This is a Phase 1/2, multi-regional, multi-center, open-label, first-in-human (FIH), dose-escalation and dose expansion study to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) and preliminary clinical activity of AP402 in HER2-positive patients with locally or advanced solid tumors.
The study will consist of 2 parts: * Part 1 (Dose Escalation): Dose escalation will consist of 7 cohorts where an IV infusion of AP402 will be administered once every 2 weeks to determine the maximum tolerated dose (MTD) (ie, the highest safe dose administered to patients) and the recommended phase 2 dose (RP2D) of AP402. For dose-escalation, an accelerated dose titration design will be utilized for the first 2 dose cohorts, followed by a standard 3+3 dose titration design for the remaining 5 cohorts. Up to 42 patients will be enrolled in Part 1. * Part 2 (Dose Expansion): After the MTD and/or RP2D are determined by the Safety Review Committee (SRC) (see Section 6.5), additional patients will be enrolled in Part 2 and will be treated with AP402 at that dose once every 2 weeks. Part 2 will be based on the Simon's two-stage optimal design (Simon, 1989) and is expected to enroll approximately 43 patients in 1 or 2 selected tumor types. Administration of the IP will continue for 12 months or until confirmed progressive disease, initiation of alternative cancer therapy, intolerable toxicity, withdrawal of consent, study completion, death or other reasons leading to treatment discontinuation, whichever comes first
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
85
Dose escalation will consist of 7 cohorts where an Intraveous infusion of AP402 will be administered once every 2 weeks to determine the maximum tolerated dose (MTD) (ie, the highest safe dose administered to patients) and the recommended phase 2 dose (RP2D) of AP402.
After the MTD and/or RP2D are determined by the SRC, additional patients will be enrolled in Phase 2 dose expansion and will be treated with AP402 at that dose.
Macquarie University Clinical Trials Unit
Macquarie, New South Wales, Australia
NOT_YET_RECRUITINGFlinders Medical Centre
Bedford Park, South Australia, Australia
NOT_YET_RECRUITINGLinear Clinical Research
Perth, Western Australia, Australia
RECRUITINGEstimate of Maximum tolerated dose (MTD)
This will be based on dose limiting toxicities (DLT) observed during the DLT evaluation period.
Time frame: Baseline to 90 days after the last dose
Number of participants with Adverse events (AEs) and Serious Adverse events (SAE) as assessed by CTCAE V5
Time frame: Baseline to 90 days after the last dose
To evaluate R2PD based on PK parameters- Cmax (Maximum plasma concentration)
Time frame: Baseline to 90 days after the last dose
To evaluate R2PD based on PK parameters- Tmax (time for maximum concentration)
Time frame: Baseline to 90 days after the last dose
To evaluate R2PD based on PK parameters- AUC (Area under curve)
Time frame: Baseline to 90 days after the last dose
To evaluate R2PD based on PK parameters- T1/2 (terminal half-life)
Time frame: Baseline to 90 days after the last dose
To evaluate objective response rate (ORR)
The proportion of patients whose best overall response (BOR) is either confirmed complete responses (CR) or confirmed partial responses (PR).
Time frame: Baseline to 30 days after the last dose
Number of patients with disease Control Rate (DCR)
The proportion of patients whose best overall response of confirmed CR, confirmed PR, or (confirmed) stable disease (SD) that was assessed at least 4 weeks (28 days) following the initiation of AP402
Time frame: Baseline to 90 days after the last dose
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Number of patients with changes in duration of objective response (DOOR)
The time from first documented objective response (confirmed CR or confirmed PR) until the earlier of disease progression or death from any cause, whichever occurs first.
Time frame: Baseline to 30 days after the last dose
Duration of disease control response (DODC):
The time from first documented disease control response (confirmed CR, confirmed PR, or confirmed SD) until the earlier of disease progression or death from any cause, whichever occurs first. This will only be applicable for patients who have a confirmed best overall response of CR, PR, or SD. Patients without the events (progressive disease or death) will be censored at the date of their last tumor assessment.
Time frame: Baseline to 30 days after the last dose
To assess progression-free survival (PFS):
The time from start of study treatment to the earlier of either disease progression or death from any cause, whichever occurs first.
Time frame: Up to 48 months
To assess overall Survival (OS)
The time from start of study treatment to the date of death from any cause. Patients alive will be censored at the date of last known alive.
Time frame: Up to 48 months
To assess time to Objective Response (TTOR):
The time from start of study treatment to the first documented objective response (confirmed CR or confirmed PR), whichever occurs first.
Time frame: Baseline to 30 days after the last dose
To assess time to disease control response (TTDC):
The time from start of study treatment to the first documented disease control response (confirmed CR, confirmed PR, or confirmed SD (at least 4 weeks (28 days) following the initiation of AP402)), whichever occurs first.
Time frame: Baseline to 30 days after the last dose
Serum concentration of AP402
Time frame: Baseline to 30 days after the last dose
To evaluate immunogenicity by the number and percentage of patients who develop ADA
Time frame: Baseline to 30 days after the last dose
To evaluate immunogenicity by the number and percentage of patients who develop neutralizing antibodies (if applicable).
Time frame: Baseline to 30 days after the last dose