A Phase 1b/2 Study to Assess the Safety and Efficacy of HBI-8000 in Combination with Nivolumab in Patients with Advanced Solid Tumors Including Melanoma, Renal Cell Carcinoma (RCC), and Non-Small Cell Lung Cancer (NSCLC). The primary objective of this study is: -To evaluate the safety and tolerability of HBI-8000 when combined with a standard dose and regimen of nivolumab, and to evaluate frequency and severity of toxicities of this combination treatment The secondary objectives of this study include: * To explore the efficacy of study treatment as measured by Objective Response Rate (ORR), Disease Control Rate (DCR), Clinical Benefit Rate (CBR), Duration of Response (DoR), Progression-Free Survival (PFS) in all subjects treated at RP2D * To obtain pharmacokinetics of twice weekly HBI-8000 when administered in combination with nivolumab administered once every two weeks (Phase 1b all sites) * To obtain pharmacokinetics of twice weekly HBI-8000 when administered in combination with nivolumab administered per package insert dose and administration (Phase 2 selected sites) * To characterize the effect of HBI-8000 on the electrocardiogram QT corrected (QTc) interval (Phase 1b only) Exploratory: * To investigate the kinetics and extent of histone acetylation in peripheral blood mononuclear cells (PBMC) at the RP2D of HBI-8000 (Phase 2 only) * To explore potential biomarkers for disease response through sequential sampling of blood and/or tumor tissue in subjects consenting to correlative sub-studies at participating sites (Phase 2 only) Dose Escalation (Phase 1b) will include up to 18 subjects, followed by Cohort Expansion (Phase 2) including up to 100 subjects (melanoma up to 60 subjects and NSCLC up to 40 subjects at MTD and/or RP2D.
A Phase 1b/2 Study to Assess the Safety and Efficacy of HBI-8000 in Combination with Nivolumab in Patients with Advanced Solid Tumors Including Melanoma, Renal Cell Carcinoma (RCC), and Non-Small Cell Lung Cancer (NSCLC). The primary objective of this study is: -To evaluate the safety and tolerability of HBI-8000 when combined with a standard dose and regimen of nivolumab, to determine Maximum Tolerated Dose (MTD) and/or Recommended Phase 2 Dose (RP2D) and to evaluate frequency and severity of toxicities of this combination treatment The secondary objectives of this study include: * To explore the efficacy of study treatment as measured by Objective Response Rate (ORR), Disease Control Rate (DCR), Clinical Benefit Rate (CBR), Duration of Response (DoR), Progression-Free Survival (PFS) in all subjects treated at RP2D * To obtain pharmacokinetics of twice weekly HBI-8000 when administered in combination with nivolumab administered once every two weeks (Phase 1b all sites; Phase 2 selected sites) * To characterize the effect of HBI-8000 on the electrocardiogram QT corrected (QTc) interval (Phase 1b only) Exploratory: -To investigate the kinetics and extent of histone acetylation in peripheral blood mononuclear cells (PBMC) at the RP2D of HBI-8000 (Phase 2 only) Dose Escalation (Phase 1b) will include up to 18 subjects, followed by Cohort Expansion (Phase 2) including up to 100 subjects (melanoma up to 60 subjects and NSCLC up to 40 subjects) at MTD and/or RP2D. HBI-8000 tablets will be administered at 20, 30, 40 mg/dose, orally twice a week until MTD or 40 mg in Phase 2, if MTD is not reached. Nivolumab: 240 mg intravenous infusions every 2 weeks for Phase 1b and in accordance with the manufacturer package insert and institution's prescribing practice for Phase 2. A treatment cycle consists of 28 days. Treatment continues until disease progression or unacceptable toxicity.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
96
Phase 1b: HBI-8000, orally, twice a week, dose escalation 20mg, 30mg, 40mg; in combination with nivolumab 240mg intravenous infusion every 2 weeks. Phase 2: HBI-8000 MTD or 40mg; in combination with nivolumab in accordance with the manufacturer package insert and institution's prescribing practice.
[Site 02] Mayo Clinic Arizona
Phoenix, Arizona, United States
[Site 11] University of California, San Diego Medical Center
La Jolla, California, United States
[Site 01] Hematology - Oncology Associates of the Treasure Coast
Port Saint Lucie, Florida, United States
[Site 09] H. Lee Moffitt Cancer Center and Research Institute, Inc.
Tampa, Florida, United States
[Site 13] Frederick Memorial Hospital d/b/a James M Stockman Cancer Institute
Frederick, Maryland, United States
[Site 12] University of Texas M.D. Anderson Cancer Center - Investigational Cancer Therapeutics
Houston, Texas, United States
Number of Patients Who Experienced at Least One DLT During the DLT Assessment Period for MTD Determination
The dose escalation schema of HBI 8000 followed the conventional 3+3 design. The starting dose was HBI 8000 20 mg twice a week. Dose escalation to 30 mg or 40 mg was determined by observation of DLT. At each dose level, a minimum of 3 subjects evaluable for DLT were enrolled. If 0 of the initial 3, or no more than 1 in a total 6 subjects experienced DLT, escalation to the next higher dose was allowed.
Time frame: First 28 days
Objective Response Rate (ORR) in All Patients Treated at RP2D
Percentage of patients with complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria.
Time frame: From screening for baseline assessment to the date of CR or PR assessed, up to approximately 4 years and 7 months
Disease Control Rate (DCR) in All Patients Treated at RP2D
Percentage of patients with complete response (CR), partial response (PR) or stable disease (SD) according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria.
Time frame: From screening for baseline assessment to the date of best response (CR, PR, or SD) on study, up to approximately 4 years and 7 months
Duration of Response (DoR) in All Patients Treated at RP2D
Time from the first assessment of CR or PR until the date of the first occurrence of PD, or until the date of death.
Time frame: From the date of CR or PR until the date of PD, or until the date of death, up to approximately 4 years and 7 months
Progression-Free Survival (PFS) in All Patients Treated at RP2D
Time from the date of first dose of HBI-8000 until tumor progression by site reported RECIST 1.1, or clinical progression, or death, whichever occurs first. If tumor progression data include more than 1 date of progression, the earliest date will be used.
Time frame: From the date of first dose of HBI-8000 until tumor progression by site reported RECIST 1.1, or clinical progression, or death, whichever occurs first, up to approximately 4 years and 7 months
Pharmacokinetic - Cmax (Single Dosing)
Maximum observed plasma concentration, obtained directly from the observed concentration versus time data.
Time frame: From predose (0.5 hour prior to breakfast) to 7 hours postdose on Cycle 1 Day 1, at 24 hours on Cycle 1 Day 2 (no dose administered)
Pharmacokinetic - Cmax (Repeat Dosing)
Maximum observed plasma concentration, obtained directly from the observed concentration versus time data.
Time frame: From predose to 7 hours postdose on Cycle 2 Day 1
Pharmacokinetic - AUC(0-7) (Single Dosing)
Area under the plasma concentration time curve from zero (predose) to 7 hours postdose, calculated by linear up/log down trapezoidal summation.
Time frame: From predose (0.5 hour prior to breakfast) to 7 hours postdose on Cycle 1 Day 1
Pharmacokinetic - AUC(0-7) (Repeat Dosing)
Area under the plasma concentration time curve from zero (predose) to 7 hours postdose, calculated by linear up/log down trapezoidal summation.
Time frame: From predose to 7 hours postdose on Cycle 2 Day 1
Pharmacokinetic - AUC(0-24)
Area under the plasma concentration time curve from zero (predose) to 24 hours postdose, calculated by linear up/log down trapezoidal summation. Calculated for C1D1 only.
Time frame: From predose (0.5 hour prior to breakfast) on Cycle 1 Day 1 to 24 hours on Cycle 1 Day 2 (no dose administered)
Pharmacokinetic - Tmax (Single Dosing)
Time of Cmax, obtained directly from the observed concentration versus time data.
Time frame: From predose (0.5 hour prior to breakfast) to 7 hours postdose on Cycle 1 Day 1, at 24 hours on Cycle 1 Day 2 (no dose administered)
Pharmacokinetic - Tmax (Repeat Dosing)
Time of Cmax, obtained directly from the observed concentration versus time data.
Time frame: From predose to 24 hours postdose on Cycle 2 Day 1
QTcF Values >450 Msec
Utilized a random coefficients mixed effects model for the change from baseline (ΔQTcF) values with continuous effects for HBI 8000 plasma concentration and baseline value (corrected for overall baseline mean), plus subject level random effects for intercept and concentration slope under unstructured covariance.
Time frame: 0 (predose) up to 4 hours postdose on C1D1 and C2D1
QTcF Increase > 30 Msec
Utilized a random coefficients mixed effects model for the change from baseline (ΔQTcF) values with continuous effects for HBI 8000 plasma concentration and baseline value (corrected for overall baseline mean), plus subject level random effects for intercept and concentration slope under unstructured covariance.
Time frame: 0 (predose) up to 4 hours postdose on C1D1 and C2D1
Concentration Slope
Slope estimate between ΔQTcF and HBI 8000 concentrations
Time frame: 0 (predose) up to 4 hours postdose on C1D1 and C2D1
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