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First-in-human Study of CA102N Monotherapy and CA102N Combined With Trifluridine/Tipiracil (LONSURF) in Subjects With Advanced Solid Tumors

Primary Purpose

Advanced or Metastatic Solid Tumors, Advanced or Metastatic Colorectal Cancer (mCRC)

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CA102N
LONSURF
Sponsored by
Holy Stone Healthcare Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced or Metastatic Solid Tumors

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects enrolled in Part 1 must have histologically documented locally advanced or metastatic solid tumor for which there is no effective therapy available.
  • Subjects enrolled in Part 2 must have histologically documented locally advanced or metastatic colorectal cancer that has relapsed after or is refractory to oxaliplatin and irinotecan-based chemotherapy, an anti-VEGF biological therapy, and if RAS wild-type, an anti-EGFR therapy.
  • Age ≥18 years (US) or ≥20 years (Taiwan).
  • ECOG performance status 0-1.
  • Measurable or non-measurable disease based on RECIST version 1.1. Subjects enrolled in Part 2 must have at least one measurable lesion.
  • Adequate organ function within 14 days before 1st dose of study drug, defined as:

    1. Platelet count ≥ 100,000/mm3.
    2. Hemoglobin ≥ 9.0 g/dL.
    3. Absolute neutrophil count ≥ 1500/mm3 (without hematopoietic growth factor support).
    4. Creatinine ≤ 1.5 x ULN, or creatinine clearance ≥ 50 mL/min as calculated using the modified Cockcroft-Gault equation.
    5. Aspartate aminotransferase: (i) ≤3 x ULN in subjects without liver metastasis or ≤5 x ULN in subjects with liver metastasis in CA102N monotherapy treatment group; (ii) ≤3 x ULN in subjects who will be treated with CA102N combined with trifluridine/tipiracil (LONSURF).
    6. Alanine aminotransferase: (i) ≤3 x ULN in subjects without liver metastasis or ≤5 x ULN in subjects with liver metastasis in CA102N monotherapy treatment group; (ii) ≤3 x ULN in subjects who will be treated with CA102N combined with trifluridine/tipiracil (LONSURF).
    7. Total bilirubin ≤1.5 x ULN (unless documented Gilbert's Syndrome).
  • Has had an adequate treatment washout period prior to 1st dose of study drug defined as:

    1. No major surgery within the past 4 weeks.
    2. No extended field radiation therapy within the prior 4 weeks.
    3. No anticancer therapy or bevacizumab within the prior 3 weeks.
    4. No investigational agent received within prior 4 weeks (or 5 times the half-life of the investigational agent, whichever is shorter).
    5. No aspirin or NSAIDs for at least 72 hours before 1st dose of study drug.
    6. No herbal supplements taken as anticancer agents within the prior 7 days.
  • Able to provide written informed consent.
  • Life expectancy of ≥ 3 months.
  • Women of childbearing potential and men with partners of childbearing potential must agree to use a highly effective means of contraception from study entry through at least 6 months after the last dose of CA102N. Women of childbearing potential are those women who have not been permanently sterilized or are not postmenopausal.

Exclusion Criteria:

  • For Part 2, active malignancies other than colorectal cancer.
  • History of hypersensitivity or hepatotoxic reaction to nimesulide or to any excipient.
  • Requiring therapeutic doses of anticoagulants.
  • History or presence of a bleeding tendency or disorder.
  • History of gastrointestinal bleed or perforation related to previous NSAID therapy.
  • Presence or history of recurrent peptic ulcer or hemorrhage.
  • History of cerebrovascular or other active bleeding.
  • Myocardial infarction within the last 12 months, severe or unstable angina, symptomatic congestive heart failure New York Heart Association (NYHA) Class III or IV.
  • History of a serious cardiac arrhythmia requiring treatment.
  • Corrected QT prolongation using Fridericia formula (QTcF), of > 450 msec for males or > 470 msec for females based on a triplicate 12-lead ECG.
  • Clinically significant lung disease (eg, interstitial pneumonia, interstitial lung disease, pneumonitis, pulmonary fibrosis, and severe radiation pneumonitis) requiring continuous systemic corticosteroid treatment for 6 months before registration or who are suspected to have such diseases by imaging at Screening.
  • Ascites, pleural effusion, or pericardial fluid requiring drainage in last 4 weeks.
  • Active autoimmune disease that has required systemic treatment in past 2 years.
  • History of allogeneic transplantation requiring immunosuppressive therapy.
  • Known positive test for hepatitis B (HBV), hepatitis C (HCV) or human immunodeficiency virus (HIV).
  • Clinically active brain metastases, defined as untreated and symptomatic, or requiring therapy with steroids or anticonvulsants to control associated symptoms.
  • Pregnant or breast feeding.
  • Unresolved toxicity of greater than or equal to NCI-CTCAE (version 5.0) Grade 2 attributed to any prior therapies (excluding anemia, alopecia, skin pigmentation, and platinum-induced neurotoxicity).
  • Concomitant medical condition that would increase the risk of toxicity, in the opinion of the Investigator.

Sites / Locations

  • Banner MD Anderson Cancer Center
  • University of Colorado Anschutz Medical Campus
  • MD Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Dose Escalation - CA102N Monotherapy

Dose Escalation - CA102N plus LONSURF

Dose Expansion - CA102N plus LONSURF

Arm Description

0.36, 0.54, and 0.72 mg/kg of nimesulide equivalents of CA102N on Days 1 and 15 of a 28-day cycle

0.36, 0.54, and 0.72 mg/kg of nimesulide equivalents of CA102N on Days 1 and 15 in combination with 35 mg/m2/dose of LONSURF orally twice daily on Days 1 through 5 and Days 8 through 12 of each 28-day cycle

The preliminary RP2D of CA102N on Days 1 and 15 in combination with 35 mg/m2/dose of LONSURF orally twice daily on Days 1 through 5 and Days 8 through 12 of each 28-day cycle

Outcomes

Primary Outcome Measures

Number of subjects with treatment-related adverse events as assessed by NCI-CTCAE v5.0
The primary endpoint for the study is the safety and tolerability of CA102N monotherapy and CA102N combined with trifluridine/tipiracil (LONSURF) as determined according to the NCI-CTCAE version 5.0.

Secondary Outcome Measures

Serum concentration of CA102N
The secondary endpoint of the study is to measure serum concentration of CA102N (ng/mL).

Full Information

First Posted
June 26, 2018
Last Updated
September 20, 2022
Sponsor
Holy Stone Healthcare Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT03616574
Brief Title
First-in-human Study of CA102N Monotherapy and CA102N Combined With Trifluridine/Tipiracil (LONSURF) in Subjects With Advanced Solid Tumors
Official Title
Phase 1,Two-part (Dose Escalation, Dose Expansion), Multicenter,Non-randomized,Open-label, Multiple Dose, First-in-human Study of CA102N Monotherapy and of CA102N Combined With Trifluridine/Tipiracil (LONSURF) in Subjects With Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Completed
Study Start Date
April 9, 2019 (Actual)
Primary Completion Date
February 8, 2022 (Actual)
Study Completion Date
March 1, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Holy Stone Healthcare Co., Ltd

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
Study HS-CA102N-101 is a phase 1, two part (dose escalation, dose expansion), multicenter, non-randomized, open-label, multiple dose, first-in-human study of CA102N monotherapy and of CA102N combined with trifluridine/tipiracil (LONSURF) in subjects with advanced solid tumors. CA102N will be evaluated in subjects with locally advanced or metastatic solid tumours for which no effective therapy is available in Part 1 (dose escalation) and in subjects with relapsed or refractory locally advanced or metastatic colorectal cancer (mCRC) after prior oxaliplatin and irinotecan-based chemotherapy in Part 2 (dose expansion).
Detailed Description
Study HS-CA102N-101 is a phase 1, two part (dose escalation, dose expansion), multicenter, non-randomized, open-label, multiple dose, first-in-human study of CA102N monotherapy and of CA102N combined with trifluridine/tipiracil (LONSURF) in subjects with advanced solid tumors. Part 1 (dose escalation) will determine the safety and tolerability of three dose levels of CA102N as monotherapy and the safety, tolerability and preliminary recommended phase 2 dose (RP2D) of CA102N in combination with trifluridine/tipiracil (LONSURF) in patients with locally advanced or metastatic solid tumors. Part 2 (dose expansion) will further investigate the safety and tolerability of the combination of CA102N and trifluridine/tipiracil (LONSURF) at the preliminary RP2D in patients with locally advanced or metastatic colorectal cancer that has relapsed after or is refractory to oxaliplatin and irinotecan-based chemotherapy, an anti-vascular endothelial growth factor (VEGF) biological therapy, and if RAS wild-type metastatic colorectal cancer, an anti-epidermal growth factor receptor (EGFR) therapy.. Preliminary efficacy will be evaluated in Parts 1 and 2 of the study as an exploratory endpoint.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced or Metastatic Solid Tumors, Advanced or Metastatic Colorectal Cancer (mCRC)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Part 1 (dose escalation) of the study will use a conventional 3+3 design (3 subjects per dose cohort, with the potential to add an additional 3 subjects if dose limiting toxicity [DLT] is observed at the same dose level at which the toxicity occurred). Enrollment will occur in 2 groups, CA102N monotherapy (Group A) and CA102N combination therapy (Group B). Subjects will be enrolled in Group A first. Once enrollment in Group A has been completed, subsequent subjects will be enrolled in Group B. In Part 2 of the study, the safety and tolerability of the preliminary RP2D of CA102N combined with trifluridine/tipiracil (LONSURF) will be further evaluated in up to 12 additional subjects with relapsed or refractory locally advanced or metastatic colorectal cancer who have previously received oxaliplatin and irinotecan-based chemotherapy, an anti-VEGF biological therapy, and if RAS wild-type, an anti-EGFR therapy.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
37 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation - CA102N Monotherapy
Arm Type
Experimental
Arm Description
0.36, 0.54, and 0.72 mg/kg of nimesulide equivalents of CA102N on Days 1 and 15 of a 28-day cycle
Arm Title
Dose Escalation - CA102N plus LONSURF
Arm Type
Experimental
Arm Description
0.36, 0.54, and 0.72 mg/kg of nimesulide equivalents of CA102N on Days 1 and 15 in combination with 35 mg/m2/dose of LONSURF orally twice daily on Days 1 through 5 and Days 8 through 12 of each 28-day cycle
Arm Title
Dose Expansion - CA102N plus LONSURF
Arm Type
Experimental
Arm Description
The preliminary RP2D of CA102N on Days 1 and 15 in combination with 35 mg/m2/dose of LONSURF orally twice daily on Days 1 through 5 and Days 8 through 12 of each 28-day cycle
Intervention Type
Drug
Intervention Name(s)
CA102N
Other Intervention Name(s)
Nim-HA Conjugate
Intervention Description
CA102N is a covalently bound conjugate of the biological polymer sodium hyaluronate (NaHA) and nimesulide (Nim).
Intervention Type
Drug
Intervention Name(s)
LONSURF
Other Intervention Name(s)
Trifluridine/Tipiracil
Intervention Description
LONSURF is a cytotoxic combination treatment of 2 new drugs: trifluridine, a thymidine-based nucleoside analog, and tipiracil, an inhibitor of thymidine phosphorylase.
Primary Outcome Measure Information:
Title
Number of subjects with treatment-related adverse events as assessed by NCI-CTCAE v5.0
Description
The primary endpoint for the study is the safety and tolerability of CA102N monotherapy and CA102N combined with trifluridine/tipiracil (LONSURF) as determined according to the NCI-CTCAE version 5.0.
Time Frame
The safety measures will be assessed and recorded throughout the trial until 30 days following treatment termination (an average of 1 year).
Secondary Outcome Measure Information:
Title
Serum concentration of CA102N
Description
The secondary endpoint of the study is to measure serum concentration of CA102N (ng/mL).
Time Frame
Serum sampling timepoints: predose, 0.5,1, 2, 4, 8, 12, 24, 48, and 72 hours postdose CA102N on Days 1 and 15 at Cycle 1 (each cycle is 28 days).
Other Pre-specified Outcome Measures:
Title
Tumor response according to RECIST v1.1
Description
The exploratory endpoint of the study is to evaluate objective tumor response to CA102N monotherapy and to CA102N in combination with trifluridine/tipiracil (LONSURF) in subjects with locally advanced or metastatic solid tumors and in subjects with locally advanced or metastatic colorectal cancer. The data of tumor response will be collected and evaluated using RECIST version 1.1.
Time Frame
Tumor response will be evaluated after every 2 cycles of treatment (each cycle is 28 days) until the subject starts alternative anti-cancer treatment or develops progressive disease, whichever occurs first (an average of 1 year).
Title
Analysis of urinary COX-2 metabolites by LC-MS/MS
Description
To determine the systemic alteration of COX-2 metabolites affected by CA102N by analyzing urinary COX-2 metabolites, such as PGEM, PGIM and TXBM, using LC-MS/MS.
Time Frame
Urine samples will be collected at predose, 8 and 72 hours postdose CA102N on Days 1 and 15 at Cycle 1, at predose of each subsequent cycle (each cycle is 28 days), until the termination visit (an average of 1 year after Cycle 1 Day 1).

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects enrolled in Part 1 must have histologically documented locally advanced or metastatic solid tumor for which there is no effective therapy available. Subjects enrolled in Part 2 must have histologically documented locally advanced or metastatic colorectal cancer that has relapsed after or is refractory to oxaliplatin and irinotecan-based chemotherapy, an anti-VEGF biological therapy, and if RAS wild-type, an anti-EGFR therapy. Age ≥18 years (US) or ≥20 years (Taiwan). ECOG performance status 0-1. Measurable or non-measurable disease based on RECIST version 1.1. Subjects enrolled in Part 2 must have at least one measurable lesion. Adequate organ function within 14 days before 1st dose of study drug, defined as: Platelet count ≥ 100,000/mm3. Hemoglobin ≥ 9.0 g/dL. Absolute neutrophil count ≥ 1500/mm3 (without hematopoietic growth factor support). Creatinine ≤ 1.5 x ULN, or creatinine clearance ≥ 50 mL/min as calculated using the modified Cockcroft-Gault equation. Aspartate aminotransferase: (i) ≤3 x ULN in subjects without liver metastasis or ≤5 x ULN in subjects with liver metastasis in CA102N monotherapy treatment group; (ii) ≤3 x ULN in subjects who will be treated with CA102N combined with trifluridine/tipiracil (LONSURF). Alanine aminotransferase: (i) ≤3 x ULN in subjects without liver metastasis or ≤5 x ULN in subjects with liver metastasis in CA102N monotherapy treatment group; (ii) ≤3 x ULN in subjects who will be treated with CA102N combined with trifluridine/tipiracil (LONSURF). Total bilirubin ≤1.5 x ULN (unless documented Gilbert's Syndrome). Has had an adequate treatment washout period prior to 1st dose of study drug defined as: No major surgery within the past 4 weeks. No extended field radiation therapy within the prior 4 weeks. No anticancer therapy or bevacizumab within the prior 3 weeks. No investigational agent received within prior 4 weeks (or 5 times the half-life of the investigational agent, whichever is shorter). No aspirin or NSAIDs for at least 72 hours before 1st dose of study drug. No herbal supplements taken as anticancer agents within the prior 7 days. Able to provide written informed consent. Life expectancy of ≥ 3 months. Women of childbearing potential and men with partners of childbearing potential must agree to use a highly effective means of contraception from study entry through at least 6 months after the last dose of CA102N. Women of childbearing potential are those women who have not been permanently sterilized or are not postmenopausal. Exclusion Criteria: For Part 2, active malignancies other than colorectal cancer. History of hypersensitivity or hepatotoxic reaction to nimesulide or to any excipient. Requiring therapeutic doses of anticoagulants. History or presence of a bleeding tendency or disorder. History of gastrointestinal bleed or perforation related to previous NSAID therapy. Presence or history of recurrent peptic ulcer or hemorrhage. History of cerebrovascular or other active bleeding. Myocardial infarction within the last 12 months, severe or unstable angina, symptomatic congestive heart failure New York Heart Association (NYHA) Class III or IV. History of a serious cardiac arrhythmia requiring treatment. Corrected QT prolongation using Fridericia formula (QTcF), of > 450 msec for males or > 470 msec for females based on a triplicate 12-lead ECG. Clinically significant lung disease (eg, interstitial pneumonia, interstitial lung disease, pneumonitis, pulmonary fibrosis, and severe radiation pneumonitis) requiring continuous systemic corticosteroid treatment for 6 months before registration or who are suspected to have such diseases by imaging at Screening. Ascites, pleural effusion, or pericardial fluid requiring drainage in last 4 weeks. Active autoimmune disease that has required systemic treatment in past 2 years. History of allogeneic transplantation requiring immunosuppressive therapy. Known positive test for hepatitis B (HBV), hepatitis C (HCV) or human immunodeficiency virus (HIV). Clinically active brain metastases, defined as untreated and symptomatic, or requiring therapy with steroids or anticonvulsants to control associated symptoms. Pregnant or breast feeding. Unresolved toxicity of greater than or equal to NCI-CTCAE (version 5.0) Grade 2 attributed to any prior therapies (excluding anemia, alopecia, skin pigmentation, and platinum-induced neurotoxicity). Concomitant medical condition that would increase the risk of toxicity, in the opinion of the Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shubham Pant, MD
Organizational Affiliation
The University of Texas MD Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Banner MD Anderson Cancer Center
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85234
Country
United States
Facility Name
University of Colorado Anschutz Medical Campus
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28392690
Citation
Jian YS, Chen CW, Lin CA, Yu HP, Lin HY, Liao MY, Wu SH, Lin YF, Lai PS. Hyaluronic acid-nimesulide conjugates as anticancer drugs against CD44-overexpressing HT-29 colorectal cancer in vitro and in vivo. Int J Nanomedicine. 2017 Mar 27;12:2315-2333. doi: 10.2147/IJN.S120847. eCollection 2017.
Results Reference
background
PubMed Identifier
36331676
Citation
Pant S, Dragovich T, Lieu C, Jimeno A, Kundranda M, Menter D, Tchaparian E, Chen YC, Kopetz S. Phase 1 study of the safety, pharmacokinetics, and preliminary efficacy of CA102N as monotherapy and in combination with trifluridine-tipiracil in patients with locally advanced or metastatic solid tumors. Invest New Drugs. 2023 Feb;41(1):25-34. doi: 10.1007/s10637-022-01308-5. Epub 2022 Nov 4.
Results Reference
derived

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First-in-human Study of CA102N Monotherapy and CA102N Combined With Trifluridine/Tipiracil (LONSURF) in Subjects With Advanced Solid Tumors

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