An Open-Label, Phase 1, Dose Escalation and Dose Expansion Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Antitumor Activities of CMG901 in Subjects With Advanced Unresectable or Metastatic Solid Tumor
Overview
- Phase
- Phase 1
- Intervention
- CMG901
- Conditions
- Not specified
- Sponsor
- Keymed Biosciences Co.Ltd
- Enrollment
- 176
- Locations
- 32
- Primary Endpoint
- Part A: Incidence of adverse events.Abnormal laboratory parameters, vital signs, 12-lead electrocardiogram and physical examination. Occurrence of Dose-limiting toxicity
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
This is a multi-center, open-label, dose escalation and dose expansion, Phase 1 study to evaluate the safety, tolerability, PK and preliminary anti-tumor activity of CMG901.
The dose escalation phase (Part A) will determine the MTD of CMG901 in subjects with relapsed and/or refractory advanced solid tumor for which there is no available standard therapy likely to confer clinical benefit, or the subject is not a candidate for such available therapy based on a modified 3+3 dose escalation design (an accelerated dose titration design followed by traditional 3+3 dose escalation design).
The dose expansion phase (Part B) will be conducted in subjects with advanced solid cancer with failure of standard treatment or no standard treatment who are Claudin 18.2 positive to preliminarily explore the efficacy and to determine the RP2D of CMG901.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Subjects with histologically or cytologically confirmed advanced solid tumors, who have failed to respond to standard of care (progression after treatment or intolerance) or who have no available standard of care regimen.
- •Part A: Must provide archival tumor tissue specimen or agree to undergo a fresh biopsy if archival specimen is unavailable for retrospective Claudin 18.2 testing prior to enrollment;Subjects enrolled in Part A are not required to be positive for Claudin 18.
- •Part A: Measurable or evaluable lesions per RECIST v 1.1.Part B: At least one measurable lesion per RECIST v1.
- •Part B: Subjects shall provide fresh or archival tumor tissue samples before enrollment for assessment of Claudin 18.2 expression level (central laboratory) and should be positive for Claudin 18.2 as determined by the central laboratory. If the subject can provide positive Claudin 18.2 expression results which had been reported by the same central laboratory using the same method, there is no need for another test.
- •Women of childbearing potential and male subjects must agree to remain abstinent or use contraceptive methods as defined by the protocol.
- •Eastern Cooperative Oncology Group Performance Status 0-
- •Side effects of any prior therapy or procedures for any medical condition has recovered to NCI-CTCAE v.5.0 Grade ≤ 1 or stable status by investigator.
Exclusion Criteria
- •Received: chemotherapy or any investigational anti-tumor agents within 28 days of the start of CMG901 treatment; molecularly-targeted agents, immunoconjugate, or antibody drug conjugate within 28 days or or 5 half-lives (whichever is shorter) of the start of CMG901 treatment; major surgery within 28 days of the start of CMG901 treatment; radiotherapy within 21 days of the start of CMG901 treatment; potent cytochrome P450 3A4 (CYP3A4) inhibitors within 14 days or or 5 half-lives (whichever is longer) of the start of CMG901 treatment.
- •Diagnosis of immunodeficiency or requiring another form of chronic immunosuppressive therapy. Or is receiving chronic systemic steroid therapy (in doses exceeding 10 mg daily of prednisone or equivalent) within 7 days prior to the first dose.
- •History of severe hypersensitivity to any component or excipient of CMG
- •Ongoing or active infection or interstitial pneumonia assessed by investigator.
- •Any severe cardiac dysfunction including left ventricular ejection fraction \<50%, congestive heart failure ≥Grade 2 (New York Heart Association), QTc \>480 msec, major cardiovascular and cerebrovascular diseases (e.g., congestive cardiac failure, acute myocardial infarction, unstable angina, stroke, transient ischemic attack, deep vein thrombosis or pulmonary embolism) within 6 months prior to the first dose of study drug.
- •Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
- •Subjects with uncontrolled ascites, pleural effusion, or pericardial effusion by investigator.
- •Preexisting sensory and/or motor neuropathy Grade ≥
- •Uncontrolled diabetes mellitus or diabetic neuropathy within 3 months of the first dose of CMG
- •Subjects with active hepatitis B or C, i.e., positive for anti-HCV antibody and positive for HCV RNA, or positive for HBsAg with detectable positive for HBV DNA (i.e., ≥ 2000 IU/mL).
Arms & Interventions
Part A, Dose escalation
CMG901 will be administered in treatment cycles once every 3 weeks (Q3W). Dose escalation will be carried out according to a modified 3+3 dose-escalation design. Accelerated dose titration design will be used for the first 2 dose levels (0.3mg/kg and 0.6mg/kg), and then traditional 3+3 dose escalation design will be used for the following levels (1.2mg/kg, 1.8mg/kg, 2.2mg/kg, 2.6mg/kg and 3.0mg/kg).
Intervention: CMG901
Part B, Dose expansion,2.2mg/kg
This cohort will comprise subjects with Claudin 18.2 positive gastric cancer (including gastroesophageal junction adenocarcinoma), pancreatic cancer, and other solid cancer with prior failure of, progression on, or intolerance to, standard therapy.
Intervention: CMG901
art B, Dose expansion,3.0mg/kg
This cohort will comprise subjects with Claudin 18.2 positive gastric cancer (including gastroesophageal junction adenocarcinoma), pancreatic cancer, and other solid cancer with prior failure of, progression on, or intolerance to, standard therapy.
Intervention: CMG901
Part B, Dose expansion,3.0mg/kg
This cohort will comprise subjects with Claudin 18.2 positive gastric cancer (including gastroesophageal junction adenocarcinoma), pancreatic cancer, and other solid cancer with prior failure of, progression on, or intolerance to, standard therapy.
Intervention: CMG901
Outcomes
Primary Outcomes
Part A: Incidence of adverse events.Abnormal laboratory parameters, vital signs, 12-lead electrocardiogram and physical examination. Occurrence of Dose-limiting toxicity
Time Frame: Up to 30 days post the last dose, initiation of new anti-tumor therapy, withdrawal from the study, or death, whichever occurs first. DLTs are up to 21 days after the first dose
Part A: To determine the maximum tolerated dose (MTD) of CMG901
Time Frame: Up to 21 days after the first dose
Part B: To preliminarily evaluate the Objective Response Rate (ORR) per RECIST v1.1 of CMG901 in subjects with Claudin 18.2-positive advanced solid cancer
Time Frame: Up to 24 months
Part B: Recommended phase II dose
Time Frame: Up to 24 months
Secondary Outcomes
- Part A & Part B: Area Under the Curve over a dosing interval [AUC(0-tau)](up to 24 months)
- Part A & Part B: Minimum concentration (Cmin)(up to 24 months)
- Part A & Part B: Accumulation ratios of peak plasma concentration (Cmax) for multiple doses(up to 24 months)
- Part A & Part B: Area Under the Curve from 0 to the time of the last measurable concentration [AUC(0-last)](up to 24 months)
- Part A & Part B: Area Under the Curve from 0 to infinity [AUC(0-inf)](21 days after the first dose)
- Part A & Part B: Duration of Response (DoR) per RECIST v1.1(up to 24 months)
- Part A & Part B: Peak Plasma Concentration (Cmax)(up to 24 months)
- Part A & Part B: Terminal elimination half-life (t1/2)(up to 24 months)
- Part A & Part B: Volume of distribution (Vz)(up to 24 months)
- Part A & Part B: Observed concentration at the end of a dosing interval(Ctrough)(21 days after the first dose)
- Time of maximum observed concentration (Tmax)(up to 24 months)
- Part A&B:To evaluate the correlation between clinical efficacy of CMG901 and Claudin 18.2 expression(up to 24 months)
- Part A & Part B: Time of Maximum Observed Concentration (Tmax)(21 days after the first dose)
- Part A & Part B: Volume of distribution at steady-state (Vss)(up to 24 months)
- Part A & Part B: Observed concentration at the end of a dosing interval (Ctrough)(up to 24 months)
- Part A & Part B: Clearance (CL)(up to 24 months)
- Part A & Part B: Accumulation ratios of area under the curve over a dosing interval [AUC(0-tau)] for multiple doses(up to 24 months)
- Part A & Part B: Incidence of anti-CMG901(up to 24 months)
- Part A & Part B: Progression Free Survival (PFS) per RECIST v1.1(up to 24 months)
- Part A & Part B: Disease Control Rate (DCR) per RECIST v1.1(up to 24 months)
- Part A & Part B: Overall Survival (OS)(up to 24 months)
- Part A: Objective Response Rate (ORR) per RECIST v1.1(up to 24 months)
- Part B: Incidence of adverse events graded using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0. Abnormal laboratory parameters, vital signs, 12-lead electrocardiogram and physical examination(Up to 30 days post the last dose, initiation of new anti-tumor therapy, withdrawal from the study, or death, whichever occurs first)