This is a global, multi-center, open-label, Phase I/II first-in-human study of XNW27011 monotherapy as an investigational product (IP) in patients with locally advanced and/or metastatic solid tumors who have failed or are intolerant to standard therapies. XNW27011 is an antibody-drug conjugate (ADC) targeting Claudin 18.2 (CLDN18.2), a transmembrane protein important to tight junctions. The study consists of 2 parts: Part 1 is the dose-escalation phase (Phase I), and Part 2 is the does-expansion phase (Phase II). In phase I part of the study, approximately 42 patients with locally advanced and/or metastatic solid tumors will be enrolled, irrespective of CLDN18.2 expression. However, the most recently available tumor tissue specimen will be collected (if available) for a retrospective CLDN18.2 expression confirmation. In phase II part of the study, only patients with confirmed CLDN18.2 expression by IHC in the central laboratory will be enrolled.The phase II part of the study will consist of the following four groups,Up to three dose cohorts for each patient group are planned currently. Each dose cohort will include approximately 20 patients. Approximately 240 patients evaluable will be enrolled in Phase Ⅱ part of the study.
This is a global, multi-center, open-label, Phase I/II first-in-human study of XNW27011 monotherapy as an investigational product (IP) in patients with locally advanced and/or metastatic solid tumors who have failed or are intolerant to standard therapies. XNW27011 is an antibody-drug conjugate (ADC) targeting Claudin 18.2 (CLDN18.2), a transmembrane protein important to tight junctions. The study consists of 2 parts: Part 1 is the dose-escalation phase (Phase I), and Part 2 is the does-expansion phase (Phase II). In phase I part of the study, approximately 42 patients with locally advanced and/or metastatic solid tumors will be enrolled, irrespective of CLDN18.2 expression. However, the most recently available tumor tissue specimen will be collected (if available) for a retrospective CLDN18.2 expression confirmation. In phase II part of the study, only patients with confirmed CLDN18.2 expression by IHC in the central laboratory will be enrolled.The phase II part of the study will consist of the following four groups,Up to three dose cohorts for each patient group are planned currently. Each dose cohort will include approximately 20 patients. Approximately 240 patients evaluable will be enrolled in Phase Ⅱ part of the study.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
240
Eligible patient(s) in each dose cohort will receive the assigned XNW27011 dose administration every 3 weeks (Q3W, cycle) until intolerable toxicity, progression of the disease without clinical benefit, or withdrawal of informed consent. An accelerated titration scheme will be used for the first two dose levels (0.6 mg/kg and 1.2 mg/kg) starting from 0.6 mg/kg dose as follows: The first patient will be enrolled for 0.6 mg/kg dose. If the subject shows no significant toxicity in cycle 1 (DLT observation period), the second patient will be enrolled for 1.2 mg/kg. 3 + 3 dose escalation:3 patients will be enrolled to the dose cohort first,If 1 of 3 patients experiences a DLT, up to 3 more patients will be enrolled in the same dose cohort.. If none of the additional 3 patients experiences a DLT, dose escalation will continue to the next dose.Dose escalation will be stopped when 2 or more patients out of 3 to 6 patients at the same dose level experience a DLT.
Group A: Gastric/gastroesophageal junction adenocarcinoma with CLDN18.2 expression, tentatively expand with 3.6, 3.0, 2.4 mg/kg. Group B: Pancreatic adenocarcinoma with CLDN18.2 expression, tentatively expand with 3.6, 3.0, 2.4 mg/kg. Group C: Ovarian cancer with CLDN18.2 expression, tentatively expand with 3.6, 3.0, 2.4 mg/kg. Group D: Other tumors with CLDN18.2 expression, including but not limited to esophagus adenocarcinoma, lung cancer, colorectal cancer, and biliary tract cancer,tentatively expand with 3.6, 3.0, 2.4 mg/kg.
Affiliated Hospital of Shandong First Medical University
Jinan, Shandong, China
RECRUITINGPhase I (Dose Escalation):To determine the maximum tolerated dose (MTD) and/or the recommended Phase 2 dose (RP2D) of XNW27011
In the dose escalation phase, if there are ≥ 2 cases of DLT among 3-6 subjects at a dose level during the DLT observation period (Cycle 1, 21days), the previous dose or intermediate dose (the midway dose between the previous dose group and the intolerant dose group) may be defined as MTD.
Time frame: Baseline up to approximately 2 years
Phase Ⅱ (Dose Expansion):To evaluate the objective response rate (ORR) of XNW27011 by cohorts at RP2D. The objective response includes the complete response (CR) and the partial response (PR).
To evaluate the objective response rate (ORR) of XNW27011 by cohorts at RP2D. The objective response includes the complete response (CR) and the partial response (PR).
Time frame: Baseline up to approximately 2 years
Phase I (Dose Escalation):To assess the dose limiting toxicities (DLTs) of XNW27011 when administered intravenously (IV) as a monotherapy during the first cycle (3 weeks [21 days]) to patients with locally advanced and/or metastatic solid tumors.
To assess the dose limiting toxicities (DLTs) of XNW27011 when administered intravenously (IV) as a monotherapy during the first cycle (3 weeks \[21 days\]) to patients with locally advanced and/or metastatic solid tumors.
Time frame: 3 weeks
Phase I (Dose Escalation):To assess the overall safety of XNW27011 when administered IV as a monotherapy every cycle (3 weeks [Q3W]) to patients with locally advanced and/or metastatic solid tumors.
The incidence and severity of adverse events graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.
Time frame: 3 weeks
Phase I (Dose Escalation):To assess the pharmacokinetic (PK) profiles of XNW27011, total antibody (XNW27011-TAb, including conjugated and unconjugated), the topoisomerase I inhibitor YL0010014 (payload/toxin) and the major metabolites.
To assess the pharmacokinetic (PK) profiles of XNW27011, total antibody (XNW27011-TAb, including conjugated and unconjugated), the topoisomerase I inhibitor YL0010014 (payload/toxin) and the major metabolites.
Time frame: Baseline up to approximately 2 years
Phase I (Dose Escalation):To evaluate the preliminary efficacy of XNW27011 as a monotherapy.
According to RECIST 1.1, the proportion of subjects' ORR was evaluated by researchers.
Time frame: Baseline up to approximately 2 years
Phase I (Dose Escalation):To assess the incidence of anti-drug antibody (ADA) against XNW27011.
To assess the incidence of anti-drug antibody (ADA) against XNW27011.
Time frame: Baseline up to approximately 2 years
Phase I (Dose Escalation):To assess the relationship between claudin 18.2 (CLDN18.2) expression and the antitumor response of XNW27011.
According to the expression rate of claudin 18.2 and the corresponding best ORR, the influence of claudin 18.2 expression rate on the curative effect was analyzed.
Time frame: Baseline up to approximately 2 years
Phase Ⅱ (Dose Expansion):To assess the safety of XNW27011 at the RP2D.
The incidence and severity of adverse events graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.
Time frame: Baseline up to approximately 2 years
Phase Ⅱ (Dose Expansion):To evaluate the efficacy of XNW27011 at the RP2D: Disease control rate (DCR)
DCR is defined as the percentage of subjects with the best tumor evaluation of CR, PR or SD among all patients with measurable disease at baseline.
Time frame: Baseline up to approximately 2 years
Phase Ⅱ (Dose Expansion):To evaluate the efficacy of XNW27011 at the RP2D:Duration of response (DOR)
DOR is defined as the duration from the first documentation of disease response (CR/PR) to the first documentation of disease progression or death; the end date is the same as the date of disease progression defined for PFS or death due to any cause, the start date is the date of the first evaluation of PR or CR.
Time frame: Baseline up to approximately 2 years
Phase Ⅱ (Dose Expansion):To evaluate the efficacy of XNW27011 at the RP2D:Time to response (TTR)
TTR is defined as the time from the date of first dose to the date of first meeting response criteria.
Time frame: Baseline up to approximately 2 years
Phase Ⅱ (Dose Expansion):To evaluate the efficacy of XNW27011 at the RP2D:Progression-Free Survival (PFS)
PFS is defined as the length of time from the first dose to progression of disease or death.
Time frame: Baseline up to approximately 2 years
Phase Ⅱ (Dose Expansion):To evaluate the efficacy of XNW27011 at the RP2D:Overall survival (OS)
OS is defined as the time from the date of first dose to the date of death due to any cause.
Time frame: Baseline up to approximately 2 years
To assess the relationship between CLDN18.2 expression and the antitumor response of XNW27011.
According to the expression rate of claudin 18.2 and the corresponding best ORR, the influence of claudin 18.2 expression rate on the curative effect was analyzed.
Time frame: Baseline up to approximately 2 years
To assess the incidence of ADA against XNW27011.
To assess the incidence of ADA against XNW27011.
Time frame: Baseline up to approximately 2 years
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