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This is a first-in-human, open-label, multicenter, Phase I study to evaluate the safety, tolerability, pharmacokinetics/pharmacodynamics (PK/PD), and preliminary antitumor activity of single-agent KGX105 in participants with locally advanced or metastatic solid tumors. The study consists of two parts: Phase 1a dose escalation and Phase 1b dose expansion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| KGX105 monotherapy-Dose level 1 | Experimental |
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| KGX105 monotherapy-Dose level 2 | Experimental |
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| KGX105 monotherapy-Dose level 3 | Experimental |
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| KGX105 monotherapy-Dose level 4 | Experimental |
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| KGX105 monotherapy-Dose level 5 | Experimental |
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| KGX105 monotherapy-Dose level 6 | Experimental |
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| KGX105 monotherapy-Dose level 7 | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| KGX105 injection | Drug | KGX105 is an investigational EGFR×CD3 TCE prodrug engineered with masked binding domains to reduce on-target, off-tumor toxicity and systemic activation. It is selectively activated in the tumor microenvironment (TME) to target EGFR-positive tumors. An integrated albumin-binding domain prolongs systemic half-life, optimizing drug exposure and efficacy.KGX105 injection is a sterile, white or slightly yellow lyophilized powder, supplied at 10.0 mg/vial for single use. |
| Measure | Description | Time Frame |
|---|---|---|
| Numbers of participants with adverse events(Phase Ia) | AE will be collected to assess participants' safety after KGX105 monotherapy | From baseline to 30 days after the last dose administration. |
| Incidence of Dose-Limiting Toxicities (DLTs) during the DLT observation period.(Phase Ia) | DLT will be observed from start of the first priming dose of KGX105 until 21 days post the first target dose of KGX105 | From Day1 after the first priming dose of KGX105 until 21 days post the first target dose of KGX105 |
| Number of participants with changes of clinical lab abnormalities(Phase Ia) | Any changes in values of the clinical chemistry, hematology, coagulation and urinalysis will be evaluated | From screening until 90 days post the last dose administration |
| The maximum tolerated dose of KGX105 monotherapy(Phase Ia) | From Day 1 post the first dosing until 21 days post the the first target dosing | |
| Objective Response Rate (ORR) of KGX105 monotherapy (Phase Ib) | The ratio of participants assessed with complete response (CR) or partial response (PR) as a best overall response. | until progression or death,whichever came first, assessed up to 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum observed concentration (Cmax) of KGX105 following single and multiple doses | Pharmacokinetic (PK) parameters | From pre-dose of the first dose of KGX105 treatment until Day 1 of the last dose. |
| Objective Response Rate (ORR) of KGX105 monotherapy (Phase Ia) |
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Inclusion Criteria:
Male or female participants with age ≥18 years, at the time of signing the informed consent.
Dose Escalation Phase (Phase Ia):
Participants with histologically or cytologically confirmed locally advanced or metastatic malignant solid tumors meeting any of the following conditions:
Have received prior standard systemic anti-tumor therapy recommended by current guidelines for their tumor type and stage, and experienced disease progression or unacceptable toxicity during or after treatment;
Have no effective standard therapy available at present;
Meet any of the following conditions rendering standard therapy unsuitable:
Priority: Non-small cell lung cancer (NSCLC), head and neck squamous cell carcinoma (HNSCC), nasopharyngeal carcinoma (NPC), pancreatic cancer, and other EGFR-positive* solid tumors such as gastroesophageal junction adenocarcinoma, gastric cancer, and esophageal squamous cell carcinoma.
Dose Expansion Phase (Phase Ib):
According to RECIST 1.1, there must be at least one measurable lesion (tumor lesions located in a previously irradiated area or other sites of locoregional therapy generally are not considered measurable unless they have demonstrated clear progression or have persisted for three months after radiation therapy).
Note: Metastatic brain lesions are not considered as target lesions.
ECOG 0-1.
Life expectancy of ≥3 months, in the opinion of the investigator.
Adequate organ function as determined by medical evaluation including:
Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to treatment.
Women of childbearing potential or male partners of women of childbearing potential must agree to use highly effective contraception throughout the treatment period and for 4 months after the last dose.
Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in this study.
Exclusion Criteria:
Diagnosis of another malignancy within 5 years prior to the first dose, except for:
Presence of leptomeningeal metastasis, spinal cord compression, symptomatic brain metastases, or brain metastases requiring steroids/antiepileptic drugs or showing radiographic progression within 4 weeks prior to enrollment.
•Exception:Asymptomatic brain metastases, or those stable for >4 weeks post-treatment without requiring steroids/antiepileptics, with a single lesion ≤1.5 cm and total number of lesions ≤5, are allowed.
History of allogeneic organ transplantation, allogeneic peripheral hematopoietic stem cell transplantation, or bone marrow transplantation.
Pregnant or breastfeeding women, or individuals planning to donate sperm/eggs during the study period (from ICF signing to 4 months after the last dose).
•Note:Breastfeeding women may be enrolled if they agree to stop breastfeeding prior to dosing and have no intention of resuming.
Any severe or uncontrolled systemic disease, including:
Active bleeding or known bleeding diathesis;
Cardiac dysfunction or clinically significant cardiovascular disease, including any of the following:
•Uncontrolled cardiac disease, such as congestive heart failure requiring treatment (NYHA > Class II);
•Uncontrolled hypertension (resting BP ≥160/100 mmHg);
•Poorly controlled arrhythmias;
•ECG with QTcF >470 ms (female) or >450 ms (male) (QTcF = QT/RR¹/³), or congenital long QT syndrome;
•Echocardiogram: Left Ventricular Ejection Fraction (LVEF) ≤50%;
•Acute myocardial infarction or unstable angina within 6 months prior to study entry;
Uncontrolled diabetes mellitus or poor compliance with hypoglycemic agents;
Other chronic diseases that, in the investigator's opinion, may compromise participant safety or preclude completion of the study.
Active infections:
Inadequate recovery from any prior surgery, or major organ surgery (excluding core needle biopsy or vascular intervention) within 4 weeks prior to study drug administration.
Receipt of any of the following treatments:
A. Prior treatment with T-cell engager drugs containing CD3 antibodies. B. Within the respective washout periods or 5 half-lives (whichever is shorter) prior to the first dose: Chemotherapy, biotherapy, or immunotherapy within 4 weeks; targeted therapy, radiotherapy, endocrine therapy, or oral fluoropyrimidines within 2 weeks; anti-tumor traditional Chinese medicine within 1 week; nitrosoureas or mitomycin C within 6 weeks.
C. Live or attenuated live vaccines within 4 weeks prior to the first dose (inactivated vaccines are allowed).
D. Diagnosis of immunodeficiency, receipt of immunosuppressive therapy, or chronic systemic/enteral steroid therapy (>10 mg/day prednisone or equivalent).
E. Interstitial pneumonia, pulmonary fibrosis, pneumoconiosis, drug-induced pneumonitis, radiation pneumonitis requiring steroids or other treatment, or a history of severe pulmonary function impairment/restrictive lung disease.
Adverse events from prior anti-tumor therapy have not resolved to CTCAE v6.0 Grade ≤1 (except for alopecia, peripheral neuropathy, ototoxicity, or stable endocrinopathies managed with hormone replacement).
Known hypersensitivity to the active ingredient or any excipients of the investigational product.
History of immunotherapy-related adverse events ≥ Grade 3 or leading to treatment discontinuation.
History of active autoimmune disease likely to recur (e.g., SLE, RA, Crohn's, ulcerative colitis, vasculitis), except:
Presence of symptomatic pleural, peritoneal, or pericardial effusion requiring paracentesis/drainage at screening.
•(Exclusion applies if drainage/intracavitary therapy was performed more than once [i.e., ≥2 times] for any cavity within 14 days prior to the first dose).
History of active tuberculosis within 1 year prior to enrollment.
History of thrombotic events (arterial or venous) within 6 months prior to screening, including cerebrovascular accidents (e.g., hemorrhage, infarction), deep vein thrombosis (DVT), and pulmonary embolism (PE).
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Li Zhang | Contact | 86-020-8743990 | zhangli@syscc.org.cn |
| Name | Affiliation | Role |
|---|---|---|
| Li Zhang | Sun Yat-Sen University Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sun Yat-sen University Cancer Center | Guangzhou | Guangdong | 510060 | China |
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The ratio of participants assessed with complete response (CR) or partial response (PR) as a best overall response. |
| From Day 1 after the first dose of KGX105 till survival follow-up every 90 days post the last treatment. |
| Disease Control Rate (DCR) of KGX105 monotherapy | The ratio of subjects assessed with CR or PR or stable disease (SD) as a best overall response. | From Day 1 after the first dose of KGX105 till survival follow-up every 90 days post the last treatment. |
| Duration of Response(DoR)of KGX105 monotherapy | DoR defined as the time from first documented evidence of CR or PR until disease progression or death. | From Day 1 after the first dose of KGX105 till survival follow-up every 90 days post the last treatment. |
| Progression-Free Survival (PFS) of KGX105 monotherapy | PFS defined as the time from first dose to radiographic progression or death due to any cause | From Day 1 after the first dose of KGX105 till survival follow-up every 90 days post the last treatment. |
| Overall Survival (OS) of KGX105 monotherapy | OS defined as the time from first dose to death due to any cause | From Day 1 after the first dose of KGX105 till survival follow-up every 90 days post the last treatment. |
| Immunogenicity- Anti-drug antibody (ADA)、Neutralizing Antibodies(Nab) | Samples will be collected to assess the immunogeniccity after each KGX105 treatment. | Samples will be collected to assess the immunogeniccity after each KGX105 treatment. |
| Numbers of participants with adverse events(Phase Ib) | AE will be collected to assess participants' safety after KGX105 monotherapy | From baseline to 30 days after the last dose administration |
| Number of participants with changes of clinical lab abnormalities(Phase Ib) | Any changes in values of the clinical chemistry, hematology, coagulation and urinalysis will be evaluated | From screening until 90 days post the last dose administration |
| Phase 2 dose (RP2D) of KGX105 monotherapy (Phase Ib) | From Day 1 after the first dose of KGX105 till survival follow-up every 90 days post the last treatment. |
| Time to Cmax (Tmax)of KGX105 following multiple doses | Pharmacokinetic (PK) parameters | From pre-dose of the first dose of KGX105 treatment until Day 1 of the last dose |
| Area under the concentration-time curve from time zero to the last quantifiable concentration (AUC₀-ₜ), AUC from time zero extrapolated to infinity (AUC₀-∞) | Pharmacokinetic (PK) parameters | From pre-dose of the first dose of KGX105 treatment until Day 1 of the last dose |
| Elimination half-life (t₁/₂) of KGX105 following multiple doses | Pharmacokinetic (PK) parameters | From pre-dose of the first dose of KGX105 treatment until Day 1 of the last dose |