The goal of this clinical trial is to test the safety of TST003 in patients with cancer. The main question\[s\] it aims to answer are: * What is the recommended dose patients can safely receive? * How long does this drug remain in the body after administration? * What are the side effects of this drug? * Does your cancer respond to TST003? * Participants on this study will get TST003 intravenously (through a needle into your vein), once every 3 weeks. * You may need to come to the study site 2-4 times to have tests to see if you are eligible to be in the study before you begin to receive the study drug. * After you start the study drug, you will need to return to the site several times after each dose so the physician can take vital signs, draw blood samples, and evaluate you for safety and wellbeing. * Participants will continue taking the drug as long as they are receiving clinical benefit. * At the end of your study participation, additional testing is required.
Part 1 of the trial will consist cohorts, one dosed every 3 weeks at increasingly higher doses following the Bayesian Optimal Interval (BOIN) design. Part 1 is the dose finding portion of the trial. All locally advanced or metastatic solid tumors are accepted. 18 - 39 patients will be enrolled. Part 2 consists of 2 pharmacodynamic cohorts of approximately 26-36 patients respectively. For Part 2, participants must have locally advanced or metastatic colorectal cancer (CRC). The trial will last approximately 3 years, with assessments including but not limited to safety labs, ECGs, ECHO/MUGA, PKs and PDs and CT/MRI tumor assessments, and tumor biopsies based on emerging data found in Part 1.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
111
IV humanized anti-GREM1 monoclonal antibody
OHSU
Portland, Oregon, United States
Mary Crowley
Dallas, Texas, United States
NEXT Oncology
San Antonio, Texas, United States
Assess the Dose limiting toxicities of TST003
Assess the Dose limiting toxicities experienced
Time frame: Observed during the first 21 day cycle
Assess Adverse events (AEs) of TST003
Assess Adverse events (AEs) as characterized by nature, frequency, and severity according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0
Time frame: through study completion, an average of 1 year
Assess abnormal findings related to TST003
Assess the abnormal findings of vital sign, physical examination, laboratory measurements, electrocardiogram (ECG) and echocardiogram (ECHO)/ multigated acquisition scan (MUGA) parameters
Time frame: through study completion, an average of 1 year
assess the Overall Response Rate of TST003 as monotherapy at the RP2D in subjects with locally advanced or metastatic GREM1 positive solid tumors (Phase 1bPart)
Overall Response Rate
Time frame: through study completion, an average of 1 year
assess the Duration of Response of TST003 as monotherapy at the RP2D in subjects with locally advanced or metastatic GREM1 positive solid tumors (Phase 1bPart)
Duration of Response
Time frame: through study completion, an average of 1 year
assess the Time to Response of TST003 as monotherapy at the RP2D in subjects with locally advanced or metastatic GREM1 positive solid tumors (Phase 1bPart)
Time to Response
Time frame: through study completion, an average of 1 year
assess the Disease Control Rate of TST003 as monotherapy at the RP2D in subjects with locally advanced or metastatic GREM1 positive solid tumors (Phase 1bPart)
Disease Control Rate
Time frame: through study completion, an average of 1 year
assess the Progression Free Survival of TST003 as monotherapy at the RP2D in subjects with locally advanced or metastatic GREM1 positive solid tumors (Phase 1bPart)
Progression Free Survival
Time frame: through study completion, an average of 1 year
assess the Overall Survival of TST003 as monotherapy at the RP2D in subjects with locally advanced or metastatic GREM1 positive solid tumors (Phase 1bPart)
Overall Survival Based on investigators' assessment using RECISTv1.1
Time frame: through study completion, an average of 1 year
To characterize Area under the Curve (AUC) of TST003
Determine AUC of serum concentration of TST003 over time
Time frame: through study completion, an average of 1 year
To characterize Cmax of TST003
Determine Cmax of serum concentration of TST003
Time frame: Measured while the patient is on study
To Determine Trough serum concentration of TST003
Determine Trough serum concentration of TST003
Time frame: through study completion, an average of 1 year
Determine the formation of Anti-drug antibody (ADA) against TST003
Determine the formation of Anti-drug antibody (ADA) against TST003
Time frame: through study completion, an average of 1 year
Determine the formation of Neutralizing antibodies (NAb) against TST003
Determine the formation of Neutralizing antibodies (NAb) against TST003
Time frame: through study completion, an average of 1 year
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