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APG-1387 in Patients With Advanced Solid Tumors or Hematologic Malignancies

Primary Purpose

Advanced Solid Tumors or Hematologic Malignancies

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
APG-1387 for Injection
Sponsored by
Ascentage Pharma Group Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Solid Tumors or Hematologic Malignancies focused on measuring IAP inhibitor

Eligibility Criteria

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

Inclusion Criteria:

  1. Histologically or cytologically confirmed solid tumor or hematological malignancies
  2. Life expectancy ≥ 3 months
  3. Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2
  4. Corrected QT interval (QTc) ≤ 450 ms in males, and ≤ 470 ms in females
  5. Adequate hematologic function
  6. International normalized ratio (INR), prothrombin time (PT) or activated partial thromboplastin time (aPTT) ≤1.5 x upper limit of normal (ULN)
  7. Adequate renal and liver function
  8. Willingness to use contraception
  9. Ability to understand and willingness to sign a written informed consent form
  10. Willingness and ability to comply with study procedures and follow-up examination
  11. Have provided tissue for biomarker analysis from a newly or recently-obtained biopsy of a tumor lesion not previously irradiated

Exclusion Criteria:

  1. Received chemotherapy within 21 days (42 days for nitrosoureas or mitomycin C) prior to entering the study
  2. Received hormonal, biologic (< 2 half-lives), small molecule targeted therapies or other anti-cancer therapy within 21 days of study entry
  3. Radiation or surgery within 14 days of study entry, thoracic radiation within 28 days of study entry
  4. Has known active central nervous (CNS) metastases and/or carcinomatous meningitis. Patients who have received prior radiotherapy for previous brain metastasis must have discontinued steroids for 14 days prior to study entry and be clinically stable
  5. Continuance of toxicities due to prior radiotherapy or chemotherapy agents that do not recover to ≤ Grade 1 except alopecia
  6. Requirement for corticosteroid treatment, with the exception of megestrol, local use of steroid
  7. Use of therapeutic anticoagulants
  8. International normalized ratio (INR) or activated partial thromboplastin time (APTT) ≥ 1.5 x ULN
  9. Concurrent treatment with an investigational agent or device within 28 days prior to the first dose of therapy
  10. Unstable angina, myocardial infarction, or a coronary revascularization procedure within 180 days of study entry
  11. Neurologic instability per clinical evaluation due to tumor involvement of the central nervous system (CNS)
  12. History of Bell's palsy
  13. Active rheumatoid arthritis (RA), active inflammatory bowel disease, chronic infections, or any other disease or condition associated with chronic inflammation
  14. Active infection requiring systemic antibiotic/ antifungal medication
  15. Known or suspected Wilson's Disease
  16. Prior treatment with IAP inhibitors
  17. History of hypersensitivity to paclitaxel, or any therapeutic antibody
  18. Has an active autoimmune disease, or a documented history of autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents
  19. Is on chronic systemic steroid therapy
  20. Has received a live vaccine within 30 days prior to first dose
  21. Has had an allogeneic tissue/solid organ transplant, prior stem cell or bone marrow transplant

Sites / Locations

  • University of Michigan
  • START Midwest
  • The START Center for Cancer Care

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

APG-1387 for Injection

Arm Description

APG-1387 will be explored sequentially using a standard 3+3 escalation scheme at the dose escalation phase and up to 20 patient per group at the dose expansion phase.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD)
Patients with APG-1387 treatment related adverse events (AE), serious adverse events (SAE) will be assessed according NCI CTCAE Version 4.03

Secondary Outcome Measures

Anti-tumor effects of APG-1387 as a single agent
Response will be evaluated every 2 cycles (8 weeks), according to the revised RECIST Guideline, Version 1.1 or the Revised Response Criteria for Malignant Lymphoma
Pharmacokinetic evaluation
Maximum plasma concentration (Cmax) will be assessed in the patients treated with APG-1387
Anti-tumor effects of APG-1387 in combination with pembrolizumab or combination with paclitaxel and carboplatin in patients with advanced solid tumors
Response will be evaluated every 2 cycles (8 weeks), according to the revised RECIST Guideline, Version 1.1 or the Revised Response Criteria for Malignant Lymphoma
Preliminary biomarker assessment
Tumor biopsy and peripheral blood sample at baseline and 15-21 days after administration of APG-1387 alone or in combination with systemic anti-cancer therapy
Pharmacokinetic evaluation
Area under the plasma concentration versus time curve (AUC) of APG-1387 will be assessed on patients treated with APG-1387

Full Information

First Posted
December 13, 2017
Last Updated
January 31, 2023
Sponsor
Ascentage Pharma Group Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03386526
Brief Title
APG-1387 in Patients With Advanced Solid Tumors or Hematologic Malignancies
Official Title
A Phase I Study of the Safety, Tolerability, Pharmacokinetic and Pharmacodynamic Properties of APG-1387 as a Single Agent or in Combination With Systemic Anti-Cancer Agents in Patients With Advanced Solid Tumors or Hematologic Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
November 21, 2017 (Actual)
Primary Completion Date
October 31, 2022 (Actual)
Study Completion Date
November 30, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ascentage Pharma Group 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
APG-1387 is a potent, bivalent small-molecule Inhibitor of Apoptosis Protein (IAP) antagonist. APG-1387 has shown strong dose- and schedule-dependent antitumor activities in multiple human cancer xenograft models, APG-1387 also demonstrates its synergistic effect in combination with immune checkpoint inhibitor anti-PD-1 antibody, and such a combinatory effect was further enhanced by chemotherapeutic agent. A total of 35 patients with advanced solid tumors or lymphomas have been treated with APG-1387 in two Phase I dose-escalation studies in Australia and in China. Ten dose levels have been tested ranging from 0.3 mg to 45 mg in these two studies. Based on the preliminary results, APG-1387 is well-tolerated at the dose levels evaluated to date. APG-1387 is intended for the treatment of patients with advanced solid tumors and hematologic malignancies. After establishing the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), and/or recommended phase 2 dose (RP2D), several Ib /II studies will be implemented accordingly to further access the antitumor effects of APG-1387 in combination with either pembrolizumab or the chemotherapeutic agents.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Tumors or Hematologic Malignancies
Keywords
IAP inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
90 (Actual)

8. Arms, Groups, and Interventions

Arm Title
APG-1387 for Injection
Arm Type
Experimental
Arm Description
APG-1387 will be explored sequentially using a standard 3+3 escalation scheme at the dose escalation phase and up to 20 patient per group at the dose expansion phase.
Intervention Type
Drug
Intervention Name(s)
APG-1387 for Injection
Intervention Description
Multiple dose cohorts, 30 minute IV infusion, once weekly for 3 weeks of a 21-day cycle
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD)
Description
Patients with APG-1387 treatment related adverse events (AE), serious adverse events (SAE) will be assessed according NCI CTCAE Version 4.03
Time Frame
18-24 months
Secondary Outcome Measure Information:
Title
Anti-tumor effects of APG-1387 as a single agent
Description
Response will be evaluated every 2 cycles (8 weeks), according to the revised RECIST Guideline, Version 1.1 or the Revised Response Criteria for Malignant Lymphoma
Time Frame
18-24 months
Title
Pharmacokinetic evaluation
Description
Maximum plasma concentration (Cmax) will be assessed in the patients treated with APG-1387
Time Frame
18-24 months
Title
Anti-tumor effects of APG-1387 in combination with pembrolizumab or combination with paclitaxel and carboplatin in patients with advanced solid tumors
Description
Response will be evaluated every 2 cycles (8 weeks), according to the revised RECIST Guideline, Version 1.1 or the Revised Response Criteria for Malignant Lymphoma
Time Frame
18-24 months
Title
Preliminary biomarker assessment
Description
Tumor biopsy and peripheral blood sample at baseline and 15-21 days after administration of APG-1387 alone or in combination with systemic anti-cancer therapy
Time Frame
18-24 months
Title
Pharmacokinetic evaluation
Description
Area under the plasma concentration versus time curve (AUC) of APG-1387 will be assessed on patients treated with APG-1387
Time Frame
18-24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed solid tumor or hematological malignancies Life expectancy ≥ 3 months Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2 Corrected QT interval (QTc) ≤ 450 ms in males, and ≤ 470 ms in females Adequate hematologic function International normalized ratio (INR), prothrombin time (PT) or activated partial thromboplastin time (aPTT) ≤1.5 x upper limit of normal (ULN) Adequate renal and liver function Willingness to use contraception Ability to understand and willingness to sign a written informed consent form Willingness and ability to comply with study procedures and follow-up examination Have provided tissue for biomarker analysis from a newly or recently-obtained biopsy of a tumor lesion not previously irradiated Exclusion Criteria: Received chemotherapy within 21 days (42 days for nitrosoureas or mitomycin C) prior to entering the study Received hormonal, biologic (< 2 half-lives), small molecule targeted therapies or other anti-cancer therapy within 21 days of study entry Radiation or surgery within 14 days of study entry, thoracic radiation within 28 days of study entry Has known active central nervous (CNS) metastases and/or carcinomatous meningitis. Patients who have received prior radiotherapy for previous brain metastasis must have discontinued steroids for 14 days prior to study entry and be clinically stable Continuance of toxicities due to prior radiotherapy or chemotherapy agents that do not recover to ≤ Grade 1 except alopecia Requirement for corticosteroid treatment, with the exception of megestrol, local use of steroid Use of therapeutic anticoagulants International normalized ratio (INR) or activated partial thromboplastin time (APTT) ≥ 1.5 x ULN Concurrent treatment with an investigational agent or device within 28 days prior to the first dose of therapy Unstable angina, myocardial infarction, or a coronary revascularization procedure within 180 days of study entry Neurologic instability per clinical evaluation due to tumor involvement of the central nervous system (CNS) History of Bell's palsy Active rheumatoid arthritis (RA), active inflammatory bowel disease, chronic infections, or any other disease or condition associated with chronic inflammation Active infection requiring systemic antibiotic/ antifungal medication Known or suspected Wilson's Disease Prior treatment with IAP inhibitors History of hypersensitivity to paclitaxel, or any therapeutic antibody Has an active autoimmune disease, or a documented history of autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents Is on chronic systemic steroid therapy Has received a live vaccine within 30 days prior to first dose Has had an allogeneic tissue/solid organ transplant, prior stem cell or bone marrow transplant
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yifan Zhai, MD, PhD
Organizational Affiliation
Ascentage Pharma Group Inc.
Official's Role
Study Chair
Facility Information:
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
START Midwest
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49503
Country
United States
Facility Name
The START Center for Cancer Care
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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APG-1387 in Patients With Advanced Solid Tumors or Hematologic Malignancies

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