An Open-label, Multicenter Phase IIa Study to Evaluate the Efficacy and Safety of Injectable ALK-N001 in Patients With Advanced Gastrointestinal Tumors
试验速览
- 阶段
- 2 期
- 状态
- 尚未招募
- 发起方
- 入组人数
- 174
- 主要终点
- Objective Response Rate (ORR), assessed per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
研究概览
简要总结
This open-label, multicenter Phase IIa study is to evaluate the efficacy and safety of injectable ALK-N001 in patients with advanced gastrointestinal tumors, with the primary objective to assess its preliminary efficacy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Voluntarily sign informed consent, understand the study and be willing and able to comply with all study procedures.
- •Age ≥18 years (male or female) at the time of signing informed consent.
- •Histologically or cytologically confirmed locally advanced or metastatic esophageal squamous cell carcinoma, colorectal adenocarcinoma, or other gastrointestinal tumors.
- •Disease progression or intolerance after prior standard-of-care (SoC) treatment:
- •Cohort1 (ESCC): Not eligible for curative surgery/radiochemotherapy; progressed or intolerant after at least 1st-line platinum-based chemotherapy plus PD-(L)1 inhibitor. If immunotherapy is declined/ineligible, progressed after ≥2 lines of systemic therapy.
- •Cohort2 (CRC): Received standard systemic therapy for metastatic colorectal cancer and experienced progression or intolerance. Must have received fluoropyrimidine, oxaliplatin and irinotecan-based chemotherapy (±bevacizumab/cetuximab), unless contraindicated. For MSI-H/dMMR tumors, prior PD-(L)1 inhibitor is required.
- •Cohort3 (Other GI tumors): Not curable by surgery; disease progression/intolerance after standard-of-care therapy, or no available effective treatment.
- •At least one measurable lesion per RECIST V1.1 (lesions in prior radiation field generally not measurable unless clear progression).
- •ECOG performance status 0 or
- •Expected survival ≥3 months.
- •Adequate organ function:
- •Bone marrow (no transfusion/growth factors within prior 14 days): ANC ≥1.5×10⁹/L; PLT ≥90×10⁹/L; Hb ≥90 g/L
- •Liver: TBIL ≤1.5×ULN; ALT ≤3×ULN (≤5×ULN for liver metastasis); AST ≤3×ULN (≤5×ULN for liver metastasis); ALB ≥35 g/L
- •Renal: Cr ≤1.5×ULN; if Cr>1.5×ULN, CrCl ≥50 mL/min (Cockcroft-Gault formula)
- •Coagulation: APTT ≤1.5×ULN; INR ≤1.5×ULN
- •Women of childbearing potential must have negative pregnancy test at screening and agree to effective contraception or abstinence from consent until 6 months after last dose. Male participants must use effective contraception or abstinence from consent until 6 months after last dose; no sperm donation.
排除标准
- •1. Received chemotherapy, radiotherapy (palliative local radiotherapy within prior 2 weeks), biotherapy, targeted therapy, immunotherapy, TIL or other anti-tumor therapies within 4 weeks before first dose.
- •Anti-endocrine therapy within 2 weeks or 5 half-lives; oral CDK4/6i, small molecule targeted agents, anti-tumor Chinese medicine.
- •CAR-T, CAR-NK or tumor vaccine within prior 3 months.
- •Live vaccine within 2 weeks; non-live vaccine within 4 weeks before first dose.
- •Investigational drug within 4 weeks or 5 half-lives before first dose (whichever shorter).
- •2. Use of strong CYP3A4 inducer/inhibitor within 7 days before first dose or planned during study.
- •3. Prior treatment with DXD-containing ADC or PDC.
- •Active infection at screening requiring systemic anti-infective therapy within 2 weeks prior to first dose.
- •5. Known BRAF mutation or NTRK fusion positive colorectal cancer (Cohort2).
- •Unstable or progressive CNS/leptomeningeal metastases (stable brain metastases ≥1 month, no new/enlarging lesions and off steroids ≥4 weeks may enroll).
- •7. Clinically uncontrolled third-space effusion requiring therapeutic paracentesis/drainage within prior 14 days.
- •8. Prior or current interstitial lung disease (ILD), non-infectious pneumonitis requiring steroids, suspected ILD or severely impaired pulmonary function.
- •9. Severe GI disease including chronic inflammatory bowel disease, bowel obstruction or chronic diarrhea.
- •10. Esophageal stent placement, tracheal stent or esophageal stricture (Cohort1).
- •11. Severe cardiovascular disease:
- •Clinically significant cardiac arrhythmias or 2nd/3rd degree AV block requiring intervention.
- •Acute coronary syndrome, heart failure, stroke or grade ≥3 cardiovascular event within 6 months.
- •NYHA Class ≥II heart failure (exception: stable NYHA II, LVEF≥50%, no exacerbation ≥6 months after optimized medical treatment, confirmed by cardiologist).
- •Uncontrolled hypertension: SBP≥150 mmHg and/or DBP≥100 mmHg.
- •History of GI perforation/fistula within 6 months before first dose, or tumor invading adjacent organs (great vessel/trachea) with high risk of bleeding/fistula.
- •13. History of severe thromboembolism within prior 6 months; known inherited/acquired thrombophilia.
- •14. Other malignancy within past 5 years (exception: cured cervical carcinoma in situ, cutaneous squamous cell carcinoma, basal cell carcinoma, papillary thyroid carcinoma).
- •15. Prior allogeneic hematopoietic stem cell or solid organ transplantation.
- •Prior anti-tumor adverse events not recovered to ≤ Grade1 (NCI-CTCAE v6.0, alopecia and investigator-assessed non-risk toxicities excluded) or not meeting eligibility lab criteria.
研究组 & 干预措施
Cohort 1 (ESCC), Dose A (37.5 mg/m²)
Participants with advanced esophageal squamous cell carcinoma (ESCC) receive injectable ALK-N001 at 37.5 mg/m² intravenously every 2 weeks (Q2W) per 28-day cycle. Enrollment and dose expansion may be adjusted by the Safety Review Committee (SRC) based on accumulated safety, PK, PD and preliminary anti-tumor data. Treatment continues until intolerable toxicity, progressive disease, or other discontinuation criteria.
干预措施: Injectable ALK-N001 (Drug)
Cohort 1 (ESCC), Dose B (50 mg/m²)
Participants with advanced esophageal squamous cell carcinoma (ESCC) receive injectable ALK-N001 at 50 mg/m² intravenously every 2 weeks (Q2W) per 28-day cycle. Enrollment and dose expansion may be adjusted by the Safety Review Committee (SRC) based on accumulated safety, PK, PD and preliminary anti-tumor data. Treatment continues until intolerable toxicity, progressive disease, or other discontinuation criteria.
干预措施: Injectable ALK-N001 (Drug)
Cohort 2 (CRC), Dose A (37.5 mg/m²)
Participants with advanced colorectal carcinoma (CRC) receive injectable ALK-N001 at 37.5 mg/m² intravenously every 2 weeks (Q2W) per 28-day cycle. Enrollment and dose expansion may be adjusted by the Safety Review Committee (SRC) based on accumulated safety, PK, PD and preliminary anti-tumor data. Treatment continues until intolerable toxicity, progressive disease, or other discontinuation criteria.
干预措施: Injectable ALK-N001 (Drug)
Cohort 2 (CRC), Dose B (50 mg/m²)
Participants with advanced colorectal carcinoma (CRC) receive injectable ALK-N001 at 50 mg/m² intravenously every 2 weeks (Q2W) per 28-day cycle. Enrollment and dose expansion may be adjusted by the Safety Review Committee (SRC) based on accumulated safety, PK, PD and preliminary anti-tumor data. Treatment continues until intolerable toxicity, progressive disease, or other discontinuation criteria.
干预措施: Injectable ALK-N001 (Drug)
Cohort 3 (Other GI Tumors), Dose A (37.5 mg/m²)
Participants with advanced other gastrointestinal tumors receive injectable ALK-N001 at 37.5 mg/m² intravenously every 2 weeks (Q2W) per 28-day cycle. Cohort 3 is exploratory and will be activated only if meaningful anti-tumor signals are observed in concurrent ALK-N001 trials. SRC may adjust enrollment based on safety, PK, PD and efficacy data. Treatment continues until intolerable toxicity, progressive disease, or other discontinuation criteria.
干预措施: Injectable ALK-N001 (Drug)
Cohort 3 (Other GI Tumors), Dose B (50 mg/m²)
Participants with advanced other gastrointestinal tumors receive injectable ALK-N001 at 50 mg/m² intravenously every 2 weeks (Q2W) per 28-day cycle. Cohort 3 is exploratory and will be activated only if meaningful anti-tumor signals are observed in concurrent ALK-N001 trials. SRC may adjust enrollment based on safety, PK, PD and efficacy data. Treatment continues until intolerable toxicity, progressive disease, or other discontinuation criteria.
干预措施: Injectable ALK-N001 (Drug)
结局指标
主要结局
Objective Response Rate (ORR), assessed per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
时间窗: Up to approximately 24 months from the first dose.
ORR is defined as the proportion of participants with confirmed complete response (CR) or partial response (PR) as evaluated by RECIST V1.1.
次要结局
- Duration of Response (DOR)(Up to approximately 24 months from the first dose.)
- Disease Control Rate (DCR)(Up to approximately 24 months from the first dose.)
- Progression-Free Survival (PFS)(Up to approximately 24 months from the first dose.)
- Overall Survival (OS)(Up to approximately 24 months from the first dose.)
- Safety (Adverse Events and Serious Adverse Events)(From informed consent until 28±7 days after last dose.)
- Population Pharmacokinetics (PopPK) of total DXD and free DXD(From first dose up to end of treatment.)
- Exposure-Response (E-R) relationship of total DXD and free DXD(From first dose up to approximately 24 months after first dose.)
