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BPI-361175 Tablets in Patients With Advanced Non-Small Cell Lung Cancer (NSCLC)

Primary Purpose

Non-small Cell Lung Carcinoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
BPI-361175
Sponsored by
Xcovery Holding Company, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-small Cell Lung Carcinoma focused on measuring non-small cell lung carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female ≥ 18 years old;
  2. Life expectancy ≥ 12 weeks;
  3. Eastern Cooperative Oncology Group (ECOG) performance status 0-1;
  4. Patients with histologically or cytologically confirmed diagnosis of inoperable locally advanced or recurrent/metastatic NSCLC with EGFR mutations. Patients must have progressed from or be intolerant to or be unfit for standard treatment.
  5. For dose escalation: patients with documented EGFR mutation that have progressed on or after third-generation EGFR-TKI. In addition, other lines of therapy may have been given.
  6. For dose expansion and Phase II: patients with EGFR C797S mutation confirmed prior to enrollment on tissue or blood samples with radiological documentation of disease progression from first-generation, second-generation or third-generation EGFR-TKIs. In addition, other lines of therapy may have been given;
  7. For dose expansion and Phase II, patients must have at least one measurable tumor lesion per RECIST v1.1 criteria as per Investigator's assessment;
  8. Adequate bone marrow, liver, and renal function:

    • Blood: Absolute neutrophil count (ANC) ≥ 1.5 × 109/L (1500/mm3), platelets count ≥ 100 × 109/L, hemoglobin ≥ 9 g/dL (90 g/L) (must not have received transfusion or granulocyte colony-stimulating factor within 2 weeks of screening tests and procedures);
    • Liver function: total bilirubin ≤ 1.5 × ULN; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3.0 × ULN; if liver metastases exist, AST and ALT ≤ 5.0 × ULN; for patients with documented Gilbert's syndrome, total bilirubin ≤ 3.0 × ULN;
    • Renal function: Estimated glomerular filtration rate (eGFR) ≥ 50 mL/min (calculated by CKD-EPI);
  9. All acute toxic effects of any prior antitumor therapy or surgery must have resolved to baseline or ≤ CTCAE Grade 1 (with the exception of alopecia);
  10. For women with childbearing potential, serum pregnancy test will be performed within 7 days before dosing, with a negative result, and they must be non-lactating; all patients should take medically recognized contraceptive measures throughout the treatment period and 3 months after the last dose (see section Error! Reference source not found.);
  11. Men with partners of childbearing potential willing to use adequate contraceptive measures during the study and for 90 days after the last dose of study medication.
  12. Patients must have fully understood and voluntarily signed informed consent form (ICF).

Exclusion Criteria:

  1. Presence of another active primary malignant tumors;
  2. Unstable, symptomatic primary CNS tumors/metastasis or leptomeningeal metastases which are not suitable for enrollment, as judged by investigators. A patient can be enrolled if his/her clinical condition is stable and imaging evidence does not show disease progression within 2 weeks prior to the first dose, and who is off corticosteroid, anticonvulsant or mannitol treatment for longer than 2 weeks prior to the first dose.
  3. Treatment with the most recent therapy (e.g., chemotherapy, immunotherapy, targeted therapy, radiation therapy, investigational therapy/agent) within 4 weeks or approximately 5 half-lives, whichever is the longer, before the first dose. (If sufficient wash-out time has not occurred due to schedule or PK properties, an alternative appropriate wash-out time based on known duration and time to reversibility of drug related adverse events could be agreed upon by the sponsor and investigators);
  4. Gastrointestinal disorders that would affect oral swallowing or the investigators judge the absorption of the study drug will be interfered;
  5. Use of strong or moderate CYP3A inhibitors or inducers within 7 days prior to the first dose;
  6. Autologous (within 3 months) or allogeneic (within 6 months) organ or stem cell transplantation prior to the first dose; any major surgery or severe trauma (except biopsy sampling) within 4 months prior to the first dose;
  7. Palliative radiation therapy within 2 weeks prior to the first dose;
  8. Patients who have active viral hepatitis B (HBV) infection (exception: HBV DNA ≤ 500 IU/mL and has been stable for longer than 4 weeks);
  9. Patients who have active infections that required systemic therapy within 1 week prior to the first dose;
  10. Any of the following cardiac conditions within the last 6 months:

    Unexplained or cardiovascular cause of presyncope or syncope, tachycardia, ventricular fibrillation, or sudden cardiac arrest. Prolonged corrected QT interval [mean resting corrected QT interval QTcF > 450 msec for males or > 470 msec for females from 3 electrocardiogram (ECG)];

  11. Any > CTCAE Grade 1 prior to the first dose;
  12. 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, any uncontrolled systemic disease, and other serious illnesses;
  13. Patients with deep venous thrombosis, pulmonary embolism or any other serious thromboembolism within 3 months prior to the first dose (implantable venous access-port, catheter-related thrombosis or superficial venous thrombosis is not considered as "serious" thromboembolism);
  14. The presence of drug abuse and medical, psychological, or social conditions that do not permit compliance with the protocol or will not be available for protocol-required study visits or procedures.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    Phase Ia Dose Escalation

    Phase Ib Expansion Study

    Phase II Study

    Arm Description

    The number of patients enrolled will be determined based on the maximum number required to establish the RP2D according to a Bayesian Optimal Interval (BOIN) method and will depend on the true DLT rate. Up to 24 patients will be enrolled for the dose-finding part.

    Based on clinical data obtained from Part 1a, up to 24 patients with advanced NSCLC harboring EGFR C797S mutation will be enrolled in this dose expansion part of the study. One or more dose levels may be investigated dependent on emerging data. The sample size will be determined based on practical considerations.

    The phase II part will be conducted using a Bayesian Optimal Phase 2 (BOP2) method with efficacy monitoring based on cumulative information on Objective Response Rate (ORR). The BOP2 method will consist of 2 interim looks occurring when the number of evaluable patients reaches the pre-specified values of 10 and 20 and a final analysis when a total of 30 patients are evaluable.

    Outcomes

    Primary Outcome Measures

    The percentage of patients with adverse events and serious adverse events graded per National Cancer Institute Common Terminology Criteria for Adverse Events and dose limiting toxicities for BPI 361175
    To characterize the pharmacokinetics (PK) of BPI-361175 tablets in advanced NSCLC
    Efficacy of BPI-361175
    To determine the recommended Phase II dose (RP2D).

    Secondary Outcome Measures

    Tmax
    Time to maximum plasma concentration
    Tumor assessments
    RECIST
    Determine maximum tolerated dose in milligrams of BPI-361175
    MTD
    Cmax
    maximum plasma concentration
    AUC0-t
    Area under the plasma concentration-time curve from zero to the time of the last measurable concentration, as calculated using the trapezoidal rule.
    AUC0-∞
    Area under the plasma concentration-time curve from zero to infinity.
    AUCextrap%
    Percentage of the extrapolated area to the entire AUC.
    λz
    Terminal elimination rate constant, as obtained by log-linear regression of the terminal segment of the plasma concentration vs time curve.
    t1/2
    Terminal half-life, as calculated based on formula t1/2 = Ln(2)/λz
    Vz/F
    Apparent volume of distribution, Vz/F = CL/F/λz.
    CL/F
    Apparent plasma clearance, CL/F = dose/AUC0-∞.
    Tmax, ss
    Time to maximum plasma concentration at steady state.
    Cmax, ss
    Maximum concentration at steady state.
    Ctrough, ss
    Trough concentration at steady state.
    Cmin, ss
    Minimum trough concentration at steady state.
    Area under the plasma concentration-time curve from zero to the end of the dosing interval.
    AUCss

    Full Information

    First Posted
    May 2, 2022
    Last Updated
    October 18, 2022
    Sponsor
    Xcovery Holding Company, LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05393466
    Brief Title
    BPI-361175 Tablets in Patients With Advanced Non-Small Cell Lung Cancer (NSCLC)
    Official Title
    A Phase I/II, Open-label Study to Evaluate the Safety, Pharmacokinetics, and Efficacy of BPI-361175 Tablets in Patients With Advanced Non-Small Cell Lung Cancer (NSCLC)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    July 1, 2023 (Anticipated)
    Primary Completion Date
    January 30, 2026 (Anticipated)
    Study Completion Date
    May 31, 2027 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Xcovery Holding Company, LLC

    4. Oversight

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

    5. Study Description

    Brief Summary
    This is a three-stage study, consisting of Phase Ia dose-escalation, Phase Ib dose expansion, and a Phase II component.
    Detailed Description
    This is a Phase I/II, open-label, non-randomized study to evaluate the safety, tolerability, pharmacokinetics, and anti-tumor activity of BPI-361175 tablets in patients with advanced NSCLC with EGFR C797S mutation and other EGFR-related mutations. Adult patients (18 and above) will receive a single dose of BPI-361175 followed by a 7-day washout period with continuous oral dosing of BPI-361175 in 28 days cycle. This is a three-stage study, consisting of Phase Ia dose-escalation, Phase Ib dose expansion, and pivotal Phase II study. It is expected to provide a brand-new treatment for advanced NSCLC. The study design utilizes a Bayesian Optimal Interval (BOIN) method to guide the dose level assignment of BPI-361175 and estimate the MTD/RP2D based on cumulative information on DLTs in the Cycle 0 + Cycle 1 of treatment.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Non-small Cell Lung Carcinoma
    Keywords
    non-small cell lung carcinoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Sequential Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    30 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Phase Ia Dose Escalation
    Arm Type
    Experimental
    Arm Description
    The number of patients enrolled will be determined based on the maximum number required to establish the RP2D according to a Bayesian Optimal Interval (BOIN) method and will depend on the true DLT rate. Up to 24 patients will be enrolled for the dose-finding part.
    Arm Title
    Phase Ib Expansion Study
    Arm Type
    Experimental
    Arm Description
    Based on clinical data obtained from Part 1a, up to 24 patients with advanced NSCLC harboring EGFR C797S mutation will be enrolled in this dose expansion part of the study. One or more dose levels may be investigated dependent on emerging data. The sample size will be determined based on practical considerations.
    Arm Title
    Phase II Study
    Arm Type
    Experimental
    Arm Description
    The phase II part will be conducted using a Bayesian Optimal Phase 2 (BOP2) method with efficacy monitoring based on cumulative information on Objective Response Rate (ORR). The BOP2 method will consist of 2 interim looks occurring when the number of evaluable patients reaches the pre-specified values of 10 and 20 and a final analysis when a total of 30 patients are evaluable.
    Intervention Type
    Drug
    Intervention Name(s)
    BPI-361175
    Intervention Description
    BPI-361175 is an oral fourth-generation EGFR inhibitor. The activation of EGFR signaling pathways is associated with various biological events such as proliferation, migration, differentiation, and apoptosis.
    Primary Outcome Measure Information:
    Title
    The percentage of patients with adverse events and serious adverse events graded per National Cancer Institute Common Terminology Criteria for Adverse Events and dose limiting toxicities for BPI 361175
    Description
    To characterize the pharmacokinetics (PK) of BPI-361175 tablets in advanced NSCLC
    Time Frame
    18 months
    Title
    Efficacy of BPI-361175
    Description
    To determine the recommended Phase II dose (RP2D).
    Time Frame
    18 months
    Secondary Outcome Measure Information:
    Title
    Tmax
    Description
    Time to maximum plasma concentration
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    Tumor assessments
    Description
    RECIST
    Time Frame
    At the end of every even cycle
    Title
    Determine maximum tolerated dose in milligrams of BPI-361175
    Description
    MTD
    Time Frame
    Baseline up to Completion of Cycle 1 (28 days)
    Title
    Cmax
    Description
    maximum plasma concentration
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    AUC0-t
    Description
    Area under the plasma concentration-time curve from zero to the time of the last measurable concentration, as calculated using the trapezoidal rule.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    AUC0-∞
    Description
    Area under the plasma concentration-time curve from zero to infinity.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    AUCextrap%
    Description
    Percentage of the extrapolated area to the entire AUC.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    λz
    Description
    Terminal elimination rate constant, as obtained by log-linear regression of the terminal segment of the plasma concentration vs time curve.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    t1/2
    Description
    Terminal half-life, as calculated based on formula t1/2 = Ln(2)/λz
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    Vz/F
    Description
    Apparent volume of distribution, Vz/F = CL/F/λz.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    CL/F
    Description
    Apparent plasma clearance, CL/F = dose/AUC0-∞.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    Tmax, ss
    Description
    Time to maximum plasma concentration at steady state.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    Cmax, ss
    Description
    Maximum concentration at steady state.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    Ctrough, ss
    Description
    Trough concentration at steady state.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    Cmin, ss
    Description
    Minimum trough concentration at steady state.
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles
    Title
    Area under the plasma concentration-time curve from zero to the end of the dosing interval.
    Description
    AUCss
    Time Frame
    Baseline, Cycle 1 Day1, Day 8, Day 15, Day 22, Day 28, and Day 1 of additional cycles

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female ≥ 18 years old; Life expectancy ≥ 12 weeks; Eastern Cooperative Oncology Group (ECOG) performance status 0-1; Patients with histologically or cytologically confirmed diagnosis of inoperable locally advanced or recurrent/metastatic NSCLC with EGFR mutations. Patients must have progressed from or be intolerant to or be unfit for standard treatment. For dose escalation: patients with documented EGFR mutation that have progressed on or after third-generation EGFR-TKI. In addition, other lines of therapy may have been given. For dose expansion and Phase II: patients with EGFR C797S mutation confirmed prior to enrollment on tissue or blood samples with radiological documentation of disease progression from first-generation, second-generation or third-generation EGFR-TKIs. In addition, other lines of therapy may have been given; For dose expansion and Phase II, patients must have at least one measurable tumor lesion per RECIST v1.1 criteria as per Investigator's assessment; Adequate bone marrow, liver, and renal function: Blood: Absolute neutrophil count (ANC) ≥ 1.5 × 109/L (1500/mm3), platelets count ≥ 100 × 109/L, hemoglobin ≥ 9 g/dL (90 g/L) (must not have received transfusion or granulocyte colony-stimulating factor within 2 weeks of screening tests and procedures); Liver function: total bilirubin ≤ 1.5 × ULN; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3.0 × ULN; if liver metastases exist, AST and ALT ≤ 5.0 × ULN; for patients with documented Gilbert's syndrome, total bilirubin ≤ 3.0 × ULN; Renal function: Estimated glomerular filtration rate (eGFR) ≥ 50 mL/min (calculated by CKD-EPI); All acute toxic effects of any prior antitumor therapy or surgery must have resolved to baseline or ≤ CTCAE Grade 1 (with the exception of alopecia); For women with childbearing potential, serum pregnancy test will be performed within 7 days before dosing, with a negative result, and they must be non-lactating; all patients should take medically recognized contraceptive measures throughout the treatment period and 3 months after the last dose (see section Error! Reference source not found.); Men with partners of childbearing potential willing to use adequate contraceptive measures during the study and for 90 days after the last dose of study medication. Patients must have fully understood and voluntarily signed informed consent form (ICF). Exclusion Criteria: Presence of another active primary malignant tumors; Unstable, symptomatic primary CNS tumors/metastasis or leptomeningeal metastases which are not suitable for enrollment, as judged by investigators. A patient can be enrolled if his/her clinical condition is stable and imaging evidence does not show disease progression within 2 weeks prior to the first dose, and who is off corticosteroid, anticonvulsant or mannitol treatment for longer than 2 weeks prior to the first dose. Treatment with the most recent therapy (e.g., chemotherapy, immunotherapy, targeted therapy, radiation therapy, investigational therapy/agent) within 4 weeks or approximately 5 half-lives, whichever is the longer, before the first dose. (If sufficient wash-out time has not occurred due to schedule or PK properties, an alternative appropriate wash-out time based on known duration and time to reversibility of drug related adverse events could be agreed upon by the sponsor and investigators); Gastrointestinal disorders that would affect oral swallowing or the investigators judge the absorption of the study drug will be interfered; Use of strong or moderate CYP3A inhibitors or inducers within 7 days prior to the first dose; Autologous (within 3 months) or allogeneic (within 6 months) organ or stem cell transplantation prior to the first dose; any major surgery or severe trauma (except biopsy sampling) within 4 months prior to the first dose; Palliative radiation therapy within 2 weeks prior to the first dose; Patients who have active viral hepatitis B (HBV) infection (exception: HBV DNA ≤ 500 IU/mL and has been stable for longer than 4 weeks); Patients who have active infections that required systemic therapy within 1 week prior to the first dose; Any of the following cardiac conditions within the last 6 months: Unexplained or cardiovascular cause of presyncope or syncope, tachycardia, ventricular fibrillation, or sudden cardiac arrest. Prolonged corrected QT interval [mean resting corrected QT interval QTcF > 450 msec for males or > 470 msec for females from 3 electrocardiogram (ECG)]; Any > CTCAE Grade 1 prior to the first dose; 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, any uncontrolled systemic disease, and other serious illnesses; Patients with deep venous thrombosis, pulmonary embolism or any other serious thromboembolism within 3 months prior to the first dose (implantable venous access-port, catheter-related thrombosis or superficial venous thrombosis is not considered as "serious" thromboembolism); The presence of drug abuse and medical, psychological, or social conditions that do not permit compliance with the protocol or will not be available for protocol-required study visits or procedures.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Esteban Sanchez
    Phone
    561-835-9356
    Ext
    217
    Email
    esteban@xcovery.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Giovanni C Selvaggi, MD
    Organizational Affiliation
    Xcovery Holding Company, LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    BPI-361175 Tablets in Patients With Advanced Non-Small Cell Lung Cancer (NSCLC)

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