This is a first-in-human Phase 1a/1b, multicenter, open-label, dose-escalation, dose and schedule optimization, and expansion study of TPST-1495 as a single agent and in combination with pembrolizumab to determine its maximum tolerated dose (MTD) and or recommended Phase 2 dose (RP2D), safety, tolerability, pharmacokinetics, pharmacodynamics and preliminary anti-tumor activity in subjects with advanced solid tumors. Subjects with all histologic types of solid tumors are eligible for the escalation and dose-finding portions of the study. However, the preferred tumor types for enrollment are colorectal cancer (CRC), non-small cell lung cancer (NSCLC), squamous cell carcinoma of the head and neck (SCCHN), urothelial cancer, endometrial cancer, and gastroesophageal junction (GEJ) or gastric adenocarcinoma. Enrollment in the expansion cohorts is limited to the following tumor types: endometrial, SCCHN, CRC, and a basket cohort in subjects selected for an activating mutation in PIK3Ca.
This is a first-in-human Phase 1a/1b, multicenter, open-label, dose-escalation, dose and schedule optimization, and expansion study of TPST-1495 as a single agent and in combination with pembrolizumab to determine its MTD, safety, tolerability, pharmacokinetics (PD), pharmacodynamics (PK) and preliminary anti-tumor activity in subjects with advanced solid tumors. Subjects with all histologic types of solid tumors are eligible for the study. However, the preferred tumor types for enrollment are colorectal cancer (CRC), non-small cell lung cancer (NSCLC), squamous cell carcinoma of the head and neck (SCCHN), urothelial cancer, endometrial cancer, and gastroesophageal junction (GEJ) or gastric adenocarcinoma. Tumor prostaglandin production and downstream signaling in both tumor cells and other cell types, including immune suppressive cell population in the tumor microenvironment, is thought to be a principal driver of progression in each of these selected malignancies. To be eligible, subjects must have no remaining standard therapy known to confer clinical benefit. The study is composed of 3 stages. The Dose-Escalation stage will determine the MTD of single-agent TPST-1495 administered twice a day (BID). The Schedule and Dose Optimization stage will evaluate alternative TPST-1495 single-agent administration schedules and determine an RP2D for the selected schedule. This arm will also evaluate TPST-1495 in combination with pembrolizumab. The Expansion stage will evaluate the activity of TPST-1495 as a single agent and in combination with pembrolizumab at the selected schedule and dose in disease-specific cohorts and in a basket cohort in subjects selected for an activating mutation in PIK3Ca.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
89
TPST-1495 administered orally twice daily
TPST-1495 administered orally once daily or on intermittent schedule
Pembrolizumab dosed per label recommendations
University of Colorado
Aurora, Colorado, United States
Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine
Baltimore, Maryland, United States
Baystate Gynecologic Oncology
Springfield, Massachusetts, United States
University of Michigan Rogel Cancer Center
Ann Arbor, Michigan, United States
START Midwest
Grand Rapids, Michigan, United States
Carolina BioOncology Institute
Huntersville, North Carolina, United States
SCRI-OK Stephenson Cancer Center
Oklahoma City, Oklahoma, United States
University of Pennsylvania Perelman School of Medicine
Philadelphia, Pennsylvania, United States
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
Tennessee Oncology
Nashville, Tennessee, United States
...and 1 more locations
Determination of maximum tolerated dose and/or recommended Phase 2 dose (RP2D) and optimum dose schedule for TPST-1495 as a single agent and in combination with pembrolizumab
Determination of maximum tolerated dose and/or recommended Phase 2 dose (RP2D) and optimum dose schedule for TPST-1495 as a single agent and in combination with pembrolizumab based on dose limiting toxicities
Time frame: From start of treatment to treatment termination visit, up to 24 months
Incidence of adverse events and serious adverse events as assessed by NCI-CTCAE v.5.0
Incidence of treatment-emergent adverse events and serious adverse events for TPST-1495
Time frame: From start of treatment to treatment termination visit, up to 24 months
Assess pharmacokinetics: maximum serum concentration (Cmax)
Maximum serum concentration (Cmax) of TPST-1495
Time frame: From start of treatment to treatment termination visit, up to 24 months
Assess pharmacokinetics: area under the serum concentration-time curve (AUC)
Area under the serum concentration-time curve (AUC) of TPST-1495
Time frame: From start of treatment to treatment termination visit, up to 24 months
Assess pharmacokinetics: Clearance (CL)
Clearance (CL) of TPST-1495
Time frame: From start of treatment to treatment termination visit, up to 24 months
Assess pharmacokinetics: terminal elimination half-life (t 1/2)
Terminal elimination half-life (t 1/2) of TPST-1495
Time frame: From start of treatment to treatment termination visit, up to 24 months
Overall response rate (ORR) using RECIST version 1.1
Preliminary efficacy of TPST-1495 as a single agent and in combination with pembrolizumab as assessed by overall response rate (ORR) using RECIST version 1.1
Time frame: From start of treatment to treatment termination visit, up to 24 months
Progression free survival (PFS)
Preliminary efficacy of TPST-1495 as a single agent and in combination with pembrolizumab as assessed by progression free survival (PFS)
Time frame: From start of treatment to treatment termination visit, up to 24 months
Duration of response (DoR)
Preliminary efficacy of TPST-1495 as a single agent and in combination with pembrolizumab as assessed by duration of response (DoR)
Time frame: From start of treatment to treatment termination visit, up to 24 months
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