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This is a Phase 1, open-label, dose-escalation and dose-expansion study comprised of a screening period, a single treatment session, an evaluation period of 21±3 days, and safety and survival follow-up period of up to 12 weeks post-treatment.
The purpose of this Phase 1 study is to initiate clinical development of gNO in patients with unresectable cutaneous or subcutaneous primary or metastatic solid tumors that are not amenable or have failed standard treatment, for which no therapy of proven efficacy exists, or which has progressed despite standard therapy. This study of gNO treatment will consist of 2 parts: a dose-escalation part to establish a safe and tolerable dose of gNO in patients with primary or metastatic unresectable cutaneous or subcutaneous solid tumors (Part A), and a dose expansion phase (Part B) which may be initiated at the Sponsor's discretion after the maximum tolerated dose (MTD) and/or optimal biological dose (OBD) (or recommended Phase 2 dose [RP2D]) has been determined in the dose-escalation phase (Part A). This study will be the basis for future studies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1 | Experimental | Subjects will receive 25,000 ppm NO |
|
| Cohort 2 | Experimental | Subjects will receive 50,000 ppm NO |
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| Cohort 3 | Experimental | Subjects will receive 100,000 ppm NO |
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| RP2D Expansion | Experimental | Subjects will receive the RP2D dose of NO |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nitric Oxide 25,000 ppm | Drug | Intratumoral injection of 25,000 gNO |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of AEs, SAEs and DLTs (safety) parameters. | The incidence and characteristics of adverse events (AEs), serious adverse events (SAEs), dose-limiting toxicities (DLTs) and changes in assessed safety parameters. Toxicity will be graded according to NCI CTCAE version 5.0 | up to12 weeks from injection |
| Measure | Description | Time Frame |
|---|---|---|
| Anti-tumor activity of a single intratumoral gNO injection at all administered doses | The anti-tumor activity of a single intratumoral gNO injection will be measured per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and secondarily immune-related RECIST (iRECIST). | up to Day 21 from injection |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of predictive biomarkers for anti-tumor activity of a single intratumoral gNO injection | Measurement of blood immune biomarkers levels | up to Day 21 from injection |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Edith Dekel | Contact | 972-50-8464449 | edekel@beyondcancer.com | |
| Yaara Ber, PhD | Contact | yber@beyondcancer.com |
| Name | Affiliation | Role |
|---|---|---|
| David Greenberg, MD | Study Internal Medical Monitor | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Soroka Medical Center | Recruiting | Beersheba | Israel | |||
| Hadassah Ein-Karem |
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| Label | URL |
|---|---|
| Meirovitz A., et al. Phase 1 study of ultra-high concentration nitric oxide (UNO) in relapsed or refractory, unresectable, primary, or metastatic cutaneous and subcutaneous malignancies. SITC 2023 | View source |
| Confino H., et al. Intratumoral administration of high-concentration nitric oxide and anti PD-1 treatment leads to higher tumor regression rates and prolonged survival in CT26 tumor-bearing mice SITC 2022 | View source |
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In Part A, the following gNO doses will be studied to determine MTD and/or OBD: 25,000 ppm, 50,000 ppm and 100,000 ppm. Additional dose levels may be evaluated based on the emerging data as determined by the Safety Review Committee.
Once the MTD and/or OBD is determined, additional patients will be treated in Part B Dose Expansion to further characterize the safety and biomarkers of gNO and determine RP2D.
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| Nitric Oxide 50,000 ppm | Drug | Intratumoral injection of 50000 gNO |
|
| Nitric Oxide 100,000 ppm | Drug | Intratumoral injection of 100,000 gNO |
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| Nitric Oxide selected dose | Drug | Intratumoral injection of selected does on gNO |
|
| Recruiting |
| Jerusalem |
| Israel |
| Sheba Medical Center | Recruiting | Ramat Ef‘al | Israel |
| Sourasky Tel Aviv Medical Center | Recruiting | Tel Aviv | Israel |
| ID | Term |
|---|---|
| D009369 | Neoplasms |
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