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This is a first-in-human, phase I clinical research study with TT-00420, an investigational, oral, multi-target, dual mechanism kinase inhibitor targeting both mitosis and tumor micro-environment, for the treatment of triple negative breast cancer (TNBC) and other advanced solid tumors. The study consists of a dose escalation part followed by a MTD expansion part.
Dose Escalation Cohorts: Eligible adult patients with advanced solid tumors will be enrolled into Dose Escalation cohorts. Starting dose of TT-00420 mono-therapy will be 1 mg p.o., q.d. TT-00420 capsule will be administered once daily on a continuous schedule. A treatment cycle consists of 28 days. An ABLRM guided by the EWOC principle will evaluate the risk of under-dose or over-dose for the dose tested in each cohort and provide the recommendation dose for next cohort. Dose limiting toxicity (DLT) will be evaluated per the pre-defined DLT criteria and managed by the pre-defined rules detailed in the protocol. Maximum Tolerated Dose (MTD) and/or Dose Recommend for Dose Expansion (DRDE) will be determined in Dose Escalation cohorts.
Dose Expansion Cohorts:
TNBC Cohort:
TNBC Dose-Expansion cohort will be opened to enroll the patients with advanced TNBC and evaluate the safety, PK and preliminary efficacy of TT-00420 to identify the optimal biological dose (OBD), when feasible, in patients with advanced TNBC.
SAT Cohort:
A parallel basket SAT Dose Expansion Cohort will be open to enroll patients with selected advanced tumors (SAT) to evaluate the safety, PK and preliminary efficacy of TT-00420 to identify the optimal biological dose (OBD), when feasible, in patients with SATs.
Recruitment in dose expansion cohorts may be put on hold if any significant safety finding(s) that was not observed in dose escalation cohorts is identified. Bayesian modeling will be updated with the new findings to evaluate if the previously determined MTD or DRDE still suitable for further enrollment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose Escalation | Experimental | Eligible adult patients with advanced solid tumors will be enrolled into Dose Escalation cohorts and treated with TT-00420 at different dose cohorts. Starting dose will be 1 mg p.o., q.d. An ABLRM guided by the EWOC principle will evaluate the risk of under-dose or over-dose for the dose tested in each cohort and provide the recommendation dose for next cohort. Dose Escalation Teleconference will be held after the last evaluable patient complete Cycle 1 treatment in each dose cohort to evaluate DLT, determine MTD and/or DRDE. |
|
| Dose Expansion | Experimental | A Dose Expansion cohort will be opened to enroll patients with selected advanced solid tumors and evaluate the safety, PK and preliminary efficacy of TT-00420 to determine the recommended phase 2 dose in patients with advanced solid tumors. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TT-00420 | Drug | TT-00420 is an investigational, oral, multi-target, dual mechanism kinase inhibitor targeting both mitosis and tumor microenvironment, for the treatment of triple negative breast cancer (TNBC) and other advanced solid tumors. TT-00420 capsule will be administered once daily on a continuous schedule. A treatment cycle consists of 28 days. The proposed dosage form for early clinical research is powder filled hard gelatin capsule (PIC) with dosage strengths as of 1 mg, 5 mg and 20 mg. |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose (MTD) and/or Dose Limiting Toxicity (DLT) | FIH Dose Finding | At the end of Cycle 1 (each cycle is 28 days) |
| Measure | Description | Time Frame |
|---|---|---|
| Dose Recommended for Dose Expansion (DRDE) | Dose Recommended for Dose Expansion | At the end of Cycle 1 (each cycle is 28 days) |
| Optimal Biological Dose (OBD) | Dose Recommended for Dose Expansion |
| Measure | Description | Time Frame |
|---|---|---|
| Exploratory Biomarker Assay | TNBC subtype; pH3, angiogenesis, p-STAT3 etc.; MSI, TMB | through study completion, an average of 6 months |
Inclusion Criteria:
Aged 18 years to 75 years at the time of provision of informed consent
Dose Escalation Cohorts: Histopathological or cytologically documented locally advanced or metastatic solid tumors who have no available standard therapeutic treatment options Dose Expansion Cohorts: Histopathological or cytologically documented locally advanced or metastatic TNBC or SATs
TNBC Dose Expansion Cohort:
At least one measurable lesion as defined by RECIST V1.1 criteria for solid tumors
ECOG performance status of 0 or 1
Adequate organ function confirmed at Screening and within 10 days of initiating treatment, as evidenced by:
Must agree to take sufficient contraceptive methods to avoid pregnancy during the study and until at least 6 months after ceasing study treatment
Able to sign informed consent and to comply with the protocol
Exclusion Criteria:
Women who are pregnant or lactating
Women of child-bearing potential (WOCBP) who does not use adequate birth control
Patients with any hematologic malignancy. This includes leukemia (any form), lymphoma, and multiple myeloma.
Patients with
Patients with the following mood disorders as judged by the Investigator or a psychiatrist, or as result of patient's mood assessment questionnaire:
Impaired cardiac function or clinically significant cardiac diseases, including but not limited to any of the following:
Patients with
Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g., uncontrolled hypertriglyceridemia [triglycerides > 500 mg/dL], active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol
Patients who have received chemotherapy, targeted therapy or immunotherapy ≤ 4 weeks (6 weeks for nitrosourea or mitomycin-C) prior to starting study drug or who have not recovered from side effects of such therapy
Patients who have received wide field radiotherapy ≤ 4 weeks or limited field radiation for palliation ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
Patients who have undergone major surgery ≤ 4 weeks prior to starting study drug or who have not recovered from side effects of such therapy
Patients who have been treated with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GM-CSF) ≤ 2 weeks prior to starting study drug. Erythropoietin or darbepoetin therapy, if initiated before enrollment, may be continued
Patients who are currently receiving treatment with therapeutic doses of warfarin sodium (Coumadin®) or any other coumarin-derivative anticoagulants
Patients who have received corticosteroids ≤ 2 weeks prior to starting study drug or who have not recovered from the side effects of such treatment
Patients who are currently receiving treatment with medication that has known risk to prolong the QT interval or inducing Torsades de Pointes, and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug
Patients who are receiving high to moderate CYP3A inhibitors and inducers as listed in Appendix F
Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is not mandatory)
Known history of active infection with Hepatitis B (e.g., HBsAg reactive), or Hepatitis C (e.g., HCV RNA (qualitative) is detected)
Has received a live-virus vaccination within 30 days of planned first dose Note: Seasonal flu vaccines are permitted.
Inability to swallow or tolerate oral medication
Has a history or current evidence of any condition, therapy, or laboratory abnormality that, in the opinion of the investigator, might confound the results of the trial, interfere with the patient's participation and compliance in the trial
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| Name | Affiliation | Role |
|---|---|---|
| Sarina A. Piha-Paul, MD | M.D. Anderson Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| MD Anderson Cancer Center | Houston | Texas | 77030 | United States | ||
| Cancer Hopital Chinese Academy of Medical Sciences |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36223547 | Derived | Peng P, Qiang X, Li G, Li L, Ni S, Yu Q, Sourd L, Marangoni E, Hu C, Wang D, Wu D, Wu F. Tinengotinib (TT-00420), a Novel Spectrum-Selective Small-Molecule Kinase Inhibitor, Is Highly Active Against Triple-Negative Breast Cancer. Mol Cancer Ther. 2023 Feb 1;22(2):205-214. doi: 10.1158/1535-7163.MCT-22-0012. |
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| ID | Term |
|---|---|
| D064726 | Triple Negative Breast Neoplasms |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
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Dose Escalation arm followed by Dose Expansion arm
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|
| At the end of Cycle 1 (each cycle is 28 days) |
| Number of Participants With Abnormal Laboratory Values | Safety and tolerability of TT-00420 | Up to 30 days from study discontinuation |
| Number of Participants With Adverse Events That Are Related to Treatment | Safety and tolerability of TT-00420 | Up to 30 days from study discontinuation |
| Peak Plasma Concentration (Cmax) of TT-00420 | PK parameters of TT-00420 | through study completion, an average of 6 months |
| Time at which Cmax was first observed (Tmax) of TT-00420 | PK parameters of TT-00420 | through study completion, an average of 6 months |
| Half-life (T1/2) of TT-00420 | PK parameters of TT-00420 | through study completion, an average of 6 months |
| Objective Response Rate (ORR) | ORR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts | through study completion, an average of 1 year |
| Disease Control Rate (DCR) | DCR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts | through study completion, an average of 1 year |
| Duration of Response (DOR) | DOR of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts | through study completion, an average of 1 year |
| Progression Free Survival (PFS) | PFS of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts | through study completion, an average of 1 year |
| Overall Survival (OS) | OS of TT-00420 in patients with TNBC or SAT treated in Dose Expansion cohorts | through study completion, an average of 1 year |
| Beijing |
| Beijing Municipality |
| 100000 |
| China |
| D012871 |
| Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |