This is an open-label, dose-escalation Phase 1/2 study to assess the safety of ASTX660, determine the maximum tolerated dose (MTD), recommended Phase 2 dose (RP2D), and recommended dosing regimen, and to obtain preliminary efficacy, pharmacokinetic (PK), and target engagement data, in subjects with advanced solid tumors or lymphoma for whom standard life-prolonging measures are not available.
ASTX660 is a synthetic small molecule dual antagonist of cellular inhibitor of apoptosis protein (cIAP) 1 and X-linked inhibitor of apoptosis protein (XIAP) that has been shown to have potent proapoptotic and tumor growth inhibitory activity in nonclinical models. The Phase 1 portion of the study (completed) will determine the MTD, RP2D, and recommended dosing regimen. The Phase 2 portion will evaluate activity in selected tumor types. Subjects will continue to receive their assigned treatment throughout the study until the occurrence of disease progression, death, or unacceptable treatment-related toxicity, or until the study is closed by the sponsor.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
253
described above
Safety (Phase 1) - number of subjects with AEs, DLTs, abnormal clinical laboratory values or physical exam results
Incidence of dose-limiting toxicities (DLTs) and other adverse events (AEs)
Time frame: Up to 78 months
Efficacy (Phase 2) - antitumor activity assessed by objective response rate (ORR)
Antitumor activity by objective response rate
Time frame: Up to 84 months
Efficacy (Phase 2) - antitumor activity assessed by disease control rate (DCR)
Antitumor activity by disease control rate
Time frame: Up to 84 months
Pharmacokinetic outcome of concentration-time curve (AUC)
Assessment of pharmacokinetic parameter area under the concentration-time curve (AUC).
Time frame: First 9 weeks of study treatment
Pharmacokinetic outcome of maximum concentration (Cmax)
Assessment of pharmacokinetic parameter maximum concentration (Cmax).
Time frame: First 9 weeks of study treatment
Pharmacokinetic outcome of minimum concentration (Cmin)
Assessment of pharmacokinetic parameter minimum concentration (Cmin).
Time frame: First 9 weeks of study treatment
Pharmacokinetic outcome of time to maximum concentration (Tmax)
Assessment of pharmacokinetic parameter time to maximum concentration (Tmax)
Time frame: First 9 weeks of study treatment
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University of Alabama at Birmingham
Birmingham, Alabama, United States
HonorHealth Research Institute
Scottsdale, Arizona, United States
USC/Norris Comprehensive Cancer Center
Los Angeles, California, United States
Cedars-Sinai Medical Center
Los Angeles, California, United States
UC Davis Medical Center
Sacramento, California, United States
Simlow Cancer Hospital at Yale
New Haven, Connecticut, United States
Emory University winship Cancer Institute
Atlanta, Georgia, United States
Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Chicago, Illinois, United States
The Sidney Kimmel Comprehensive Cancer Center at John Hopkins
Baltimore, Maryland, United States
Tufts Medical Center
Boston, Massachusetts, United States
...and 58 more locations
Pharmacokinetic outcome of samples over time
Assessment of pharmacokinetic parameter elimination half life (t½).
Time frame: First 9 weeks of study treatment
Pharmacokinetic outcome of samples over time
Assessment of pharmacokinetic parameter of other secondary PK parameters of ASTX660 if data permit.
Time frame: First 9 weeks of study treatment
Pharmacokinetic outcome of analysis of ASTX660 metabolites if applicable
Assessment of pharmacokinetic parameter analysis of ASTX660 metabolites if applicable.
Time frame: First 9 weeks of study treatment
Duration of antitumor response
Time from the date of the earliest assessment of complete response or partial response to the date of relapse or death, whichever occurs earlier, or the last efficacy assessment date for subjects without a relapse or death.
Time frame: Up to 84 months
Progression-free survival
Number of days from the start of the study treatment to disease progression or death, whichever occurs first.
Time frame: Up to 84 months
Overall survival
Number of days from the day the subject received the first study treatment to the date of death, regardless of cause.
Time frame: Up to 84 months
Assessment of target (cIAP1) engagement
Percentage degradation of cIAP1 protein in PBMCs from baseline, in response to ASTX660 treatment.
Time frame: Up to 84 months