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| Name | Class |
|---|---|
| Chinese Academy of Medical Sciences | OTHER |
| Jiangsu GQ Pharma Co., Ltd. | UNKNOWN |
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The purpose of this clinical trial is to evaluate the safety and tolerability of SXRN Plasmid DNA Technique in patients with advanced solid tumors.
This is a Phase I, open-label, dose-escalation study to investigate the safety, tolerability, pharmacokinetics and preliminary efficacy of SXRN Plasmid DNA Technique in patients with advanced solid tumors. Three dose levels are initially formulated, namely 2mg, 4mg, and 10mg of SXRN, adopting an accelerated titration followed by the traditional "3+3" design. SXRN will be administered daily x 5 with 2 days off (total of 21 days) for 3 weeks followed by a no-treatment observation period.
Add a continuous dosing exploration cohort: based on the Phase I dose-escalation study, a randomized, double-blind, placebo-controlled continuous dosing exploration cohort (utilizing an operationally seamless design) will be added to further evaluate the efficacy and safety of continuous administration of Shuxinrui Na Injection in patients with cancer anorexia-cachexia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose Escalation | Experimental | In this study, three dose levels are initially formulated, namely 2mg, 4mg, and 10mg of SXRN, adopting an accelerated titration followed by the traditional "3+3" design. The first day of infusion for each dose is referred to as C1D1, with the administration of QD for 5 consecutive days, followed by a 2-day break; Each treatment cycle will last 3 weeks (21 days), and the subsequent infusion regimen, including interval, frequency and dose, may be adjusted based on the initial safety and PK parameters. |
|
| Expansion Cohort-Placebo | Placebo Comparator | In the initial 2-week treatment period (Cycle 1), patients receive placebo, intravenous infusion, once daily for 14 consecutive days; in the subsequent 2 weeks (Cycle 2), all patients uniformly receive open-label treatment with 4 mg SXRN injection. |
|
| Expansion Cohort 1-SXRN 4mg | Experimental | In the initial 2-week treatment period (Cycle 1), patients receive 4 mg SXRN injection, intravenous infusion, once daily for 14 consecutive days; in the subsequent 2 weeks (Cycle 2), all patients uniformly receive open-label treatment with 4 mg SXRN injection. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SXRN | Drug | SXRN is a naked plasmid DNA drug targeting miRNA. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose (MTD) and Recommended Dose for Expansion (RDE) of SXRN | To determine the Maximum Tolerated Dose (MTD) and Recommended Dose for Expansion (RDE) of SXRN in the treatment of advanced solid tumors | 12 months |
| Effect for SXRN on Appetite compared to placebo | measured by FAACT-A/CS-12 score; For the expansion cohort only. | Baseline, weekly up to Day 28 |
| Effect of SXRN on physical function compared to placebo | measured by 6MWT; For the expansion cohort only | Baseline, Weekly up to Day 28 |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetic parameters of SXRN | Maximum plasmid Concentration [Cmax] | 12 months |
| Preliminary anti-tumor efficacy of SXRN | Anti-tumor activity: objective remission rate (ORR), duration of remission (DOR), disease control rate (DCR), time to remission (TTR) and progression free survival (PFS) basing on RECIST v1.1; overall survival (OS); |
| Measure | Description | Time Frame |
|---|---|---|
| the SXRN transcripts,its targets, and possible regulated targets | Explore the expression changes of the following indicators:the SXRN transcripts 1-RNA, Its targets -miR-214, possible regulated targets-A2AR, INSL3, and Inflammatory Biomarkers | 12 months |
| Effect for SXRN on pain compared to placebo |
For Dose-Escalation Phase:
Note: the criteria above shall still be maintained within 14 days before the initial infusion, either without the need of blood transfusion, or using supportive treatment including granulocyte colony-stimulating factor (G-CSF), thrombopoietin (TPO), interleukin-11 (IL-11), and erythropoietin (EPO), and etc.
Note: for subjects receiving precautious anti-coagulation treatment, the investigator shall determine whether INR and APTT remains in a safe and effective range for treatment.
Exclusion Criteria:
Subjects who meet any of the criteria below must not be included:
has received any of the anti-tumor treatments below:a) received cytotoxic chemotherapy, tumor immunotherapy, anti-tumor biologics or other trail agents within 4 weeks or 5 half-times (whichever is shorter) before the initial infusion.b)received an oral small-molecule targeted anti-tumor agent within 2 weeks before the first infusion or for five half-lives(whichever was shorter).c) received anti-tumor Chinese patent medicine approved by NMPA within 2 weeks before the initial infusion.d) received more than 30% bone marrow radiotherapy or large area radiotherapy within 2 weeks before initial infusion (palliative radiotherapy at the bone or superficial lesions is acceptable).
participated in and received an investigational drug or device clinical trial within 4 weeks before initial infusion.
Patients who had undergone or planned to undergo major surgery or interventional therapy (excluding tumor biopsy, puncture, etc.) within 4 weeks before initial infusion.
unrecovered from the toxic reaction caused by previous anti-tumor treatment (not recovered to ≤ grade 1 or baseline; not including toxic reactions with no safety risk as determined by the investigator, such as alopecia, asymptomatic hypothyroidism caused by immune checkpoint inhibitors that can be treated with only thyroid hormone and remains stable, and etc.).
with clinically uncontrollable serous effusion (pleural effusion, ascites and pericardio effusion). Conditions may include: moderate or above sized effusion, received within 2 weeks before the selection or plans to receive local treatments (including drainage, peritoneal shunt, and cell-free concentrated ascites reinfusion, and etc.), or effusion obviously increased within 2 weeks after the local treatment and thus needs long-term catherterization. Candidates who meet any of the conditions above, or determined by the investigator as unsuitable, shall not be included.
with central nervous system metastasis and show relating symptoms.
with a history of other malignant tumors, except for those that have received radical surgery and not relapsed 5 years thereafter, such as carcinoma in situ of cervix, skin basal cell carcinoma, and etc.
with a history of immune deficiency diseases, including acquired or congenital immunodeficiency disorders; or a history of organ transplantation, heterogeneous bone marrow transplantation, or autologous hematopoietic stem cell transplantation.
had (non-infectious) lung inflammation / interstitial lung disease that required steroid treatment within 4 weeks before the initial infusion.
with a history of severe cardiovascular and cerebrovascular diseases, including but not limited to:
with uncontrollable high blood pressure (systolic pressure ≥160 mmHg and/or diastolic pressure ≥100 mmHg) after treatment with anti-hypertensive drugs of stable doses.
with active chronic hepatitis B (such as, HbsAg or HbcAb positive and HBV DNA ≥ lower limit of detection, active hepatisis C (such as, HCV antibody positive and HCV RNA≥ lower limit of detection), or HIV infection.
with active infections within 2 weeks before the initial infusion that require systematic treatment.
with a history of active tuberculosis infection within 1 year before the initial infusion.
had or has uncontrollable or serious diseases that may interfere with the participation or evaluation in the study, as considered by the investigator;
known to be allergic or taking drugs contradictionary to the study drug (Suplussirna) or its excipients.
premenopause female candidates (postmenopausal female patients can only be considered infertilewhen they have been postmenopausal for at least 12 months) with positive results in serum pregnancy test; candidates of reproductive age (also including female spouse of reproductive age of male candidates), during the study or within 6 months after the last infusion, who will probably bear children, breastfeed, or are unwilling to cake effective contraceptives, as considered by the investigator.
other conditions that are determined by the investigator as unsitable for entering this trial.
For Expansion Cohort(Randomized, Double-blind, Placebo-controlled Part):
Inclusion Criteria:
Male or female, aged 18 to 75 years at time of signing ICF.
Histologically or cytologically confirmed solid tumor.
Patients who have failed standard therapy, lack standard therapy, or are in a treatment holiday period (4 weeks) without need for anti-tumor therapy.
Diagnosis of cancer anorexia-cachexia according to 2025 CSCO guideline, meeting either (â‘ +â‘¡) or (â‘ +â‘¢):
Involuntary weight loss >5% in 6 months; OR weight loss >2% with BMI <18.5 kg/m²; OR weight loss >2% with reduced muscle mass.
Anorexia (VAS ≤70 or FAACT-A/CS-12 score ≤37).
ECOG performance status 0-2.
Life expectancy ≥12 weeks.
Adequate organ function and laboratory parameters within 7 days prior to first study drug, meeting the same criteria as listed above for the dose-escalation phase (i.e., ANC, platelets, hemoglobin, liver/kidney function, coagulation, LVEF, etc.).
Same informed consent requirement as the dose-escalation phase: able to understand and voluntarily sign the ICF, and willing/able to complete study procedures and follow-up.
Exclusion Criteria:
The exclusion criteria are the same as those for the dose-escalation phase above, with the following additional or modified criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ning Li | Contact | +86 10 8778 8713 | lining@cicams.ac.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cancer Hospital Chinese Academy of Medical Sciences | Recruiting | Beijing | 100021 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21508927 | Background | Garcia GE, Truong LD, Chen JF, Johnson RJ, Feng L. Adenosine A(2A) receptor activation prevents progressive kidney fibrosis in a model of immune-associated chronic inflammation. Kidney Int. 2011 Aug;80(4):378-88. doi: 10.1038/ki.2011.101. Epub 2011 Apr 20. | |
| 33628646 | Background | Wang Q, Liu Y, Wu Y, Wen J, Man C. Immune function of miR-214 and its application prospects as molecular marker. PeerJ. 2021 Feb 16;9:e10924. doi: 10.7717/peerj.10924. eCollection 2021. |
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Accelerated titration and "3+3" dose escalation: This study plans to start dose escalating from 2 mg, followed by 4 mg, and 10 mg as tentatively designated escalating dose groups. An "accelerated titration" strategy will be implemented in the early dose escalation phase (2 mg dose group) in this study, with only 1 subject enrolled.
The newly added continuous dosing exploration cohort initially plans to include two study arms (a 4 mg dose group and a placebo control group). During the initial 2-week treatment period (Cycle 1), patients will be double-blindly randomized to receive either 4 mg or placebo, administered via intravenous infusion once daily for 14 consecutive days. In the subsequent 2 weeks (Cycle 2), all patients will uniformly receive open-label treatment with 4 mg.
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| Placebo | Drug | Matching placebo, same dosing regimen (IV infusion once daily for 14 days) |
|
| 12 months |
| Weight improvement of SXRN in patients with advanced solid tumors | Body weight | 12 months |
| Appetite improvement of SXRN in patients with advanced solid tumors | Change in patient's quality of life on the FAACT-A/ CS-12 questionnaire (score) | 12 months |
| Pain alleviating efficacy of SXRN in patients with advanced solid tumors | Change in patient's quality of life on the numeric rate scale (NRS) questionnaire (score) | 12 months |
| Effect for SXRN on body weight/fat-free mass compared to placebo | For the expansion cohort only | Baseline, Weekly up to Day 28 |
| Effect for SXRN on QoL compared to placebo | measured by EORTC QLQ-C30; For the expansion cohort only | Baseline, Weekly up to Day 28 |
| Effect for SXRN on dietary intake compared to placebo | measured by Brief Dietary Self-Assessment Scale; For the expansion cohort only | Baseline, up to Day 28 |
| Safety and tolerability of SXRN | Incidence and severity of adverse events (AEs) and serious adverse events (SAEs), | Up to 28 days after first dose |
measured by NRS and and analgesic use; For the expansion cohort only |
| Baseline, Weekly up to Day 28 |
| Effect for SXRN on sleep quality compared to placebo | measured by PSQI; For the expansion cohort only | Baseline, Day 14, Day 28 |
| Effect for SXRN on bowel function compared to placebo | measured by BSFS; For the expansion cohort only | Baseline, Weekly up to Day 28 |
| 26171727 | Background | Zhao L, Liu YW, Yang T, Gan L, Yang N, Dai SS, He F. The mutual regulation between miR-214 and A2AR signaling plays an important role in inflammatory response. Cell Signal. 2015 Oct;27(10):2026-34. doi: 10.1016/j.cellsig.2015.07.007. Epub 2015 Jul 11. |
| 27003901 | Background | Takayama K, Atagi S, Imamura F, Tanaka H, Minato K, Harada T, Katakami N, Yokoyama T, Yoshimori K, Takiguchi Y, Hataji O, Takeda Y, Aoe K, Kim YH, Yokota S, Tabeta H, Tomii K, Ohashi Y, Eguchi K, Watanabe K. Quality of life and survival survey of cancer cachexia in advanced non-small cell lung cancer patients-Japan nutrition and QOL survey in patients with advanced non-small cell lung cancer study. Support Care Cancer. 2016 Aug;24(8):3473-80. doi: 10.1007/s00520-016-3156-8. Epub 2016 Mar 22. |
| 16762946 | Background | Fearon KC, Voss AC, Hustead DS; Cancer Cachexia Study Group. Definition of cancer cachexia: effect of weight loss, reduced food intake, and systemic inflammation on functional status and prognosis. Am J Clin Nutr. 2006 Jun;83(6):1345-50. doi: 10.1093/ajcn/83.6.1345. |
| 34768626 | Background | Malik M, Michalak M, Radecka B, Gelej M, Jackowska A, Filipczyk-Cisarz E, Hetman K, Foszczynska-Kloda M, Kania-Zembaczynska B, Manka D, Orlikowska M, Rogowska-Dros H, Bodnar L. Prognostic Value of Sarcopenia in Metastatic Colorectal Cancer Patients Treated with Trifluridine/Tipiracil. J Clin Med. 2021 Oct 30;10(21):5107. doi: 10.3390/jcm10215107. |
| 25291291 | Background | Argiles JM, Busquets S, Stemmler B, Lopez-Soriano FJ. Cancer cachexia: understanding the molecular basis. Nat Rev Cancer. 2014 Nov;14(11):754-62. doi: 10.1038/nrc3829. Epub 2014 Oct 9. |
| 17626119 | Background | Loberg RD, Bradley DA, Tomlins SA, Chinnaiyan AM, Pienta KJ. The lethal phenotype of cancer: the molecular basis of death due to malignancy. CA Cancer J Clin. 2007 Jul-Aug;57(4):225-41. doi: 10.3322/canjclin.57.4.225. |
| 22042788 | Background | Scarpi E, Maltoni M, Miceli R, Mariani L, Caraceni A, Amadori D, Nanni O. Survival prediction for terminally ill cancer patients: revision of the palliative prognostic score with incorporation of delirium. Oncologist. 2011;16(12):1793-9. doi: 10.1634/theoncologist.2011-0130. Epub 2011 Oct 31. |
| 25513730 | Background | Mondello P, Mian M, Aloisi C, Fama F, Mondello S, Pitini V. Cancer cachexia syndrome: pathogenesis, diagnosis, and new therapeutic options. Nutr Cancer. 2015;67(1):12-26. doi: 10.1080/01635581.2015.976318. Epub 2014 Dec 16. |
| ID | Term |
|---|---|
| D002100 | Cachexia |
| ID | Term |
|---|---|
| D015431 | Weight Loss |
| D001836 | Body Weight Changes |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D013851 | Thinness |
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