This is a Phase I open, multi-center, first-in-human study evaluating JSKN016 in subjects with advanced metastatic solid tumors, divided into dose escalation and dose extension.
A total of seven (Q3W, the first day of intravenous administration every 3 weeks) dose groups were designed during the dose escalation period. The dose groups were 0.5, 1.0, 2.0, 4.0, 6.0, 7.0 and 8.0 mg/kg, respectively. The DLT observation period was 21 days with accelerated titration BOIN design. The specific steps for conducting a clinical trial using the BOIN design are as follows: 1. The accelerated titration is performed as follows: the first patient is assigned to dose level 1. If this patient does not develop dose-limiting toxicity (DLT), the second patient will be treated at the next higher dose level. Only one patient at a time is treated, and the dose-climbing process continues until the first DLT is observed, or a second grade 2 toxicity is present, or the highest dose is reached, or a Safety Inspection Committee (SMC) discussion decides to end accelerated titration, whichever occurs first. At least two more patients are then treated on the current dose. After that, follow steps 2 and 3 below with at least 3 patients in each group to treat follow-up patients (≥3 patients in the non-accelerated titration dose group). 2. Assign the dose to the next group of subjects according to the dose rise and fall rule shown in the Bayesian optimal interval (BOIN). Note the following: 1. "Elimination" means the removal of current and higher doses from the trial. The removed dose is a hypertoxic dose and will no longer be used to treat any newly enrolled patients. 2. If the current dose is removed, the dose is automatically lowered to the next lower level and administered to the subject for treatment. If the lowest dose is eliminated, the trial is terminated early to ensure subject safety. In this case, the MTD cannot be determined. 3. If none of the decision conditions (i.e., raise, lower, or remove the dose) are met, continue to treat the next group (3 subjects) with the current dose. 4. If the current dose is the minimum dose but the dose is still required to be reduced by the rules, the new subject is still treated at the current minimum dose. If the number of subjects with DLT reaches the exclusion threshold, the trial is terminated early to ensure subject safety. 5. If the current dose is the maximum dose but a higher dose is required by rule, the new subject is treated at the current maximum dose. 3. Repeat Step 2 until the set dose escalation phase has a maximum sample size of 20, or the number of evaluable subjects treated at the current dose reaches 9 and the current decision is to maintain the current dose according to the rise and fall rule of the dose escalation decision table. During dose escalation, the SMC will conduct an ongoing safety assessment. The safety data for each dose group is reviewed by the SMC before the next dose group is administered. For the 6th dose group 7 mg/kg, SMC can decide whether to skip this dose group by comprehensively considering the previous safety, PK and other data. The composition and responsibilities of the SMC will be further detailed in the SMC Constitution. In each dose group, the administration of the second subject was initiated at least 24 hours after the administration of the first subject to identify some acute toxicities, such as infusion-related reactions. Allow patients to proceed with intragroup dose escalation to minimize the potential for undertreatment of patients. Intrapatient dose escalation will be performed in the following manner: (1) Intrapatient dose escalation will only be performed if ≤ grade 2 toxicity is observed during the previous treatment cycle; (2) Does not increase to the next higher dose level until the full DLT observation period is evaluated for the next higher dose level and the SMC does not confirm safety concerns; (3) Patients receiving the first dose escalation should be dosed for at least 4 cycles without disease progression. For example, if patients in the 1 mg/kg group completed DLT observation and 4 cycles of dosing, only if patients in the 2 mg/kg cohort completed a complete DLT evaluation, the SMC did not confirm safety concerns, and no grade 2 toxicity was observed in patients in the 1 mg/kg cohort during the previous treatment cycle. Subsequent doses may be increased to 2 mg/kg with the consent of the SMC. The recommended dose for cohort expansion (RDE) will be determined by the SMC based on safety/tolerability, PK data, and preliminary antitumor activity, as well as other available data. RDE can be at the same dose level as MTD or at a lower dose level than MTD; Rdes may also be different for different indications.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
140
JSKN016 is a bispecific antibody drug conjugate targeting HER3 and TROP2.
Fujian Cancer Hospital
Fuzhou, Fujian, China
RECRUITINGSun Yat-sen Hospital, Sun Yat-sen University
Guangzhou, Guangdong, China
RECRUITINGIncidence of DLTs
DLTs are defined as one or more serious toxic reactions that occur within 21 days (Q3W) after the start of dosing and are determined to be reasonably associated with the study drug
Time frame: 21 days after the first dose for subjects at dose escalation stage
The frequency and severity of treatment-related adverse events (TEAE), treatment-related adverse events (TRAE), and serious adverse events (SAE).
Clinically significant changes in lab test findings
Time frame: From first dose to 30 days after last dose
MTD or RP2D of JSKN 016
To determinate MTD and/ or RP2D of JSKN016
Time frame: Postdose of last participant up to 1 year
Objective Response Rate (ORR) in Extended queue
Objective response rate (ORR) was defined as the proportion of participants who achieve either complete response \[CR\] or partial response \[PR\] per Response Evaluation Criteria in Solid Tumors (RECIST v1.1)
Time frame: Postdose of last participant up to 1 year
Clinical benefit rates (CBR)
Clinical benefit rate (CR+PR+\[stable disease (SD) ≥ 6 months\]) is defined as those participants with best response as CR or PR or else SD with a duration of at least 6 months. SD for 6 months duration was defined as the time from the first dose to the first documentation of PD or to the last adequate response assessment prior to data cut-off date, whichever is earlier.
Time frame: Postdose of last participant up to 1 year
Cmax of JSKN016
Maximum (Peak) Observed blood Concentration (Cmax) of JSKN016 Following First Dose
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Time frame: Predose to 90 days after last dose
Tmax of JSKN016
Time of Maximum blood Concentration (Tmax) of JSKN016 Following First Dose
Time frame: Predose to 90 days after last dose
AUC of JSKN016
The blood PK parameters of JSKN016 and its analytes for area under the concentration-versus-time curve from time 0 to the last quantifiable concentration as calculated by the linear-up log-down trapezoidal method (AUClast) and AUC from time 0 to infinity (AUCinf) elimination rate constant associated with the terminal phase were estimated using standard non-compartmental methods.
Time frame: Postdose of last participant up to 1 year
Terminal Elimination Half-life (t1/2)
The blood PK parameters of Terminal elimination half-life for JSKN016
Time frame: Postdose of last participant up to 1 year
Duration Of Response (DOR)
Defined as the time from the first evaluation of objective response to the first evaluation of PD or death from any cause prior to PD
Time frame: Postdose of last participant up to 1 year