This is a single-arm, allocation open label study. Phase 1 is a dose-finding phase in patients with advanced/ metastatic hepatocellular carcinoma (HCC) who have progressed on first line Sorafenib or Lenvatinib. The primary objective of this study will be to establish the maximal tolerable dose (MTD) of ASLAN001 (Varlitinib) in the study population The secondary objectives include: 1. To evaluate the efficacy of ASLAN001 (Varlitinib), as measured by duration of response (DoR), progression free survival (PFS), overall survival (OS) and disease control rate (DCR) 2. To assess the ORR, DoR, PFS, DCR and OS by tumor EGFR/HER2/HER3/HER4 status 3. To identify tumor and host biomarkers predictive of treatment response or toxicity to ASLAN001.
* There are currently no effective and approved second line treatment options for advanced/ metastatic HCC. * ASLAN001 (Varlitinib) is a small molecule tyrosine kinase inhibitor against HER1 (EGFR), HER2, and HER4. * In vivo studies on HER2/3 expressing HCC PDX models suggest inhibition of pERB B2/3, pERK1 and pERK 2 with treatment with ASLAN001 (Varlitinib). Dose dependent inhibition of Cdc2 and pAKT in HCC PDX models treated with ASLAN001 (Varlitinib) also suggest robust inhibition of the PI3K pathway. * EGFR overexpression in HCC and matched non tumor tissues were detected in (32.5%) and (28.6%), respectively. Moreover, missense and silent mutations were detected in (39.4%) and (33.3%) of HCC tissues, respectively. * Determine the maximum tolerable dose (MTD) of ASLAN001 (Varlitinib) in advanced/metastatic HCC patients. * After the recommended dose is determined, the Phase Ib portion of the study will evaluate the efficacy of ASLAN001 (Varlitinib) in HCC patients who have progressed on Sorafenib.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
22
Starting dose at 300mg BD Dose level +1: 400mg BD (which is the target dose for this study) Dose reduction of ASLAN001 in event of adverse events grade 2 and above: Dose level -1: 200mg BD Dose level -2: 100mg BD
National University Hospital
Singapore, Singapore
RECRUITINGDefinition of MTD (maximum tolerable dose)
The maximum tolerable dose is defined as the highest evaluated dose where \< 1/6 patients experiences DLT during the DLT evaluation window.
Time frame: up to 1 year since the start of treatment
Objective Response Rate
Defined as the proportion of patients with a response of Partial Response or Complete Response, as defined by RECIST v1.1 criteria. Measurable disease: Tumor lesions: Must be accurately measured in at least one dimension (longest diameter in the plane of measurement is to be recorded) with a minimum size of 10mm on CT scan Malignant lymph node: ≥15mm in short axis on CT scan Non-measurable disease: All other lesions, including small lesions (longest diameter \<10mm or pathological lymph nodes with \>10 to \<15mm short axis) as well as truly non-measurable lesions
Time frame: up to 1 year since the start of treatment
Progression Free Survival
Defined as the time from the start of treatment until the date of objective disease progression or death (by any cause in the absence of progression). Progression is defined in accordance with RECIST v1.1 criteria.
Time frame: up to 1 year since the start of treatment
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