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Study of CBX-12 in Subjects With Advanced or Metastatic Refractory Solid Tumors

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04902872
Recruitment Status : Recruiting
First Posted : May 26, 2021
Last Update Posted : May 13, 2022
Sponsor:
Information provided by (Responsible Party):
Cybrexa Therapeutics

Brief Summary:
This is a first-in-human, Phase 1/2 open-label, multicenter, dose-escalation, safety, pharmacokinetics (PK), and biomarker study of CBX-12 in subjects with advanced or metastatic refractory solid tumors.

Condition or disease Intervention/treatment Phase
Solid Tumor, Adult Epithelial Ovarian Cancer Small Cell Lung Carcinoma Breast Cancer Colorectal Cancer Pancreas Cancer Appendix Cancer Non-small Cell Lung Cancer Gastric Cancer Esophagus Cancer Urothelial Carcinoma Sarcoma Drug: CBX-12 Phase 1 Phase 2

Detailed Description:

Phase 1 is the dose-escalation portion of the study in which the safety and tolerability of two dosing schedules of CBX-12 will be evaluated. Subjects in Part A will be treated with CBX-12 on a daily x 5 every 3 weeks schedule (treatment in Part A was discontinued in October 2021). Subjects in Phase 1 Part B will be treated with CBX-12 on a daily x 3 every 3 weeks schedule. Subjects in Phase 1 Part C will be treated with CBX-12 once weekly.

For all parts in Phase 1, after all subjects in a cohort have completed treatment through the DLT period or discontinued treatment due to a DLT, the SRC, composed of the Investigators who have enrolled subjects in the current cohort(s), the study Medical Monitor and ad hoc members (e.g., other Investigators, a statistician) as needed, will review all available safety data, including DLTs and all available PK data for that cohort and make dose-level recommendations.

Once the recommended phase 2 dose (RP2D) has been established in both Part B and Part C, Phase 2 expansion cohorts may open.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 112 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Intervention Model Description: Parts B and C will follow a 3 + 3 design, enrolling 3 subjects in each cohort. (De)escalation rules: DLT period for each subject in Phase 1 Part B will be 3 weeks & 4 weeks in Part C (i.e., 1 cycle). If none of the 3 subjects experience a DLT, dose will be escalated to next highest dose level. If 1 of 3 subjects in cohort experiences a DLT, up to 3 additional subjects will be enrolled/treated at same dose. If none of the additional 3 subjects experience a DLT (i.e., only 1 of 6 subjects in cohort has a DLT), dose will be escalated to next highest level. If 2 or more of up to 6 subjects at dose level have DLTs, enrollment to that cohort will stop, dose will be considered above MTD. Dose will be decreased to previous dose level or to a level intermediate to those previously evaluated. MTD will be highest dose evaluated at which ≤ 1 of 6 have a DLT. A minimum of 6 DLT-evaluable subjects will be enrolled to any dose level being evaluated as possible MTD.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2 Study of CBX-12 in Subjects With Advanced or Metastatic Refractory Solid Tumors
Actual Study Start Date : May 3, 2021
Estimated Primary Completion Date : January 2024
Estimated Study Completion Date : April 2024


Arm Intervention/treatment
Experimental: Phase 1 Dose Escalation (Daily Dosing x 3)
CBX-12 administered on a daily x 3, 3 week schedule
Drug: CBX-12
CBX-12 is an alphalex construct which consists of a low-pH insertion peptide, a self-immolating linker, and exatecan as the pharmacologically active moiety

Experimental: Phase 1 Dose Escalation (Once Weekly Dosing )
CBX-12 administered once weekly, 4 week schedule
Drug: CBX-12
CBX-12 is an alphalex construct which consists of a low-pH insertion peptide, a self-immolating linker, and exatecan as the pharmacologically active moiety

Experimental: Phase 2 Ovarian Cancer Expansion Cohort
CBX-12 administered on a daily x 5 every 3 weeks or on a daily x 3 every 3 weeks schedule
Drug: CBX-12
CBX-12 is an alphalex construct which consists of a low-pH insertion peptide, a self-immolating linker, and exatecan as the pharmacologically active moiety

Experimental: Phase 2 Small Cell Lung Cancer Expansion Cohort
CBX-12 administered on a daily x 5 every 3 weeks or on a daily x 3 every 3 weeks schedule
Drug: CBX-12
CBX-12 is an alphalex construct which consists of a low-pH insertion peptide, a self-immolating linker, and exatecan as the pharmacologically active moiety




Primary Outcome Measures :
  1. Phase 1: Incidence of treatment-emergent adverse events (TEAEs) [ Time Frame: Through the end of study, estimated as 6 months ]
    NCI CTCAE v5.0

  2. Phase 1: Recommended Phase 2 Dose for Daily x 3 every 3 weeks schedule of CBX-12 [ Time Frame: 15 months ]
    Safety Review Committee Analysis of Safety and PK Data each schedule in Part B and Part C

  3. Phase 1: Recommended Phase 2 Dose for Once Weekly schedule of CBX-12 [ Time Frame: 15 months ]
    Safety Review Committee Analysis of Safety and PK Data

  4. Phase 2: Overall response rate (ORR) [ Time Frame: Through the end of study, estimated as 6 months ]
    ORR Based on RECIST v1.1


Secondary Outcome Measures :
  1. Maximum concentration of CBX-12 [ Time Frame: 5 days ]
    PK Analysis

  2. Area under the curve from 0-24 hours of CBX-12 [ Time Frame: 5 days ]
    PK Analysis

  3. Time to maximum concentration of CBX-12 [ Time Frame: 5 days ]
    PK Analysis

  4. Half-life of CBX-12 [ Time Frame: 5 days ]
    PK Analysis

  5. Clearance (CL) of CBX-12 [ Time Frame: 5 days ]
    PK Analysis

  6. Apparent Volume of Distribution at Steady State (Vss) CBX-12 [ Time Frame: 5 days ]
    PK Analysis

  7. Phase 1: ORR [ Time Frame: Through the end of study, estimated as 6 months ]
    Based on RECIST v1.1

  8. Duration of Response (DoR) [ Time Frame: Through the end of study, estimated as 6 months ]
    Based on RECIST v1.1

  9. Progression-free Survival (PFS) [ Time Frame: Through the end of study, estimated as 6 months ]
    Based on RECIST v1.1

  10. Phase 2: Incidence of TEAEs [ Time Frame: Through the end of study, estimated as 6 months ]
    NCI CTCAE v5.0



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:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

  • Subject has a histologically- or cytologically-diagnosed solid tumor which is advanced or metastatic and which has progressed on or following at least one systemic therapy regimen administered for advanced or metastatic disease or for which no approved therapy exists. Subject's prior treatment should include all approved regimens that have demonstrated a survival advantage for the subject's disease, stage, and line of therapy.
  • Has measurable disease per RECIST 1.1.
  • An adequate tumor sample must be available from core needle biopsies obtained during the Screening Period and following the subject's most recent systemic therapy.
  • Agrees to an on-treatment biopsy preferably of the same lesion from which the pre-CBX-12 treatment sample was obtained as long as the Investigator determines such biopsy can be performed with acceptable safety.

Exclusion Criteria:

  • Cytotoxic chemotherapy, biologic agent, investigational agent, or radiation therapy less than or equal to 3 weeks prior to the first dose of CBX-12. The interval may be reduced to 2 weeks for bone only radiation therapy or investigational agents not expected to be associated with adverse events (AEs) after 2 weeks of last administration, with Medical Monitor approval.
  • Small-molecule kinase inhibitors or hormonal agents less than or equal to 14 days prior to the first dose of CBX-12.
  • Subjects who are currently receiving any other anti cancer or investigational agent(s).
  • Clinically significant intercurrent disease.
  • Subjects with primary central nervous system (CNS) tumors or clinically active CNS metastases or carcinomatous meningitis. Subjects with stable brain metastasis may be enrolled with Medical Monitor approval.

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): NCT04902872


Contacts
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Contact: Project Manager 860-501-3027 clinicalstudies@cybrexa.com

Locations
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United States, Connecticut
Yale Cancer Center Recruiting
New Haven, Connecticut, United States, 06511
Contact: Ingrid Palma    203-833-1034    ingrid.palma@yale.edu   
Principal Investigator: Joseph Paul Eder, MD         
United States, Texas
NEXT Oncology Recruiting
Austin, Texas, United States, 78758
Contact: Glenda Chambers    210-580-9520    gchambers@nextoncology.com   
Contact: Nicole Klein    737-618-5210    nklein@nextoncology.com   
Principal Investigator: Andrae L Vandross, MD         
MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: Krystle Luna    713-302-9904    kaluna@mdanderson.org   
Principal Investigator: Funda Meric-Bernstam, MD         
NEXT Oncology Recruiting
San Antonio, Texas, United States, 78229
Contact: Cynthia De Leon    210-580-9521    cdeleon@nextoncology.com   
Principal Investigator: Anthony Tolcher, MD         
Sponsors and Collaborators
Cybrexa Therapeutics
Investigators
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Study Director: Chief Medical Officer Cybrexa Therapeutics
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Responsible Party: Cybrexa Therapeutics
ClinicalTrials.gov Identifier: NCT04902872    
Other Study ID Numbers: CBX-12-101
First Posted: May 26, 2021    Key Record Dates
Last Update Posted: May 13, 2022
Last Verified: May 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
Keywords provided by Cybrexa Therapeutics:
SCLC
small cell lung cancer
ovarian
breast
appendix
colorectal
pancreatic
NSCLC
Sarcoma
Additional relevant MeSH terms:
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Carcinoma
Sarcoma
Carcinoma, Ovarian Epithelial
Pancreatic Neoplasms
Small Cell Lung Carcinoma
Esophageal Neoplasms
Appendiceal Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Lung Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Intestinal Diseases
Ovarian Neoplasms
Endocrine Gland Neoplasms
Ovarian Diseases
Adnexal Diseases
Genital Neoplasms, Female
Urogenital Neoplasms