Phase 1 Study of ACE-232 to Treat Patients With Metastatic Castration-Resistant Prostate Cancer

Phase 1

Recruiting

• Conditions: Prostate Cancer (Adenocarcinoma); mCRPC (Metastatic Castration-resistant Prostate Cancer)
• Interventions: Drug: ACE-232 tablets

• Registration Number: NCT06801236
• Lead Sponsor: Acerand Therapeutics (Hong Kong) Limited

Brief Summary

This is an open label, phase I, multi-center study aiming to assess the safety and tolerability in patients with metastatic castration resistant prostate cancer (mCRPC).

Detailed Description

The study consists of two parts, Phase 1A dose escalation and Phase 1B dose optimization. Phase 1A aims to assess the safety, tolerability, pharmacokinetic (PK) profile, and changes in pharmacodynamic (PD) markers in patients treated with ACE-232, and to determine the maximum tolerated dose (MTD), if applicable. In Phase 1B, patients with AR gene alterations will be treated at two different dose levels to establish the recommended Phase 2 dose (RP2D).

Study Timeline

• Study First Submitted: 2025-01-19
• Study First Submitted QC: 2025-01-24
• Study First Posted: 2025-01-30
• Status Verified: 2025-05
• Study Start: 2025-05-12
• Last Update Submitted: 2025-05-14
• Last Update Posted: 2025-05-18
• Primary Completion: 2028-03-01
• Study Completion: 2028-08-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: Male
• Target Recruitment: 67

Inclusion Criteria

• Provide written informed consent
• Metastatic Castration-resistant Prostate Cancer with ongoing androgen - deprivation therapy (ADT) or have bilateral orchiectomy
• Difficult to treat or intolerant to standard treatment (post at least 1 line of NHA and taxane-based chemo in mHSPC or mCRPC), suitable for investigational treatment;
• Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Has a life expectancy of at least 6 months
• Adequate organ function and bone marrow function

Exclusion Criteria

• Receiving any anti-cancer drugs or other treatment, major surgery, extensive radiation therapy, or local radiation therapy within protocol-defined wash-out period;
• Concomitant use of medications or herbal supplements known to be moderate to strong CYP3A4 inhibitors/inducers, or P-gp inhibitors, known to prolong the QT interval.
• Any previous treatment-related toxicities have not recovered.
• Spinal cord compression or known brain metastases or leptomeningeal carcinomatosis.
• Severe cardiovascular disorders.
• Known gastrointestinal (GI) disorder or GI procedure
• History of gastric and duodenal perforation.
• History of pituitary dysfunction.
• Poorly controlled diabetes mellitus.
• Active or uncontrolled autoimmune disease
• Active infections, or a known history of HIV infection, or a known active hepatitis B or C, or a known active tuberculosis.
• Other malignancies requiring treatment within 3 years prior to the first dose of study drug
• Known allergy or hypersensitivity to any of the excipients of ACE-232.
• Has other medical conditions that at the discretion of the investigator interfere with safety or efficacy evaluation, or treatment compliance.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
ACE-232	ACE-232 tablets	-

Primary Outcome Measures

Name	Time	Method
Number of patients experiencing adverse events (AEs)/serious adverse events (SAEs)	From time of information consent to 30 days post last dose, up to approximately 37 months	Number of patients with incidence of adverse events and with serious adverse events including changes from baseline in laboratory parameters, vital signs, ECGs, and physical examination, etc.
Recommended Phase 2 dose (RP2D) and/or maximum tolerated dose (MTD)	Up to approximately 37 months	RP2D will be finally determined by the SMC and sponsor based on all data from the dose escalation module and backfill module, as well as the exposure-response relationship evaluated (if available). MTD is defined as the maximum dose level at which ≤1 patient have DLTs during the DLT observation period, and it should be determined with 6 evaluable patients.
Number of patients experiencing dose limiting toxicity (DLT), as defined in the protocol	From the first dose of ACE-232 on Cycle 1 Day 1 up to and including the planned end of Cycle 1 (at the end of 28 days)	A DLT is defined as any toxicity events related to ACE-232 that occur from the first dose of study treatment until the planned end date of Cycle 1 (DLT assessment period), meeting the criteria specified in protocol.

Secondary Outcome Measures

Name	Time	Method
Pharmacokinetics characterization by using Maximum concentration (Cmax)	Up to approximately 37 months	To determine the pharmacokinetics (PK) using Cmax of ACE-232 after a single dose and at steady state after multiple doses
Prostate Specific Antigen (PSA) response	Up to approximately 37 months	PSA response is defined as PSA decline of 30% and 50% from baseline at any time point
Pharmacokinetics characterization by using Area under the plasma concentration versus time curve (AUC)	Up to approximately 37 months	To determine the pharmacokinetics (PK) using AUC of ACE-232 after a single dose and at steady state after multiple doses.
Objective Response Rate (ORR)	Up to approximately 37 months	ORR is defined as a complete response (CR) or partial response (PR), as determined by the investigator using Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) and Prostate Cancer Working Group Criteria 3 (PCWG3 criteria), in patients with measurable disease at baseline.
Duration of Response (DoR)	Up to approximately 37 months	DOR is defined, for patients with an objective response, as the time from first documentation of objective tumor response (CR or PR) to the first documentation of objective tumor progression or death due to any cause.
Radiographic Progression Free Survival (rPFS)	Up to approximately 37 months	rPFS is defined as the time from the first dose of ACE-232 to the first documented disease progression by either RECIST progression and/or progression on bone scan by PCWG3 or death due to any cause, whichever occurs first.
Overall Survival (OS)	Up to approximately 37 months	OS is defined as the time from the first dose of ACE-232 to the date of death due to any cause.
Blood concentration of steroid hormone	Up to approximately 37 months	To determine the blood concentration of steroid hormones at various timepoints and change from baseline

Trial Locations

Locations (8)

Xcancer (Urology Cancer Center); 🇺🇸 Omaha, Nebraska, United States

Fred Hutchinson Cancer Research Center; 🇺🇸 Seattle, Washington, United States

University of California San Diego, Moores Cancer Center; 🇺🇸 La Jolla, California, United States

Moffitt Cancer Center, Tampa; 🇺🇸 Tampa, Florida, United States

University of Maryland, Greenebaum Comprehensive Cancer Center; 🇺🇸 Baltimore, Maryland, United States

Harvard Medical School-Massachusetts General Hospital; 🇺🇸 Boston, Massachusetts, United States

M Health Fairview Clinics and Surgery Center; 🇺🇸 Minneapolis, Minnesota, United States

Carolina Urologic Research Center; 🇺🇸 Myrtle Beach, South Carolina, United States