A phase I/II trial of ABTL0812 in children with relapsed/refractory neuroblastoma and other solid tumours

2023-504246-64-00 Protocol ETNA Phase I and Phase II (Integrated) - Other Not authorised

Status Not authorised · 1 EU/EEA countries · 6 sites · Protocol ETNA

Overview

Sponsor-declared trial summary

Phase Phase I and Phase II (Integrated) - Other
Status Not authorised
Participants planned 48
Countries 1
Sites 6

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

  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

#TitleAllocationBlindingRoles blindedArms
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. 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. 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

  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

Sodium 2-HYDROXYLINOLEATE

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

3 Total trials 1 Recruiting
Academic / Non-commercial
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

CountryMS statusPlanned subjectsSites
Spain Not authorised 48 6
Rest of world 0

Investigational sites

Spain

6 sites · Not authorised
Hospital Universitario Y Politecnico La Fe
Pediatric Hemato-oncology, Avenida De Fernando Abril Martorell 106, 46026, Valencia
Hospital Infantil Universitario Nino Jesus
Paediatric Haemato-oncology, Avenida Menendez Pelayo 65, 28009, Madrid
Sant Joan De Deu Barcelona Hospital
Pediatric-Oncology, Passeig De Sant Joan De Deu 2, 08950, Esplugues De Llobregat
Hospital Universitari Vall D Hebron
Pediatric Oncology and Hematology Unit, Edificio Materno-Infantil, Passeig De La Vall D'hebron 119-129, Barcelona
University Hospital Virgen Del Rocio S.L.
Pediatric Oncology Unit, Avenida De Manuel Siurot S/n, 41013, Sevilla
Hospital Universitario De Cruces
Pediatric Oncology/Hematology, Cruces Plaza S/n, 48903, Barakaldo

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2023-07-18 Spain Not acceptable
2023-10-23
2023-10-24