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A Study on the Safety, Tolerability, Efficacy, Pharmacokinetics and Pharmacodynamics of CAN106 in Subjects With PNH

Primary Purpose

PNH, Hemolysis

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CAN106 20 mg/kg
CAN106 40 mg/kg
CAN106 80 mg/kg
Sponsored by
CARE Pharma Shanghai Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for PNH focused on measuring C5 complement inhibitor, CAN106, PNH

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female patients ≥18 years of age.
  2. Body weight ≥40 kg at screening.
  3. Documented diagnosis of PNH within 6 months prior to screening, confirmed by high-sensitivity flow cytometry evaluation of red blood cells (RBCs), with granulocyte or monocyte clone size of ≥10%.
  4. LDH level ≥ 1.5 X ULN at screening.
  5. Mean hemoglobin(Hb)<10 g/dL for those who have not received blood. transfusion at screening, based on 2 measurements from separate blood samples collected at interval of 2-8 weeks apart prior to the first dosing. Or hemoglobin < 10 g/dL at the first screening and then with subsequent red blood cell transfusions.
  6. Presence of 1 or more of the following PNH-related signs or symptoms within 3 months of Screening: fatigue, hemoglobinuria, abdominal pain, shortness of breath (dyspnea), anemia (hemoglobin < 10 g/dL), history of a major adverse vascular event (including thrombosis), dysphagia, or erectile dysfunction; or history of pRBC transfusion due to PNH.
  7. All patients must be vaccinated against meningococcal infections within 3 years prior to, or at the time of, initiating study drug. Patients who initiate study drug treatment less than 2 weeks after receiving a meningococcal vaccine must receive treatment with appropriate prophylactic antibiotics until 2 weeks after vaccination.
  8. If available, Haemophilus influenzae type b and Streptococcus pneumoniae vaccines can be administered according to national vaccine guidelines, and antibiotic prophylaxis should be given until 2 weeks after vaccination if the vaccines are administered within 14 days prior to administration.
  9. All females of childbearing potential and all males must be willing to use at least one highly effective method of contraception from signing of informed consent until 8 months after the last dose of CAN106 Injection; Male subjects with female partners of childbearing potential must be willing to use condoms in addition to using a highly effective method of contraception.
  10. Subjects should be willing to sign the informed consent forms and comply with the study visit.

Exclusion Criteria:

  1. Current or previous treatment with a complement inhibitor.
  2. Positive pregnancy test on day 1, or female patients who are planning to become pregnant or are pregnant or breastfeeding.
  3. Participation in an interventional clinical study within 28 days before initiation of dosing on Day 1, or within 5 half-lives of the investigational product, whichever is greater.
  4. Platelet count < 30 × 10^9/L at Screening.
  5. Absolute neutrophil count < 0.5 × 10^9/L at Screening.
  6. Alanine aminotransferase (ALT) > 3 × ULN, or both direct bilirubin and alkaline phosphatase (ALP) > 2 × ULN during the screening period.
  7. Serum creatinine > 2.5 × ULN and creatinine clearance < 30 mL/min as calculated by the Cockcroft-Gault formula during the screening period.
  8. History of malignancy within 5 years of Screening with the exception of nonmelanoma skin cancer or carcinoma in situ of the cervix that has been treated with no evidence of recurrence.
  9. History of bone marrow transplantation.
  10. Major surgery within 90 days prior to screening.
  11. History of N. meningitidis infection or unexplained, recurrent infection.
  12. Known or suspected hereditary complement deficiency.
  13. Active systemic bacterial, viral, or fungal infection within 14 days prior to dosing
  14. Presence of fever ≥38°C within 7 days prior to study drug administration.
  15. Having received splenectomy within 6 months prior to screening.
  16. Known history of severe allergic or anaphylactic reactions to antibiotics and are unwilling to use prophylaxis as specified in the protocol.
  17. Patients are excluded if they are taking any of the following medications and are not on a stable regimen(as judged by investigator) for the time period indicated prior to screening:

    1. Erythropoietin or immunosuppressants for at least 8 weeks;
    2. Corticosteroids for at least 4 weeks;
    3. Vitamin K antagonists with a stable international normalized ratio for 4 weeks;
    4. Iron supplements or folic acid for at least 4 weeks;
    5. Low molecular weight heparin for at least 4 weeks.
  18. Known allergy to excipients of CAN106 or allergy to Chinese hamster ovary cell proteins.
  19. Immunization with a live-attenuated vaccine 1 month prior to dosing on day 1.
  20. Known or suspected history of drug or alcohol abuse or dependence within 1 year prior to the start of Screening.
  21. Inability to comply with study requirements.
  22. History of or ongoing major cardiac, pulmonary, renal, endocrine, or hepatic disease (eg, active hepatitis) that, in the opinion of the Investigator or Sponsor, precludes the patient's participation in an investigational clinical trial.
  23. Known medical or psychological condition(s) or risk factor that, in the opinion of the Investigator, might interfere with the patient's full participation in the study, pose any additional risk for the patient, or confound the assessment of the patient or outcome of the study.

Sites / Locations

  • Peking Union Medical College HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Dose escalation CAN106 in cohort 1

Dose escalation CAN106 in cohort 2

Dose escalation CAN106 in cohort 3

Arm Description

Subjects are administered CAN106 20 mg/kg IV maintenance dosing.

Subjects are administered CAN106 40 mg/kg IV maintenance dosing.

Subjects are administered CAN106 80 mg/kg IV maintenance dosing.

Outcomes

Primary Outcome Measures

Incidence and severity of treatment-emergent adverse events (TEAEs) of multiple doses of CAN106 as assessed by CTCAE v5.(Phase 1b)
TEAEs were defined as adverse events (AE) that occurred after dosing on Day 1 and up to 28 days after the last dose of CAN106, include adverse events (AEs), serious adverse events (SAEs), AEs of special interest (AESIs), abnormal laboratory data compared with baseline, vital signs, and electrocardiograms (ECGs)
Percent Change In Lactate Dehydrogenase (LDH) Levels Normalization From Baseline to Day 182(Phase 2)
Baseline is defined as the average of all available assessments prior to first CAN106 infusion.

Secondary Outcome Measures

Area Under the Curve (AUC) - Pharmacokinetics parameter
Area under the plasma concentration versus time curve to the last visit (AUC)
Maximum Plasma Concentration (Cmax) - Pharmacokinetics parameter
Peak plasma concentration
Time to Maximum Concentration (Tmax) - Pharmacokinetics parameter
Time to reach maximum of concentration (days)
t1/2 - Pharmacokinetics parameter
Terminal elimination half-life
PD parameters-free C5
Maximal change from baseline in free C5 concentrations at each of scheduled post baseline assessment time-points (µg/ml)
PD parameters-CH50
Maximal change from baseline total complement activity (CH50) at each of scheduled post baseline assessment time-points (%)
PD parameters- total C5
Measure the absolute change from baseline in total C5 concentrations at each of scheduled post baseline assessment time-points (µg/ml)
Immunogenicity
Anti-drug Antibody (ADA) titers
Changes from Baseline in Serum Lactate Dehydrogenase (LDH) Level
Changes from baseline in serum LDH level to Day 182
Percent Change In Free Hemoglobin Level From Baseline to Day 182
Changes from baseline in free hemoglobin level at each of the scheduled post-baseline time-points
Percent Change In Haptoglobin Levels From Baseline to Day 182
Changes in haptoglobin from baseline to each of the scheduled post-baseline time-points
Changes in scores of patient-reported outcomes as measured by FACIT-Fatigue from Baseline to Day 182
The FACIT-F is a 13-item, self-reported PRO measure assessing an individual's level of fatigue during their usual daily activities over the past week. This questionnaire is part of the FACIT measurement system, a compilation of questions measuring health-related QoL in patients with cancer and other chronic illnesses. The FACIT-fatigue assesses the level of fatigue using a 4-point Likert scale ranging from 0 (not at all) to 4 (very much). Scores range from 0 to 52, with higher scores indicating greater fatigue
Changes in scores of patient-reported outcomes as measured by European Organization for Research and Treatment of Cancer [EORTC]- Quality of life questionnaire-core 30 (QLQ-30)
EORTC QLQ-C30 is a self-reported, 30-item generic questionnaire developed to assess 15 domains: global health status scale, five functional scales (physical, role, emotional, cognitive, and social functioning) and nine symptom scales (fatigue, nausea, vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties). All the scales range from 0 to 100. A high score on the functional scales represents a high level of functioning, and a high score on the symptom scales represents a high level of symptomatology

Full Information

First Posted
July 7, 2022
Last Updated
September 10, 2022
Sponsor
CARE Pharma Shanghai Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05539248
Brief Title
A Study on the Safety, Tolerability, Efficacy, Pharmacokinetics and Pharmacodynamics of CAN106 in Subjects With PNH
Official Title
A Multicenter, Open-label, Multiple Ascending Dose Phase 1b/2 Trial to Evaluate the Safety, Tolerability, Efficacy, Pharmacokinetics and Pharmacodynamics of CAN106 Intravenously in Subjects With PNH Naïve to Complement-Inhibitor Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 25, 2022 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CARE Pharma Shanghai Ltd.

4. Oversight

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

5. Study Description

Brief Summary
The purpose of the study is to evaluate the safety, tolerability, efficacy, pharmacokinetics, and pharmacodynamics of CAN106 administered intravenously to subjects with PNH who have not previously been treated with a complement inhibitor.
Detailed Description
This is an open-label, multiple dose escalation study to assess the safety, tolerability, efficacy, PK, PD and immunogenicity of CAN106 given as an IV infusion. The data presented is up to the primary completion date of the study and is for the 26-week primary evaluation period. The study also includes an extension period of up to 52 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
PNH, Hemolysis
Keywords
C5 complement inhibitor, CAN106, PNH

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
78 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dose escalation CAN106 in cohort 1
Arm Type
Experimental
Arm Description
Subjects are administered CAN106 20 mg/kg IV maintenance dosing.
Arm Title
Dose escalation CAN106 in cohort 2
Arm Type
Experimental
Arm Description
Subjects are administered CAN106 40 mg/kg IV maintenance dosing.
Arm Title
Dose escalation CAN106 in cohort 3
Arm Type
Experimental
Arm Description
Subjects are administered CAN106 80 mg/kg IV maintenance dosing.
Intervention Type
Drug
Intervention Name(s)
CAN106 20 mg/kg
Intervention Description
Induction and maintenance dosing for cohort 1: 12 mg/kg on Day 1, 16 mg/kg on Day 8, and 20 mg/kg on Day 15 and every 4 weeks thereafter;
Intervention Type
Drug
Intervention Name(s)
CAN106 40 mg/kg
Intervention Description
Induction and maintenance dosing for cohort 2: 30 mg/kg on Day 1, and 40mg/kg on Day 8 and every 4 weeks thereafter;
Intervention Type
Drug
Intervention Name(s)
CAN106 80 mg/kg
Intervention Description
Induction and maintenance dosing for cohort 3: 60 mg/kg on day 1, and 80 mg/kg on day 15 and every 8 weeks thereafter.
Primary Outcome Measure Information:
Title
Incidence and severity of treatment-emergent adverse events (TEAEs) of multiple doses of CAN106 as assessed by CTCAE v5.(Phase 1b)
Description
TEAEs were defined as adverse events (AE) that occurred after dosing on Day 1 and up to 28 days after the last dose of CAN106, include adverse events (AEs), serious adverse events (SAEs), AEs of special interest (AESIs), abnormal laboratory data compared with baseline, vital signs, and electrocardiograms (ECGs)
Time Frame
182 days
Title
Percent Change In Lactate Dehydrogenase (LDH) Levels Normalization From Baseline to Day 182(Phase 2)
Description
Baseline is defined as the average of all available assessments prior to first CAN106 infusion.
Time Frame
Baseline, Day 182
Secondary Outcome Measure Information:
Title
Area Under the Curve (AUC) - Pharmacokinetics parameter
Description
Area under the plasma concentration versus time curve to the last visit (AUC)
Time Frame
182 days
Title
Maximum Plasma Concentration (Cmax) - Pharmacokinetics parameter
Description
Peak plasma concentration
Time Frame
182 days
Title
Time to Maximum Concentration (Tmax) - Pharmacokinetics parameter
Description
Time to reach maximum of concentration (days)
Time Frame
182 days
Title
t1/2 - Pharmacokinetics parameter
Description
Terminal elimination half-life
Time Frame
182 days
Title
PD parameters-free C5
Description
Maximal change from baseline in free C5 concentrations at each of scheduled post baseline assessment time-points (µg/ml)
Time Frame
182 days
Title
PD parameters-CH50
Description
Maximal change from baseline total complement activity (CH50) at each of scheduled post baseline assessment time-points (%)
Time Frame
182 days
Title
PD parameters- total C5
Description
Measure the absolute change from baseline in total C5 concentrations at each of scheduled post baseline assessment time-points (µg/ml)
Time Frame
182 days
Title
Immunogenicity
Description
Anti-drug Antibody (ADA) titers
Time Frame
182 days
Title
Changes from Baseline in Serum Lactate Dehydrogenase (LDH) Level
Description
Changes from baseline in serum LDH level to Day 182
Time Frame
182 days
Title
Percent Change In Free Hemoglobin Level From Baseline to Day 182
Description
Changes from baseline in free hemoglobin level at each of the scheduled post-baseline time-points
Time Frame
182 days
Title
Percent Change In Haptoglobin Levels From Baseline to Day 182
Description
Changes in haptoglobin from baseline to each of the scheduled post-baseline time-points
Time Frame
182 days
Title
Changes in scores of patient-reported outcomes as measured by FACIT-Fatigue from Baseline to Day 182
Description
The FACIT-F is a 13-item, self-reported PRO measure assessing an individual's level of fatigue during their usual daily activities over the past week. This questionnaire is part of the FACIT measurement system, a compilation of questions measuring health-related QoL in patients with cancer and other chronic illnesses. The FACIT-fatigue assesses the level of fatigue using a 4-point Likert scale ranging from 0 (not at all) to 4 (very much). Scores range from 0 to 52, with higher scores indicating greater fatigue
Time Frame
182 days
Title
Changes in scores of patient-reported outcomes as measured by European Organization for Research and Treatment of Cancer [EORTC]- Quality of life questionnaire-core 30 (QLQ-30)
Description
EORTC QLQ-C30 is a self-reported, 30-item generic questionnaire developed to assess 15 domains: global health status scale, five functional scales (physical, role, emotional, cognitive, and social functioning) and nine symptom scales (fatigue, nausea, vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties). All the scales range from 0 to 100. A high score on the functional scales represents a high level of functioning, and a high score on the symptom scales represents a high level of symptomatology
Time Frame
182 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients ≥18 years of age. Body weight ≥40 kg at screening. Documented diagnosis of PNH within 6 months prior to screening, confirmed by high-sensitivity flow cytometry evaluation of red blood cells (RBCs), with granulocyte or monocyte clone size of ≥10%. LDH level ≥ 1.5 X ULN at screening. Mean hemoglobin(Hb)<10 g/dL for those who have not received blood. transfusion at screening, based on 2 measurements from separate blood samples collected at interval of 2-8 weeks apart prior to the first dosing. Or hemoglobin < 10 g/dL at the first screening and then with subsequent red blood cell transfusions. Presence of 1 or more of the following PNH-related signs or symptoms within 3 months of Screening: fatigue, hemoglobinuria, abdominal pain, shortness of breath (dyspnea), anemia (hemoglobin < 10 g/dL), history of a major adverse vascular event (including thrombosis), dysphagia, or erectile dysfunction; or history of pRBC transfusion due to PNH. All patients must be vaccinated against meningococcal infections within 3 years prior to, or at the time of, initiating study drug. Patients who initiate study drug treatment less than 2 weeks after receiving a meningococcal vaccine must receive treatment with appropriate prophylactic antibiotics until 2 weeks after vaccination. If available, Haemophilus influenzae type b and Streptococcus pneumoniae vaccines can be administered according to national vaccine guidelines, and antibiotic prophylaxis should be given until 2 weeks after vaccination if the vaccines are administered within 14 days prior to administration. All females of childbearing potential and all males must be willing to use at least one highly effective method of contraception from signing of informed consent until 8 months after the last dose of CAN106 Injection; Male subjects with female partners of childbearing potential must be willing to use condoms in addition to using a highly effective method of contraception. Subjects should be willing to sign the informed consent forms and comply with the study visit. Exclusion Criteria: Current or previous treatment with a complement inhibitor. Positive pregnancy test on day 1, or female patients who are planning to become pregnant or are pregnant or breastfeeding. Participation in an interventional clinical study within 28 days before initiation of dosing on Day 1, or within 5 half-lives of the investigational product, whichever is greater. Platelet count < 30 × 10^9/L at Screening. Absolute neutrophil count < 0.5 × 10^9/L at Screening. Alanine aminotransferase (ALT) > 3 × ULN, or both direct bilirubin and alkaline phosphatase (ALP) > 2 × ULN during the screening period. Serum creatinine > 2.5 × ULN and creatinine clearance < 30 mL/min as calculated by the Cockcroft-Gault formula during the screening period. History of malignancy within 5 years of Screening with the exception of nonmelanoma skin cancer or carcinoma in situ of the cervix that has been treated with no evidence of recurrence. History of bone marrow transplantation. Major surgery within 90 days prior to screening. History of N. meningitidis infection or unexplained, recurrent infection. Known or suspected hereditary complement deficiency. Active systemic bacterial, viral, or fungal infection within 14 days prior to dosing Presence of fever ≥38°C within 7 days prior to study drug administration. Having received splenectomy within 6 months prior to screening. Known history of severe allergic or anaphylactic reactions to antibiotics and are unwilling to use prophylaxis as specified in the protocol. Patients are excluded if they are taking any of the following medications and are not on a stable regimen(as judged by investigator) for the time period indicated prior to screening: Erythropoietin or immunosuppressants for at least 8 weeks; Corticosteroids for at least 4 weeks; Vitamin K antagonists with a stable international normalized ratio for 4 weeks; Iron supplements or folic acid for at least 4 weeks; Low molecular weight heparin for at least 4 weeks. Known allergy to excipients of CAN106 or allergy to Chinese hamster ovary cell proteins. Immunization with a live-attenuated vaccine 1 month prior to dosing on day 1. Known or suspected history of drug or alcohol abuse or dependence within 1 year prior to the start of Screening. Inability to comply with study requirements. History of or ongoing major cardiac, pulmonary, renal, endocrine, or hepatic disease (eg, active hepatitis) that, in the opinion of the Investigator or Sponsor, precludes the patient's participation in an investigational clinical trial. Known medical or psychological condition(s) or risk factor that, in the opinion of the Investigator, might interfere with the patient's full participation in the study, pose any additional risk for the patient, or confound the assessment of the patient or outcome of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tianci Kou
Phone
+86 21 52996609
Ext
807
Email
tianci.kou@canbridgepharma.com
First Name & Middle Initial & Last Name or Official Title & Degree
Chuting Zhang
Email
chuting.zhang@canbridgepharma.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bing Han, MD
Organizational Affiliation
Peking Union Medical College Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hongzhong Liu, MMed
Organizational Affiliation
Peking Union Medical College Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peking Union Medical College Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100730
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tianci Kou
Email
tianci.kou@canbridgepharma.com
First Name & Middle Initial & Last Name & Degree
Bing Han, MD
First Name & Middle Initial & Last Name & Degree
Hongzhong Liu, MMed

12. IPD Sharing Statement

Learn more about this trial

A Study on the Safety, Tolerability, Efficacy, Pharmacokinetics and Pharmacodynamics of CAN106 in Subjects With PNH

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