This is a Phase 1/2, open-label, multicenter study of HS-10296 with dose escalation, dose expansion and extension cohorts in locally advanced or metastatic non-small-cell lung cancer (NSCLC) patients who have progressed following prior therapy with an epidermal growth factor receptor(EGFR) tyrosine kinase inhibitor (TKI) agent. The study is designed to evaluate safety, tolerability, pharmacokinetics (PK), and anti-tumor activity of once-daily and orally (PO) administered HS-10296. The overall study design is shown in the flow chart below, which consists of 3 phases: dose escalation, dose expansion and extension cohort.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
364
HS-10296: 5-, 10-, 40-, and 55-mg tablet, immediate-release formulation. Patients should avoid consumption of food for at least 1 hour prior to and 2 hours post dosing. RP2D is determined at 110 mg QD.
Pacific Cancer Medical Center, Inc.
Anaheim, California, United States
Beverly Hills Cancer Center
Beverly Hills, California, United States
University of California San Diego Medical Center Moores Cancer Center
San Diego, California, United States
University of Colorado-1775 Aurora Court
Aurora, Colorado, United States
Sylvester Comprehensive Cancer Center
Deerfield Beach, Florida, United States
University Cancer & Blood Center, LLC
Athens, Georgia, United States
Baptist Healthcare Systems Inc. Baptist Health Floyd
New Albany, Indiana, United States
Dartmouth-Hitchcock Medical Center
Hanover, New Hampshire, United States
University of Texas Medical Branch at Galveston
Galveston, Texas, United States
MultiCare Institute for Research and Innovation
Tacoma, Washington, United States
Number of Participants With Dose Limiting Toxicity (DLT) Phase I Part
DLT is defined as one of the following HS-10296 related adverse event (AE) :(1) Hematological toxicity ≥ Grade 4 neutropenia lasting more than 5 days, febrile neutropenia of any duration (absolute neutrophil count \[ANC\]) \< 1.0 × 109/L and fever ≥ 38.5°C), Grade 4 thrombocytopenia, Grade 3 thrombocytopenia with bleeding, any requirement for platelet transfusion, Grade 4 anemia (unexplained by underlying disease); (2)Non-hematological toxicity ≥ CTCAE Grade 3 including Infection (including febrile neutropenia), confirmed prolongation of QT interval corrected with Fridericia's (QTcF) (\> 500 ms absolute or \> 60 ms above Baseline) and cardiac toxicity greater than Grade 3;(3)Any other toxicity that is greater than that at Baseline (clinically significant and/or unacceptable, and judged to be a DLT by the SRC), meets a protocol-defined stopping criteria (i.e., confirmed corneal ulceration), or results in a disruption of dosing schedule of more than 7 days.
Time frame: 21 days
Overall Response Rate (ORR) Phase II Part
ORR is defined as the percentage of patients with a complete response (CR) or partial response (PR) that was confirmed at a subsequent scan at least 6 weeks later, as assessed according to RECIST (Response Evaluation Criteria In Solid Tumors Criteria) version 1.1 for target lesions and assessed by CT/MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
Time frame: From the date of first dose until the date of disease progression or withdrawal from study, approximately 15 months
Incidence and Severity of Adverse Events (AEs) Phase I Part
An AE is the development of an undesirable medical condition or the deterioration of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. An undesirable medical condition can be symptoms (e.g., nausea, chest pain), signs (e.g., tachycardia, enlarged liver), or the abnormal results of an investigation (e.g., laboratory findings, ECG). Any deterioration of the disease under study and associated symptoms or findings should not be regarded as an AE as far as the deterioration can be anticipated. The AE was graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0.
Time frame: From the screening period to 28 days after treatment completion, approximately 16 months
Area Under the Plasma Concentration Versus Time Curve (AUC) of HS-10296 and HAS-719 From Zero to the 24-Hour Sampling Time (AUC0-24) After Single Dose of HS-10296
Area under the plasma concentration versus time curve from time zero to the 24-hour sampling time at which the concentration was at or above the lower limit of quantification (LLQ). AUC0-24 was to be calculated according to the mixed log-linear trapezoidal rule.
Time frame: From pre-dose to 24 hours after single dose on Day 1 of Cycle 0
Elimination Half-life(T1/2) of HS-10296 and HAS-719
Elimination half-life is the time measured for the concentration to decrease by one half. Half-life calculated by natural log 2 divided by λz.
Time frame: From pre-dose to 120 hours after single dose on Day 1 of Cycle 0
Css Max of HS-10296 and HAS-719 After Multiple Dose
Observed maximum plasma concentration (Css max) after multiple dose of HS-10296 and HAS-719
Time frame: From pre-dose to 21 days after multiple dose on Day 1 of Cycle 2
AUCss of HS-10296 and HAS-719 After Multiple Dose of HS-10296
Area Under the Plasma Concentration Versus Time Curve at steady state (AUCss) of HS-10296 and HAS-719 after multiple dose of HS-10296
Time frame: From pre-dose to 21 days after multiple dose on Day 1 of Cycle 2
Overall Response Rate (Phase I Part)
ORR is defined as the percentage of patients with a complete response (CR) or partial response (PR) that was confirmed at a subsequent scan at least 6 weeks later, as assessed according to RECIST (Response Evaluation Criteria In Solid Tumors Criteria) version 1.1 for target lesions and assessed by CT/MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
Time frame: From the date of first dose until the date of disease progression or withdrawal from study, approximately 15 months
Progression-free Survival (PFS)
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The PFS is defined as the time from date of first dosing until the date of objective disease progression as defined by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 or death (by any cause in the absence of progression) regardless of whether the patients withdraws from HS-10296 therapy or receives another anti-cancer therapy prior to progression. Progression is defined as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time frame: From the date of enrollment until the date of disease progression or death from any cause, approximately 15 months
Disease Control Rate (DCR)
Objective response is assessed by RECIST 1.1 thereby to evaluate disease control rate. The DCR is defined as the proportion of patients with a best overall response of CR, PR, or SD (stable disease).
Time frame: From the date of first dose until the date of disease progression or withdrawal from study, approximately 15 months
Overall Survival (OS) Phase II Part
Overall survival will be assessed based on the date of first dose and survival status at the time of analysis. Overall survival is defined as the time from date of first dose until the documentation of death from any cause.
Time frame: From the date of enrollment until the date of death from any cause, approximately 48 months
Depth of Response (DepOR)
Depth of Response (DepOR) Only in part II dose-extention phase. DepOR is defined as the percentage change in tumor size, based on longest diameter or reconstructed volume, observed at the lowest point compared with baseline.
Time frame: From the date of enrollment until the date of disease progression or death, approximately 15 months
Duration of Response (DoR)
Duration of response (DoR) is defined as the time from the date of first documented response until the date of documented progression or death in the absence of disease progression. The end of response should coincide with the date of progression or death from any cause used for the PFS endpoint. The time of the initial response will be defined as the latest of the dates contributing towards the first visit response of PR or CR. If a patient does not progress following a response, then DoR will be used as the PFS censoring time.
Time frame: From the date of enrollment until the date of disease progression or death, approximately 18 months
Incidence and Severity of AEs Phase II Part
An AE is the development of an undesirable medical condition or the deterioration of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. An undesirable medical condition can be symptoms (e.g., nausea, chest pain), signs (e.g., tachycardia, enlarged liver), or the abnormal results of an investigation (e.g., laboratory findings, ECG). Any deterioration of the disease under study and associated symptoms or findings should not be regarded as an AE as far as the deterioration can be anticipated. The AE was graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0.
Time frame: From the screening period to 28 days after treatment completion, approximately 16 months