Testing ASKC202 alone or with ASK120067 in adults with advanced solid tumors

A Phase I ,Open, Multicenter Study to Assess the Safety, Tolerability, Pharmacokinetics and Preliminary Anti-tumor Activity of ASKC202 With or Without ASK120067 in Patients With Advanced Solid Tumors

This trial will test whether the new drug ASKC202, alone or together with ASK120067, is safe and shows anti-tumor activity in adults with advanced solid tumors, including some forms of lung cancer.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 150 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Jiangsu Aosaikang Pharmaceutical Co., Ltd. (Industry-sponsored)
• Drugs / interventions: crizotinib, chemotherapy, immunotherapy, radiation, prednisone
• Locations: 3 sites (Zhengzhou, Henan and 2 other locations)
• Trial ID: NCT05306132 on ClinicalTrials.gov

What this trial studies

This is a first-in-human, open-label, non-randomized, multicenter Phase 1 study with dose-escalation and dose-expansion parts to characterize safety, tolerability, pharmacokinetics, and preliminary anti-tumor activity of ASKC202 alone and in combination with ASK120067. Part 1 and Part 3 evaluate ASKC202 monotherapy in patients with locally advanced or metastatic solid tumors who have no standard treatment options, while Part 2 tests combination therapy specifically in patients with EGFR-sensitizing mutated NSCLC who progressed on prior EGFR TKIs. The expansion cohorts focus on patients whose tumors have MET gene amplification or protein overexpression, with a cohort limited to unresectable or metastatic NSCLC. Key endpoints include adverse events, dose-limiting toxicities, drug plasma levels, and early signs of tumor response.

Who should consider this trial

Good fit: Adults (age ≥18) with unresectable locally advanced or metastatic solid tumors who have no available standard therapies (Parts 1 and 3), and patients with EGFR-sensitizing mutated NSCLC who progressed on prior EGFR TKIs and have MET amplification/overexpression for the combination or expansion cohorts (Parts 2 and 3).

Not a fit: Patients with early-stage or resectable cancers, those who have effective standard treatment options available, or those without the specific molecular features required for expansion cohorts (for example no MET amplification/overexpression or lacking EGFR-sensitizing mutations) are unlikely to benefit from this study.

Why it matters

Potential benefit: If successful, this approach could provide a new treatment option for people with advanced solid tumors and for some patients with EGFR-mutant or MET-amplified lung cancer who have progressed after standard therapies.

How similar studies have performed: Other early-phase efforts combining targeted agents with EGFR inhibitors have shown promise in overcoming resistance, but ASKC202 is first-in-human and has no published clinical results yet.

Eligibility criteria

Inclusion Criteria:

1. Willing and able to provide signed and dated informed consent;
2. Aged 18 years old or more, male or female;
3. Part 1 (Monotherapy Dose-Escalation) and Part 3 (Monotherapy Expansion): the subjects with locally advanced or metastatic solid tumors for whom no standard therapy regimens are available currently or who are intolerable to standard therapy regimens; Part 3: the subjects with MET gene amplification or protein overexpression; Part 3 cohort 1: histologically or cytologically confirmed unresectable locally advanced or metastatic NSCLC.

4）Part 2:(Combination Therapy Dose-Escalation):a)histologically or cytologically confirmed unresectable locally advanced or metastatic NSCLC;b)Histologically confirmed EGFR sensitizing mutation (Ex19del or L858R).；c)Disease progression following treatment with a third-generation EGFR TKI, or treatment with a first-/second-generation EGFR-TKI with confirmed T790M-negative status upon progression; d)MET gene amplification or protein overexpression.

5\) Part 4:(Combination Therapy Dose-Expansion):a)histologically or cytologically confirmed unresectable locally advanced or metastatic NSCLC;b)Histologically confirmed EGFR sensitizing mutation (Ex19del or L858R).；c)MET gene amplification or protein overexpression.

6\) At least one measurable lesion (based on the RECIST 1.1 criterion) (this article is only for the dose expansion phase); 7) ECOG score 0\~1; 8) Expected survival time ≥ 3 months; 9) Major organ function is essentially normal (no transfusions, erythropoietin (EPO), granulocyte colony-stimulating factor (G-CSF), or other medically supportive care have been received in the 14 days prior to the administration of the study drug), and laboratory tests during the screening period meet the following criteria: system Laboratory test values haematology Absolute neutrophil count ≥1.5 ×109/L platelet ≥90×109/L haemoglobin ≥90g/L kidney Serum creatinine or Creatinine clearance (CrCl). ≤ 1.5 × ULN or

≥60 mL/min (estimated from the Cockcroft-Gault formula) liver Total bilirubin ≤1.5 × ULN or ≤2 × ULN (for patients with liver cancer or liver metastases). AST(SGOT) and ALT (SGPT). ≤2.5 × ULN or ≤5 × ULN (for patients with liver cancer or liver metastases). Coagulation (no anticoagulation was received in the 7 days prior to the administration of the study drug).

International normalized ratio (INR) or prothrombin time (PT). ≤1.5 × ULN Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN 10) Women of childbearing age must have a pregnancy test (serum or urine) within 7 days of enrolling and have a negative result, or meet one of the following criteria to prove that there is no risk of pregnancy: a Postmenopausal is defined as amenorrhea at least 12 months after age \>50 years and discontinuation of all exogenous hormone replacement therapy; b Women younger than 50 years of age who are considered postmenopausal if they have been amenorrhea for 12 months or more after stopping all exogenous hormone therapy, and luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels are within the laboratory reference values for postmenopausal; c Previously undergone irreversible sterilization procedures, including hysterectomy, bilateral ovarian resection, or bilateral salping, with the exception of bilateral tubal ligation; 11) Women of childbearing age should use strict contraceptive contraception throughout trial 7 and within 3 months after the last dose of the test drug; male subjects should use strict contraception throughout the trial period and for 6 months after the last dose of the test drug and no sperm donation; 12) The patient understands the purpose and steps of the trial, voluntarily participates in the trial, and signs a written informed consent form; 13) Patients have good comprehension, are able to follow protocol requirements and can cooperate with investigators in this trial.

Exclusion Criteria:

1. Have previously received or are receiving any treatment for c-Mets (including all monoclonal antibodies or small molecule drugs targeted at the target, except for crizotinib);
2. Have received chemotherapy, hormone therapy, immunotherapy, or biological therapy such as antibody therapy within 4 weeks prior to the first dose, or traditional Chinese medicine with anti-tumor indications within 2 weeks, or small molecule targeted therapy with an interval of less than 5 half-lives; palliative radiotherapy within 7 days or extensive/therapeutic radiotherapy within 14 days prior to the first dose;
3. Those who still need to continue to use systemic immunosuppressants or systemic corticosteroids (≥ 10 mg of prednisone or its equivalent other corticosteroid) for 2 weeks prior to the first dose;
4. Patients who have used strong inhibitors or strong inducers of CYP3A within 2 weeks prior to the first administration, or who need to continue treatment with these drugs during the study period;
5. Participation in clinical trials of other drugs within 4 weeks prior to the first administration (except for failed screening);
6. Patients who underwent other major surgical procedures other than diagnosis or biopsy within 4 weeks prior to the first dose, or who were expected to undergo major surgeries during the study period;
7. Prior to the first administration, there are unhealed toxic reactions of ≥ grade 2 (CTCAE 5.0 standard) associated with any previous treatment, any level of hair loss, and platinum drugs Except for grade 2 neuropathy caused;
8. Patients with primary central nervous system tumors or central nervous system metastases including meningeal metastases (except those who are asymptomatic and stable, do not require steroid use for at least 4 weeks before the first dose);
9. Gastrointestinal disorders (e.g., Crohn's disease, ulcerative colitis, intestinal obstruction, short bowel syndrome) or other malabsorption conditions that have difficulty swallowing or affect drug absorption;
10. There are any other serious or uncontrolled acute and chronic diseases, such as severe or uncontrollable liver or kidney disease (except liver and kidney cancer), uncontrollable hypertension (blood pressure \> 150/95 mmHg after antihypertensive therapy), and Acute pancreatitis, uncontrollable hyperglycemia (fasting blood glucose \>8.0 mmol/L after hypoglycemic therapy), severe or uncontrolled eye lesions, etc
11. Previous history includes interstitial lung disease (ILD), drug-induced ILD, radiation pneumonitis requiring steroid therapy, or evidence of clinically active ILD
12. Have previously received hematopoietic stem cell transplants or solid organ transplants, or plan to receive hematopoietic stem cell transplants or solid organ transplants during the current period of study;
13. If not controlled, large pleural effusions, pericardial effusions, or ascites that need to be drained still need;
14. There are serious or active infections that required intravenous antibiotics or hospitalization, such as HBV (HBsAg-positive and peripheral HBV-DNA titer test≥1×10\^4 copies/mL or 2000 IU/mL), HCV, HIV, and syphilis
15. Meets any of the following cardiac criteria:

    a Average QTc interval prolongation of 3 ECG examinations at rest (QTcF: 450 ms\> for men \> 470 ms for women, corrected by Fredericcia's formula); b Presence of uncontrolled or symptomatic arrhythmias, familial arrhythmias, or congenital long QT syndromes; c Had undergone coronary angioplasty, stent implantation, and coronary artery bypass grafting within 6 months before admission; d Myocardial ischemia or myocardial infarction, unstable angina within 6 months before admission; e Judged to be class III-IV congestive heart failure according to the New York Heart Association's cardiac function grade; f Echocardiography (ECHO) shows a left ventricular ejection fraction (LVEF) ≤ 50%;
16. allergies, or a previous history of severe allergies, or known allergies to any of the components of the drug under study;
17. Pregnant, Lactating women;
18. Other primary malignancies have been diagnosed within the last 5 years, and the following conditions can be enrolled: non-melanoma skin cancer, superficial bladder cancer, cervical carcinoma in situ that has undergone surgery and has been cured;
19. Alcohol abuse, substance abuse, and other conditions that may increase the risk of the study or may interfere with study execution and analysis of results, or that the investigator believes that there are other reasons for which they are not suitable for this clinical study.

Where this trial is running

Zhengzhou, Henan and 2 other locations

• The First Affiliated Hospital of Zhengzhou University — Zhengzhou, Henan, China (Recruiting)
• Xiangya Hospital Central South University — Changsha, Hunan, China (Recruiting)
• Shanghai East Hospital Affiliated to Tongji University — Shanghai, Shanghai Municipality, China (Recruiting)

Study contacts

• Principal investigator: Zhou Caicun, MD — Shanghai East Hospital Affiliated to Tongji University
• Study coordinator: Han Luwei

Conditions Advanced Solid Tumor