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This study is a Phase I/II, open-label, dose escalation, and cohort expansion study designed to characterize the safety, tolerability, pharmacokinetic (PK), pharmacodynamics (PD), immunogenicity, and preliminary antitumor activity of ZL-1211 administered by IV infusion on a every 2 weeks (Q2W) schedule.
The study consists of two stages, Phase I -Dose Escalation Phase to determine the maximum tolerated dose (MTD) or maximum administered dose (MAD) (if no MTD is defined) of ZL-1211, and Phase II -Cohort Expansion Phase to further define the safety and initial antitumor activity of ZL-1211 with the dose established in the Dose Escalation Phase. The trial was intended to be a Phase 1/2 trial but the Phase 2 was not initiated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ZL-1211 monotherapy | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ZL-1211 | Drug | Phase 1 dose escalation part will enroll about 12-42 patients, Phase 2 dose expansion part will enroll about 15-40 patients in each cohort |
|
| Measure | Description | Time Frame |
|---|---|---|
| Phase I :MTD or MAD | To determine the maximum tolerated dose (MTD) or maximum administered dose (MAD) (if no MTD is defined) of ZL-1211 | One month |
| Phase I and Phase II: safety and tolerability | Incidence of Treatment-Related Adverse Events as Assessed by CTCAE v5.0 | Approximately 10 months |
| Phase II: preliminary antitumor activity | Objective response rate defined as the proportion of patients with partial response (PR) proportion of patients with partial response (PR) or complete response (CR) based on Investigator assessment of tumor lesions per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 | Approximately 10 months |
| Measure | Description | Time Frame |
|---|---|---|
| Phase I and Phase II: pharmacokinetics (PK):AUC | Area under the curve (AUC) | Approximately 10 months |
| Phase I and Phase II: pharmacokinetics (PK):Cmax | Maximum serum concentration (Cmax) |
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Inclusion Criteria:
Patients are eligible to be included in the study only if all the following inclusion criteria apply:
Adults≥ 18 years of age.
Willing and able to provide signed and dated informed consent prior to any study related procedures and willing and able to comply with all study procedures.
All patients from Phase I and Phase II are required to provide tumor tissue for CLDN18.2 IHC assessment, and only patients with CLDN18.2-positive tumors will be included in this study.
Patients with histologically or cytologically confirmed metastatic or locally advanced solid tumors, refractory to standard treatment
Evaluable disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
Adequate hepatic function
Adequate renal function, as defined by serum creatinine < 1.5 × ULN OR calculated creatinine CL > 40 mL/min, Cockroft-Gault Equation:
Hematological function defined as:
Prothrombin time, international normalized ratio or/and activated partial thromboplastin time < 1.5 × ULN.
Recovery, to Grade 0-1, from AEs related to prior anticancer therapy except alopecia, < Grade 2 sensory neuropathy, lymphopenia.
Exclusion Criteria:
Patient with known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome related illness or known active or chronic hepatitis B virus infection or hepatitis C virus.
Any uncontrolled active infection.
Previous exposure to any CLDN18.2 antibody or CLDN18.2 chimeric antigen receptor T cell therapy.
Newly diagnosed or symptomatic brain metastases anticonvulsants are allowed.
Severe cardiovascular disease; New York Heart Association Class II-IV heart failure within 6 months of screening; uncontrolled arrhythmia within 6 months of screening.
Anticancer therapy or radiation therapy within 5 half-lives or 4 weeks (whichever is shorter) prior to screening; palliative radiotherapy within 2 weeks prior to screening.
Major surgery within 4 weeks prior to first dose; minor surgery within 2 weeks prior to first dose.
Symptomatic intrinsic lung disease (chronic obstructive pulmonary disease, pulmonary fibrosis).
Gastrointestinal abnormalities including:
Patient has received systemic immunosuppressive therapy, including systemic corticosteroids 2 weeks prior to first dose of study drug.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zai Lab Site 2012 | Scottsdale | Arizona | 85258 | United States | ||
| Zai Lab Site 2016 |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36922936 | Derived | Konno H, Lin T, Wu R, Dai X, Li S, Wang G, Chen M, Li W, Wang L, Sun BC, Luo Z, Huang T, Chen Y, Zhang J, Ye Q, Bellovin D, Wan B, Kang L, Szeto C, Hsu K, Kabbarah O. ZL-1211 Exhibits Robust Antitumor Activity by Enhancing ADCC and Activating NK Cell-mediated Inflammation in CLDN18.2-High and -Low Expressing Gastric Cancer Models. Cancer Res Commun. 2022 Sep 7;2(9):937-950. doi: 10.1158/2767-9764.CRC-22-0216. eCollection 2022 Sep. |
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Phase I, the Dose Escalation Phase of the study will enroll patients with locally advanced or metastatic solid tumors of any histology with positive CLDN18.2. Phase II, the Cohort Expansion Phase of the study, will be conducted after determination of the dose level (RP2D) for cohort expansion based on the results of Phase I to explore the preliminary efficacy.
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| Approximately 10 months |
| Phase I and Phase II: pharmacokinetics (PK):Tmax | Time to reach Cmax (Tmax) | Approximately 10 months |
| Phase I and Phase II: pharmacokinetics (PK):Ctrough | Ctrough | Approximately 10 months |
| Phase I and Phase II: pharmacokinetics (PK):Vss | Volume of distribution at steady state (Vss) | Approximately 10 months |
| Phase I and Phase II: pharmacokinetics (PK):CL | Clearance (CL) | Approximately 10 months |
| Phase I and Phase II: pharmacokinetics (PK):t1/2 | Half-life (t1/2) | Approximately 10 months |
| Phase I and Phase II: immunogenicity | Incidence of anti-drug antibodies (ADAs) | Approximately 10 months |
| Phase I and Phase II: immunogenicity | Quantity of anti-drug antibodies (ADAs) | Approximately 10 months |
| Phase II: preliminary antitumor activity | Duration of response (DOR), defined as the time from the first date of objective response (CR or PR) to the first documented date of disease progression per RECIST v1.1 or the date of death due to any cause, whichever occurs first | Approximately 10 months |
| Lynwood |
| California |
| 90262 |
| United States |
| Zai Lab Site 2014 | Indianapolis | Indiana | 46250 | United States |
| Zai Site 2020 | Hackensack | New Jersey | 07601 | United States |
| Zai Lab Site 2025 | New York | New York | 10016 | United States |
| Zai Lab Site 2015 | Cincinnati | Ohio | 45219 | United States |
| Zai Lab Site 2011 | Nashville | Tennessee | 37203 | United States |
| Zai Lab Site 2023 | Fairfax | Virginia | 22031 | United States |
| Zai Lab Site 2013 | Spokane | Washington | 99208 | United States |
| Zai Lab Site 2022 | Tacoma | Washington | 98405 | United States |
| Zai Lab Site 1725 | Hefei | Anhui | 230031 | China |
| Zai Lab Site 1548 | Beijing | Beijing Municipality | 100032 | China |
| Zai Lab Site 1551 | Harbin | Heilongjiang | 150000 | China |
| Zai Lab Site 1549 | Zhengzhou | Henan | 450003 | China |
| Zai Lab Site 1202 | Zhengzhou | Henan | 450052 | China |
| Zai Lab Site 1537 | Wuhan | Hubei | 430022 | China |
| Zai Lab Site 1539 | Jinan | Shandong | 250014 | China |
| Zai Lab Site 1542 | Shanghai | Shanghai Municipality | 200092 | China |
| Zai Lab Site 1712 | Chengdu | Sichuan | 610044 | China |
| Zai Lab Site 1529 | Hangzhou | Zhejiang | 310003 | China |
| Zai Lab Site 1714 | Hangzhou | Zhejiang | 310014 | China |