Advanced Solid Tumor, B-cell Non Hodgkin Lymphoma
Conditions
Brief summary
This is a phase I dose-escalation study of oral PCLX-001, conducted in a multicenter, non-randomized, open-label, non-controlled design. The study is comprised of two parts: Part A (single-agent dose escalation) and Part B (single-agent expansion cohorts).
Detailed description
This is a phase I dose-escalation study of oral PCLX-001, conducted in a multicenter, non-randomized, open-label, non-controlled design. The study is comprised of two parts: Part A (single-agent dose escalation) and Part B (single-agent expansion cohorts). For Part A dose-escalation, patients will be enrolled in cohorts of 3 to 6 patients to each dose level. A new dose level cannot open to accrual until toxicity has been determined in the preceding dose level (i.e. all patients have completed their first cycle of therapy and data for all patients in that dose level have been reviewed at a safety cohort review meeting). Six patients will be treated at the maximum tolerated dose (MTD) and/or recommended phase II dose (RP2D). If required, the MTD cohort may be expanded by an additional 10 patients for further toxicity and response assessment. The MTD cohort expansion may be restricted to B-cell lymphoma or advanced solid tumours to ensure there is proper distribution during dose escalation. For Part B (single agent expansion cohorts), two expansion cohorts (N=20 each) will be opened to determine the preliminary clinical activity of PCLX-001 at the RP2D: * Expansion Cohort A: Participants with advanced solid malignancies showing preclinical sensitivity or molecular markers of sensitivity to PCLX-001. This includes breast, nonsmall cell lung (NSCLC), small-cell lung (SCLC), colorectal (CRC), and bladder cancers * Expansion Cohort B: Participants with relapsed/refractory (R/R) B-cell lymphoma: diffuse large B-cell lymphoma (DLBCL), high grade B-cell lymphoma (HGBL), follicular lymphoma (FL), mantle cell lymphoma (MCL), and Burkitt lymphoma. Transformed large B-cell lymphoma will also be included.
Interventions
DRUGPCLX-001 - 20mg
20mg daily oral pills
DRUGPCLX-001 - 40mg
40mg daily oral pills
DRUGPCLX-001 - 70mg
70mg daily oral pills
DRUGPCLX-001 - 100mg
100mg daily oral pills
DRUGPCLX-001 - 140mg
140mg daily oral pills
DRUGPCLX-001 - 210mg
210mg daily oral pills
DRUGPCLX-001 - 280mg
280mg daily oral pills
Sponsors
Pacylex Pharmaceuticals
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
For Part A dose-escalation, patients will be enrolled in cohorts of 3 to 6 patients to each dose level. Six patients will be treated at the maximum tolerated dose (MTD) and/or recommended phase II dose (RP2D).
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Ability to understand and the willingness to sign a written informed consent. A signed informed consent must be obtained before any study-specific procedures are performed. 2. Male or female patients aged ≥ 18 years 3. Dose Escalation 1. Participants with histologically-confirmed advanced solid tumor who have failed at least one prior therapy and/or are not eligible for therapies expected to provide clinical benefit. 2. Histologically-confirmed B-cell lymphomas that are expected to express CD20 including DLBCL, HGBL, FL (grades 1 to 3b), MCL, and Burkitt lymphoma who have failed at least two prior therapies and/or are not eligible for therapies expected to provide clinical benefit (including autologous stem cell transplantation). Transformed large B-cell lymphoma patients are eligible. FL patients should meet criteria for requiring treatment. Dose Expansion Cohort A: Participants with histologically-confirmed advanced breast, NSCLC, SCLC, colorectal, and bladder cancers who have failed at least one prior therapy and/or are not eligible for therapies expected to provide clinical benefit. Cohort B: Participants with histologically-confirmed R/R B-cell lymphomas that are expected to express CD20 including DLBCL, HGBL, FL (grades 1-3a), FL (grade 3b), MCL, and Burkitt lymphoma who have failed at least two prior therapies and/or are not eligible for therapies expected to provide clinical benefit. Transformed large B-cell lymphoma patients are eligible. FL patients should meet criteria for requiring treatment. 4. Patients must have evaluable or measurable disease. 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1. 6. Life expectancy of at least 12 weeks 7. Patients must have adequate bone marrow, liver, kidney and cardiac function. 8. Patients must have adequate coagulation. 9. Women of childbearing potential must have a negative pregnancy test. 10. Women of childbearing potential and fertile men must agree to use adequate contraception when sexually active from signing of the informed consent form for the full study until at least 6 months after the last study drug administration.
Exclusion criteria
1. Known hypersensitivity to the study drugs or excipients of the preparations or any agent given in association with this study. 2. History of cardiac disease: congestive heart failure New York Heart Association (NYHA) class \> II, unstable angina (angina symptoms at rest), new-onset angina (within the past 6 months before study entry), myocardial infarction within the past 6 months before study entry, or uncontrolled cardiac arrhythmias. 3. Uncontrolled arterial hypertension despite optimal medical management. 4. Moderate or severe hepatic impairment. 5. Patients with known human immunodeficiency virus (HIV) infection. 6. Patients who have an active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection requiring treatment. 7. Infections not responding to therapy or active clinically serious infections. 8. Symptomatic metastatic brain or meningeal tumors unless the patient is \> 3 months from definitive therapy, has a stable imaging study and is clinically stable. Patients with asymptomatic brain metastases must not be on steroid therapy. 9. Current or past history of central nervous system (CNS) lymphoma. 10. Uncontrolled seizure disorder requiring therapy. 11. History of organ allograft transplantation or autologous stem cell transplantation ≤ 3 months prior to the first dose of study drug. Patients who received prior CAR-T or other T-cell targeting treatment (approved or investigational) ≤ 4 weeks prior to study drug administration. 12. Evidence or history of bleeding disorder within 4 weeks before the first dose of study drug. 13. Serious, non-healing wound, ulcer, or bone fracture. 14. Any malabsorption condition. 15. Breastfeeding. Female patients must not breastfeed during treatment and until 4 months after last study drug administration. 16. Treatment with systemic steroids (prednisone dose ≥10 mg/day or equivalent dose). 17. Acute toxic effects of previous anticancer chemotherapy or immunotherapy that have not yet stabilized or if significant post-treatment toxicities have been observed. 18. Radiotherapy for target lesions during study or within 3 weeks before the first dose of study drug. 19. Major surgery or significant trauma within 4 weeks before the first dose of study drug. 20. Concomitant participation in another clinical study with investigational medicinal product(s). 21. Substance abuse, medical, psychological, or social conditions that may interfere with the patient's participation in the study or evaluation of the study results. 22. Use of strong CYP3A4 inhibitors and inducers from 14 days prior to first administration of study drug. Strong CYP3A4 inhibitors and inducers are prohibited during the study and until the active follow up visit. 23. Clinically relevant findings in the ECG.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To Determine, During the Dose Escalation Phase, the Recommended Dose of PCLX-001 for the Dose Expansion Phase of the Trial. | Through study completion, an average of ~90 days | The recommended dose will be the dose level below that for the cohort in which maximum tolerated dose (MTD) was reached/exceeded. MTD will have been reached when 2 or more patients in a cohort experience DLT. |
Countries
Canada
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| PCLX-001 Intervention 20mg Cohort 1: Participants were administered 20mg of PCLX-001 orally as continuous daily dosing on a 28-day cycle. | 3 |
| PCLX-001 Intervention 40mg Cohort 2: Participants were administered 40mg of PCLX-001 orally as continuous daily dosing on a 28-day cycle. | 3 |
| PCLX-001 Intervention 70mg Cohort 3: Participants were administered 70mg of PCLX-001 orally as continuous daily dosing on a 28-day cycle. | 3 |
| PCLX-001 Intervention 100mg Cohort 4: Participants were administered 100mg of PCLX-001 orally as continuous daily dosing on a 28-day cycle. | 6 |
| PCLX-001 Intervention 140mg Cohort 5: Participants were administered 140mg of PCLX-001 orally as continuous daily dosing on a 28-day cycle. | 3 |
| PCLX-001 Intervention 210mg Cohort 6: Participants were administered 210mg of PCLX-001 orally as continuous daily dosing on a 28-day cycle. | 8 |
| PCLX-001 Intervention 280mg Cohort 7: Participants were administered 280mg of PCLX-001 orally as continuous daily dosing on a 28-day cycle. | 3 |
| Total | 29 |
Baseline characteristics
| Characteristic | PCLX-001 Intervention 20mg | PCLX-001 Intervention 40mg | PCLX-001 Intervention 70mg | PCLX-001 Intervention 100mg | PCLX-001 Intervention 140mg | PCLX-001 Intervention 210mg | PCLX-001 Intervention 280mg | Total |
|---|---|---|---|---|---|---|---|---|
| Age, Continuous | 56 years | 68 years | 66 years | 53 years | 65 years | 56 years | 48 years | 65 years |
| Patients enrolled | 3 participants | 3 participants | 3 participants | 6 participants | 3 participants | 8 participants | 3 participants | 29 participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 2 Participants | 2 Participants | 3 Participants | 6 Participants | 3 Participants | 8 Participants | 3 Participants | 27 Participants |
| Region of Enrollment Canada | 3 Participants | 3 Participants | 3 Participants | 6 Participants | 3 Participants | 8 Participants | 3 Participants | 29 Participants |
| Sex: Female, Male Female | 3 Participants | 2 Participants | 0 Participants | 5 Participants | 1 Participants | 5 Participants | 2 Participants | 18 Participants |
| Sex: Female, Male Male | 0 Participants | 1 Participants | 3 Participants | 1 Participants | 2 Participants | 3 Participants | 1 Participants | 11 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk |
|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 3 | 1 / 3 | 1 / 3 | 1 / 6 | 0 / 3 | 0 / 8 | 0 / 3 |
| other Total, other adverse events | 0 / 3 | 0 / 3 | 0 / 3 | 0 / 6 | 0 / 3 | 0 / 8 | 0 / 3 |
| serious Total, serious adverse events | 0 / 3 | 1 / 3 | 1 / 3 | 1 / 6 | 0 / 3 | 0 / 8 | 3 / 3 |
Outcome results
Primary
To Determine, During the Dose Escalation Phase, the Recommended Dose of PCLX-001 for the Dose Expansion Phase of the Trial.
The recommended dose will be the dose level below that for the cohort in which maximum tolerated dose (MTD) was reached/exceeded. MTD will have been reached when 2 or more patients in a cohort experience DLT.
Time frame: Through study completion, an average of ~90 days
Population: Refractory solid tumour and Non-Hodgkins Lymphoma patients for whom no other therapies were available. All evaluable patients were assessed.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| PCLX-001 Intervention | To Determine, During the Dose Escalation Phase, the Recommended Dose of PCLX-001 for the Dose Expansion Phase of the Trial. | 210 mg |