Clinical trial NCT02448251: Safety, Pharmacokinetic and Preliminary Efficacy Study of AC0010MA in Advanced Non Small Cell Lung Cancer
Official title: A Phase I, Multicenter, Open-Label Safety, Pharmacokinetic and Preliminary Efficacy Study of Wild-type Sparing EGFR Inhibitor, AC0010MA, in Adult Patients With Previously Treated EGFRmut and Acquired T790M Mutation Non-Small Cell Lung Cancer (NSCLC)
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE1
Conditions: Non Small Cell Lung Cancer
Lead sponsor: ACEA Therapeutics, Inc.
Sponsor class: INDUSTRY
First posted: 2015-05-19
Enrollment: 28
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: AC0010MA is a new, irreversible, Epidermal Growth Factor Receptor (EGFR) mutation selective Tyrosine Kinase Inhibitor. Aim at local advanced or metastatic non-small cell lung cancer patients with EGFR mutation or T790M drug-resistant mutation. The molecular mechanism: by irreversible combining the EGFR-RTKs ATP binding site of cell, selectively suppress the activities of EGFR tyrosine kinase phosphorylation, block the signal transduction pathway of EGFR and inhibit the function of ras/raf/MAPK downstream, thus block the tumor cell growth by EGFR induction, and promotes apoptosis. AC0010MA Maleate Capsules has three characters: 1. Irreversible binding to EGFR; 2. Effectively suppresses the tumor cell with EGFR mutant while has no suppression to EGFR wild-type cell; 3. Efficient suppress the tumor cell with EGFR T790M drug-resistant mutation.


Eligibility criteria: Inclusion Criteria:

1. Is male or female, aged 18 years or older at the time of consent; preferably non-Asian.
2. Has histologically or cytologically confirmed metastatic, or unresectable locally advanced, recurrent NSCLC.
3. Has at least one measurable disease by computed tomography (CT) or magnetic resonance imaging (MRI), according to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1.
4. Has documented evidence of an activating EGFR mutation in the tumor tissue determined by either sequencing or PCR-based technique (Part 1).
5. For Part 1 only: subjects with a positive T790M mutation are preferred, but not required. Confirmation of T790M mutation status will be determined from an archived tumor tissue sample or fresh tumor tissue sample obtained via biopsy if archived tissue is not available. In Part 2, subjects must have a confirmed, positive T790M EGFR mutation (acquired T790M EGFR mutation or "de novo" T790M EGFR mutation).
6. Has a life expectancy of at least 3 months.
7. Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
8. Has adequate hematological and physiological functions.
9. Has documented disease progression while receiving at least 30 days of treatment with a currently approved EGFR tyrosine kinase inhibitor (TKI) (e.g., erlotinib, gefitinib or afatinib) with intervening treatment after most recent EGFR TKI therapy (not required for "de novo" T790M EGFR mutation).
10. Signed and dated written informed consent obtained prior to any study-specific evaluation.

Exclusion Criteria:

1. Has a history of interstitial lung disease related to prior EGFR inhibitor therapy.
2. Has an EGFR TKI- related toxicity that has NOT resolved to Grade 1 or less.
3. Is test positive for hepatitis C virus (HCV), hepatitis B virus (HBV) or human immunodeficiency virus (HIV) antibody.
4. Has received the prohibited therapy (e.g., concurrent anti-cancer therapy including but not limited to: chemotherapy, radiation, hormonal, or immunotherapy) ≤14 days prior to first planned dose of AC0010MA.
5. Received prior treatment with AZD9291 (osimertinib) or CO1686 (rociletinib) and experienced disease progression.
6. Is a female subject who is pregnant or breastfeeding.
7. Female subjects (if of child bearing potential) and male subjects (with a partner of child bearing potential) must use medically acceptable methods of birth control before study entry, for the duration of the study, and for at least 6 months after the last intake of study drug.
8. Has a serious or unstable concomitant systemic disorder incompatible with the clinical study (e.g., substance abuse, uncontrolled psychiatric condition, uncontrolled intercurrent illness including active infection, arterial thrombosis, or symptomatic pulmonary embolism).
9. Has any other reason(s) for the investigator to consider that the subject should not participate in the study.
10. Is receiving treatment with medication(s) that are known to be strong inhibitors or inducers of CYP3A4/5.

Primary outcomes:
measure: Safety and tolerability, and the maximum tolerated dose (MTD) of AC0010MA determined by incidence of dose limiting toxicity (DLT)
timeFrame: Within the first 28 days of treatment.
Secondary outcomes:
measure: Evaluation of tumor response and duration of response of AC0010MA ((objective response rate, ORR)
timeFrame: within the time frame of every 8 weeks (2 cycles) for up to 3 years
measure: Maximum plasma concentration (Cmax) of AC0010MA
timeFrame: Blood samples will be collected at pre-treatment, and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24h post-treatment on Days 1, 8, and 28 in the first treatment cycle (QD and BID) in Phase I
measure: Time to Cmax
timeFrame: Blood samples will be collected at pre-treatment, and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24h post-treatment on Days 1, 8, and 28 in the first treatment cycle (QD and BID) in Phase I
measure: Terminal half-life (t1/2)
timeFrame: Blood samples will be collected at pre-treatment, and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24h post-treatment on Days 1, 8, and 28 in the first treatment cycle (QD and BID) in Phase I
measure: Area under the plasma concentration-time curve
timeFrame: Blood samples will be collected at pre-treatment, and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24h post-treatment on Days 1, 8, and 28 in the first treatment cycle (QD and BID) in Phase I
measure: Volume of distribution (V/F)
timeFrame: Blood samples will be collected at pre-treatment, and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24h post-treatment on Days 1, 8, and 28 in the first treatment cycle (QD and BID) in Phase I
measure: Plasma Concentration (CL/F)
timeFrame: Blood samples will be collected at pre-treatment, and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24h post-treatment on Days 1, 8, and 28 in the first treatment cycle (QD and BID) in Phase I
Other outcomes:
Locations:
city: Duarte
country: United States
facility: City of Hope Comprehensive Cancer Center
state: California
city: Palo Alto
country: United States
facility: Stanford University
state: California
city: Atlanta
country: United States
facility: Emory University School of Medicine
state: Georgia
city: Houston
country: United States
facility: MD Anderson Cancer Center
state: Texas
city: Marseille
country: France
facility: CEPCM - Hopital Timone
city: Barcelona
country: Spain
facility: Hospital Universitari Vall d'Hebron
city: Madrid
country: Spain
facility: START-Madrid-FJD
city: Madrid
country: Spain
facility: START-Madrid-CIOCC
Study officials:
affiliation: MD Anderson Cancer Center, Houston, TX, USA
name: Vali A. Papadimitrakopoulou, MD
role: STUDY_DIRECTOR
affiliation: Emory University School of Medicine, Atlanta, GA, USA
name: Suresh S. Ramalingam, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Stanford University, Palo Alto, CA, USA
name: Heather Wakelee, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: City of Hope Comprehensive Cancer Center, Duarte, CA, USA
name: Karen L Reckamp, MD
role: PRINCIPAL_INVESTIGATOR
References: