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This is a first-in-human, Phase 1/2 open-label, multicenter, dose-escalation, safety, pharmacokinetics (PK), and biomarker study of CBX-12 in subjects with advanced or metastatic refractory solid tumors.
Phase 1 is the dose-escalation portion of the study in which the safety and tolerability of three dosing schedules of CBX-12 will be evaluated. Subjects in Part A will be treated with CBX-12 on a daily x 5 every 3 weeks schedule (treatment in Part A was discontinued in October 2021). Subjects in Phase 1 Part B will be treated with CBX-12 on a daily x 3 every 3 weeks schedule. Subjects in Phase 1 Part C will be treated with CBX-12 once weekly. Subjects in Phase 1 Modified Part B will be treated with CBX-12 once every 3 weeks.
For all parts in Phase 1, after all subjects in a cohort have completed treatment through the DLT period or discontinued treatment due to a DLT, the SRC, composed of the Investigators who have enrolled subjects in the current cohort(s), the study Medical Monitor and ad hoc members (e.g., other Investigators, a statistician) as needed, will review all available safety data, including DLTs and all available PK data for that cohort and make dose-level recommendations.
Once the recommended phase 2 dose (RP2D) has been established in Part B, Part C and Modified Part B, Phase 2 expansion cohorts may open.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phase 1 Schedule B Dose Escalation (Daily Dosing x 3) | Experimental | CBX-12 administered on a daily x 3, 3 week schedule |
|
| Phase 1 Schedule C Dose Escalation (Once Weekly Dosing ) | Experimental | CBX-12 administered once weekly, 4 week schedule |
|
| Phase 2 Ovarian Cancer Expansion Cohort | Experimental | CBX-12 administered TBD |
|
| Phase 2 Metastatic Breast Expansion Cohort | Experimental | CBX-12 administered TBD |
|
| Phase 1 Schedule A Dose Escalation (Daily Dosing x 5) | Experimental | CBX-12 administered on a daily x 5, 3 week schedule |
|
| Phase 1 Modified Schedule B Dose Escalation (Once Every 3 weeks) | Experimental | CBX-12 administered once every 3 weeks |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CBX-12 | Drug | CBX-12 is an alphalex construct which consists of a low-pH insertion peptide, a self-immolating linker, and exatecan as the pharmacologically active moiety |
|
| Measure | Description | Time Frame |
|---|---|---|
| Phase 1: Incidence of treatment-emergent adverse events (TEAEs) | NCI CTCAE v5.0 | Through the end of study, estimated as 6 months |
| Phase 1: Recommended Phase 2 Dose for Daily x 3 every 3 weeks schedule of CBX-12 (Schedule B) | Safety Review Committee Analysis of Safety and PK Data | 15 months |
| Phase 1: Recommended Phase 2 Dose for Once Weekly schedule of CBX-12 (Schedule C) | Safety Review Committee Analysis of Safety and PK Data | 15 months |
| Phase 1: Recommended Phase 2 Dose for Once Every 3 Weeks schedule of CBX-12 (Modified Schedule B) | Safety Review Committee Analysis of Safety and PK Data | 15 months |
| Phase 2: Overall response rate (ORR) | ORR Based on RECIST v1.1 | Through the end of study, estimated as 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum concentration of CBX-12 | PK Analysis | 5 days |
| Area under the curve from 0-24 hours of CBX-12 | PK Analysis | 5 days |
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Key Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yale Cancer Center | New Haven | Connecticut | 06511 | United States | ||
| NEXT Oncology |
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Parts B, C & Modified Part B will follow a 3 + 3 design, enrolling 3 subjects in each cohort. (De)escalation rules: DLT period for each subject in Phase 1 Part B & Modified Part B will be 3 weeks & 4 weeks in Part C (i.e., 1 cycle). If none of the 3 subjects experience a DLT, dose will be escalated to next highest dose level. If 1 of 3 subjects in cohort experiences a DLT, up to 3 additional subjects will be enrolled/treated at same dose. If none of the additional 3 subjects experience a DLT (i.e., only 1 of 6 subjects in cohort has a DLT), dose will be escalated to next highest level. If 2 or more of up to 6 subjects at dose level have DLTs, enrollment to that cohort will stop, dose will be considered above MTD. Dose will be decreased to previous dose level or to a level intermediate to those previously evaluated. MTD will be highest dose evaluated at which ≤ 1 of 6 have a DLT. A minimum of 6 DLT-evaluable subjects will be enrolled to any dose level being evaluated as possible MTD.
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|
| Time to maximum concentration of CBX-12 | PK Analysis | 5 days |
| Half-life of CBX-12 | PK Analysis | 5 days |
| Clearance (CL) of CBX-12 | PK Analysis | 5 days |
| Apparent Volume of Distribution at Steady State (Vss) CBX-12 | PK Analysis | 5 days |
| Phase 1: ORR | Based on RECIST v1.1 | Through the end of study, estimated as 6 months |
| Duration of Response (DoR) | Based on RECIST v1.1 | Through the end of study, estimated as 6 months |
| Progression-free Survival (PFS) | Based on RECIST v1.1 | Through the end of study, estimated as 6 months |
| Phase 2: Incidence of TEAEs | NCI CTCAE v5.0 | Through the end of study, estimated as 6 months |
| Austin |
| Texas |
| 78758 |
| United States |
| MD Anderson Cancer Center | Houston | Texas | 77030 | United States |
| NEXT Oncology | San Antonio | Texas | 78229 | United States |
| ID | Term |
|---|---|
| D000077216 | Carcinoma, Ovarian Epithelial |
| D055752 | Small Cell Lung Carcinoma |
| D001943 | Breast Neoplasms |
| D015179 | Colorectal Neoplasms |
| D010190 | Pancreatic Neoplasms |
| D001063 | Appendiceal Neoplasms |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D013274 | Stomach Neoplasms |
| D004938 | Esophageal Neoplasms |
| D002295 | Carcinoma, Transitional Cell |
| D012509 | Sarcoma |
| ID | Term |
|---|---|
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D010051 | Ovarian Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
| D009371 | Neoplasms by Site |
| 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 |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D010182 | Pancreatic Diseases |
| D002430 | Cecal Neoplasms |
| D002429 | Cecal Diseases |
| D013272 | Stomach Diseases |
| D006258 | Head and Neck Neoplasms |
| D004935 | Esophageal Diseases |
| D018204 | Neoplasms, Connective and Soft Tissue |
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