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This is a multicenter, open-label Phase I clinical trial of BEBT-507 in subjects with polycythemia vera(PV). Phase Ia is a single-agent dose-escalation study designed to evaluate the safety, tolerability, pharmacokinetics (PK), preliminary efficacy, and pharmacodynamics of BEBT-507 in subjects with PV . Based on the results of Phase Ia, two doses will be selected for further evaluation in Phase Ib to assess the efficacy, safety, and PK profile of BEBT-507 in subjects with PV , and to recommend a dose for Phase III clinical trials.
Phase Ia Study:Phase Ia plans to set up 5 dose groups (Cohorts A1-A5), with 3-6 subjects planned for enrollment in each dose group. The 5 dose groups are 1.25 mg/kg, 2.5mg/kg, 5mg/kg, 10mg/kg, and 15mg/kg, respectively. Subcutaneous injection is administered every 12 weeks, for a total of 2 doses. A "3+3" dose-escalation design will be used. If no dose-limiting toxicity (DLT) is observed in Cohort A5, further dose escalation will be determined by investigators and sponsors based on PK and safety data. Additional dose groups can be added if necessary.
Phase Ib Study:Based on the results of the Phase Ia study, two doses will be selected for the phase Ib study. Each dose cohort will enroll approximately 10-30 eligible subjects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phase Ia-Dose Escalation | Experimental | Phase Ia plans to set up 5 dose groups. If no DLT is observed in cohort A5, further dose escalation will be determined by investigators and sponsors based on PK and safety data. Additional dose groups can be added if necessary. |
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| Phase Ib-Dose Expansion | Experimental | Based on the results of the phase Ia study, two doses will be selected for the phase Ib study. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BEBT-507 Injection | Drug | The initial dose of BEBT-507 injection is 1.25mg/kg, administered subcutaneously at 1.25mg/kg, 2.5mg/kg, 5mg/kg, 10mg/kg or 15mg/kg every 12 weeks for two doses in total. |
| Measure | Description | Time Frame |
|---|---|---|
| MTD | Maximum Tolerated Dose | Up to 52 weeks |
| DLT | Dose-Limiting Toxicity | Up to 52 weeks |
| Proportion of Subjects With Hematocrit (HCT) < 45% | The proportion of subjects with HCT<45% following at least 21 days without or with specified therapies (phlebotomy or erythrocytapheresis). | Up to 100 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| AUC0-∞ | The area under the plasma concentration-time curve from time zero to infinity. | Pre-dose to 168h post-dose on day 1; Pre-dose to 168h post-dose on day 85 (day 85±3 days). |
| AUC0-last | The area under the plasma concentration-time curve from administration to the last measurable concentration time point. |
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Inclusion Criteria:
1)Hydroxyurea-resistant or -intolerant Must meet the definition of hydroxyurea (HU) resistance or intolerance in the 2024 chinese society of clinical oncology (CSCO) Guidelines for the diagnosis and treatment of malignant hematological diseases and satisfy at least one of the following criteria:a) Resistance: Despite ≥3 months of HU treatment at a dose of ≥2 g/d, phlebotomy is still required to maintain HCT <45%; after ≥3 months of HU treatment at a dose of ≥2 g/d, bone marrow proliferation remains uncontrolled (e.g., platelets >400×10⁹/L and WBC >10×10⁹/L); after ≥3 months of HU treatment at a dose of ≥2 g/d, a palpable massive splenomegaly fails to reduce by >50% or splenomegaly-related clinical symptoms do not fully resolve;b) Intolerance: At the minimum hydroxyurea (HU) dose required to achieve a complete or partial clinical hematologic response for the disease, absolute neutrophil count (ANC) <1.0×10⁹/L or PLT count <100×10⁹/L or Hemoglobin (HGB) <100 g/L occurs; during HU treatment at any dose, lower extremity ulcers or other intolerable non-hematological toxicities emerge, such as skin and mucous membrane manifestations (skin, teeth, or nail darkening; oral ulcers, mucositis; skin ulcers, rash, etc.), gastrointestinal symptoms (nausea, anorexia, indigestion, vomiting, abdominal pain, constipation, etc.), pneumonia, fever, etc.; 2)Interferon α-resistant or -intolerant Must satisfy at least one of the following criteria:a) Resistance: After achieving at least 12 weeks of interferon α therapy and a dose of at least 25×10⁶ U/week (or the subject's maximum tolerated dose if it is less than 25×10⁶ U/week), phlebotomy is still required to maintain HCT <45%, or PLT >400×10⁹/L and WBC >10×10⁹/L, or palpable splenomegaly (starting >10 cm from the left costal margin) fails to reduce by >50%;b) Intolerance: At the minimum interferon α dose required for complete or partial clinical hematologic remission, ANC <1.0×10⁹ or PLT <100×10⁹ or hemoglobin <100 g/L (<10 g/dL) occurs, or depression, influenza-like symptoms, neuropsychiatric symptoms, autoimmune issues, or other unacceptable non-hematological toxicities related to interferon-alpha (IFN-α) emerge, defined as common terminology criteria for adverse events (CTCAE) V5.0 grade 3-4 events, or CTCAE V5.0 grade 2 events lasting over 1 week, or permanent discontinuation of interferon α, or interruption of interferon α until toxicity resolves, or hospitalization due to interferon α toxicity.
4.The subject has intact skin at the injection site, and the investigator deems it is suitable for subcutaneous injection; 5.Eastern cooperative oncology group (ECOG) performance status score is 0, 1, or 2; 6.The subject has undergone bone marrow biopsy within 12 months prior to enrollment; 7.The subject or the subject's legal guardian has signed a written informed consent, and the subject is able to comply with the study requirements.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kegang Jiang, Master | Contact | +86-18664786382 | kjiang@bebettermed.com |
| Name | Affiliation | Role |
|---|---|---|
| Zhijian Xiao, Ph.D | Blood Diseases Hospital, Chinese Academy of Medical Sciences | Principal Investigator |
| Hongyan Tong, Ph.D | Zhejiang University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Blood Diseases Hospital, Chinese Academy of Medical Sciences | Tianjin | Tianjin Municipality | 311100 | China |
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| ID | Term |
|---|---|
| D011087 | Polycythemia Vera |
| ID | Term |
|---|---|
| D019046 | Bone Marrow Neoplasms |
| D019337 | Hematologic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| Pre-dose to 168h post-dose on day 1; Pre-dose to 168h post-dose on day 85 (day 85±3 days). |
| Cmax | The maximum plasma drug concentration | Pre-dose to 168h post-dose on day 1; Pre-dose to 168h post-dose on day 85 (day 85±3 days). |
| Tmax | The time to reach maximum plasma drug concentration | Pre-dose to 168h post-dose on day 1; Pre-dose to 168h post-dose on day 85 (day 85±3 days). |
| t1/2 | The time for plasma drug concentration to halve | Pre-dose to 168h post-dose on day 1;Pre-dose to 168h post-dose on day 85 (day 85±3 days). |
| CL/F | The ratio of an orally administered drug's absorbed amount to the administered dose | Pre-dose to 168h post-dose on day 1; Pre-dose to 168h post-dose on day 85 (day 85±3 days). |
| Changes in White Blood Cell (WBC) | Changes in WBC over time relative to baseline. | Up to 100 weeks |
| Changes in Platelet (PLT) | Changes in PLT over time relative to baseline. | Up to 100 weeks |
| Time to First HCT Response | Time to first HCT response (days from study drug administration to HCT <45% without phlebotomy or erythrocytapheresis during this period). | Up to 100 weeks |
| Duration of Peripheral Blood HCT Response | Duration of peripheral blood HCT response (days from achieving HCT <45% after study drug administration to HCT ≥45% without phlebotomy or erythrocytapheresis during this period). | Up to 100 weeks |
| Changes in Serum Iron | Serum Iron changes at each dose level. | Up to 100 weeks |
| Changes in Hepcidin | Hepcidin changes at each dose level. | Up to 100 weeks |
| Changes in Ferritin | Ferritin changes at each dose level. | Up to 100 weeks |
| Changes in Transferrin Saturation | Transferrin saturation changes at each dose level. | Up to 100 weeks |
| Changes in Spleen Volume Size | Mean and percentage changes from baseline in spleen volume. | Up to 100 weeks |
| Symptom Improvement | Symptom changes are assessed using the Myeloproliferative Neoplasms 10 (MPN10) questionnaire, with symptoms rated on a scale from 1 to 10 (0 if absent), where 1 indicates the mildest severity and 10 the most severe. | Up to 100 weeks |
| Thrombotic and Hemorrhagic Events | The proportion of subjects without thrombotic or hemorrhagic events. | Up to 100 weeks |
| Occurrence of Adverse Events (AEs) | Occurrence of AEs will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events Version 5.0 (NCI CTCAE V5.0). | Up to 36 months |
| D001855 |
| Bone Marrow Diseases |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D009196 | Myeloproliferative Disorders |