APG-1252 is a highly potent Bcl-2 family protein inhibitor, a promising drug candidate which shown high binding affinities to Bcl-2, Bcl-xL and Bcl-w. The preclinical studies have shown that APG-1252 alone achieves complete and persistent tumor regression in multiple tumor xenograft models with a twice weekly or weekly dose-schedule, including SCLC, colon, breast and acute lymphocytic leukemia (ALL) cancer xenografts; achieves strong synergy with the chemotherapeutic agents, indicating that APG-1252 may have a broad therapeutic potential for the treatment of human cancer as a single agent and in combination with other classes of anticancer drugs. APG-1252 is intended for the treatment of patients with SCLC or other solid tumors. This is a multi-center, open-label, dose escalation Phase I study to determine the MTD and DLTs of intravenously administered APG-1252. After dose escalation to 240mg twice weekly, 2 dose cohorts two different dosing schedules including weekly and twice weekly will be assessed to evaluate for safety, tolerability, pharmacokinetics (PK) and preliminary anti-tumor efficacy. Treatment with APG-1252 will be administered to 30-60 patients at approximately 2 investigational sites in US.
In dose cohort 1, patients will be treated in cycles, which are defined by APG-1252 intravenous administration on Days 1, 4, 8, 11, 15, 18 and 22, over a 28-day cycle the start dose is 10mg. After dose escalation to 240mg twice weekly in dose cohort 1, dose cohort 2 will be performed with dose cohort 1 parallelly, patients will be treated in the same 28-day-cycles, APG-1252 intravenous administration on Days 1, 8, 15, and 22, the start dose is 240mg. In both dose cohorts' patients could continue to receive cycles of APG-1252 until disease progress or unacceptable toxicity. Study drug will be administered by intravenous infusion for 30 minutes at the investigational site by site staff.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Multiple dose cohorts, 30 minute IV infusion, twice weekly for 3 weeks of a cycle with 28 days.
START Midwest
Grand Rapids, Michigan, United States
The START Center for Cancer Care
San Antonio, Texas, United States
Dose limiting toxicity (DLT) determination
Number of participants with APG-1252 treatment-related adverse events as assessed by NCI CTCAE v4.03
Time frame: 28 days
Maximum tolerated dose (MTD) determination
If ≥ 2/6 patients develop a DLT at any dose level, then this dose will be declared as the MTD
Time frame: 18 - 24 months
Pharmacokinetic evaluation
Peak plasma concentration (Cmax) will be assessed on all participants with APG-1252 treatments
Time frame: 18 - 24 months
Pharmacokinetic evaluation
Area under the plasma concentration versus time curve (AUC) will be assessed on all participants with APG-1252 treatments
Time frame: 18 - 24 months
Pharmacodynamic evaluation
Platelet counts will be measured on the participants with APG-1252 treatments
Time frame: 18-24 months
Pharmacodynamic evaluation
Bcl-2 protein in peripheral blood mononuclear cells (PBMCs) will be measured on the participants with APG-1252 treatments
Time frame: 18-24 months
Pharmacodynamic evaluation
Activation of apoptosis will be measured on the participants with APG-1252 treatments
Time frame: 18-24 months
Preliminary efficacy assessment
Patients will be evaluated for response every 2 cycles (i.e., 8 weeks), according to the new response evaluation criteria in solid tumors: revised RECIST Guideline, Version 1.1
Time frame: 18-24 months
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