A Study of Tinengotinib (TT-00420) in Combination With Standard Treatments in People With Prostate Cancer

Prostate Cancer Clinical Trial

Official title:

A Phase 1b/2 Study Evaluating the Activity of Tinengotinib (TT-00420) in Combination With Androgen Receptor Signaling Inhibitors (ARSIs) in Patients With Metastatic Castration Resistant Prostate Cancer (mCRPC)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06457919
• Other study ID #: 24-103
• Status: Recruiting
• Phase: Phase 1/Phase 2
• Start date: June 4, 2024
• Est. completion date: June 2027

Study information

• Verified date: June 2024
• Source: Memorial Sloan Kettering Cancer Center
• Contact: Wassim Abida, MD, PhD
• Phone: 646-442-4633
• Email: abidam[@]mskcc.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to find out whether tinengotinib in combination with abiraterone acetate and prednisone or enzalutamide is a safe treatment that causes few or mild side effects in people with metastatic castration-resistant prostate cancer (mCRPC).

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: June 2027
• Est. primary completion date: June 2027
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Participants = 18 years old, with signed informed consent

• Histologically confirmed carcinoma of the prostate (neuroendocrine differentiation is allowed, but pure small cell carcinoma is not permitted)

• Metastatic disease documented by at least 2 bone lesions on whole body radionuclide bone scan, or soft tissue disease documented by computed tomography (CT) scan/magnetic resonance imaging (MRI). Note: Metastatic disease seen only on PET imaging does not qualify.

• Current ongoing therapy and observed tolerance with full standard dose of abiraterone acetate (1000 mg QD) or enzalutamide (160 mg QD) at the time of study entry, started at least 90 days before consent. An interruption of dosing of a maximum of 30 days is permitted prior to resuming the agent. Please note: Patients who are on a reduced dose or are intolerant of abiraterone acetate or enzalutamide will not be eligible for study participation.

• Progressive disease on enzalutamide or abiraterone acetate documented by PCWG3 criteria for study entry. Progressive disease is defined as at least one of the following:

1. PSA progression defined as a minimum of 2 rising PSA levels with a minimum of a 1-week interval between each determination, reaching a minimum PSA value of 1.0 ng/mL.

2. Nodal or visceral progression as defined by PCWG3-modified RECIST 1.1

3. Appearance of 2 or more new lesions on a bone scan

• At least one of the following at study entry:

1. RECIST 1.1 measurable disease at baseline; i.e., soft tissue tumor lesions or pathologically enlarged lymph nodes that can be accurately measured in at least one dimension OR

2. a PSA of 2.0 ng/mL or above

• Participants must be medically or surgically castrated with ongoing androgen deprivation therapy (ADT) for =90 days or have documented history of bilateral orchiectomy.

• ECOG 0 - 2

• Adequate organ function confirmed at screening, as evidenced by:

• Absolute neutrophil count = 1.5 × 10^9 /L

• Hemoglobin = 9 g/dL

• Platelets = 75 × 10^9 /L

• Aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) = 2.5 × upper limit of normal (ULN) or = 5.0 × ULN if liver metastases are present

• Total bilirubin = 1.5 × ULN; or < 2.5 × ULN if Gilbert syndrome or disease involving liver

• Creatinine clearance >30 mL/min (Cockcroft-Gault formula)

• Adequate blood coagulation function as evidence by an international normalized ratio (INR) = 1.5 unless participant is on anticoagulants

• Tumor biopsy during screening is required if safe and feasible.

Exclusion Criteria:

• The presence of any of the following criteria excludes a patient from participating in the study:

• Pure small cell carcinoma

• Previous exposure to multi-TKI therapies.

• Uncontrolled hypertension (persistent systolic blood pressure = 140 mm Hg and/or diastolic blood pressure = 90 mm Hg) or known coronary artery disease with angina. Patients with known hypertension must be on antihypertensive medication with BPs generally <140/90 to be eligible.

• History of congestive heart failure of Class II-IV New York Heart Association criteria, or serious cardiac arrhythmia requiring treatment (except atrial fibrillation, paroxysmal supraventricular tachycardia), history of myocardial infarction within 6 months of study entry, or QT interval corrected by the Fridericia correction formula (QTcF) >480 msec at screening.

• Any prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessments.

• Symptomatic and/or untreated CNS metastases.

• Pre-existing duodenal stent or any gastrointestinal disorder or defect which would interfere with absorption of study medication, as determined by the Investigator.

• Requirement for systemic therapy with either corticosteroids (>10 mg daily prednisone equivalents) or immunosuppressive medications within 14 days before study treatment start.

• Other anticancer therapies within 3 weeks of study treatment start, or within 5 half-lives of study treatment start for non-cytotoxic oral agents, whichever is shorter; with the exception of androgen deprivation therapy, enzalutamide, or abiraterone acetate which should be continued through study treatment.

• Palliative radiation within 2 weeks of study treatment start.

Related Conditions & MeSH terms

• Prostate Cancer
• Prostatic Neoplasms

Intervention

Drug:
• Tinengotinib
Tinengotinib will be administered daily for 28-day cycles. A flat dose of 10 mg PO once daily.
• abiraterone acetate
Abiraterone acetate 1000 mg PO QD
• Prednisone or Enzalutamide
Prednisone 5 mg PO once or twice daily (QD or BID) or enzalutamide 160 mg PO QD
• Tinengotinib
The recommended phase 2 dose (RP2D).

Locations

Country	Name	City	State
United States	Memorial Sloan Kettering Basking Ridge (Limited Protocol Activities)	Basking Ridge	New Jersey
United States	Memorial Sloan Kettering Suffolk - Commack (Limited Protocol Activities)	Commack	New York
United States	Memorial Sloan Kettering Westchester (Limited Protocol Activities)	Harrison	New York
United States	Memorial Sloan Kettering Monmouth (Limited Protocol Activities)	Middletown	New Jersey
United States	Memorial Sloan Kettering Bergen (Limited Protocol Activities)	Montvale	New Jersey
United States	Memorial Sloan Kettering Cancer Center	New York	New York
United States	Memorial Sloan Kettering Nassau (Limited Protocol Activities)	Uniondale	New York

Sponsors (2)

Lead Sponsor	Collaborator
Memorial Sloan Kettering Cancer Center	TransThera Sciences

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	RP2D	Evaluate DLT occurrence to confirm safety and RP2D	From the start of study treatment through the DLT window (28 days)
Primary	Objective Response Rate (ORR)	by local investigator's assessment per PCWG3-modified RECIST v1.1 in participants with baseline measurable disease OR rate of PSA decline of = 50% from baseline in patients with a baseline PSA of 2.0 ng/mL or above	up to 6months
Secondary	Time to Radiographic Response (phase II)	Time to radiographic response by local investigator's assessment per PCWG3-modified RECIST v1.1 in participants with baseline measurable disease (CR) or Partial Response (PR) per Prostate Cancer Clinical Trials Working Group 3 (PCWG3)-modified RECIST v1.1 in patients with baseline measurable disease	From start of study treatment until 6 months post study treatment start

External Links

•   Memorial Sloan Kettering Cancer Center