A Phase Ⅰ/Ⅱ, Open-Label Study of ABSK061 to Assess Safety, Tolerability, Pharmacokinetics, and Efficacy in Children With Achondroplasia
试验速览
- 阶段
- 1 期
- 状态
- 尚未招募
- 入组人数
- 110
- 试验地点
- 7
- 主要终点
- Incidence of dose-limiting toxicities (DLTs)
研究概览
简要总结
This is a multicenter, non-randomized, open-label, phase I/II study in children with ACH. This study will start with a dose escalation of ABSK061 in children with ACH to evaluate the safety, tolerability, PK, and efficacy. The RDE confirmation part will evaluate the safety and efficacy of ABSK061 at the recommended doses for expansion (RDEs) in children with ACH. All patients enrolled in the dose escalation part and RDE confirmation part can enter the extended treatment period to further evaluate the long-term safety, tolerability, and long-term efficacy of ABSK061 in children with ACH.
详细描述
Up to 50 children aged 6 to < 12 years (inclusive of 6 years) with ACH and up to 30 children aged 3 to < 6 years (inclusive of 3 years) with ACH are expected to be enrolled in the dose escalation part of the study; up to 30 children aged 3 to < 12 years (inclusive of 3 years) with ACH are expected to be enrolled in the RDE confirmation part.
Children enrolled in this study will be required to complete at least 6 months and up to 2 years of growth assessment and observation of natural history of ACH in the sponsor's observational study (ABSK061-001).
Dose Escalation Part All patients enrolled in the dose escalation part will continue to receive ABSK061 once daily (QD) dosing frequency and will enter the extended treatment period for 52 weeks after completing 26 weeks of treatment.
The dose escalation includes a total of 5 potential dose levels starting at an initial dose of 0.064 mg/kg QD. In the absence of DLTs or ≥ grade 2 drug-related adverse events, the initial maximum permitted dose increment will not exceed 200%. In the presence of a DLT or ≥ grade 2 drug-related adverse event, dose escalation for subsequent cohorts will follow a modified Fibonacci scheme, in which the first two consecutive dose cohorts will each receive a maximum dose increase of up to 67% and 50%, respectively, and the remaining dose cohorts will receive a maximum of 33% increase. The potential dose levels to be explored are listed in the table below. Based on cumulative safety, PK/PD, efficacy data, other potential dose levels not listed may also be explored in this study following the dose escalation rules.
Dose escalation part will be divided into Part A and Part B according to patient age, with Part A enrolling children with ACH aged 6 to < 12 years (inclusive of 6 years) and Part B enrolling children with ACH aged 3 to < 6 years (inclusive of 3 years). In this study, two sentinel patients will be set for both parts of each dose level, thereby the interval for the first dose between the first 2 patients and the third patient is not less than 28 days.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 3 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Prior to screening, the guardians and children with ACH (if applicable) must voluntarily provide signed informed consent.
- •Patients with a clear clinical diagnosis of ACH confirmed by genetic testing for an FGFR3 mutation.
- •Male or female, age at screening:
- •Dose Escalation Part A: 6 to < 12 years (inclusive 6 years) Dose Escalation Part B: 3 to < 6 years (inclusive 3 years) RDE Confirmation Part: 3 to < 12 years (inclusive 3 years).
- •Have completed at least 6 months (i.e., the "Day 181" visit) of growth assessment and observation of natural history of ACH in the observational study (ABSK061-001) before study entry.
- •Tanner Stage 1 breast development for females or Tanner Stage 1 external genitalia development for males at screening
排除标准
- •Known allergy or hypersensitivity to any component of the study drug.
- •Bone age ≥ 14 years as assessed by the investigator based on hand and wrist X-ray.
- •Have a form of skeletal dysplasia other than ACH or known medical conditions that result in short stature or abnormal growth, including but not limited to severe achondroplasia with developmental delay and acanthosis nigricans (SADDAN), Turner syndrome, pseudoachondroplasia, inflammatory bowel disease, chronic renal insufficiency, active celiac disease a, Vitamin D deficiency b, untreated hypothyroidism c, poorly controlled diabetes (HbA1c ≥8.0%) or diabetic complications
- •History or presence of injury or disease of the growth plate(s), other than ACH, that affects growth potential of long bones.
- •AGV ≤ 1.5 cm/year over at least 6 months (i.e., must have completed the 'Day 181' visit) in the observational study (ABSK061-001), or current evidence of growth plate closure (proximal tibia, distal femur).
- •Current epiphyseal injury (Salter-Harris fracture) or severe hip pain.
- •For ACH-related complications: current severe sleep apnea, symptomatic and/or requiring intervention for hydrocephalus, or spinal cord compression at the cranio-cervical junction, or prior ventriculoperitoneal shunt surgery.
- •Have received any dose of medications affecting stature or body proportionality, such as human growth hormone, insulin-like growth factor 1 (IGF-1), or anabolic steroids within 12 months prior to screening.
- •Prior treatment with any CNP analogues or FGFR inhibitors. Prior use of any investigational drugs or investigational medical devices that affect height or body proportion.
- •History of any prior bone-related surgery that affects long bone growth, such as orthopaedic reconstructive surgery, limb lengthening, or osteotomy (patients who have previously undergone foramen magnum decompression or intervertebral disc/laminectomy are allowed if they have fully recovered after surgery and bone healing has occurred for at least 6 months. Patients who have previously undergone eight-plate epiphysiodesis are allowed if the plate has been removed and healed for at least 4 weeks).
研究组 & 干预措施
ABSK061
Dose escalation part will be divided into Part A and Part B according to patient age, with Part A enrolling children with ACH aged 6 to < 12 years (inclusive of 6 years) and Part B enrolling children with ACH aged 3 to < 6 years (inclusive of 3 years). In this study, two sentinel patients will be set for both parts of each dose level, thereby the interval for the first dose between the first 2 patients and the third patient is not less than 28 days.
This study will employ the Bayesian optimal interval (BOIN) design for dose escalation part to guide dose escalation. The target toxicity rate for the MTD is φ = 0.25 and the maximum sample size for the dose escalation part will be 80 (50 in Part A and 30 in Part B). The DLT observation period is defined as the first 28 days after administration of ABSK061.
After the RDE is confirmed in the dose Escalation part, the dose Expansion phase will be conducted.
干预措施: ABSK061 (Drug)
结局指标
主要结局
Incidence of dose-limiting toxicities (DLTs)
时间窗: Day 1 to Day 28 of dosing
Incidence of dose-limiting toxicities (DLTs) in the DLT observation period, defined as Day 1 to Day 28 of dosing
Incidence and severity of adverse events (AEs)
时间窗: up to 87 weeks
Incidence and severity of adverse events (AEs), adverse events of special interest (AESIs), and serious adverse events (SAEs) using Common Terminology Criteria for Adverse Events, version 5.0 (CTCAE v5.0), and relatedness, rate of dose modifications (including dose interruption and dose reduction) or discontinuation of study drug due to toxicity, and changes from baseline in safety assessments such as laboratory parameters, x-ray, electrocardiograms (ECGs), echocardiograms, vital signs, and physical examinations (including ophthalmic examinations)
Changes from baseline in the Annualized Growth Velocity (AGV, cm/year)
时间窗: Day 1 of dosing to 78-week End of Treatment
Changes from baseline in the Annualized Growth Velocity (AGV, cm/year) over 52 weeks \[baseline is defined as the AGV obtained through at least 6 months of observation in the observational study (ABSK061-001)\]
次要结局
- Cmax(Day 1 of dosing to 78-week End of Treatment)
- Tmax(Day 1 of dosing to 78-week End of Treatment)
- AUC(Day 1 of dosing to 78-week End of Treatment)
- Vz/F(Day 1 of dosing to 78-week End of Treatment)
- t1/2(Day 1 of dosing to 78-week End of Treatment)
- Cmax,ss(Day 1 of dosing to 78-week End of Treatment)
- Cmin,ss(Day 1 of dosing to 78-week End of Treatment)
- AR(Day 1 of dosing to 78-week End of Treatment)
- CL/F(Day 1 of dosing to 78-week End of Treatment)
- AUCtau,ss(Day 1 of dosing to 78-week End of Treatment)
- standing height(Day 1 of dosing to 78-week End of Treatment)
- sitting height(Day 1 of dosing to 78-week End of Treatment)
- sitting height to standing height ratio(Day 1 of dosing to 78-week End of Treatment)
- height Z scores(Day 1 of dosing to 78-week End of Treatment)