Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia (CLL/SLL, Relapsed/Refractory Diffuse Large B-cell Lymphoma (DLBCL; Including Richter Transformation), Relapsed/Refractory Follicular Lymphoma (FL), Relapsed/Refractory Hematological Malignancies, Relapsed/Refractory Mantle Cell Lymphoma (MCL), Relapsed/Refractory Marginal Zone Lymphoma (MZL), Relapsed/Refractory Waldenström Macroglobulinemia (WM)
Conditions
Keywords
Relapsed/Refractory Hematological Malignancies, APG-3288
Brief summary
This is a Phase I, multicenter, open-label, two-stage study of APG-3288 monotherapy, aiming to determine the Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D) of APG-3288 administered orally once daily in patients with relapsed/refractory (R/R) hematologic malignancies.
Detailed description
Part 1 (Dose Escalation Phase): Patients will receive orally administered APG-3288 at specified doses once daily in 28-day cycles. This phase aims to determine the MTD or RP2D of APG-3288 for patients who have failed standard therapy and for whom no standard therapy offering clinical benefit is available. Part 2 (Dose Expansion Phase): Following the completion of Part 1, Part 2 will be initiated to further evaluate dose safety. Doses will be determined based on a comprehensive assessment of the pharmacokinetic (PK), pharmacodynamic (PD), safety, and efficacy data of APG-3288 from Part 1. In Part 2, up to 60 patients per chosen indication will be enrolled and randomly assigned in equal proportions to 2 or 3 dose cohorts to evaluate dose safety.
Interventions
DRUGAPG-3288
Orally administered daily; 28 days per cycle.
Sponsors
Ascentage Pharma Group Inc.
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Key Inclusion Criteria: * Eastern Cooperative Oncology Group (ECOG) status ≤ 1 in Part 1 (dose escalation), and ≤ 2 in Part 2 (dose expansion). * Part 1 (Dose Escalation): histologically or cytologically confirmed diagnosis of R/R CLL/SLL, DLBCL (including Richter Transformation), MCL, WM, MZL, or FL. * Prior systemic therapy: at least 2 prior lines of systemic therapy (including BTK inhibitor for approved indications) and who have failed or are not eligible for available therapies with established clinical benefit. * Measurable disease per response criteria specific to the malignant condition. * Adequate organ and bone marrow function. Key
Exclusion criteria
* Concurrent anti-cancer therapy (chemotherapy, radiation therapy, surgery, immunotherapy, hormonal therapy, targeted therapy, biologic therapy, with the exception of hormones for hypothyroidism or estrogen replacement therapy, anti-estrogen analogs, agonists required to suppress serum testosterone levels). * Any investigational therapy within 14 days prior to the first dose of study drug or within 5 half-lives of the respective investigational drug (whichever is shorter). * Persistent toxicities from prior radiotherapy, targeted therapy, immunotherapy, or chemotherapy agents that have not recovered to Grade \<2 (except for alopecia or vitiligo). * Symptomatic brain metastases due to tumor involvement of the central nervous system (CNS). Patients with CNS tumors who have been treated, are asymptomatic, and who have discontinued steroids (for the treatment of CNS tumors) for \> 28 days may be enrolled. * Use of therapeutic-dose anticoagulants or antiplatelet agents. (Use of low-dose anticoagulants to maintain central venous catheter patency is permitted) * Biological growth factors within 7 days prior to the first dose of study drug. * Patients who, in the investigator's judgment, have not adequately recovered from prior surgery, or have undergone major surgery within 28 days prior to enrollment, or minor surgery within 14 days prior to enrollment. * Significant cardiac disease defined as: 1. New York Heart Association class III or IV cardiac disease, including pre-existing uncontrolled, clinically-significant arrhythmia, congestive heart failure, or cardiomyopathy. 2. Unstable angina, myocardial infarction, or a coronary revascularization procedure within ≤ 3 months prior to initiation of study treatment. 3. History of left ventricular ejection fraction \< 50%. 4. Poorly controlled hypertension, or history of poor compliance with antihypertensive drug regimens. * Clinically active and uncontrolled symptomatic infection; well-controlled human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV) infection may be considered for enrollment. * Autoimmune diseases, active inflammatory bowel disease, chronic infections, or any other disease or condition associated with chronic inflammation. * Concurrent use of QT-prolonging medications or history of torsades de pointes. * Concurrent malignancy other than the one being treated in this study with the exception of the following: cured malignancy without recurrence within 3 years prior to study entry; completely resected basal cell and squamous cell skin cancer; completely resected carcinoma in situ of any type. * Any severe and/or uncontrolled medical condition that, in the investigator's opinion, may compromise the individual's safety or the evaluation of study results. * Prior treatment with: BTK degrader treatment or allogeneic stem cell transplant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of dose-limiting toxicities (DLTs) at each dose level | From first dose through the end of Cycle 1 (e.g., Day 1 to Day 28) | A DLT is defined as any treatment-related adverse event (TRAE) meeting protocol-specified toxicity criteria occurring during the DLT evaluation period (Cycle 1). DLTs will be assessed in participants receiving escalating dose levels of APG-3288 to evaluate its safety and tolerability. |
| Incidence of treatment emergent adverse events (TEAEs) | From first dose of study treatment through 30 days after the last dose | The incidence of treatment emergent adverse events (TEAEs), including Grade 3-5 TEAEs, serious adverse events (SAEs), TEAEs leading to dose interruption, dose reduction, or treatment discontinuation, and deaths, will be assessed in participants receiving APG-3288 in Part 1 (dose escalation) and Part 2 (dose expansion) of the study. |
| Maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D) of APG 3288 | During the dose escalation phase (Part 1) | The MTD and/or RP2D of APG-3288 will be determined during the dose escalation phase based on the incidence of DLTs, overall safety, tolerability, and available pharmacokinetic and pharmacodynamic data. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peak plasma concentration (Cmax) of APG-3288 | From first dose through 24 hours post-dose | The assessment of maximum observed plasma concentration (Cmax) following administration of APG-3288. |
| Area Under the Plasma Concentration-Time Curve (AUC) of APG-3288 | From first dose through last measurable concentration, assessed up to 24 hours post-dose | Area under the plasma concentration vs time curve (AUC0-t and AUC0-inf) of APG-3288 following administration APG-3288 at escalating dose levels. |
| Pharmacodynamic (PD) profile of APG 3288 | From baseline of study treatment through 30 days after the last dose | The pharmacodynamic effects of APG 3288 will be evaluated by changes in Bruton's tyrosine kinase (BTK) levels from baseline over time during treatment. |
| Objective response rate (ORR) | From first dose until the first documented disease progression or end of treatment, assessed up to 24 months | ORR is defined as the proportion of patients who achieve partial response (PR) or better as assessed by the investigator at each efficacy assessment and upon disease progression or at end-of-treatment |
| Duration of response (DoR) | From the first documented response until disease progression or death, assessed up to 24 months | DoR is defined as duration in days from the date of initial documentation of a response (PR or better) to the date of first documented evidence of progressive disease for responders (PR or better) as assessed by the investigator or death due to any cause, whichever occurs first. |
| Time to response (TTR) | From first dose until the first documented response, assessed up to 24 months | TTR is defined as the time interval from date of first dose of study drug to the date of initial documentation of a response (PR or better) as assessed by the investigator. |
| Progression free survival (PFS) | From first dose until the first documented disease progression or death, whichever occurs first, assessed up to 24 months | PFS is defined as the time interval from date of first dose of study drug to the date of initial documentation of disease progression or death due to any cause, whichever occurs first, as assessed by the investigator. |
| Overall survival (OS) | From first dose until death from any cause, assessed up to 24 months | OS is defined as the time interval from date of first dose of study drug to the date of death due to any cause. |
Countries
China, United States
Contacts
CONTACTYifan Zhai, M.D., Ph.D.
CONTACTQiwei Chen, M.D.
PRINCIPAL_INVESTIGATORKeshu Zhou, M.D.,Ph.D.
Henan Cancer Hospital
Outcome results
None listed