MedPath

Study of Infigratinib in Children with Achondroplasia

Registration Number
NCT04265651
Lead Sponsor
QED Therapeutics, Inc.
Brief Summary

This is a Phase 2, multicenter, open-label, dose-escalation and dose-expansion study to evaluate the safety, tolerability, and efficacy of infigratinib, a fibroblast growth factor receptor (FGFR) 1-3-selective tyrosine kinase inhibitor, in children 3 to 11 years of age with Achondroplasia (ACH) who previously participated in the PROPEL study (Protocol QBGJ398-001) for at least 6 months. The study includes dose escalation with extended treatment, and dose expansion. The study also includes a PK Substudy to fully characterize the pharmacokinetics of infigratinib in children with ACH.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
84
Inclusion Criteria
  1. Signed informed consent by participant or parent(s) or legally authorized representative (LAR) and signed informed assent by the participant (when applicable).
  2. Diagnosis of ACH, documented clinically and confirmed by genetic testing.
  3. At least a 6-month period of growth assessment in the PROPEL study (Protocol QBGJ398-001) before study entry.
  4. Ambulatory and able to stand without assistance
  5. Able to swallow oral medication.
Exclusion Criteria
  1. Hypochondroplasia or short stature condition other than ACH.
  2. In females, having had their menarche.
  3. Height < -2 or > +2 standard deviations for age and sex based on reference tables on growth in children with ACH.
  4. Significant concurrent disease or condition that, in the view of the Investigator and/or Sponsor, would confound assessment of efficacy or safety of infigratinib.
  5. Current evidence of corneal or retinal disorder/keratopathy.
  6. History of malignancy.
  7. Currently receiving treatment with agents that are known strong inducers or inhibitors of CYP3A4 and medications which increase serum phosphorus and/or calcium concentration.
  8. Treatment with growth hormone, insulin-like growth factor 1 (IGF-1), or anabolic steroids in the previous 6 months or long-term treatment (>3 months) at any time.
  9. Treatment with a C-type natriuretic peptide (CNP) analog, fibroblast growth factor (FGF) ligand trap, or treatment targeting FGFR inhibition at any time.
  10. Regular long-term treatment (>3 weeks) with oral corticosteroids (low-dose ongoing inhaled steroid for asthma is acceptable).
  11. Treatment with any other investigational product or investigational medical device for the treatment of ACH or short stature.
  12. Previous limb-lengthening surgery or guided growth surgery.
  13. Fracture within 12 months of screening.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Infigratinib 0.016 mg/kgInfigratinib 0.016 mg/kgDose Escalation: Infigratinib is provided as minitablets in 2 strengths: 0.1 mg and 1 mg for daily oral administration. The dose and number of minitablets/day will be calculated based on individual participant weight. Doses will be adjusted based on weight changes approximately every 3 months.
Infigratinib 0.032 mg/kgInfigratinib 0.032 mg/kgDose Escalation and PK substudy: Infigratinib is provided as minitablets in 2 strengths: 0.1 mg and 1 mg for daily oral administration. The dose and number of minitablets/day will be calculated based on individual participant weight. Doses will be adjusted based on weight changes approximately every 3 months.
Infigratinib 0.128 mg/kgInfigratinib 0.128 mg/kgDose Escalation and PK substudy: Infigratinib is provided as minitablets in 2 strengths: 0.1 mg and 1 mg for daily oral administration. The dose and number of minitablets/day will be calculated based on individual participant weight. Doses will be adjusted based on weight changes approximately every 3 months.
Infigratinib 0.064 mg/kgInfigratinib 0.064 mg/kgDose Escalation and PK substudy: Infigratinib is provided as minitablets in 2 strengths: 0.1 mg and 1 mg for daily oral administration. The dose and number of minitablets/day will be calculated based on individual participant weight. Doses will be adjusted based on weight changes approximately every 3 months.
Infigratinib 0.25 mg/kgInfigratinib 0.25 mg/kgDose Escalation and PK substudy: Infigratinib is provided as minitablets in 2 strengths: 0.1 mg and 1 mg for daily oral administration. The dose and number of minitablets/day will be calculated based on individual participant weight. Doses will be adjusted based on weight changes approximately every 3 months. Dose Expansion: Upon identification of the recommended dose from all cohorts analyzed, an expansion cohort of 20 subjects may begin enrollment to further determine safety, tolerability, efficacy, pharmacokinetics (PK) and pharmacodynamics (PD) of the selected dose.
Primary Outcome Measures
NameTimeMethod
Change from baseline in annualized height velocityUp to 18 months
Incidence of treatment-emergent adverse events (TEAEs) that lead to dose decrease or discontinuationUp to 18 months
PK parameters of infigratinib (Clast- PK substudy only)21 days
PK parameters of infigratinib (Racc- PK substudy only)21 days
PK parameters of infigratinib (Tmax- PK substudy only)21 days
PK parameters of infigratinib (Vz/F- PK substudy only)21 days
PK parameters of infigratinib (Cmax- PK substudy only)21 days
PK parameters of infigratinib (AUCinf- PK substudy only)21 days
PK parameters of infigratinib (AUC24- PK substudy only)21 days
PK parameters of infigratinib (T1/2- PK substudy only)21 days
PK parameters of infigratinib (CL/F- PK substudy only)21 days
Secondary Outcome Measures
NameTimeMethod
Incidence of adverse events (AEs) and serious adverse events (SAEs) as a measure of safety and tolerabilityUp to 18 months
Absolute height velocity (annualized to cm/year), expressed numerically and as Z-score in relation to ACH and non-ACH tablesUp to 18 months
Absolute and change from baseline in weight (kg)Up to 18 months
Absolute and change from baseline in sitting height (cm)Up to 18 months
Absolute and change from baseline in head circumference (cm)Up to 18 months
Absolute and change from baseline in upper and lower arm length (cm)Up to 18 months
Absolute and change from baseline in thigh length (cm)Up to 18 months
Absolute and change from baseline in knee height (cm)Up to 18 months
Absolute and change from baseline in arm span (cm)Up to 18 months
Pharmacokinetic profile of infigratinib by assessment of maximum concentration (Cmax)Up to 18 months
Pharmacokinetic profile of infigratinib by assessment of time-to-maximum concentration (Tmax)Up to 18 months
Changes in pharmacodynamic parameters by assessing collagen X markerUp to 18 months

Trial Locations

Locations (19)

Johns Hopkins School of Medicine

🇺🇸

Baltimore, Maryland, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

UCSF Benioff Children's Hospital

🇺🇸

Oakland, California, United States

Nemours Alfred I. Dupont Hospital for Children

🇺🇸

Wilmington, Delaware, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Stollery Children's Hospital

🇨🇦

Edmonton, Alberta, Canada

Hopital Femme Mere Enfant

🇫🇷

Lyon, France

Murdoch Children's Hospital

🇦🇺

Parkville, Victoria, Australia

Hopital des Enfants

🇫🇷

Toulouse, France

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hopital Necker-Enfants Malades

🇫🇷

Paris, France

Hospital Universitario Virgen de la Victoria

🇪🇸

Málaga, Spain

Vithas Hospital San José

🇪🇸

Vitoria-Gasteiz, Álava, Spain

Sheffield Children's Hospital

🇬🇧

Sheffield, England, United Kingdom

Birmingham Children's Hospital

🇬🇧

Birmingham, United Kingdom

Manchester University Children's Hospital

🇬🇧

Manchester, United Kingdom

Evelina London Children's Hospital

🇬🇧

London, United Kingdom

University Hospitals Bristol and Weston NHS Foundation Trust

🇬🇧

Bristol, United Kingdom

Queen Elizabeth University Hospital

🇬🇧

Glasgow, United Kingdom

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