A Modular, Multi-Part, Multi-Arm, Phase 1/2 Study to Evaluate the Safety and Tolerability of CT7439 Alone and in Combination With Anticancer Treatments in Participants With Solid Malignancies
Summary
This modular, multi-part, multi-arm, Phase 1/2, FIH study allows the evaluation of the safety and tolerability of CT7439, dosed as a monotherapy and in combination with anticancer treatment in participants with solid malignancies.
Detailed description
This study will initially evaluate CT7439 as a monotherapy in participants with locally advanced or metastatic solid malignancies, i.e., Module 1, which includes dose escalation cohort (Part A). \- Part A of Module 1: a First-in Human dose escalation investigating the safety and tolerability of CT7439 to identify the minimum biologically active dose (MBAD) and either maximum tolerated dose (MTD) or maximum feasible dose (MFD) of CT7439 when dosed as monotherapy. SRC, consisting of study investigators and sponsor medical personnel, will be formed to monitor the safety, tolerability, PK, and PDc data during this part of the study. In Part A, cohorts (maximum 6) will be opened sequentially following review from the SRC who will make recommendations on CT7439 dosage selection for subsequent cohorts. Participants will continue to receive IMP until evidence of disease progression, unacceptable toxicities, the participant withdraws their informed consent or is withdrawn from the study, or completion of the primary study analysis. Further cohort(s) of specific participant sub-populations may be initiated in Module 1 following approval of a protocol amendment.
Arms & interventions
- DrugCT7439 Capsules (0.5 mg, 1mg, 3mg)
CT7439 capsules administered by mouth once a day as monotherapy with a single starting dose of 1mg in Cohort 1 on Cycle 0 Day 1, followed by a minimum 48 hours treatment -free period before continuous daily dosing in cycles of 28 days (Cycle1 onwards) until DLT or disease progression is observed.
Outcome measures
Primary
Incidence and severity of treatment emergent adverse events will be assessed as per CTCAE v5.0.
Time frame: From first dosing at Cycle 0 to until 30 days after the last dose at Cycle 6. Each cycle is 28 days
Incidence and severity of treatment emergent Laboratory Abnormalities will be assessed as per CTCAE v5.0.
Time frame: From first dosing at Cycle 0 to until 30 days after the last dose at Cycle 6. Each cycle is 28 days.
Change from Baseline in Eastern Cooperative Oncology Group Cooperative Oncology Group (ECOG) Performance scale.
ECOG has 6 levels (0 to 5). 0=Fully Active (Most Favorable Activity); 1=Restricted activity but ambulatory; 2=Ambulatory but unable to carry out work activities; 3=Limited Self-Care; 4=Completely Disabled, No self-care (Least Favorable Activity); 5=Dead.
Time frame: Screening, Cycle 0 Day 1, Cycle 1- Days 1,8,15; Cycle 2 -Days 1,15; Cycle 3 Day 1 - Cycle 6 Day 1 (each cycle 28 days); End of Treatment (within 3 days after last CT7439 dose) and End of Study (30 +/-7 days after the last CT7439 dose administration)
Systolic Blood Pressure as determined by blood pressure changes from baseline in systolic blood pressure (measured in mmHg)
Time frame: Screening, Cycle 0 - Days 1 and Day 2; Cycle 1 - Days 1,8,15; Cycle 2 Day 1 - Cycle 6 Day 1 (each cycle 28 days)
Diastolic Blood Pressure as determined by blood pressure changes from baseline in diastolic blood pressure (measured in mmHg)
Time frame: Screening, Cycle 0 - Days 1 and Day 2; Cycle 1 - Days 1,8,15; Cycle 2 Day 1 - Cycle 6 Day 1 (each cycle 28 days)
Heart Rate as determined by heart rate changes from baseline in beats per minute
Time frame: Screening, Cycle 0 - Days 1 and Day 2; Cycle 1 - Days 1,8,15; Cycle 2 Day 1 - Cycle 6 Day 1 (each cycle 28 days)
Body Temperature. as determined by body temperature changes from baseline in Celsius or Fahrenheit
Time frame: Screening, Cycle 0 - Days 1 and Day 2; Cycle 1 - Days 1,8,15; Cycle 2 Day 1 - Cycle 6 Day 1 (each cycle 28 days)
Respiratory Rate as determined by respiratory rate changes from baseline in breaths per minute
Time frame: Screening, Cycle 0 - Days 1 and Day 2; Cycle 1 - Days 1,8,15; Cycle 2 Day 1 - Cycle 6 Day 1 (each cycle 28 days)
Oxygen Saturation as determined by changes from baseline in %
Time frame: Screening, Cycle 0 - Days 1 and Day 2; Cycle 1 - Days 1,8,15; Cycle 2 Day 1 - Cycle 6 Day 1 (each cycle 28 days)
Change from Baseline in 12-lead Electrocardiogram (ECG): Heart Rate
Time frame: From baseline to end of Cycle 6. Each cycle is 28 days
Change from Baseline in 12-lead Electrocardiogram (ECG): PR interval
Time frame: From baseline to end of Cycle 6. Each cycle is 28 days
Change from Baseline in 12-lead Electrocardiogram (ECG): QRS complex
Time frame: From baseline to end of Cycle 6. Each cycle is 28 days
Change from Baseline in 12-lead Electrocardiogram (ECG): QT intervals
Time frame: From baseline to end of Cycle 6. Each cycle is 28 days
Change from Baseline in 12-lead Electrocardiogram (ECG): QTcF intervals (QT Interval Corrected by the Fridericia Formula)
Time frame: From baseline to end of Cycle 6. Each cycle is 28 days
Module 1 Part A additional primary outcome measures: Maximum tolerated dose (MTD) determination
Maximum tolerated dose (MTD) defined as the highest dose level at which ≤ 1/6 participants experience DLT in the first cycle. A minimum of 6 participants must be enrolled at the MTD level
Time frame: Up to 28 days after the first dose of CT7439
Secondary
CT7439 PK Plasma exposure: Cmax
Time frame: PK urine exposure Cmax: At the end of Cycle 0 Day 1 (cycle 0 is 2 days)
CT7439 PK plasma exposure: C-trough
Time frame: Cycle 0 Day 2, Cycle 1 - Days 1, 8, 15; Cycle 2 Day 2; on Cycle 3 day 1 and upwards on Day 1 of every other cycle (each cycle is 28 days)
Changes in CT or MRI tumor imaging to monitor anti-tumor activity
Time frame: Screening, Cycles 3 Day 1 to Cycle 6 Day 1 (28 days each cycle) and End of Module/ End of Treatment visit (within 3 days after last CT7439 dose)
CT7439 PK urine exposure: Cmax
Time frame: At Cycle 0, Day 1. Cycle 0 Day 1 is 24 hours.
Module 1 Part A additional secondary outcome measures - determination of recommended Phase 2 Dose (RP2D) and minimally biologically active dose (MBAD) of CT7439 when administered as monotherapy
Time frame: from cohort 1 to cohort 6. (each cohort is 6 cycles , each cycle is 28 days)
Module 1 Part A additional secondary outcome measures - Incidence of Dose Limited Toxicities (DLT)
Time frame: At end of Cycle 1 (each cycle is 28 days)
Module 1A secondary outcome measures- Renal clearance
Time frame: Screening, Cycle 0 Day 1, Cycle 1 - Day 1,8,15, Cycle 2 - Day 1,15; Cycle 3 - Cycle 6 (28 day each cycle), End of Module/ End of Treatment (within 3 days after last CT7439 dose)
Module 1A secondary outcome measures - Pharmacodynamic evidence of the downstream effects of target engagement
Time frame: Screening; Cycle 0 Day 1; Cycle 1 - Day 1, 8 and 15; Cycle 2- Cycle 6 (28 day each cycle) - Day 1; and EOT visit
Module 1A secondary outcome measures - Incidence and prevalence of adverse events (AE) resulting in treatment withdrawal
Time frame: From 1st dose of IMP administration at Cycle 0 Day 1 throughout treatment Cycles 1, Cycle 2 - Cycles 6 ( each cycle 28 days) and until End of Treatment (within 3 days of last CT7439 dose) and End of Study (30+/- 7 days after the last CT7439 dose)
Module 1A secondary outcome measures - Best overall response (BOR)
Time frame: Up to 24 weeks
Module 1A Overall response rate (ORR)
Time frame: Up to 24 weeks
Module 1A Duration of Response (DOR)
Time frame: Up to 24 weeks
Module 1A PFS (Progression-free survival) assessment
Time frame: Up to 18 months
Eligibility criteria
Study locations (3)
Research site 03
Dallas, Texas, 75230-2571
Research site 01
San Antonio, Texas, 78229
Research site 02
Fairfax, Virginia, 22031