ZE94-0605 is an oral, selective cyclin-dependent kinase 2 (CDK2) inhibitor. This multicenter, open-label, first-in-human Phase 1 study will evaluate ZE94-0605 in adults with advanced, unresectable or metastatic solid tumors. Phase 1a will use sequential dose escalation to determine the maximally tolerated dose and biologically effective dose. Phase 1b will randomize participants with CCNE1 amplification, or another prospectively specified molecular feature, between two dose levels to select the recommended Phase 2 dose.
This is a multicenter, open-label, first-in-human Phase 1 study of oral ZE94-0605 in adults with pathologically confirmed advanced, unresectable or metastatic solid tumors that are refractory to, or intolerant of, available therapies known to provide clinical benefit, if available. ZE94-0605 is a selective inhibitor of cyclin-dependent kinase 2 (CDK2). Phase 1a is a sequential dose-escalation portion using a standard 3+3 design. The planned once-daily dose levels are 100 mg, 200 mg, 350 mg, 500 mg, and 650 mg; an optional 50 mg dose level may be evaluated if 100 mg is not tolerated. Additional approximately 33% dose increments may be explored after 650 mg if a maximally tolerated dose or biologically effective dose has not been identified. Dose-limiting toxicities are evaluated during Cycle 1, which is 28 days. After dose escalation, Phase 1b will randomize approximately 30 participants with CCNE1 amplification, or another prospectively specified molecular or cellular feature, between two expansion doses: the maximally tolerated dose and one dose level below it. Approximately 15 participants will be assigned to each dose. The recommended Phase 2 dose will be selected based on integrated safety, tolerability, pharmacokinetic, pharmacodynamic, and preliminary clinical-activity data. ZE94-0605 is administered orally once daily in the fasted state in continuous 28-day cycles. Treatment may continue until disease progression, unacceptable toxicity, withdrawal, or completion of 26 cycles. Response assessments are scheduled before dosing on Day 1 of Cycles 3, 5, 7, 10, 13, 19, and 26. Pharmacokinetic and serum thymidine kinase 1 assessments are performed intensively during Cycles 1 and 2. Plasma circulating tumor DNA is assessed during Cycles 1, 2, 3, and 6, at scheduled response assessments, and at end of treatment, relapse, or progression.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Oral capsules QD
St. George Private hospital
Kogarah, New South Wales, Australia
RECRUITINGSOCRU - Southern Oncology Clinical Research Unit
Bedford Park, South Australia, Australia
RECRUITINGRepublican Specialized Scientific and Practical Medical Center of Oncology and Radiology Uzbekistan
Tashkent, Uzbekistan
RECRUITINGNumber of Participants With Dose-Limiting Toxicities
Number and percentage of participants in Phase 1a who experience a protocol-defined dose-limiting toxicity. Dose-limiting toxicities are specified hematologic or non-hematologic toxicities graded using National Cancer Institute Common Terminology Criteria for Adverse Events, Version 6.0, that are not primarily attributable to the underlying cancer, a known disease complication, or a comorbid condition.
Time frame: Cycle 1, Day 1 through Day 28
Maximally Tolerated Dose of ZE94-0605
The maximally tolerated dose is the highest evaluated dose at which no more than 1 of up to 6 participants experiences a dose-limiting toxicity during Cycle 1. Dose-exposure saturation and evidence of an efficacious dose with an acceptable safety margin may also inform termination of dose escalation.
Time frame: Through completion of the Phase 1a dose-escalation portion, estimated up to approximately 24 months
Recommended Phase 2 Dose of ZE94-0605
The recommended Phase 2 dose will be selected following randomized evaluation of two Phase 1b expansion doses based on integrated safety, tolerability, pharmacokinetic, pharmacodynamic, and preliminary clinical-activity data.
Time frame: Through completion of the Phase 1b dose-expansion portion, estimated up to approximately 24 months
Number of Participants With Treatment-Emergent Adverse Events
Number and percentage of participants with treatment-emergent adverse events, serious adverse events, and adverse events leading to dose modification, treatment discontinuation, or death. Severity will be graded using National Cancer Institute Common Terminology Criteria for Adverse Events, Version 6.0.
Time frame: From first dose through 30 days after the last dose of ZE94-0605
Overall Response Rate
The proportion of evaluable participants whose best overall response is complete response or partial response, assessed using Response Evaluation Criteria in Solid Tumors, Version 1.1, or other disease-appropriate response criteria specified for the participant. Results will be summarized by tumor type and CCNE1 amplification status.
Time frame: From baseline through Cycle 26 or end of treatment, up to approximately 24 months
Duration of Response
Among participants with a complete or partial response, duration of response is the time from the first documented response until documented disease progression or death from any cause, whichever occurs first. Results will be summarized by CCNE1 amplification status.
Time frame: From first documented response through study completion, up to approximately 24 months
Overall Survival
Overall survival is the time from the first dose of ZE94-0605 until death from any cause.
Time frame: From first dose through long-term follow-up and study completion, up to approximately 24 months
Maximum Observed Plasma Concentration of ZE94-0605
Maximum observed plasma concentration (Cmax) of ZE94-0605 derived from serial plasma pharmacokinetic samples.
Time frame: Cycle 1 Day 1 through Cycle 2 Day 2; each cycle is 28 days
Area Under the Plasma Concentration-Time Curve of ZE94-0605
Area under the plasma concentration-time curve (AUC) of ZE94-0605 derived from serial plasma pharmacokinetic samples.
Time frame: Cycle 1 Day 1 through Cycle 2 Day 2; each cycle is 28 days
Time to Maximum Observed Plasma Concentration of ZE94-0605
Time to maximum observed plasma concentration (Tmax) of ZE94-0605 derived from serial plasma pharmacokinetic samples.
Time frame: Cycle 1 Day 1 through Cycle 2 Day 2; each cycle is 28 days
Terminal Elimination Half-Life of ZE94-0605
Apparent terminal elimination half-life of ZE94-0605 derived from serial plasma pharmacokinetic samples.
Time frame: Cycle 1 Day 1 through Cycle 2 Day 2; each cycle is 28 days
Change From Baseline in Serum Thymidine Kinase 1
Serum thymidine kinase 1 concentrations and change from baseline will be evaluated as a pharmacodynamic marker of ZE94-0605 activity.
Time frame: Cycle 1 Day 1 through Cycle 2 Day 2, including additional predose assessments on Cycle 1 Days 8 and 15
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