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A Study to Evaluate the Safety and Efficacy of ALMB-0168 in Patients With Osteosarcoma

Primary Purpose

Osteosarcoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
ALMB-0168
Sponsored by
AlaMab Therapeutics (Shanghai) Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteosarcoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Histopathologically confirmed osteosarcoma;
  2. Patients will be enrolled according to different stages:

    1. Part I: Patients with osteosarcoma whose prior standard treatment have failed.;
    2. Part II: Patients with high-grade osteosarcoma whose prior standard treatment have failed.; Standard treatment failure is defined as the progression on or within 6 months after the first-line chemotherapy (including high-dose methotrexate, doxorubicin, cisplatin, ifosfamide, etc.); For patients with disease progression more than 6 months after the chemotherapy, the risk-benefit assessment should be conducted by the investigators;
  3. 16 years of age or older, male or female;
  4. Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1 or 2;
  5. Either measurable or non-measurable disease per RECIST v1.1. Non-measurable disease should be assessable by conventional imaging techniques including isotope bone scans, CT or MRI scans. Patients in part II stage must have at least one measurable lesion confirmed by CT or MRI at baseline.
  6. Adequate major system function defined as:

    1. Bone marrow reserve: Absolute neutrophil count (ANC) ≥1.5 x109/L; Platelet count ≥ 75 x 109/L; Hemoglobin ≥ 90 g/L (not receiving blood transfusion within 14 days before the first administration);
    2. Hepatic function: Total bilirubin ≤1.5 x upper limit of normal (ULN), Transaminases (aspartate aminotransferase/serum glutamic oxaloacetic transaminase (AST/SGOT) and/or alanine aminotransferase/serum glutamic pyruvic transaminase (ALT/SGPT)) ≤ 3 x ULN (<5 x ULN for liver metastases);
    3. Renal function: Normal serum creatinine ≤1.5 mg/dL (133 μmol/L) OR calculated creatinine clearance ≥50 mL/min. (Cockcroft - Gault formula);
    4. Coagulation: Adequate coagulation parameters defined as International Normalization Ratio (INR) ≤2.
  7. Female patients of childbearing potential must have negative results of serum pregnancy test within 7 days before the first dose. Male patients with female partners of childbearing potential and female patients of childbearing potential are required to use two forms of acceptable contraception, including 1 barrier method, during their participation in the study and for 3 months following the last dose. Male patients must also refrain from donating sperm during their participation in the study;
  8. Life expectancy ≥3 months;
  9. Ability to understand the entire process of this study, voluntarily participate and sign a written informed consent form.

Exclusion Criteria:

  1. Any recent anti-tumour therapy ≤ 28 days before the first dose or residual more than Grade 1 chemotherapy-related side effects per NCI CTCAE v5.0, with the exception of alopecia.
  2. Have participated in the other clinical trial and received the investigational drug treatment within 4 weeks before the first dose of study drug;
  3. Wide-field radiotherapy (including therapeutic radioisotopes such as strontium 89) administered ≤28 days or limited field radiation for palliation ≤7 days prior to starting study drug or has not recovered from side effects of such therapy;
  4. Major surgical procedures ≤28 days of beginning study drug, or minor surgical procedures ≤7 days. No waiting required following port-a-cath placement;
  5. Brain metastases, leptomeningeal metastases or, spinal cord compression or central nervous system (CNS) injuries/abnormalities;
  6. Pregnant women. Breastfeeding women should stop breastfeeding before signing the informed consent;
  7. Any of the following cardiac diseases currently or within the last 6 months:

    1. Left ventricular ejection fraction (LVEF) <45% as determined by echocardiogram (ECHO);
    2. The corrected QT interval (Fridericia formula) interval (QTcF) > 470 msec for females and > 450 msec for men in electrocardiogram (ECG) at screening;
    3. Unstable angina pectoris;
    4. Heart failure (New York Heart Association (NYHA) >2 grade);
    5. Acute myocardial infarction;
    6. Uncontrolled arrhythmia;
    7. Acute coronary syndromes;
    8. Stent placement;
  8. Uncontrolled hypertension (systolic blood pressure (SBP) > 160 mmHg or diastolic blood pressure (DBP) > 100 mmHg (Patients with blood pressure values higher than these levels must use drugs to control blood pressure below this level before the first dose of study drug));
  9. Have a serious active infection (systemic intravenous antibiotics within 14 days but oral antibiotics allowed) that is not well controlled, or have another serious underlying medical condition that would prevent the patients from receiving the protocol treatment;
  10. Known diagnosis of human immunodeficiency virus, active hepatitis B or C;
  11. Have received Chinese herbal medicine or Chinese patent drug with anti-tumor activity within 14 days before the first administration;
  12. Has other active tumors or a history of infiltrative tumor treatment within 3 years. Patients with a history of definitively locally treated stage I tumors who are considered unlikely to recur can be accepted. Patients with a history of prior treatment for carcinoma in situ (e.g., non-invasive) and history of non-melanoma skin cancer are acceptable.
  13. According to the researchers' judgment, patients with other factors that may lead to the termination of the study, such as other serious diseases (including severe mental disorders) requiring combined treatment, serious laboratory abnormalities, family or social factors, which may affect the safety or the collection of data and samples. Psychological, family, social or geographical conditions and other factors are not consistent with the experimental scheme.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    ALMB-0168

    Arm Description

    Dose Escalation Cohort :The accelerated titration and traditional "3+3" design will be used in the dose-escalation phase. Seven dose cohorts will be evaluated. ALMB-0168 will be administered intravenously once every 3 weeks until either the disease progresses or intolerable toxicity occurs. Dose Expansion Cohort: Based on the results of Part I, 1-3 dose expansion cohorts will be started to further evaluate the safety and efficacy of ALMB-0168.

    Outcomes

    Primary Outcome Measures

    Incidence of adverse events
    Defined by the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE V5.0). Incidence of adverse events will be assessed in both PART I and PART II.
    Dose-Limited Toxicities (DLT)
    DLTs were assessed according to NCI-CTCAE v.5.0 during the first cycle
    6-Month Progression-free Survival Rate (6m-PFSR)
    6m-PFSR is defined as the percentage of patients who will be alive and without PD at 6 months from the randomization date. 6m-PFSR will be assessed only in PART II.

    Secondary Outcome Measures

    Maximum concentration (Cmax) of ALMB-0168
    Measure the maximum (peak) plasma concentration
    Time to maximum concentration (Tmax) of ALMB-0168
    Measure the time to reach maximum (peak) plasma concentration
    Minimum concentration(Cmin) of ALMB-0168
    Measure the minimum (trough) plasma concentration
    The area under the curve (AUC) of ALMB-0168
    Measure the area under the curve
    Half-life (t1/2) of ALMB-0168
    calculate the half-life of ALMB-0168
    Clearance (CL) of ALMB-0168
    Measure apparent total clearance(s) from plasma after administration
    Objective Response Rate (ORR)
    ORR will be assessed by Blinded Independent Review Committee (IRC) per RECIST Version 1.1.
    Disease control rate (DCR)
    DCR will be determined by Response evaluation criteria in solid tumours v1.1
    Duration of response (DOR)
    DOR was defined as the time from first documented evidence of complete response (CR) or partial response (PR) until progressive disease (PD) or death.
    Progression-free survival (PFS)
    PFS was defined as the time from randomization to the first documented PD or death due to any cause, whichever occurred first.
    Time to Response (TTR)
    TTR was defined as the time to a confirmed CR (disappearance of all target lesions) or PR (At least a 30 percent decrease in the sum of diameters of target lesions) per RECIST 1.1.
    Overall survival (OS)
    OS was defined as the time from randomization to death due to any cause.
    Rate of Skeletal Related Events (SRE)
    Including pathological fractures, spinal cord compression, hypercalcemia caused by malignant tumors, radiotherapy or surgery for bone lesions for symptom relief
    Change from baseline in alkaline phosphatase (ALP) and lactate dehydrogenase (LDH)
    pre- and post-treatment ALP and LDH changes in blood samples
    Change from baseline in Bone Mineral Density (BMD)
    Dual-energy X-ray absorptiometry (DXA) to determine the bone mineral density of the subjects' lumbar spine, hip bone and femoral neck.
    Dose of morphine compared with baseline
    pre- and post-treatment dose changes of morphine
    Frequency of morphine compared with baseline
    pre- and post-treatment frequency changes of morphine
    Change from baseline of numeric pain scale (NRS) scores
    pre- and post-treatment changes of NRS scores (min~max: 0~10; higher scores means a worse outcome)
    Change from baseline of quality of life scale (EQ-5D) scores
    pre- and post-treatment changes of EQ-5D scores (min~max: 0~100; higher scores means a better outcome)
    The incidence of anti-drug antibody (ADA)
    The percentage of patients with ADA

    Full Information

    First Posted
    May 5, 2021
    Last Updated
    May 10, 2021
    Sponsor
    AlaMab Therapeutics (Shanghai) Inc.
    Collaborators
    CSPC ZhongQi Pharmaceutical Technology Co., Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04886765
    Brief Title
    A Study to Evaluate the Safety and Efficacy of ALMB-0168 in Patients With Osteosarcoma
    Official Title
    A Phase I/II, Multi-center, Single-Arm, Open-Label Study to Evaluate the Safety and Efficacy of ALMB-0168 in Patients With Osteosarcoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2021
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    May 2021 (Anticipated)
    Primary Completion Date
    November 2023 (Anticipated)
    Study Completion Date
    May 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    AlaMab Therapeutics (Shanghai) Inc.
    Collaborators
    CSPC ZhongQi Pharmaceutical Technology 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
    This is a phase I / II, multi-center, single-arm, open-label study to evaluate the safety and efficacy of ALMB-0168 in patients with osteosarcoma whose prior standard treatment have failed.
    Detailed Description
    This is a phase I / II, multi-centre, single-arm, open-label study with two parts, a dose-escalation phase (Part I) and a dose-expansion phase (part II). In part I, patients with osteosarcoma whose prior standard treatment have failed will be assigned to receive sequentially higher doses of ALMB-0168 intravenously. The dose-escalation initially will follow an accelerated titration design for the first two dosing groups, then follow a classic 3+3 design. The maximum tolerated dose (MTD) and the recommended Phase 2 dose (RP2D) of ALMB-0168 will be determined in part I. In Part II, 1-3 expansion cohorts will begin to further assess the safety profile and explore efficacy, and each cohort will enroll up to 60 patients with high-grade osteosarcoma in each cohort. All patients will receive multiple administration of ALMB-0168 until either the disease progresses or intolerable toxicity occurs.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Osteosarcoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Sequential Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    238 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    ALMB-0168
    Arm Type
    Experimental
    Arm Description
    Dose Escalation Cohort :The accelerated titration and traditional "3+3" design will be used in the dose-escalation phase. Seven dose cohorts will be evaluated. ALMB-0168 will be administered intravenously once every 3 weeks until either the disease progresses or intolerable toxicity occurs. Dose Expansion Cohort: Based on the results of Part I, 1-3 dose expansion cohorts will be started to further evaluate the safety and efficacy of ALMB-0168.
    Intervention Type
    Drug
    Intervention Name(s)
    ALMB-0168
    Intervention Description
    ALMB-0168 will be administered intravenously until either the disease progresses or intolerable toxicity occurs.
    Primary Outcome Measure Information:
    Title
    Incidence of adverse events
    Description
    Defined by the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE V5.0). Incidence of adverse events will be assessed in both PART I and PART II.
    Time Frame
    From enrollment to 28 days after the last dose in each part study.
    Title
    Dose-Limited Toxicities (DLT)
    Description
    DLTs were assessed according to NCI-CTCAE v.5.0 during the first cycle
    Time Frame
    Up to 21 days in Cycle 1
    Title
    6-Month Progression-free Survival Rate (6m-PFSR)
    Description
    6m-PFSR is defined as the percentage of patients who will be alive and without PD at 6 months from the randomization date. 6m-PFSR will be assessed only in PART II.
    Time Frame
    From enrollment to 6 month after the first dose of the last patient in PART II
    Secondary Outcome Measure Information:
    Title
    Maximum concentration (Cmax) of ALMB-0168
    Description
    Measure the maximum (peak) plasma concentration
    Time Frame
    From enrollment to 4 weeks after the last dose of the last patient
    Title
    Time to maximum concentration (Tmax) of ALMB-0168
    Description
    Measure the time to reach maximum (peak) plasma concentration
    Time Frame
    From enrollment to 4 weeks after the last dose of the last patient
    Title
    Minimum concentration(Cmin) of ALMB-0168
    Description
    Measure the minimum (trough) plasma concentration
    Time Frame
    From enrollment to 4 weeks after the last dose of the last patient
    Title
    The area under the curve (AUC) of ALMB-0168
    Description
    Measure the area under the curve
    Time Frame
    From enrollment to 4 weeks after the last dose of the last patient
    Title
    Half-life (t1/2) of ALMB-0168
    Description
    calculate the half-life of ALMB-0168
    Time Frame
    From enrollment to 4 weeks after the last dose of the last patient
    Title
    Clearance (CL) of ALMB-0168
    Description
    Measure apparent total clearance(s) from plasma after administration
    Time Frame
    From enrollment to 4 weeks after the last dose of the last patient
    Title
    Objective Response Rate (ORR)
    Description
    ORR will be assessed by Blinded Independent Review Committee (IRC) per RECIST Version 1.1.
    Time Frame
    2 year
    Title
    Disease control rate (DCR)
    Description
    DCR will be determined by Response evaluation criteria in solid tumours v1.1
    Time Frame
    2 year
    Title
    Duration of response (DOR)
    Description
    DOR was defined as the time from first documented evidence of complete response (CR) or partial response (PR) until progressive disease (PD) or death.
    Time Frame
    2 year
    Title
    Progression-free survival (PFS)
    Description
    PFS was defined as the time from randomization to the first documented PD or death due to any cause, whichever occurred first.
    Time Frame
    up to 3 years
    Title
    Time to Response (TTR)
    Description
    TTR was defined as the time to a confirmed CR (disappearance of all target lesions) or PR (At least a 30 percent decrease in the sum of diameters of target lesions) per RECIST 1.1.
    Time Frame
    2 year
    Title
    Overall survival (OS)
    Description
    OS was defined as the time from randomization to death due to any cause.
    Time Frame
    up to 3 years
    Title
    Rate of Skeletal Related Events (SRE)
    Description
    Including pathological fractures, spinal cord compression, hypercalcemia caused by malignant tumors, radiotherapy or surgery for bone lesions for symptom relief
    Time Frame
    through study completion, an average of 3 year
    Title
    Change from baseline in alkaline phosphatase (ALP) and lactate dehydrogenase (LDH)
    Description
    pre- and post-treatment ALP and LDH changes in blood samples
    Time Frame
    through study completion, an average of 3 year
    Title
    Change from baseline in Bone Mineral Density (BMD)
    Description
    Dual-energy X-ray absorptiometry (DXA) to determine the bone mineral density of the subjects' lumbar spine, hip bone and femoral neck.
    Time Frame
    through study completion, an average of 3 year
    Title
    Dose of morphine compared with baseline
    Description
    pre- and post-treatment dose changes of morphine
    Time Frame
    through study completion, an average of 3 year
    Title
    Frequency of morphine compared with baseline
    Description
    pre- and post-treatment frequency changes of morphine
    Time Frame
    through study completion, an average of 3 year
    Title
    Change from baseline of numeric pain scale (NRS) scores
    Description
    pre- and post-treatment changes of NRS scores (min~max: 0~10; higher scores means a worse outcome)
    Time Frame
    through study completion, an average of 3 year
    Title
    Change from baseline of quality of life scale (EQ-5D) scores
    Description
    pre- and post-treatment changes of EQ-5D scores (min~max: 0~100; higher scores means a better outcome)
    Time Frame
    through study completion, an average of 3 year
    Title
    The incidence of anti-drug antibody (ADA)
    Description
    The percentage of patients with ADA
    Time Frame
    From enrollment to 4 weeks after the last dose of the last patient

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    16 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Histopathologically confirmed osteosarcoma; Patients will be enrolled according to different stages: Part I: Patients with osteosarcoma whose prior standard treatment have failed.; Part II: Patients with high-grade osteosarcoma whose prior standard treatment have failed.; Standard treatment failure is defined as the progression on or within 6 months after the first-line chemotherapy (including high-dose methotrexate, doxorubicin, cisplatin, ifosfamide, etc.); For patients with disease progression more than 6 months after the chemotherapy, the risk-benefit assessment should be conducted by the investigators; 16 years of age or older, male or female; Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1 or 2; Either measurable or non-measurable disease per RECIST v1.1. Non-measurable disease should be assessable by conventional imaging techniques including isotope bone scans, CT or MRI scans. Patients in part II stage must have at least one measurable lesion confirmed by CT or MRI at baseline. Adequate major system function defined as: Bone marrow reserve: Absolute neutrophil count (ANC) ≥1.5 x109/L; Platelet count ≥ 75 x 109/L; Hemoglobin ≥ 90 g/L (not receiving blood transfusion within 14 days before the first administration); Hepatic function: Total bilirubin ≤1.5 x upper limit of normal (ULN), Transaminases (aspartate aminotransferase/serum glutamic oxaloacetic transaminase (AST/SGOT) and/or alanine aminotransferase/serum glutamic pyruvic transaminase (ALT/SGPT)) ≤ 3 x ULN (<5 x ULN for liver metastases); Renal function: Normal serum creatinine ≤1.5 mg/dL (133 μmol/L) OR calculated creatinine clearance ≥50 mL/min. (Cockcroft - Gault formula); Coagulation: Adequate coagulation parameters defined as International Normalization Ratio (INR) ≤2. Female patients of childbearing potential must have negative results of serum pregnancy test within 7 days before the first dose. Male patients with female partners of childbearing potential and female patients of childbearing potential are required to use two forms of acceptable contraception, including 1 barrier method, during their participation in the study and for 3 months following the last dose. Male patients must also refrain from donating sperm during their participation in the study; Life expectancy ≥3 months; Ability to understand the entire process of this study, voluntarily participate and sign a written informed consent form. Exclusion Criteria: Any recent anti-tumour therapy ≤ 28 days before the first dose or residual more than Grade 1 chemotherapy-related side effects per NCI CTCAE v5.0, with the exception of alopecia. Have participated in the other clinical trial and received the investigational drug treatment within 4 weeks before the first dose of study drug; Wide-field radiotherapy (including therapeutic radioisotopes such as strontium 89) administered ≤28 days or limited field radiation for palliation ≤7 days prior to starting study drug or has not recovered from side effects of such therapy; Major surgical procedures ≤28 days of beginning study drug, or minor surgical procedures ≤7 days. No waiting required following port-a-cath placement; Brain metastases, leptomeningeal metastases or, spinal cord compression or central nervous system (CNS) injuries/abnormalities; Pregnant women. Breastfeeding women should stop breastfeeding before signing the informed consent; Any of the following cardiac diseases currently or within the last 6 months: Left ventricular ejection fraction (LVEF) <45% as determined by echocardiogram (ECHO); The corrected QT interval (Fridericia formula) interval (QTcF) > 470 msec for females and > 450 msec for men in electrocardiogram (ECG) at screening; Unstable angina pectoris; Heart failure (New York Heart Association (NYHA) >2 grade); Acute myocardial infarction; Uncontrolled arrhythmia; Acute coronary syndromes; Stent placement; Uncontrolled hypertension (systolic blood pressure (SBP) > 160 mmHg or diastolic blood pressure (DBP) > 100 mmHg (Patients with blood pressure values higher than these levels must use drugs to control blood pressure below this level before the first dose of study drug)); Have a serious active infection (systemic intravenous antibiotics within 14 days but oral antibiotics allowed) that is not well controlled, or have another serious underlying medical condition that would prevent the patients from receiving the protocol treatment; Known diagnosis of human immunodeficiency virus, active hepatitis B or C; Have received Chinese herbal medicine or Chinese patent drug with anti-tumor activity within 14 days before the first administration; Has other active tumors or a history of infiltrative tumor treatment within 3 years. Patients with a history of definitively locally treated stage I tumors who are considered unlikely to recur can be accepted. Patients with a history of prior treatment for carcinoma in situ (e.g., non-invasive) and history of non-melanoma skin cancer are acceptable. According to the researchers' judgment, patients with other factors that may lead to the termination of the study, such as other serious diseases (including severe mental disorders) requiring combined treatment, serious laboratory abnormalities, family or social factors, which may affect the safety or the collection of data and samples. Psychological, family, social or geographical conditions and other factors are not consistent with the experimental scheme.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Xiaojing Lee, Master
    Phone
    +86-028-63925025
    Email
    lixiaojing@mail.ecspc.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Jingnan Shen, Doctor
    Organizational Affiliation
    the first affiliated Hospital, Sun Yat-sen Unibersity
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    A Study to Evaluate the Safety and Efficacy of ALMB-0168 in Patients With Osteosarcoma

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