This clinical trial is looking at a drug called BT1718 in adult patients with advanced solid tumours. The main aim of the study is to find the maximum dose of BT1718 that can be given safely to patients; learn more about the potential side effects of BT1718 and how they can be treated and also what happens to BT1718 inside the body.
BT1718 is a type of drug called a 'bicycle drug conjugate' which is designed to target and inhibit the function of the protein 'membrane type 1 metalloproteinase' (MT1-MMP). MT1-MMP is involved in breaking down the proteins that usually surround a cell; however in cancer cells it can allow a cancer to grow and spread. MT1-MMP is usually found at a low level in normal cells, but can reach higher levels in cancer cells. BT1718 has been designed to recognise and attach itself to the MT1-MMP protein. Once attached a segment of BT1718 is taken into the cancer cell which causes it to die (DM1 toxin). This is a first in human clinical study which has two phases. A 'dose escalation' phase where groups of patients will receive increasing doses of BT1718 to find a safe dose that best targets the cancer cells. In this phase it is expected that approximately 50-60 patients with advanced solid tumours will be entered in the study. An 'expansion phase' where larger groups of patients will receive the selected dose of BT1718 to allow us to find out more about how the drug is working. In this phase at the optimal dose/schedule(s), patients will be enrolled with tumour types known to commonly overexpress MT1-MMP and where MT1-MMP overexpression is confirmed during prospective and retrospective (in appropriate patients) selection at enrolment (i.e. squamous non-small cell lung cancer). It is expected that up to an additional 70 patients will be required to complete this phase.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
72
Dose escalation will consist of Stage 1 and 2. Stage 1 patients will receive BT1718 intravenously twice a week (D: 1,4,8,11,15,18) for 3 out of 4 weeks. Starting dose will be 0.6mg/m2. Single patient cohorts will be explored, but it will change to 3 to 6 patients cohorts. Stage 2 patients will receive BT1718 intravenously once a week (D: 1,8,15) for 3 out of 4 weeks. This stage will have 3 to 6 patient cohorts until the recommended dose is established. The expansion phase will consist of two or more expansion cohorts to include tumour types known to commonly over-express MT1-MMP and where MT1-MMP overexpression is confirmed during prospective and retrospective (in appropriate patients) selection at enrolment. A squamous NSCLC and basket cohort will include approximately 16 patients each with high MT1-MMP levels. In the expansion cohorts BT1718 will be administered intravenously at the once weekly RP2D established in Phase I, Stage 2.
Queen Elizabeth Hospital
Birmingham, United Kingdom
Addenbrookes Hospital
Cambridge, United Kingdom
The Beatson Hospital
Glasgow, United Kingdom
Royal Marsden Hospital and The Institute of Cancer Research
London, United Kingdom
Determination of the maximum dose
Determine a dose at which no more than one out of six patients at the same dose level experiences a probable or highly probable BT1718-related dose limiting toxicity (DLT).
Time frame: When sufficient patients have had the opportunity to complete 1 Cycle (28 days).
Determination of the frequency and causality of each adverse event
Determine the frequency and causality of each adverse event (AE) to BT1718 and grade severity according to National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.02.
Time frame: When sufficient patients have had the opportunity to complete 1 Cycle (28 days).
Measurement of the maximum observed plasma concentration (Cmax) of BT1718 in plasma, both as an intact and cleaved molecule.
Measurement of the maximum observed plasma concentration (Cmax) of BT1718 in plasma, both as an intact and cleaved molecule.
Time frame: Up to 24 timepoints from the first dose of BT1718 over the first two cycles (i.e. Cycle 1 and Cycle 2). Each Cycle is 28 days.
Measurement of the area under the curve (AUC) of BT1718 in plasma, both as an intact and cleaved molecule.
Measurement of the area under the curve (AUC) of BT1718 in plasma, both as an intact and cleaved molecule.
Time frame: Up to 24 timepoints from the first dose of BT1718 over the first two cycles (i.e. Cycle 1 and Cycle 2). Each Cycle is 28 days.
Measurement of the terminal elimination half-life (t½) of BT1718 in plasma, both as an intact and cleaved molecule.
Measurement of the terminal elimination half-life (t½) of BT1718 in plasma, both as an intact and cleaved molecule.
Time frame: Up to 24 timepoints from the first dose of BT1718 over the first two cycles (i.e. Cycle 1 and Cycle 2). Each Cycle is 28 days.
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University College London Hospital NHS Foundation Trust
London, United Kingdom
The Christie Hospital
Manchester, United Kingdom
Measurement of other PK parameters of BT1718 in plasma, both as an intact and cleaved molecule.
Measurement of other PK parameters of BT1718 in plasma, both as an intact and cleaved molecule.
Time frame: Up to 24 timepoints from the first dose of BT1718 over the first two cycles (i.e. Cycle 1 and Cycle 2). Each Cycle is 28 days.
Assess anti-tumour response according to Response Evaluation Criteria in Solid Tumours (RECIST) Version 1.1 using computerised tomography (CT) or magnetic resonance imaging (MRI) scans.
Assess anti-tumour response according to Response Evaluation Criteria in Solid Tumours (RECIST) Version 1.1 using computerised tomography (CT) or magnetic resonance imaging (MRI) scans.
Time frame: Evaluation will be at database lock - 4 weeks after the last patient last visit
Estimate progression-free survival
Estimate progression-free survival
Time frame: Evaluation will be at database lock - 4 weeks after the last patient last visit
Estimate progression-free survival rate at six months
Estimate progression-free survival rate at six months
Time frame: Six months
Estimate overall survival
Estimate overall survival
Time frame: Evaluation will be at database lock - 4 weeks after the last patient last visit
Estimate duration of response
Estimate duration of response
Time frame: Evaluation will be at database lock - 4 weeks after the last patient last visit