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TT-10 as a Single Agent in Subjects With Advanced Selected Solid Tumors

Primary Purpose

Renal Cell Cancer, Castrate Resistant Prostate Cancer, Non Small Cell Lung Cancer

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
TT-10
Sponsored by
Portage Biotech
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Renal Cell Cancer focused on measuring Failed or not eligible for standard of care, Advanced Selected Solid Tumors, TT-10, Adenosine, Adenosine Antagonist, A2A, A2AR Inhibitor, PORT-6, ADPORT-601

Eligibility Criteria

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

Inclusion Criteria:

To eligible for inclusion in the dose escalation cohort or expansion cohort 1 in this study, subjects must meet all of the following criteria:

  1. Subjects must be ≥18 years of age.
  2. Subjects or their legal representative must be able to provide written informed consent to participate in the trial prior to the performance of any study-specific procedures.
  3. Diagnosis of histologically or cytologically confirmed advanced selected solid tumors

    • Cohort A dose escalation: Renal cell cancer (RCC), castrate resistant prostate cancer (CRPC) and Non-small cell lung cancer (NSCLC) who have failed or are not eligible for standard of care treatment.
    • Cohort B: Advanced RCC who have failed or are not eligible for standard of care treatment.
    • Cohort C: Advanced CRPC who have failed or are not eligible for standard of care treatment.
    • Cohort D: Advanced NSCLC who have failed or are not eligible for standard of care treatment.
    • Cohort E: Exploratory Biopsy: Inclusive of subjects w/RCC, CRPC and/or NSCLC who have failed or are not eligible for standard of care treatment and have an accessible tumor for pre and post dose biopsies.
  4. ECOG performance status (PS) score 0-1
  5. Have measurable disease per RECIST 1.1 or (for subjects in the expansion cohorts) irRECIST as assessed by the local site investigator/radiology. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
  6. Subjects must have locally advanced, recurrent or metastatic neoplastic disease that is not curable by currently available local therapies.
  7. Failure to respond to standard therapy, or for whom no appropriate therapies are available (based on the judgment of the Investigator)
  8. Cohort E Only: Fresh tissue sample obtained prior to treatment initiation and agree to on treatment biopsy from same lesion.
  9. Life expectancy of ≥ 3 months
  10. Subjects must have adequate hematologic function based on the following:

    • Absolute neutrophil count ≥ 1.5 x 109/L
    • Platelet count ≥ 100 x 109/L
    • Hemoglobin ≥ 9.0 g/dL
  11. Subjects must have adequate hepatic function based on the following:

    • Total bilirubin <1.5 × upper limit of normal (ULN) (unless elevated due to Gilbert's syndrome)
    • Alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ≤2.5 x ULN (≤5 × ULN for subjects with known hepatic metastases)
  12. Subjects must have adequate renal function based on the following:

    • Serum creatinine ≤1.5 × ULN; or
    • Serum creatinine clearance ≥ 45 mL/min (≥ 30 mL/min for subjects), as determined by Cockcroft-Gault equation
  13. Human immunodeficiency virus (HIV) infected subjects must be on antiretroviral therapy (ART) and have a well-controlled HIV infection/disease defined as:

    1. Subjects on ART must have a CD4+ T cell count >350 cells/mm3 at time of screening
    2. Subjects on ART must have achieved and maintained virologic suppression defined as confirmed HIV RNA level below 50 copies/mL or the lower limit of qualification (below the limit of detection) using the locally available assay at the time of screening and for at least 12 weeks prior to screening
    3. Subjects on ART must have been on a stable regimen, without changes in drugs or dose modification, for at least 4 weeks prior to study entry (Day 1).
  14. For women of childbearing potential (WCBP): negative urine pregnancy test (UPT) within 1 week before first treatment (WCBP defined as a sexually mature woman who has not undergone surgical sterilization or who has not been naturally post-menopausal for at least 12 consecutive months for women > 55 years of age). WCBP should be placed on effective birth control directly after testing negative for pregnancy; if not, then WCBP should have a UPT on Day 1 of every cycle, prior to drug administration. Any positive or indeterminant UPT result must be confirmed by Serum.
  15. Female subjects of childbearing potential must use a highly effective mode of contraception or abstain from heterosexual activity for the duration of the trial and for 120 days following the last dose of study medication. A female is NOT of childbearing potential if she has undergone bilateral salpingoophorectomy or is menopausal, defined as an absence of menses for 12 consecutive months. Male subjects must agree to use highly effective contraception.
  16. Ability to adhere to the study visit schedule and all protocol requirements

Exclusion Criteria:

Subjects will be excluded from the study if they satisfy any of the following criteria at the screening visit unless otherwise stated:

Subjects are to be excluded from the study if they meet any of the following criteria:

  1. Major surgery within 4 weeks prior to Screening
  2. Subjects with active central nervous system (CNS) metastases; however, subjects who have undergone radiation and/or surgery for the treatment of CNS metastases, who are neurologically stable, and who are no longer taking pharmacologic doses of corticosteroids are eligible; subjects with leptomeningeal metastases are not eligible.
  3. Has received prior radiotherapy within 2 weeks of start of study treatment. Subjects must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-CNS disease.
  4. Primary CNS malignancy
  5. HIV-infected subjects with a history of Kaposi sarcoma and/or Multicentric Castleman Disease.
  6. Subjects who are hepatitis B surface antigen positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load prior to enrollment.

    Note: Subjects should remain on antiviral therapy throughout study intervention and follow local guidelines for HBV antiviral therapy post completion of study intervention.

    Hepatitis B screening tests are not required unless:

    • Known history of HBV infection
    • As mandated by local health authority.
  7. Subjects with a history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at screening. Note: Subjects must have completed curative antiviral therapy at least 4 weeks prior to enrollment.

    Hepatitis C screening tests are not required unless:

    • Known history of HCV infection
    • As mandated by local health authority.
  8. Subjects who require immunosuppressive therapy including, but not limited to, treatment with corticosteroids in pharmacologic doses (equivalent to ≥10 mg prednisone daily), cyclosporine, mycophenolate, azathioprine, methotrexate, adalimumab, infliximab, vedolizumab, tofacitinib, dupilumab, rituximab, etc. or systemic steroids (except for steroid use as cortisol replacement therapy in documented adrenal insufficiency)
  9. Ongoing systemic bacterial, fungal, or viral infections at Screening

    a. NOTE: Subjects on antimicrobial, antifungal, or antiviral prophylaxis are not specifically excluded if all other inclusion/exclusion criteria are met

  10. Administration of a live vaccine within 6 weeks of first dose of study drug
  11. Baseline QT interval corrected with Fridericia's method (QTcF) > 480 ms (average of triplicate readings)

    a. NOTE: Criterion does not apply to subjects with a right or left bundle branch block.

  12. Prior surgery or gastrointestinal dysfunction that may affect drug absorption (eg, gastric bypass surgery, gastrectomy)
  13. Female subjects who are pregnant or breastfeeding
  14. Concurrent active malignancy other than non-melanoma skin cancer, carcinoma in situ of the cervix, or prostate intraepithelial neoplasia
  15. Past medical history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis which required steroid treatment, or any evidence of clinically active interstitial lung disease
  16. History of peptic ulcer and/or gastrointestinal bleed within the past 6 months prior to Screening
  17. History of stroke, unstable angina, myocardial infarction, or ventricular arrhythmia requiring medication or mechanical control within the last 6 months prior to Screening
  18. Unstable or severe uncontrolled medical condition (eg, unstable cardiac function, unstable pulmonary condition including pneumonitis and/or interstitial lung disease, uncontrolled diabetes) or any important medical illness or abnormal laboratory finding that would, in the Investigator's judgment, increase the risk to the subject associated with his or her participation in the study.

Sites / Locations

  • USC Norris Comprehensive Cancer Center
  • University of California San Francisco UCSF
  • Sarah Cannon Research Institute DenverRecruiting
  • Norton Cancer Institute
  • Washington University
  • Jefferson Health-Thomas Jefferson University Hospitals
  • The University of Texas MD Anderson Cancer Center
  • Virginia Cancer Specialists

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Multiple Ascending Dose

Arm Description

3+3 Dose escalation until MTD and/or R2PD of TT-10 is determined

Outcomes

Primary Outcome Measures

Number of subjects with Dose Limiting Toxicities (DLTs) of TT-10 during the dose escalation phase
All toxicities will be graded using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0
Define the maximum tolerated dose (MTD) or phase 2 recommended dose of TT-10 during the dose escalation phase
To confirm the maximum tolerated dose (MTD) of TT-10, defined as the highest dose level at which <2 out of 6 participants experience a dose-limiting toxicity
Expansion cohort primary objective - safety
Incidence and severity of treatment-related adverse events (TRAEs) in participants treated at the recommended phase 2 dose in the expansion phase

Secondary Outcome Measures

Overall Response Rate (ORR)
ORR is to be reported as the proportion of patients who have a Complete Response or Partial Response per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
Duration of Response (DoR)
Defined as the time from first documented objective response per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 to the date of first documented radiographic progression of disease (PD) or death.
Progression Free Survival (PFS)
Time from first dose to the date of the first confirmed documented progression per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
Peak serum concentration (Cmax) of TT-10
PK Parameter
Area under the serum concentration versus time curve (AUC) of TT-10
PK Parameter
Half-life of TT-10
PK Parameter

Full Information

First Posted
July 5, 2021
Last Updated
September 25, 2023
Sponsor
Portage Biotech
Collaborators
Tarus Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04969315
Brief Title
TT-10 as a Single Agent in Subjects With Advanced Selected Solid Tumors
Official Title
Phase I/II First-in-Human Study of TT-10 as a Single Agent in Subjects With Advanced Selected Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 23, 2023 (Actual)
Primary Completion Date
May 14, 2025 (Anticipated)
Study Completion Date
August 14, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Portage Biotech
Collaborators
Tarus Therapeutics, Inc.

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and tolerability of orally administered TT-10 in subjects with advanced selected solid tumors. The dose escalation portion of the study will determine the maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D) of TT-10.
Detailed Description
Multicenter, open-label dose-escalation Phase I/II clinical study, designed to evaluate the safety, tolerability, PK, PD, anti-tumor activity, and efficacy of TT-10 in subjects diagnosed with advanced Renal cell cancer (RCC), castrate resistant prostate cancer (CRPC) and Non-small cell lung cancer (NSCLC); who have failed or are not eligible for standard of care treatment. The study will be conducted in two phases. Dose escalation (Phase 1) will be to determine the maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D), safety and tolerability of TT-10 in subjects with advanced subjects diagnosed with advanced Renal cell cancer (RCC), castrate resistant prostate cancer (CRPC) and Non-small cell lung cancer (NSCLC); who have failed or are not eligible for standard of care treatment. Dose expansion (Phase 2) will be to further explore the safety and tolerability of the MTD and/or RP2D, PK, PD, anti-tumor activity, and efficacy of TT-10.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Renal Cell Cancer, Castrate Resistant Prostate Cancer, Non Small Cell Lung Cancer, Head and Neck Squamous Cell Carcinoma
Keywords
Failed or not eligible for standard of care, Advanced Selected Solid Tumors, TT-10, Adenosine, Adenosine Antagonist, A2A, A2AR Inhibitor, PORT-6, ADPORT-601

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
90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Multiple Ascending Dose
Arm Type
Experimental
Arm Description
3+3 Dose escalation until MTD and/or R2PD of TT-10 is determined
Intervention Type
Drug
Intervention Name(s)
TT-10
Intervention Description
TT-10 orally administered BID starting at 10 mg and will be increased to 200 mg (additional dose levels maybe explored, if appropriate based on emerging safety, PK or PD data).
Primary Outcome Measure Information:
Title
Number of subjects with Dose Limiting Toxicities (DLTs) of TT-10 during the dose escalation phase
Description
All toxicities will be graded using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0
Time Frame
28 Days
Title
Define the maximum tolerated dose (MTD) or phase 2 recommended dose of TT-10 during the dose escalation phase
Description
To confirm the maximum tolerated dose (MTD) of TT-10, defined as the highest dose level at which <2 out of 6 participants experience a dose-limiting toxicity
Time Frame
Through study completion, an average of 1 year
Title
Expansion cohort primary objective - safety
Description
Incidence and severity of treatment-related adverse events (TRAEs) in participants treated at the recommended phase 2 dose in the expansion phase
Time Frame
Through study completion, an average of 1 year
Secondary Outcome Measure Information:
Title
Overall Response Rate (ORR)
Description
ORR is to be reported as the proportion of patients who have a Complete Response or Partial Response per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
Time Frame
From study enrollment until participant discontinuation, first occurrence of progressive disease, or death from any cause, whichever occurs first (approximately 2 years)
Title
Duration of Response (DoR)
Description
Defined as the time from first documented objective response per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 to the date of first documented radiographic progression of disease (PD) or death.
Time Frame
From study enrollment until participant discontinuation, first occurrence of progressive disease, or death from any cause, whichever occurs first (approximately 2 years)
Title
Progression Free Survival (PFS)
Description
Time from first dose to the date of the first confirmed documented progression per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
Time Frame
From study enrollment until participant discontinuation, first occurrence of progressive disease, or death from any cause, whichever occurs first (approximately 2 years)
Title
Peak serum concentration (Cmax) of TT-10
Description
PK Parameter
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8, 24 hours post-dose
Title
Area under the serum concentration versus time curve (AUC) of TT-10
Description
PK Parameter
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8, 24 hours post-dose
Title
Half-life of TT-10
Description
PK Parameter
Time Frame
Predose, 0.5, 1, 2, 4, 6, 8, 24 hours post-dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Participants must be ≥ 18 years of age. Participants or their legal representative must be able to provide written informed consent to participate in the study prior to the performance of any study-specific procedures. Diagnosis of histologically or cytologically confirmed advanced selected solid tumors Cohort A dose escalation: RCC, CRPC and NSCLC who have failed or are not eligible for standard of care treatment. Cohort B: Metastatic RCC who have failed or are not eligible for standard of care treatment. Cohort C: Metastatic CRPC who have failed or are not eligible for standard of care treatment. Cohort D: Metastatic NSCLC who have failed or are not eligible for standard of care treatment. Cohort E: Exploratory Biopsy - Inclusive of participants with RCC, CRPC and/or NSCLC who have failed or are not eligible for standard of care treatment and have an accessible tumor for pre- and post dose biopsies. Eastern Cooperative Oncology Group performance status score 0 - 1 Have measurable disease per RECIST 1.1 as assessed by the local site investigator/radiology. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions. Failure to respond to standard therapy, or for whom no appropriate therapies are available (based on the judgment of the investigator) Cohort E Only: Fresh tissue sample obtained prior to treatment initiation and agree to on-treatment biopsy from same lesion. Life expectancy of ≥ 3 months Participants must have adequate hematologic function based on the following: Absolute neutrophil count ≥ 1.5 x 109/L Platelet count ≥ 100 x 109/L Hemoglobin ≥ 9.0 g/dL Participants must have adequate hepatic function based on the following: Total bilirubin < 1.5 x upper limit of normal (ULN) (unless elevated due to Gilbert's syndrome) Alanine aminotransferase/aspartate aminotransferase ≤ 2.5 x ULN (≤ 5 x ULN for participants with known hepatic metastases) Participants must have adequate renal function based on the following: Serum creatinine ≤ 1.5 x ULN; or Serum creatinine clearance ≥ 60 mL/min, as determined by Cockcroft-Gault equation Exclusion Criteria: Major surgery within 4 weeks prior to Screening Participants with active central nervous system (CNS) metastases; however, participants who have undergone radiation and/or surgery for the treatment of CNS metastases, who are neurologically stable, and who are no longer taking pharmacologic doses of corticosteroids are eligible; participants with leptomeningeal metastases are not eligible. Has received prior radiotherapy within 2 weeks of start of study intervention. Participants must have recovered from all radiation-related toxicities, not require corticosteroids and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤ 2 weeks of radiotherapy) to non-CNS disease. Prior anti-cancer therapy within 4 weeks prior to the start of study intervention. A 2 week washout is acceptable for short-acting drugs (eg, tyrosine kinase inhibitors). Any treatment-related toxicities must be resolved to Grade 0 - 1. Human immunodeficiency virus-infected participants Participants who are hepatitis B surface antigen positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load prior to enrollment. Note: Participants should remain on antiviral therapy throughout study intervention and follow local guidelines for HBV antiviral therapy post completion of study intervention. Hepatitis B screening tests are not required unless: Known history of HBV infection As mandated by local health authority Participants with a history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at Screening. Note: Participants must have completed curative antiviral therapy at least 4 weeks prior to enrollment. Hepatitis C screening tests are not required unless: Known history of HCV infection As mandated by local health authority Participants who require immunosuppressive therapy including, but not limited to, treatment with corticosteroids in pharmacologic doses (equivalent to ≥ 10 mg prednisone daily), cyclosporine, mycophenolate, azathioprine, methotrexate, adalimumab, infliximab, vedolizumab, tofacitinib, dupilumab, rituximab, etc. or systemic steroids (except for steroid use as cortisol replacement therapy in documented adrenal insufficiency) Participants requiring administration of drugs known to be strong inhibitors or inducers of CYP3A4, 2C9 or 2C19 Participants requiring drugs that modify gastric pH, such as proton-pump inhibitors, H2 blockers or antacids (eg, calcium, magnesium or aluminum containing over-the-counter medications) Ongoing systemic bacterial, fungal or viral infections at Screening - NOTE: Participants on antimicrobial, antifungal or antiviral prophylaxis are not specifically excluded if all other inclusion/exclusion criteria are met Administration of a live vaccine within 6 weeks of first dose of study intervention. Messenger ribonucleic acid vaccines for the prevention of Coronavirus Disease 2019 (COVID-19) infection are permitted. Baseline QT interval corrected with Fridericia's method (QTcF) > 470 ms (average of triplicate readings) - NOTE: Criterion does not apply to participants with a right or left bundle branch block. Prior surgery or gastrointestinal dysfunction that may affect drug absorption (eg, gastric bypass surgery, gastrectomy) Female participants who are pregnant or breastfeeding Concurrent active malignancy other than non-melanoma skin cancer, carcinoma in situ of the cervix or prostate intraepithelial neoplasia Past medical history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis which required steroid treatment, or any evidence of clinically active interstitial lung disease History of peptic ulcer and/or gastrointestinal bleed within the past 6 months prior to Screening History of stroke, unstable angina, myocardial infarction or ventricular arrhythmia requiring medication or mechanical control within the last 6 months prior to Screening Unstable or severe uncontrolled medical condition (eg, unstable cardiac function, unstable pulmonary condition including pneumonitis and/or interstitial lung disease, uncontrolled diabetes) or any important medical illness or abnormal laboratory finding that would, in the investigator's judgment, increase the risk to the participant associated with his or her participation in the study
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Portage Clinical Trials
Phone
+1-860-539-2649
Email
clinicaltrials@portagebiotech.com
Facility Information:
Facility Name
USC Norris Comprehensive Cancer Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
University of California San Francisco UCSF
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Sarah Cannon Research Institute Denver
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Individual Site Status
Recruiting
Facility Name
Norton Cancer Institute
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40241
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Washington University
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Jefferson Health-Thomas Jefferson University Hospitals
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Virginia Cancer Specialists
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
Individual Site Status
Not yet recruiting

12. IPD Sharing Statement

Plan to Share IPD
No
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TT-10 as a Single Agent in Subjects With Advanced Selected Solid Tumors

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