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APG-2449 in Patients With Advanced Solid Tumors

Primary Purpose

Advanced Solid Cancer, Non Small Cell Lung Cancer, Esophageal Cancer

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
APG-2449
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 Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Dose exploration stage: non-small cell lung cancer diagnosed by histology and/or cytology and positive for ALK/ROS1 gene fusion (molecular diagnosis confirmed by the investigator) and malignant pleural mesothelioma, esophageal cancer and ovarian cancer. Kind of patients with advanced tumors.

    Expansion stage: cohort one, Patients with non-small cell lung cancer who have progressed or are not tolerated on second-generation ALK TKI therapy or any ROS1 TKI therapy treatment ; cohort two, ALK/ROS1 fusion gene positive without TKI treatment Patients with non-small cell lung cancer. The molecular diagnosis results of the above patients can be confirmed by the investigator.

  2. ECOG Performance Status ≤ 1.
  3. Expectation of life ≥ 3 months.
  4. According to RECIST version 1.1, there is at least 1 measurable lesion.
  5. Adequate hematologic and bone marrow functions.
  6. Adequate renal and liver function.
  7. Normal cardiac function.
  8. Brain metastases with clinically controlled neurologic symptoms.
  9. Serum pregnancy test results of women of childbearing age were negative within 7 days before taking the first dose of study drug.
  10. Men, women of childbearing age (postmenopausal women must have been menopausal for at least 12 months before they can be considered infertile) and their partners voluntarily take the study drug for at least 30 days after signing the informed consent form and taking the study drug as deemed effective by the investigator Contraceptive measures
  11. Ability to understand and willingness to sign a written informed consent form
  12. Subjects must be willing and able to complete the research procedures and follow-up inspections.

Exclusion Criteria:

  1. Receiving concurrent anti-cancer therapy (chemotherapy, radiotherapy, immunotherapy, biologic therapy); or any investigational therapy within 28 days prior to the first dose of study drug.
  2. Receiving TKI therapy within 8 days prior to the first dose of study drug.
  3. Continuance of toxicities due to prior therapy that do not recover (CTCAE V5.0 Grade> 1).
  4. Has difficulty in swallowing, absorbing barrier, or other diseases blocking APG-2449' taken.
  5. Obvious cardiovascular disease history.
  6. Failure to recover adequately, as judged by the investigator, from prior surgical procedures. Patients who have had major surgery within 28 days from study entry, and patients who have had minor surgery within 14 days of study entry.
  7. Active symptomatic fungal, bacterial and/or viral infection including, but not limited to, active human immunodeficiency virus (HIV) or viral hepatitis (B or C).
  8. Known allergies to study drug ingredients or their analogs.
  9. Female subjects who are pregnant or breastfeeding, or expecting to become pregnant during the study period.
  10. According to the judgment of the investigator or sponsor, any symptoms or disease of the subject may endanger its safety or interfere with the safety assessment of the study drug.
  11. Subjects who have used CYP3A4, CYP2C9, or CYP2C19 moderately potent inhibitors or moderately potent inducers 1 week before receiving the study drug for the first time.
  12. Subjects who used CYP3A4 substrates and narrow treatment window 1 week before the first study drug.

Sites / Locations

  • Beijing Cancer HospitalRecruiting
  • Fujian Medical University Union Hospital
  • Fujian Cancer Hospital
  • Sun-Yat Sen University Cancer CenterRecruiting
  • The First affiliated hospital, Sun Yat-sen UniversityRecruiting
  • Henan Provincial Oncology HospitalRecruiting
  • Union Hospital medical college Huazhong University of Science and TechnologyRecruiting
  • Hunan Provincial Oncology HospitalRecruiting
  • West China hospital of Sichuan University
  • Zhejiang Provincial Oncology HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

APG-2449

Arm Description

APG-2449 will be explored sequentially using a standard 3+3 escalation scheme at the dose escalation phase and up to 30-40 patient at the MTD/RP2D dose level.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD)
To determine the maximum tolerated dose (MTD) of APG-2449 in subjects with advanced solid tumors
Recommended Phase 2 dose (RP2D)
To determine the tentative recommended Phase 2 dose (RP2D) of APG-2449 in subjects with advanced solid tumors

Secondary Outcome Measures

Maximum plasma concentration (Cmax)
Maximum plasma concentration (Cmax) will be assessed on all participants with APG-2449 treatments
Area under the plasma concentration versus time curve (AUC)
Area under the plasma concentration versus time curve (AUC) will be assessed on all participants with APG-2449 treatments
Phosphorylation of FAK protein
Phosphorylation of FAK protein will be assessed in peripheral blood mononuclear cells on all participants with APG-2449 treatments
Preliminary efficacy assessment: Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
To assess preliminary efficacy in subjects with solid tumors using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1

Full Information

First Posted
March 25, 2019
Last Updated
August 25, 2023
Sponsor
Ascentage Pharma Group Inc.
Collaborators
Suzhou Yasheng Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03917043
Brief Title
APG-2449 in Patients With Advanced Solid Tumors
Official Title
A Phase I Study of the Safety, Pharmacokinetic and Pharmacodynamic Properties of Orally Administered APG-2449 in Patients With Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 27, 2019 (Actual)
Primary Completion Date
January 2025 (Anticipated)
Study Completion Date
February 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ascentage Pharma Group Inc.
Collaborators
Suzhou Yasheng Pharmaceutical Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
APG-2449 is a novel, orally active, multi-targeted tyrosine kinase inhibitor, which inhibits FAK, ALK, and ROS1 with nanomolar potencies. In preclinical studies, APG-2449 demonstrated potent antiproliferative activity in various cancer cell lines as a single agent. In combination treatment, APG-2449 enhanced anti-proliferative activities of several chemotherapeutic and targeted agents. It is indicated that APG-2449 may have a broad therapeutic potential for the treatment of human cancer as a single agent and in combination with other classes of anticancer drugs. APG-2449 is intended for the treatment of patients with advanced solid tumors. Upon completion of the Phase 1 dose escalation study to establish the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), and/or recommended phase 2 dose (RP2D), several phase Ib/II studies will be implemented accordingly.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Cancer, Non Small Cell Lung Cancer, Esophageal Cancer, Ovarian Cancer, Malignant Pleural Mesothelioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Dose escalation of APG-2449 will use standard 3+3 design. The starting dose is 150 mg and will be increased in subsequent cohorts to 300mg, 450mg, 600mg, 750mg, 900mg, 1200mg and 1500mg, accordingly.
Masking
None (Open Label)
Allocation
N/A
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
APG-2449
Arm Type
Experimental
Arm Description
APG-2449 will be explored sequentially using a standard 3+3 escalation scheme at the dose escalation phase and up to 30-40 patient at the MTD/RP2D dose level.
Intervention Type
Drug
Intervention Name(s)
APG-2449
Other Intervention Name(s)
APG-2449 Capsule
Intervention Description
Capsule, multiple dose cohorts, oral administration every day (QD) of a 28-day cycle
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD)
Description
To determine the maximum tolerated dose (MTD) of APG-2449 in subjects with advanced solid tumors
Time Frame
28 days
Title
Recommended Phase 2 dose (RP2D)
Description
To determine the tentative recommended Phase 2 dose (RP2D) of APG-2449 in subjects with advanced solid tumors
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Maximum plasma concentration (Cmax)
Description
Maximum plasma concentration (Cmax) will be assessed on all participants with APG-2449 treatments
Time Frame
28 days
Title
Area under the plasma concentration versus time curve (AUC)
Description
Area under the plasma concentration versus time curve (AUC) will be assessed on all participants with APG-2449 treatments
Time Frame
28 days
Title
Phosphorylation of FAK protein
Description
Phosphorylation of FAK protein will be assessed in peripheral blood mononuclear cells on all participants with APG-2449 treatments
Time Frame
28 days
Title
Preliminary efficacy assessment: Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
Description
To assess preliminary efficacy in subjects with solid tumors using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
Time Frame
4 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Dose exploration stage: non-small cell lung cancer diagnosed by histology and/or cytology and positive for ALK/ROS1 gene fusion (molecular diagnosis confirmed by the investigator) and malignant pleural mesothelioma, esophageal cancer and ovarian cancer. Kind of patients with advanced tumors. Expansion stage: cohort one, Patients with non-small cell lung cancer who have progressed or are not tolerated on second-generation ALK TKI therapy or any ROS1 TKI therapy treatment ; cohort two, ALK/ROS1 fusion gene positive without TKI treatment Patients with non-small cell lung cancer. The molecular diagnosis results of the above patients can be confirmed by the investigator. ECOG Performance Status ≤ 1. Expectation of life ≥ 3 months. According to RECIST version 1.1, there is at least 1 measurable lesion. Adequate hematologic and bone marrow functions. Adequate renal and liver function. Normal cardiac function. Brain metastases with clinically controlled neurologic symptoms. Serum pregnancy test results of women of childbearing age were negative within 7 days before taking the first dose of study drug. Men, women of childbearing age (postmenopausal women must have been menopausal for at least 12 months before they can be considered infertile) and their partners voluntarily take the study drug for at least 30 days after signing the informed consent form and taking the study drug as deemed effective by the investigator Contraceptive measures Ability to understand and willingness to sign a written informed consent form Subjects must be willing and able to complete the research procedures and follow-up inspections. Exclusion Criteria: Receiving concurrent anti-cancer therapy (chemotherapy, radiotherapy, immunotherapy, biologic therapy); or any investigational therapy within 28 days prior to the first dose of study drug. Receiving TKI therapy within 8 days prior to the first dose of study drug. Continuance of toxicities due to prior therapy that do not recover (CTCAE V5.0 Grade> 1). Has difficulty in swallowing, absorbing barrier, or other diseases blocking APG-2449' taken. Obvious cardiovascular disease history. Failure to recover adequately, as judged by the investigator, from prior surgical procedures. Patients who have had major surgery within 28 days from study entry, and patients who have had minor surgery within 14 days of study entry. Active symptomatic fungal, bacterial and/or viral infection including, but not limited to, active human immunodeficiency virus (HIV) or viral hepatitis (B or C). Known allergies to study drug ingredients or their analogs. Female subjects who are pregnant or breastfeeding, or expecting to become pregnant during the study period. According to the judgment of the investigator or sponsor, any symptoms or disease of the subject may endanger its safety or interfere with the safety assessment of the study drug. Subjects who have used CYP3A4, CYP2C9, or CYP2C19 moderately potent inhibitors or moderately potent inducers 1 week before receiving the study drug for the first time. Subjects who used CYP3A4 substrates and narrow treatment window 1 week before the first study drug.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yifan Zhai, M.D., Ph.D.
Phone
+86-20-28069260
Email
yzhai@ascentage.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Li Zhang, Professor
Organizational Affiliation
Sun Yat-sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jun Zhao, M.D.
Email
ohjerry@163.com
First Name & Middle Initial & Last Name & Degree
Jian Fang, Ph.D.
Email
fangjian5555@163.com
First Name & Middle Initial & Last Name & Degree
Jun Zhao, M.D.
First Name & Middle Initial & Last Name & Degree
Jian Fang, Ph.D.
Facility Name
Fujian Medical University Union Hospital
City
Fuzhou
State/Province
Fujian
ZIP/Postal Code
350001
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaoyan Lin, Ph.D
First Name & Middle Initial & Last Name & Degree
Xiaoyan Lin, Ph.D
Facility Name
Fujian Cancer Hospital
City
Fuzhou
State/Province
Fujian
ZIP/Postal Code
350014
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wu Zhuang, Ph.D
First Name & Middle Initial & Last Name & Degree
Wu Zhuang, Ph.D
Facility Name
Sun-Yat Sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
LI ZHANG, Professor
Phone
+86-20-87343560
Email
Zhangli@sysucc.cn
Facility Name
The First affiliated hospital, Sun Yat-sen University
City
Guangzhou
State/Province
Guangdong
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yubiao Guo, Professor
Facility Name
Henan Provincial Oncology Hospital
City
Zhengzhou
State/Province
Henan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yanqiu Zhao, Professor
Facility Name
Union Hospital medical college Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gang Wu, Professor
Facility Name
Hunan Provincial Oncology Hospital
City
Changsha
State/Province
Hunan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jianhua Chen, Professor
Facility Name
West China hospital of Sichuan University
City
Chengdu
State/Province
Sichuan
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Youling Gong, Professor
Facility Name
Zhejiang Provincial Oncology Hospital
City
Hangzhou
State/Province
Zhejiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yiping Zhang, Professor

12. IPD Sharing Statement

Citations:
PubMed Identifier
35820889
Citation
Fang DD, Tao R, Wang G, Li Y, Zhang K, Xu C, Zhai G, Wang Q, Wang J, Tang C, Min P, Xiong D, Chen J, Wang S, Yang D, Zhai Y. Discovery of a novel ALK/ROS1/FAK inhibitor, APG-2449, in preclinical non-small cell lung cancer and ovarian cancer models. BMC Cancer. 2022 Jul 11;22(1):752. doi: 10.1186/s12885-022-09799-4.
Results Reference
derived

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APG-2449 in Patients With Advanced Solid Tumors

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