This trial is a multi-center, single-arm, open-label, Phase I clinical trial in 3 phases: dose escalation phase, dose expansion phase and indication expansion phase, which will explore the safety, tolerability, PK and preliminary efficacy of TGRX-326 in patients with ALK-positive or ROS1-positive advanced NSCLC.
This is the first-in-human trial with TGRX-326 which aims to evaluate the safety profile and preliminary efficacy profile in patients with ALK-positive or ROS1-positive advanced NSCLC. The primary purpose of this study is to evaluate the safety profile of TGRX-326, including determination of the maximal tolerated dose (MTD) and recommended phase II dose (RP2D), and other safety measures of the investigational drug, such as adverse events and abnormal clinical outcomes. Preliminary efficacy profiles of TGRX-326 is also evaluated according to RECIST Version 1.1. The safety, tolerability and efficacy profiles, along with pharmacokinetic analysis, will be assessed together to determine the optimal dose for expansion.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
198
Participants are given TGRX-326 tablets orally at one of the dose levels as pre-determined.
Sun Yat-sen University Cancer Center
Guangzhou, Guangdong, China
Maximal tolerated dose (MTD)
To determine the MTD of TGRX-326 in NSCLC patients
Time frame: At end of Cycle 1 (each cycle is 21 days) when the probability of DLT of a dose level is higher than 33%
Recommended phase II dose (RP2D)
To determine the RP2D of TGRX-326 in NSCLC patients for Phase II
Time frame: At completion of the dose expansion study, an average of 1 year
Safety profile (DLT)
To record and analyse subjects with dose-limiting toxicities (DLTs)
Time frame: Collect during Cycle 1 (each cycle is 21 days)
Safety profile (AEs/SAEs)
To record and analyse subjects with adverse events (AEs) and serious adverse events (SAEs)
Time frame: Through completion of the study, an average of 1.5 years
Plasma Cmax
Cmax of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
Plasma Tmax
Tmax of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
T1/2
Half life of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
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Plasma AUCinf
AUCinf of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
Plasma Cmin
Cmin of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
Plasma AUCss
AUCss of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
Plasma Cmax,ss
Cmax at steady state of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
Plasma Tmax,ss
Tmax at steady state of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
CL
Clearance of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
Vd
Volume of distribution of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
Plasma T1/2,ss
T1/2 at steady state of TGRX-326 as measured in plasma
Time frame: Day1/3 of single-dose period; Day1/8/15 of Cycle 1; Day1 of Cycle 2-5, Day 1 of every other cycle starting from Cycle 7; Day 1 of every 4 cycles starting from Cycle 17 (each cycle is 21 days)
ORR
Objective response rate (ORR) as the percentage of patients achieving a CR or PR
Time frame: At screening, Day 1 of every other cycle starting from Cycle 3, and Day 1 of every 4 cycles starting Cycle 17 (each cycle is 21 days)
IC-ORR
Intracranial objective response rate (IC-ORR) as the percentage of patients achieving an intracranial CR or PR among those with confirmed intracranial lesions
Time frame: At screening, Day 1 of every other cycle starting from Cycle 3, and Day 1 of every 4 cycles starting Cycle 17 (each cycle is 21 days)
DCR
Disease control rate (DCR) as the percentage of patients who achieve a response (PR + CR) and stable disease (SD) after the treatment
Time frame: At screening, Day 1 of every other cycle starting from Cycle 3, and Day 1 of every 4 cycles starting Cycle 17 (each cycle is 21 days)
IC-DCR
Intracranial disease control rate (IC-DCR) as the percentage of patients achieving an intracranial response (PR + CR) and a stable disease (SD) after the treatment among those with confirmed intracranial lesions
Time frame: At screening, Day 1 of every other cycle starting from Cycle 3, and Day 1 of every 4 cycles starting Cycle 17 (each cycle is 21 days)
DOR
Duration of response (DOR) as the length of time from the first confirmation of CR or PR until the date of the first occurrence of PD or death, applicable to subjects achieving a response only
Time frame: At screening, Day 1 of every other cycle starting from Cycle 3, and Day 1 of every 4 cycles starting Cycle 17 (each cycle is 21 days)
IC-DOR
Intracranial duration of response (IC-DOR) as the length of time from the first confirmation of intracranial CR or intracranial PR until the date of the first occurrence of PD or death, applicable to subjects achieving an intracranial response only
Time frame: At screening, Day 1 of every other cycle starting from Cycle 3, and Day 1 of every 4 cycles starting Cycle 17 (each cycle is 21 days)