FIH XON7 in Advanced/Metastatic Solid Tumors

Advanced Solid Tumor Clinical Trial

— FIPO23  

Official title:

Phase I/II, Multi Center, Open Label, First-in-human, Dose Escalation and Expansion Study to Investigate the Safety, Pharmacokinetics, and Anti-tumors Efficacy of the Glyco-humanized Polyclonal Antibody XON7 in Patients With Advanced or Metastatic Solid Tumors

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06154291
• Other study ID #: XT 23-01
• Secondary ID: 2023-505266-29-0
• Status: Recruiting
• Phase: Phase 1/Phase 2
• Start date: November 14, 2023
• Est. completion date: November 2027

Study information

• Verified date: January 2024
• Source: Xenothera SAS
• Contact: Françoise SHNEIKER, MD
• Phone: +33652720301
• Email: francoise.shneiker[@]xenothera.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a two-stage trial consisting of a Part I, dose escalation and dose-finding component to establish the Maximal Tolerated Dose (MTD), if any, and Recommended Part 2 Dose (RP2D) of XON7, followed by a Part II component to investigate anti-tumors efficacy in selected solid tumor types and to further evaluate safety and tolerability of XON7 at RP2D.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 255
• Est. completion date: November 2027
• Est. primary completion date: December 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Provide signed, written informed consent.

2. Male and female participant, age = 18 years old (at the time consent is obtained)

3. Solid tumors indications:

• Participant in phase I, must have a histologically or cytologically confirmed advanced or metastatic solid tumors for which no effective standard therapy is available. All tumor types except glioblastoma, could be included.
• Participant in phase II, must have histologically or cytologically confirmed advanced or metastatic solid tumors of the following: NSCLC, gastro-esophageal adenocarcinoma, CRC, pancreatic cancer, Sarcoma, TNBC, or ovarian cancer.

4. Line of treatment: Participant must have solid tumors progressing after = 4 lines of standard appropriate anticancer therapies for the specific tumor type, or for which the patient is ineligible. Participants whose cancers harbor molecular alterations for which targeted therapy is standard of care should have received health authority-approved appropriate targeted therapy for their tumor types before enrollment.

5. Measurable disease per RECIST version 1.1 - v5

6. (ECOG) performance status (PS) 0-1

7. Life expectancy of at least 12 weeks.

8. Adequate organ function

9. QT duration corrected for heart rate by Fridericia's formula (QTcF) <450 msec or QTcF <480 msec for participants with bundle branch block.

10. In France, a participant will be eligible for inclusion in this trial only if either affiliated to or a beneficiary of a social security category.

11. Female participant who are not of child-bearing potential, and female participants of child-bearing potential who have a negative serum pregnancy test within 7 days prior to initial trial treatment. Female participants of child-bearing potential, and all male partners must consent to use a medically acceptable method of contraception throughout the trial period and for at least 60 days after the last dose of XON7. A barrier method of contraception must be included.

12. Male participant willing to use adequate contraceptive measures throughout the trial period and for at least 60 days after the last dose of trial intervention.

13. For phase II, participant in pharmacodynamics cohort must provide biopsy of a tumor lesion not previously irradiated during the screening period and must agree to provide at least one additional on-treatment biopsy between day 36 and 42 after trial intervention administration.

14. For phase II, participant in pharmacodynamics cohort must have accessible tumor tissue available for fresh biopsy except for ovarian cancer and sarcoma.

Exclusion Criteria:

1. A participant who has received more than 4 prior lines of therapy for advanced or metastatic disease.

2. A participant who has had a prior anti-cancer mAb within 3 weeks prior to trial Day 1 or who has not recovered (i.e., = Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier prior to trial Day 1.

3. A participant who has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to trial Day 1 or who have not recovered (i.e., = Grade 1 or at baseline) from adverse events due to a previously administered agent (Except alopecia, hearing loss, grade 2 neuropathy or endocrinopathy managed with replacement therapy).

4. A participant with =Grade 3 toxicity related to prior immunotherapy leading to treatment discontinuation.

5. A participant whose toxicity related to prior treatment has not resolved to Grade 1 (except alopecia, hearing loss, grade 2 neuropathy or endocrinopathy managed with replacement therapy).

6. A participant who has received major surgery 2 weeks before the first dose of trial treatment or has not recovered adequately from the toxicity and/or complications from any surgery (major or minor) before initiating trial treatment.

7. Concomitant use of another experimental drug, or wash-out period of at least 5 half-lives for a previous experimental drug not completed before start of trial intervention

8. Participant treated with drugs known to prolong the QT interval

9. Participant with carcinomatous meningitis.

10. Central nervous system (CNS) metastases, with the exception of individuals who have been previously treated CNS metastases, are asymptomatic, and have had no requirement for steroids for 3 weeks prior to first dose of trial drug.

11. Malignancies other than disease under trial within 3 years prior to first dose of trial intervention.

12. History of autoimmune disease

13. Active or uncontrolled infections requiring systemic treatment (known human immunodeficiency virus infection, or positive test for hepatitis B surface antigen or hepatitis C).

14. Any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the trial such as history or evidence of cardiovascular

risk including any of the following:

• Recent (within the past 6 months) history of serious uncontrolled cardiac arrhythmia or clinically significant ECG abnormalities including second degree (Type II) or third-degree atrioventricular block.
• Documented cardiomyopathy, myocardial infarction, acute coronary syndromes (including unstable angina pectoris), coronary angioplasty, stenting, or bypass grafting within the past 6 months before enrollment.
• Documented congestive heart failure (Class II, III, or IV) as defined by the New York Heart Association functional classification system (NYHA, 1994).

15. Prior allogeneic or autologous bone marrow transplantation or other solid organ transplantation.

16. Current active liver or biliary disease (Except for Gilbert's syndrome or asymptomatic gallstones, liver metastases, or otherwise stable chronic liver disease per investigator assessment).

17. Concurrent medical condition requiring the use of systemic immunosuppressive medications within 28 days before the first dose of trial treatment.

18. Recent history (within the past 6 months) of acute diverticulitis, inflammatory bowel disease, intra-abdominal abscess, or gastrointestinal obstruction.

19. Current or history of idiopathic pulmonary fibrosis, interstitial lung disease, or organizing pneumonia. Note: post-radiation changes in the lung related to prior radiotherapy and/or asymptomatic radiation-induced pneumonitis not requiring treatment may be permitted if agreed by the investigator and Medical Monitor.

20. History of (non-infectious) pneumonitis that required steroids or current pneumonitis.

21. Recent history (within 6 months) of uncontrolled symptomatic ascites or pleural effusions.

22. Participant who has received transfusion of blood products (including platelets or red blood cells) or administration of colony stimulating factors (including granulocyte colony- stimulating factor [G-CSF], granulocyte-macrophage colony-stimulating factor [GM- CSF], recombinant erythropoietin) within 2 weeks before the first dose of trial intervention.

23. Known, current drug or alcohol abuse.

24. Female participant who is pregnant or lactating.

25. Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol.

26. Inability or unwillingness to comply with trial and/or follow-up procedures outlined in the protocol.

27. For France, patients under legal protection (safeguard, guardianship, curatorship)

Related Conditions & MeSH terms

• Advanced Solid Tumor
• Metastatic Cancer
• Neoplasm Metastasis
• Neoplasms

Intervention

Drug:
• XON7
The trial intervention (XON7) is a glyco-humanized polyclonal antibody drug which is formulated for intravenous (IV) administration

Locations

Country	Name	City	State
Belgium	Institut Jules Bordet	Anderlecht
France	Centre Léon Bérard	Lyon
France	Hôpital Foch	Suresnes
France	IUCT-Oncopole	Toulouse

Sponsors (1)

Lead Sponsor	Collaborator
Xenothera SAS

Countries where clinical trial is conducted

Belgium,  France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Dose Escalation part: Dose Limiting Toxicities (DLTs)	Investigator defined DLT during first treatment cycle	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: treatment emergent adverse events (TEAEs)	An overall summary of AE occurrences with onset during the first treatment cycle will be presented; this will include the following AE attributes: Preferred term,; Maximum CTCAE grade,; Outcome,; Time to first occurrence [days].	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Leucocytes count	Incidence and magnitude of clinically significant changes in Leucocytes Count (G/L)	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Red Blood Cells Count	Incidence and magnitude of clinically significant changes in Red Blood Cells Count (T/L)	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Hemoglobin	Incidence and magnitude of clinically significant changes in Hemoglobin (g/dL).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Hematocrit	Incidence and magnitude of clinically significant changes in Hematocrit (%).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Absolute Neutrophil Count	Incidence and magnitude of clinically significant changes in Absolute Neutrophil Count (G/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Absolute Eosinophil Count	Incidence and magnitude of clinically significant changes in Absolute Eosinophil Count (G/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Absolute Basophil Count	Incidence and magnitude of clinically significant changes in Absolute Basophil Count (G/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Absolute Lymphocytes Count	Incidence and magnitude of clinically significant changes in Absolute Lymphocytes Count (G/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Absolute Monocytes Count	Incidence and magnitude of clinically significant changes in Absolute Monocytes Count (G/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Platelet Count	Incidence and magnitude of clinically significant changes in Platelet Count (G/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Albumin	Incidence and magnitude of clinically significant changes in Albumin (g/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Bicarbonate	Incidence and magnitude of clinically significant changes in Bicarbonate (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Total Bilirubin	Incidence and magnitude of clinically significant changes in Total Bilirubin (µmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Calcium	Incidence and magnitude of clinically significant changes in Calcium (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Urea	Incidence and magnitude of clinically significant changes in Urea (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Chloride	Incidence and magnitude of clinically significant changes in Chloride (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Creatinine	Incidence and magnitude of clinically significant changes in Creatinine (µmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Creatinine Clearance	Incidence and magnitude of clinically significant changes in Creatinine Clearance (mL/min).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Glucose	Incidence and magnitude of clinically significant changes in Glucose (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Magnesium	Incidence and magnitude of clinically significant changes in Magnesium (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Phosphate	Incidence and magnitude of clinically significant changes in Phosphate (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Potassium	Incidence and magnitude of clinically significant changes in Potassium (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Sodium	Incidence and magnitude of clinically significant changes in Sodium (mmol/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Total Protein	Incidence and magnitude of clinically significant changes in Total Protein (g/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Alanine aminotransferase (ALT)	Incidence and magnitude of clinically significant changes in Alanine aminotransferase (ALT) (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Aspartate aminotransferase (AST)	Incidence and magnitude of clinically significant changes in Aspartate aminotransferase (AST) (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Gamma-glutamyl transférase (GGT)	Incidence and magnitude of clinically significant changes in Gamma-glutamyl transférase (GGT) (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Alkaline Phosphatase (ALP)	Incidence and magnitude of clinically significant changes in Alkaline Phosphatase (ALP) (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Lactate dehydrogenase (LDH)	Incidence and magnitude of clinically significant changes in Lactate dehydrogenase (LDH) (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Amylase	Incidence and magnitude of clinically significant changes in Amylase (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Lipase	Incidence and magnitude of clinically significant changes in Lipase (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Total Protein Creatine Kinase (CK)	Incidence and magnitude of clinically significant changes in Total Protein Creatine Kinase (CK) (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Creatine kinase - cardiac muscle isoenzyme (CK-MB)	Incidence and magnitude of clinically significant changes in Creatine kinase - cardiac muscle isoenzyme (CK-MB) (U/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Troponin T	Incidence and magnitude of clinically significant changes in Troponin T (ng/L).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Prothrombin Time (PT)	Incidence and magnitude of clinically significant changes in Prothrombin Time (PT) (Sec).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in INR (if under VKA Therapy)	Incidence and magnitude of clinically significant changes in INR (if under VKA Therapy)	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant changes in Activated Partial Thromboplastin Time (aPTT)	Incidence and magnitude of clinically significant changes in Activated Partial Thromboplastin Time (aPTT) (Sec).	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant findings in blood pressure (BP)	Incidence and severity of clinically significant findings in blood pressure: Significant blood pressure increase will be defined as BP >150/100 mmHg in a subject without a history of hypertension or increased >20 mmHg (diastolic) from baseline measurement in a subject with a previous history of hypertension.	At the end of Cycle 1 (28 days)
Primary	Dose Escalation part: clinically significant findings in electrocardiogram (ECGs)	Incidence of clinically significant findings in Electrocardiogram (ECG): Significant QTc prolongation will be defined as an interval =500 msec or an interval which increases by =60 msec over baseline	At the end of Cycle 1 (28 days)
Primary	Expansion part: Anti-tumors efficacy	Objective response rate (ORR): defined as the proportion of participants with a confirmed complete response [CR] or confirmed partial response [PR] assessed by investigators according to RECIST v1.1.	Within 3 months after XON7 initiation
Secondary	Pharmacokinetics (PK) of XON7 (Part 1): Cmax	XON7 peak plasma concentration (Cmax) in plasma	Cycle 1-Day 1 Predose and Postdose: 5 minutes; 1; 2; 4; 8; 24; 72 or 96; 144 hours after the end of infusion. Cycle 1 Day 15; Cycle 2 Day 1; Cycle 3 Day 1; Cycle 7 Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 2): Cmax	XON7 peak plasma concentration (Cmax) in plasma	Cycle 1-Day 1; Cycle 2-Day 1; Cycle 3-Day 1; Cycle 6-Day 1; Cycle 9-Day1 and Cycle 12-Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 1): Tmax	Time to peak drug concentration in plasma (Tmax)	Cycle 1-Day 1 Predose and Postdose: 5 minutes; 1; 2; 4; 8; 24; 72 or 96; 144 hours after the end of infusion. Cycle 1 Day 15; Cycle 2 Day 1; Cycle 3 Day 1; Cycle 7 Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 2): Tmax	Time to peak drug concentration in plasma (Tmax)	Cycle 1-Day 1; Cycle 2-Day 1; Cycle 3-Day 1; Cycle 6-Day 1; Cycle 9-Day1 and Cycle 12-Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 1): AUC	Area under the plasma concentration versus time curve (AUC). AUC24hours; AUC0-14days and AUC15-28days will be assessed	Cycle 1-Day 1 Predose and Postdose: 5 minutes; 1; 2; 4; 8; 24; 72 or 96; 144 hours after the end of infusion. Cycle 1 Day 15; Cycle 2 Day 1; Cycle 3 Day 1; Cycle 7 Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 2): AUC	Area under the plasma concentration versus time curve (AUC). AUC24hours; AUC0-14days and AUC15-28days will be assessed	Cycle 1-Day 1; Cycle 2-Day 1; Cycle 3-Day 1; Cycle 6-Day 1; Cycle 9-Day1 and Cycle 12-Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 1): Ctrough	Trough concentration (Ctrough) is the concentration reached by XON7 immediately before the next dose is administered	Cycle 1-Day 1 Predose and Postdose: 5 minutes; 1; 2; 4; 8; 24; 72 or 96; 144 hours after the end of infusion. Cycle 1 Day 15; Cycle 2 Day 1; Cycle 3 Day 1; Cycle 7 Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 2): Ctrough	Trough concentration (Ctrough) is the concentration reached by XON7 immediately before the next dose is administered	Cycle 1-Day 1; Cycle 2-Day 1; Cycle 3-Day 1; Cycle 6-Day 1; Cycle 9-Day1 and Cycle 12-Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 1): Cmin	Cmin for the minimum blood plasma concentration reached by XON7 during the time interval between administration of two doses	Cycle 1-Day 1 Predose and Postdose: 5 minutes; 1; 2; 4; 8; 24; 72 or 96; 144 hours after the end of infusion. Cycle 1 Day 15; Cycle 2 Day 1; Cycle 3 Day 1; Cycle 7 Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 2): Cmin	Cmin for the minimum blood plasma concentration reached by XON7 during the time interval between administration of two doses	Cycle 1-Day 1; Cycle 2-Day 1; Cycle 3-Day 1; Cycle 6-Day 1; Cycle 9-Day1 and Cycle 12-Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 1): T1/2	Half-life (T1/2) refers to the time required for plasma concentration of XON7 to decrease by 50%	Cycle 1-Day 1 Predose and Postdose: 5 minutes; 1; 2; 4; 8; 24; 72 or 96; 144 hours after the end of infusion. Cycle 1 Day 15; Cycle 2 Day 1; Cycle 3 Day 1; Cycle 7 Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 2): T1/2	Half-life (T1/2) refers to the time required for plasma concentration of XON7 to decrease by 50%	Cycle 1-Day 1; Cycle 2-Day 1; Cycle 3-Day 1; Cycle 6-Day 1; Cycle 9-Day1 and Cycle 12-Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 1): CL	Clearance (CL) is the volume of blood or plasma cleared of XON7 from the body per unit of time	Cycle 1-Day 1 Predose and Postdose: 5 minutes; 1; 2; 4; 8; 24; 72 or 96; 144 hours after the end of infusion. Cycle 1 Day 15; Cycle 2 Day 1; Cycle 3 Day 1; Cycle 7 Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 2): CL	Clearance (CL) is the volume of blood or plasma cleared of XON7 from the body per unit of time	Cycle 1-Day 1; Cycle 2-Day 1; Cycle 3-Day 1; Cycle 6-Day 1; Cycle 9-Day1 and Cycle 12-Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 1): Vd	Volume of distribution (Vd) is defined as the total amount of XON7 in the body divided by its concentration in plasma	Cycle 1-Day 1 Predose and Postdose: 5 minutes; 1; 2; 4; 8; 24; 72 or 96; 144 hours after the end of infusion. Cycle 1 Day 15; Cycle 2 Day 1; Cycle 3 Day 1; Cycle 7 Day 1: Predose and 5 minutes after the end of infusion
Secondary	Pharmacokinetics (PK) of XON7 (Part 2): Vd	Volume of distribution (Vd) is defined as the total amount of XON7 in the body divided by its concentration in plasma	Cycle 1-Day 1; Cycle 2-Day 1; Cycle 3-Day 1; Cycle 6-Day 1; Cycle 9-Day1 and Cycle 12-Day 1: Predose and 5 minutes after the end of infusion
Secondary	Host immunogenicity to XON7 (Part 1 and part 2)	Number of participants who develop detectable anti-drug antibodies	Cycle 1-Day 1; Cycle 1-Day4; Cycle 1-Day7; Cycle 1-Day15; Cycle 2 and additional cycles-Day1; 30 and 60 days after the last dose of XON7
Secondary	Host immunogenicity to XON7 (Part 1 and part 2)	Percentage of participants who develop detectable anti-drug antibodies	Cycle 1-Day 1; Cycle 1-Day4; Cycle 1-Day7; Cycle 1-Day15; Cycle 2 and additional cycles-Day1; 30 and 60 days after the last dose of XON7
Secondary	Further assess anti-tumor efficacy (Part 1): ORR	Objective response rate (ORR): defined as the proportion of participants with a confirmed complete response [CR] or confirmed partial response [PR] assessed by investigators according to RECIST v1.1. within 3 months after XON7 initiation	Tumor imaging (computed tomography [CT]) will be performed within 28 days prior to enrollment, and while on study approximately every 8 weeks during the treatment period. During the survival follow-up, results of CT only performed in current practice
Secondary	Further assess anti-tumor efficacy (Part 2): CBR	Clinical Benefit Rate (CBR) defined as the proportion of participants who achieve CR, PR, and durable SD [SD=24 weeks] assessed by investigators according to the RECIST criteria v 1.1.	Tumor imaging (computed tomography [CT]) will be performed within 28 days prior to enrollment, and while on study approximately every 8 weeks during the treatment period. During the survival follow-up, results of CT only performed in current practice
Secondary	Further assess anti-tumor efficacy (Part 1 and part 2): DCR	Disease control rate (DCR): defined as the proportion of participants who achieve confirmed complete response [CR], confirmed partial response [PR] or stable disease [SD] assessed by investigators according to the RECIST criteria version 1.1.	Tumor imaging (computed tomography [CT]) will be performed within 28 days prior to enrollment, and while on study approximately every 8 weeks during the treatment period. During the survival follow-up, results of CT only performed in current practice
Secondary	Further assess anti-tumor efficacy (Part 1 and part 2): DoR	Duration of response (DoR): defined as the time interval between the first confirmed objective response (CR or PR per RECIST 1.1 by investigators) and the first occurrence of objective tumor progression (Progressive disease (PD) per RECIST 1.1 by investigators) or death from any cause.	Tumor imaging (computed tomography [CT]) will be performed within 28 days prior to enrollment, and while on study approximately every 8 weeks during the treatment period. During the survival follow-up, results of CT only performed in current practice
Secondary	Further assess anti-tumor efficacy (Part 2): TTR	Time to response (TTR): defined as the time from the date of XON7 initiation to first confirmed objective response (CR or PR per RECIST 1.1 by investigators)..	Tumor imaging (computed tomography [CT]) will be performed within 28 days prior to enrollment, and while on study approximately every 8 weeks during the treatment period. During the survival follow-up, results of CT only performed in current practice
Secondary	Further assess anti-tumor efficacy (Part 1 and part 2): PFS	Progression-free survival (PFS): defined as the time from the date of XON7 initiation to the date of first documented progression (RECIST 1.1 by investigators) or death.	Tumor imaging (computed tomography [CT]) will be performed within 28 days prior to enrollment, and while on study approximately every 8 weeks during the treatment period. During the survival follow-up, results of CT only performed in current practice
Secondary	Further assess anti-tumor efficacy (Part 1 and part 2): OS	Overall survival (OS): defined as the time interval between the date of XON7 initiation and the date of death due to any cause.	Tumor imaging (computed tomography [CT]) will be performed within 28 days prior to enrollment, and while on study approximately every 8 weeks during the treatment period. During the survival follow-up, results of CT only performed in current practice
Secondary	Expansion part: treatment emergent adverse events (TEAEs)	An overall summary of AE occurrences with onset during the first treatment cycle will be presented; this will include the following AE attributes: Preferred term,; Maximum CTCAE grade,; Outcome,; Time to first occurrence [days].	Participants will be assessed for AEs and SAEs beginning immediately after the first dose of investigational drug and continuing through to follow-up which is 60 ± 5 days of last dose of investigational drug.
Secondary	Dose Escalation part: clinically significant findings in blood pressure (BP)	Incidence and severity of clinically significant findings in blood pressure: Significant blood pressure increase will be defined as BP >150/100 mmHg in a subject without a history of hypertension or increased >20 mmHg (diastolic) from baseline measurement in a subject with a previous history of hypertension.	Before and immediately after the first dose of investigational drug and continuing through to follow-up which is 60 ± 5 days of last dose of investigational drug
Secondary	Dose Escalation part: clinically significant findings in electrocardiogram (ECGs)	Incidence of clinically significant findings in Electrocardiogram (ECG): Significant QTc prolongation will be defined as an interval =500 msec or an interval which increases by =60 msec over baseline	Before and immediately after the first dose of investigational drug and continuing through to follow-up which is 60 ± 5 days of last dose of investigational drug
Secondary	Expansion part: clinically significant changes in Leucocytes count	Incidence and magnitude of clinically significant changes in Leucocytes Count (G/L)	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Red Blood Cells Count	Incidence and magnitude of clinically significant changes in Red Blood Cells Count (T/L)	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Hemoglobin	Incidence and magnitude of clinically significant changes in Hemoglobin (g/dL).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Hematocrit	Incidence and magnitude of clinically significant changes in Hematocrit (%).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Absolute Neutrophil Count	Incidence and magnitude of clinically significant changes in Absolute Neutrophil Count (G/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Absolute Eosinophil Count	Incidence and magnitude of clinically significant changes in Absolute Eosinophil Count (G/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Absolute Basophil Count	Incidence and magnitude of clinically significant changes in Absolute Basophil Count (G/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Absolute Lymphocytes Count	Incidence and magnitude of clinically significant changes in Absolute Lymphocytes Count (G/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Absolute Monocytes Count	Incidence and magnitude of clinically significant changes in Absolute Monocytes Count (G/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Platelet Count	Incidence and magnitude of clinically significant changes in Platelet Count (G/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Albumin	Incidence and magnitude of clinically significant changes in Albumin (g/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Bicarbonate	Incidence and magnitude of clinically significant changes in Bicarbonate (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Total Bilirubin	Incidence and magnitude of clinically significant changes in Total Bilirubin (µmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Calcium	Incidence and magnitude of clinically significant changes in Calcium (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Urea	Incidence and magnitude of clinically significant changes in Urea (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Chloride	Incidence and magnitude of clinically significant changes in Chloride (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Creatinine	Incidence and magnitude of clinically significant changes in Creatinine (µmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Creatinine Clearance	Incidence and magnitude of clinically significant changes in Creatinine Clearance (mL/min).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Glucose	Incidence and magnitude of clinically significant changes in Glucose (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Magnesium	Incidence and magnitude of clinically significant changes in Magnesium (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Phosphate	Incidence and magnitude of clinically significant changes in Phosphate (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Potassium	Incidence and magnitude of clinically significant changes in Potassium (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Sodium	Incidence and magnitude of clinically significant changes in Sodium (mmol/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Total Protein	Incidence and magnitude of clinically significant changes in Total Protein (g/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Alanine aminotransferase (ALT)	Incidence and magnitude of clinically significant changes in Alanine aminotransferase (ALT) (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Aspartate aminotransferase (AST)	Incidence and magnitude of clinically significant changes in Aspartate aminotransferase (AST) (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Gamma-glutamyl transférase (GGT)	Incidence and magnitude of clinically significant changes in Gamma-glutamyl transférase (GGT) (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Alkaline Phosphatase (ALP)	Incidence and magnitude of clinically significant changes in Alkaline Phosphatase (ALP) (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Lactate dehydrogenase (LDH)	Incidence and magnitude of clinically significant changes in Lactate dehydrogenase (LDH) (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Amylase	Incidence and magnitude of clinically significant changes in Amylase (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Lipase	Incidence and magnitude of clinically significant changes in Lipase (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Total Protein Creatine Kinase (CK)	Incidence and magnitude of clinically significant changes in Total Protein Creatine Kinase (CK) (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Creatine kinase - cardiac muscle isoenzyme (CK-MB)	Incidence and magnitude of clinically significant changes in Creatine kinase - cardiac muscle isoenzyme (CK-MB) (U/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Troponin T	Incidence and magnitude of clinically significant changes in Troponin T (ng/L).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Prothrombin Time (PT)	Incidence and magnitude of clinically significant changes in Prothrombin Time (PT) (Sec).	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in INR (if under VKA Therapy)	Incidence and magnitude of clinically significant changes in INR (if under VKA Therapy)	At the end of Cycle 1 (28 days)
Secondary	Expansion part: clinically significant changes in Activated Partial Thromboplastin Time (aPTT)	Incidence and magnitude of clinically significant changes in Activated Partial Thromboplastin Time (aPTT) (Sec).	At the end of Cycle 1 (28 days)