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Safety, Tolerability, Pharmacokinetics and Antitumor Activity of FCN-437c

Primary Purpose

Breast Neoplasms

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
FCN-437c
Letrozole 2.5mg
Sponsored by
Ahon Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Neoplasms focused on measuring ER-Positive, HER2-Negative, Breast Neoplasms

Eligibility Criteria

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

Inclusion Criteria:

  • Adult (>= 18 years old) patients diagnosed as ER +/ HER2 - advanced breast cancer, without standard treatment or unable to receive standard treatment;
  • The eastern cooperative oncology group (ECOG) score is 0 or 1;
  • According to RECIST version 1.1, there was at least one measurable lesion or only bone metastasis;
  • The expected survival period is at least 12 weeks;
  • Patients have sufficient bone marrow and organ function;
  • Patients is willing and able to follow the planned visit, treatment plan, laboratory examination and other test procedures;
  • Patients fully understand the study and are willing to sign the informed consent form (ICF);
  • The inclusion criteria specific for the dose expansion stage are as follows.
  • The postmenopausal patients (>= 18 years old) diagnosed as ER +/ HER2 - breast cancer have evidence of local recurrence or metastasis, and are not suitable for surgical resection or radiotherapy for the purpose of cure;
  • There was neither history of systematic treatment nor clinical indication for chemotherapy for patients in the dose expansion stage;
  • The patients in the dose expansion stage should neither have received neoadjuvant or adjuvant endocrine therapy previously, nor have progression free survival during or after the neoadjuvant or adjuvant endocrine therapy was shorter than 12 months.

Exclusion Criteria:

  • HER2 + breast cancer, either defined as by fluorescence hybridization (FISH) or detected by standard immunohistochemistry (IHC);
  • History of previous CDK4 / 6 inhibitors treatment;
  • Received anti-tumor chemotherapy, major surgery, radiotherapy, biological drug therapy or other research drug treatment within 28 days before enrollment;
  • The toxicity of previous anti-tumor therapy has not recovered (>= grade 2 according to NCI CTCAE version 5.0), except for hair loss; the neurotoxicity of patients who have received chemotherapy before should be restored to grade 2 or below based on NCI CTCAE version 5.0;
  • The patient used CYP3A strong inhibitor or CYP3A inducer 14 days before the first dose administration;
  • Cardiac dysfunction or disease are consistent with one of the following conditions such as arrhythmia with clinical significance, any risk factors increasing risk of QTc interval prolongation, or congestive heart failure (CHF) with grade ≥ 3 according to NYHA ;
  • Dysphagia, active digestive system disease, major gastrointestinal surgery, malabsorption syndrome, or other conditions that may impair the absorption of FCN-437c;
  • Known allergy to letrozole, FNC-437c or any other excipients;
  • Uncontrolled central system metastasis;
  • Active infection, including HBV, HCV, HIV, et al;
  • Any other disease or condition of clinical significance (e.g., uncontrolled diabetes, active or uncontrollable infection) that the researchers believe may affect protocol compliance or affect patients' signing of ICF;
  • The exclusion criteria specific for the dose expansion stage was as follows.
  • Postmenopausal women with advanced breast cancer who have received neoadjuvant / adjuvant endocrine therapy and progressed less than 12 months after treatment;
  • Patients with advanced breast cancer who had received systemic anti-tumor therapy including endocrine and chemotherapy (patients with ER + and HER2 - who had received aromatase inhibitors for no more than 14 days were allowed to be enrolled) ;
  • Other exclusion criteria are the same as those of the dose escalation stage.

Sites / Locations

  • Fudan University Shanghai Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Dose escalation cohort of FCN-437c

Dose expansion cohort of FCN-437c + letrozole

Arm Description

This study plans to start escalating from 50 mg QD, through 100 mg, 200 mg, 300 mg, 450 mg, to 600 mg. Participants will receive FCN-437c in sequential 28-day cycles which are made up of monotherapy QD for 21 days followed by a 7 day rest period. Participants must be histologically or cytologically diagnosed with ER+/ HER2- advanced breast cancer.

The dose expansion stage will be initiated after escalating to MTD. Six patients will be treated with FCN-437c combined with letrozole. DLT assessment and PK blood collection will be completed in the first 28-day cycle. If DLT does not occur in the first three patients, 15 additional patients were enrolled to complete the expansion study of MTD group. If one DLT occurs in the first three patients, three additional patients will be enrolled onal patients were enrolled and completed the MTD group. Patients will be evaluated every 8 weeks until disease progression, intolerable toxicity, death, investigator's decision or patient's voluntary withdrawal from the study.

Outcomes

Primary Outcome Measures

DLT within 7 days of FCN-437c monotherapy
The incidence of DLT occurred within 7 days of FCN-437c monotherapy
DLT within 28 days of FCN-437c monotherapy
The incidence of DLT occurred within 28 days of FCN-437c monotherapy
DLT within 28 days of FCN-437c combined therapy
The incidence of DLT occurred within 28 days of the letrozole-combined treatment.
Adverse events until the last followup
The types and frequencies of adverse events (AEs) evaluated according to the National Cancer Institute Common Terminology Criteria for adverse events (NCI-CTCAE) version 5.0.
Serious and significant adverse events
Serious adverse events (SAE) and toxic reactions leading to permanent drug withdrawal occurred during the treatment.
Incidence of Deaths
The frequency and causes of deaths during the treatment.
Incidence of abnormal laboratory results
Abnormal laboratory results of safety concerns such as ALT, AST, Cr and BUN, et al according to NCI-CTCAE 5.0 classification.
Changes of ECGs from baselines
Changes of ECGs from baselines, such as QT interval。

Secondary Outcome Measures

Anti-tumor efficacy of monotherapy
Objective response rate (ORR) of FCN-437c monotherapy.
Anti-tumor efficacy of combined treatment
Objective response rate (ORR) of FCN-437c and letrozole-combined treatment.
FPS
Progression free survival (PFS) during the treatment.
OS
overall survival (OS) during the treatment.
survival rate
1-year OS rate during the 1st year of treatment.
DOR
duration of response (DOR) during the treatment.
CBR
clinical benefit response (CBR) during the treatment.
Cmax of FCN-437c in monotherapy
Maximal plasma concentration of FCN-437c in monotherapy.
AUC of FCN-437c in monotherapy
Entire exposure of FCN-437c in monotherapy.
Cmax of FCN-437c in combined treatment
Maximal plasma concentration of FCN-437c combined with letrozole.
AUC of FCN-437c in combined treatment
Entire exposure of FCN-437c combined with letrozole.

Full Information

First Posted
July 13, 2020
Last Updated
July 23, 2020
Sponsor
Ahon Pharmaceutical Co., Ltd.
Collaborators
Fudan University, Zhejiang Cancer Hospital, Sir Run Run Shaw Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04488107
Brief Title
Safety, Tolerability, Pharmacokinetics and Antitumor Activity of FCN-437c
Official Title
A Multicenter, Open, Single Arm Dose-escalation and Dose-expansion Study: to Evaluate the Safety, Tolerability, Pharmacokinetics, and Antitumor Activity of FCN-437c Alone or in Combination With Letrozole in ER+/ HER2- Advanced Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Unknown status
Study Start Date
February 14, 2019 (Actual)
Primary Completion Date
December 31, 2021 (Anticipated)
Study Completion Date
June 30, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ahon Pharmaceutical Co., Ltd.
Collaborators
Fudan University, Zhejiang Cancer Hospital, Sir Run Run Shaw Hospital

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
This is a multicenter, open, single arm dose escalation and dose expansion clinical study to evaluate the safety, tolerability, pharmacokinetics, and antitumor activity of FCN-437c alone or in combination with letrozole in women with ER +/ HER2 - advanced breast cancer.
Detailed Description
This is a multicenter, open, single arm clinical study to evaluate the safety, tolerability, and antitumor activity of FCN-437c in combination with letrozole in postmenopausal women with ER + / HER2 - advanced breast cancer, and to evaluate the PK characteristics of FCN-437c monotherapy and combined therapy. The single drug administration period (7 days) . The continuous administration period made up of 21 days of continuous administration, followed by 7 days of withdrawal, which made up of 28 days as a treatment cycle. The evaluation was conducted every 8 weeks until one of the following happened, disease progression, intolerable toxicity, death, the researcher's decision or the patients' voluntary withdrawal from the study. The follow-up visit was conducted 30 days after the last administration. The telephone follow-up was conducted once every 3 months until the end of the study to record the survival period. In the expansion period, FCN-437c was continuous administration per day for 21 days, followed by 7 days of withdrawal, making a treatment cycle of 28 days during which letrozole was continuously administrated 2.5 mg QD. Evaluation was conducted every 8 weeks until one of the following occurred, disease progression, intolerable toxicity, death, decision of the researcher or patients' voluntary withdrawal of the study. Follow up visit was conducted 30 days after the last administration, followed by the survival period telephone follow-up every 3 months until the end of the study. End of of the study was defined as the last patient in the dose expansion stage took the treatment for more than one year, or terminated the treatment (depending on which occurred earlier. At the end of the study, patients with no disease progression were determined to continue taking FCN-437c according to the clinical benefits.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Neoplasms
Keywords
ER-Positive, HER2-Negative, Breast Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
This study plans to start dose escalating from 50 mg, followed by 100, 200, 300, 450, and 600 mg as tentatively designated escalating dose groups. After the initial dose group, it is allowed to adjust the subsequent dose level according to the test data, but it will not exceed 100% dose increment. After the completion of DLT observation in each group, the next dose group and the number of cases were determined according to the safety, efficacy and PK data of the dose group. The traditional "3+3" method was used in the design of dose escalating stage, and the improved Fibonacci series was used for the dose increasing stage.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
78 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dose escalation cohort of FCN-437c
Arm Type
Experimental
Arm Description
This study plans to start escalating from 50 mg QD, through 100 mg, 200 mg, 300 mg, 450 mg, to 600 mg. Participants will receive FCN-437c in sequential 28-day cycles which are made up of monotherapy QD for 21 days followed by a 7 day rest period. Participants must be histologically or cytologically diagnosed with ER+/ HER2- advanced breast cancer.
Arm Title
Dose expansion cohort of FCN-437c + letrozole
Arm Type
Experimental
Arm Description
The dose expansion stage will be initiated after escalating to MTD. Six patients will be treated with FCN-437c combined with letrozole. DLT assessment and PK blood collection will be completed in the first 28-day cycle. If DLT does not occur in the first three patients, 15 additional patients were enrolled to complete the expansion study of MTD group. If one DLT occurs in the first three patients, three additional patients will be enrolled onal patients were enrolled and completed the MTD group. Patients will be evaluated every 8 weeks until disease progression, intolerable toxicity, death, investigator's decision or patient's voluntary withdrawal from the study.
Intervention Type
Drug
Intervention Name(s)
FCN-437c
Other Intervention Name(s)
Dose-escalation and expansion
Intervention Description
- FCN-437c is a selective and potent CDK4/6 dual inhibitor, with broad antitumor activity in preclinical pharmacology models, favorable physical and pharmacokinetic (PK) properties, and acceptable toxicity profile in nonclinical studies.
Intervention Type
Drug
Intervention Name(s)
Letrozole 2.5mg
Other Intervention Name(s)
Dose-escalation
Intervention Description
Letrozole is the latest generation of aromatase inhibitor. Letrozole lowers estrogen levels in postmenopausal women, which may slow the growth of certain types of breast tumors that need estrogen to grow in the body. Letrozole is used to treat breast cancer in postmenopausal women. It is often given to women who have been taking tamoxifen (Nolvadex, Soltamox) for 5 years.
Primary Outcome Measure Information:
Title
DLT within 7 days of FCN-437c monotherapy
Description
The incidence of DLT occurred within 7 days of FCN-437c monotherapy
Time Frame
7 days
Title
DLT within 28 days of FCN-437c monotherapy
Description
The incidence of DLT occurred within 28 days of FCN-437c monotherapy
Time Frame
28 days
Title
DLT within 28 days of FCN-437c combined therapy
Description
The incidence of DLT occurred within 28 days of the letrozole-combined treatment.
Time Frame
28 days
Title
Adverse events until the last followup
Description
The types and frequencies of adverse events (AEs) evaluated according to the National Cancer Institute Common Terminology Criteria for adverse events (NCI-CTCAE) version 5.0.
Time Frame
through study completion, assessed up to 24 months
Title
Serious and significant adverse events
Description
Serious adverse events (SAE) and toxic reactions leading to permanent drug withdrawal occurred during the treatment.
Time Frame
through study completion, assessed up to 24 months
Title
Incidence of Deaths
Description
The frequency and causes of deaths during the treatment.
Time Frame
through study completion, assessed up to 24 months
Title
Incidence of abnormal laboratory results
Description
Abnormal laboratory results of safety concerns such as ALT, AST, Cr and BUN, et al according to NCI-CTCAE 5.0 classification.
Time Frame
through study completion, assessed up to 24 months
Title
Changes of ECGs from baselines
Description
Changes of ECGs from baselines, such as QT interval。
Time Frame
through study completion, assessed up to 24 months
Secondary Outcome Measure Information:
Title
Anti-tumor efficacy of monotherapy
Description
Objective response rate (ORR) of FCN-437c monotherapy.
Time Frame
through study completion, assessed up to 24 months
Title
Anti-tumor efficacy of combined treatment
Description
Objective response rate (ORR) of FCN-437c and letrozole-combined treatment.
Time Frame
through study completion, assessed up to 24 months
Title
FPS
Description
Progression free survival (PFS) during the treatment.
Time Frame
through study completion, assessed up to 24 months
Title
OS
Description
overall survival (OS) during the treatment.
Time Frame
through study completion, assessed up to 24 months
Title
survival rate
Description
1-year OS rate during the 1st year of treatment.
Time Frame
through study completion, assessed up to 24 months
Title
DOR
Description
duration of response (DOR) during the treatment.
Time Frame
through study completion, assessed up to 24 months
Title
CBR
Description
clinical benefit response (CBR) during the treatment.
Time Frame
through study completion, assessed up to 24 months
Title
Cmax of FCN-437c in monotherapy
Description
Maximal plasma concentration of FCN-437c in monotherapy.
Time Frame
through study completion, assessed up to 24 months
Title
AUC of FCN-437c in monotherapy
Description
Entire exposure of FCN-437c in monotherapy.
Time Frame
through study completion, assessed up to 24 months
Title
Cmax of FCN-437c in combined treatment
Description
Maximal plasma concentration of FCN-437c combined with letrozole.
Time Frame
through study completion, assessed up to 24 months
Title
AUC of FCN-437c in combined treatment
Description
Entire exposure of FCN-437c combined with letrozole.
Time Frame
through study completion, assessed up to 24 months

10. Eligibility

Sex
Female
Gender Based
Yes
Gender Eligibility Description
Women with breast cancer,
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult (>= 18 years old) patients diagnosed as ER +/ HER2 - advanced breast cancer, without standard treatment or unable to receive standard treatment; The eastern cooperative oncology group (ECOG) score is 0 or 1; According to RECIST version 1.1, there was at least one measurable lesion or only bone metastasis; The expected survival period is at least 12 weeks; Patients have sufficient bone marrow and organ function; Patients is willing and able to follow the planned visit, treatment plan, laboratory examination and other test procedures; Patients fully understand the study and are willing to sign the informed consent form (ICF); The inclusion criteria specific for the dose expansion stage are as follows. The postmenopausal patients (>= 18 years old) diagnosed as ER +/ HER2 - breast cancer have evidence of local recurrence or metastasis, and are not suitable for surgical resection or radiotherapy for the purpose of cure; There was neither history of systematic treatment nor clinical indication for chemotherapy for patients in the dose expansion stage; The patients in the dose expansion stage should neither have received neoadjuvant or adjuvant endocrine therapy previously, nor have progression free survival during or after the neoadjuvant or adjuvant endocrine therapy was shorter than 12 months. Exclusion Criteria: HER2 + breast cancer, either defined as by fluorescence hybridization (FISH) or detected by standard immunohistochemistry (IHC); History of previous CDK4 / 6 inhibitors treatment; Received anti-tumor chemotherapy, major surgery, radiotherapy, biological drug therapy or other research drug treatment within 28 days before enrollment; The toxicity of previous anti-tumor therapy has not recovered (>= grade 2 according to NCI CTCAE version 5.0), except for hair loss; the neurotoxicity of patients who have received chemotherapy before should be restored to grade 2 or below based on NCI CTCAE version 5.0; The patient used CYP3A strong inhibitor or CYP3A inducer 14 days before the first dose administration; Cardiac dysfunction or disease are consistent with one of the following conditions such as arrhythmia with clinical significance, any risk factors increasing risk of QTc interval prolongation, or congestive heart failure (CHF) with grade ≥ 3 according to NYHA ; Dysphagia, active digestive system disease, major gastrointestinal surgery, malabsorption syndrome, or other conditions that may impair the absorption of FCN-437c; Known allergy to letrozole, FNC-437c or any other excipients; Uncontrolled central system metastasis; Active infection, including HBV, HCV, HIV, et al; Any other disease or condition of clinical significance (e.g., uncontrolled diabetes, active or uncontrollable infection) that the researchers believe may affect protocol compliance or affect patients' signing of ICF; The exclusion criteria specific for the dose expansion stage was as follows. Postmenopausal women with advanced breast cancer who have received neoadjuvant / adjuvant endocrine therapy and progressed less than 12 months after treatment; Patients with advanced breast cancer who had received systemic anti-tumor therapy including endocrine and chemotherapy (patients with ER + and HER2 - who had received aromatase inhibitors for no more than 14 days were allowed to be enrolled) ; Other exclusion criteria are the same as those of the dose escalation stage.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xichun Hu, M.D.
Phone
13816110335
Email
xchu2009@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jian Zhang, M.D.
Email
syner2000@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xichun Hu, M.D.
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fudan University Shanghai Cancer Center
City
Shanghai
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xichun Hu, M.D.
Phone
13816110335
Email
xchu2009@hotmail.com
First Name & Middle Initial & Last Name & Degree
Jian zhang, M.D.
Email
syner2000@163.com

12. IPD Sharing Statement

Citations:
PubMed Identifier
27336726
Citation
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Results Reference
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Citation
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Results Reference
derived
Available IPD and Supporting Information:
Available IPD/Information Type
ICH topic S9 - nonclinical evaluation for anticancer pharmaceuticals. 2009
Available IPD/Information URL
https://database.ich.org/sites/default/files/S9_Guideline.pdf
Available IPD/Information Identifier
ICH topic S9
Available IPD/Information Type
label for IBRANCE® (palbociclib) capsules
Available IPD/Information URL
https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/207103s000lbl.pdf
Available IPD/Information Identifier
IBRANCE® (palbociclib) capsule
Available IPD/Information Type
label for IBRANCE® (palbociclib) tablets,
Available IPD/Information URL
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/212436lbl.pdf
Available IPD/Information Identifier
IBRANCE® (palbociclib) tablets
Available IPD/Information Type
Label for KISQALI® (ribociclib) tablets
Available IPD/Information URL
https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/209092s005lbl.pdf
Available IPD/Information Identifier
KISQALI® (ribociclib) tablets
Available IPD/Information Type
ICH Topic E6 (R1) Guideline for Good Clinical Practice
Available IPD/Information URL
https://www.ema.europa.eu/en/documents/scientific-guideline/ich-e6-r1-guideline-good-clinical-practice_en.pdf
Available IPD/Information Identifier
ICH Topic E6 (R1)
Available IPD/Information Type
ICH Topic E9 Statistical Principles for Clinical Trials
Available IPD/Information URL
https://www.ema.europa.eu/en/documents/scientific-guideline/ich-e-9-statistical-principles-clinical-trials-step-5_en.pdf
Available IPD/Information Identifier
ICH Topic E9

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Safety, Tolerability, Pharmacokinetics and Antitumor Activity of FCN-437c

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