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Safety of TT-00420 Monotherapy in Patients With Advanced Solid Tumors and Triple Negative Breast Cancer

Primary Purpose

Advanced Solid Tumors, Triple Negative Breast Cancer

Status
Unknown status
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
TT-00420
Sponsored by
TransThera Sciences (Nanjing), Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Solid Tumors

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Aged 18 years to 75 years at the time of provision of informed consent
  2. Dose Escalation Cohorts: Histopathological or cytologically documented locally advanced or metastatic solid tumors who have no available standard therapeutic treatment options Dose Expansion Cohorts: Histopathological or cytologically documented locally advanced or metastatic TNBC or SATs
  3. TNBC Dose Expansion Cohort:

    1. Histologically proven invasive breast carcinoma with triple negative receptor status per institutional standard and with confirmed negative for ER and PR by IHC (<10% positive tumor nuclei)
    2. relapsed/refractory to at least one line of systemic chemotherapy
  4. At least one measurable lesion as defined by RECIST V1.1 criteria for solid tumors
  5. ECOG performance status of 0 or 1
  6. Adequate organ function confirmed at Screening and within 10 days of initiating treatment, as evidenced by:

    • Absolute Neutrophil Count (ANC) ≥ 1.5 x 10^9/L
    • Hemoglobin (Hgb) ≥ 9 g/dl
    • Platelets (plt) ≥ 100 x 10^9/L
    • AST/SGOT and ALT/SGPT ≤ 2.5 x Upper Limit of Normal (ULN) or ≤ 5.0 x ULN if liver metastases are present
    • Total bilirubin ≤ 1.5 x ULN, or direct bilirubin < ULN for patients with total bilirubin levels >1.5 ULN
    • Serum creatinine ≤ 1.5 x ULN or calculated 24-hour clearance ≥ 50 mL/min
    • Negative pregnancy test within 72 hours before starting study treatment in all pre-menopausal women and women < 12 months after the onset of menopause
  7. Must agree to take sufficient contraceptive methods to avoid pregnancy during the study and until at least 6 months after ceasing study treatment
  8. Able to sign informed consent and to comply with the protocol

Exclusion Criteria:

  1. Women who are pregnant or lactating
  2. Women of child-bearing potential (WOCBP) who does not use adequate birth control
  3. Patients with any hematologic malignancy. This includes leukemia (any form), lymphoma, and multiple myeloma.
  4. Patients with

    1. a history of primary central nervous system tumors or
    2. carcinomatous meningitis Note: Patients with treated brain metastases that are off corticosteroid and have been clinically stable 28 days are eligible for enrollment
  5. Patients with the following mood disorders as judged by the Investigator or a psychiatrist, or as result of patient's mood assessment questionnaire:

    • Medically documented history of or active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia; a history of suicidal attempt or ideation, or homicidal ideation (immediate risk of doing harm to others)
    • ≥ CTCAE grade 3 anxiety
    • The psychiatric judgment, if available, overrules the mood assessment questionnaire result/investigator judgment
  6. Impaired cardiac function or clinically significant cardiac diseases, including but not limited to any of the following:

    1. LVEF < 45% as determined by MUGA scan or ECHO
    2. Congenital long QT syndrome
    3. QTc ≥ 450 msec on screening ECG
    4. Unstable angina pectoris ≤ 3 months prior to starting study drug
    5. Acute myocardial infarction ≤ 3 months prior to starting study drug
  7. Patients with

    1. unresolved diarrhea ≥ CTCAE grade 2, or
    2. impairment of gastrointestinal (GI) function, or
    3. GI disease that may significantly alter the absorption of TT-00420 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection).
  8. Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g., uncontrolled hypertriglyceridemia [triglycerides > 500 mg/dL], active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol
  9. Patients who have received chemotherapy, targeted therapy or immunotherapy ≤ 4 weeks (6 weeks for nitrosourea or mitomycin-C) prior to starting study drug or who have not recovered from side effects of such therapy
  10. Patients who have received wide field radiotherapy ≤ 4 weeks or limited field radiation for palliation ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  11. Patients who have undergone major surgery ≤ 4 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  12. Patients who have been treated with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GM-CSF) ≤ 2 weeks prior to starting study drug. Erythropoietin or darbepoetin therapy, if initiated before enrollment, may be continued
  13. Patients who are currently receiving treatment with therapeutic doses of warfarin sodium (Coumadin®) or any other coumarin-derivative anticoagulants
  14. Patients who have received corticosteroids ≤ 2 weeks prior to starting study drug or who have not recovered from the side effects of such treatment
  15. Patients who are currently receiving treatment with medication that has known risk to prolong the QT interval or inducing Torsades de Pointes, and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug
  16. Patients who are receiving high to moderate CYP3A inhibitors and inducers as listed in Appendix F
  17. Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is not mandatory)
  18. Known history of active infection with Hepatitis B (e.g., HBsAg reactive), or Hepatitis C (e.g., HCV RNA (qualitative) is detected)
  19. Has received a live-virus vaccination within 30 days of planned first dose Note: Seasonal flu vaccines are permitted.
  20. Inability to swallow or tolerate oral medication
  21. Has a history or current evidence of any condition, therapy, or laboratory abnormality that, in the opinion of the investigator, might confound the results of the trial, interfere with the patient's participation and compliance in the trial

Sites / Locations

  • MD Anderson Cancer Center
  • Cancer Hopital Chinese Academy of Medical Sciences

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Dose Escalation

Dose Expansion

Arm Description

Eligible adult patients with advanced solid tumors will be enrolled into Dose Escalation cohorts and treated with TT-00420 at different dose cohorts. Starting dose will be 1 mg p.o., q.d. An ABLRM guided by the EWOC principle will evaluate the risk of under-dose or over-dose for the dose tested in each cohort and provide the recommendation dose for next cohort. Dose Escalation Teleconference will be held after the last evaluable patient complete Cycle 1 treatment in each dose cohort to evaluate DLT, determine MTD and/or DRDE.

A Dose Expansion cohort will be opened to enroll patients with selected advanced solid tumors and evaluate the safety, PK and preliminary efficacy of TT-00420 to determine the recommended phase 2 dose in patients with advanced solid tumors.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD) and/or Dose Limiting Toxicity (DLT)
FIH Dose Finding

Secondary Outcome Measures

Dose Recommended for Dose Expansion (DRDE)
Dose Recommended for Dose Expansion
Optimal Biological Dose (OBD)
Dose Recommended for Dose Expansion
Number of Participants With Abnormal Laboratory Values
Safety and tolerability of TT-00420
Number of Participants With Adverse Events That Are Related to Treatment
Safety and tolerability of TT-00420
Peak Plasma Concentration (Cmax) of TT-00420
PK parameters of TT-00420
Time at which Cmax was first observed (Tmax) of TT-00420
PK parameters of TT-00420
Half-life (T1/2) of TT-00420
PK parameters of TT-00420
Objective Response Rate (ORR)
ORR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Disease Control Rate (DCR)
DCR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Duration of Response (DOR)
DOR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Progression Free Survival (PFS)
PFS of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Overall Survival (OS)
OS of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts

Full Information

First Posted
August 21, 2018
Last Updated
October 25, 2021
Sponsor
TransThera Sciences (Nanjing), Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03654547
Brief Title
Safety of TT-00420 Monotherapy in Patients With Advanced Solid Tumors and Triple Negative Breast Cancer
Official Title
A Phase I, First-In-Human, Multicenter, Open-Label Study of TT-00420, Administered Orally in Adult Patients With Advanced Solid Tumors and Triple Negative Breast Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Unknown status
Study Start Date
January 8, 2019 (Actual)
Primary Completion Date
June 30, 2021 (Actual)
Study Completion Date
December 30, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
TransThera Sciences (Nanjing), Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a first-in-human, phase I clinical research study with TT-00420, an investigational, oral, multi-target, dual mechanism kinase inhibitor targeting both mitosis and tumor micro-environment, for the treatment of triple negative breast cancer (TNBC) and other advanced solid tumors. The study consists of a dose escalation part followed by a MTD expansion part.
Detailed Description
Dose Escalation Cohorts: Eligible adult patients with advanced solid tumors will be enrolled into Dose Escalation cohorts. Starting dose of TT-00420 mono-therapy will be 1 mg p.o., q.d. TT-00420 capsule will be administered once daily on a continuous schedule. A treatment cycle consists of 28 days. An ABLRM guided by the EWOC principle will evaluate the risk of under-dose or over-dose for the dose tested in each cohort and provide the recommendation dose for next cohort. Dose limiting toxicity (DLT) will be evaluated per the pre-defined DLT criteria and managed by the pre-defined rules detailed in the protocol. Maximum Tolerated Dose (MTD) and/or Dose Recommend for Dose Expansion (DRDE) will be determined in Dose Escalation cohorts. Dose Expansion Cohorts: TNBC Cohort: TNBC Dose-Expansion cohort will be opened to enroll the patients with advanced TNBC and evaluate the safety, PK and preliminary efficacy of TT-00420 to identify the optimal biological dose (OBD), when feasible, in patients with advanced TNBC. SAT Cohort: A parallel basket SAT Dose Expansion Cohort will be open to enroll patients with selected advanced tumors (SAT) to evaluate the safety, PK and preliminary efficacy of TT-00420 to identify the optimal biological dose (OBD), when feasible, in patients with SATs. Recruitment in dose expansion cohorts may be put on hold if any significant safety finding(s) that was not observed in dose escalation cohorts is identified. Bayesian modeling will be updated with the new findings to evaluate if the previously determined MTD or DRDE still suitable for further enrollment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Tumors, Triple Negative Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Dose Escalation arm followed by Dose Expansion arm
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
48 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation
Arm Type
Experimental
Arm Description
Eligible adult patients with advanced solid tumors will be enrolled into Dose Escalation cohorts and treated with TT-00420 at different dose cohorts. Starting dose will be 1 mg p.o., q.d. An ABLRM guided by the EWOC principle will evaluate the risk of under-dose or over-dose for the dose tested in each cohort and provide the recommendation dose for next cohort. Dose Escalation Teleconference will be held after the last evaluable patient complete Cycle 1 treatment in each dose cohort to evaluate DLT, determine MTD and/or DRDE.
Arm Title
Dose Expansion
Arm Type
Experimental
Arm Description
A Dose Expansion cohort will be opened to enroll patients with selected advanced solid tumors and evaluate the safety, PK and preliminary efficacy of TT-00420 to determine the recommended phase 2 dose in patients with advanced solid tumors.
Intervention Type
Drug
Intervention Name(s)
TT-00420
Intervention Description
TT-00420 is an investigational, oral, multi-target, dual mechanism kinase inhibitor targeting both mitosis and tumor microenvironment, for the treatment of triple negative breast cancer (TNBC) and other advanced solid tumors. TT-00420 capsule will be administered once daily on a continuous schedule. A treatment cycle consists of 28 days. The proposed dosage form for early clinical research is powder filled hard gelatin capsule (PIC) with dosage strengths as of 1 mg, 5 mg and 20 mg.
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) and/or Dose Limiting Toxicity (DLT)
Description
FIH Dose Finding
Time Frame
At the end of Cycle 1 (each cycle is 28 days)
Secondary Outcome Measure Information:
Title
Dose Recommended for Dose Expansion (DRDE)
Description
Dose Recommended for Dose Expansion
Time Frame
At the end of Cycle 1 (each cycle is 28 days)
Title
Optimal Biological Dose (OBD)
Description
Dose Recommended for Dose Expansion
Time Frame
At the end of Cycle 1 (each cycle is 28 days)
Title
Number of Participants With Abnormal Laboratory Values
Description
Safety and tolerability of TT-00420
Time Frame
Up to 30 days from study discontinuation
Title
Number of Participants With Adverse Events That Are Related to Treatment
Description
Safety and tolerability of TT-00420
Time Frame
Up to 30 days from study discontinuation
Title
Peak Plasma Concentration (Cmax) of TT-00420
Description
PK parameters of TT-00420
Time Frame
through study completion, an average of 6 months
Title
Time at which Cmax was first observed (Tmax) of TT-00420
Description
PK parameters of TT-00420
Time Frame
through study completion, an average of 6 months
Title
Half-life (T1/2) of TT-00420
Description
PK parameters of TT-00420
Time Frame
through study completion, an average of 6 months
Title
Objective Response Rate (ORR)
Description
ORR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Time Frame
through study completion, an average of 1 year
Title
Disease Control Rate (DCR)
Description
DCR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Time Frame
through study completion, an average of 1 year
Title
Duration of Response (DOR)
Description
DOR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Time Frame
through study completion, an average of 1 year
Title
Progression Free Survival (PFS)
Description
PFS of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Time Frame
through study completion, an average of 1 year
Title
Overall Survival (OS)
Description
OS of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts
Time Frame
through study completion, an average of 1 year
Other Pre-specified Outcome Measures:
Title
Exploratory Biomarker Assay
Description
TNBC subtype; pH3, angiogenesis, p-STAT3 etc.; MSI, TMB
Time Frame
through study completion, an average of 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged 18 years to 75 years at the time of provision of informed consent Dose Escalation Cohorts: Histopathological or cytologically documented locally advanced or metastatic solid tumors who have no available standard therapeutic treatment options Dose Expansion Cohorts: Histopathological or cytologically documented locally advanced or metastatic TNBC or SATs TNBC Dose Expansion Cohort: Histologically proven invasive breast carcinoma with triple negative receptor status per institutional standard and with confirmed negative for ER and PR by IHC (<10% positive tumor nuclei) relapsed/refractory to at least one line of systemic chemotherapy At least one measurable lesion as defined by RECIST V1.1 criteria for solid tumors ECOG performance status of 0 or 1 Adequate organ function confirmed at Screening and within 10 days of initiating treatment, as evidenced by: Absolute Neutrophil Count (ANC) ≥ 1.5 x 10^9/L Hemoglobin (Hgb) ≥ 9 g/dl Platelets (plt) ≥ 100 x 10^9/L AST/SGOT and ALT/SGPT ≤ 2.5 x Upper Limit of Normal (ULN) or ≤ 5.0 x ULN if liver metastases are present Total bilirubin ≤ 1.5 x ULN, or direct bilirubin < ULN for patients with total bilirubin levels >1.5 ULN Serum creatinine ≤ 1.5 x ULN or calculated 24-hour clearance ≥ 50 mL/min Negative pregnancy test within 72 hours before starting study treatment in all pre-menopausal women and women < 12 months after the onset of menopause Must agree to take sufficient contraceptive methods to avoid pregnancy during the study and until at least 6 months after ceasing study treatment Able to sign informed consent and to comply with the protocol Exclusion Criteria: Women who are pregnant or lactating Women of child-bearing potential (WOCBP) who does not use adequate birth control Patients with any hematologic malignancy. This includes leukemia (any form), lymphoma, and multiple myeloma. Patients with a history of primary central nervous system tumors or carcinomatous meningitis Note: Patients with treated brain metastases that are off corticosteroid and have been clinically stable 28 days are eligible for enrollment Patients with the following mood disorders as judged by the Investigator or a psychiatrist, or as result of patient's mood assessment questionnaire: Medically documented history of or active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia; a history of suicidal attempt or ideation, or homicidal ideation (immediate risk of doing harm to others) ≥ CTCAE grade 3 anxiety The psychiatric judgment, if available, overrules the mood assessment questionnaire result/investigator judgment Impaired cardiac function or clinically significant cardiac diseases, including but not limited to any of the following: LVEF < 45% as determined by MUGA scan or ECHO Congenital long QT syndrome QTc ≥ 450 msec on screening ECG Unstable angina pectoris ≤ 3 months prior to starting study drug Acute myocardial infarction ≤ 3 months prior to starting study drug Patients with unresolved diarrhea ≥ CTCAE grade 2, or impairment of gastrointestinal (GI) function, or GI disease that may significantly alter the absorption of TT-00420 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection). Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g., uncontrolled hypertriglyceridemia [triglycerides > 500 mg/dL], active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol Patients who have received chemotherapy, targeted therapy or immunotherapy ≤ 4 weeks (6 weeks for nitrosourea or mitomycin-C) prior to starting study drug or who have not recovered from side effects of such therapy Patients who have received wide field radiotherapy ≤ 4 weeks or limited field radiation for palliation ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy Patients who have undergone major surgery ≤ 4 weeks prior to starting study drug or who have not recovered from side effects of such therapy Patients who have been treated with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GM-CSF) ≤ 2 weeks prior to starting study drug. Erythropoietin or darbepoetin therapy, if initiated before enrollment, may be continued Patients who are currently receiving treatment with therapeutic doses of warfarin sodium (Coumadin®) or any other coumarin-derivative anticoagulants Patients who have received corticosteroids ≤ 2 weeks prior to starting study drug or who have not recovered from the side effects of such treatment Patients who are currently receiving treatment with medication that has known risk to prolong the QT interval or inducing Torsades de Pointes, and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug Patients who are receiving high to moderate CYP3A inhibitors and inducers as listed in Appendix F Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is not mandatory) Known history of active infection with Hepatitis B (e.g., HBsAg reactive), or Hepatitis C (e.g., HCV RNA (qualitative) is detected) Has received a live-virus vaccination within 30 days of planned first dose Note: Seasonal flu vaccines are permitted. Inability to swallow or tolerate oral medication Has a history or current evidence of any condition, therapy, or laboratory abnormality that, in the opinion of the investigator, might confound the results of the trial, interfere with the patient's participation and compliance in the trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sarina A. Piha-Paul, MD
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Cancer Hopital Chinese Academy of Medical Sciences
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100000
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
36223547
Citation
Peng P, Qiang X, Li G, Li L, Ni S, Yu Q, Sourd L, Marangoni E, Hu C, Wang D, Wu D, Wu F. Tinengotinib (TT-00420), a Novel Spectrum-Selective Small-Molecule Kinase Inhibitor, Is Highly Active Against Triple-Negative Breast Cancer. Mol Cancer Ther. 2023 Feb 1;22(2):205-214. doi: 10.1158/1535-7163.MCT-22-0012.
Results Reference
derived

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Safety of TT-00420 Monotherapy in Patients With Advanced Solid Tumors and Triple Negative Breast Cancer

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