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TerminatedNCT03256331Updated Jun 1, 2020

Evaluate the Safety of BEL-X-HG in Advanced Cancer Patients

A Phase 1 interventional study of BEL-X-HG in Advanced Solid Tumors, sponsored by Belx Bio-Pharmaceutical (Taiwan) Corporation. Terminated at 2 sites in Taiwan. Open to participants aged 20 Years and older. Per ClinicalTrials.gov, last updated 2020-06-01.

Sponsored by Belx Bio-Pharmaceutical (Taiwan) Corporation · Phase 1, Interventional, and Treatment

Why this study was terminated
In the light of the on-going COVID-19 pandemic and the resulted difficulty in patient recruitment.
Phase
Phase 1
Study type
Interventional
Enrollment
23
Ages
20 Years and older
Sex
All
01

Study summary

This is a Phase I, open-label, uncontrolled, multicenter dose escalation and extension study to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT), to evaluate safety / tolerability and preliminary effects of BEL-X-HG in patients with advanced refractory solid tumors. Dose escalation during the study will be made based on dose-limiting toxicity (DLT).

Read the detailed description

This study will be carried out in 2 parts:

Part 1: A sequential Dose Escalation Part of four doses following a 3 + 3 design where dose escalation will be made based on dose-limiting toxicity (DLT), for a single cycle (28-days) of BEL-X-HG treatment

Part 2: A Dose Extension Part of up to 5 cycles (28-days each) at the same dose level (starting dose) of BEL-X-HG treatment

Approximately 24-48 eligible subjects with confirmed advanced refractory solid tumors will be enrolled sequentially, in 3 subject cohorts, from the lower to the higher dose cohort into the study. Escalating dose levels of BEL-X-HG in 4 study cohorts and one modified dose will be as follows:

Cohort 1: Dose level 1 - 0.5 g/day (0.25 g, bid)

Cohort 2: Dose level 2 - 1.0 g/day (0.5 g, bid)

Cohort 3: Dose level 3 - 2.0 g/day (1.0 g, bid)

Cohort 4: Dose level 4 - 4.0 g/day (2.0 g, bid)

Modified dose level Cohort 5: Dose level 5 - 1.5 g/day (0.75g bid) This re-escalation is allowed only when dose de-escalates from Dose level 3 to Dose level 2, and 1 DLT in 6 evaluable subjects of Dose level 2.

BEL-X-HG will be administered orally at the assigned dose level for a single cycle consisting of 28 days during the Dose Escalation Part to each subject. Thereafter, if eligible and willing, subjects can continue to Extension Part for 5 more cycles of treatment (each cycle lasting 28 days), at the same assigned dose level of BEL-X-HG treatment.

02

Conditions studied

  • Advanced Solid Tumors
03

Who can participate

Ages eligible
20 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Male or female patients of age ≥20 years
  2. Pathologically or cytologically confirmed advanced refractory solid tumors for which standard therapy proven to provide clinical benefit does not exist or is no longer effective. It is acceptable for HCC subjects with Child Pugh stage A to confirm diagnosis of the advanced refractory solid tumors by imaging (CT scan).
  3. Evaluable disease, at least one measurable target lesion on imaging by RECIST 1.1 (Response Evaluation Criteria in Solid Tumors) criteria.
  4. Eastern Cooperative Oncology Group (ECOG) performance score ≤ 2
  5. Life expectancy ≥ 3 months
  6. Patients able to swallow and retain orally administered medication and does not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major restriction of the stomach or bowels
  7. Laboratory values at screening and baseline (Day 1) of:

    • Absolute neutrophil count (ANC) ≥ 1,500 /mm3
    • Platelets ≥ 75,000 /mm3
    • Hemoglobin (Hb) ≥ 8.5 g/dL
    • Serum creatinine (Cr.) ≤1.5 mg/dL or estimated Glomerular Filtration Rate (eGFR) ≥ 60 mL/min/1.73 m2.

    MDRD Study equation: eGFR = 186 x (SCr)\^-1.154 x (age)\^0.203 x (0.742 if female) x (1.210 if African American) SCr: serum creatinine in mg/dL; age: in year

  8. Patients with primary liver cancer or hepatic metastasis are eligible to enroll, provided that, at screening and baseline (Day 1), the following criteria are met:

    • Total bilirubin (T-Bil) ≤2.0 mg/dL
    • AST and ALT ≤ 5 times the institutional upper limit of normal
    • Child-Pugh Class A; (Score ≤6)
    • Serum albumin ≥2.8 g/dL
  9. Patients with a history of esophageal bleeding have varices that have been sclerosed or banded and no bleeding episodes have occurred during the prior 6 months
  10. If history of brain metastases treated with radiation therapy, radiation therapy is required to be completed at least 3 months prior to enrolment and metastasis achieve stable disease (SD) since radiation completion
  11. Must have recovered from toxicities of previous anti-cancer treatments to NCI-CTCAE version 4.03 grade 1 or lower, except for alopecia
  12. Females patient must be either of non-childbearing potential, i.e. surgically sterilized (e.g. tubal ligation, hysterectomy, or ovariectomy) or one year post- menopausal; or, if of childbearing potential, confirmed not pregnant at screening and use of two adequate contraceptive precautions (as per investigator) i.e. condoms plus oral contraceptives or condoms plus endometrial contraceptive devices, during the entire treatment period of this study and for 6 months after exiting from the study
  13. Male patients with female partners of childbearing potential must be willing to use a reliable form of contraception (condoms), from screening until 6 months after existing from the study
  14. Given signed and dated written informed consent and willing/able to comply with all protocol required visits/procedures

Exclusion criteria

Exclusion Criteria:

  1. Primary major surgery \< 4 weeks prior to the planned first study treatment day
  2. Lactating or pregnant women or plans to be become pregnant
  3. Except for alopecia, any drug-related AE from any previous treatments not recovered to NCI-CTCAE version 4.03 grade 1 or lower prior to the planned first study treatment day
  4. With active systemic infections, active and clinically significant cardiac diseases, active gastrointestinal diseases, active pulmonary diseases, or medical conditions that may significantly affect adequate absorption of investigational product.
  5. Known allergy to BEL-X-HG or its formulation excipients
  6. History of autoimmune disease that in the investigator's opinion may be significant to exclude participation in the study
  7. Use of any investigational agents or non-registered product within 4 weeks of baseline
  8. Known human immunodeficiency virus (HIV) positivity
  9. Known hepatitis B virus (HBV) or hepatitis C virus (HCV) carrier who has:

    • serum HBV DNA > 2,000 IU/mL and abnormal ALT (> 5 ULN) (for HBV carrier)
    • abnormal ALT (> 5 ULN) (for HCV carrier)
  10. With conditions, judged by the investigator, as unsuitable for the study
  11. Mean QTc with Fridericia's correction (QTcF*) greater than 450 ms in screening ECG or history of familial long QT syndrome

    *: Fridericia's formula:

  12. Any cancer-directed therapy (chemotherapy, radiotherapy, biological or immunotherapy, etc.) within 4 weeks or 5 half-lives, (whichever is shorter) of baseline
04

Study design

Phase
Phase 1
Primary purpose
Treatment
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
23 participants (actual)

Study arms

  • Experimental
    BEL-X-HG

    3+3 dose escalation

    Drug: BEL-X-HG

Interventions

  • DrugBEL-X-HG

    This study will be carried out in 2 parts: 1. A sequential Dose Escalation Part of four doses following a 3 + 3 design where dose escalation will be made based on DLT, for a single cycle (28 days) of BEL-X-HG treatment 2. A Dose Extension Part of up to 5 cycles (28 days each) at the same dose level (starting dose) of BEL-X-HG treatment Escalating dose levels of BEL-X-HG in 5 study cohorts and one modified dose will be as follows: * Cohort 1: Dose level 1 - 0.5 g/day (0.25 g, bid) * Cohort 2: Dose level 2 - 1.0 g/day (0.5 g, bid) * Cohort 3: Dose level 3 - 2.0 g/day (1.0 g, bid) * Cohort 4: Dose level 4 - 4.0 g/day (2.0 g, bid) Modified dose level Cohort 5: Dose level 5 - 1.5 g/day (0.75g bid) This re-escalation is allowed only when dose de-escalates from Dose level 3 to Dose level 2, and 1 DLT in 6 evaluable subjects of Dose level 2.

05

What researchers measure

Primary outcomes

  1. Maximum Tolerated Dose (MTD)

    The prior dose level below the dose level at which ≥2/3 or ≥2/6 subjects suffer dose-limiting toxicity (DLT).

    Time frame: 28 days (first treatment cycle of every subjects)

Secondary outcomes

  1. Incidence of Treatment-Emergent Adverse Events

    Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Time frame: up to 168 days (up to 6 cycles of each enrolled subjects)

  2. Tumor response per Response Evaluation Criteria in Solid Tumors (RECIST)

    Tumor response per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

    Time frame: up to 168 days (up to 6 cycles of each enrolled subjects)

  3. Oxidative stress

    Oxidative stress

    Time frame: up to 168 days (up to 6 cycles of each enrolled subjects)

  4. nutritional status

    serum prealbumin, triglyceride, and total cholesterol

    Time frame: up to 168 days (up to 6 cycles of each enrolled subjects)

  5. immunological status

    TNF-alpha, IL-1, IL-2, IL-4, and IL-6

    Time frame: up to 168 days (up to 6 cycles of each enrolled subjects)

  6. cachexia status

    fast blood glucose, C-reactive protein, and testosteron

    Time frame: up to 168 days (up to 6 cycles of each enrolled subjects)

  7. Quality of life (QoL) of patients with advanced refractory solid tumors

    SF-36 Quality of Life (QoL) Questionnaire

    Time frame: up to 168 days (up to 6 cycles of each enrolled subjects)

  8. liver function

    serum AST, ALT, AKP, albumin, gamma-GT, ferritin, PT/INR and APRI

    Time frame: up to 168 days (up to 6 cycles of each enrolled subjects)

06

Study locations

2 sites
  • National Cheng Kung University Hospital
    Tainan, 704, Taiwan
  • National Taiwan University Hospital
    Taipei, 100, Taiwan
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03256331
Lead sponsor
Belx Bio-Pharmaceutical (Taiwan) Corporation
Collaborators
A2 Healthcare Taiwan Corporation
Responsible party
Sponsor
First posted
Aug 22, 2017
Start date
Jun 21, 2017
Primary completion
Mar 30, 2020
Completion
Mar 30, 2020
Last update
Jun 1, 2020

Study contacts

Chia-Chi Lin, MD, PhD
principal investigator · National Taiwan University Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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