Open-label, Phase 1 Trial to Evaluate the Safety and Pharmacokinetic Parameters of a 2-day Pulse of Intravenous (IV) AC480 (AC480IV) Administered as Monotherapy and in Combination With Docetaxel in Patients With Advanced Solid Tumors
Inclusion Criteria:
1. Male or female age ≥18 years
2. Provide written informed consent
3. Has histological diagnosis of a primary solid tumor malignancy that meets study
criteria
4. Has measurable disease (or evaluable if not in MTD expansion cohort) via computed
tomography (CT) or magnetic resonance imaging (MRI) scans with or without
non-measurable tumors (a lesion in a previously irradiated area is eligible to be
considered as measurable disease as long as there is objective evidence of
progression of that lesion prior to enrollment)
5. Less than 4 prior systemic cancer therapies (with the exception of hormonal agents),
including experimental agents, prior HER-family TKI therapies, and prior docetaxel
and other taxane therapy; there are no limits to the number of prior therapies for
Part 1
6. Women of childbearing potential (WOCBP) must be using an adequate method of
contraception.
7. WOCBP must have a negative serum or urine pregnancy test (sensitivity ≤ 25IU human
chorionic gonadotropin [hCG]/L) within 72 hours prior to the start of study drug
administration
8. Has an ECOG performance status of 0 or 1
9. Has a life expectancy >3 months
10. Has adequate organ function as determined by laboratory tests
Exclusion Criteria:
1. Patient is currently receiving or has received within the last month prior to Cycle 1
Day 1 (6 weeks for nitrosoureas, mitomycin-C, and liposomal doxorubicin) other
chemotherapeutic, hormonal, or investigational anti-cancer agents with the exception
of gonadal suppression agents and bisphosphonates for osteoporosis and skeletal
metastases which may be continued while on study
2. Patient has received other chemotherapeutic, hormonal, or investigational anti cancer
agents that are outside of the timeframe described above and thus would be allowed in
the study, but has toxicity that is unresolved (i.e., toxicity has resolved to Grade
≤ 1 or is deemed irreversible)
3. Current or anticipated need for drugs that are known cytochrome P450 isozyme CYP3A4
or CYP2C8 inducers or inhibitors; only exception is oral glucocorticoids, which are a
required premedication for docetaxel
4. Patient received previous treatment with oral AC480
5. Patient using herbal and dietary supplements that may interact with CYP3A4
6. Patient received radiation therapy or major surgery within one month of Cycle 1 Day
1
7. Patient has evidence of clinically unstable brain metastases (controlled and stable
brain metastasis must be previously treated and asymptomatic)
8. Patient has uncontrolled or significant cardiovascular disease, including:
- A myocardial infarction within 6 months prior to study entry;
- Uncontrolled angina within 6 months prior to study entry;
- History of congestive heart failure (CHF) New York Heart Association (NYHA)
class 3 or 4;
- LVEF that is ≤50% (or ≥ institutional lower limit of normal);
- Heart rate <50 beats per minute;
- Diagnosed or suspected congenital long QT syndrome;
- Any history of clinically significant ventricular arrhythmias (such as
ventricular tachycardia, ventricular fibrillation, or Torsades de Pointes
[TdP]);
- Prolonged corrected interval between the Q wave and T wave (QTc) by Fridericia's
correction factor (QTcF) interval on pre-entry ECG ≥450 ms (average of 3 ECG
readings done in triplicate);
- Any history of second or third degree heart block;
- Uncontrolled hypertension;
- Obligate need for a cardiac pacemaker;
- Complete left bundle branch block;
- Atrial fibrillation; and
- Abnormal baseline Troponin-I.
9. Patient is using drugs (or has medical conditions) that are generally accepted to
have a risk of causing torsades de pointes (TdP) patients who have discontinued any
of these medications must have a wash-out period of at least 5 days or 5 half-lives
of the drug (whichever is greater) prior to the first dose of AC480IV
10. Patient is in need of anticoagulation therapy except for low-dose heparin or low-dose
coumadin for maintenance of patency of central venous access or prevention of deep
vein thrombosis (DVT)
11. Women who are pregnant or breastfeeding
12. Male or female patients who are sexually active and unwilling to take contraceptive
measures for the duration of the treatments and for 3 months following
discontinuation of AC480IV
13. Patient with serious uncontrolled concurrent medical illness including but not
limited to ongoing or active infection, and "currently active" second malignancies
other than non-melanoma skin cancers
14. Patient with psychiatric illness or social situations that would limit compliance
with treatment or adequate informed consent
15. Patient has pre-existing peripheral neuropathy Grade >1
16. Patient has prior hypersensitivity reaction or intolerance to docetaxel or other
drugs formulated with polysorbate 80