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| Name | Class |
|---|---|
| Shanghai East Hospital | OTHER |
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This is an open-label, single-arm, multicenter, dose-escalation and dose-expansion, phase I study to the safety, tolerability, pharmacokinetics, and preliminary efficacy of SY-9453 in patients with advanced solid tumors.
The study will be conducted in 2 parts:
Dose-escalation phase: Participants will be allocated to one of the seven dose groups ranging from 5mg to 80mg and receive a single dose of SY-9453 capsules.This phase is designed to determine the DLTs (Dose-limiting toxicity) and recommended phase II dose (RP2D) and characterize the safety, tolerability and PK of SY-9453 in patients with advanced solid tumors.
Dose-expansion phase: Based on the recommended doses (RDEs) obtained in the escalation phase (possibly 1-2 doses), a dose expansion study will be conducted in 1-3 MTAP homozygous deletion advanced or metastatic solid tumor cohorts, with 10-20 patients per dose in each cohort to further evaluate the safety, tolerability, PK characteristics and anti-tumor activity of SY-9453 to clarify RP2D.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose-escalation and Dose-expansion | Experimental | In dose-escalation phase, SY-9453 will be given orally in ascending doses (escalation cohort) until the DLT or Recommended doses(RDEs) is reached. In dose-expansion phase, SY-9453 will be given orally in RDEs (possibly 1-2 doses) for the expansion period based on the escalation phase in 28-day cycle continuously. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SY-9453 | Drug | Dose-escalation phase: Multiple doses of SY-9453 for oral administration ranging from 5mg to 80mg. Dose-expansion phase: RDEs of SY-5007 asdetermined during Dose Escalation. |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of adverse events (AEs) | Characterization of the safety and tolerability | Up to 3 years |
| Incidence of dose limiting toxicities (DLTs) | Characterization of the safety and tolerability | Escalation phase (35 days after the first dose) |
| Number of Participants With Abnormal Laboratory Values | Characterization of the safety and tolerability | up to 3 years |
| Recommended Phase II Doses (RP2D) of SY-9453 | Up to 2 years | |
| Maximum tolerated dose of SY-9453 (if applicable) | Characterization of the safety and tolerability | up to 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetics (Cmax) for SY-9453 | Defined as maximum observed plasma concentration | At the end of Cycle 1 (each cycle is 28 days) |
| Pharmacokinetics (Tmax) for SY-9453 | Defined as time to maximum plasma concentration |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in serum symmetric dimethylarginine (SDMA) from baseline | Biomarkers related to the efficacy of SY-9453 (if applicable) | up to 3 years |
| Changes in ctDNA from baseline | up to 3 years |
Inclusion Criteria:
Patients must meet all of the following criteria to be eligible for this study:
For subjects participating in the dose escalation phase (only for dose groups of 30 mg and above) and the dose expansion phase: be able to provide a previous test report confirmed by NGS or IHC to be homozygous deletion of the MTAP gene approved by the investigator, or agree to provide sufficient archived or baseline tumor tissue samples, confirmed to be homozygous deletion of the MTAP gene by central laboratory testing.
4.At least one measurable extracranial lesion as defined by Response Evaluation Criteria in Solid Tumors (RECIST) v 1.1 criteria or mRECIST V1.1(Mesothelioma subjects only)(subjects participating in accelerated titration phase are not required to meet this requirement).
5.Expected survival of >3 months. 6.Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1. 7.Organ function levels must meet the following requirements:
8.Female patients with reproductive potential must have a negative serum pregnancy test within 7 days prior to the first dose, male and female patients of childbearing potential must be willing to completely abstain or agree to use an appropriate method of contraception during the entire study duration and for at least 3 months after the last dose of study medication.
Exclusion Criteria:
1. Patients previously treated with a MAT2A inhibitor or PRMT5 inhibitor. 2. History of allergy to any component or excipient of SY-9453 capsules. 3. Received the following treatments prior to the first dose:
4.Adverse events from prior anti-cancer therapies have not recovered to Grade ≤1 as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0 (except for toxicities assessed by the investigator as posing no safety risk, such as alopecia and Grade 2 peripheral neuropathy).
5.Other malignancies within 3 years before screening, with the following exceptions: cured cervical carcinoma in situ, squamous cell carcinoma of the skin, and cured basal cell carcinoma(except for the subjects participating in accelerated titration phase).
6.Dysphagia, or presence of a gastrointestinal disorder or other malabsorption condition that affects drug absorption, such as intestinal obstruction, Crohn's disease, ulcerative colitis, severe peptic ulcer, gastrointestinal perforation, or acute gastrointestinal bleeding.
7. Presence of active central nervous system (CNS) disease (if the clinical performance is stable assessed by the investigator at least 4 weeks before the first dose of SY-9453, and steroid treatment has been discontinued for ≥14 days, the patients can be included.
8.Hepatitis B during screening (positive results for hepatitis B surface antigen [HBsAg] and/or hepatitis B core antibody [HBcAb] with HBV-DNA ≥1000 IU/mL; patients whose HBV-DNA levels drop to below 1000 IU/mL after regular antiviral treatment can be included), or active hepatitis C (HCV RNA > central detection upper limit of normal [ULN]), active syphilis (positive for both Treponema pallidum-specific and non-specific antibodies); history of tuberculosis (evidence of active tuberculosis infection within 1 year), Human immunodeficiency virus (HIV) positive during screening, or known history of other immunodeficiency diseases.
9.Presence of other underlying medical conditions as assessed by the investigator may put the subject at risk or affect the assessment of the toxicity of SY-9453 or AEs.
10. History of neurological or mental disorders, such as dementia. 11. Presence of the following clinically significant comorbidities, including but not limited to:
12. History of allogeneic organ transplantation or allogeneic peripheral blood stem cell transplantation (allo-HSCT)/bone marrow transplantation.
13. Use of or inability to stop using the following CYP3A4 potent inhibitors or inducers within 2 weeks before the first dose during the study.
14. Pregnancy or breastfeeding women. 15. Other situations deemed unsuitable for participation in this clinical trial by the investigator.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| chen guang wang | Contact | 010-8885-8866 | cgwang@centaurusbio.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai East Hospital | Recruiting | Shanghai | China |
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| At the end of Cycle 1 (each cycle is 28 days) |
| Pharmacokinetics (AUC0-t) for SY-9453 | Defined as area under the single-dose plasma concentration-time curve from Hour 0 to the last quantifiable measurable plasma concentration | At the end of Cycle 1 (each cycle is 28 days) |
| Pharmacokinetics (t½) for SY-9453 | Defined as the apparent plasma terminal phase disposition half-life | At the end of Cycle 1 (each cycle is 28 days) |
| Overall Response Rate (ORR) assessed by RECIST v1.1 | Preliminary anti-tumor activity of SY-9453 | Up to 3 years |
| Disease control rate (DCR) as assessed by RECIST v1.1 | Preliminary anti-tumor activity of SY-9453 | Up to 3 years |
| Duration of response (DOR) as assessed by RECIST v1.1 | Preliminary anti-tumor activity of SY-9453 | up to 3 years |
| Overall survival | up to 3 years |
| The incidence of adverse events related to QTcF prolongation | Explore the effect of SY-9453 on QTcF | At the end of Cycle 1 (each cycle is 28 days) |
| The correlation between QTcF prolongation and SY-9453 plasma concentration | At the end of Cycle 1 (each cycle is 28 days) |