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Combination of GT90001 and Nivolumab in Patients With Metastatic Hepatocellular Carcinoma(HCC)

Primary Purpose

Metastatic Hepatocellular Carcinoma, HCC, Combinations of Drugs; Dependence

Status
Unknown status
Phase
Phase 1
Locations
Taiwan
Study Type
Interventional
Intervention
GT90001 and Nivolumab
Sponsored by
Suzhou Kintor Pharmaceutical Inc,
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Hepatocellular Carcinoma focused on measuring Phase Ib/II, HCC, Metastatic Hepatocellular Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Be willing and able to provide written informed consent for the trial;
  2. Age ≥20 years male and female;
  3. Subjects must have confirmed diagnosis of unresectable HCC with any of following criteria:

    i. Histologically or cytologically confirmed diagnosis of HCC ii. Have Barcelona Clinic Liver Cancer (BCLC) Stage C disease or BCLC Stage B disease not amenable to locoregional therapy or refractory to locoregional therapy;

  4. Have documented disease progression or intolerance after first-line systemic treatment;
  5. At least one measurable lesion based on RECIST version 1.1 ;
  6. Child-Pugh score ≤ 6 (Child-Pugh A)score within 7 days of first dose of study drug;
  7. ECOG performance status: 0-1;
  8. Have a predicted life expectancy of greater than 3 months;
  9. The functions of the important organs are confirmed with the following requirement:

    • Hemoglobin (HGB) ≥ 90 g/L;
    • White blood cell count (WBC) ≥ 3×10^9/L;
    • Absolute neutrophil count (ANC) ≥ 1.5×10^9/L;
    • Platelets (PLT) ≥ 100×10^9/L;
    • Total bilirubin (TBIL) ≤ 1.5× Upper limit of normal value (ULN)
    • Aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) ≤ 5× ULN
    • Creatinine (Cr) ≤ 1.5×ULN;
    • International normalization ratio (INR)or prothrombin time (PT) ≤ 1.5×ULN ;
  10. Women must have a negative serum or urine pregnancy test within 72 hours prior to the start of investigational product;
  11. Women of childbearing potential must agree to contraception for the duration of study treatment and 5 months after the last dose of study treatment;
  12. Willing and able to comply with all aspects of the protocol

Exclusion Criteria:

  1. Imaging findings for HCC corresponding to any of the following:

    • HCC with ≥ 50% liver occupation
    • Clear invasion into the bile duct
    • Portal vein invasion or thrombosis at the main portal branch (Vp4)
  2. Gastric or esophageal varices that require treatment;
  3. If prior history of DVT/PE, the patient needs to be on stable doses of anticoagulation with low molecular weight heparin or oral anticoagulant for at least two weeks;
  4. Esophageal vein dilation, grade A of active peptic ulcer rating, and all bleeding risk by gastroscopy;
  5. History of arterial thromboembolic event in past 6 months;
  6. Active bleeding disorder, including gastrointestinal bleeding event or active hemoptysis within 28 days prior to study treatment;
  7. Have central nervous system (CNS) metastases;
  8. Has a known history of human immunodeficiency virus (HIV);
  9. Has received prior immune checkpoint inhibitor (including those targeting PD-1, PD-L1 or PD-L2, CD137, or cytotoxic T-lymphocyte antigen [CTLA-4]);
  10. Has a known history of, or any evidence of, interstitial lung disease or active non- infectious pneumonitis;
  11. Has active autoimmune disease that has required systemic treatment in past 2 years;
  12. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial;
  13. Any history of drug or alcohol dependency or abuse within the prior 1 years;
  14. Has known active Hepatitis B or Hepatitis C within 2 weeks prior to initiation of study treatment Note: Patients with HBV infection are required to be receiving effective antiviral therapy over two weeks, and then have continuous therapy in study period;
  15. Pregnant, breast feeding, or planning to become pregnant;
  16. Have a history of severe hypersensitivity reaction to monoclonal antibody;
  17. Significant cardiovascular impairment: history of congestive heart failure greater than New York Heart Association (NYHA) Class II, unstable angina, myocardial infarction or stroke within 6 months of the first dose of study drug;
  18. Have surgery, radiotherapy, ablation within one month before screening;
  19. Subjects with any other serious disease considered by the investigator not in the condition to enter into the trial

Sites / Locations

  • National Cheng Kung University Hospital
  • MacKay Memorial Hospital
  • National TaiWan University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

metastatic HCC

Arm Description

Stage one - Dose de-escalation: Each dose cohort will assess toxicity within the 28 days following the first dose of nivolumab and GT90001. Stage two- the expansion cohort: 14 patients will be enrolled to the expansion cohort where one or no DLT takes place in planned study cohort.

Outcomes

Primary Outcome Measures

Dose-limiting Toxicity(DLT)
Each dose cohort will initially include 6 evaluable patients for assessment of toxicity within the 28 days following the first dose of nivolumab and GT90001.

Secondary Outcome Measures

overall response rate (ORR)
To estimate ORR, per RECIST 1.1 assessed by investigator review
the duration of response (DOR),
To evaluate the DOR per RECIST 1.1 assessed by investigator review
disease control rate (DCR),
To evaluate the DCR per RECIST 1.1 assessed by investigator review
time to response (TTR)
To evaluate the TTR per RECIST 1.1 assessed by investigator review
progression-free survival (PFS)
To evaluate the PFS per RECIST 1.1 assessed by investigator review
maximum concentration (Cmax)
Pharmacokinetics
time that maximum concentration is observed (tmax)
Pharmacokinetics
area under the concentration time-curve from time zero to infinity (AUC0∞)
Pharmacokinetics
area under the plasma concentration-time curve from time zero hours to time (t hrs), (AUC0-t)
Pharmacokinetics
area under the plasma concentration-time curve from time zero hours to 24 hours (AUC0-24)
Pharmacokinetics
terminal elimination rate constant (λz)
Pharmacokinetics
terminal elimination half life (t½)
Pharmacokinetics
volume of distribution (Vz)
Pharmacokinetics
volume of plasma cleared of the drug per unit time (C)
Pharmacokinetics
Exploratory Biomarker: circulating tumor deoxyribonucleic acid (ctDNA)
HCC-related pathway alterations including VEGF and TGF-β pathway genes

Full Information

First Posted
March 21, 2019
Last Updated
July 8, 2021
Sponsor
Suzhou Kintor Pharmaceutical Inc,
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1. Study Identification

Unique Protocol Identification Number
NCT03893695
Brief Title
Combination of GT90001 and Nivolumab in Patients With Metastatic Hepatocellular Carcinoma(HCC)
Official Title
Combination of GT90001 and Nivolumab in Patients With Metastatic Hepatocellular Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Unknown status
Study Start Date
May 25, 2019 (Actual)
Primary Completion Date
June 25, 2022 (Anticipated)
Study Completion Date
June 25, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Suzhou Kintor Pharmaceutical Inc,

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This single arm, open label, two stage study will be conducted in several medical centers around Taiwan. Stage one determine safety and tolerability in patients with HCC, and stage two assess anti-tumor activities of GT90001 in combination with nivolumab in patients with metastatic HCC. Subjects who fulfill all the entry criteria and have written informed consent will be enrolled to the study.
Detailed Description
Based on published and first-hand experience with the safety and tolerability of both GT90001 and nivolumab, the proposed dose is GT90001 7 mg/kg in combination with nivolumb 3 mg/kg. Nivolumab will first be administered by intravenous infusion over 60 minutes, then 30 minutes later, give GT90001 intravenous infusion for 1 hour. All participants will receive GT90001 + Nivolumab until unacceptable toxicity, disease progression or loss of clinical benefit as determined by the investigator.The primary objective of the study is to determine the safety and tolerability of GT90001 in combination with nivolumab in subjects with advanced and or metastatic HCC who were progressed on or were intolerant of first-line and/or second-line systemic therapy. The secondary objectives will be to evaluate the anti-tumor efficacy and the PK profile of this combination therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Hepatocellular Carcinoma, HCC, Combinations of Drugs; Dependence
Keywords
Phase Ib/II, HCC, Metastatic Hepatocellular Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Single arm, Open label,Two stage study
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
metastatic HCC
Arm Type
Experimental
Arm Description
Stage one - Dose de-escalation: Each dose cohort will assess toxicity within the 28 days following the first dose of nivolumab and GT90001. Stage two- the expansion cohort: 14 patients will be enrolled to the expansion cohort where one or no DLT takes place in planned study cohort.
Intervention Type
Drug
Intervention Name(s)
GT90001 and Nivolumab
Other Intervention Name(s)
GT90001 and Opdivo
Intervention Description
Stage1:Dose de-escalation. Stage2:the expansion cohort where one or no DLT takes place in planned study cohort.
Primary Outcome Measure Information:
Title
Dose-limiting Toxicity(DLT)
Description
Each dose cohort will initially include 6 evaluable patients for assessment of toxicity within the 28 days following the first dose of nivolumab and GT90001.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
overall response rate (ORR)
Description
To estimate ORR, per RECIST 1.1 assessed by investigator review
Time Frame
2 years
Title
the duration of response (DOR),
Description
To evaluate the DOR per RECIST 1.1 assessed by investigator review
Time Frame
2 years
Title
disease control rate (DCR),
Description
To evaluate the DCR per RECIST 1.1 assessed by investigator review
Time Frame
2 years
Title
time to response (TTR)
Description
To evaluate the TTR per RECIST 1.1 assessed by investigator review
Time Frame
2 years
Title
progression-free survival (PFS)
Description
To evaluate the PFS per RECIST 1.1 assessed by investigator review
Time Frame
2 years
Title
maximum concentration (Cmax)
Description
Pharmacokinetics
Time Frame
2 years
Title
time that maximum concentration is observed (tmax)
Description
Pharmacokinetics
Time Frame
2 years
Title
area under the concentration time-curve from time zero to infinity (AUC0∞)
Description
Pharmacokinetics
Time Frame
2 years
Title
area under the plasma concentration-time curve from time zero hours to time (t hrs), (AUC0-t)
Description
Pharmacokinetics
Time Frame
2 years
Title
area under the plasma concentration-time curve from time zero hours to 24 hours (AUC0-24)
Description
Pharmacokinetics
Time Frame
2 years
Title
terminal elimination rate constant (λz)
Description
Pharmacokinetics
Time Frame
2 years
Title
terminal elimination half life (t½)
Description
Pharmacokinetics
Time Frame
2 years
Title
volume of distribution (Vz)
Description
Pharmacokinetics
Time Frame
2 years
Title
volume of plasma cleared of the drug per unit time (C)
Description
Pharmacokinetics
Time Frame
2 years
Title
Exploratory Biomarker: circulating tumor deoxyribonucleic acid (ctDNA)
Description
HCC-related pathway alterations including VEGF and TGF-β pathway genes
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be willing and able to provide written informed consent for the trial; Age ≥20 years male and female; Subjects must have confirmed diagnosis of unresectable HCC with any of following criteria: i. Histologically or cytologically confirmed diagnosis of HCC ii. Have Barcelona Clinic Liver Cancer (BCLC) Stage C disease or BCLC Stage B disease not amenable to locoregional therapy or refractory to locoregional therapy; Have documented disease progression or intolerance after first-line systemic treatment; At least one measurable lesion based on RECIST version 1.1 ; Child-Pugh score ≤ 6 (Child-Pugh A)score within 7 days of first dose of study drug; ECOG performance status: 0-1; Have a predicted life expectancy of greater than 3 months; The functions of the important organs are confirmed with the following requirement: Hemoglobin (HGB) ≥ 90 g/L; White blood cell count (WBC) ≥ 3×10^9/L; Absolute neutrophil count (ANC) ≥ 1.5×10^9/L; Platelets (PLT) ≥ 100×10^9/L; Total bilirubin (TBIL) ≤ 1.5× Upper limit of normal value (ULN) Aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) ≤ 5× ULN Creatinine (Cr) ≤ 1.5×ULN; International normalization ratio (INR)or prothrombin time (PT) ≤ 1.5×ULN ; Women must have a negative serum or urine pregnancy test within 72 hours prior to the start of investigational product; Women of childbearing potential must agree to contraception for the duration of study treatment and 5 months after the last dose of study treatment; Willing and able to comply with all aspects of the protocol Exclusion Criteria: Imaging findings for HCC corresponding to any of the following: HCC with ≥ 50% liver occupation Clear invasion into the bile duct Portal vein invasion or thrombosis at the main portal branch (Vp4) Gastric or esophageal varices that require treatment; If prior history of DVT/PE, the patient needs to be on stable doses of anticoagulation with low molecular weight heparin or oral anticoagulant for at least two weeks; Esophageal vein dilation, grade A of active peptic ulcer rating, and all bleeding risk by gastroscopy; History of arterial thromboembolic event in past 6 months; Active bleeding disorder, including gastrointestinal bleeding event or active hemoptysis within 28 days prior to study treatment; Have central nervous system (CNS) metastases; Has a known history of human immunodeficiency virus (HIV); Has received prior immune checkpoint inhibitor (including those targeting PD-1, PD-L1 or PD-L2, CD137, or cytotoxic T-lymphocyte antigen [CTLA-4]); Has a known history of, or any evidence of, interstitial lung disease or active non- infectious pneumonitis; Has active autoimmune disease that has required systemic treatment in past 2 years; Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial; Any history of drug or alcohol dependency or abuse within the prior 1 years; Has known active Hepatitis B or Hepatitis C within 2 weeks prior to initiation of study treatment Note: Patients with HBV infection are required to be receiving effective antiviral therapy over two weeks, and then have continuous therapy in study period; Pregnant, breast feeding, or planning to become pregnant; Have a history of severe hypersensitivity reaction to monoclonal antibody; Significant cardiovascular impairment: history of congestive heart failure greater than New York Heart Association (NYHA) Class II, unstable angina, myocardial infarction or stroke within 6 months of the first dose of study drug; Have surgery, radiotherapy, ablation within one month before screening; Subjects with any other serious disease considered by the investigator not in the condition to enter into the trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yuwei Xu
Organizational Affiliation
Suzhou Kintor Pharmaceuticals,inc.
Official's Role
Study Director
Facility Information:
Facility Name
National Cheng Kung University Hospital
City
Tainan
Country
Taiwan
Facility Name
MacKay Memorial Hospital
City
Taipei
Country
Taiwan
Facility Name
National TaiWan University Hospital
City
Taipei
Country
Taiwan

12. IPD Sharing Statement

Learn more about this trial

Combination of GT90001 and Nivolumab in Patients With Metastatic Hepatocellular Carcinoma(HCC)

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