A Phase 1B/2A Study of the Safety, Tolerability and Initial Efficacy of Oral AMXT 1501 Dicaprate and Intravenous Difluoromethylornithine (DFMO) in Patients With Cancer

Status: Terminated
Location: See all (7) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

A Phase 1B/2A study will be conducted to establish safety and dose level of AMXT 1501 dicaprate in combination with IV DFMO, in cancer patients.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 12
Healthy Volunteers: f
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• IMPORTANT NOTE- Younger 12-17 year old patients are also eligible for this study if they meet the noted DIPG or DMG criteria noted below, which is separate from Patient Diagnosed with Advanced Solid Tumors.

• Patients will be eligible for study participation only if they meet ALL the inclusion criteria applicable to their diagnosis.

∙ INCLUSION FOR PATIENTS DIAGNOSED WITH ADVANCED SOLID TUMORS

• Understand and sign written IRB-approved informed consent form and be willing to comply with all study procedures.

• Diagnosed with unresectable, locally advanced, or metastatic solid tumor for which no standard therapy is recognized or for which standard therapy has failed. Planned tumor types for evaluation include:

‣ Platinum resistant ovarian cancer (including - primary peritoneal cancer and fallopian tube cancer)

⁃ Breast cancer

⁃ Papillary thyroid cancer

⁃ Head and neck cancer

⁃ Gastric cancer

⁃ Non-small cell lung cancer (NSCLC)

⁃ Mesothelioma: Pleural and peritoneal

⁃ Esophageal

⁃ Endometrial cancer

⁃ Cervical

⁃ Melanoma

⁃ Colorectal cancers (colon, rectal)

⁃ Grade 4 Gliomas (including both IDH WT and IDH-mutant astrocytoma)

• Must be ≥18 years of age.

• Histologically or cytologically documented disease.

• Has evaluable or measurable disease by RECIST v1.1 or mRECIST criteria.

• o For patients with Grade 4 glioma, has evaluable or measurable disease by RANO (Appendix 5).

• Provide tumor tissue from biopsy taken during Screening period.

• Performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) scale.

∙ INCLUSION FOR PATIENTS DIAGNOSED WITH DIPG OR DMG Patients must also meet other generally noted criteria as noted within the protocol

• For patients \<18 years of age, the parents or legal guardians must understand and sign the written IRB-approved informed consent form (ICF). The patient, if able, must understand and sign the IRB-approved consent (assent) and be willing to comply with all study procedures.

• o For patients ≥18 years of age, the patient must understand and sign written IRB-approved ICF and be willing to comply with all study procedures.

• Diagnosed with DIPG or DMG.

• o Any anatomic site of origin is acceptable.

• Must be ≥12 years of age and \>40 kg in body weight.

• Radiologically documented disease.

‣ (a) - Patient with refractory or progressive DIPG or DMG, defined as tumors with a pontine epicenter and diffuse involvement of at least 2/3 of the pons, are eligible without histologic confirmation.

⁃ (b) - Patients with brainstem tumors that do not meet radiographic criteria or are not considered to be typical DIPG or DMG will be eligible if the tumors have been biopsied and proven to be high-grade gliomas (such as anaplastic astrocytoma, glioblastoma, H3 K27M-mutant DMG).

• Has evaluable or measurable disease by RANO or RAPNO criteria.

• o Has evaluable or measurable disease by RANO (for adults) or RAPNO (for children

• Provide cerebrospinal fluid (CSF) sample. Patients with pontine lesions for whom a radiological diagnosis of DIPG, or DMG is made will be eligible without a CSF sample, although CSF sample is strongly encouraged.

• Performance score:

‣ (a) Patients \>16 years of age, Karnofsky score ≥50%.

⁃ (b) Patients ≥12 and ≤16 years of age, Lansky ≥50%. Note: Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score.

∙ INCLUSION FOR ALL PATIENTS All patients are required to meet these inclusion exclusion criteria to be considered eligible for the study

• Patients must have fully recovered from the acute toxic effects of all prior anti-cancer chemotherapy: The following minimum periods from treatment apply:

‣ (a) Myelosuppressive chemotherapy: At least 21 days after the last dose of myelosuppressive chemotherapy (42 days if prior nitrosourea).

⁃ (b) Hematopoietic growth factors: At least 14 days after the last dose of a long-acting growth factor (e.g., Neulasta) or 7 days for short-acting growth factor.

⁃ (c) Biologic (anti-neoplastic agent): At least 7 days after the last dose of a biologic agent. For agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur.

⁃ (d) Immunotherapy: At least 42 days after the completion of any type of vaccination.

⁃ (e) Monoclonal antibodies: \>21 days must have elapsed from the infusion of last dose of antibody and toxicity related to antibody therapy must be recovered to Grade ≤1.

⁃ (f) Radiation therapy: Patients must have had their last fraction of craniospinal or focal irradiation a minimum of 8-12 weeks prior to enrollment.

⁃ (g) Stem cell transplant: Patients must be ≥3 months since autologous stem cell transplant. Patients who received allogenic stem cell transplant or solid organ transplant are not eligible for study.

• Patient is able to take oral medications and willing to use an at-home infusion pump.

• Must have adequate bone marrow and renal/hepatic function at the screening and baseline visits, defined as:

‣ (a) Absolute neutrophil count (ANC) ≥1.5×109/L without granulocyte colony-stimulating factor (G-CSF) support within 7 days

⁃ (b) Platelet ≥100×109/L, without transfusion within 7 days

⁃ (c) Hemoglobin ≥9 g/dL, without transfusion support within 7 days

⁃ (d) Activated partial thromboplastin time/ partial thromboplastin time (aPTT/PTT) ≤1.5×ULN.

⁃ (e) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5×ULN (if liver metastases are present, then ≤5×ULN is allowed).

⁃ (f) Total serum bilirubin ≤1.5×ULN, (except for patients with known Gilbert's Syndrome in whom ≤3×ULN is permitted).

⁃ (g) The patient is clinically euthyroid.

⁃ (h) Renal: Serum creatinine \<1.5×ULN or creatinine clearance ≥60 mL/min/1.73 m2 for patients with serum creatinine levels \>1.5×ULN.

⁃ (i) Any Grade 3 or higher lab abnormalities should be discussed and approved by the Medical Monitor prior to enrollment (even if not considered clinically significant).

• Active secondary malignancies will not be allowed, with the exception of:

‣ (a) Adequately treated basal cell carcinoma, SCC of the skin, or in situ cervical cancer;

⁃ (b) Adequately treated Stage 1 cancer from which the subject is currently in remission and has been in remission for ≥2 years;

⁃ (c) Low-risk prostate cancer with Gleason score \<7 and prostate-specific antigen \<10 ng/mL, or

⁃ (d) Any other cancer from which the patient has been disease-free for ≥3 years.

• Patient compliance and geographic proximity (as determined by the Principal Investigator \[PI\]) to allow adequate follow-up.

• Both male and female patients must be willing to consent to using highly effective contraception prior to study entry, while on treatment, and at least 3 months thereafter

Locations
United States
Arizona
Mayo Clinic - Arizona
Phoenix
Florida
Mayo Clinic - Florida
Jacksonville
Minnesota
Mayo Clinic - Minnesota
Rochester
Ohio
Cincinnati Children's Hospital Medical Center
Cincinnati
Texas
MD Anderson Cancer Center
Houston
Washington
Fred Hutch Cancer Center - Seattle Cancer Care Alliance
Seattle
Other Locations
Australia
Kids Cancer Centre
Sydney
Time Frame
Start Date: 2022-11-29
Completion Date: 2024-12-12
Participants
Target number of participants: 15
Treatments
Experimental: Escalation
Dose escalation of DFMO with AMXT1501 fixed dose will follow a 3 + 3 dose escalation design.~The AMXT 1501 starting dose administered in the first cohort will be 1200mg total daily dose (200 mg capsules; 3 capsules in morning; 3 capsules in evening) along with IV DFMO administered in continuous infusion at 2mL/hr over a 28 days per cycle. The patient can be treated for additional 28 day treatment cycles as deemed appropriate by their study investigator. Dose escalation of DFMO alone will increase per cohort.
Experimental: Expansion
The expansion cohort will include up to 40 evaluable patients at a proposed RP2D level of AMXT1501 and DFMO defined by AMXT1501-101A study to further characterize safety at proposed RP2D dose level with repeat dosing, and characterize early anti-tumor activity.
Sponsors
Leads: Aminex Therapeutics, Inc.

This content was sourced from clinicaltrials.gov