This is a phase 1b, open-label, dose-escalation study to evaluate the safety, tolerability, pharmacokinetics of Sapu003 in combination with Exemestane in in patients with advanced mTOR-sensitive solid tumors (HR+/HER2-negative breast cancer, renal cell carcinoma \[RCC\], neuroendocrine tumors \[NETs\], tuberous sclerosis complex \[TSC\]-associated tumors, and hepatocellular carcinoma \[HCC\]).
The study will include two cohorts: * Cohort A: Patients with HR+/HER2-negative breast cancer who will receive Sapu003 in combination with exemestane. * Cohort B: Patients with RCC, NETs, TSC-associated tumors, or HCC who will receive Sapu003 without exemestane. The dose levels planned for this study are 5 mg/m², 7.5 mg/m², and 10 mg/m² administered as weekly 30-minute IV infusions, with each treatment cycle lasting 4 weeks (28 days). The primary purpose of this study is to determine the maximum tolerated dose (MTD) of weekly intravenous Sapu003. Secondary objectives include characterizing the pharmacokinetic profile of Sapu003, evaluating its safety and tolerability, and assessing preliminary antitumor activity.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
27
Sapu003 weekly IV at 5, 7.5 or 10 mg/m²
Exemestane 25 mg QD (Breast Cancer Only)
SOCRU
Adelaide, Australia
RECRUITINGMaximum Tolerated Dose (MTD) and Dose Limiting Toxicities (DLTs) of Sapu003 in Patients with Advanced mTOR-Sensitive Solid Tumors
The primary outcome of the study is to determine the Maximum Tolerated Dose (MTD) of Sapu003, defined as the dose level where the estimated true probability of Dose-Limiting Toxicity (DLT) is closest to the target toxicity probability (TTP) of 0.27. This will be evaluated through a dose-escalation design, where patients receive Sapu003 intravenously every week, with doses ranging from 5 to 10 mg/m². The analysis will include the cumulative number of DLTs observed at each dose level, guiding decisions for dose escalation or de-escalation, ultimately reporting the recommended MTD based on isotonic regression estimates
Time frame: The primary outcome timeframe is assessed during the first 28-day cycle of treatment, specifically looking at dose-limiting toxicities (DLTs) to determine the maximum tolerated dose (MTD) of Sapu003
Pharmacokinetic Endpoint - Cmax
Characterization of the Pharmacokinetic Endpoint - Peak Plasma Concentration (Cmax)
Time frame: Week 1 of Cycle 1 and Cycle 2 (28 days per Treatment Cycle)
Pharmacokinetic Endpoint - AUClast
Characterization of the Pharmacokinetic Endpoint - Area Under the Curve from time zero to the last quantifiable concentration (AUClast)
Time frame: Week 1 of Cycle 1 and Cycle 2 (28 days per Treatment Cycle)
Pharmacokinetic Endpoint - AUCinf
Characterization of the Pharmacokinetic Endpoint - Area Under the Curve to Infinity (AUCinf)
Time frame: Week 1 of Cycle 1 and Cycle 2 (28 days per Treatment Cycle)
Pharmacokinetic Endpoint - tmax
Characterization of the Pharmacokinetic Endpoint - Time to reach maximum concentration (tmax)
Time frame: Week 1 of Cycle 1 and Cycle 2 (28 days per Treatment Cycle)
Characterization of the Pharmacokinetic Endpoint - t1/2
Characterization of the Pharmacokinetic Endpoint - Elimination half-life (t1/2)
Time frame: Week 1 of Cycle 1 and Cycle 2 (28 days per Treatment Cycle)
Pharmacokinetic Endpoint - CL
Characterization of the Pharmacokinetic Endpoint - Clearance (CL)
Time frame: Week 1 of Cycle 1 and Cycle 2 (28 days per Treatment Cycle)
Pharmacokinetic Endpoint - Vd
Characterization of the Pharmacokinetic Endpoint - Volume of Distribution (Vd)
Time frame: Week 1 of Cycle 1 and Cycle 2 (28 days per Treatment Cycle)
Anti-Tumor Activity Assessment - ORR
Preliminary anti-tumor activity - ORR (Objective Response Rate)
Time frame: Through study completion
Anti-Tumor Activity Assessment - DCR
Preliminary anti-tumor activity - DCR (Disease Control Rate)
Time frame: Through study completion
Anti-Tumor Activity Assessment - PFS
Preliminary anti-tumor activity - PFS (Progression-Free Survival)
Time frame: Until the end of the study
Anti-Tumor Activity Assessment - DoR
Preliminary anti-tumor activity - DoR (Duration of Response)
Time frame: Until the end of the study
Anti-Tumor Activity Assessment - OS
Preliminary anti-tumor activity - OS (Overall Survival)
Time frame: Until the end of the study
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