This is a multicenter, single-arm, open, dose-escalation Phase I/II clinical trial, consisting of a dose-escalation phase (accelerated titration phase, 3+3 design) and a dose expansion phase.
Based on the safety, tolerability, PK results, and antitumor activity of EX103 in patients with relapsed or refractory CD20-positive non-Hodgkin lymphoma, this study will determine dose-limiting toxicity (DLT) and determine the maximum tolerated dose (MTD) or optimal biological dose (OBD) to provide a basis for the recommended Phase 2 dose (RP2D). The dose expansion phase will further evaluate the safety, tolerability, PK, PD profile, initial antitumor effect, and immunogenicity of several extended cohorts.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
415
Administered as specified in the treatment arm.
Cancer Hospital Affiliated to Zhengzhou University, Henan Cancer Hospital
Zhengzhou, Henan, China
RECRUITINGQilu Hospital, Cheeloo College of Medicine, Shandong University
Jinan, Shandong, China
RECRUITINGShanghai Sixth People's Hospital, Shanghai Jiaotong University school of Medicine
Shanghai, Shanghai Municipality, China
Incidence of Dose Limiting Toxicities (DLTs) [dose escalation (Cycle 0 and Cycle 1)]
To determine the RP2D and the MTD, if reached.
Time frame: During the DLT evaluation period (28 days from Cycle1 Day1 at the dose escalation stage).
Safety endpoints:incidence and severity of adverse events (AE), laboratory tests, etc.
Treatment-emergent AEs (TEAEs) as assessed by CTCAE v5.0. Abnormal laboratory values are reported as AEs per protocol.
Time frame: From first dose until the end of the safety follow-up period [within 28 ± 7 days after the last study treatment or before the start of other anti-tumor treatments (whichever occurs earlier)].
All parts: Time to reach Cmax (Tmax)
Tmax is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Maximum (peak) plasma concentration (Cmax)
Cmax is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Area under the concentration-time curve from time 0 to the last measurable concentration using linear-log trapezoidal rule (AUC0-t)
AUC0-t is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Elimination half-life (t 1/2)
t 1/2 is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
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Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences
Tianjin, Tianjin Municipality, China
RECRUITINGAll parts: Total body clearance of drug from the plasma (CL)
CL is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Steady-state maximum plasma concentration(Css,max)
Css,max is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Steady-state minimum plasma concentration(Css,min)
Css,min is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Steady-state time to maximum concentration(Tss,max)
Tss,max is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Area under the plasma concentration versus time curve at Steady-State(AUCss)
AUCss is one of the characteristics of Pharmacokinetic (PK) endpoint.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Pharmacodynamic (PD) endpoint
Before and after administration of EX103, changes in lymphocyte subsets and peripheral blood cytokine levels.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Objective response rate (ORR)
ORR is defined as the proportion of subjects whose optimal response is CR or CRi or PR. Subjects who did not undergo tumor evaluation after baseline were considered to have no objective, as determined by the investigator using Lugano 2014 criteria.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Disease control rate (DCR)
DCR is defined as the proportion of subjects whose best response is CR or CRi or PR or SD.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Duration of response (DoR)
Duration of response (DoR) is defined as the time between the first onset of CR or CRi or PR and the onset of PD or death from any cause, whichever occurs first, in subjects with objective response.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Incidence of anti-drug antibodies (ADA)
Percentage of positive patients of anti-drug antibody.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Incidence of neutralizing antibody (NAb)
Percentage of positive patients of neutralizing antibody.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.
All parts: Confirmation of anti-drug antibody and neutralizing antibodies.
Screening of antibodies against corresponding antigens and confirmation of positive antibodies, and determination of the titers of related antibodies (IgG, etc.) produced in the humoral and cellular immunity.
Time frame: From first dose until treatment discontinuation, expected average of 3.5 years.