Advanced Solid TumorsPhase 1/2CURATENCT05272709
TT-702 in Patients With Advanced Solid Tumours.
A Phase 1/2 study testing TT-702 and Anti-PD-1 and PD-L1 agent in people with Advanced Solid Tumors, run by Cancer Research UK at 3 sites in United Kingdom.
Trial summary
This clinical trial is evaluating the drug candidate TT-702 in patients with advanced solid tumours. The main aims of the trial are to determine the maximum dose of TT-702 that can be given safely to patients alone and in combination with other anti-cancer agents. Read more about this study
- Who is it for?
- Ages 16 years and older
- Conditions the study is for
- Advanced Solid Tumors
- What is being tested?
- TT-702 and Anti-PD-1 and PD-L1 agent
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 3 sitesUnited Kingdom
- Study dates
- 19 Jan 2022to Apr 2028
- Phase
- Phase 1/2
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 16 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Be able to provide informed consent and be capable of co-operating with IMP administration, procedures and follow-up.
- Be willing to provide samples (blood and tissue) as required.
- Consent to access any available archival tissue.
- Consent for fresh tumour biopsy samples at baseline and on trial (may be Investigator mandated for patients in the dose escalation phase. Investigators will consider whether a biopsy is feasible for the patient in the dose escalation phase and this will not impede participation in the trial if biopsy is not a suitable option.
- Life expectancy estimated by the Investigator to be at least 12 weeks.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
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- Aged 16 years or over at the time consent is given.
- Haematological and biochemical indices within the protocol specified ranges.
- Objectively or measurable evaluable disease, radiologically according to RECIST Version 1.1 (and/or, in mCRPC patients, according to PCWG3 criteria). Has radiological disease progression (and/or, in mCRPC patients, PSA progression according to PCWG3 criteria) at the time of trial enrolment.
- Castrate levels of testosterone (<1.7 nmol/L [50 ng/dL]) (mCRPC patients only).
- Phase I, dose escalation phase
- Histologically or cytologically proven advanced solid tumours refractory to conventional treatment, or for which no conventional therapy is considered appropriate by the Investigator or is declined by the patient. Phase I dose escalation cohorts are:
- Phase I, Cohort 1M (TT-702 monotherapy cohort):
- MMRd tumour, confirmed by either:
- Loss of MSH2, MSH6, MLH1, PMS2 by ICH (total or near total) OR ii. Loss of function mutation f MMR gene(s) AND iii. High tumour mutation burden (depends on assay but typically >15 mutations/MB sequenced).
- Non-MMRd tumours:
- mCRPC: - Prior treatment with a next generation hormonal agent. - Adenocarcinoma without neuroendocrine or small cell features.
- TNBC:
- Human epidermal growth factor receptor 2 negativity (negative immunohistochemistry [IHC] staining [score 0 or 1] or negative fluorescence in situ hybridisation based on the American Society of Clinical Oncology/College of American Pathologists guidelines and recommendations) and determined through local testing in NHS lab within UKAS/ISO 15198 scope of accreditation.
- ER and progesterone receptor negativity (<1% positive staining cells in the invasive tumour) determined locally using IHC per American Society of Clinical Oncology/College of American Pathologists criteria.
- Patients who have received prior anti-PD-1/anti-PD-L1 agent must have experienced Investigator-assessed initial clinical benefit from the most recent anti-PD-1/anti-PD-L1 treatment (either as monotherapy or in combination with other compounds) for at least 10 weeks, followed by subsequent progression. Initial benefit is defined as SD or better with an anti-PD-1/anti-PD-L1 therapy.
- CRC, NSCLC and PDAC:
- Histologically or cytologically proven diagnosis of CRC, NSCLC or PDAC
- Phase I, Cohort 1P (TT-702 \& PD-1/PD-L1 combination cohort): Patients who have had prior treatment with an ICI.
- Phase II (expansion phase)
- Histologically or cytologically proven advanced solid tumour of particular interest based on preclinical and clinical data, refractory to conventional treatment or, for which no conventional therapy is considered appropriate by the Investigator or, is declined by the patient. Phase II expansion cohorts are:
- Cohort 2M (TT-702 Monotherapy expansion cohort) and Cohort 2P (TT-702 \& anti-PD-1/PD-L1 combination cohort):
- Patients must have been previously treated with an ICI
- MMRd tumour, confirmed by either:
- Loss of MSH2, MSH6, MLH1, PMS2 by IHC (total or near total) OR ii. Loss of function mutation of MMR gene(s) AND iii. High tumour mutation burden (depends on assay but typically >15 mutations/MB sequenced).
Who cannot join
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- Radiotherapy (except single fractions for palliative reasons), endocrine therapy during the previous four weeks, immunotherapy and chemotherapy during the previous four weeks(previous six weeks for nitrosoureas, Mitomycin-C) before receiving TT-702. A washout period of eight weeks is required for enzalutamide and apalutamide before the patient receives their first dose of TT-702. A washout period of 4 weeks or 5 half-lives whichever is shorter for any other previous preceding IMPs is required before the patient receives their first dose of TT-702 (no washout is needed from ICI).
- Patients with ongoing toxic manifestations of previous treatments greater than NCI CTCAE Version 5.0 Grade 1. Exceptions to this are alopecia and any ongoing toxic manifestation which in the opinion of the Investigator should not exclude the patient.
- Patients with symptomatic brain or leptomeningeal metastases should be excluded. Asymptomatic patients with previously treated and stable brain metastases (in previous four weeks to trial entry) and not requiring any steroids are eligible for the trial. Patients who are stable on anticonvulsants are also eligible.
- Women of childbearing potential (or are already pregnant or lactating). However, those patients who meet the following points are considered eligible:
- Have a negative highly sensitive pregnancy test of a serum sample within 7 days prior to trial inclusion; and
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- Agree to use two forms of medically approved contraception: i. one highly effective form including but not limited to: oral, injected,implanted, transdermal or intravaginal hormonal contraception associated with inhibition of ovulation; intrauterine device; intrauterine hormonereleasing system, bilateral tubal occlusion or vasectomised partner; ii. plus a barrier method (for example, condom plus spermicide); iii. or agree to sexual abstinence. Effective from the first administration of TT-702, throughout the trial and for six months after the last administration of IMP.
- Male patients with partners of childbearing potential. However, those patients who meet the following points are considered eligible:
- Agree to take measures not to father children by using a barrier method of contraception [condom plus spermicide] or sexual abstinence effective from the first administration of IMP throughout the trial and for six months after the last administration of IMP.
- Male patients with pregnant or lactating partners must be advised to use barrier method contraception (for example, condom plus spermicide) to prevent exposure of the foetus or neonate.
- Non-vasectomised male patients must also be willing to ensure that any partner of childbearing potential uses a highly effective method of contraception (for example, oral, injected, implanted, transdermal or intravaginal hormonal contraception associated with inhibition of ovulation, intrauterine device, intrauterine hormone-releasing system or bilateral tubal occlusion) or agree to sexual abstinence for the same duration.
- Major thoracic or abdominal surgery from which the patient has not yet recovered.
- At high medical risk because of non-malignant systemic disease including active uncontrolled infection. Patients with previous Hepatitis C exposure but no current infection are eligible to participate.
- Known to be serologically positive for Hepatitis B, Hepatitis C or Human Immunodeficiency Virus (HIV).
- Prior bone marrow transplant or have had extensive radiotherapy to greater than 25% of bone marrow within eight weeks.
- Concurrent congestive heart failure, prior history of class II-IV cardiac disease (New York Heart Association [NYHA]), prior history of clinically significant cardiac ischaemia or prior history of clinically significant cardiac arrhythmia. Patients with significant cardiovascular disease are excluded as defined by:
- History of congestive heart failure requiring therapy (NYHA III or IV); b. History of unstable angina pectoris or myocardial infarction up to six months prior to trial entry (patients with previous cardiac or thrombotic events who are now stable and or recovered are eligible); c. Presence of severe valvular heart disease; d. Presence of a ventricular arrhythmia requiring treatment; e. Left ventricular ejection fraction < 50%; f. Has a QTcF prolongation to >470 milliseconds (ms) based on a 12-lead ECG in triplicate; g. Previous stroke or transient ischaemic attack within 6 months of trial entry; h. History of clinically significant peripheral vascular disease/vasculitis/vasculopathy.
- Is a participant or plans to participate in another interventional clinical trial, whilst taking part in this Phase I/II trial of TT-702. Participation in an observational trial or interventional clinical trial which does not involve administration of an IMP and which would not place an unacceptable burden on the patient in the opinion of the Investigator would be acceptable.
- Previous malignancies of other types, apart from adequately treated in situ carcinoma of the cervix uteri and basal or squamous cell carcinoma of the skin. Cancer survivors, who have undergone potentially curative therapy for a prior malignancy, have no evidence of that disease for five years or more and are deemed at negligible risk for recurrence, are eligible for the trial.
- A concomitant significant other illness that might in the opinion of the Investigator affect compliance with the protocol or interpretation of results, examples include but are not limited to autoimmune diseases or immune deficiency, or other disease with ongoing fibrosis (such as scleroderma, pulmonary fibrosis, emphysema, neurofibromatosis, palmar/plantar fibromatosis), alcoholic hepatitis, cirrhosis, and inherited liver disease, previous organ transplantation, uncontrolled or poorly controlled diabetes mellitus (for example HbA1c >10%) and patients with non-alcoholic steatohepatitis.
- History of an immune-mediated adverse event of Grade 3 or above attributed to prior cancer immunotherapy that resulted in permanent discontinuation of the prior immunotherapeutic agent. Immune-mediated adverse events related to prior immunomodulatory therapy (other than endocrinopathy managed with replacement therapy or stable vitiligo) that have not either resolved completely to baseline or are Grade ≤2 in severity.
- Patients on systemic corticosteroids (apart from replacement doses for endocrinopathy up to an equivalent of 10 mg QD prednisolone). Topical or inhaled steroids for pre-existent diseases are allowed.
- Patients who received a live vaccine within 30 days before trial enrolment are excluded.
- Patients with a known or suspected history of hypersensitivity or allergy to TT-702, or any of its excipients (for any strength) are excluded:
- TT-702 10 mg strength, excipients: hydroxypropyl cellulose, sodium lauryl sulfate, lactose monohydrate, microcrystalline cellulose, croscarmellose sodium and magnesium stearate;
- TT-702 40 mg strength, excipients: hydroxypropyl cellulose, sodium lauryl sulfate, mannitol, croscarmellose sodium and magnesium stearate;
- TT-702 120 mg strength, excipients: poloxamer-188, sodium lauryl sulfate, mannitol, croscarmellose sodium and magnesium stearate in hydroxypropyl methylcellulose (HPMC) capsules;
- TT-478 (also known as GS-6201 or CVT-6883).
- Patients who take therapies that inhibit or induce CYP3A must be excluded.
- Any other condition which in the Investigator's opinion would not make the patient a good candidate for the clinical trial.
- If a patient is taking any dietary supplements or complementary medicines/botanicals, the Sponsor's Centre for Drug Development (CDD) must be informed at the earliest opportunity both prior to enrolment and during the patient's time on trial.
Trial locations and contacts
3 sites in 1 country. Contact the study team or a site near you to ask about taking part.
United Kingdom3 sites, 3 recruiting
- Recruiting
Royal Marsden Hospital NHS Foundation Trust
London, SM2 5PT
Johann de Bono, Prof, Johann.debono@icr.ac.uk
- Recruiting
The Christie NHS Foundation Trust
Manchester, M20 4BX
Natalie Cook, Dr, natalie.cook17@nhs.net
- Recruiting
University Hospital Southampton NHS Foundation Trust
Southampton, SO16 6YD
Simon Crabb, Dr, S.J.Crabb@southampton.ac.uk
About this study
Official title: CURATE: A Cancer Research UK Phase I/II, Dose Escalation and Expansion Trial of TT-702, A Selective Adenosine A2BR Antagonist, Given Orally as a Monotherapy Agent and in Combination, in Patients With Advanced Solid Tumours
This clinical trial is evaluating the drug candidate TT-702 in patients with advanced solid tumours. The main aims of the trial are to determine the maximum dose of TT-702 that can be given safely to patients alone and in combination with other anti-cancer agents.
Read the detailed description
TT-702 is a 'small molecule prodrug'. TT-702 is converted into TT-478, which then targets and blocks the function of the 'A2B adenosine receptor'. It is hoped that by blocking this receptor the immune system will become more active in recognising and removing tumour cells.
This clinical trial has two phases:
- Phase I, dose escalation phase - groups of patients will receive increasing doses of TT-702 to find an optimal dose that best targets the tumours. This phase will consist of both monotherapy and combination escalation cohorts. In the combination escalation cohorts, TT-702 will be evaluated in combination with an anti-PD-1/PD-L1 agent to be assessed in patients with Mismatch Repair deficiency (MMRd) tumours or patients with non-MMRd tumours in one of the following subtypes: colorectal cancer (CRC), metastatic castration-resistant prostate cancer (mCRPC), non-small cell lung cancer (NSCLC), pancreatic ductal adenocarcinoma (PDAC), triple-negative breast cancer (TNBC).
- Phase II, expansion phase - larger groups of patients will receive the selected dose of TT-702 considered to be optimal in the Phase I, dose escalation phase. This phase will consist of one monotherapy expansion cohort and one combination expansion cohort. In the combination expansion cohorts, TT-702 will be evaluated in combination with an anti-PD-1/PDL1 agent. Potential agents for further combination expansion cohorts have not yet been defined.
The main aims of this trial are to:
- Find the maximum dose of TT-702 as a monotherapy and in combination with other anti-cancer drugs that can be given safely to patients.
- Define the side effects of TT-702 and how these can be managed.
- Determine the pharmacokinetics (PK) and elimination kinetics of TT-702.
- Conditions
- Advanced Solid Tumors
- Being tested
- TT-702, Anti-PD-1 and PD-L1 agent
- Keywords
- Adenosine receptors, MSI Deficient Cancers, MMR Deficient Cancer, Castrate resistant Prostate Cancer, Triple Negative Breast Cancer, Pancreatic Ductal Adenocarcinoma, Non-Small Cell Lung Cancer, Colorectal Cancer
- Medical subject headings
- Triple Negative Breast Neoplasms, Carcinoma, Non-Small-Cell Lung, Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TT-702Drug
TT-702 will be administered orally, once daily, for up to 12 months.
Anti-PD-1 and PD-L1 agentDrug
An appropriate anti-PD-1/PD-L1 combination agent will be selected and implemented following a substantial amendment.
| Study group | Role | What they receive |
|---|---|---|
| Cohort 1M (Monotherapy escalation cohort) | Experimental | This cohort will recruit patients with MMRd tumours or non-MMRd CRC, mCRPC, NSCLC, PDAC, TNBC. Receives: Drug: TT-702 |
| Cohort 2M: (Monotherapy expansion cohort) | Experimental | This cohort will recruit patients with MMR defective tumours who have had prior treatment with an immune checkpoint inhibitor (ICI). Receives: Drug: TT-702 |
| Cohort 1P (Combination escalation cohort) | Experimental | This cohort will recruit patients who have had prior treatment with an ICI. Receives: Drug: Anti-PD-1 and PD-L1 agent |
| Cohort 2P (Combination expansion cohort) | Experimental | This cohort will recruit patients with MMRd tumours who have had prior treatment with an ICI. Receives: Drug: Anti-PD-1 and PD-L1 agent |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Dose Limiting Toxicities (DLTs) (Dose Escalation Phase)
Dose Limiting Toxicities to TT-702 are determined by testing increasing doses of TT-702 administered once daily in continuous 21-day cycles in escalation cohorts. Dose limiting toxicities are defined per protocol as a highly probably or probably TT-702-related adverse events (AEs) of neutropenia, thrombocytopenia, non-haematological toxicities, photosensitivity, death or other drug-related toxicity causing TT-702 interruption, occurring during Cycle 0 or Cycle 1 administration.
Measured: From the first dose in Cycle 0, until completion of Cycle 1 (3 weeks [+ 3-9 days to account for initial pharmacokinetic (PK) profiling period following the Cycle 0 dose]).
Number of Treatment-Emergent AEs (TEAEs), Related TEAEs and Grade 3, 4 or 5 TEAEs (Dose Escalation Phase)
Number of TEAEs, TEAEs related to TT-702 and Grade 3, 4 or 5 TEAEs in the dose escalation phase. AEs are categorised according to Medical Dictionary for Regulatory Activities (MedDRA) and graded for severity according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) versions applicable at time of reporting. AEs are assessed by the reporting study doctors for a causal relationship to TT-702. Related are those AEs with a causality of possible, probable or highly probable. All AEs are collected until the off-study visit, approximately 21 (±7) days after the final dose of TT-702 and TT-702-related AEs present at the off-study visit are to be followed up monthly until resolution, return to baseline, stabilisation or initiation of another anti-cancer treatment.
Measured: From the time of first dose until the end of the safety follow-up period for TT-702.
Objective Response Rate (ORR)
ORR is defined as the proportion of participants with a confirmed Complete Response (CR) or Partial Response (PR) at 6 months (Expansion Phase) and is used to assess antitumour activity according to PCWG3 or RECIST v1.1 criteria. Responses must be confirmed by repeat assessment ≥4 weeks after initial response criteria are met.
Measured: From the first dose and until the final radiological disease assessment at the off-study visit.
Number and Percentage of Participants that Achieved Clinical Benefit Assessed by PCWG3 and RECIST v1.1 (Expansion Phase)
Antitumour activity measured according to PCWG3 and RECIST version 1.1. Complete Response or PR/remission is confirmed by repeat measurements ≥4 weeks after response criteria are met; participants with SD are to meet criteria at least once ≥6 weeks after first dose of TT-702. Clinical Benefit Rate is defined as the proportion of participants with absence of disease progression (i.e. confirmed CR, PR or SD) for at least 24 weeks from the start of trial treatment.
Measured: From the first dose and until the final radiological disease assessment at the off-study visit.
Secondary outcomes (16)
Measurement of Maximum (or Peak) Plasma Concentration (Cmax) of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Pharmacokinetic parameters are derived from analysing the concentration of TT-702 and its active metabolite, TT-478, in plasma via Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS).
Measured: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Measurement of Minimal Plasma Concentration (Cmin) of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Pharmacokinetic parameters are derived from analysing the concentration of TT-702 and its active metabolite, TT-478, in plasma via LC-MS/MS.
Measured: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Measurement of Time at Cmax (Tmax) of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Pharmacokinetic parameters are derived from analysing the concentration of TT-702 and its active metabolite, TT-478, in plasma via LC-MS/MS.
Measured: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Area Under the Curve (AUC) of TT-702 and its active product, TT-478, as appropriate (Dose Escalation and Expansion Phase)
Pharmacokinetic parameters are derived from analysing the concentration of TT-702 and its active metabolite, TT-478, in plasma via LC-MS/MS.
Measured: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Apparent Clearance of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Pharmacokinetic parameters are derived from analysing the concentration of TT-702 and its active metabolite, TT-478, in plasma via LC-MS/MS.
Measured: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Volume of Distribution of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Pharmacokinetic parameters are derived from analysing the concentration of TT-702 and its active metabolite, TT-478, in plasma via LC-MS/MS.
Measured: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Terminal Elimination Half-Life (T1/2) of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Pharmacokinetic parameters are derived from analysing the concentration of TT-702 and its active metabolite, TT-478, in plasma via LC-MS/MS.
Measured: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Objective Response Rate Defined as the Proportion of Participants with Confirmed CR or PR According to PCWG3 or RECIST v1.1 at 6 Months (Dose Escalation Phase)
Antitumour activity via ORR measured according to PCWG3 (cRPC) and RECIST v1.1 (solid tumours). Complete Response or PR/remission is to be confirmed by repeat measurements ≥4 weeks after response criteria are met.
Measured: From the first dose until the final radiological assessment at the off-study visit.
Number and Percentage of Participants that Achieved Clinical Benefit Assessed by PCWG3 or RECIST v1.1 (Dose Escalation Phase)
Antitumour activity measured according to PCWG3 (cRPC) and RECIST version 1.1 (solid tumours). Complete response or PR/remission is confirmed by repeat measurements ≥4 weeks after response criteria are met; participants with SD are to meet criteria at least once ≥6 weeks after first dose of TT-702. Clinical benefit rate is defined as the proportion of participants with absence of disease progression (i.e. confirmed CR, PR or SD) for at least 24 weeks from the start of trial treatment.
Measured: From the first dose and until the final radiological disease assessment at the off-study visit.
Objective Response Rate Defined as the Proportion of Participants with Confirmed CR or PR According to PCWG3 or RECIST v1.1 at Cycles 3, 6, 9, 12 (Dose Escalation and Expansion Phase)
Antitumour activity measured according to PCWG3 (cRPC) and RECIST version 1.1 (solid tumours). Complete response or PR/remission is confirmed by repeat measurements ≥4 weeks after response criteria are met.
Measured: From the first dose and until the final radiological disease assessment at the off-study visit.
Objective Response Rate Defined as the Proportion of Participants with Confirmed CR or PR According to PCWG3 or RECIST v1.1 at Any Timepoint (Dose Escalation and Expansion Phase)
Antitumour activity measured according to PCWG3 (cRPC) and RECIST version 1.1 (solid tumours). Complete response or PR/remission is confirmed by repeat measurements ≥4 weeks after response criteria are met.
Measured: From the first dose and until the final radiological disease assessment at the off-study visit.
Median Duration of Response and 90% Confidence Interval for Participants that Achieved a Confirmed Response (Dose Escalation and Expansion Phase)
Antitumour activity measured according to PCWG3 (cRPC) and RECIST version 1.1 (solid tumours). Complete response or PR/remission is confirmed by repeat measurements ≥4 weeks after response criteria are met. Duration of response is defined as the time from the first observation of CR or PR to PD or death from any cause in participants with confirmed CR or PR.
Measured: From the first dose and until the final radiological disease assessment at the off-study visit.
Median Duration of Clinical Benefit and 90% Confidence Interval for Participants that Achieved Clinical Benefit (Dose Escalation and Expansion Phase)
Antitumour activity measured according to PCWG3 (cRPC) and RECIST version 1.1 (solid tumours). Complete response or PR/remission is confirmed by repeat measurements ≥4 weeks after response criteria are met; participants with SD are to meet criteria at least once ≥6 weeks after first dose of TT-702. Duration of clinical benefit is defined as duration from date of first administration of TT-702 to PD or death from any cause in participants with confirmed CR, PR or SD for at least 24 weeks from date of administration of the first dose of TT-702.
Measured: From the first dose and until the final radiological disease assessment at the off-study visit.
Number and Percentage of Participants who Remained Progression Free at 6 Months with 90% Confidence Intervals (Dose Escalation and Expansion Phase)
Antitumour activity measured according to PCWG3 (cRPC) and RECIST version 1.1 (solid tumours). Complete or partial response/remission is confirmed by repeat measurements ≥4 weeks after response criteria are met; participants with SD met criteria at least once ≥6 weeks after first dose of TT-702.
Measured: From the first dose and until confirmation of progression, at the 6-month timepoint.
Number and Percentage of Participants who are Alive at 12 Months with Associated 90% Confidence Intervals (Dose Escalation and Expansion Phase)
Overall survival of participants at the 12 month post-first dose timepoint.
Measured: From the first dose and until confirmation of alive or deceased from any cause, at the 12-month timepoint.
Number of TEAEs, related TEAEs, and Grade 3, 4 or 4 TEAEs (Dose Expansion Phase)
Number of TEAEs, TEAEs related to TT-702 and Grade 3, 4 or 5 TEAEs in the dose expansion phase. Adverse events are categorised according to MedDRA and graded for severity according to NCI CTCAE versions applicable at time of reporting. Adverse events are assessed by the reporting study doctors for a causal relationship to TT-702. Related are those AEs with a causality of possible, probable or highly probable. All AEs are collected until the off-study visit, approximately 21 (±7) days after the final dose of TT-702 and TT-702-related AEs present at the off-study visit are to be followed up monthly until resolution, return to baseline, stabilisation or initiation of another anti-cancer treatment.
Measured: From the time of first dose until the end of the safety follow-up period for TT-702.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Mar 2022
- Study start19 Jan 2022
- Primary completionApr 2028 (estimated)
- Study completionApr 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Advanced Solid TumorsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cancer Research UK
- Sponsor type
- University, hospital or other
- Collaborators
- Teon Therapeutics, Inc.
- Responsible party
- Sponsor
- Investigators
- Johann de Bono, Prof, Principal investigator, The Royal Marsden Hospital/ The Institute of Cancer Research
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05272709
- Sponsor's protocol ID
- CRUKD/21/005
- Other IDs
- 2021-001062-37
- Acronym
- CURATE
- Status last verified
- Aug 2026
- First submitted
- 9 Feb 2022
- Last updated
- 12 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Whitaker D, Francis L, Karaborni S, Smith S, Craigen JL, Svetlik S, Barnett S, Veal GJ. Development and validation of an LC-MS/MS method for the quantification of novel therapeutic TT-478, a selective adenosine receptor 2B antagonist, for a phase I/II clinical trial. Bioanalysis. 2025 Sep;17(17):1105-1112. doi: 10.1080/17576180.2025.2554564. Epub 2025 Oct 17.
PubMed 41104540
Study at a glance
From the registry record, last updated by the sponsor on 12 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- CURATE: A Cancer Research UK Phase I/II, Dose Escalation and Expansion Trial of TT-702, A Selective Adenosine A2BR Antagonist, Given Orally as a Monotherapy Agent and in Combination, in Patients With Advanced Solid Tumours
- ClinicalTrials.gov ID
- NCT05272709
- Acronym / sponsor ID
- CURATE / CRUKD/21/005
- Conditions
- Advanced Solid Tumors
- Keywords
- Adenosine receptors, MSI Deficient Cancers, MMR Deficient Cancer, Castrate resistant Prostate Cancer, Triple Negative Breast Cancer, Pancreatic Ductal Adenocarcinoma, Non-Small Cell Lung Cancer, Colorectal Cancer
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Cancer Research UKUniversity, hospital or other
- Collaborators
- Teon Therapeutics, Inc.
- Study start
- 19 Jan 2022 (actual)
- Primary completion
- Apr 2028 (estimated)
- Study completion
- Apr 2028 (estimated)
- First posted
- 9 Mar 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This clinical trial is evaluating the drug candidate TT-702 in patients with advanced solid tumours. The main aims of the trial are to determine the maximum dose of TT-702 that can be given safely to patients alone and in combination with other anti-cancer agents.
Detailed description
TT-702 is a 'small molecule prodrug'. TT-702 is converted into TT-478, which then targets and blocks the function of the 'A2B adenosine receptor'. It is hoped that by blocking this receptor the immune system will become more active in recognising and removing tumour cells.
This clinical trial has two phases:
- Phase I, dose escalation phase - groups of patients will receive increasing doses of TT-702 to find an optimal dose that best targets the tumours. This phase will consist of both monotherapy and combination escalation cohorts. In the combination escalation cohorts, TT-702 will be evaluated in combination with an anti-PD-1/PD-L1 agent to be assessed in patients with Mismatch Repair deficiency (MMRd) tumours or patients with non-MMRd tumours in one of the following subtypes: colorectal cancer (CRC), metastatic castration-resistant prostate cancer (mCRPC), non-small cell lung cancer (NSCLC), pancreatic ductal adenocarcinoma (PDAC), triple-negative breast cancer (TNBC).
- Phase II, expansion phase - larger groups of patients will receive the selected dose of TT-702 considered to be optimal in the Phase I, dose escalation phase. This phase will consist of one monotherapy expansion cohort and one combination expansion cohort. In the combination expansion cohorts, TT-702 will be evaluated in combination with an anti-PD-1/PDL1 agent. Potential agents for further combination expansion cohorts have not yet been defined.
The main aims of this trial are to:
- Find the maximum dose of TT-702 as a monotherapy and in combination with other anti-cancer drugs that can be given safely to patients.
- Define the side effects of TT-702 and how these can be managed.
- Determine the pharmacokinetics (PK) and elimination kinetics of TT-702.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Cohort 1M (Monotherapy escalation cohort) | Experimental | Drug: TT-702This cohort will recruit patients with MMRd tumours or non-MMRd CRC, mCRPC, NSCLC, PDAC, TNBC. |
| Cohort 2M: (Monotherapy expansion cohort) | Experimental | Drug: TT-702This cohort will recruit patients with MMR defective tumours who have had prior treatment with an immune checkpoint inhibitor (ICI). |
| Cohort 1P (Combination escalation cohort) | Experimental | Drug: Anti-PD-1 and PD-L1 agentThis cohort will recruit patients who have had prior treatment with an ICI. |
| Cohort 2P (Combination expansion cohort) | Experimental | Drug: Anti-PD-1 and PD-L1 agentThis cohort will recruit patients with MMRd tumours who have had prior treatment with an ICI. |
Who may qualify
- Ages
- 16 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (30 listed)
- Be able to provide informed consent and be capable of co-operating with IMP administration, procedures and follow-up.
- Be willing to provide samples (blood and tissue) as required.
- Consent to access any available archival tissue.
- Consent for fresh tumour biopsy samples at baseline and on trial (may be Investigator mandated for patients in the dose escalation phase. Investigators will consider whether a biopsy is feasible for the patient in the dose escalation phase and this will not impede participation in the trial if biopsy is not a suitable option.
- Life expectancy estimated by the Investigator to be at least 12 weeks.
Key exclusion criteria (31 listed)
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- Radiotherapy (except single fractions for palliative reasons), endocrine therapy during the previous four weeks, immunotherapy and chemotherapy during the previous four weeks(previous six weeks for nitrosoureas, Mitomycin-C) before receiving TT-702. A washout period of eight weeks is required for enzalutamide and apalutamide before the patient receives their first dose of TT-702. A washout period of 4 weeks or 5 half-lives whichever is shorter for any other previous preceding IMPs is required before the patient receives their first dose of TT-702 (no washout is needed from ICI).
- Patients with ongoing toxic manifestations of previous treatments greater than NCI CTCAE Version 5.0 Grade 1. Exceptions to this are alopecia and any ongoing toxic manifestation which in the opinion of the Investigator should not exclude the patient.
- Patients with symptomatic brain or leptomeningeal metastases should be excluded. Asymptomatic patients with previously treated and stable brain metastases (in previous four weeks to trial entry) and not requiring any steroids are eligible for the trial. Patients who are stable on anticonvulsants are also eligible.
- Women of childbearing potential (or are already pregnant or lactating). However, those patients who meet the following points are considered eligible:
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TT-702TT-702 will be administered orally, once daily, for up to 12 months. | Drug | Cohort 1M (Monotherapy escalation cohort), Cohort 2M: (Monotherapy expansion cohort) |
| Anti-PD-1 and PD-L1 agentAn appropriate anti-PD-1/PD-L1 combination agent will be selected and implemented following a substantial amendment. | Drug | Cohort 1P (Combination escalation cohort), Cohort 2P (Combination expansion cohort) |
Primary outcome
Number of Dose Limiting Toxicities (DLTs) (Dose Escalation Phase)
Time frame: From the first dose in Cycle 0, until completion of Cycle 1 (3 weeks [+ 3-9 days to account for initial pharmacokinetic (PK) profiling period following the Cycle 0 dose]).
Dose Limiting Toxicities to TT-702 are determined by testing increasing doses of TT-702 administered once daily in continuous 21-day cycles in escalation cohorts. Dose limiting toxicities are defined per protocol as a highly probably or probably TT-702-related adverse events (AEs) of neutropenia, thrombocytopenia, non-haematological toxicities, photosensitivity, death or other drug-related toxicity causing TT-702 interruption, occurring during Cycle 0 or Cycle 1 administration.
Number of Treatment-Emergent AEs (TEAEs), Related TEAEs and Grade 3, 4 or 5 TEAEs (Dose Escalation Phase)
Time frame: From the time of first dose until the end of the safety follow-up period for TT-702.
Number of TEAEs, TEAEs related to TT-702 and Grade 3, 4 or 5 TEAEs in the dose escalation phase. AEs are categorised according to Medical Dictionary for Regulatory Activities (MedDRA) and graded for severity according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) versions applicable at time of reporting. AEs are assessed by the reporting study doctors for a causal relationship to TT-702. Related are those AEs with a causality of possible, probable or highly probable. All AEs are collected until the off-study visit, approximately 21 (±7) days after the final dose of TT-702 and TT-702-related AEs present at the off-study visit are to be followed up monthly until resolution, return to baseline, stabilisation or initiation of another anti-cancer treatment.
Objective Response Rate (ORR)
Time frame: From the first dose and until the final radiological disease assessment at the off-study visit.
ORR is defined as the proportion of participants with a confirmed Complete Response (CR) or Partial Response (PR) at 6 months (Expansion Phase) and is used to assess antitumour activity according to PCWG3 or RECIST v1.1 criteria. Responses must be confirmed by repeat assessment ≥4 weeks after initial response criteria are met.
Number and Percentage of Participants that Achieved Clinical Benefit Assessed by PCWG3 and RECIST v1.1 (Expansion Phase)
Time frame: From the first dose and until the final radiological disease assessment at the off-study visit.
Antitumour activity measured according to PCWG3 and RECIST version 1.1. Complete Response or PR/remission is confirmed by repeat measurements ≥4 weeks after response criteria are met; participants with SD are to meet criteria at least once ≥6 weeks after first dose of TT-702. Clinical Benefit Rate is defined as the proportion of participants with absence of disease progression (i.e. confirmed CR, PR or SD) for at least 24 weeks from the start of trial treatment.
16 secondary outcomes
Measurement of Maximum (or Peak) Plasma Concentration (Cmax) of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Time frame: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Measurement of Minimal Plasma Concentration (Cmin) of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Time frame: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Measurement of Time at Cmax (Tmax) of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Time frame: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Area Under the Curve (AUC) of TT-702 and its active product, TT-478, as appropriate (Dose Escalation and Expansion Phase)
Time frame: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Apparent Clearance of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Time frame: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Volume of Distribution of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Time frame: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Terminal Elimination Half-Life (T1/2) of TT-702 and its Active Product, TT-478, as Appropriate (Dose Escalation and Expansion Phase)
Time frame: From the first dose of TT-702 until the discontinuation visit (max 12 months).
Objective Response Rate Defined as the Proportion of Participants with Confirmed CR or PR According to PCWG3 or RECIST v1.1 at 6 Months (Dose Escalation Phase)
Time frame: From the first dose until the final radiological assessment at the off-study visit.
Number and Percentage of Participants that Achieved Clinical Benefit Assessed by PCWG3 or RECIST v1.1 (Dose Escalation Phase)
Time frame: From the first dose and until the final radiological disease assessment at the off-study visit.
Objective Response Rate Defined as the Proportion of Participants with Confirmed CR or PR According to PCWG3 or RECIST v1.1 at Cycles 3, 6, 9, 12 (Dose Escalation and Expansion Phase)
Time frame: From the first dose and until the final radiological disease assessment at the off-study visit.
Objective Response Rate Defined as the Proportion of Participants with Confirmed CR or PR According to PCWG3 or RECIST v1.1 at Any Timepoint (Dose Escalation and Expansion Phase)
Time frame: From the first dose and until the final radiological disease assessment at the off-study visit.
Median Duration of Response and 90% Confidence Interval for Participants that Achieved a Confirmed Response (Dose Escalation and Expansion Phase)
Time frame: From the first dose and until the final radiological disease assessment at the off-study visit.
Median Duration of Clinical Benefit and 90% Confidence Interval for Participants that Achieved Clinical Benefit (Dose Escalation and Expansion Phase)
Time frame: From the first dose and until the final radiological disease assessment at the off-study visit.
Number and Percentage of Participants who Remained Progression Free at 6 Months with 90% Confidence Intervals (Dose Escalation and Expansion Phase)
Time frame: From the first dose and until confirmation of progression, at the 6-month timepoint.
Number and Percentage of Participants who are Alive at 12 Months with Associated 90% Confidence Intervals (Dose Escalation and Expansion Phase)
Time frame: From the first dose and until confirmation of alive or deceased from any cause, at the 12-month timepoint.
Number of TEAEs, related TEAEs, and Grade 3, 4 or 4 TEAEs (Dose Expansion Phase)
Time frame: From the time of first dose until the end of the safety follow-up period for TT-702.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Aug 2026.
- Derived from this study: PubMed 41104540Whitaker D, Francis L, Karaborni S, Smith S, Craigen JL, Svetlik S, Barnett S, Veal GJ. Development and validation of an LC-MS/MS method for the quantification of novel therapeutic TT-478, a selective adenosine receptor 2B antagonist, for a phase I/II clinical trial. Bioanalysis. 2025 Sep;17(17):1105-1112. doi: 10.1080/17576180.2025.2554564. Epub 2025 Oct 17.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Johann de Bono, Prof principal investigator
The Royal Marsden Hospital/ The Institute of Cancer Research
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing TT-702 and Anti-PD-1 and PD-L1 agent in people with Advanced Solid Tumors, run by Cancer Research UK at 3 sites in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 30 inclusion and 31 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 12 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Johann de Bono, Prof (+44 (0)208 722 4029, Johann.debono@icr.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Dose Limiting Toxicities (DLTs) (Dose Escalation Phase) (time frame: From the first dose in Cycle 0, until completion of Cycle 1 (3 weeks [+ 3-9 days to account for initial pharmacokinetic (PK) profiling period following the Cycle 0 dose]).). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05272709, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2026; AzTrials last refreshed its copy on 26 Oct 2026.