Surufatinib in Combination With Tislelizumab in Subjects With Advanced Solid Tumors

Study Overview
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Brief Summary
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This open-label, phase Ib/II study of surufatinib in combination with tislelizumab will evaluate the safety, tolerability, PK and efficacy in patients with advanced solid tumors. The study consists of 2 parts - dose finding (Part 1) and dose expansion (Part 2).

Detailed Description
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This open-label, phase Ib/II study of surufatinib in combination with tislelizumab will evaluate the safety, tolerability, PK and efficacy in patients with advanced solid tumors. The study consists of 2 parts - dose finding (Part 1) and dose expansion (Part 2). Part 1 will be conducted to determine the recommended phase 2 dose (RP2D) and/or the maximum tolerated dose (MTD) of surufatinib in combination with tislelizumab in patients with advanced or metastatic solid tumors who have progressed on, or are intolerant to standard therapies. Part 2 will be an open-label, multi-cohort design to evaluate the anti-tumor activity of surufatinib in combination with tislelizumab in patients with specific types of advanced or metastatic solid tumors. Patients will receive the RP2D determined in part 1 of this study.

Official Title
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An Open-Label Phase Ib/II Study of Surufatinib in Combination With Tislelizumab in Subjects With Advanced Solid Tumors

Conditions
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Neuroendocrine Tumors, Metastatic Solid Tumor, Colorectal Cancer, Small Cell Lung Cancer, Gastric Cancer, Soft Tissue Sarcoma, Anaplastic Thyroid Cancer

Intervention / Treatment
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* Drug: Surufatinib and Tislelizumab _ Part 1
* Drug: Surufatinib and Tislelizumab _ Part 2


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Willing and able to provide informed consent ≥18 years of age Part 1-have evaluable lesions (according to Response Evaluation Criteria in Solid Tumors version 1.1 [RECIST v1.1]) Part 2-have measurable lesions (according to RECIST v1.1) Have a performance status of 0 or 1 on the ECOG scale For female subjects of childbearing potential and male patients with partners of childbearing potential, agreement to use a highly effective form(s) of contraception Dose Escalation: Histologically or cytologically documented, locally advanced or metastatic solid malignancy of any type,. Dose Expansion: Histologically or cytologically documented, locally advanced or metastatic: Cohort A: adenocarcinoma of the colon or rectum that is microsatellite stable. Subjects must have progressed on, or had intolerable toxicity to, at least 3 prior regimens of standard chemotherapy. Cohort B: progressive, low or intermediate grade (grade 1 or grade 2) NETs of thoracic or GEP origins. Subjects must have radiological documentation of progression of disease in the last 6 months and must have progressed on at least one line of standard therapy for metastatic disease. Cohort C: SCLC that has progressed on standard first line chemotherapy treatment. Cohort D: adenocarcinoma of the stomach or gastroesophageal junction and have progressed on at least 2 prior lines of therapy. Tumor stain for PD-L1 by Combined Positive Score (CPS) ≥5%. Cohort E: ASPS or UPS. Subjects must have radiological documentation of disease progression in the last 3 months and have progressed on at least one line of standard therapy or refused standard frontline cytotoxic chemotherapy. Cohort F: Anaplastic thyroid cancer that is considered not curable by resection. Patients with a BRAFV600E mutation must have previously been treated with 1 line of systemic therapy with a BRAF-targeted therapy. Exclusion Criteria: Adverse events (AEs) due to previous anti-tumor therapy has not recovered to Common Terminology Criteria for Adverse Event (CTCAE) ≤Grade 1; Part 2 subjects with CRC , NETs and STS any previous treatment with anti-PD-1, anti PD-L1/L2 antibodies, anti-cytotoxic T lymphocyte associated antigen-4 (CTLA-4) antibody, or any other antibody acting on T cell costimulatory or checkpoint pathway; Previous treatment with surufatinib; Uncontrollable hypertension; History or presence of a serious hemorrhage (>30 ml within 3 months), hemoptysis (>5 ml blood within 4 weeks) or life threatening thromboembolic event within 6 months; Clinically significant cardiovascular disease; Any clinically significant active infection, including, but not limited to, known human immunodeficiency virus (HIV) infection; Brain metastases and/or leptomeningeal disease and/or spinal cord compression untreated with surgery and/or radiotherapy, and without clinical imaging evidence of SD for 14 days or longer; subjects requiring steroids within 4 weeks prior to start of study treatment will be excluded; Active autoimmune diseases or history of autoimmune diseases that may relapse with the following exceptions: Controlled Type 1 diabetes Hypothyroidism (provided it is managed with hormone-replacement therapy only) Controlled celiac disease Skin diseases not requiring systemic treatment (eg, vitiligo, psoriasis, or alopecia) Any other disease that is not expected to recur in the absence of external triggering factors. Arterial thrombosis or thromboembolic events (including stroke and/or transient ischemic attack) within 12 months prior to first dosing; History of deep venous thrombosis within 6 months; Female patients who are pregnant or breastfeeding; Any condition by which investigators judge patients not suitable to participate in this study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Surufatinib and tislelizumab (dose escalation_Part 1)<br>In Part 1 (dose escalation), surufatinib and will be administered orally (PO) once daily (QD) and tislelizumab 200 mg intravenous (IV) infusion every 3 weeks (Q3W). | Drug: Surufatinib and Tislelizumab _ Part 1<br>* Part 1 (all cohorts): oral surufatinib at a dose based on cohort level and intravenous tislelizumab at a 200-mg dose<br>* Other names: HMPL-012, sulfatinib, BGB-A317;|
| Experimental: Surufatinib and tislelizumab (indication specific_Part 2)<br>In Part 2, the indication-specific expansion portion of the study, patients will receive surufatinib at the Recommended Phase 2 Dose (RP2D) dose selected in Part 1 with 200 mg tislelizumab IV, Q3W | Drug: Surufatinib and Tislelizumab _ Part 2<br>* Part 2 (all cohorts): oral surufatinib at the RP2D dose selected in Part 1 and intravenous tislelizumab at a 200-mg dose<br>* Other names: HMPL-012, sulfatinib, BGB-A317;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of dose limiting toxicity | The primary outcome during dose escalation will be the incidence rate of dose limiting toxicities | up to 60 days | 
| Objective response rate (ORR) | The primary outcome of dose expansion will be objective response rate (ORR) in patients with advanced solid tumors when treated with surufatinib in combination with tislelizumab in each cohort | up to 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression Free Survival (PFS) | the duration between the enrollment date and the first disease progression (PD) or death (whichever comes first). | up to 6 months | 
| Maximum plasma concentrations of surufatinib and tislelizumab with blood sampling | Blood samples will be taken to measure levels of study drug | up to 18 months | 
| To evaluate the safety, in subjects, treated with surufatinib and tislelizumab | Adverse events evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0 | up to 2 years | 
| Disease Control Rate (DCR) | The incidence of complete response, partial response and stable disease | Up to 24 months | 
| Duration of Response (DoR) | The duration between the date the criteria for complete response or partial response was first measured (first record shall prevail) and the date of disease recurrence or progression as objectively recorded | up to 24 months | 
| Clinical Benefit Rate (CBR) | The incidence of partial response and stable disease | Up to 24 months | 
| Time to Response (TTR) | The period from the date of enrollment to the date when the criteria for complete response or partial response was first measured (first record shall prevail). | up to 24 months | 
| Overall Survival | The period from date of enrollment to date of death | up to 36 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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VEGF, PD-1