This is a Phase 1b/Phase 2a, open-label, multicenter study to determine the safety, tolerability, recommended Phase 2 dose (RP2D), efficacy, pharmacokinetics (PK) and pharmacodynamic (PD) properties of idronoxil when rectally administered as a suppository (NOX66) to patients with any solid tumor (Part 1) and patients with metastatic castration-resistant prostate cancer (mCRPC), breast cancer (BC) and non-small-cell lung cancer (NSCLC) (Part 2) who are eligible for low-dose external beam radiotherapy (EBRT) for at least one symptomatic or minimally symptomatic lesion (for the prevention of symptoms).
The study is divided into 2 parts: Part 1 (dose escalation) and Part 2 (dose expansion). The study design allows an exploration of different doses of NOX66 (800 mg, 1200 mg, 1600 mg and 2400 mg) with safety monitoring to ensure the safety of the patients. In Cycle 1, NOX66 will be administered for 14 days followed by a 7-day rest period on a 21-day cycle. From Cycle 2 onwards, NOX66 will be administered for 7 days followed by a 7-day rest period on a 14-day cycle. Patients will continue to receive NOX66 on a cyclical basis until disease progression, unacceptable toxicity, withdrawal of consent, start of a new anticancer therapy, withdrawal of the patient by the Investigator or the end of study is reached.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
21
NOX66 800 mg daily (400 mg suppository twice daily \[BID\]).
NOX66 1200 mg daily (600 mg suppository BID).
NOX66 1600 mg daily (800 mg suppository BID).
NOX66 2400 mg daily (1200 mg suppository BID).
NOX66 RP2D
The dose levels of EBRT will be either 8 Gy as a single fraction, or 20/25 Gy as 5 fractions given over 5 to 10 days.
Beverly Hills Cancer Center
Beverly Hills, California, United States
The University of Texas - MD Anderson Cancer Center - Genitourinary (GU) Cancer Center
Houston, Texas, United States
Part 1 (Dose Escalation): Number of Dose-limiting Toxicities (DLTs)
Maximum tolerated dose (MTD) and RP2D of NOX66 in combination with low-dose EBRT in patients with any solid tumor. MTD is defined as the dose level at which no more than 1 patient out of 6 has a DLT at the end of Cycle 1. RP2D is the highest dose at which no more than 1 patient out of 6 has a DLT at the end of Cycle 1 and the dosage form, is acceptable to patients. A DLT is defined as an AE that occurs during Cycle 1 (Day 1 to Day 21) that is unrelated to the disease, intercurrent illness or concomitant medications and that, possibly- definitely related to NOX66 alone or in combination with EBRT: Grade (G) ≥3 non-hematological toxicity; G≥3 febrile neutropenia; G4 thrombocytopenia \> 5 days; G3 thrombocytopenia with bleeding or in combination with a G ≥3 blood and lymphatic system disorder.; G3 AST or ALT that is + a ≥G2 rise in bilirubin \>7 days; AST or ALT \> 8 × ULN; AE causing treatment delay \> 14 days.
Time frame: Cycle 1 (Day 1 to Day 21)
Part 1: Incidence of Adverse Events (AEs) for NOX66
Characterization of the safety and tolerability of NOX66.
Time frame: From Screening (Days -28 to -2) until the Follow-up visit/End of Study (EOS) (through study completion, an average of 19 month)
Part 1: TEAEs by Relationship to EBRT Administration
Evaluation of the safety and tolerability of both doses of EBRT (8 Gy or 20/25 Gy).
Time frame: From Screening (Days -28 to -2) until the Follow-up visit/EOS (through study completion, an average of 19 month)
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