HS-10365 is a small molecular, oral potent, selective RET inhibitor. The purpose of this study is to investigate the safety/tolerability、the pharmacokinetic profile and efficacy of HS-10365 in Chinese advanced solid tumor patients.
This is a multicenter, open-label phase 1/2 study in participants with advanced solid tumors, including RET fusion-positive non-small cell lung cancer and other tumors with RET activation. The trial will be conducted in 2 parts: Phase 1 and phase 2. Participants with advanced cancer are eligible if they have progressed on or intolerant to available standard therapies, or no standard or available curative therapy exists. The phase 1 study is a dose-escalation study, which is designed to evaluate the safety, tolerability, pharmacokinetics and preliminary anti-tumor activity of single dose and multiple doses of HS-10365 given once every day (QD) or twice every day (BID). A dose of 160 milligrams (mg) twice a day (BID) has been selected as the recommended phase 2 dose (RP2D). Approximately 273 participants with advanced solid tumors harboring a RET gene alteration will be enrolled to one of nine phase 2 cohorts: Cohort 1: RET fusion non-small cell lung cancer (NSCLC) that has progressed after at least first-line therapy Cohort 2: RET fusion NSCLC not previously treated for metastatic disease Cohort 3: Medullary thyroid carcinoma that has progressed after at least first-line therapy Cohort 4: RET mutation-positive MTC not previously treated for metastatic disease Cohort 5: RET fusion Radioiodine-refractory thyroid cancer Cohort 6: Advanced solid tumors with RET gene fusion except for cohort 1 to 5 Cohort 7: Advanced solid tumors with RET gene abnormalities and drug resistance or intolerance previously treated with RET inhibitors except for cohort 1 to 6 Cohort 8: Advanced solid tumors with RET gene abnormality except for cohort 1 to 7 Cohort 9: NSCLC with RET gene abnormality except for cohort 1 to 2
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
306
Single or multiple dose(s) of HS-10365 daily or twice every day. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and/or unequivocal disease progression.
Shanghai Chest Hospital
Shanghai, Shanghai Municipality, China
RECRUITINGPhase 1: To determine the maximum tolerated dose (MTD) or maximum administrated dose(MAD)
MTD was defined as the previous dose level at which 2 out of 3 subjects or 2 out of 6 subjects experienced a dose limiting toxicity (DLT).
Time frame: Up to 28 days.
Phase 2: Response Rate (ORR) assessed by independent review committee (IRC)
anti-tumor efficacy will be assessed by best radiographic response based on response evaluation criteria in solid tumors at baseline (Day -28 to -1). For patients that continue on repeating 28-Day cycles after the primary evaluation period, progression will be assessed after each 6 weeks before 18 weeks of therapy and then each 12 weeks. ORR is defined as the percentage of patients with a CR or PR that was confirmed at a subsequent scan at least 4 weeks later, as assessed according to RECIST version 1.1.
Time frame: From the date of first occurrence of complete response (CR) or partial response (PR) on 2 consecutive occasions (≥4 weeks), until the date of disease progression or withdrawal from study, whichever came first, up to 24 months.
Incidence and severity of treatment-emergent adverse events
Assessed by number and severity of adverse events as recorded on the case report form, vital signs, laboratory variables, physical examination, electrocardiogram, and NCI CTCAE v5.0.
Time frame: From baseline until 28 days after the last dose
Observed maximum plasma concentration (Cmax) after single dose of HS-10365
n the study of single-dose, Cmax will be obtained following administration of a single oral dose of HS-10365 on Day 1 to Day 6.
Time frame: From pre-dose to 120 hours after single dose on Day 1
Observed maximum plasma concentration (Cmax ss) after multiple dose of HS-10365
At multiple-dose, Cmax ss will be obtained on Day 1 of dosing in the following 21-Day cycles of therapy.
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Time frame: From pre-dose to 24 hours after the first dose of multiple dosing on Day 1 of the following 21-Day cycles of therapy
Time to reach maximum plasma concentration (Tmax) after single dose of HS-10365
In the study of single-dose, Tmax will be obtained following administration of a single oral dose of HS-10365 on Day 1 to Day 6.
Time frame: From pre-dose to 120 hours after single dose on Day 1
Apparent terminal half-life (T1/2) after single dose of HS-10365
Apparent terminal half-life is the time measured for the concentration to decrease by one half. Terminal half-life calculated by natural log 2 divided by λz.
Time frame: From pre-dose to 120 hours after single dose on Day 1
Area under plasma concentration versus time curve from zero to last sampling time (AUC0-t) after single dose of HS-10365
Area under the plasma concentration versus time curve from time zero to the last sampling time t at which the concentration was at or above the lower limit of quantification (LLQ). AUC0-t was to be calculated according to the mixed log-linear trapezoidal rule.
Time frame: From pre-dose to 120 hours after single dose on Day 1
ORR of HS-10365
Anti-tumor efficacy will be assessed by best radiographic response based on response evaluation criteria in solid tumors at baseline (Day -28 to -1). For patients that continue on repeating 28-Day cycles after the primary evaluation period, progression will be assessed after each 6 weeks before 18 weeks of therapy and then each 12 weeks. ORR is defined as the percentage of patients with a CR or PR that was confirmed at a subsequent scan at least 4 weeks later, as assessed according to RECIST version 1.1.
Time frame: From the date of first occurrence of CR or PR on 2 consecutive occasions (≥4 weeks), until the date of disease progression or withdrawal from study, whichever came first, up to 24 months](Only phase 1)
Disease control rate of HS-10365 (DCR)
Objective response was assessed by RECIST 1.1 thereby to evaluate disease control rate. Disease control was defined as the percentage of patients who have a best overall response (confirmed CR, PR, or stable disease for at least 5 weeks).
Time frame: From the first occurrence of confirmed CR or PR or SD until the date of disease progression or withdrawal from study, whichever came first, up to 24 months.
Duration of response of HS-10365 (DoR)
Duration of response assessed by RECIST 1.1. Duration of response was defined as the time from when the criteria for CR or PR were first met to the occurrence of a objective disease progression (PD) or death.
Time frame: From the date of the first dose to disease progression or death in patients who achieve CR or PR, whichever came first, up to 24 months.
Progression-free survival of HS-10365 (PFS)
Progression of tumor was assessed by RECIST 1.1 thereby to evaluate progression free survival. Progression-free survival was defined as the time from date of first dose until the documentation of objective PD or death from any cause in the absence of progression (whichever occurred first), regardless of whether they subsequently received non-study anti-cancer therapy.
Time frame: From the date of the first dose until the date of disease progression or death from any cause, whichever came first, up to 24 months.
Overall survival (OS)
Overall survival (OS)
Time frame: The time from initial administration to death from any cause, up to 4 years