Phase I/II First-in-Human Study of TT-10 (PORT-6), an Adenosine 2A Receptor Antagonist, and PORT-7, an Adenosine 2B Receptor Antagonist, as Single Agents and in Combination in Participants With Advanced Selected Solid Tumors

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Trial Details

Sponsor: Portage Biotech (industry)

Phase: 1/2

Start date: June 23, 2023

Planned enrollment: 90

Trial ID: NCT04969315
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More trial details at ClinicalTrials.gov More info

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Goal: Evaluate safety, tolerability, and preliminary antitumor activity of TT-10 (PORT-6, an A2A receptor antagonist), TT-4 (PORT-7, an A2B receptor antagonist), and their combination; determine MTD/RP2D for each regimen and estimate early efficacy in advanced solid tumors lacking standard options.

Patients: Adults ≥18 years with histologically/cytologically confirmed advanced solid tumors after or ineligible for standard therapies. Phase Ia dose-escalation cohorts: TT-10 in RCC, mCRPC, NSCLC, SCCHN; TT-4 in CRC, mCRPC, NSCLC, endometrial, and ovarian cancers. Combination cohort includes one or more of these tumor types per safety monitoring committee guidance. ECOG 0–1, measurable disease per RECIST 1.1 (exceptions for PSA-only mCRPC with approval), adequate marrow, hepatic, and renal function, ability to swallow capsules, and willingness for baseline biopsy unless exceptions apply. Key exclusions include active CNS/leptomeningeal disease (unless treated/stable without steroids), recent major surgery/radiation/systemic therapy, need for strong CYP3A4/2C9/2C19 modulators or acid-reducing agents, significant cardiac/pulmonary GI risk factors, active infections, and pregnancy/breastfeeding.

Design: Multicenter, open-label, nonrandomized Phase I/II study with dose escalation followed by expansion. Three parallel dose-escalation cohorts (TT-10, TT-4, and TT-10+TT-4) to define MTD/RP2D, then expansion at RP2D to further characterize safety and preliminary efficacy.

Treatments: TT-10 (PORT-6) is an oral small-molecule antagonist of the adenosine A2A receptor designed to reverse adenosine-mediated immunosuppression in hypoxic tumor microenvironments. Preclinical data show high-affinity binding with slow dissociation and monotherapy activity in murine tumor models. Early clinical safety from the ongoing program has reported mainly grade 1–2 AEs without dose-limiting toxicities to date in a small cohort; full efficacy remains investigational. Dosing is oral BID in 28-day cycles with ascending dose levels. TT-4 (PORT-7) is an oral small-molecule antagonist of the adenosine A2B receptor intended to block adenosine-driven immunosuppression and protumorigenic signaling; human efficacy data are not yet established. Dosing is oral QD in 28-day cycles with ascending dose levels or adjusted frequency. The combination arm administers TT-10 plus TT-4 orally with dose levels informed by monotherapy safety, aiming to assess dual adenosine receptor blockade.

Outcomes: Primary: incidence of dose-limiting toxicities during dose escalation; determination of MTD/RP2D; and, in expansion, incidence and severity of treatment-related adverse events (CTCAE v5.0). Secondary: overall response rate per RECIST 1.1, duration of response, progression-free survival, and pharmacokinetics of TT-10 (Cmax, AUC, half-life) with intensive sampling around dosing.

Burden on patient: High. As a first-in-human Phase I/II with oral agents, patients should expect frequent on-site visits in early cycles, intensive PK blood draws at multiple time points (predose through 24 hours), mandated baseline tumor biopsy or recent archival tissue, and regular safety labs and imaging per RECIST. Concomitant medication restrictions (strong CYP modulators and acid-reducing agents) may necessitate regimen changes. Combination dosing and potential dose escalations add monitoring complexity. Travel frequency is greater than standard care early in treatment, though pill administration is at home once dosing is established.

Last updated: Oct 2025

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Sites (3)

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USC Norris Comprehensive Cancer Center

Los Angeles, California, 90033, United States

No email / No phone

Status: Recruiting

Norton Cancer Institute

Louisville, Kentucky, 40241, United States

No email / No phone

Status: Recruiting

The University of Texas MD Anderson Cancer Center

Houston, Texas, 77030, United States

No email / No phone

Status: Recruiting