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Phase 1 / 2 Study of X-396, an Oral ALK Inhibitor, in Patients With ALK-positive Non-Small Cell Lung Cancer

Trial Status: Complete

This is the first human study to use X-396 (ensartinib), a drug being developed for treatment of advanced cancers. The initial purpose of the study is to determine the largest amount of X-396 that can be safely given to humans (the maximum tolerated dose). Once the recommended Phase 2 dose has been determined, an expansion phase will assess the preliminary anti-tumor activity of X-396 in ALK-positive non-small cell lung cancer. The study will also provide early information on how the body handles the drug (pharmacokinetics) and on the efficacy of X-396.

Inclusion Criteria

  • Histologically or cytologically confirmed diagnosis of advanced solid tumor malignancy. Patients may be ALK TKI-naive or may have received prior crizotinib and/or second generation ALK TKIs. In addition, patients with a known ALK 1198 mutation will be allowed. -For the expanded cohort portion of the study, patients must have NSCLC with ALK genomic alterations; however, patients will be allowed to enroll based on local FDA-approved ALK results.
  • Eastern Cooperative Group ECOG) Performance Status score of 0 or 1.
  • Ability to swallow and retain oral medication.
  • Adequate organ system function.
  • Patients with treated or untreated asymptomatic CNS metastases may be allowed to enroll.
  • Male patients willing to use adequate contraceptive measures.
  • Female patients who are not of child-bearing potential, and female patients of child-bearing potential who agree to use adequate contraceptive measures.
  • Patients must be ≥ 18 years of age.
  • Patients must have measurable or evaluable disease for the dose escalation portion of the study and measurable disease for the expanded cohort portion of the study (except for patients in the CNS metastases and leptomeningeal cohorts).
  • Willingness and ability to comply with the trial and follow-up procedures.
  • Ability to understand the nature of this trial and give written informed consent.

Exclusion Criteria

  • Patients currently receiving cancer therapy.
  • Use of an investigational drug within 21 days or 5 half-lives (whichever is shorter) prior to the first dose of X-396. A minimum of 10 days between treatment and X-396 and 2 days between ALK TKI and X-396.
  • Any major surgery, radiotherapy, or immunotherapy within the last 21 days (focal radiation does not require a washout period; ≥4 weeks for WBRT). Chemotherapy regimens with delayed toxicity within the last 4 weeks. Chemotherapy regimens given continuously or on a weekly basis with limited potential for delayed toxicity within the last 2 weeks.
  • Prior stem cell transplant.
  • Patients with a known allergy or delayed hypersensitivity reaction to drugs chemically related to X-396 (e.g., crizotinib) or to the active ingredient of X-396.
  • Patients with primary CNS tumors are ineligible.
  • Patients receiving CYP3A substrates with narrow therapeutic indices, strong CYP3A inhibitors, and strong CYP3A inducers.
  • Concomitant use of herbal medications at least 7 days prior to the first dose of study drug and throughout participation in the trial.
  • Females who are pregnant or breastfeeding.
  • Presence of active gastrointestinal (GI) disease or other condition that will interfere significantly with the absorption, distribution, metabolism, or excretion of X-396.
  • Clinically significant cardiovascular disease.
  • Patients who are immunosuppressed (including known HIV infection), have a serious active infection at the time of treatment, have known hepatitis C, or have any serious underlying medical condition that would impair the ability of the patient to receive protocol treatment.
  • Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol.
  • Concurrent condition that in the investigator's opinion would jeopardize compliance with the protocol or would impart excessive risk associated with study participation that would make it inappropriate for the patient to be enrolled.
  • Inability or unwillingness to comply with study and/or follow-up procedures outlined in the protocol.

California

Duarte
City of Hope Comprehensive Cancer Center
Status: CLOSED_TO_ACCRUAL
Contact: Roy Maya
Phone: 626-256-4673
Email: rmaya@coh.org
Los Angeles
USC / Norris Comprehensive Cancer Center
Status: CLOSED_TO_ACCRUAL
Contact: Gina Tse
Phone: 323-865-0514
Palo Alto
Stanford Cancer Institute Palo Alto
Status: CLOSED_TO_ACCRUAL
San Diego
University of California San Diego
Status: CLOSED_TO_ACCRUAL

Florida

Tampa
Moffitt Cancer Center
Status: CLOSED_TO_ACCRUAL

Massachusetts

Boston
Brigham and Women's Hospital
Status: CLOSED_TO_ACCRUAL
Dana-Farber Cancer Institute
Status: CLOSED_TO_ACCRUAL
Contact: Bryan Daniel Marion
Phone: 617-632-3383

Missouri

Saint Louis
Siteman Cancer Center at Washington University
Status: COMPLETED

New York

Bronx
Montefiore Medical Center-Weiler Hospital
Status: COMPLETED
New York
Laura and Isaac Perlmutter Cancer Center at NYU Langone
Status: COMPLETED

Ohio

Columbus
Ohio State University Comprehensive Cancer Center
Status: ADMINISTRATIVELY_COMPLETE

Pennsylvania

Philadelphia
Fox Chase Cancer Center
Status: ADMINISTRATIVELY_COMPLETE

South Carolina

Charleston
Medical University of South Carolina
Status: COMPLETED

Tennessee

Nashville
Vanderbilt University / Ingram Cancer Center
Status: COMPLETED

Texas

Houston
M D Anderson Cancer Center
Status: COMPLETED

Virginia

Charlottesville
University of Virginia Cancer Center
Status: COMPLETED

Wisconsin

Madison
University of Wisconsin Hospital and Clinics
Status: CLOSED_TO_ACCRUAL
Contact: Hilary Hernan

This is the first study of X-396 (ensartinib) in humans and the investigational drug will be

given as a once or twice daily oral dose in 28 day cycles until there is disease progression

or unacceptable safety issues. X-396 will be given to small groups of patients (1 - 6) at

each dose level and the patients will be observed to see if there are any adverse safety

effects. As long as there are no unacceptable safety issues after 28 days, the dose of X-396

will be increased for the next group of patients. This process will continue until the

maximum tolerated dose (MTD) of X-396 is reached. Once the MTD is reached, up to 170

additional patients will also be given X-396 to further determine the activity of X-396 in

patients with ALK-positive non-small cell lung cancer. These additional patients will be

enrolled in the following expansion cohorts: ALK TKI-naïve patients, patients that progressed

on crizotinib, patients that progressed on one or more 2nd generation ALK TKIs (patients may

or may not have also received prior crizotinib), including patients with asymptomatic CNS

metastases.

Trial Phase Phase I/II

Trial Type Treatment

Lead Organization
Xcovery Holding Company, LLC

  • Primary ID X396-CLI-101
  • Secondary IDs NCI-2012-01257, s16-00885
  • Clinicaltrials.gov ID NCT01625234