rate (ORR)
Description
Primary efficacy endpoint is a change in the proportion of subjects showing overall objective response rate (ORR) from baseline to final tumor assessment point after treatment. As Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria, the percentage of subjects indicating PR (partial response) and CR (complete response) will be calculated.
According to RECIST 1.1 criteria, complete response (CR) - the disappearance of all target lesions and partial response ( PR ) - at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter.
Time Frame
From fist administration of WX-0593 to 28 days after last medication.
Title
Progression-free survival (PFS)
Description
PFS defined as the time from baseline to first observed disease progression or death from any cause.
Time Frame
From fist administration of WX-0593 to 28 days after last medication.
Title
Disease Control Rate (DCR)
Description
DCR is the percentage of patients with best response of CR, PR or Stable Disease (SD).
SD was defined as neither sufficient shrinkage to qualify for a PR nor sufficient increase to qualify for PD, taking as reference the smallest sum of the longest diameter.
Time Frame
From fist administration of WX-0593 to 28 days after last medication.
Title
Duration of Response (DOR) and so on
Description
The DOR is defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date on which progressive disease (PD) is first noted or date of death.
Time Frame
From fist administration of WX-0593 to 28 days after last medication.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
18 to 70 years, inclusive.
Female or male
Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1.
Life expectancy of at least 12 weeks.
At least one measurable lesion (according to RECIST v1.1)
Histologically or cytologically confirmed diagnosis of advanced solid tumor malignancy with ALK/ROS1+ (For the expansion phase, patients must have NSCLC with ALK+ ):
Patients with advanced tumor (eg. NSCLC, lymphoma, inflammatory myofibroblastic tumor) who failed in standard treatment (eg. resistant of ALK inhibitors or chemotherapy)
Patients with advanced NSCLC who cannot accept chemotherapy or intolerance with chemotherapy.
Advanced NSCLC patients who could not afford ALK inhibitor treatment.
Patients with treated or untreated asymptomatic Central Nervous System(CNS) metastases may be allowed to enroll.
Patients must have normal function as defined: ANC≥1.5*10^9/L PLT≥100*10^9/L, Total Bilirubin (TBIL)≤1.5*Upper Limit of Normal(ULN) ( Gilbert's Syndrome TBIL ≤3.0*ULN and DBIL≤1.5*ULN ),Alanine Transaminase (ALT)and Aspartate Aminotransferase(AST)≤2.5*ULN. For liver metastasis patients, ALT and AST≤5*ULN, Cr≤1.5*ULN, LVEF≥50%.
Any surgery or radiation (expect for palliative radiation) must have been completed at least 4 weeks prior to first dosing. Palliative radiation must have been completed at least 48 hours prior to first dosing.
All related adverse events from previous anti-cancer therapies must have recovered to ≤ Grade 1 (except for alopecia).
Patients must be able to understand and volunteer to sign the informed consent.
Exclusion Criteria:
Clinically significant cardiovascular disease within 3 months prior to first dosing.
Ongoing cardiac dysrhythmias, or any grade of uncontrolled atrial fibrillation, or prolonged QT interval (QTc > 480 ms).
Patients need medications that may prolong QT interval or induce torsades de pointes within 14 days prior to the first dosing or during the study.
Peripheral neuropathy ≥ Grade 3 according to CTCAE 4.03.
Patients who received continuous use of steroids for more than 30 days, or who need long-term use of steroid hormones or other immunosuppressive agents.
History of extensive disseminated/bilateral pulmonary interstitial fibrosis, interstitial fibrosis or interstitial lung disease of Grade 3/4 .
Presence of active gastrointestinal (GI) disease or other condition that will interfere significantly with the absorption, distribution, metabolism, or excretion of WX-0593.
Patients who are receiving warfarin sodium (Coumadin) or any other coumadin-derived anticoagulants,and patients with coagulation disturbance and bleeding tendency.
Patient has received other investigational drug within 1 month.
Patients with acute or chronic infectious medical conditions, including active hepatitis (Hepatitis A、 Hepatitis B、 Hepatitis C ) or HIV infection.
Patients who received prior anti-cancer therapy within 2 weeks (t1/2 ≤ 3 days) or within 4 weeks (3 days < t1/2). Patients previously treated with crizotinib could start WX-0593 dosing after 1 week from the last dosing.
Patients who could not discontinue therapy with potent CYP3A4 inhibitors or inducers within 1 week prior first dosing, or patients who need therapy with CYP3A4 inhibitors or inducers during the study.
Patients received medications known to be metabolized by CYP3A4 and with narrow therapeutic indices, who could not discontinue within 1 week prior to the start of WX-0593 administration. Patients who need therapy with those medications during the study.
Females who are pregnant or breastfeeding.
Patients with childbearing potential must agree to use adequate contraception for the duration of treatment and for 6 months after the study.
Drug abusers and alcoholics.
History of definite nerves or psychosis diseases including epilepsy or dementia.
History of other malignancy.
Concurrent condition that in the investigator's opinion would jeopardize compliance with the protocol or would impart excessive risk associated with study participation that would make it inappropriate for the patient to be enrolled.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yuankai Shi, M.D.
Organizational Affiliation
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jian Fang, M.D.
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Shucai Zhang, M.D.
Organizational Affiliation
Beijing Chest Hospital, Capital Medical University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Yunpeng Liu, M.D.
Organizational Affiliation
First Hospital of China Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100021
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yuankai Shi, M.D.
Phone
86-010-87788293
Email
syuankaipumc@126.com
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
35087031
Citation
Shi Y, Fang J, Hao X, Zhang S, Liu Y, Wang L, Chen J, Hu Y, Hang X, Li J, Liu C, Zhang Y, Wang Z, Hu Y, Gu K, Huang J, Zhang L, Shan J, Ouyang W, Zhao Y, Zhuang W, Yu Y, Zhao J, Zhang H, Lu P, Li W, Si M, Ge M, Geng H. Safety and activity of WX-0593 (Iruplinalkib) in patients with ALK- or ROS1-rearranged advanced non-small cell lung cancer: a phase 1 dose-escalation and dose-expansion trial. Signal Transduct Target Ther. 2022 Jan 28;7(1):25. doi: 10.1038/s41392-021-00841-8.
Results Reference
derived
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A Study Evaluates the Safety, Pharmacokinetics and Efficacy of WX-0593 in Advanced Solid Tumor Patients
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