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A Phase Ib/IIa Clinical Study to Evaluate the Safety, Tolerability, Pharmacokinetic Profile, and Preliminary Efficacy of Intratumoral Injection of Carbon Nanoparticle-Loaded Iron Suspension Injection [CNSI-Fe(II)] With Multiple Administrations in Subjects With Advanced Solid Tumors

Status: Recruiting
Location: See all (9) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

Independently developed by Sichuan Yingrui Pharmaceutical Technology Co., Ltd., CNSI-Fe is an innovative anti-cancer drug with Fe2+ as the active ingredient, which exerts anti-tumor effects by regulating the ferroptosis pathway. CNSI-Fe intratumoral injection has the following three effects: 1. Nanocarbon can increase the content of hydrogen peroxide in tumor cells and tumor microenvironment, and is a reactive oxygen species that catalyzes hydrogen peroxide through the Fenton reaction of iron ions to produce ferroptosis, which complements each other; 2. The adsorption of Fe2+ by nanocarbon can help Fe2+ better enter the cell, thereby exerting anti-tumor effects; 3. The lesion localization and lymphatic tracing functions of nanocarbon are retained. The combination of the regulatory mechanism of ferroptosis and the characteristics of nanocarbon particles has increased the advantages of new nanopharmaceuticals in cancer prevention and treatment. At present, CNSI-Fe has carried out a first-in-human phase I clinical trial of dose escalation in subjects with advanced solid tumors in China, and has conducted safety and efficacy exploration in four dose groups, including: 30 mg, 60 mg, 90 mg, and 120 mg, and the overall safety and tolerability of the 16 subjects enrolled have been good, no obvious liver and kidney impairment and hematologic toxicity have been observed, and only one subject in the 90 mg dose group has a dose-limiting toxicity (DLT) event; Partial response (PR) was observed in 1 subject (30 mg group), complete tumor response (CR) was observed in 1 subject (60 mg group), and stable tumor (SD) was observed in 11 subjects (including 1 in the 30 mg group, 2 in the 60 mg group, 5 in the 90 mg group, and 3 in the 120 mg group), and the disease control rate (DCR) of the trial treatment was 87%. This Phase I clinical study is planned to continue dose exploration at 150 mg or higher. Therefore, based on the results of the Phase I clinical trial obtained, it is planned to conduct this Phase Ib/IIa clinical study in subjects with advanced solid tumors in China to further evaluate the safety, tolerability, pharmacokinetic (PK) characteristics and preliminary efficacy of CNSI-Fe intratumoral injection and multiple administration, so as to provide a basis for clinical development in the later stage.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 80
Healthy Volunteers: f
View:

‣ Patients must meet all of the following criteria to be eligible:

• Understand and voluntarily sign the written informed consent form (ICF), be willing and able to comply with all trial requirements;

• Male or female aged 18\

‣ 80 years old (including cut-off value) at the time of signing the ICF;

• Stage Ib: patients with advanced solid tumors confirmed by histology or cytology, and the current standard therapy is ineffective (disease progression after treatment or treatment is not tolerated) or there is no effective standard treatment, such as soft tissue sarcoma, refractory thyroid cancer, colorectal cancer, pancreatic cancer, breast cancer, gastric cancer, cervical cancer, lung cancer, head and neck cancer, liver cancer, bile duct cancer, kidney cancer, prostate cancer, vulvar cancer, etc.; Note: Subjects with advanced solid tumors whose disease progresses due to no standard therapy for any reason, or advanced solid tumors whose disease has progressed after receiving the first course of standard therapy for tumor types that are not sensitive to existing standard therapies (e.g., pancreatic cancer, undifferentiated thyroid cancer, sarcoma, etc.) can be included.

• At least one measurable lesion according to RESICT v1.1 and the lesion has not previously undergone radiotherapy (unless the lesion has clearly progressed after radiotherapy) and has not undergone a tissue biopsy within 7 days prior to screening;

• Have injectable lesions (such as direct injection or assisted injection by medical imaging instruments), which are judged by the investigator to be suitable for repeated intratumoral injection;

• The ECOG score within 7 days before the first dose is 0\

‣ 1 points;

• Expected survival ≥ 3 months;

• Adverse drug reactions (ADRs) caused by prior therapy have recovered to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0 criteria grade 1 and below before screening (alopecia, grade 2 or below peripheral neurotoxicity, etc., except for toxicities judged by the investigator to be of low safety risk);

• Left ventricular ejection fraction (LVEF) ≥50%;

⁃ Within 7 days prior to the first dose, adequate hematologic and end-organ function with laboratory tests meeting the following criteria:

⁃ haematology No treatment with granulocyte colony-stimulating factor (G-CSF) within 14 days prior to hematology laboratory tests, and absolute neutrophil count (ANC) ≥ 1.5×109/L; Have not been treated with platelet transfusion or interleukin-11 (IL-11) or recombinant human thrombopoietin injection before hematological laboratory examination, and the platelet count (PLT) ≥ 90×109/L; No blood transfusion or erythropoietin within 14 days prior to hematology laboratory tests, and hemoglobin (Hb) ≥ 90 g/L; Kidney function Serum creatinine (Cr) ≤ 1.5× upper limit of normal (ULN) or 50 mL/min (Cr only) calculated using the Cockcroft-Gault formula (Cr) 50 mL/min (Cr ≥\> only). 1.5 Calculate Ccr when ×ULN); Liver function TBIL ≤ 1.5× ULN (3.0 ≤× ULN for subjects with Gilbert's syndrome or liver metastases);

⁃ AST, ALT, and ALP≤3×ULN, and subjects with confirmed liver metastases or bone metastases must meet the following conditions:

⁃ Subjects with confirmed liver metastases: AST and ALT≤5×ULN; Subjects with confirmed bone metastases: ALP≤5×ULN; serum albumin≥ 2.8 g/dL; Coagulation function International normalized ratio (INR) or prothrombin time (PT) and aPTT ≤1.5×ULN; Note: Subjects receiving anticoagulant medication are allowed to prolong their INR, PT and aPTT if the injected lesion is in the skin and/or subcutaneous, because excessive bleeding can be controlled by applying direct pressure, at the discretion of the investigator; Subjects receiving anticoagulant therapy are advised to discontinue anticoagulant medication for at least 1 week before deep lesion injection, at the discretion of the investigator.

⁃ Female subjects of childbearing potential (WOCBP) who must have a negative serum pregnancy test result within 7 days prior to the first dose of study drug and a commitment to adequate and effective contraception or abstinence during treatment with study drug and for 6 months after the end of study drug treatment. In addition, female subjects must be non-lactating.

⁃ Note: WOCBP is defined as non-postmenopausal women who have experienced menarche but have not yet undergone sterilization surgery (hysterectomy or bilateral salpingectomy). Postmenopausal is defined as meeting any of the following conditions: (1) prior bilateral oophorectomy; (2) Age≥ 60 years old; (3) Age \< 60 years and have been out of menstruation for 12 months or more without chemotherapy and taking tamoxifen, toremifene and ovarian function suppression therapy; (4) If taking tamoxifen or toremiaphene and \< age 60 years, FSH and plasma estradiol levels must be in the postmenopausal range.

⁃ Hormone replacement therapy (HRT) may artificially suppress FSH levels in women and may require a washout period to return to physiological FSH levels. The duration of the washout period is one of the effects of the HRT type. The following washout period duration is recommended as a guideline, and the investigator should judge the results of the serum FSH level on his own.

⁃ vaginal hormonal preparations (drug rings, creams, gels) for at least 1 week; transdermal preparation for at least 4 weeks; Oral preparation for at least 8 weeks; Other parenteral preparations may require a washout period of up to 6 months. If the serum FSH level \> 40 mIU/mL during the washout period, a postmenopausal woman may be considered.

⁃ Male subjects commit to adequate and effective contraception or abstinence during study drug treatment and for 6 months after the end of study drug treatment. In addition, male subjects must agree not to donate sperm during this period.

Locations
Other Locations
China
Peking Union Medical College Hospital
NOT_YET_RECRUITING
Beijing
West China Hospital, Sichuan University
RECRUITING
Chengdu
The First Affiliated Hospital of Chongqing Medical University
RECRUITING
Chongqing
Fujian provincial cancer hospital
NOT_YET_RECRUITING
Fuzhou
Second Affiliated Hospital of Hainan Medical University
RECRUITING
Haikou
Harbin medical university cancer hospital
NOT_YET_RECRUITING
Heilongjiang
The First Affiliated Hospital of Zhengzhou University
RECRUITING
Henan
Hunan Provincial Tumor Hospital
NOT_YET_RECRUITING
Hunan
Fudan University Shanghai Cancer Center
NOT_YET_RECRUITING
Shanghai
Contact Information
Primary
Xiaohai Tang, PhD & MD
pharmmateceo@enraypharm.com
+86 13880881962
Backup
Yan Chen, Bachelor's
chenyan@enraypharm.com
+86 17308142669
Time Frame
Start Date: 2024-11-12
Estimated Completion Date: 2026-12-31
Participants
Target number of participants: 54
Treatments
Experimental: Carbon Nanoparticle-Loaded Iron
Sponsors
Leads: Sichuan Enray Pharmaceutical Sciences Company

This content was sourced from clinicaltrials.gov