AVA6000 for Cancer

Recruiting in Palo Alto (17 mi)

+8 other locations

Overseen by Chris Twelves, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 1

Recruiting

Sponsor: Avacta Life Sciences Ltd

Must not be taking: Trastuzumab, Anthracyclines, QT prolonging drugs

Disqualifiers: CNS metastases, Other malignancy, Cardiovascular, others

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

This trial tests AVA6000, a new drug that activates only in cancer cells, in patients with advanced or spreading tumors. The goal is to find the safest dose and see how well it works.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you are on certain medications like trastuzumab or have conditions that require specific treatments, you may need to discuss this with the trial team.

What data supports the effectiveness of the drug AVA6000 for cancer?

Research shows that a similar drug, which targets the same protein (FAPα) in tumors, effectively releases doxorubicin directly at the tumor site, reducing heart-related side effects and improving tumor targeting. This suggests that AVA6000, which uses a similar mechanism, may also effectively target tumors while minimizing damage to healthy tissues. ^{1 2 3 4 5}

Is AVA6000 safe for humans?

Research on similar FAP-activated doxorubicin prodrugs suggests they may have improved safety compared to traditional doxorubicin, with reduced heart-related side effects and better tolerability in preclinical models. However, specific safety data for AVA6000 in humans is not provided in the available research. ^{1 3 5 6 7}

What makes the drug AVA6000 unique for cancer treatment?

AVA6000 is a unique cancer treatment because it is a prodrug (an inactive form of a drug that becomes active in the body) of doxorubicin, designed to be activated specifically in tumor tissues by the enzyme fibroblast activation protein-alpha (FAPα). This targeted activation helps to reduce the harmful side effects typically associated with doxorubicin, such as heart damage, by limiting its activity to cancerous areas. ^{1 3 5 7 8}

Research Team

Chris Twelves, MD

Principal Investigator

St James's University Hospital, Leeds, UK

Eligibility Criteria

This trial is for adults over 18 with certain advanced or metastatic solid tumors (like breast, ovarian, bladder cancer) that have not responded to standard treatments. Participants must be in good physical condition with a life expectancy of more than 12 weeks and have recovered from previous treatments' side effects.

Inclusion Criteria

My cancer has returned or worsened after standard treatment, or I cannot tolerate the standard treatment.

Neutrophil count of ≥1.5× 10^9 cells/L

I have recovered from side effects of previous cancer treatments, except for hair loss and mild nerve damage.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Dose Escalation

Participants receive escalating doses of AVA6000 to evaluate safety, tolerability, and determine the maximum tolerated dose (MTD) or recommended Phase 2 dose (RP2D).

Up to 28 days per cycle

Visits every 14 or 21 days depending on schedule

Dose Expansion

Participants receive AVA6000 at the recommended dose for expansion to further evaluate safety and efficacy.

Until disease progression or unacceptable toxicity

Follow-up

Participants are monitored for safety and effectiveness after treatment

Up to 30 days after last dose

Treatment Details

Interventions

• AVA6000 (Anti-tumor antibiotic)

Trial Overview AVA6000, a new drug given through the vein, is being tested on patients with FAP-positive tumors. The study has two parts: first finding the right dose and then seeing how well it works at that dose in more people.

Participant Groups

Group I: AVA6000 Phase 1b Dose Expansion Experimental Treatment 1 Intervention

Patients in this arm will receive AVA6000 at the recommended dose for expansion, until disease progression, unacceptable toxicities, withdrawal from treatment for other reasons, reaching maximum lifetime cumulative exposure to doxorubicin (or other anthracyclines), or death, whichever occurs first.

Group II: AVA6000 Phase 1a Dose Escalation Q3W Experimental Treatment 1 Intervention

Patients in this arm will receive escalating doses of AVA6000 following a 3+3 design, Q3W until disease progression, unacceptable toxicities, withdrawal from treatment for other reasons, reaching maximum lifetime cumulative exposure to doxorubicin (or other anthracyclines), or death, whichever occurs first.

Group III: AVA6000 Phase 1a Dose Escalation Q2W Experimental Treatment 1 Intervention

Patients in this arm will receive escalating doses of AVA6000 following a 3+3 design, Q2W until disease progression, unacceptable toxicities, withdrawal from treatment for other reasons, reaching maximum lifetime cumulative exposure to doxorubicin (or other anthracyclines), or death, whichever occurs first.

Who Is Running the Clinical Trial?

Avacta Life Sciences Ltd

Lead Sponsor

Trials

1

Recruited

160+

Findings from Research

The FAPα-targeting prodrug of Doxorubicin (FTPD) effectively releases the drug in the presence of FAPα, demonstrating its potential for targeted tumor therapy, particularly in FAPα-positive tumors like the 4T1 model.

FTPD shows similar antitumor efficacy to free Doxorubicin in mice but with significantly reduced cardiotoxicity, indicating a safer delivery method for cancer treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of the tumor targeting of a FAPα-based doxorubicin prodrug. Huang, S., Fang, R., Xu, J., et al.[2021]

The newly synthesized prodrug (+)-FDI-CBIM, which binds to human albumin, allows for over three times the dosage to be administered compared to the free drug, enhancing its potential for treatment.

In animal models, this prodrug demonstrated significantly improved antitumor efficacy against both syngeneic tumors and human ovarian xenografts, suggesting that forming drug-albumin conjugates could be a promising strategy for enhancing cancer treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Synthesis and antitumor activity evaluations of albumin-binding prodrugs of CC-1065 analog. Wang, Y., Jiang, J., Jiang, X., et al.[2019]

Doxorubicin conjugates and prodrugs are being developed to selectively activate the drug at tumor sites, aiming to reduce severe side effects seen in previous treatments like cBR96-Dox, which was discontinued due to toxicity.

New strategies, including antibody-directed enzyme prodrug therapy (ADEPT) and receptor-mediated targeting, are being explored to enhance the delivery and effectiveness of doxorubicin, with some conjugates already reaching clinical levels and showing promise in treating solid tumors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Doxorubicin conjugates for selective delivery to tumors. Florent, JC., Monneret, C.[2013]

The study developed a doxorubicin prodrug conjugate linked to a monoclonal antibody targeting the insulin-like growth factor-1 receptor, which is overexpressed in many tumors, allowing for selective binding and accumulation in cancer cells.

This approach resulted in over 200-fold improved therapeutic index and reduced tumor load without systemic toxicity, effectively bypassing resistance mechanisms like p-glycoprotein efflux, making it a promising strategy for more effective cancer treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prodrug chemotherapeutics bypass p-glycoprotein resistance and kill tumors in vivo with high efficacy and target-dependent selectivity. Guillemard, V., Uri Saragovi, H.[2018]

PhAc-ALGP-Dox is a novel targeted prodrug designed to reduce the toxic effects of doxorubicin, showing improved safety profiles in normal tissues and significantly higher tolerability in preclinical models, with a 10-fold increase compared to standard doxorubicin.

In preclinical studies, PhAc-ALGP-Dox demonstrated impressive efficacy, achieving 63% to 96% tumor growth inhibition and an 8-fold improvement in effectiveness in patient-derived xenograft models, while also reducing metastatic burden and improving survival rates by 30%.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

PhAc-ALGP-Dox, a Novel Anticancer Prodrug with Targeted Activation and Improved Therapeutic Index. Casazza, A., Van Helleputte, L., Van Renterghem, B., et al.[2023]

In a study involving 9 patients with advanced solid tumors, 90Y-FAPI-46 radioligand therapy was found to be well tolerated, with a low incidence of serious adverse events, indicating its safety for use in heavily pretreated patients.

The therapy demonstrated sufficient tumor uptake in 78% of patients and showed signs of tumor response in 50%, suggesting potential efficacy, although further research is needed to confirm these findings in larger groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Initial Clinical Experience with 90Y-FAPI-46 Radioligand Therapy for Advanced-Stage Solid Tumors: A Case Series of 9 Patients. Ferdinandus, J., Costa, PF., Kessler, L., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Evaluation of the tumor targeting of a FAPα-based doxorubicin prodrug. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Synthesis and antitumor activity evaluations of albumin-binding prodrugs of CC-1065 analog. [2019]

3. Germany pubmed.ncbi.nlm.nih.gov

Doxorubicin conjugates for selective delivery to tumors. [2013]

4. England pubmed.ncbi.nlm.nih.gov

Prodrug chemotherapeutics bypass p-glycoprotein resistance and kill tumors in vivo with high efficacy and target-dependent selectivity. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

PhAc-ALGP-Dox, a Novel Anticancer Prodrug with Targeted Activation and Improved Therapeutic Index. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Initial Clinical Experience with 90Y-FAPI-46 Radioligand Therapy for Advanced-Stage Solid Tumors: A Case Series of 9 Patients. [2022]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Synthesis, Characterization, Cellular Uptake, and In Vitro Anticancer Activity of Fullerenol-Doxorubicin Conjugates. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

A Dual-Mechanism Targeted Bioorthogonal Prodrug Therapy. [2023]