Overview
Sponsor-declared trial summary
Relapsed/refractory neuroblastoma and other solid tumours
Defining the paediatric recommended phase 2 dose (RP2D) of ABTL0812 as single agent and in combination with chemotherapy (irinotecan-temozolomide) or targeted therapies.
Key facts
- Sponsor
- Fir Huvh Fundacio Institut De Recerca Hospital Universitari Vall De Hebron
- Participant type
- Pediatric, Patients
- Age range
- 0-17 years, 18-64 years
- Gender
- Male and Female
- Therapeutic area
- Diseases [C] - Neoplasms [C04]
- Decision date (initial)
- 2023-10-24
- Transition trial
- No
- Low-intervention
- No
- Rare-disease indication
- No
- Vulnerable population
- No
Trial design
CTIS Part I — objectives, methods, condition coding
Main objective
Scope: Safety, Efficacy
Defining the paediatric recommended phase 2 dose (RP2D) of ABTL0812 as single agent and in combination with chemotherapy (irinotecan-temozolomide) or targeted
therapies.
Secondary objectives 1
- Evaluating safety, antitumour activity, progression free survival, overall survival, pharmacokinetics and pharmacodynamics of ABTL0812 in children.
Conditions and MedDRA coding
Relapsed/refractory neuroblastoma and other solid tumours
Study design 1 period
| # | Title | Allocation | Blinding | Roles blinded | Arms |
|---|---|---|---|---|---|
| 1 | ETNA National, multicentre, open-label, non-randomized, phase I/II study to evaluate the safety, antitumour activity, pharmacokinetics and pharmacodynamics of ABTL0812 as single agent and in combination with chemotherapy or targeted therapies in children with neuroblastoma and other relapsed/refractory solid tumours.
The trial will include three dose confirmation cohorts:
- Cohort A: A cohort to establish the paediatric RP2D of ABTL0812 as single agent (100% of BSA-adjusted adult dose equivalent) given continuously in 28-day cycles, following a rolling-6 design.
- Cohort B: After completion of cohort A, a cohort of ABTL0812 in combination with irinotecan-temozolomide in 21-day cycles with a rolling-6 design to establish the paediatric RP2D for the combination. The starting dose of ABTL0812 will be 75% of the single agent paediatric RP2D combined with 100% of the established chemotherapy dose. Based on the number of dose limiting toxicities (DLTs) it will be consider a dose escalation to ABTL0812 at 100% dose and chemotherapy at 100% dose.
After establishing the RP2D for the combination, a BOP2 design will be used to simultaneously monitor efficacy and toxicity. This cohort will be enriched with patients with neuroblastoma.
ABTL0812 will be given continuously. Before starting the first day of combination treatment, ABTL0812 will be administered as single agent during a loading period of seven days (day -7 to day -1). Irinotecan-temozolomide will be given in 21-day cycles. Based on that, cycle 1 will be 28 days and the following cycles will be 21 days.
- Cohort C: After completion of cohort A and once results of the ongoing preclinical studies are available, this cohort will explore the combination of ABTL0812 with targeted therapies (such as immune checkpoint inhibitors, anti-GD2 directed immunotherapy or bevacizumab). Clinical trial protocol will then be amended to include this regimen as a dose confirmation/expansion cohort.
|
Not Applicable | None |
Eligibility criteria
Principal inclusion / exclusion criteria as submitted by sponsor
Inclusion criteria 1
- 1. Signed informed consent of the patient, parents or legal representatives before any study-specific screening procedures are conducted, and age-appropriate assent. 2. Aged 1 to ≤21 years at time of signing informed consent. 3. BSA ≥0.5 m2 . 4. Patient must be able to swallow intact capsules. 5. Diagnosis of a solid tumour that has progressed, relapsed or is refractory to at least one standard therapy and/or for which there is not known curative option. Histologic confirmation of progression or relapse is recommended but not mandatory. 6. At least one evaluable or measurable radiological site of disease as defined by INRC, RECIST v1.1 or RAPNO criteria. 7. Adequate performance status: Patients 60%. Patients ≥16 years of age: Karnofsky >60%. 8. Adequate haematological, hepatic and renal function defined by the following laboratory results obtained within 7 days prior to initiation of study drug according to CTCAE v5.0: *Haematological function: - Haemoglobin ≥ 8 g/dL (transfusion allowed). - Peripheral ANC ≥1x109 /L. No G-CSF support for 72 hours prior to initiation of study treatment. Pegylated forms need a wash-out of 7 days. - Platelet count ≥75x109 /L, unsupported for 72 hours prior to initiation of study treatment. *Renal and liver function: - Normal serum creatinine based on age/gender. If serum creatinine is greater than maximum serum creatinine for age/gender, then creatinine clearance (or radioisotope glomerular filtration rate [GFR]) must be >70 mL/min/1.73m2 . - Total bilirubin ≤1.5 x ULN (≤3 x ULN if liver metastases). - AST or ALT ≤3 x ULN (≤5 x ULN if liver metastases). 9. Appropriate contraceptive methods for sexually active males and women of childbearing age. 10. A negative pregnancy test for women of childbearing age. 11. Absence of any psychological, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up Schedule
Exclusion criteria 1
- 1. Symptomatic or bleeding CNS metastases that result in a neurologically unstable clinical state or require increasing doses of corticosteroids or local CNS-directed therapy to control. 2. Gastrointestinal malabsorption, gastrointestinal anastomosis, or any other condition that in the opinion of the investigator might affect the absorption of ABTL0812 or temozolomide. 3. Any additional uncontrolled illness or known active infection, including HBV, HCV and HIV. 4. Presence of any grade >2 clinically significant toxicities related to prior treatments with the exception of alopecia, peripheral neuropathy or other long-term sequelae of cancer therapy, and parameters otherwise permitted in the inclusion criteria. 5. Any uncontrolled medical condition or other identified abnormality that precludes the patient's safe participation in and completion of the study, as judged by the investigator. 6. Systemic anticancer therapy within 21 days or 5 half-lives, whichever is shorter, prior to initiation of study treatment. Seven days for oral metronomic chemotherapy. 7. I-131 MIBG therapy within 6 weeks prior to initiation of study treatment. 8. Myeloablative therapy with autologous hematopoietic stem cell rescue within 60 days or allogeneic hematopoietic stem cell rescue within 120 days of study treatment initiation. 9. Active graft versus host disease requiring systemic therapy. 10. Radiotherapy (non-palliative) within 21 days prior to study treatment initiation. 11. Major surgical procedure within 21 days of study treatment initiation, or anticipated need for major surgical procedure during the course of the study
Endpoints
Primary and secondary outcome measures (English text)
Primary endpoints 1
- Incidence of dose limiting toxicities assessed during the first cycle of study treatment of ABTL0182 (cohorts A and B).
Investigational products
Investigational medicinal products (IMPs), comparators, placebo, auxiliary
Test 1
PRD10568698 · Product
- Active substance
- Sodium 2-HYDROXYLINOLEATE
- Substance synonyms
- ABTL-0812 SODIUM
- Pharmaceutical form
- CAPSULE
- Route of administration
- ORAL
- Authorisation status
- Not Authorised
- MA holder
- ABILITY PHARMACEUTICALS, S.L
- Paediatric formulation
- Yes
- Orphan designation
- Yes
- Orphan designation number
- EU/3/15/1485
Sponsors and contacts
Sponsor organisations, regulatory contacts, third parties
Fir Huvh Fundacio Institut De Recerca Hospital Universitari Vall De Hebron
- Sponsor organisation
- Fir Huvh Fundacio Institut De Recerca Hospital Universitari Vall De Hebron
- Address
- Passeig De La Vall D'hebron 119-129
- City
- Barcelona
- Postcode
- 08035
- Country
- Spain
Scientific contact point
- Organisation
- Fir Huvh Fundacio Institut De Recerca Hospital Universitari Vall De Hebron
- Contact name
- Angélica Valderrama Rodríguez
Public contact point
- Organisation
- Fir Huvh Fundacio Institut De Recerca Hospital Universitari Vall De Hebron
- Contact name
- Angélica Valderrama Rodríguez
Locations
1 EU/EEA country · 6 investigational sites
By country
| Country | MS status | Planned subjects | Sites |
|---|---|---|---|
| Spain | Not authorised | 48 | 6 |
| Rest of world | — | 0 | — |
Investigational sites
Application history
1 submissions — initial application plus substantial / non-substantial modifications
| # | Type | Code | Submitted | Reference MS | Conclusion | Decision date |
|---|---|---|---|---|---|---|
| 1 | INITIAL | IN | 2023-07-18 | Spain | Not acceptable 2023-10-23
|
2023-10-24 |