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临床试验/NCT05283226
NCT05283226招募中2 期

A Phase 2 Multicenter, Open-Label, Single-Arm Study to Evaluate the Safety and Efficacy of Oral NRC-2694-A in Combination With Paclitaxel in Patients With Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma, Who Progressed on or After Immune Checkpoint Inhibitor Therapy

NATCO Pharma Ltd.13 个研究点 分布在 2 个国家目标入组 21 人开始时间: 2022年9月30日最近更新:
干预措施

试验速览

阶段
2 期
状态
招募中
入组人数
21
试验地点
13
主要终点
To determine if NRC-2694-A administered orally in combination with paclitaxel demonstrates objective response in patients with R/M HNSCC, who have had radiological progression on or after treatment with ICI therapies like pembrolizumab or nivolumab

研究概览

简要总结

This is a Phase 2, open-label, multicenter, single-arm study of NRC-2694-A in combination with paclitaxel in patients with R/M HNSCC with progression on or after ICI therapy.

A total of approximately 46 male and female patients will be enrolled. This sample size is based on Simon's 2-stage design with historical control ORR of 30% and a target ORR of 50%.

详细描述

Patients with recurrent and/or metastatic unresectable Head and Neck Cancer have a poor prognosis and limited treatment options. Pembrolizumab and Nivolumab, both ICIs (Immune Checkpoint Inhibitors), are approved therapies for this condition. However, no approved treatment options exist for patients who progress on ICI therapies. Hence, there is an unmet medical need post-failure of ICI therapy. NRC-2694-A is an orally administered small-molecule tyrosine kinase inhibitor. It was discovered and developed by NATCO Pharma Ltd. NRC-2694-A demonstrated response in HNSCC patients in a Phase-I study as a monotherapy. This was further substantiated in a Phase-II study in combination with cisplatin/carboplatin and paclitaxel.

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
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Is willing and capable of understanding the written informed consent, provides signed and witnessed written informed consent, and agrees to comply with protocol requirements.
  • Is male or female aged 18 years or older at the time of consent.
  • Has histologically confirmed unresectable R/M HNSCC (oral cavity, oropharynx, hypopharynx, and larynx).
  • Has documented progressive disease assessed by the principal investigator according to RECIST v1.
  • Has a measurable lesion per RECIST v1.
  • Has ECOG performance status score of ≤
  • Must have progressed during or after receiving ICI therapy, such as pembrolizumab or nivolumab. Patients with prior immune-mediated reactions due to ICI therapies (eg, pembrolizumab or nivolumab) and who had recovered prior to study entry will also be eligible.
  • Female patients of childbearing potential should have a negative urine test before enrollment. If the urine pregnancy test is positive or gives equivocal results, a serum pregnancy will be required for confirmation.
  • Patients of reproductive age must use acceptable methods of contraception throughout the study period and for 30 days following the last dose of investigational product (see protocol for further guidance).
  • During screening and at subsequent visits, the investigator should ensure adequate bone marrow reserve (neutrophil count ≥1500/mm3, platelet count ≥100,000/mm3, and hemoglobin level 8.0 g/dL), renal function (creatinine clearance ≥30 mL/min calculated by Cockcroft-Gault formula), liver function (total bilirubin level ≤1.5 × ULN [except patients with documented Gilbert's syndrome] and serum transaminase levels ≤2.5 × ULN or ≤5 × ULN for liver metastasis and/or obstructive jaundice).
  • Must have completed a duration of at least two weeks after stopping ICI therapy/investigational therapy/salvage therapy and must have recovered to grade ≤1 from all toxicities due to such therapies.

排除标准

  • Has cardiac, hepatic, endocrine, pulmonary, or autoimmune disease, interstitial lung disease, renal or psychiatric disorders, not controlled with therapy corresponding to the illness or a condition that contraindicates the use of a taxane or an EGFR inhibitor.
  • Has Cirrhosis of liver at a level of Child-Pugh B (or worse).
  • Has uncontrolled brain metastases. Patients are allowed if brain metastasis has been previously treated with surgery, whole brain irradiation, and/or stereotactic radiosurgery and are considered controlled (controlled by the dose ≤10 mg/day of prednisone or equivalent) at the time of the first dose of investigational product. Radiological evaluation of brain metastasis will be performed only if the patient has symptoms. For asymptomatic patients, brain imaging during screening is not required.
  • Has baseline prolongation of QT/QTc interval (eg, repeated demonstration of a QTc interval >480 milliseconds [CTCAE Grade 1] using Fredericia's QT correction formula).
  • Has a history of additional risk factors for Torsade de pointes (eg, heart failure, hypokalemia, family history of long QT syndrome).
  • Has had prior cetuximab therapy for recurrent or metastatic disease. Note that cetuximab used concomitantly with radiotherapy or as an induction therapy is acceptable
  • Has received any other EGFR-targeted therapies for recurrent or metastatic disease.
  • Currently participating in any clinical trial or receiving investigational therapy on expanded access or compassionate basis.
  • Has nasopharyngeal carcinomas or salivary gland cancers.
  • Female patient who tested positive for pregnancy.
  • Female patient who is breastfeeding or planning to become pregnant, or male patient planning to father a child within the duration of the study.
  • Has tested positive for HIV, HBsAg, HCV antibody, or HCV RNA at screening. However, patients who test positive for HCV antibody, but negative for HCV RNA, will be allowed. In addition, patients with controlled HIV, chronic HBV on suppressive antiviral therapy, or a history of HCV infection status post-curative antiviral treatment with an HCV viral load below limit of quantification are permitted to participate (DHHS 2020).
  • Has active infection requiring intravenous anti-infective therapy within 7 days prior to Day 1 Cycle 1 or is febrile due to infection.
  • Has had major surgery within 4 weeks prior to screening.
  • Administered a live attenuated vaccine within 4 weeks prior to Day 1 Cycle 1 or anticipation that such a live attenuated vaccine will be required during the study.
  • Has known or suspected hypersensitivity to any components of the formulation used for this investigational product.
  • Has concurrent disease or any clinically significant abnormality following the investigator's review of the screening physical examination findings, 12-lead ECG results, and clinical laboratory tests, which in the judgment of the investigator would interfere with the patient's participation in this study or evaluation of study results.
  • Unable to come for study visits per schedule.
  • Has current drug or alcohol abuse.
  • Has received prior treatment with paclitaxel or docetaxel or any other drugs with taxane like mode of action for recurrent or metastatic or recurrent HNSCC. However, prior paclitaxel or docetaxel or any other drugs with taxane like mode of action as a component of a curatively-intended multimodality treatment for locally advanced HNSCC is permitted.

研究组 & 干预措施

NRC-2694-A In Combination with paclitaxel

Experimental

Patients will receive NRC-2694-A 300 mg orally once daily and paclitaxel 175 mg/m² IV infusion over approximately 3 hours once in 21 days for 6 cycles or more.

干预措施: NRC-2694-A (Drug)

NRC-2694-A In Combination with paclitaxel

Experimental

Patients will receive NRC-2694-A 300 mg orally once daily and paclitaxel 175 mg/m² IV infusion over approximately 3 hours once in 21 days for 6 cycles or more.

干预措施: Paclitaxel (Drug)

结局指标

主要结局

To determine if NRC-2694-A administered orally in combination with paclitaxel demonstrates objective response in patients with R/M HNSCC, who have had radiological progression on or after treatment with ICI therapies like pembrolizumab or nivolumab

时间窗: Baseline through approximately up to 24 weeks

Objective response in terms of CR/PR per RECIST v1.1

次要结局

  • Progression-free survival(Baseline through approximately up to 24 weeks)
  • Number of participants with abnormal clinical laboratory tests results(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via Cmax (Maximum plasma concentration)(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via Ctrough (observed trough plasma concentration at the dosing interval tau)(Baseline through approximately up to 24 weeks)
  • Overall survival(Baseline through approximately up to 24 weeks)
  • Duration of response(Baseline through approximately up to 24 weeks)
  • Clinical benefit response(Baseline through approximately up to 26 weeks)
  • Number of participants with abnormal physical examination findings(Baseline through approximately up to 24 weeks)
  • Number of participants with abnormal vital signs(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via AUC0-τ (area under the concentration-time curve from time zero to the dosing interval tau)(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via CL/F (apparent clearance)(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via Vz/F (apparent volume of distribution)(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via Rac Cmax (accumulation ratio based on maximum plasma concentration)(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via Rac AUC (accumulation ratio based on area under the concentration-time curve)(Baseline through approximately up to 24 weeks)
  • Number of adverse events(Baseline through approximately up to 24 weeks)
  • Assessing safety through ECOG (Eastern Cooperative Oncology Group)(Baseline through approximately up to 24 weeks)
  • Number of participants with abnormal ECGs (Electrocardiograms)(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via Tmax (time to reach the maximum plasma concentration)(Baseline through approximately up to 24 weeks)
  • Plasma PK parameters of NRC-2694-A measured via AUC0-t (area under the concentration-time curve from time zero to the time of last measurable concentration)(Baseline through approximately up to 24 weeks)

研究者

申办方类型
Industry
责任方
Sponsor

研究点 (13)

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