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| Name | Class |
|---|---|
| Suzhou Yasheng Pharmaceutical Co., Ltd. | INDUSTRY |
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APG-2449 is a novel, orally active, multi-targeted tyrosine kinase inhibitor, which inhibits FAK, ALK, and ROS1 with nanomolar potencies. In preclinical studies, APG-2449 demonstrated potent antiproliferative activity in various cancer cell lines as a single agent. In combination treatment, APG-2449 enhanced anti-proliferative activities of several chemotherapeutic and targeted agents. It is indicated that APG-2449 may have a broad therapeutic potential for the treatment of human cancer as a single agent and in combination with other classes of anticancer drugs. APG-2449 is intended for the treatment of patients with advanced solid tumors. Upon completion of the Phase 1 dose escalation study to establish the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), and/or recommended phase 2 dose (RP2D), several phase Ib/II studies will be implemented accordingly.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| APG-2449 | Experimental | APG-2449 will be explored sequentially using a standard 3+3 escalation scheme at the dose escalation phase and up to 30-40 patient at the MTD/RP2D dose level. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| APG-2449 | Drug | Capsule, multiple dose cohorts, oral administration every day (QD) of a 28-day cycle |
|
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose (MTD) | To determine the maximum tolerated dose (MTD) of APG-2449 in subjects with advanced solid tumors | 28 days |
| Recommended Phase 2 dose (RP2D) | To determine the tentative recommended Phase 2 dose (RP2D) of APG-2449 in subjects with advanced solid tumors | 28 days |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum plasma concentration (Cmax) | Maximum plasma concentration (Cmax) will be assessed on all participants with APG-2449 treatments | 28 days |
| Area under the plasma concentration versus time curve (AUC) |
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Inclusion Criteria:
Dose exploration stage: non-small cell lung cancer diagnosed by histology and/or cytology and positive for ALK/ROS1 gene fusion (molecular diagnosis confirmed by the investigator) and malignant pleural mesothelioma, esophageal cancer and ovarian cancer. Kind of patients with advanced tumors.
Expansion stage: cohort 1, patients with non-small cell lung cancer who have progressed or are intolerant to TKI therapy, including patients with second-generation ALK TKI, or either ROS1 TKI, or third-generation ALK inhibitor (lorlatinib, etc.) with pFAK expression (pFAK expression is subject to central laboratory results) of about 10 or above; Cohort 2, TKI-naïve patients with ALK/ROS1 fusion gene positive NSCLC. The molecular diagnosis results of the above patients can be confirmed by the investigator.
ECOG Performance Status ≤ 1.
Expectation of life ≥ 3 months.
According to RECIST version 1.1, there is at least 1 measurable lesion.
Adequate hematologic and bone marrow functions.
Adequate renal and liver function.
Normal cardiac function.
Brain metastases with clinically controlled neurologic symptoms.
Serum pregnancy test results of women of childbearing age were negative within 7 days before taking the first dose of study drug.
Men, women of childbearing age (postmenopausal women must have been menopausal for at least 12 months before they can be considered infertile) and their partners voluntarily take the study drug for at least 30 days after signing the informed consent form and taking the study drug as deemed effective by the investigator Contraceptive measures
Ability to understand and willingness to sign a written informed consent form
Subjects must be willing and able to complete the research procedures and follow-up inspections.
Subjects are required to provide fresh (for recurrent subjects only) or archived tumor tissue samples from within 28 days prior to treatment. If none of these specimens are available, they may be included after consultation with the sponsor.
Subjects should provide fresh biopsy tumor tissue specimens prior to treatment.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yifan Zhai, M.D., Ph.D. | Contact | +86-20-28069260 | yzhai@ascentage.com |
| Name | Affiliation | Role |
|---|---|---|
| Li Zhang, Professor | Sun Yat-Sen University Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Cancer Hospital | Recruiting | Beijing | Beijing Municipality | 100142 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41146927 | Derived | Ma Y, Song Z, Chen J, Zhao Y, Fang W, Guo Y, Dong Y, Yang Y, Wu G, Fang J, Lin X, Li J, Huang Y, Zhao Y, Hong S, Xue J, Zhang Y, Liu Q, Yang C, Xu L, Yang Y, Xiong D, Yang D, Zhai Y, Zhang L, Zhao H. Safety, pharmacokinetic, pharmacodynamic, and efficacy properties of orally administered APG-2449 in patients with advanced ALK + and ROS1 + non-small-cell lung cancer: a multicentre, open-label, single-arm phase 1 trial. EClinicalMedicine. 2025 Oct 16;89:103556. doi: 10.1016/j.eclinm.2025.103556. eCollection 2025 Nov. | |
| 35820889 |
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| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D004938 | Esophageal Neoplasms |
| D010051 | Ovarian Neoplasms |
| D000086002 | Mesothelioma, Malignant |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
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Dose escalation of APG-2449 will use standard 3+3 design. The starting dose is 150 mg and will be increased in subsequent cohorts to 300mg, 450mg, 600mg, 750mg, 900mg, 1200mg and 1500mg, accordingly.
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Area under the plasma concentration versus time curve (AUC) will be assessed on all participants with APG-2449 treatments
| 28 days |
| Phosphorylation of FAK protein | Phosphorylation of FAK protein will be assessed in peripheral blood mononuclear cells on all participants with APG-2449 treatments | 28 days |
| Preliminary efficacy assessment: Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 | To assess preliminary efficacy in subjects with solid tumors using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 | 4 weeks |
| Fujian Medical University Union Hospital | Not yet recruiting | Fuzhou | Fujian | 350001 | China |
|
| Fujian Cancer Hospital | Not yet recruiting | Fuzhou | Fujian | 350014 | China |
|
| Sun-Yat Sen University Cancer Center | Recruiting | Guangzhou | Guangdong | 510060 | China |
|
| The First affiliated hospital, Sun Yat-sen University | Recruiting | Guangzhou | Guangdong | China |
|
| Henan Provincial Oncology Hospital | Recruiting | Zhengzhou | Henan | China |
|
| Union Hospital medical college Huazhong University of Science and Technology | Recruiting | Wuhan | Hubei | China |
|
| Hunan Provincial Oncology Hospital | Recruiting | Changsha | Hunan | China |
|
| Zhejiang Provincial Oncology Hospital | Recruiting | Hangzhou | Zhejiang | China |
|
| Derived |
| Fang DD, Tao R, Wang G, Li Y, Zhang K, Xu C, Zhai G, Wang Q, Wang J, Tang C, Min P, Xiong D, Chen J, Wang S, Yang D, Zhai Y. Discovery of a novel ALK/ROS1/FAK inhibitor, APG-2449, in preclinical non-small cell lung cancer and ovarian cancer models. BMC Cancer. 2022 Jul 11;22(1):752. doi: 10.1186/s12885-022-09799-4. |
| D013899 |
| Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D006258 | Head and Neck Neoplasms |
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004701 | Endocrine Gland Neoplasms |
| D010049 | Ovarian Diseases |
| D000291 | Adnexal Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D005833 | Genital Neoplasms, Female |
| D014565 | Urogenital Neoplasms |
| D000091662 | Genital Diseases |
| D004700 | Endocrine System Diseases |
| D006058 | Gonadal Disorders |
| D008654 | Mesothelioma |
| D000236 | Adenoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D018301 | Neoplasms, Mesothelial |
| D010997 | Pleural Neoplasms |