Phase I/IIa Study of H002 in NSCLC With Active EGFR Mutation

• ClinicalTrials.gov Identifier: NCT05519293
• Recruitment Status: Recruiting
• First Posted: August 29, 2022
• Last Update Posted: April 11, 2024
• Sponsor: RedCloud Bio
• Collaborator: Parexel
• Information provided by (Responsible Party): RedCloud Bio

Study Description

Brief Summary:

This is a phase I/IIa, open-label, dose-escalation and expansion study to evaluate the safety, tolerability, PK and preliminary anti-tumor activity of H002 when given orally in patients with active EGFR mutation locally advanced or metastatic non-small cell lung cancer (NSCLC).

The study will contain two parts: Part A is dose escalation phase (i.e., Phase I) and Part B is dose expansion phase (i.e., Phase IIa).

Condition or disease	Intervention/treatment	Phase
Non-small Cell Lung Cancer	Drug: H002	Phase 1; Phase 2

Detailed Description:

Part A (Dose Escalation Phase) Approximately 36 subjects will be enrolled, based on the "3+3" design for dose escalation and safety evaluation requirements. The total number of subjects will depend upon the number of dose escalations necessary.

Part B (Dose Expansion Phase) Up to 20 subjects will be enrolled in each expansion arm, the total number of subjects will depend upon the number of dose expansions (expansions may be at more than one dose depending upon emerging data).

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 76 participants
• Allocation: Non-Randomized
• Intervention Model: Sequential Assignment
• Intervention Model Description: Dose-escalation and Expansion
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Phase I/IIa, Open-label, Dose-escalation and Expansion Study to Evaluate the Safety, Tolerability, Pharmacokinetic and Preliminary Anti-tumor Activity of H002 in Patients With Active EGFR Mutation Locally Advanced or Metastatic NSCLC
• Actual Study Start Date: December 15, 2022
• Estimated Primary Completion Date: February 28, 2025
• Estimated Study Completion Date: February 28, 2025

Arms and Interventions

Arm	Intervention/treatment
Experimental: 20 mg QD, oral; H002 20mg QD, orally administered in fasting state, receive a single dose of H002 orally, followed by a 4-day washout period. Then, the same dose of H002 will be administered QD until disease progression or not tolerated.	Drug: H002; Small molecule, Capsule
Experimental: 40 mg QD, oral; H002 40mg QD, orally administered in fasting state, receive a single dose of H002 orally, followed by a 4-day washout period. Then, the same dose of H002 will be administered QD until disease progression or not tolerated.	Drug: H002; Small molecule, Capsule
Experimental: 80 mg QD, oral; H002 80mg QD, orally administered in fasting state, receive a single dose of H002 orally, followed by a 4-day washout period. Then, the same dose of H002 will be administered QD until disease progression or not tolerated.	Drug: H002; Small molecule, Capsule
Experimental: 150 mg QD, oral; H002 150mg QD, orally administered in fasting state, receive a single dose of H002 orally, followed by a 4-day washout period. Then, the same dose of H002 will be administered QD until disease progression or not tolerated.	Drug: H002; Small molecule, Capsule
Experimental: 250 mg QD, oral; H002 250mg QD, orally administered in fasting state, receive a single dose of H002 orally, followed by a 4-day washout period. Then, the same dose of H002 will be administered QD until disease progression or not tolerated.	Drug: H002; Small molecule, Capsule
Experimental: 350 mg QD, oral; H002 350mg QD, orally administered in fasting state, receive a single dose of H002 orally, followed by a 4-day washout period. Then, the same dose of H002 will be administered QD until disease progression or not tolerated.	Drug: H002; Small molecule, Capsule

Outcome Measures

Primary Outcome Measures :

1. DOSE ESCALATION PHASE：Incidence of dose-limiting toxicities (DLTs) at Cycle 0 and Cycle1. Incidence and severity of treatment-emergent adverse events (TEAEs), with severity determined according to National Cancer Institute (NCI) CTCAE v5.0. [ Time Frame: At the end of Cycle 1 (include 4 days in Cycle 0 and 21 days in Cycle1) ]
   To evaluate the safety and tolerability of H002 and to determine the maximal tolerable dose (MTD), or if possible, a dose/exposure predicted to result in optimal biological dose (OBD) or recommended phase II dose (RP2D).
2. DOSE EXPANSION PHASE：Objective Response Rate (ORR) [ Time Frame: Up to approximately 30 months ]
   To obtain a preliminary evaluation of the anti-tumor activity at the selected dose(s) of H002 when given orally as determined according to RECIST v1.1.
3. DOSE EXPANSION PHASE：Incidence and severity of TEAEs, with severity determined according to NCI CTCAE v5.0. [ Time Frame: Up to approximately 30 months ]
   To evaluate the safety at the selected dose(s) of H002 when given orally.

Secondary Outcome Measures :

1. Peak Plasma Concentration (Cmax) [ Time Frame: Up to approximately 30 months ]
   To evaluate the pharmacokinetic (PK) characteristics of H002 when given orally following single and multiple doses.
2. Time to reach maximum concentration (Tmax) [ Time Frame: Up to approximately 30 months ]
   To evaluate the pharmacokinetic (PK) characteristics of H002 when given orally following single and multiple doses.
3. Area under the plasma concentration versus time curve (AUC) [ Time Frame: Up to approximately 30 months ]
   To evaluate the pharmacokinetic (PK) characteristics of H002 when given orally following single and multiple doses.
4. Time for half the drug concentration to be eliminated（t1/2） [ Time Frame: Up to approximately 30 months ]
   To evaluate the pharmacokinetic (PK) characteristics of H002 when given orally following single and multiple doses.
5. DOSE ESCALATION PHASE：Objective Response Rate (ORR) [ Time Frame: Up to approximately 30 months ]
   To obtain a preliminary evaluation of the anti-tumor activity of H002 when given orally as determined according to response evaluation criteria in solid tumors version 1.1 (RECIST v1.1).
6. Disease control rate (DCR) [ Time Frame: Up to approximately 30 months ]
   To obtain a preliminary evaluation of the anti-tumor activity of H002 when given orally as determined according to response evaluation criteria in solid tumors version 1.1 (RECIST v1.1).
7. Duration of response (DOR) [ Time Frame: Up to approximately 30 months ]
   To obtain a preliminary evaluation of the anti-tumor activity of H002 when given orally as determined according to response evaluation criteria in solid tumors version 1.1 (RECIST v1.1).
8. Progression-free survival (PFS) [ Time Frame: Up to approximately 30 months ]
   To obtain a preliminary evaluation of the anti-tumor activity of H002 when given orally as determined according to response evaluation criteria in solid tumors version 1.1 (RECIST v1.1).
9. Time to progression (TTP) [ Time Frame: Up to approximately 30 months ]
   To obtain a preliminary evaluation of the anti-tumor activity of H002 when given orally as determined according to response evaluation criteria in solid tumors version 1.1 (RECIST v1.1).
10. Overall survival (OS) [ Time Frame: Up to approximately 30 months ]
    To obtain a preliminary evaluation of the anti-tumor activity of H002 when given orally as determined according to response evaluation criteria in solid tumors version 1.1 (RECIST v1.1).

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Males or females aged ≥ 18 years at time of signing informed consent form (ICF).
2. Histological or cytological confirmed diagnosis of unresectable locally advanced or metastatic NSCLC.

3. Subjects must have NSCLC harboring one or more active EGFR mutations known to be associated with EGFR-TKI sensitivity (including, but not limited to Del19 and L858R).

   • Part A: All subjects may provide tumor sample to central laboratory to analyze the EGFR mutation status according to their own willingness;
   • Part B: All subjects must provide tumor sample to central laboratory to analyze the EGFR mutation status. And subjects must have NSCLC harboring EGFR C797S mutation.

   Note: Tumor sample can be either an archival sample or a sample obtained by pretreatment biopsy prior to H002 treatment.

4. Subjects must have radiological documented disease progression while on a previous continuous treatment with osimertinib or another third-generation EGFR-TKI as well as disease progression on the last treatment administered prior to enrolling in the study.
5. Presence of at least one measurable lesion according to RECIST v1.1 per investigator assessment.
6. ECOG performance status of 0-1.
7. Life expectancy ≥ 12 weeks.
8. Adequate hematologic and organ function per protocol.
9. Women of childbearing potential (WOCBP) and fertile males with WOCBP partners must use highly effective contraception per protocol throughout the study. WOCBP must have a negative serum and/or urine pregnancy test result within 7 days prior to the first dose of H002.
10. Signed ICF, and this must be obtained before the performance of any protocol-specific procedures.

Exclusion Criteria:

1. Treatment with any of the following:

   Prior treatment with an EGFR-TKI within 8 days or approximately 5 × t1/2 prior to the first dose of H002, whichever is longer; Prior treatment with immunotherapy or biotherapy within 4 weeks prior to the first dose of H002; Radiotherapy (palliative radiotherapy is completed at least 2 weeks prior to the first dose of H002 can be enrolled) within 4 weeks prior to the first dose of H002; Herbal therapy that has anti-tumor effects within 2 weeks prior to the first dose of H002; Mitomycin and nitrosourea within 6 weeks prior to the first dose of H002; Oral fluorouracil such as tegafur and capecitabine within 2 weeks prior to the first dose of H002; Chemotherapy (except for mitomycin, nitrosourea, and fluorouracil oral drugs), or other anti-tumor drugs for the treatment of NSCLC within 4 weeks or approximately 5 × t1/2 prior to the first dose of H002, whichever is longer.

2. Subjects with EGFR exon 20 insertion mutations only.
3. Prior marketed and/or investigational treatment for EGFR C797S mutation (including, but not limited to BTP-661411, TQB3804 and BLU-945).
4. Is currently participating and receiving investigational therapy or using an investigational device, or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks or 5 × t1/2 of the investigational product, whichever is longer, prior to the first dose of H002.
5. Is expected to require any other form of anti-tumor therapy while on study.
6. Unresolved toxicity greater than CTCAE v5.0 Grade 1 from prior anti-tumor therapy.
7. ≥ CTCAE v5.0 Grade 2 skin toxicity at screening.
8. Treatment with strong inhibitors, strong inducers and sensitive substrates of CYP3A4, substrates and inhibitors for P-glycoprotein (P-gp), as well as substrates for breast cancer resistance protein (BCRP) within 2 weeks prior to the first dose of H002, or anticipation of need for such drugs during study treatment.
9. Uncontrollable pleural effusion, ascites, or pericardial effusion.
10. Subjects who have symptomatic brain metastases, meningeal metastasis or spinal cord compression.
11. Subjects who have a chronic or active infection that required systemic treatment within 2 weeks prior to the first dose of H002.
12. Subjects who have gastrointestinal disorders that will affect oral administration or the investigator judges that the absorption of H002 will be interfered.
13. History of hypersensitivity to active or inactive excipients of H002 or drugs with a similar chemical structure or class to H002.
14. Subjects who received a diagnosis of, and/or tested positive at screening for human immunodeficiency virus (HIV).
15. Subjects with active hepatitis B.
16. Presence or history of malignancy other than NSCLC with the exception of some certain early-stage cancers.
17. Subjects who have clinically significant cardiovascular diseases that occurred within 6 months prior to the first dose of H002, include but not limited to QTc interval ≥ 470 msec.
18. Major surgery or significant traumatic injury occurring within 4 weeks prior to the first dose of H002 or anticipation of need for a major surgery during the study.
19. Medical history of ILD.
20. Medical history of severe eye disease without recovery to CTCAE v5.0 Grade 0 or 1.
21. Severe gastrointestinal disease within 4 weeks prior to the first dose of H002 and did not recover to ≤ CTCAE v5.0 Grade 2.
22. Has any bleeding tendency or coagulopathy within 6 months prior to the first dose of H002.
23. Has known psychiatric disorders that would interfere with cooperation with the requirements of the trial or is still requiring for medication control.
24. Administration of a live, attenuated vaccine within 4 weeks prior to the first dose of H002 or anticipation of need for such a vaccine during the study. Administration of an mRNA Corona Virus Disease 2019 (COVID-19) vaccine within 72 hours prior to the first dose of H002.
25. Female subjects in pregnancy or lactation.
26. Any other circumstances that would, in the investigator's judgment, prevent the subject's participation in the clinical study due to safety concerns or compliance with clinical study procedures.

Contacts and Locations

Contacts

Contact: Anna Chen; +886 2 2176-9685; Anna.Chen@parexel.com

Locations

United States, California

Valkyrie Clinical Trials; Recruiting

Los Angeles, California, United States, 90067

Contact: David Berz, MD 424-535-1874 david.berz@valkyrieclinicaltrials.com

Contact: Francisco Capilla (424) 535-1874 Francisco.capilla@valkyrieclinicaltrials.com

United States, Massachusetts

Dana-Farber Cancer Institute; Recruiting

Boston, Massachusetts, United States, 02215

Contact: Julia Rotow, MD 617-582-8844 Julia_Rotow@DFCI.HARVARD.EDU

Contact: Kathryn Miller, MPH 617-582-8844 kathrynw_miller@dfci.harvard.edu

United States, New York

Columbia University; Recruiting

New York, New York, United States, 10032

Contact: Catherine Shu, MD 212-305-3248 cas2145@cumc.columbia.edu

Contact: Robert Garofano, MA 212-305-3248 rfg2115@cumc.columbia.edu

United States, Virginia

NEXT Virginia; Recruiting

Fairfax, Virginia, United States, 22031

Contact: Alex Spira 703-280-5390 aspira@nextoncology.com

Principal Investigator: Alex Spira, MD

Sponsors and Collaborators

RedCloud Bio

Parexel

Investigators

• Study Director: Louis Zhang; RedCloud Bio

More Information

• Responsible Party: RedCloud Bio
• ClinicalTrials.gov Identifier: NCT05519293
• Other Study ID Numbers: H002-101
• First Posted: August 29, 2022
• Last Update Posted: April 11, 2024
• Last Verified: April 2024

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Carcinoma, Non-Small-Cell Lung; Carcinoma, Bronchogenic; Bronchial Neoplasms; Lung Neoplasms; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases