Clinical trial NCT06457919: A Study of Tinengotinib (TT-00420) in Combination With Standard Treatments in People With Prostate Cancer
Official title: A Phase 1b/2 Study Evaluating the Activity of Tinengotinib (TT-00420) in Combination With Androgen Receptor Signaling Inhibitors (ARSIs) in Patients With Metastatic Castration Resistant Prostate Cancer (mCRPC)
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE1
PHASE2
Conditions: Prostate Cancer
Keywords: Tinengotinib (TT-00420)
Androgen Receptor Signaling Inhibitors (ARSIs)
TIP Study: Tinengotinib In Prostate Cancer
Prostate Cancer Clinical Trials Consortium, LLC (PCCTC)
24-103
Lead sponsor: Memorial Sloan Kettering Cancer Center
Sponsor class: OTHER
Collaborators: name: TransThera Sciences
First posted: 2024-06-13
Enrollment: 50
Sex: MALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: In the Phase 1b portion of the study, participants will be enrolled sequentially in cohorts of 3 for each studied combination. The recommended Phase II dose (RP2D) of each combination will be estimated separately based on the de-escalation rules.
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to find out whether tinengotinib in combination with abiraterone acetate and prednisone or enzalutamide is a safe treatment that causes few or mild side effects in people with metastatic castration-resistant prostate cancer (mCRPC).


Eligibility criteria: Inclusion Criteria:

* Participants ≥ 18 years old, with signed informed consent
* Histologically confirmed carcinoma of the prostate (neuroendocrine differentiation is allowed, but pure small cell carcinoma is not permitted)
* Metastatic disease documented by at least 2 bone lesions on whole body radionuclide bone scan, or soft tissue disease documented by computed tomography (CT) scan/magnetic resonance imaging (MRI). Note: Metastatic disease seen only on PET imaging does not qualify.
* Current ongoing therapy and observed tolerance with full standard dose of abiraterone acetate (1000 mg QD) or enzalutamide (160 mg QD) at the time of study entry, started at least 90 days before consent. An interruption of dosing of a maximum of 30 days is permitted prior to resuming the agent. Please note: Patients who are on a reduced dose or are intolerant of abiraterone acetate or enzalutamide will not be eligible for study participation.
* Progressive disease on enzalutamide or abiraterone acetate documented by PCWG3 criteria for study entry. Progressive disease is defined as at least one of the following:

  1. PSA progression defined as a minimum of 2 rising PSA levels with a minimum of a 1-week interval between each determination, reaching a minimum PSA value of 1.0 ng/mL.
  2. Nodal or visceral progression as defined by PCWG3-modified RECIST 1.1
  3. Appearance of 2 or more new lesions on a bone scan
* At least one of the following at study entry:

  1. RECIST 1.1 measurable disease at baseline; i.e., soft tissue tumor lesions or pathologically enlarged lymph nodes that can be accurately measured in at least one dimension OR
  2. a PSA of 2.0 ng/mL or above
* Participants must be medically or surgically castrated with ongoing androgen deprivation therapy (ADT) for ≥90 days or have documented history of bilateral orchiectomy.
* ECOG 0 - 2
* Adequate organ function confirmed at screening, as evidenced by:

  * Absolute neutrophil count ≥ 1.5 × 10\^9 /L
  * Hemoglobin ≥ 9 g/dL
  * Platelets ≥ 75 × 10\^9 /L
  * Aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) ≤ 2.5 × upper limit of normal (ULN) or ≤ 5.0 × ULN if liver metastases are present
  * Total bilirubin ≤ 1.5 × ULN; or \< 2.5 × ULN if Gilbert syndrome or disease involving liver
  * Creatinine clearance \>30 mL/min (Cockcroft-Gault formula)
  * Adequate blood coagulation function as evidence by an international normalized ratio (INR) ≤ 1.5 unless participant is on anticoagulants
* Tumor biopsy during screening is required if safe and feasible.

Exclusion Criteria:

* The presence of any of the following criteria excludes a patient from participating in the study:
* Pure small cell carcinoma
* Previous exposure to multi-TKI therapies.
* Uncontrolled hypertension (persistent systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg) or known coronary artery disease with angina. Patients with known hypertension must be on antihypertensive medication with BPs generally \<140/90 to be eligible.
* History of congestive heart failure of Class II-IV New York Heart Association criteria, or serious cardiac arrhythmia requiring treatment (except atrial fibrillation, paroxysmal supraventricular tachycardia), history of myocardial infarction within 6 months of study entry, or QT interval corrected by the Fridericia correction formula (QTcF) \>480 msec at screening.
* Any prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessments.
* Symptomatic and/or untreated CNS metastases.
* Pre-existing duodenal stent or any gastrointestinal disorder or defect which would interfere with absorption of study medication, as determined by the Investigator.
* Requirement for systemic therapy with either corticosteroids (\>10 mg daily prednisone equivalents) or immunosuppressive medications within 14 days before study treatment start.
* Other anticancer therapies within 3 weeks of study treatment start, or within 5 half-lives of study treatment start for non-cytotoxic oral agents, whichever is shorter; with the exception of androgen deprivation therapy, enzalutamide, or abiraterone acetate which should be continued through study treatment.
* Palliative radiation within 2 weeks of study treatment start.

Primary outcomes:
measure: RP2D
timeFrame: From the start of study treatment through the DLT window (28 days)
measure: Objective Response Rate (ORR)
timeFrame: up to 6months
Secondary outcomes:
measure: Time to Radiographic Response (phase II)
timeFrame: From start of study treatment until 6 months post study treatment start
Other outcomes:
Locations:
city: Basking Ridge
country: United States
facility: Memorial Sloan Kettering Basking Ridge (Limited Protocol Activities)
state: New Jersey
city: Middletown
country: United States
facility: Memorial Sloan Kettering Monmouth (Limited Protocol Activities)
state: New Jersey
city: Montvale
country: United States
facility: Memorial Sloan Kettering Bergen (Limited Protocol Activities)
state: New Jersey
city: Commack
country: United States
facility: Memorial Sloan Kettering Suffolk - Commack (Limited Protocol Activities)
state: New York
city: Harrison
country: United States
facility: Memorial Sloan Kettering Westchester (Limited Protocol Activities)
state: New York
city: New York
country: United States
facility: Columbia University
state: New York
city: New York
country: United States
facility: Memorial Sloan Kettering Cancer Center
state: New York
city: Uniondale
country: United States
facility: Memorial Sloan Kettering Nassau (Limited Protocol Activities)
state: New York
city: Durham
country: United States
facility: Duke University
state: North Carolina
city: Portland
country: United States
facility: Oregon Health & Science University
state: Oregon
city: Philadelphia
country: United States
facility: Thomas Jefferson University Hospital
state: Pennsylvania
Study officials:
affiliation: Memorial Sloan Kettering Cancer Center
name: Wassim Abida, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References: