ClinicalTrials.gg
RecruitingNCT03917043Updated Jul 23, 2026

APG-2449 in Patients With Advanced Solid Tumors

A Phase 1 interventional study of APG-2449 in Advanced Solid Cancer, Non Small Cell Lung Cancer and Esophageal Cancer, sponsored by Ascentage Pharma Group Inc.. Recruiting at 9 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-23.

Sponsored by Ascentage Pharma Group Inc. (part of Ascentage Pharma Group International) · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Started May 2019; still recruiting 7 years 5 months later.
Phase
Phase 1
Study type
Interventional
Enrollment
165
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

APG-2449 is a novel, orally active, multi-targeted tyrosine kinase inhibitor, which inhibits FAK, ALK, and ROS1 with nanomolar potencies. In preclinical studies, APG-2449 demonstrated potent antiproliferative activity in various cancer cell lines as a single agent. In combination treatment, APG-2449 enhanced anti-proliferative activities of several chemotherapeutic and targeted agents. It is indicated that APG-2449 may have a broad therapeutic potential for the treatment of human cancer as a single agent and in combination with other classes of anticancer drugs. APG-2449 is intended for the treatment of patients with advanced solid tumors. Upon completion of the Phase 1 dose escalation study to establish the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), and/or recommended phase 2 dose (RP2D), several phase Ib/II studies will be implemented accordingly.

02

Conditions studied

  • Advanced Solid Cancer
  • Non Small Cell Lung Cancer
  • Esophageal Cancer
  • Ovarian Cancer
  • Malignant Pleural Mesothelioma
03

In context

Carcinoma, Non-Small-Cell Lung

7,620 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,838 are open to participants now.

This study's planned enrollment of 165 is above the median of 62 across 6,019 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

Ascentage Pharma Group Inc. is the lead sponsor of 53 studies on the registry; 31 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Dose exploration stage: non-small cell lung cancer diagnosed by histology and/or cytology and positive for ALK/ROS1 gene fusion (molecular diagnosis confirmed by the investigator) and malignant pleural mesothelioma, esophageal cancer and ovarian cancer. Kind of patients with advanced tumors.

    Expansion stage: cohort 1, patients with non-small cell lung cancer who have progressed or are intolerant to TKI therapy, including patients with second-generation ALK TKI, or either ROS1 TKI, or third-generation ALK inhibitor (lorlatinib, etc.) with pFAK expression (pFAK expression is subject to central laboratory results) of about 10 or above; Cohort 2, TKI-naïve patients with ALK/ROS1 fusion gene positive NSCLC. The molecular diagnosis results of the above patients can be confirmed by the investigator.

  2. Performance Status ≤ 1.
  3. Expectation of life ≥ 3 months.
  4. According to version 1.1, there is at least 1 .
  5. Adequate hematologic and bone marrow functions.
  6. Adequate renal and liver function.
  7. Normal cardiac function.
  8. with clinically controlled neurologic symptoms.
  9. Serum pregnancy test results of women of childbearing age were negative within 7 days before taking the first dose of study drug.
  10. Men, women of childbearing age ( women must have been menopausal for at least 12 months before they can be considered infertile) and their partners voluntarily take the study drug for at least 30 days after signing the form and taking the study drug as deemed effective by the investigator measures
  11. Ability to understand and willingness to sign a written informed consent form
  12. Subjects must be willing and able to complete the research procedures and follow-up inspections.
  13. Subjects are required to provide fresh (for recurrent subjects only) or archived tumor tissue samples from within 28 days prior to treatment. If none of these specimens are available, they may be included after consultation with the sponsor.
  14. Subjects should provide fresh tumor tissue specimens prior to treatment.

Exclusion criteria

Exclusion Criteria:

  1. Receiving concurrent anti-cancer therapy (chemotherapy, radiotherapy, immunotherapy, biologic therapy); or any therapy within 28 days prior to the first dose of study drug.
  2. Receiving TKI therapy within 8 days prior to the first dose of study drug.
  3. Continuance of toxicities due to prior therapy that do not recover ( V5.0 Grade> 1).
  4. Has difficulty in swallowing, absorbing barrier, or other diseases blocking APG-2449' taken.
  5. Obvious cardiovascular disease history.
  6. Failure to recover adequately, as judged by the investigator, from prior surgical procedures. Patients who have had major surgery within 28 days from study entry, and patients who have had minor surgery within 14 days of study entry.
  7. Active symptomatic fungal, bacterial and/or viral infection including, but not limited to, active (HIV) or viral hepatitis (B or C).
  8. Known allergies to study drug ingredients or their analogs.
  9. Female subjects who are pregnant or breastfeeding, or expecting to become pregnant during the study period.
  10. According to the judgment of the investigator or sponsor, any symptoms or disease of the subject may endanger its safety or interfere with the safety assessment of the study drug.
  11. Subjects who have used , CYP2C9, or CYP2C19 moderately potent inhibitors or moderately potent inducers 1 week before receiving the study drug for the first time.
  12. Subjects who used CYP3A4 substrates and narrow treatment window 1 week before the first study drug.
Terms in these criteria, in plain language(12)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
165 participants (estimated)

Study arms

  • Experimental
    APG-2449

    APG-2449 will be explored sequentially using a standard 3+3 escalation scheme at the dose escalation phase and up to 30-40 patient at the MTD/RP2D dose level.

    Drug: APG-2449

Interventions

  • DrugAPG-2449

    Capsule, multiple dose cohorts, oral administration every day (QD) of a 28-day cycle

    Also known as: APG-2449 Capsule

06

What researchers measure

Primary outcomes

  1. Maximum Tolerated Dose (MTD)

    To determine the maximum tolerated dose (MTD) of APG-2449 in subjects with advanced solid tumors

    Time frame: 28 days

  2. Recommended Phase 2 dose (RP2D)

    To determine the tentative recommended Phase 2 dose (RP2D) of APG-2449 in subjects with advanced solid tumors

    Time frame: 28 days

Secondary outcomes

  1. Maximum plasma concentration (Cmax)

    Maximum plasma concentration (Cmax) will be assessed on all participants with APG-2449 treatments

    Time frame: 28 days

  2. Area under the plasma concentration versus time curve (AUC)

    Area under the plasma concentration versus time curve (AUC) will be assessed on all participants with APG-2449 treatments

    Time frame: 28 days

  3. Phosphorylation of FAK protein

    Phosphorylation of FAK protein will be assessed in peripheral blood mononuclear cells on all participants with APG-2449 treatments

    Time frame: 28 days

  4. Preliminary efficacy assessment: Response Evaluation Criteria In Solid Tumors (RECIST) 1.1

    To assess preliminary efficacy in subjects with solid tumors using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1

    Time frame: 4 weeks

07

Study locations

7 of 9 sites recruiting
  • Beijing Cancer Hospital
    Beijing, Beijing Municipality 100142, China
    Recruiting
    • Jun Zhao, M.D. · Contactohjerry@163.com
    • Jian Fang, Ph.D. · Contactfangjian5555@163.com
    • Jun Zhao, M.D. · Principal investigator
    • Jian Fang, Ph.D. · Principal investigator
  • Fujian Medical University Union Hospital
    Fuzhou, Fujian 350001, China
    Not yet recruiting
    • Xiaoyan Lin, Ph.D · Contact
    • Xiaoyan Lin, Ph.D · Principal investigator
  • Fujian Cancer Hospital
    Fuzhou, Fujian 350014, China
    Not yet recruiting
    • Wu Zhuang, Ph.D · Contact
    • Wu Zhuang, Ph.D · Principal investigator
  • Sun-Yat Sen University Cancer Center
    Guangzhou, Guangdong 510060, China
    Recruiting
  • The First affiliated hospital, Sun Yat-sen University
    Guangzhou, Guangdong, China
    Recruiting
    • Yubiao Guo, Professor · Contact
  • Henan Provincial Oncology Hospital
    Zhengzhou, Henan, China
    Recruiting
    • Yanqiu Zhao, Professor · Contact
  • Union Hospital medical college Huazhong University of Science and Technology
    Wuhan, Hubei, China
    Recruiting
    • Gang Wu, Professor · Contact
  • Hunan Provincial Oncology Hospital
    Changsha, Hunan, China
    Recruiting
    • Jianhua Chen, Professor · Contact
  • Zhejiang Provincial Oncology Hospital
    Hangzhou, Zhejiang, China
    Recruiting
    • Yiping Zhang, Professor · Contact
08

References and documents

Publications

  • Ma Y, Song Z, Chen J, Zhao Y, Fang W, Guo Y, Dong Y, Yang Y, Wu G, Fang J, Lin X, Li J, Huang Y, Zhao Y, Hong S, Xue J, Zhang Y, Liu Q, Yang C, Xu L, Yang Y, Xiong D, Yang D, Zhai Y, Zhang L, Zhao H. Safety, pharmacokinetic, pharmacodynamic, and efficacy properties of orally administered APG-2449 in patients with advanced ALK + and ROS1 + non-small-cell lung cancer: a multicentre, open-label, single-arm phase 1 trial. EClinicalMedicine. 2025 Oct 16;89:103556. doi: 10.1016/j.eclinm.2025.103556. eCollection 2025 Nov. PubMed 41146927 ↗
  • Fang DD, Tao R, Wang G, Li Y, Zhang K, Xu C, Zhai G, Wang Q, Wang J, Tang C, Min P, Xiong D, Chen J, Wang S, Yang D, Zhai Y. Discovery of a novel ALK/ROS1/FAK inhibitor, APG-2449, in preclinical non-small cell lung cancer and ovarian cancer models. BMC Cancer. 2022 Jul 11;22(1):752. doi: 10.1186/s12885-022-09799-4. PubMed 35820889 ↗
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03917043
Collaborators
Suzhou Yasheng Pharmaceutical Co., Ltd.
Responsible party
Sponsor
First posted
Apr 16, 2019
Start date
May 27, 2019
Primary completion
Dec 2027 (estimated)
Completion
Jan 2028 (estimated)
Last update
Jul 23, 2026

Study contacts

Yifan Zhai, M.D., Ph.D.
Contact
yzhai@ascentage.com
+86-20-28069260
Li Zhang, Professor
principal investigator · Sun Yat-Sen University Cancer Center

Oversight

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

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