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Evaluation of Safety and Efficacy of KPG-121 Plus Enzalutamide, Abiraterone or Apalutamide in CRPC Patients

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ClinicalTrials.gov Identifier: NCT03569280
Recruitment Status : Recruiting
First Posted : June 26, 2018
Last Update Posted : April 6, 2022
Information provided by (Responsible Party):
Kangpu Biopharmaceuticals, Ltd.

Brief Summary:
This is a Phase 1, open-label, multicenter study of KPG-121 administered orally once daily (QD) in 28-day treatment cycles (21 days on and 7 days off) to adult subjects. The primary objective is to determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) and assess dose-limiting toxicity (DLT) of KPG-121 in combination with Enzalutamide or Abiraterone or Apalutamide when administered orally to adult subjects with non-metastatic or metastatic castration-resistant prostate cancer (CRPC).

Condition or disease Intervention/treatment Phase
Castration-Resistant Prostate Cancer Combination Product: Enzalutamide or Abiraterone or Apalutamid Phase 1

Detailed Description:
This Phase 1 study will comprise two parts: Part 1 will be a 3+3 dose escalation design to characterize the MTD and a RP2D, Part 2 will be an expansion cohort at RP2D. In Part 1, multiple escalating dose levels of KPG-121 (six cohorts: 1.5, 2.5, 5.0, 10, 20, and 30 mg/day) in combination with Enzalutamide or Abiraterone or Apalutamide will be evaluated to determine the MTD and RP2D of KPG-121. A RP2D will be selected based on the MTD as well as the information including safety, efficacy, and PSA data. The Part 2 will follow the same schedule of procedures as Part 1 once the RP2D has been decided. For the expansion cohort of part 2, subjects will be given the RP2D once daily for 21 consecutive days along with Enzalutamide or Abiraterone or Apalutamide followed by 7 days without KPG-121 for each 28-day cycle.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 36 participants
Allocation: N/A
Intervention Model: Sequential Assignment
Intervention Model Description: KPG-121 Plus Enzalutamide or Abiraterone or Apalutamid
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A First-in-Human Study to Determine the Safety, Pharmacokinetics and Efficacy of KPG-121 When Administered With Enzalutamide, Abiraterone, or Apalutamide in Subjects With Non-Metastatic or Metastatic Castration-Resistant Prostate Cancer
Actual Study Start Date : November 26, 2019
Estimated Primary Completion Date : December 2022
Estimated Study Completion Date : December 2022

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Prostate Cancer

Arm Intervention/treatment
Experimental: KPG-121
Safety and Antitumor Activity of KPG-121 capsules 1.5, 2.5, 5.0, 10, 20, and 30 mg/day daily for 21 days
Combination Product: Enzalutamide or Abiraterone or Apalutamid
Antitumor treatment

Primary Outcome Measures :
  1. Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D) of KPG-121 [ Time Frame: Cycle-1 (28-day) ]
    MTD is one dose level below the dose level that results in ≥33% of subjects with a DLT

Secondary Outcome Measures :
  1. Incidence of Adverse Events [Safety and Tolerability] [ Time Frame: Up to Cycle-6 (28-day per cycle) ]
    Treatment-Emergent Adverse events

  2. Pharmacokinetic (PK) profile of KPG-121 [ Time Frame: Cycle-1 (up to 23-day) ]
    Plasma concentrations of KPG-121

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Gender Based Eligibility:   Yes
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Signed informed consent provided prior to any study-related procedure being performed;
  2. Able to swallow and retain orally administered medication;
  3. Male aged 18 years and older (adult, older adult) at the time consent is obtained;
  4. Histologically or cytologically confirmed diagnosis of prostate carcinoma;
  5. Men with either non-metastatic or metastatic CRPC are eligible;
  6. Completed at least 4 or more weeks of prior continuous therapy with fixed stable dose enzalutamide, abiraterone or apalutamide prior to initiating study treatment (for Part 1), or with fixed stable dose enzalutamide (for Part 2), with no change in dose for at least 2 weeks prior to screening;
  7. Serum testosterone level <50 ng/dL (<0.5 ng/mL, <7.0 nmol/L). Subjects may have ongoing androgen deprivation therapy (ADT) with a luteinizing hormone-releasing hormone (LHRH) "super-agonist" or antagonist, and/or be surgically or medically castrated;
  8. ECOG performance status of 0 or 1;
  9. Adequate baseline organ function;
  10. Must have a QT interval corrected for heart rate according to Fridericia's formula (QTcF) <470 milliseconds (msec) or <480 msec with bundle branch block;
  11. Male subject with a female partner of childbearing potential must have either had a prior vasectomy or agree to use effective contraception from time of screening until 3 months after the last dose of study medication;
  12. Willing and able to comply with all protocol required visits and assessments.

Exclusion Criteria:

  1. Life expectancy less than 3 months;
  2. Discontinuation of bicalutamide or nilutamide in less than 6 weeks, and other antiandrogens in less than 4 weeks, prior to the start of study medication;
  3. Prior chemotherapy, radiation (limited radiotherapy to control bone pain is permitted), sipuleucel-T or other experimental immunotherapy less than 4 weeks prior to the start of study medication;
  4. Prior malignancy other than CRPC. Subjects who have been disease-free for 5 years, or subjects with a history of completely resected non-melanoma skin cancer or successfully treated in situ carcinoma are eligible;
  5. Screening blood counts with:

    1. absolute neutrophil count <1500/μL
    2. platelets <100,000/μL
    3. hemoglobin <9 g/dL;
  6. Screening chemistry test results with:

    1. alanine aminotransferase (ALT) and aspartate transaminase (AST) >2.5 × ULN
    2. total bilirubin >2 × ULN
    3. for the dose escalation cohort, creatinine clearance of <70 mL/min as determined by Cockcroft and Gault formula
    4. for the dose expansion cohort, subjects with creatinine clearance of <50 mL/min will be excluded (if kidneys are not working properly, there is a risk that KPG-121 may stay in the blood circulation longer than expected and may increase side-effects)
    5. albumin <2.8 g/dL;
  7. Uncontrolled hypothyroidism, or TSH >2.0 x ULN at screening. Subjects who are clinically euthyroid and on stable thyroid replacement therapy for 2 months prior to enrollment are allowed;
  8. Current use of or anticipated requirement during the study of prohibited medication(s), any investigational drug, other anti-cancer therapy (chemotherapy, radiation therapy, immunotherapy, biologic therapy, or hormone therapy other than for replacement), AR antagonists (e.g., bicalutamide, flutamide, nilutamide), 5-alpha reductase inhibitors (e.g., finasteride, dutasteride), androgens (e.g., testosterone, dihydroepiandrosterone), Herbal medication(s) that may affect PSA levels (e.g., saw palmetto), Other herbal medications including, but not limited to: St. John's wort, kava, ephedra (ma huang), gingko biloba, yohimbe and ginseng);
  9. Any unresolved ≥grade 2 (per CTCAE v5.0) toxicity from previous anti-cancer therapy at the time of enrollment, except for grade 2 alopecia, anemia (if hemoglobin is >9.0 g/dL) or neuropathy;
  10. Any ≥grade 2 hypophosphatemia (per CTCAE v5.0) at the time of enrollment;
  11. Serum calcium ≥grade 1 (per CTCAE v5.0) at time of enrollment, unless ionized calcium is within normal range;
  12. Presence of any clinically significant gastrointestinal (GI) abnormality or other condition(s) that may alter absorption such as malabsorption syndrome or major resection of the stomach or substantial portion of the small intestine;
  13. Active peptic ulcer disease or history of abdominal fistula, GI perforation, or intra abdominal abscess within 28 days prior to enrollment;
  14. Previous history of difficulty swallowing capsules;
  15. Known active infection requiring intravenous (IV) or oral anti-infective treatment or serious persistent infection within 14 days prior to the start of study medication;
  16. Presence of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test result at screening or within 3 months prior to the start of study medication;
  17. Evidence of severe or uncontrolled systemic diseases (e.g., unstable or uncompensated respiratory, hepatic, renal or cardiac disease);
  18. History of seizure or any condition that may predispose subject to seizure (e.g., prior cortical stroke or significant brain trauma). History of loss of consciousness or transient ischemic attack within 12 months prior to the start of study medication;
  19. Poorly controlled hypertension (defined as systolic BP ≥150 mmHg) or diastolic BP >100 mmHg based on a mean of three measurements at approximately 2-minute intervals);
  20. Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to enzalutamide or abiraterone or apalutamide or excipients. Allergy to acetaminophen or NSAIDs;
  21. History of impaired adrenal gland function (e.g., Addison's disease, Cushing's syndrome);
  22. History or evidence of cardiovascular risk including any of the following: Clinically significant ECG abnormalities including second degree (Type II) or third degree atrioventricular block; history of myocardial infarction, acute coronary syndromes (including unstable angina), coronary angioplasty, stenting, or bypass grafting within 6 months prior to enrollment, Class III or IV heart failure as defined by the New York Heart Association functional classification system, left ventricular ejection fraction (LVEF) below 45% at screening; known cardiac metastases;
  23. Anticoagulants used by subjects with a history of thromboembolic conditions within 6 months prior to enrollment. Note: Subjects receiving anticoagulants for atrial fibrillation are eligible for the study;
  24. Use of systemic glucocorticoid (e.g., prednisone, dexamethasone) within 14 days prior to the start of study medication;
  25. Serious concurrent medical condition including central nervous system disorders;
  26. Previous major surgery within 30 days prior to the start of study medication;
  27. Blood transfusion (including blood products) within 1 week of screening;
  28. Any condition that, in the opinion of the investigator, would impair the subject's ability to comply with study procedures.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03569280

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Contact: YONG GUO, MD 1-732-910-5945 yong.guo@kangpugroup.com

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United States, Nevada
Clinical Trial Site Recruiting
Las Vegas, Nevada, United States, 89169
Contact: AnaArlene SJ Ramirez, RN    702-952-3406    anaarlene.ramirez@usoncology.com   
Principal Investigator: Nicholas Vogelzang, MD         
United States, New York
Clinical Trial Site Recruiting
Port Jefferson Station, New York, United States, 11776
Contact: Clinical T Site, LPN    631-675-5146    lbrady@nycancer.com   
Principal Investigator: Richard Zuniga, MD         
Sponsors and Collaborators
Kangpu Biopharmaceuticals, Ltd.
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Study Director: YONG GUO, MD Kangpu Biopharmacuticals
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Responsible Party: Kangpu Biopharmaceuticals, Ltd.
ClinicalTrials.gov Identifier: NCT03569280    
Other Study ID Numbers: KPG-121-101
First Posted: June 26, 2018    Key Record Dates
Last Update Posted: April 6, 2022
Last Verified: April 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Keywords provided by Kangpu Biopharmaceuticals, Ltd.:
Non-metastatic and Metastatic Prostate Cancer
Additional relevant MeSH terms:
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Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Prostatic Diseases