Trial of Surufatinib Combined With JS001 in the Treatment of Advanced Solid Tumors

This is an open-label, phase I study evaluating safety, tolerability, pharmacokinetics and efficacy of Surufatinib combined with the humanized anti-PD-1 antibody JS001 in patients with solid tumors.


Eligibility Criteria:
Inclusion Criteria:

1. Must have read, understood, and provided written informed consent voluntarily. Willing to adhere to the study visit schedule and the prohibitions and restrictions specified in this protocol.
2. Male and Female aged between 18 and 75 years are eligible;
3. Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1;
4. Histologic diagnosis of locally advanced or metastatic unresectable solid tumors (neuroendocrine tumors, liver carcinoma, gastric carcinomas considered with priority);
5. Failed after standard treatment (disease progression or intolerable for toxic side effects) or no effective to treatment;
6. For liver carcinoma with Child-Pugh of grade A and grade B (≤ 7 points);
7. Radiographic evidence of disease rogression by RECIST criteria on or after last anti-cancer therapy within 6 months; If the single lesion previously received radiation, ablation, there must be an imaging identification for disease progression;
8. Predicted survival \>=3 months;
9. At least 1 measurable lesion (only 1 measurable lymph node lesion is excluded) (routine CT scan \>=20mm, spiral CT scan \>=10mm, no prior radiation to measurable lesions);
10. Screening laboratory values must meet the following criteria (within past 14 days): hemoglobin ≥ 9.0 g/dL; neutrophils ≥ 1500 cells/ μL; platelets ≥ 100 x 10\^3/ μL; total bilirubin ≤ 1.5 x upper limit of normal (ULN); aspartic transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 x ULN without, and ≤ 5 x ULN with hepatic metastasis; serum creatinine ≤1╳ULN, creatinine clearance \>50ml/min (CockcroftGault equation) PT/INR, aPTT≤1.5 x ULN;
11. Males or female of childbearing potential must: agree to use using a reliable form of contraception (eg, oral contraceptives, intrauterine device, control sex desire, double barrier method of condom and spermicidal) during the treatment period and for at least 12 months after the last dose of study drug.

Exclusion Criteria:

1. The toxicity associated with previous anti-tumor treatment has not recovered to ≤CTCAE1, except for peripheral neurotoxicity and alopecia ≤CTCAE2 caused by oxaliplatin;
2. Had other malignant tumors in the past 5 years (except for basal cell carcinoma or squamous cell carcinoma, cervical carcinoma in situ that have been effectively controlled);
3. Evidence with active CNS disease;
4. Prior treatment with chemotherapy, biological immunotherapy, targeted therapy, Chinese herbal medicine within 2 weeks.
5. Prior treatment with radical radiation within 4 weeks
6. Prior treatment with antiPD1/PDL1/PDL2/CTLA-4 antibody or Sulfatinib;
7. Prior treatment with corticosteroids (dose \> 10 mg/day prednisone or other hormones) or other immunosuppressive agents within 2 weeks, nasal or inhalation in allowed (dose \> 10 mg/day prednisone or other hormones).
8. Patients with any active autoimmune disease or a documented history of autoimmune disease, or history of syndrome that required systemic steroids or immunosuppressive medications, such as hypophysitis, pneumonia, colitis, hepatitis, nephritis, hyperthyroidism or hypothyroidism;
9. Prior live vaccine therapy within past 4 weeks;
10. Prior major surgery within past 4 weeks (diagnostic surgery excluded);
11. Uncontrolled malignant pleural effusion, ascites or pericardial effusion;
12. Hypertension that is not controlled by the drug, and is defined as: SBP≥140 mmHg and/or DBP≥90 mmHg;
13. The patient currently has disease or condition that affects the absorption of the drug, or the patient cannot be administered orally;
14. Received a potent inducer or inhibitor of CYP3A4 within 2 weeks, or continue receiving these drugs during the study;
15. Digestive tract disease such as gastric and duodenal active ulcer, ulcerative colitis or unresected tumor, or other conditions determined by the investigator that may cause gastrointestinal bleeding and perforation;
16. Evidence of bleeding tendency or history within 2 months, or thromboembolic event (including a stroke event and/or a transient ischemic attack) occurred within 12 month;
17. Severe, uncontrolled medical condition that would affect patients' compliance or obscure the interpretation of toxicity determination or adverse events, including active severe infection, uncontrolled diabetes, angiocardiopathy (heart failure \> class II NYHA, LVEF \<50%, myocardial infarction, unstable arrhythmia or unstable angina within past 6 months, cerebral infarction within past 3 months) or pulmonary disease ( interstitial pneumonia, obstructive pulmonary disease or symptomatic bronchospasm);
18. Clinically significant severe electrolyte abnormality judged by investigator ;
19. Active infection or unexplained fever during the screening period (temperature \>38.5C)
20. History with tuberculosis who are receiving or have received anti-TB treatment within 1 year.
21. Pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, radiation pneumonitis, drug-associated pneumonia, severe impaired lung function, etc; Radiation pneumonitis in the radiotherapy area is allowed;
22. Positive tests for HIV, HCV, HBsAg or HBcAb with positive test for HBV DNA (\>2000IU/ml);
23. Prior antitumor therapy (including corticosteroids and immunotherapy) or participation in other clinical trials within past 4 weeks, or have not recovered from toxicities since the last treatment;
24. Pregnant or nursing;
25. Hypersensitivity to Sulfatinib or recombinant humanized antiPD1 monoclonal Ab;
26. Underlying medical condition that, in the Investigator's opinion, would increase the risks of study drug administration or obscure the interpretation of toxicity determination or adverse events.