The goal of this study is to identify a safe and tolerated dose of the orally administered DHX9 inhibitor ATX-559. In addition, this study will evaluate the pharmacokinetics, pharmacodynamics and preliminary antitumor activity of ATX-559 in patients with advanced solid tumors and molecularly defined cancers.
ATX-559 is an oral drug that inhibits a protein called DHX9, a multi-functional RNA helicase that is involved in the maintenance of genomic stability by resolving DNA/RNA secondary structures that may lead to DNA replication stress and DNA damage in certain molecularly defined cancers. ATX-559 has been shown preclinically to induce robust anti-tumor activity of a variety of different solid tumors, including models with BRCA deficiency and microsatellite instability-high (MSI-H) and/or deficient mismatch repair (dMMR). This is a first-in-human, Phase 1, open-label, single-arm, dose-escalation and expansion study to: Evaluate the safety profile of ATX-559 and determine the recommended phase 2 dose (RP2D). In addition, the study aims to characterize the PK, PD, and preliminary anti-tumor activity of orally administered ATX-559. Exploratory objectives include examination of biomarker responses in relationship to ATX-559 exposure. Patients with molecularly selected locally advanced or metastatic solid tumors (for example, BRCA1- or BRCA2-deficient breast cancer and solid tumors with microsatellite instability (MSI-H) and/or deficient mismatch repair (dMMR) will be enrolled to preliminarily assess the anti-tumor effect, and further examine the safety and PK of ATX-559 at the RP2D.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
17
DHX9 tablets will be taken orally
University of Colorado Cancer Center - Anschutz Medical Campus,
Aurora, Colorado, United States
Stephenson Cancer Center at OU Medicine
Oklahoma City, Oklahoma, United States
SCRI Oncology Partners
Nashville, Tennessee, United States
The University of Texas MD Anderson Cancer Center
Houston, Texas, United States
NEXT Oncology
San Antonio, Texas, United States
Recommended phase 2 dose (RP2D) and/or maximum tolerated dose (MTD) of ATX-559
Identification of a tolerable and safe dose for expansion cohorts based on dose limiting toxicities
Time frame: 12 months
Safety and tolerability of ATX-559
Incidence of adverse events graded according to CTCAE v5.0
Time frame: 12 months
Preliminary evidence of antitumor activity
Objective response rate based on RECIST v1.1
Time frame: 12 months
Pharmacodynamic activity of ATX-559 in blood over time via measurement of circBRIP1 RNA levels
Time frame: 12 months
Maximum observed plasma concentration of ATX-559 (Cmax)
Time frame: 12 months
Calculated time to reach maximum observed plasma concentration (Tmax)
Time frame: 12 months
Calculated area under the plasma concentration-time curve of ATX-559 (AUC0-t)
Time frame: 12 months
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