BPI-1178 is a novel, orally administered inhibitor of both cyclin-dependent kinase 4(CDK4)and CDK6 kinase activity. This Phase I study is a first-in-human (FIH) clinical trial designed to evaluate the safety, tolerability, and pharmacokinetic (PK) profile of oral BPI-1178 in patients with advanced solid tumors. The Phase IIa trial is designed to investigate the anti-tumor activity and safety of BPI-1178 in combination with endocrine therapy in patients with HR+/HER2-advanced breast cancer and to determine the dosing regimen for combination with endocrine therapy in a later confirmatory study.
This is a study which consists of phase 1study(dose-escalation study、dose-expansion study and PK trial) and phase 2a study. Phase 1 study will adopt the classical 3+3 dose escalation design, exploring the safety and tolerance of 6 dose cohorts (25mg, 75mg, 150mg, 250mg, 400mg and 500mg) in subjects with advanced solid tumor and determining the maximum tolerated dose of BPI-1178 for phase 2a study. Phase 2a is an open-label clinical study in subjects of HR+/HER2- breast cancer using 3+3 design, to evaluate the efficacy and safety of BPI-1178 in combination with endocrine therapy. Cohort A is BPI-1178 in combination with fulvestrant for advanced or recurrent HR+/HER2- breast cancer after failure or intolerance of non-fulvestrant first-line endocrine therapy. Cohort B is BPI-1178 in combination with letrozole for advanced or relapse more than 1 year after the end of adjuvant endocrine therapy as first-line treatment. Phase 1 and 2a consist of screening period (28 days before enrollment), treatment period and follow up period (every 3 months until death or the end of study). Phase 1 study: Subjects in each dose group will first receive a single dose. After a single dose for washout period, if the subject has no dose-limiting toxicity (DLT) related to the investigational product, the subject will enter the continuous dose cycle and receive continuous dose in a 28-day treatment cycle (single daily dose for 3 consecutive weeks/drug withdrawal for 1 week) .Once the maximum tolerated dose (MTD) is reached in phase 1, phase 2a study will explore the dose of BPI-1178 from MTD in combination with fulvestrant or letrozole. Phase 2a study: Subjects in Cohort A and Cohort B with intermittent dosing (3-week continuous dosing followed by 1-week rest) and continuous dosing (28-day continuous dosing) will be received in combination with fulvestrant or letrozole. Each 28-day is a complete treatment cycle during the concomitant-drug period. Dose limiting toxicity (DLT) will be recorded for the single dose period of 7 days and the multiple dose period up to 28 days in phase 1 study, as well as 28 days after the first dose of BPI-1178 in phase 2a. Efficacy will be evaluated by RECIST v1.1 and the Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) every 2 months. Adverse events will be monitored throughout the trial. Other exploration of pharmacokinetic information will be assessed throughout the trial.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
224
BPI-1178 once daily on Days 1 to 21 of a 28-day cycle
Fulvestrant 500mg intramuscularly on Days 1 and 15 of Cycle 1, and on Day 1 of Cycle 2 and beyond
Letrozole 2.5 mg once daily of a 28-day cycle
BPI-1178 once daily of a 28-day cycle
Fudan University Shanghai Cancer Center
Shanghai, Shanghai Municipality, China
RECRUITINGphase 1 and 2a: Number of subjects with dose limiting toxicity (DLT)
Time frame: Up to Day 28 of Cycle 1 (28 days/cycle)
phase 1: Maximum tolerated dose (MTD)
Time frame: Up to Day 28 in Cycle 1 (28 days/cycle)
phase 2a: Objective response rate (ORR)
Time frame: Up to approximately 18 months
phase 1 and 2a: Number of subjects with adverse events
Time frame: Up to 30 days after the last dose of BPI-1178
phase 1: Objective response rate (ORR)
Time frame: Up to approximately 18 months
Phase 1 and 2a: Maximum plasma concentration (Cmax) of BPI-1178 and its main metabolites
Time frame: From single dosing in phase 1 or from baseline in phase 2a to the end of Cycle 1 (28 days/cycle)
Phase 1 and 2a: Peak Plasma Time (Tmax) of BPI-1178 and its main metabolites
Time frame: From single dosing in phase 1 or from baseline in phase 2a to the end of Cycle 1 (28 days/cycle)
Phase 1 and 2a: Area under the plasma concentration versus time curve (AUC) of BPI-1178 and its main metabolites
Time frame: From single dosing in phase 1 or from baseline in phase 2a to the end of Cycle 1 (28 days/cycle)
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