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A Study Evaluating the Safety and Efficacy of AUR108 in Patients With Relapsed Advanced Lymphomas (ASHA-1) (ASHA-1)

Primary Purpose

Relapsed Advanced Lymphomas

Status
Not yet recruiting
Phase
Phase 1
Locations
India
Study Type
Interventional
Intervention
AUR108
Sponsored by
Aurigene Discovery Technologies Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed Advanced Lymphomas focused on measuring Relapse Advanced Lymphomas, Diffuse large B-cell lymphoma, Follicular lymphoma, Mature T/NK-cell lymphomas, Other Hodgkin lymphoma

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Males or females ≥ 18 years of age Eastern Cooperative Oncology Group (ECOG) Performance status of 0 or 1 Acceptable bone marrow and organ function at screening as described below: ANC ≥ 1000/μL (without WBC growth factor support) Platelet count ≥ 75,000/μL without transfusion support Hemoglobin ≥ 9 g/dL (Transfusion is allowed to achieve this Hb) Total Bilirubin ≤ 1.5 x ULN; (Patients with known Gilbert's syndrome are allowed with a Total Bilirubin ≤ 2.5 x ULN) AST (SGOT) ≤ 3 x ULN (≤ 5 × ULN if known liver metastases) ALT (SGPT) ≤ 3 x ULN (≤ 5 × ULN if known liver metastases) Creatinine clearance (CrCl) ≥ 30 mL/min (either measured or estimated by the Cockcroft-Gault formula). (Cockcroft-Gault formula for estimated creatinine clearance [eCrCl]: eCrCl = [140- Age] × Weight [kg] × [0.85 if Female] / [72 × serum creatinine (mg/dL)]). Ability to swallow and retain oral medications Histo-pathological diagnosis of a Non-Hodgkin lymphoma orHodgkin Lymphoma. Note: The lymphoma should be either in Stage III or IV according to Lugano classification (Cheson BD et al, 2014) at screening. In the case of subjects who have lymphoma for which high-dose chemotherapy and autologous stem cell transplantation (HDASCT) is considered a standard curative therapy, eligibility for this study requires that the subject's disease has relapsed after HDASCT, that the subject is not eligible for HD-ASCT, or that the subject has refused HD-ASCT. In the case of subjects who have lymphoma for which CAR-T therapy is considered a standard therapy, eligibility for this study requires that the subjects disease has relapsed after CAR-T, or that the subject has refused CAR-T, or that the CAR-T therapy is not accessible to the patient. Evidence of measurable disease as per Lugano Criteria for Lymphoma (Cheson BD et al, 2014). Standard curative measures do not exist, and patient must have exhausted all effective therapies, available locally. At a minimum, the patients must have received at least 2 prior lines of systemic therapies. These systemic therapies could be either in the stage II, III or IV. Any cancer patient with access to any effective therapy must not be enrolled. Exclusion Criteria: Systemic anti-cancer therapy, such as chemotherapy, or biological therapy, immunomodulatory drug therapy, received within the past 28 days or 5 half-lives, whichever is longer, from the Cycle 1 Day 1 of the study. Note: Concomitant use of low dose prednisone (up to 10 mg/day) is allowed. Presence of an acute or chronic toxicity resulting from prior anticancer treatment, with the exception of alopecia or nail changes, that has not resolved to Grade ≤ 1, as determined by NCI CTCAE v 5.0. Definitive Radiotherapy within the last 21 days of Cycle 1 Day 1 (limited field palliative radiation is allowed and no restrictions during the screening period or during the trial). Use of any investigational agent within 28 days or 5 half-lives (whichever is longer) prior to Cycle 1 Day 1. Patients with cutaneous lymphomas, mycosis fungoides (MF) or Sézary syndrome (SS). Primary CNS lymphoma Known symptomatic or untreated or recently treated (≤ 6 months of screening) central nervous system (CNS) lymphoma. Patients with previously treated (> 6 months of screening) CNS lymphoma and are now stable and asymptomatic, from CNS perspective, are allowed Patients with lymphoma that requires immediate cytoreductive therapy Patients with lymphoma that requires immediate cytoreductive therapy Patients on the drugs which are sensitive substrates of CYP2C8 and cannot be discontinued at least one week prior to Cycle 1 Day 1 Patients on the drugs which are sensitive substrates of either Poglycoprotein (P-gp) or breast cancer resistance protein (BCRP) and cannot be discontinued at least one week prior to Cycle 1 Day 1 Major surgery ≤ 28 days from Cycle 1 Day 1 (major surgery is defined as a procedure requiring general anesthesia) Active infection requiring systemic therapy. Note: Prophylactic use of antibiotics is allowed. Any infection detected during screening period which is resolved adequately according to investigator before the Cycle 1 Day 1, is allowed. Known to be human immunodeficiency virus (HIV) positive or have an acquired immunodeficiency syndrome-related illness Known active or chronic hepatitis B (HbsAg +ve) or hepatitis C infection (HCV antibody +ve) The patient who is expected to require any other form of antineoplastic therapy or targeted therapy while on study. Uncontrolled congestive heart failure (New York Heart Association (NYHA) Class 2-4), angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, or transient ischemic attack, or pulmonary embolism within 3 months prior to Cycle 1 Day 1 Ongoing cardiac dysrhythmias requiring treatment of any grade or treatment of cardiac dysrhythmias in past 3 months, before Cycle 1 Day 1. QTc (Bazzett) interval >460 ms on ECG at screening and/or at Cycle 1 Day 1 pre-dose. Uncontrolled intercurrent illness including, but not limited to, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, active peptic ulcer disease or significant gastritis, active bleeding diatheses, presence of any major medical illness (e.g. renal, hepatic, hematologic, gastrointestinal, endocrine, pulmonary, or psychiatric illness/social situations or clinically significant laboratory / ECG abnormalities at screening, any or a combination of illnesses, which, in the opinion of the PI, may either put the patient at risk because of participation in the study, or influence the results or the patient's ability to participate in the study Current swab-positive or suspected (under investigation) Covid-19 infection or fever and other signs or symptoms suggestive of Covid-19 infection with recent contact of person(s) with confirmed Covid-19 infection, at screening or Cycle 1 Day 1. History of another primary malignancy within 5 years prior to starting study drug, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ and the disease under study. Positive pregnancy test for women of child-bearing potential (WOCBP) at the screening or enrolment visit Lactating women or WOCBP who are neither surgically sterilized nor willing to use reliable contraceptive methods (hormonal contraceptive, IUD, or any double combination of male or female condom, spermicidal gel, diaphragm, sponge, cervical cap).

Sites / Locations

  • Omega Cancer Hospitals
  • Unique Hospital
  • Kiran Multi Speciality Hospital
  • KLES Dr Prabhakar Kore Hospital and MRC
  • Sujan Surgical Cancer Hospital and Amravati Cancer Foundation
  • HCG Manavata Cancer Centre
  • All India Institute of Medical Sciences
  • Sparsh Hospital and Critical Care (P) Ltd.
  • MNJ Institute of Oncology and Regional Cancer Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AUR108, 50mg to 300mg

Arm Description

Currently, planned dose levels are 50,90,150,220,300 mg will be administered in 3+/4- regimen.

Outcomes

Primary Outcome Measures

1. First cycle Dose Limiting Toxicities (DLT)
Assess dose limiliting toxicities of AUR108
Safety of AUR108 as measured by the number of participants with treatment-related adverse events (AE) graded according to NCI CTCAE version 5.0
Number of participants with TEAEs
Pharmacokinetics Maximum Concentration (Cmax)
Maximum Concentration of AUR108
Pharmacokinetics: Time to Maximum concentration (Tmax)
Tmax in hours
Pharmacokinetics: Area under the curve (AUC)
Area under the curve (AUC) of AUR108 in h* ng/mL
Pharmacokinetics: Terminal elimination half-life
Terminal elimination half-life of AUR 108 in hours
Maximum concentration (Cmax) administered under fasting/fed condition
Compare in fast and fed conditions
Time to Maximum concentration (Tmax) administered under fasting/fed condition
Compare Tmax in fast and fed conditions
Area under curve (AUC) administered under fasting/fed condition
Compare AUC in fast and fed conditions

Secondary Outcome Measures

Full Information

First Posted
July 20, 2023
Last Updated
August 9, 2023
Sponsor
Aurigene Discovery Technologies Limited
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1. Study Identification

Unique Protocol Identification Number
NCT05984147
Brief Title
A Study Evaluating the Safety and Efficacy of AUR108 in Patients With Relapsed Advanced Lymphomas (ASHA-1)
Acronym
ASHA-1
Official Title
A Phase 1, Open Label, Dose Escalation, Dose Expansion, Multicenter Study Evaluating the Safety, Pharmacokinetics and Pharmacodynamics of Oral AUR108 in Patients With Relapsed Advanced Lymphomas(ASHA-1)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
August 14, 2023 (Anticipated)
Primary Completion Date
August 30, 2025 (Anticipated)
Study Completion Date
August 30, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aurigene Discovery Technologies Limited

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
An open-label, first-in-human, Phase 1 study in adult patients with relapsed advanced lymphomas will be done to assess AUR108 safety, tolerability, pharmacokinetics, pharmacodynamics, and optimal biological dose.
Detailed Description
This is a Phase I, Open Label, Dose-Escalation, First-in-Human study in adult patients with select relapsed advanced lymphomas. The safety and tolerability of oral AUR108 will be evaluated in patients with Non-Hodgkin lymphoma and Hodgkin lymphoma who do not have any available curative or life-prolonging treatment options and have exhausted all effective locally available therapies. The traditional 3+3 design for dose escalation will be used to evaluate the safety, pharmacokinetics/pharmacodynamics, and determine the Optimal Biological Dose of AUR108 as a single agent. The Optimal Biological Dose will be selected using a totality of safety, PK, and PD data.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed Advanced Lymphomas
Keywords
Relapse Advanced Lymphomas, Diffuse large B-cell lymphoma, Follicular lymphoma, Mature T/NK-cell lymphomas, Other Hodgkin lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Sequential Assignment Dose Escalation "3+3" Design
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
AUR108, 50mg to 300mg
Arm Type
Experimental
Arm Description
Currently, planned dose levels are 50,90,150,220,300 mg will be administered in 3+/4- regimen.
Intervention Type
Drug
Intervention Name(s)
AUR108
Intervention Description
3 Days dosing, and 4 days no dose in a week
Primary Outcome Measure Information:
Title
1. First cycle Dose Limiting Toxicities (DLT)
Description
Assess dose limiliting toxicities of AUR108
Time Frame
28 Days
Title
Safety of AUR108 as measured by the number of participants with treatment-related adverse events (AE) graded according to NCI CTCAE version 5.0
Description
Number of participants with TEAEs
Time Frame
Through study completion, an average of 1 year
Title
Pharmacokinetics Maximum Concentration (Cmax)
Description
Maximum Concentration of AUR108
Time Frame
Day 1 and Day 17
Title
Pharmacokinetics: Time to Maximum concentration (Tmax)
Description
Tmax in hours
Time Frame
Day 1 and Day 17
Title
Pharmacokinetics: Area under the curve (AUC)
Description
Area under the curve (AUC) of AUR108 in h* ng/mL
Time Frame
Day 1 and Day 17
Title
Pharmacokinetics: Terminal elimination half-life
Description
Terminal elimination half-life of AUR 108 in hours
Time Frame
Day 17
Title
Maximum concentration (Cmax) administered under fasting/fed condition
Description
Compare in fast and fed conditions
Time Frame
Day 8
Title
Time to Maximum concentration (Tmax) administered under fasting/fed condition
Description
Compare Tmax in fast and fed conditions
Time Frame
Day 8
Title
Area under curve (AUC) administered under fasting/fed condition
Description
Compare AUC in fast and fed conditions
Time Frame
Day 8
Other Pre-specified Outcome Measures:
Title
PD biomarker assessment
Description
Change from baseline in biomarker (DHO) levels
Time Frame
Day 1, Day 2, Day 17 and Day 18
Title
Overall Response Rate
Description
Efficacy assessments by Overall Response Rate
Time Frame
Through study completion, an average of 1 year
Title
Duration of Response
Description
Efficacy assessments by Duration of Response
Time Frame
Through study completion, an average of 1 year
Title
Progression Free Survival
Description
Efficacy assessments by Progression Free Survival (PFS)
Time Frame
Through study completion, an average of 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or females ≥ 18 years of age Eastern Cooperative Oncology Group (ECOG) Performance status of 0 or 1 Acceptable bone marrow and organ function at screening as described below: ANC ≥ 1000/μL (without WBC growth factor support) Platelet count ≥ 75,000/μL without transfusion support Hemoglobin ≥ 9 g/dL (Transfusion is allowed to achieve this Hb) Total Bilirubin ≤ 1.5 x ULN; (Patients with known Gilbert's syndrome are allowed with a Total Bilirubin ≤ 2.5 x ULN) AST (SGOT) ≤ 3 x ULN (≤ 5 × ULN if known liver metastases) ALT (SGPT) ≤ 3 x ULN (≤ 5 × ULN if known liver metastases) Creatinine clearance (CrCl) ≥ 30 mL/min (either measured or estimated by the Cockcroft-Gault formula). (Cockcroft-Gault formula for estimated creatinine clearance [eCrCl]: eCrCl = [140- Age] × Weight [kg] × [0.85 if Female] / [72 × serum creatinine (mg/dL)]). Ability to swallow and retain oral medications Histo-pathological diagnosis of a Non-Hodgkin lymphoma orHodgkin Lymphoma. Note: The lymphoma should be either in Stage III or IV according to Lugano classification (Cheson BD et al, 2014) at screening. In the case of subjects who have lymphoma for which high-dose chemotherapy and autologous stem cell transplantation (HDASCT) is considered a standard curative therapy, eligibility for this study requires that the subject's disease has relapsed after HDASCT, that the subject is not eligible for HD-ASCT, or that the subject has refused HD-ASCT. In the case of subjects who have lymphoma for which CAR-T therapy is considered a standard therapy, eligibility for this study requires that the subjects disease has relapsed after CAR-T, or that the subject has refused CAR-T, or that the CAR-T therapy is not accessible to the patient. Evidence of measurable disease as per Lugano Criteria for Lymphoma (Cheson BD et al, 2014). Standard curative measures do not exist, and patient must have exhausted all effective therapies, available locally. At a minimum, the patients must have received at least 2 prior lines of systemic therapies. These systemic therapies could be either in the stage II, III or IV. Any cancer patient with access to any effective therapy must not be enrolled. Exclusion Criteria: Systemic anti-cancer therapy, such as chemotherapy, or biological therapy, immunomodulatory drug therapy, received within the past 28 days or 5 half-lives, whichever is longer, from the Cycle 1 Day 1 of the study. Note: Concomitant use of low dose prednisone (up to 10 mg/day) is allowed. Presence of an acute or chronic toxicity resulting from prior anticancer treatment, with the exception of alopecia or nail changes, that has not resolved to Grade ≤ 1, as determined by NCI CTCAE v 5.0. Definitive Radiotherapy within the last 21 days of Cycle 1 Day 1 (limited field palliative radiation is allowed and no restrictions during the screening period or during the trial). Use of any investigational agent within 28 days or 5 half-lives (whichever is longer) prior to Cycle 1 Day 1. Patients with cutaneous lymphomas, mycosis fungoides (MF) or Sézary syndrome (SS). Primary CNS lymphoma Known symptomatic or untreated or recently treated (≤ 6 months of screening) central nervous system (CNS) lymphoma. Patients with previously treated (> 6 months of screening) CNS lymphoma and are now stable and asymptomatic, from CNS perspective, are allowed Patients with lymphoma that requires immediate cytoreductive therapy Patients with lymphoma that requires immediate cytoreductive therapy Patients on the drugs which are sensitive substrates of CYP2C8 and cannot be discontinued at least one week prior to Cycle 1 Day 1 Patients on the drugs which are sensitive substrates of either Poglycoprotein (P-gp) or breast cancer resistance protein (BCRP) and cannot be discontinued at least one week prior to Cycle 1 Day 1 Major surgery ≤ 28 days from Cycle 1 Day 1 (major surgery is defined as a procedure requiring general anesthesia) Active infection requiring systemic therapy. Note: Prophylactic use of antibiotics is allowed. Any infection detected during screening period which is resolved adequately according to investigator before the Cycle 1 Day 1, is allowed. Known to be human immunodeficiency virus (HIV) positive or have an acquired immunodeficiency syndrome-related illness Known active or chronic hepatitis B (HbsAg +ve) or hepatitis C infection (HCV antibody +ve) The patient who is expected to require any other form of antineoplastic therapy or targeted therapy while on study. Uncontrolled congestive heart failure (New York Heart Association (NYHA) Class 2-4), angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, or transient ischemic attack, or pulmonary embolism within 3 months prior to Cycle 1 Day 1 Ongoing cardiac dysrhythmias requiring treatment of any grade or treatment of cardiac dysrhythmias in past 3 months, before Cycle 1 Day 1. QTc (Bazzett) interval >460 ms on ECG at screening and/or at Cycle 1 Day 1 pre-dose. Uncontrolled intercurrent illness including, but not limited to, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, active peptic ulcer disease or significant gastritis, active bleeding diatheses, presence of any major medical illness (e.g. renal, hepatic, hematologic, gastrointestinal, endocrine, pulmonary, or psychiatric illness/social situations or clinically significant laboratory / ECG abnormalities at screening, any or a combination of illnesses, which, in the opinion of the PI, may either put the patient at risk because of participation in the study, or influence the results or the patient's ability to participate in the study Current swab-positive or suspected (under investigation) Covid-19 infection or fever and other signs or symptoms suggestive of Covid-19 infection with recent contact of person(s) with confirmed Covid-19 infection, at screening or Cycle 1 Day 1. History of another primary malignancy within 5 years prior to starting study drug, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ and the disease under study. Positive pregnancy test for women of child-bearing potential (WOCBP) at the screening or enrolment visit Lactating women or WOCBP who are neither surgically sterilized nor willing to use reliable contraceptive methods (hormonal contraceptive, IUD, or any double combination of male or female condom, spermicidal gel, diaphragm, sponge, cervical cap).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Divyesh Mandavia
Phone
9427181182
Email
divyesh_m@aurigene.com
First Name & Middle Initial & Last Name or Official Title & Degree
Suresh Oduru
Phone
9866225593
Email
suresh_o@aurigene.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Akhil Kumar
Organizational Affiliation
Chief Medical Officer
Official's Role
Principal Investigator
Facility Information:
Facility Name
Omega Cancer Hospitals
City
Visakhapatnam
State/Province
Andhra Pradesh
ZIP/Postal Code
530040
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Bellala Ravishankar
Phone
9849123256
Email
dr.bellalaravishankar@gmail.com
Facility Name
Unique Hospital
City
Surat
State/Province
Gujarat
ZIP/Postal Code
395002
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr. Ankit Patel
Phone
9825404202
Email
drankitoncologist@gmail.com
Facility Name
Kiran Multi Speciality Hospital
City
Surat
State/Province
Gujarat
ZIP/Postal Code
395004
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr. Anshul Agarwal
Phone
8657068668
Email
drankitoncologist@gmail.com
Facility Name
KLES Dr Prabhakar Kore Hospital and MRC
City
Belagam
State/Province
Karnataka
ZIP/Postal Code
590010
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr. Rohan Bhise
Phone
9448866712
Email
rohanbhise30@gmail.com
Facility Name
Sujan Surgical Cancer Hospital and Amravati Cancer Foundation
City
Amaravati
State/Province
Maharashtra
ZIP/Postal Code
444606
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr. Rajendrasingh Arora
Phone
9823097573
Email
rsaroradr@gmail.com
Facility Name
HCG Manavata Cancer Centre
City
Nashik
State/Province
Maharashtra
ZIP/Postal Code
422002
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr. Rajesh Nagarkar
Phone
9823061929
Email
drraj@manavatacancercentre.com
Facility Name
All India Institute of Medical Sciences
City
Delhi
State/Province
New Delhi
ZIP/Postal Code
10029
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Deepam Pushpam
Phone
9650629370
Email
deepampushpam@gmail.com
Facility Name
Sparsh Hospital and Critical Care (P) Ltd.
City
Bhubaneswar
State/Province
Odisha
ZIP/Postal Code
751007
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr. Ghanashyam Biswas
Phone
9937500878
Email
drgbiswas@gmail.com
Facility Name
MNJ Institute of Oncology and Regional Cancer Centre
City
Hyderabad
State/Province
Telangana
ZIP/Postal Code
500004
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr. P.K. Chaithanya
Phone
8897199994
Email
mnjiorccchaithanya@gmail.com

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study Evaluating the Safety and Efficacy of AUR108 in Patients With Relapsed Advanced Lymphomas (ASHA-1)

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