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Trial of INI-4001 in Patients With Advanced Solid Tumours

PHASE1NOT_YET_RECRUITING

Phase 1 open-label, dose-escalation and dose-expansion study of INI-4001 as a single agent and in combination with approved checkpoint inhibitors in subjects with advanced solid tumors.

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Study details:

This is a Phase Ia/Ib, open-label, dose-escalation, and dose expansion study. This study will be conducted in two parts: Phase Ia (dose escalation) and Phase Ib (dose expansion). Phase Ia will initially seek to establish the MTD of INI-4001 administered as a monotherapy.

Following identification of the MTD, any dose level at or below the MTD may be further expanded to further explore the safety, PK, PD, and preliminary efficacy of INI-4001 alone and in combination with a complementary therapy (Phase Ib). Following cessation of INI-4001, patients will be requested to participate in long-term follow-up to assess overall survival. This long-term follow-up will continue for each patient until at least 1 year after their last dose of INI-4001, or until otherwise advised by the Sponsor.

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Eligibility criteria

Researchers look for people who fit a certain description, called eligibility criteria. See if you qualify.

Inclusion criteria

  • Patient has locally advanced or metastatic cancer (all solid tumours allowed except primary brain/CNS tumour or untreated spinal cord compression)
  • Patient has at least one extracranial measurable disease lesion per RECIST 1.1/ iRECIST criteria.
  • Patients with known brain metastases are eligible if they meet all the following criteria:
  • Patient has received definitive treatment of brain metastases with stereotactic body radiation therapy (SBRT) or surgery provided that the brain lesions are stable (without evidence of progression by imaging for at least 4 weeks before the first dose of study treatment)
  • Patient is neurologically stable and has had no persistent side effects / complications from prior treatment.
  • Patient has no evidence of new or enlarging brain metastases (confirmed by repeat imaging) and has not required steroids for at least 14 days prior to first dose administration on Day 1.
  • Female patients must be of non-child-bearing potential i.e., surgically sterilised at least 6 weeks before the screening visit or postmenopausal
  • Exclusion criteria

  • Prior therapy with a TLR7 and/or TLR8 agonist, unless first approved by the medical monitor.
  • Has primary brain/CNS tumour or untreated spinal cord compression.
  • Has known active, uncontrolled brain or CNS metastases and/or carcinomatous meningitis.
  • Evidence of abnormal cardiac function
  • Clinically significant active infection within 2 weeks prior to commencement of treatment, or unexplained fever (temperature > 38.1°C) within 7 days prior to first dose administration on Cycle 1 Day 1.
  • Known active human immunodeficiency virus (HIV-1 or HIV-2), hepatitis B surface antigen (HBsAg) or hepatitis C virus (HCV) antibodies at the screening visit.
  • History of other malignancy not meeting inclusion criterion #1 within the past 2 years
  • Major surgery within 28 days of Cycle 1, Day 1, or minor surgical procedures within 7 days of Cycle 1, Day 1.
  • Received cancer-directed therapy
  • A history of autoimmune diseases that has caused terminal organ damage or required systemic immunosuppression / systemic disease modulating drugs within the past 2 years.
  • Chronic use of immune-suppressive drugs (i.e., systemic corticosteroids used in the management of cancer or non-cancer related illnesses, (e.g., COPD) in dosing exceeding 10 mg daily of prednisone equivalent). Inhaled steroids are allowed.
  • History of prior organ allograft.
  • Known hypersensitivity to the study drug or its inactive ingredients.
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    Eligibility

    Age eligible for study : 18 and older

    Healthy volunteers accepted : No

    Gender eligible for study: All

    Things to know

    Study dates

    Study start: 2024-03-29

    Primary completion: 2024-08-01

    Study completion finish: 2026-04-30

    study type

    Study type

    TREATMENT

    phase

    Phase

      PHASE1

    trial

    Trial ID

    NCT06302426

    Intervention or treatment

    DRUG: INI-4001

    COMBINATION_PRODUCT: Nivolumab

    COMBINATION_PRODUCT: Pembrolizumab

    COMBINATION_PRODUCT: Cemiplimab

    COMBINATION_PRODUCT: Avelumab

    COMBINATION_PRODUCT: Atezolizumab

    COMBINATION_PRODUCT: Durvalumab

    Conditions

    • Advanced Solid Tumor

    Find a site

    Closest Location:

    The Border Cancer Hospital

    Research sites nearby

    Select from list below to view details:

    • The Border Cancer Hospital

      Albury, New South Wales, Australia

    • Cabrini Hospital

      Malvern, Victoria, Australia

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    Study Plan

    This section provides details of the study plan, including how the study is designed and what the study is measuring.

    How is the study designed?

    Participant Group/ArmIntervention/Treatment
    EXPERIMENTAL: INI-4001 Monotherapy Dose Escalation - INI-4001 Dose Level 1
    • For dose-level 1, INI-4001 will be administered intravenously once per week on Days 1, 8 and 15 of a 21-day cycle. A complementary therapy may be introduced in combination with INI-4001.
    DRUG: INI-4001
    • INI-4001 is a small molecule TLR7/8 agonist being developed as a standalone treatment for the induction of anti-tumour immune responses and sensitization to immune checkpoint inhibitor (ICI) therapy.
    EXPERIMENTAL: INI-4001 Monotherapy Dose Escalation - INI-4001 Dose Level 2
    • For dose-level 2, INI-4001 will be administered intravenously once per week on Days 1, 8 and 15 of a 21-day cycle. A complementary therapy may be introduced in combination with INI-4001.
    DRUG: INI-4001
    • INI-4001 is a small molecule TLR7/8 agonist being developed as a standalone treatment for the induction of anti-tumour immune responses and sensitization to immune checkpoint inhibitor (ICI) therapy.
    EXPERIMENTAL: INI-4001 Monotherapy Dose Escalation - INI-4001 Dose Level 3
    • For dose-level 3, INI-4001 will be administered intravenously once per week on Days 1, 8 and 15 of a 21-day cycle. A complementary therapy may be introduced in combination with INI-4001.
    DRUG: INI-4001
    • INI-4001 is a small molecule TLR7/8 agonist being developed as a standalone treatment for the induction of anti-tumour immune responses and sensitization to immune checkpoint inhibitor (ICI) therapy.
    EXPERIMENTAL: INI-4001 Monotherapy Dose Escalation - INI-4001 Dose Level 4
    • For dose-level 4, INI-4001 will be administered intravenously once per week on Days 1, 8 and 15 of a 21-day cycle. A complementary therapy may be introduced in combination with INI-4001.
    DRUG: INI-4001
    • INI-4001 is a small molecule TLR7/8 agonist being developed as a standalone treatment for the induction of anti-tumour immune responses and sensitization to immune checkpoint inhibitor (ICI) therapy.
    EXPERIMENTAL: INI-4001 Monotherapy Dose Escalation - INI-4001 Dose Level 5
    • For dose-level 5, INI-4001 will be administered intravenously once per week on Days 1, 8 and 15 of a 21-day cycle. A complementary therapy may be introduced in combination with INI-4001.
    DRUG: INI-4001
    • INI-4001 is a small molecule TLR7/8 agonist being developed as a standalone treatment for the induction of anti-tumour immune responses and sensitization to immune checkpoint inhibitor (ICI) therapy.
    EXPERIMENTAL: INI-4001 Monotherapy Dose Escalation - INI-4001 Dose Level 6
    • For dose-level 6, INI-4001 will be administered intravenously once per week on Days 1, 8 and 15 of a 21-day cycle. A complementary therapy may be introduced in combination with INI-4001.
    DRUG: INI-4001
    • INI-4001 is a small molecule TLR7/8 agonist being developed as a standalone treatment for the induction of anti-tumour immune responses and sensitization to immune checkpoint inhibitor (ICI) therapy.

    What is the study measuring?

    Primary outcome

    Primary Outcome MeasurePrimary Outcome DescriptionPrimary Outcome Time Frame
    Incidence of dose-limiting toxicities (DLTs) during Cycle 1 to determine the maximum tolerated dose of INI-4001 MonotherapyGraded using a 5 point scaleAssessed from Cycle 1 Day 1 through to Cycle 1 Day 21

    Secondary outcome

    Secondary Outcome MeasureSecondary Outcome DescriptionSecondary Outcome Time Frame
    Incidence, type, and severity of treatment-emergent adverse events (TEAEs) leading to discontinuation of study treatment after multiple ascending dosesGraded using a 5 point scaleAssessed at Screening, then daily from Cycle 1 Day 1 through to 30 days post last dose of INI-4001
    Incidence and nature of dose-limiting toxicities (DLTs) and regimen-limiting toxicities (RLTs) leading to discontinuation of study treatment after multiple ascending dosesGraded using a 5 point scaleAssessed from Cycle 1 Day 1 through to Cycle 1 Day 21
    Number of Participants with a Change from baseline in Vital signs measurements after multiple ascending dosesPulse rate \[PR\], systolic and diastolic blood pressure \[BP\], temperature, respiratory rate.\[RR\] and oxygen saturation. Blood pressure will be measured using a sphygmomanometer, body temperature will be measured using a thermometer, Heart rate (HR) is measured using vital sign machine,respiratory rate is measured manually via 60- second count.\[RR\] and oxygen saturation is measured using a Oximeter. All abnormal assessments measured as Clinically significant post dose will be recorded as AEs.Assessed at Screening, then Cycle 1 Day 1 through to 30 days post last dose of INI-4001
    Number of Participants with a Change from baseline in body weight after multiple ascending dosesWeight will be measured utilising scalesAssessed at Screening then pre-dose on Day 1 of each 21 day cycle, assessed for up to 36 months or until disease progression, which occurs first
    Number of Participants with a Change from baseline in clinical laboratory parameters (haematology) after multiple ascending dosesHaematology - blood samples will be collected. All safety laboratory assessments will be assessed by a local laboratory according to their reference ranges.Assessed at Screening, then Day 1 and Day 15 of each 21 day cycle, assessed for up to 36 months or until disease progression, which occurs first
    Number of Participants with a Change from baseline in clinical laboratory parameters (serum chemistry) after multiple ascending dosesSerum Chemistry - blood samples will be collected. All safety laboratory assessments will be assessed by a local laboratory according to their reference ranges.Assessed at Screening, then Day 1 and Day 15 of each 21 day cycle, assessed for up to 36 months or until disease progression, which occurs first
    Number of Participants with a Change from baseline in clinical laboratory parameters (urinalysis) after multiple ascending dosesUrinalysis - urine samples will be collected. All safety laboratory assessments will be assessed by a local laboratory according to their reference ranges.Assessed at Screening, then Day 1 and Day 15 of each 21 day cycle, assessed for up to 36 months or until disease progression, which occurs first
    Change from baseline in measurements of HR in beats per minute after multiple ascending doses12-lead ECG parameters include the measurements of HR in beats per minute. 12-lead ECG will be taken in triplicate at screening and prior to infusion and as single measurements at all other timepoints.Assessed at Screening, then Cycle 1 Day 1 through to Day 16 and then at 7 days and 30 days post last dose of INI-4001
    Change from baseline in measurements of PR interval via 12-lead electrocardiogram after multiple ascending doses12-lead ECG parameters include the measurements of PR interval. 12-lead ECG will be taken in triplicate at screening and prior to infusion and as single measurements at all other timepoints.Assessed at Screening, then Cycle 1 Day 1 through to Day 16 and then at 7 days and 30 days post last dose of INI-4001
    Change from baseline in measurements of QT interval via 12-lead electrocardiogram after multiple ascending doses12-lead ECG parameters include the . 12-lead ECG will be taken in triplicate at screening and prior to infusion and as single measurements at all other timepoints.Assessed at Screening, then Cycle 1 Day 1 through to Day 16 and then at 7 days and 30 days post last dose of INI-4001
    Change from baseline in measurements of RR interval in breaths per minute via 12-lead electrocardiogram after multiple ascending doses12-lead ECG parameters include the measurements of RR interval in breaths per minute. 12-lead ECG will be taken in triplicate at screening and prior to infusion and as single measurements at all other timepoints.Assessed at Screening, then Cycle 1 Day 1 through to Day 16 and then at 7 days and 30 days post last dose of INI-4001
    Change from baseline in measurements of QRS duration via 12-lead electrocardiogram after multiple ascending doses12-lead ECG parameters include the measurements of QRS duration. 12-lead ECG will be taken in triplicate at screening and prior to infusion and as single measurements at all other timepoints.Assessed at Screening, then Cycle 1 Day 1 through to Day 16 and then at 7 days and 30 days post last dose of INI-4001
    Change from baseline in measurements of QTcF via 12-lead electrocardiogram after multiple ascending doses12-lead ECG parameters include the measurements of QTcF. 12-lead ECG will be taken in triplicate at screening and prior to infusion and as single measurements at all other timepoints.Assessed at Screening, then Cycle 1 Day 1 through to Day 16 and then at 7 days and 30 days post last dose of INI-4001
    Change from baseline in Eastern Cooperative Oncology Group (ECOG) score after multiple ascending dosesGraded using a 6 point scaleScreening, then Cycle 1 & Cycle 2 (each cycle is 21 days) on Day 1, Day 8 and Day 15 and then at 7 days and 30 days post last dose of INI-4001
    Single dose PK Parameters - maximum observed concentration (Cmax)Pharmacokinetics (PK) of INI-4001 in blood plasma following a single doseCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Multiple dose PK Parameters - maximum observed concentration (Cmax)Pharmacokinetics (PK) of INI-4001 in blood plasma following multiple dosesCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Single dose PK Parameters - Time to Cmax (Tmax)Pharmacokinetics (PK) of INI-4001 in blood plasma following a single doseCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Multiple dose PK Parameters - Time to Cmax (Tmax)Pharmacokinetics (PK) of INI-4001 in blood plasma following multiple dosesCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Single dose PK Parameters - Area under the concentration-time curve from time 0 to 24 hours post-dose (AUC0-24)Pharmacokinetics (PK) of INI-4001 in blood plasma following a single doseCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Single dose PK Parameters - Total amount excreted in urine (Ae)Pharmacokinetics (PK) of INI-4001 in urine following a single doseCycle 1 Day 1 pre-dose, then 0-2, 2-4 and 4-6 hours post-dose, Day 1 to Day 2 6-24 hours post-dose (each cycle is 21 days)
    Single dose PK Parameters - Fraction excreted in the urine (Fe)Pharmacokinetics (PK) of INI-4001 in urine following a single doseCycle 1 Day 1 pre-dose, then 0-2, 2-4 and 4-6 hours post-dose, Day 1 to Day 2 6-24 hours post-dose (each cycle is 21 days)
    Single dose PK Parameters - Renal clearance (CLr)Pharmacokinetics (PK) of INI-4001 in urine following a single doseCycle 1 Day 1 pre-dose, then 0-2, 2-4 and 4-6 hours post-dose, Day 1 to Day 2 6-24 hours post-dose (each cycle is 21 days)
    Multiple dose PK Parameters - Area under the concentration-time curve from time 0 to 24 hours post-dose (AUC0-24)Pharmacokinetics (PK) of INI-4001 in blood plasma following multiple dosesCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Single dose PK Parameters - Area under the concentration-time curve (AUC0-t)Pharmacokinetics (PK) of INI-4001 in blood plasma following a single doseCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Multiple dose PK Parameters - Area under the concentration-time curve (AUC0-t)Pharmacokinetics (PK) of INI-4001 in blood plasma following multiple dosesCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Single dose PK Parameters - Half-life (t1/2)Pharmacokinetics (PK) of INI-4001 in blood plasma following a single doseCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Multiple dose PK Parameters - Half-life (t1/2)Pharmacokinetics (PK) of INI-4001 in blood plasma following multiple dosesCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Single dose PK Parameters - Clearance (Cl)Pharmacokinetics (PK) of INI-4001 in blood plasma following a single doseCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Multiple dose PK Parameters - Clearance (Cl)Pharmacokinetics (PK) of INI-4001 in blood plasma following multiple dosesCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Single dose PK Parameters - Volume of distribution (Vz)Pharmacokinetics (PK) of INI-4001 in blood plasma following a single doseCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)
    Multiple dose PK Parameters - Volume of distribution (Vz)Pharmacokinetics (PK) of INI-4001 in blood plasma following multiple dosesCycle 1 Day 1 & Day 15, pre-dose, EOI (within 2 minutes), then 15 & 30 minutes, 1, 2, 4 & 6 hours post-dose, Day 2 & Day 16 at 24 hours post-dose, Cycle 2 & 4 Day 1 pre-dose, EOI, Day 8 pre-dose then 7 days post last infusion (a cycle is 21 days)

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    References

    Clinical Trials Gov: Trial of INI-4001 in Patients With Advanced Solid Tumours

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