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The goal of this clinical trial is to learn if drug AROG4-01 is safe in patients with solid tumors who have no available treatment alternative. Different doses will be tested in order to identify the most suitable one. Once it is identiffied, up to 20 patients will be treated with that dose, to check if thye get clinical benefit.
Participants will: receive intravenous administrations of ARG4-01 twice weekly, and visit the clinic twice every week for checkups and tests.
This study is an open label, Phase 1 dose escalation trial with two expansion cohorts to investigate the safety, tolerability, pharmacokinetics, pharmacodynamics and preliminary antitumor activity of AROG4-01 in patients with mesothelioma and other advanced solid tumors.
This clinical trial is divided into two parts: dose escalation (part A), and dose expansion (part B).
Dose escalation In the present trial, patients will be enrolled sequentially into escalating dose cohorts, and will continue receiving AROG4-01 until disease progression, unacceptable toxicity, withdrawal of consent or otherwise as specified in the investigational medicinal product (IMP) discontinuation criteria.
Patients in a dose cohort will receive AROG4-01 as intravenous (IV) administrations at the same dose in a dosing interval of twice a week, four weeks (equal to one cycle) consecutively without interruption, except when necessary to manage adverse events (AEs).
Six cohorts at escalating dose levels are envisaged. Dose escalation may continue beyond, until the recommended for part B dose, which will be the recommended for phase 2 dose (RP2D), can be defined based on safety, preliminary efficacy, PK and PD data, based on the recommendations of the Safety Review Committee (SRC). The RP2D is defined as the recommended for phase 2 dose, but two cohorts will be treated as part of the phase 1 expansion with that particular dose, in order to get more safety and efficacy data.
Escalation to the next dose level will occur following the SRC meeting for the most recently completed cohort. In considering the appropriate dose level for the next cohort the following will be applied:
If the prior circumstances do not occur, dose escalation will continue at higher increments (not exceeding three times prior dose level), as determined by the SRC.
Extension phase At the dose expansion part, two cohorts of patients with advanced solid tumor each will be recruited. One cohort of patients with advanced MPM (cohort 1) and a second cohort of patients with other solid tumors (cohort 2). Patients will be treated with AROG4-01 at the RP2D of AROG4-01 resulting from part A.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose escalation | Experimental | Four dose levels will be tested. If there are no safety concerns, dose escalation may continue with up to two additional dose levels |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AROG4-01 | Drug | AROG4-01 will be administered as IV infusions in biweekly dosing interval. The first dosing day will be Day 1, 28 days cycle. |
|
| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the safety and tolerability of AROG4-01 | To evaluate the safety and tolerability of AROG4-01 in adult patients with advanced solid tumors, including determination of the main DLT associated to AROG4-01. To assess the MTD (RP2D) defined as the highest dose at which no more than one in six patients experience a AROG4-01-related DLT. DLTs will be evaluated after the first treatment cycle. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the preliminary antitumor activity of AROG4-01 monotherapy as measured by Overall Response Rate (ORR) according to standard criteria (RECIST 1.1 [18] or mRECIST v1.1 | • To assess progression-free survival (PFS) in patients with mesothelioma and other advanced solid tumors. | 24 months |
| To characterize the PK of AROG4-01. |
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Inclusion Criteria:
Male or female patients, 18 years or older, with a diagnosis (histology or citology) of advanced (unresectable or metastatic) solid tumor for which there is no curative therapy, has progressed on SOC treatment or for whom SOC is no longer an option. In part B patients will be included in different cohorts according to the histology (mesothelioma vs. non-mesothelioma).
Evaluable (part A) or measurable disease (part B) as per RECIST v1.1 (part A) or mRECIST v1.1. (part B). Progressive disease to the on or following the last line of antitumor treatment.
ECOG performance status ≤ 2.
Life expectancy ≥12 weeks.
Hematology and clinical chemistry laboratory parameters within acceptable ranges.
Adequate organ function as defined below:
Adequate coagulation profile as defined below:
No previous antitumor treatment (radiation therapy, systemic treatment, or surgery) in the previous 28 days and current adverse events from them ≤ grade 1.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Carme Plasencia, PhD | Contact | +34 670 594 309 | carme.plasencia@aromics.es | |
| Sonia Macia, MD, PhD | Contact | +34606432153 | sonia.macia@aromics.es |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32708710 | Background | Aubets E, J Felix A, Garavis M, Reyes L, Avino A, Eritja R, Ciudad CJ, Noe V. Detection of a G-Quadruplex as a Regulatory Element in Thymidylate synthase for Gene Silencing Using Polypurine Reverse Hoogsteen Hairpins. Int J Mol Sci. 2020 Jul 16;21(14):5028. doi: 10.3390/ijms21145028. | |
| Background | 19- Phan, A. T., & Patel, D. J. (2005). "RNA tetraplexes, structures and functions." Biochemistry, 44(2), 639-649. doi:10.1021/bi048804m | ||
| Background | Simon, J. S., et al. (2018). "Hairpin structures near G-quadruplexes can modulate G4 stability and drug binding." Nature Communications, 9, 4621. doi:10.1038/s41467-018-07055-8 | ||
| 26350216 |
| Label | URL |
|---|---|
| Company website | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| Study Protocol | View IPD |
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This clinical trial is divided into two parts: dose escalation (part A), and dose expansion (part B). In part A (dose escalation), patients will be treated with AROG4-01 at different doses, starting at 9 mg/m2. Escalation to next dose levels will occur following the Safety Review Committee meeting for the most recently completed cohort.
The MTD decided as per part A (dose escalation) will be used for part B (dose expansion).
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| AROG4-01 | Drug | AROG4-01 will be administered as IV infusions in biweekly dosing interval. The first dosing day will be Day 1, 28 days cycle. This study is an open label, Phase 1 dose escalation trial with two expansion cohorts. The study consists of two parts:
|
|
Cmax |
| 24 months |
| To characterize the PK of AROG4-01 | half-life | 12 months |
| Background |
| Rhodes D, Lipps HJ. G-quadruplexes and their regulatory roles in biology. Nucleic Acids Res. 2015 Oct 15;43(18):8627-37. doi: 10.1093/nar/gkv862. Epub 2015 Sep 8. |
| ID | Term |
|---|---|
| D008654 | Mesothelioma |
| D015179 | Colorectal Neoplasms |
| D010051 | Ovarian Neoplasms |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D000236 | Adenoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D018301 | Neoplasms, Mesothelial |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal 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 |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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