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This is a Phase I, multicenter, open-label, two-stage study of APG-3288 monotherapy, aiming to determine the Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D) of APG-3288 administered orally once daily in patients with relapsed/refractory (R/R) hematologic malignancies.
Part 1 (Dose Escalation Phase): Patients will receive orally administered APG-3288 at specified doses once daily in 28-day cycles. This phase aims to determine the MTD or RP2D of APG-3288 for patients who have failed standard therapy and for whom no standard therapy offering clinical benefit is available.
Part 2 (Dose Expansion Phase): Following the completion of Part 1, Part 2 will be initiated to further evaluate dose safety. Doses will be determined based on a comprehensive assessment of the pharmacokinetic (PK), pharmacodynamic (PD), safety, and efficacy data of APG-3288 from Part 1. In Part 2, up to 60 patients per chosen indication will be enrolled and randomly assigned in equal proportions to 2 or 3 dose cohorts to evaluate dose safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part 1 (Dose Escalation Phase) | Experimental | APG-3288 at multiple dose levels will be evaluated to determine the recommended phase 2 dose (RP2D) or maximum tolerated dose (MTD). |
|
| Part 2 (Dose Expansion Phase) | Experimental | Indications and dose cohorts to be determined from Part 1 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| APG-3288 | Drug | Orally administered daily; 28 days per cycle. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of dose-limiting toxicities (DLTs) at each dose level | A DLT is defined as any treatment-related adverse event (TRAE) meeting protocol-specified toxicity criteria occurring during the DLT evaluation period (Cycle 1). DLTs will be assessed in participants receiving escalating dose levels of APG-3288 to evaluate its safety and tolerability. | From first dose through the end of Cycle 1 (e.g., Day 1 to Day 28) |
| Incidence of treatment emergent adverse events (TEAEs) | The incidence of treatment emergent adverse events (TEAEs), including Grade 3-5 TEAEs, serious adverse events (SAEs), TEAEs leading to dose interruption, dose reduction, or treatment discontinuation, and deaths, will be assessed in participants receiving APG-3288 in Part 1 (dose escalation) and Part 2 (dose expansion) of the study. | From first dose of study treatment through 30 days after the last dose |
| Maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D) of APG 3288 | The MTD and/or RP2D of APG-3288 will be determined during the dose escalation phase based on the incidence of DLTs, overall safety, tolerability, and available pharmacokinetic and pharmacodynamic data. | During the dose escalation phase (Part 1) |
| Measure | Description | Time Frame |
|---|---|---|
| Peak plasma concentration (Cmax) of APG-3288 | The assessment of maximum observed plasma concentration (Cmax) following administration of APG-3288. | From first dose through 24 hours post-dose |
| Area Under the Plasma Concentration-Time Curve (AUC) of APG-3288 |
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Key Inclusion Criteria:
Key Exclusion Criteria:
Concurrent anti-cancer therapy (chemotherapy, radiation therapy, surgery, immunotherapy, hormonal therapy, targeted therapy, biologic therapy, with the exception of hormones for hypothyroidism or estrogen replacement therapy, anti-estrogen analogs, agonists required to suppress serum testosterone levels).
Any investigational therapy within 14 days prior to the first dose of study drug or within 5 half-lives of the respective investigational drug (whichever is shorter).
Persistent toxicities from prior radiotherapy, targeted therapy, immunotherapy, or chemotherapy agents that have not recovered to Grade <2 (except for alopecia or vitiligo).
Symptomatic brain metastases due to tumor involvement of the central nervous system (CNS). Patients with CNS tumors who have been treated, are asymptomatic, and who have discontinued steroids (for the treatment of CNS tumors) for > 28 days may be enrolled.
Use of therapeutic-dose anticoagulants or antiplatelet agents. (Use of low-dose anticoagulants to maintain central venous catheter patency is permitted)
Biological growth factors within 7 days prior to the first dose of study drug.
Patients who, in the investigator's judgment, have not adequately recovered from prior surgery, or have undergone major surgery within 28 days prior to enrollment, or minor surgery within 14 days prior to enrollment.
Significant cardiac disease defined as:
Clinically active and uncontrolled symptomatic infection; well-controlled human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV) infection may be considered for enrollment.
Autoimmune diseases, active inflammatory bowel disease, chronic infections, or any other disease or condition associated with chronic inflammation.
Concurrent use of QT-prolonging medications or history of torsades de pointes.
Concurrent malignancy other than the one being treated in this study with the exception of the following: cured malignancy without recurrence within 3 years prior to study entry; completely resected basal cell and squamous cell skin cancer; completely resected carcinoma in situ of any type.
Any severe and/or uncontrolled medical condition that, in the investigator's opinion, may compromise the individual's safety or the evaluation of study results.
Prior treatment with: BTK degrader treatment or allogeneic stem cell transplant
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yifan Zhai, M.D., Ph.D. | Contact | 18998334688 | Yzhai@ascentage.com | |
| Qiwei Chen, M.D. | Contact | Qiwei.Chen@ascentage.com |
| Name | Affiliation | Role |
|---|---|---|
| Keshu Zhou, M.D.,Ph.D. | Henan Cancer Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic | Jacksonville | Florida | 32224 | United States | ||
| Henan Cancer Hospital |
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Area under the plasma concentration vs time curve (AUC0-t and AUC0-inf) of APG-3288 following administration APG-3288 at escalating dose levels. |
| From first dose through last measurable concentration, assessed up to 24 hours post-dose |
| Pharmacodynamic (PD) profile of APG 3288 | The pharmacodynamic effects of APG 3288 will be evaluated by changes in Bruton's tyrosine kinase (BTK) levels from baseline over time during treatment. | From baseline of study treatment through 30 days after the last dose |
| Objective response rate (ORR) | ORR is defined as the proportion of patients who achieve partial response (PR) or better as assessed by the investigator at each efficacy assessment and upon disease progression or at end-of-treatment | From first dose until the first documented disease progression or end of treatment, assessed up to 24 months |
| Duration of response (DoR) | DoR is defined as duration in days from the date of initial documentation of a response (PR or better) to the date of first documented evidence of progressive disease for responders (PR or better) as assessed by the investigator or death due to any cause, whichever occurs first. | From the first documented response until disease progression or death, assessed up to 24 months |
| Time to response (TTR) | TTR is defined as the time interval from date of first dose of study drug to the date of initial documentation of a response (PR or better) as assessed by the investigator. | From first dose until the first documented response, assessed up to 24 months |
| Progression free survival (PFS) | PFS is defined as the time interval from date of first dose of study drug to the date of initial documentation of disease progression or death due to any cause, whichever occurs first, as assessed by the investigator. | From first dose until the first documented disease progression or death, whichever occurs first, assessed up to 24 months |
| Overall survival (OS) | OS is defined as the time interval from date of first dose of study drug to the date of death due to any cause. | From first dose until death from any cause, assessed up to 24 months |
| Zhengzhou |
| Henan |
| China |
|
| ID | Term |
|---|---|
| D019337 | Hematologic Neoplasms |
| D012008 | Recurrence |
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D020522 | Lymphoma, Mantle-Cell |
| D008258 | Waldenstrom Macroglobulinemia |
| D018442 | Lymphoma, B-Cell, Marginal Zone |
| D008224 | Lymphoma, Follicular |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D016393 | Lymphoma, B-Cell |
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D054219 | Neoplasms, Plasma Cell |
| D020141 | Hemostatic Disorders |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006474 | Hemorrhagic Disorders |
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