An Open-label Phase 1/2 Dose Finding, Safety and Efficacy Study of Oral NEO212 in Patients with Astrocytoma IDH-mutant, Glioblastoma IDH-wildtype or Uncontrolled Brain Metastasis in Patients with Select Solid Tumors.

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

This multi-site, Phase 1/2 clinical trial is an open-label study to identify the safety, pharmacokinetics, and efficacy of a repeated dose regimen of NEO212 alone for the treatment of patients with radiographically-confirmed progression of Astrocytoma IDH- mutant, Glioblastoma IDH-wildtype, and the safety, pharmacokinetics and efficacy of a repeated dose regimen of NEO212 when given with select SOC for the treatment of solid tumor patients with radiographically confirmed uncontrolled metastases to the brain. The study will have three phases, Phase 1, Phase 2a and Phase 2b.

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

• Patient must be ≥ 18yrs of age.

• Patient must have the ability to understand, and the willingness to sign, a written informed consent form.

• Patient has been on a stable or decreasing dose of steroids for at least five days prior to the date of informed consent.

• Any toxicity from prior therapy must be resolved or at maximum Grade 1 prior to initiation of NEO212.

• If progression of disease occurs within 90 days or conformal radiation, the progression/recurrence must be outside of the radiation field or proven by biopsy/resection.

• Patient with Astrocytoma IDH-mutant, Glioblastoma IDH-wildtype must have a Karnofsky Performance Status (KPS) of ≥ 60.

• Patient with select solid tumors (see Appendix 2) must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.

• Patient must have an expected survival or at least three months.

• Patient must have a baseline MRI of the brain with gadolinium within 14 days of administration of NEO212.

• Patient with select solid tumors (see Appendix 2) must have a baseline CT scan with IV contrast and oral contrast of neck, chest, abdomen and pelvis within 14 days of administration of NEO212.

• Patients must be able to comply with all study assessments.

• If patient suffers from seizures (s)he must be controlled on a stable dose of anti-epileptics for 14-days prior to the date of informed consent.

• Patient must have adequate organ and marrow function as follows:

‣ Absolute neutrophil count ≥ 1,500/microliter

⁃ Platelets ≥ 100,000/microliter

⁃ Total bilirubin within normal institutional limits

⁃ AST (SGOT) / ALT (SPGT) ≤ 2.5 x institutional upper limit of normal

⁃ Creatinine clearance (CrCl) of \>60 mL/min (using the Cockcroft-Gault formula or 24- hour urine collection).

• Female patients of child-bearing potential and male patients must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for 30 days prior to the first dose of NEO212, for the duration of study participation, and for 90 days following completion of therapy.

∙ A female of child-bearing potential is any women (regardless of sexual orientation, not having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:

• Has not undergone a hysterectomy or bilateral oophorectomy; or

• Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has not had menses at any time in the preceding 12 consecutive months).

• A negative serum pregnancy test will be required of all female patients of child-bearing potential within seven days prior to the receipt of NEO212.

• A serum pregnancy test will be repeated immediately if pregnancy is suspected.

∙ Phase 1: (dose escalation)

• Patient must:

‣ have radiographically confirmed Astrocytoma IDH-mutant, Glioblastoma IDH-wildtype following previous radiation therapy or treatment with temozolomide and radiation, or

⁃ have select solid tumors (see Appendix 2) with uncontrolled metastases to the brain (confirmed by cranial CT or MRI) that is not controlled by surgery or radiation therapy and receiving one of the protocol approved SOC regimens.

• Patients receiving prior systemic therapy must have a minimum wash-out period (defined as the period prior to receipt of the first dose of NEO212) of:

‣ 28 days or 5 half-lives (whichever is shorter) elapsed from the administration from any experimental agent;

⁃ 2 weeks from administration of immunotherapies;

⁃ 28 days from administration of cytotoxic agents; and

⁃ 7 days from administration of non-cytotoxic agents (interferon, tamoxifen, thalidomide, cis-retinoic acid, and herbal medicine).

∙ NOTE: No washout is necessary for alternating electrical fields.

∙ Phase 2a: (safety run-in)

• Patient must have select solid tumors (see Appendix 2) with uncontrolled metastases to the brain (confirmed by cranial CT or MRI) that is not controlled by surgery or radiation therapy and receiving one of the protocol approved SOC regimens.

• Patients receiving prior systemic therapy must be receiving one of the protocol approved Standard of Care (SOC) regimens listed on Appendix 1.

• Patient must have measurable/evaluable CNS disease per RANO or RANO-BM criteria.

• Patient must have measurable/evaluable systemic disease per RECIST v1.1 criteria.

∙ Phase 2b: (efficacy)

• Patient must:

‣ have radiographically confirmed Astrocytoma IDH-mutant, Glioblastoma IDH-wildtype following previous radiation therapy or treatment with temozolomide and radiation, or

⁃ have select solid tumors (see Appendix 2) with uncontrolled metastases to the brain (confirmed by cranial CT or MRI) that is not controlled by surgery or radiation therapy and receiving one of the protocol approved SOC regimens.

• Patients receiving prior systemic therapy must be receiving one of the protocol approved Standard of Care (SOC) regimens listed on Appendix 1.

• Patient must have measurable/evaluable CNS disease per RANO or RANO-BM criteria

• Patient with select solid tumors (see Appendix 2) must have measurable/evaluable systemic disease per RECIST v1.1 criteria.

• Creatinine clearance (CrCl) of \>60 mL/min (using the Cockcroft-Gault formula or 24-hour urine collection). Female patients of child-bearing potential and male patients must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for 30 days prior to the first dose of NEO212, for the duration of study participation, and for 90 days following completion of therapy.

Locations
United States
California
Precision NextGen Oncology
RECRUITING
Beverly Hills
Washington
Northwest Medical Specialties
RECRUITING
Tacoma
Contact Information
Primary
Christopher Beardmore
chris@anovaevidence.com
224 218 2408
Backup
Chloe Richmond
chloe@anovaevidence.com
224 218 2408
Time Frame
Start Date: 2023-11-01
Estimated Completion Date: 2026-08-31
Participants
Target number of participants: 134
Treatments
Experimental: Phase 2a Safety Run-In - NEO212 and Pembrolizumab
The following primary cancers with uncontrolled metrastases to the brain:~* Unresectable or metastatic melanoma.~* NSCLC expressing PD-L1, with no EGFR or ALK genomic tumor aberrations.~* Metastatic NSCLC whose tumors express PD-L1.~* EGFR or ALK genomic tumor aberrations must have disease progression.~* SCLC.~* Unresectable, recurrent HNSCC whose tumors express PD-L1.~* HNSCC on or after platinum-containing chemotherapy.~* Urothelial carcinoma whose tumors express PD-L1.~* Urothelial carcinoma.~* Microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR).~* Microsatellite Instability-high or Mismatch Repair Deficient Colorectal Cancer (CRC).~* Gastric or gastroesophageal junction adenocarcinoma.~* Esophageal or gastroesophageal juncUon (GEJ).~* Cervical cancer.~* Merkel cell carcinoma.~NEO212 - Same as Arm 1.~Pembrolizumab - 200 mg administered every 3 weeks per package insert.
Experimental: Phase 2a Safety Run-In - NEO212 and Nivolumab
The following primary cancers with uncontrolled metrastases to the brain:~* Unresectable or metastatic melanoma.~* Metastatic non-small cell lung cancer.~* Advanced renal cell carcinoma.~* Squamous cell carcinoma of the head and neck.~* Urothelial carcinoma.~* Microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer.~* Unresectable esophageal squamous cell carcinoma (ESCC).~NEO212 - Starting one dose level under RP2D administered orally on days 1 - 5 of a 28-day treatment cycle, escalated to RP2D per Protocol dose escalation rules.~Nivolumab - 240 mg administered every 2 weeks per package insert
Experimental: Phase 2a Safety Run-In - NEO212 and Stivarga (Regorafenib)
\- Colorectal cancer (CRC) with uncontrolled metastases to the brain who have been previously treated with fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy, an anti-VEGF therapy, and, if KRAS wild type, an anU-EGFR therapy.~NEO212 - Starting one dose level under RP2D administered orally on days 1 - 5 of a 28-day treatment cycle, escalated to RP2D per Protocol dose escalation rules.~Stivarga - 160 mg orally, once daily for the first 21 days of each 28-day cycle per package insert
Experimental: Phase 2a Safety Run-In - NEO212 and CarbolaUn (ParaplaUn) + Paclitaxel (Taxol)
\- Colorectal cancer (CRC) with uncontrolled metastases to the brain.~NEO212 - Starting one dose level under RP2D administered orally on days 1 - 5 of a 28-day treatment cycle, escalated to RP2D per Protocol dose escalation rules.~Carboplatin - 300 mg/m2 IV on day 1 every 4 weeks for 6 cycles per package insert.~Paclitaxel - 135mg/m2 IV administered over 24 hours, every 3 weeks per package insert.
Experimental: Phase 2a Safety Run-In - NEO212 and FOLFIRI (Zaltrap) + Bevacizumab (Avastin)
\- Metastatic colorectal cancer (mCRC) with uncontrolled metastases to the brain, that is resistant to or has progressed following an oxaliplatin-containing regimen~NEO212 - Starting one dose level under RP2D administered orally on days 1 - 5 of a 28-day treatment cycle, escalated to RP2D per Protocol dose escalation rules.~FOLFIRI - 4 mg/kg aIV over 1 hour every 2 weeks.~Bevacizumab - 10 mg/kg IV every 2 weeks.
Experimental: Phase 2b efficacy - NEO212 for Astrocytoma IDH-mutant and Glioblastoma IDH-wildtype
Patients receiving NEO212 alone for treatment of Astrocytoma IDH-mutant and Glioblastoma IDH-wildtype.~NEO212 - Starting one dose level under RP2D administered orally on days 1 - 5 of a 28-day treatment cycle, escalated to RP2D per Protocol dose escalation rules.
Experimental: Phase 2b efficacy - NEO212 & SOC for Uncontrolled Metastases to the Brain
Patients receiving NEO212 in combination with select standard of care treatments for treatment of uncontrolled metastases to the brain.~NEO212 - Starting one dose level under RP2D administered orally on days 1 - 5 of a 28-day treatment cycle, escalated to RP2D per Protocol dose escalation rules.~SOC treatments established to be safe in Phase 2a of the study will be used in this arm of Phase 2b.
Experimental: Phase 2a Safety Run-In - NEO212 and Ipilimumab
\- Unresectable or metastatic melanoma with uncontrolled metastases to the brain.~NEO212 - Starting one dose level under RP2D administered orally on days 1 - 5 of a 28-day treatment cycle, escalated to RP2D per Protocol dose escalation rules.~Ipilimumab - 3 mg/kg administered IV over 90 minutes every 3 weeks for a maximum of 3 doses per package insert.
Sponsors
Leads: Neonc Technologies, Inc.

This content was sourced from clinicaltrials.gov

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