Brief Summary
This is a multi-centre, two-part, open-label, phase 1, first in human study of multiple ascending doses of RC220 bisantrene formulation alone and in combination with fixed dosethe amount of medication taken doxorubicin to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) in adult patients with advancedat a late stage, far along solid tumours where an anthracycline may be considered as a treatment option / or is indicated.
The study will consist of Part 1 – dose-escalation, to determine the maximum tolerated combination dose of RC220 with doxorubicin to be evaluated in Part 2 – dose-expansion cohort, in patients with solid tumours that are anthracycline treatment naïve and for whom treatment with doxorubicin is indicated. The objective of Part 2 will be to confirm the safety and tolerability and evaluate the preliminary cardioprotective and anti-tumour efficacy of the maximum tolerated combined dose (MTCD) of RC220 with doxorubicin.
Intervention / Treatment
- Drug: RC220
- Drug: Doxorubicin (Adriamycin)
Inclusion Criteria:
- Able to give voluntary informed consenta process in which a patient receives detailed information about a procedure or treatment, including its potential risks, benefits, and alternatives. The patient then has the opportunity to understand the information and voluntarily agree to the procedure or treatment. and understand the study and are willing to follow and complete all the study required procedures.
- Aged ≥ 18 years at the time of informed consent.
- Life expectancy ≥ 3 months.
- Have measurable or evaluable disease per RECIST v1.1. The target lesions must not have prior radiation or other locally treated area unless imaging-based progression has been clearly documented following radiation or other local therapy.
- Adequate haematological, liver, and kidneya pair of bean-shaped organs in the abdomen that are responsible for filtering excess water and waste products from the blood and converting them into urine to be removed from the body function as follows:
- Bone marrowsoft, spongy tissue found in bones that makes blood cells reserve:
• Absolute neutrophil count (ANC) ≥ 1.5 × 109/L without growth factor support in the 2 weeks prior to study entry.
• Haemoglobin ≥ 90 g/L without transfusion and/or without growth factor support in 2 weeks prior to study entry.
- Platelet count ≥ 100 × 109/L without transfusion in 2 weeks prior to study entry.
- Hepatic function:
- Aspartate aminotransferase (AST), alanine aminotransferase (ALT) < 3 × upper limit of normal (ULN) (≤5 × ULN if liver metastases or hepatic cell carcinomacancer arising from tissues that line organs (HCC)).
- Renal function:
- Serum creatinine < 1.5 × ULN or Serum creatinine clearance (CrCL) > 50 mL/min, as per the Cockcroft-Gault Equation Glomerular Filtration Rate: [(140-age in years) × weight in kg] / (7.2 × serum creatinine in mg/dL) (× 0.85 for females).
In PART 2 only: Out of range values for 5a, b and c are allowable based on the discretion of the Investigator and with approval from Sponsor Medical Monitorto check on, keep track of.
- Bone marrowsoft, spongy tissue found in bones that makes blood cells reserve:
- International normalized ratio (INR) /prothrombin time (PT) < 2 x ULN, activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN.
In PART 2 only: Out of range values are allowable based on the discretion of the Investigator and with approval from Sponsor Medical Monitor.
- Practice adequate contraceptive measures as per below:
Female patients must:
- Be of nonchildbearing potential i.e., surgically sterilised or postmenopausal, or;
- If of childbearing potential, must have a negative serum pregnancy test at Screeningtesting for cancer or conditions that can lead to cancer before symptoms appear, also known as cancer screening and a negative urine pregnancy test before the first study drug administration and on Day 1 of each Cycle. They must agree not to attempt to become pregnant, must not donate ova, and must agree to use 2 forms of highly effective contraceptive method between signing consent, during the study, and at least 90 days after the last dose of study drug, OR use 1 form of highly effective contraceptive method, plus an additional barrier method of contraception between signing consent, during the study, and at least 90 days after the last dose of study drug.
- Women of childbearing potential with same sex partners (abstinence from penile vaginal intercourse) are eligible when this is their preferred and usual lifestyle.
Male patients must:
- be willing not to donate sperm and if engaging in sexual intercourse with a female partner who could become pregnant, a willingness to use a condom in addition to having the female partner use a highly effective contraceptive method between signing consent, during the study, and at least 90 days after the last dose of the study drug.
PART 1 only – Dose Escalation Specific Inclusion Criteria
- Histologically/cytologically confirmed, locally advanced unresectable or metastatic solid tumours for whom prior treatments have failed, and where an anthracycline may be considered as a treatment option or is indicated. Note that certain malignancies can be included based on imagingtests that create detailed images of areas inside the body (e.g., HCC) based on the discretion of the Investigator with Sponsor Medical Monitor approval.
- Eastern Cooperative Oncologythe study, diagnosis and treatment of cancer Group (ECOG) performance status ≤ 1
- Adequate Hepatic function as per below:
- Serum Total bilirubin (TBIL) as per below:
- Patients with documented Gilbert’s syndrome – baseline TBIL < 3 × ULN,
- Patient with either HCC or liver metastases – baseline TBIL < 2 × ULN
- All other patients baseline TBIL < 2 × ULN. Exceptions are allowable based on the discretion of the Investigator and with approval from Sponsor Medical Monitor
- Serum Total bilirubin (TBIL) as per below:
PART 2 only – Exploratory Dose Expansion Specific Inclusion Criteria 8. Histologically/cytologically confirmed solid tumours of any stage for which the patient has not received prior treatment with an anthracycline and for whom treatment with doxorubicin is indicated.
9. ECOG performance status ≤ 2 10. Adequate Hepatic function as per below:
• Serum TBIL as per below:
- Patients with documented Gilbert’s syndrome – baseline TBIL < 3 × ULN,
- Patient with either HCC or liver metastases – baseline TBIL < 3 × ULN
- All other patients baseline TBIL < 2 × ULN. Exceptions are allowable based on the discretion of the Investigator and with approval from Sponsor Medical Monitor