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An Open-label Phase I Study of Orally Available Novel Small-molecule Fibroblast Growth Factor Receptors (FGFR) 1,2,3 and 4 Inhibitor, ASP5878 at Single and Multiple Doses in Patients With Solid Tumors

Phase 1
Completed
Conditions
Solid Tumors
Interventions
Registration Number
NCT02038673
Lead Sponsor
Astellas Pharma Inc
Brief Summary

The objectives of this study are to determine the tolerability, safety, pharmacokinetics (PK), pharmacodynamics (PD), and efficacy of oral ASP5878 in participants with solid tumors.

Detailed Description

This study consists of two parts. In the dose-escalation part, ASP5878 (orally available novel small-molecule FGFR 1,2,3 and 4 inhibitor, multiple dosing once-a-day (q.d.), multiple dosing twice-a-day (b.i.d.) or 5-day on/2-day off dosing twice-a-day (5on-2off)) is administered to participants with solid tumors in an increasing dose manner, and the tolerability, safety, pharmacokinetics (PK), pharmacodynamics (PD) and efficacy of ASP5878 are evaluated in these participants. Cycle 0 consists of 3 days and Cycle 1 and subsequent cycles consist of 28 days each in the dose-escalation part. In the expansion part, 16mg twice-a-day 5-day on/2-day off dose of ASP5878 (5on-2off) is administered to participants with solid tumors and safety, PK, PD and efficacy of ASP5878 are evaluated. The expansion part starts from Cycle 1 and each cycle consists of 28 days.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
86
Inclusion Criteria
  • Histologically or cytologically confirmed solid tumor.

  • Participant must meet at least one of the following criteria in the judgment of the investigator or sub-investigator:

    • Disease progression despite standard therapies
    • Progressive disease without any standard therapies established
    • Standard therapies are considered intolerable
  • Eastern Cooperative Oncology Group performance status 0 or 1.

  • Predicted life expectancy ≥ 12 weeks in the judgment of the investigator or sub-investigator.

Exclusion Criteria
  • Participant with ≥ Grade 2 (CTCAE v 4.0-JCOG) persistent symptoms and objective findings due to the toxicity attributable to prior treatment with antitumor effect (except alopecia).
  • Participant who received a prior treatment intended for antitumor effect (medication, surgery, radiotherapy, etc.) within 4 weeks prior to the planned first day of study drug dosing (or participant who received mitomycin C or Nitrosourea within 6 weeks prior to the planned first day of study drug dosing).
  • A major surgical procedure within 4 weeks prior to the planned first day of study drug dosing or a surgical procedure is planned during the course of the study.
  • Participant who were treated with other investigational drug or medical device within 4 weeks prior to the planned first day of study drug dosing.
  • Participant who has a history of organ transplantation.
  • Participant with a brain metastasis with symptoms or requiring treatment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Dose escalation part 0.5 mg QDASP5878Oral
Dose escalation part 6.0 mg BIDASP5878Oral
Dose escalation part 2.0 mg BIDASP5878Oral
Dose escalation part 20.0 mg BIDASP5878Oral
Expansion part Urothelial CarcinomaASP5878Oral
Dose escalation part 1.0 mg QDASP5878Oral
Dose escalation part 10.0 mg BIDASP5878Oral
Expansion part Hepatocellular CarcinomaASP5878Oral
Expansion part Squamous Cell Lung CarcinomaASP5878Oral
Dose escalation part 2.0 mg QDASP5878Oral
Dose escalation part 4.0 mg BIDASP5878Oral
Dose escalation part 16.0 mg BIDASP5878Oral
Primary Outcome Measures
NameTimeMethod
Dose-escalation part and Expansion part:Safety assessed by Body weightUp to 18 months

Until one of the discontinuation criteria is met.

Dose-escalation part and Expansion part: Computed tomography (CT) Imaging assessmentUp to 18 months

Until one of the discontinuation criteria is met.

Dose-escalation part and Expansion part:Safety assessed by Vital signsUp to 18 months

Blood pressure, pulse rate and body temperature, Until one of the discontinuation criteria is met.

Dose-escalation part and Expansion part: OphthalmologyUp to 18 months

Eyesight, funduscopy, slit lamp microscopy, and Optical Coherence Tomography, until one of the discontinuation criteria is met.

Dose-escalation part and Expansion part:Safety assessed by Laboratory testsUp to 18 months

Hematology, blood biochemistry, blood coagulation tests and urinalysis, until one of the discontinuation criteria is met.

Expansion part only: EchocardiogramUp to 18 months

Until one of the discontinuation criteria is met.

Dose-escalation part and Expansion part:Safety assessed by 12-lead ECGsUp to 18 months

ECG: Electrocardiogram, until one of the discontinuation criteria is met.

Dose-escalation part and Expansion part: Safety assessed by Adverse Events (AEs)Up to 18 months

Until one of the discontinuation criteria is met.

Dose-escalation part and Expansion part: Bone density measurementUp to 18 months

Until one of the discontinuation criteria is met.

Secondary Outcome Measures
NameTimeMethod
Dose-escalation part:PK parameter of ASP5878 in plasma: tmaxDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

tmax: Time of Cmax

Dose-escalation part:PK parameter of ASP5878 in plasma: AUClastDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

AUClast: Area under the concentration-time curve from the time of dosing extrapolated to the last measurable concentration

Dose-escalation part: PD parameter: Serum inorganic phosphorus concentrationsDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1
Expansion part: PK parameter of ASP5878 in plasma: AUCinfDay 1 and 5 at Cycle 1
Expansion part: PK parameter of ASP5878 in plasma: Vz/FDay 1 and 5 at Cycle 1
Expansion part: PD parameter: Serum FGF23 concentrationsUp to 18 months

Until one of the discontinuation criteria is met.

Expansion part: PD parameter: Serum iPTH concentrationsUp to 18 months

Until one of the discontinuation criteria is met.

Expansion part: PD parameter: Serum calcitriol concentrationsUp to 18 months

Until one of the discontinuation criteria is met.

Dose-escalation part: Pharmacokinetics (PK) parameter of ASP5878 in plasma: CmaxDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

Cmax: Maximum concentration, Cycle 0: single dose, Cycle 1: multiple dose after Cycle 0

Dose-escalation part: PK parameter of ASP5878 in plasma: AUCinfDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

AUCinf: Area under the concentration-time curve from the time of dosing extrapolated to time infinity

Dose-escalation part: PK parameter of ASP5878 in plasma: t1/2Day 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

t1/2: Terminal elimination half-life

Dose-escalation part: PK parameter of ASP5878 in urine: AeDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

Ae: Amount of ASP5878 excreted into the urine

Dose-escalation part: PD parameter: Serum calcium concentrationsDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1
Dose-escalation part: PD parameter: Serum calcitriol concentrationsDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1
Expansion part: Progression free survival (PFS)Up to 18 months

Time from the start of the study treatment until death from any cause or Progressive Disease assessed according to RECIST 1.1.

Dose-escalation part: PK parameter of ASP5878 in plasma: CL/FDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

CL/F: Apparent total systemic clearance

Dose-escalation part: PK parameter of ASP5878 in plasma: Vz/FDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

Vz/F: Apparent volume of distribution during the terminal elimination phase

Expansion part: PK parameter of ASP5878 in plasma: CmaxDay 1 and 5 at Cycle 1
Expansion part: PK parameter of ASP5878 in plasma: AUClastDay 1 and 5 at Cycle 1
Expansion part: PK parameter of ASP5878 in plasma: t1/2Day 1 and 5 at Cycle 1
Expansion part: PK parameter of ASP5878 in plasma: CL/FDay 1 and 5 at Cycle 1
Expansion part: PD parameter: Serum 7α-hydroxy-4-cholesten-3-oneUp to 18 months

Until one of the discontinuation criteria is met

Expansion part: Overall responseUp to 18 months

Antitumor activity evaluated based on RECIST version 1.1, until one of the discontinuation criteria is met. Antitumor response is rated on a 4-level scale shown below (complete response \[CR\], partial response \[PR\], progressive disease \[PD\] and stable disease \[SD\]).

Expansion part: Maximum Shrinkage in Target LesionUp to 18 months

Best percent change from baseline in the sum of diameters of all target lesions.

Expansion part: Overall survival (OS)Up to 18 months

Time from randomization to death from any cause.

Dose-escalation part: PK parameter of ASP5878 in urine: CLRDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

CLR: Renal clearance

Expansion part: PD parameter: Serum FGF19 concentrationsUp to 18 months

Until one of the discontinuation criteria is met.

Expansion part: Time to progression (TTP)Up to 18 months

Time from the start of the study treatment until Progressive Disease assessed according to RECIST 1.1.

Dose-escalation part: Pharmacodynamic (PD) parameter: Serum FGF23 concentrationsDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

FGF: Fibroblast Growth Factor

Dose-escalation part: PD parameter: Serum iPTH concentrationsDay 1 at Cycle 0 and Day 5 (5on-2off) or 27 (q.d./b.i.d.) at Cycle 1

iPTH: Intact Parathyroid Hormone

Expansion part: PK parameter of ASP5878 in plasma: tmaxDay 1 and 5 at Cycle 1
Expansion part: PD parameter: Serum inorganic phosphorus concentrationsUp to 18 months

Until one of the discontinuation criteria is met.

Expansion part: Time to treatment failure (TTF)Up to 18 months

Time from the start of the study drug treatment until discontinuation of study drug treatment for any reason.

Trial Locations

Locations (35)

Site US404

🇺🇸

Cleveland, Ohio, United States

Site US406

🇺🇸

Spartanburg, South Carolina, United States

Site US410

🇺🇸

Fairfax, Virginia, United States

Site JP108

🇯🇵

Fukuoka, Japan

Site JP122

🇯🇵

Chiba, Japan

Site US402

🇺🇸

Orange, California, United States

Site US401

🇺🇸

New York, New York, United States

Site US403

🇺🇸

Seattle, Washington, United States

Site JP115

🇯🇵

Fukuoka, Japan

Site JP120

🇯🇵

Fukuoka, Japan

Site JP116

🇯🇵

Hokkaido, Japan

Site JP113

🇯🇵

Hyogo, Japan

Site JP111

🇯🇵

Ishikawa, Japan

Site JP103

🇯🇵

Ibaraki, Japan

Site JP119

🇯🇵

Kanagawa, Japan

Site JP101

🇯🇵

Kyoto, Japan

Site JP112

🇯🇵

Nagoya, Japan

Site JP109

🇯🇵

Miyagi, Japan

Site JP110

🇯🇵

Miyagi, Japan

Site JP121

🇯🇵

Okayama, Japan

Site JP104

🇯🇵

Osaka, Japan

Site JP106

🇯🇵

Osaka, Japan

Site JP117

🇯🇵

Niigata, Japan

Site JP118

🇯🇵

Osaka, Japan

Site JP102

🇯🇵

Tokyo, Japan

Site JP124

🇯🇵

Shizuoka, Japan

Site KR203

🇰🇷

Seoul, Korea, Republic of

Site JP123

🇯🇵

Tokyo, Japan

Site KR202

🇰🇷

Gyeonggi-do, Korea, Republic of

Site KR201

🇰🇷

Seoul, Korea, Republic of

Site KR204

🇰🇷

Seoul, Korea, Republic of

Site TW302

🇨🇳

Tainan, Taiwan

Site TW303

🇨🇳

Taipei, Taiwan

Site TW301

🇨🇳

Taipei, Taiwan

Site JP107

🇯🇵

Tokyo, Japan

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