APG-1252 treatment for relapsed or refractory Non-Hodgkin Lymphoma

A Phase Ib/II Study of APG-1252 as a Single Agent or in Combination With Other Therapeutic Agent in Patients With Relapsed and/or Refractory Non-Hodgkin Lymphoma(NHL)

This study is testing a new treatment called APG-1252, alone and with another drug, to see if it helps people with relapsed or hard-to-treat Non-Hodgkin Lymphoma feel better.

Quick facts

• Phase: Phase1; Phase2
• Study type: Interventional
• Enrollment: 51 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Ascentage Pharma Group Inc. (Industry-sponsored)
• Drugs / interventions: chemotherapy, immunotherapy
• Locations: 4 sites (Zhengzhou, Henanan and 3 other locations)
• Trial ID: NCT05186012 on ClinicalTrials.gov

What this trial studies

This study evaluates the safety and efficacy of APG-1252, both as a standalone treatment and in combination with chidamide, for patients with relapsed or refractory Non-Hodgkin Lymphoma (NHL) and peripheral T cell lymphomas (PTCL). It is an open-label, multi-center Phase Ib/II trial that includes a dose escalation phase and a dose expansion phase to determine the maximum tolerated dose and recommended dose for treatment. Patients will receive APG-1252 via intravenous infusion and chidamide orally, with treatment cycles lasting 28 days until disease progression or unacceptable side effects occur.

Who should consider this trial

Good fit: Ideal candidates are adults with relapsed or refractory Non-Hodgkin Lymphoma or peripheral T cell lymphomas who have undergone at least one prior line of therapy.

Not a fit: Patients with Burkitt's lymphoma, lymphoblastic lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, or primary central nervous system lymphoma will not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new therapeutic option for patients with difficult-to-treat forms of Non-Hodgkin Lymphoma.

How similar studies have performed: Other studies have shown promise with similar therapeutic approaches, but the specific combination of APG-1252 and chidamide is novel.

Eligibility criteria

Inclusion Criteria:

1. Life expectancy ≥ 3 months.
2. Eastern Cooperative Oncology Group (ECOG) 0-1.
3. Corrected QT interval (QTcB or QTcF ) ≤ 450ms (male), or ≤ 470ms (female).
4. Patients with relapsed/refractory NHL in Part 1 (excluding Burkitt's lymphoma, lymphoblastic lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma or primary central nervous system lymphoma) and relapsed/refractory PTCL in Part 2, previously treated with at least 1 prior line of therapy.
5. Patients must have an adequate bone marrow function.
6. Adequate hepatic, renal and coagulation function.
7. Male and female subjects of childbearing potential who agree to use highly effective methods of birth control during the period of therapy and for 90 days after the last dose of study drug.
8. Ability to understand and voluntarily sign a written informed consent form before performing any study procedures.
9. Compliance to study procedures.

Exclusion Criteria:

1. Prior history of allogeneic cell transplant, adoptive cellular immunotherapy within 2 years, or autologous hematopoietic stem cell transplantation within 6 months prior to the first dose.
2. Monoclonal antibody therapy within 4 weeks prior to the first dose.
3. Received anti-cancer therapy within 14 days prior to the first dose of therapy, including chemotherapy, radiotherapy, immunotherapy or hormone therapy for anti-tumor purposes; or 28 days for any investigational agent prior to the first dose of therapy.
4. Continuance of toxicities due to prior radiotherapy or chemotherapy agents that do not recover to ≤ Grade 1 except alopecia or neuropathy.
5. Not recovered from recent surgical procedures based on investigator's discretion. Major surgical procedure within ≤28 days or minor surgical procedure (excluding biopsy) within ≤14 days prior to initiating study treatment.
6. Prior exposure to BCL-xL inhibitor. Subjects who have been treated with chidamide can still be included in the study unless they were intolerant.
7. Intolerant to other Bcl-2 family protein inhibitors.
8. Has known central nervous system (CNS) involvement or the prior history of primary central nervous system lymphoma.
9. Prior history of cardiovascular disease ≥ grade 2 (New York Heart Association grade 2 cardiovascular disease is defined as that the patient feels comfortable at rest, but ordinary physical activities lead to fatigue, palpitation, dyspnea or angina pectoris). Unstable angina, myocardial infarction, or coronary revascularization within 180 days prior to the first dose.
10. Use of therapeutic doses of anti-coagulants is an exclusion, including anti-platelet agents. Use of low-dose anticoagulation medications to maintain the patency of a central intravenous catheter is permitted. Aspirin taken within 1 week before the first dose is an exclusion.
11. Known bleeding diathesis/disorder. Recent history of non-chemotherapy induced thrombocytopenia associated a major bleeding episode or a history of being refractory to platelet transfusions within 1 year prior to the first dose. Gastrointestinal bleeding or active peptic ulceration within 3 months prior to the first dose. Active immune thrombocytopenic purpura (ITP), active autoimmune hemolytic anemia (AIHA).
12. A potentially bleeding condition or the presence of clinically significant bleeding signs.
13. Known to be allergic to the drug component or its analogues.
14. Pregnancy or lactation, or pregnancy is expected during the study period or within 3 months after the last administration of treatment.
15. Within 3 years before entering the study, the subject had a history of active malignant tumors other than NHL, except that: Fully treated cervical carcinoma in situ; Completely resected basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin; Confinement and resection of previously cured malignancies (or other treatment).
16. Uncontrolled systemic infections (viruses, bacteria, or fungi), including but not limited to Covid-19 RNA positive, HBV-SURFACE antigen positive and HBV-DNA≥2,000 copies/mL or ≥500 IU/ mL; Hepatitis C virus (HCV) antibody positive; human immunodeficiency virus (HIV) antibody positive.
17. A significant history of renal, neurological, psychiatric, pulmonary, endocrine, metabolic, immune, cardiovascular or liver disease. The investigator believes that participating in this study will have an adverse effect on him / her.
18. Uncontrolled other clinically significant symptoms, including but not limited to uncontrolled serious infection, febrile neutropenia occured within 1 week before administration. Symptomatic congestive heart failure, unstable angina, arrhythmia, or social environment that may affect study compliance.
19. Any other condition or circumstance that would, in the opinion of the investigator, make the patient unsuitable for participation in the study.

Where this trial is running

Zhengzhou, Henanan and 3 other locations

• Henan Provincial Oncology Hospital — Zhengzhou, Henanan, China (Not_yet_recruiting)
• Fudan University Shanghai Cancer Center — Shanghai, Shanghai, China (Not_yet_recruiting)
• Jiangsu Province Hospital — Nanyang, China (Not_yet_recruiting)
• Shanghai Jiao Tong University school of medicine Ruijin Hospital — Shanghai, China (Recruiting)

Study contacts

• Study coordinator: Weili Zhao, MD.

Conditions NHL, Adult; APG-1252