A Phase IIa Open Label Study Evaluating the Preliminary Efficacy of Intratumoural Tigilanol Tiglate in Advanced and/or Metastatic Soft Tissue Sarcoma of the Extremities and Body Wall.

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Investigational drug late phase More information Active drug More information Moderate burden on patient More information

Trial Details

Sponsor: QBiotics Group Limited (industry)

Phase: 2

Start date: April 13, 2023

Planned enrollment: 40

Trial ID: NCT05755113
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More trial details at ClinicalTrials.gov More info

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Investigational Drug AI Analysis

chevron Show for: Tigilanol Tiglate (EBC-46, Stelfonta)

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Goal: Evaluate preliminary efficacy of intratumoural tigilanol tiglate for local ablation of soft tissue sarcoma (STS) lesions in the extremities and body wall, and, in a later stage, its effect on overall disease control beyond injected lesions. Key secondary aims are to characterize safety/tolerability and systemic pharmacokinetics after intratumoural dosing, with exploratory assessments of tumor microenvironment, immune activation, local recurrence, and metabolite profiling.

Patients: Adults (≥18 years) with histologically confirmed advanced and/or metastatic soft tissue sarcoma of the extremities, body wall, or scalp, with at least one lesion amenable to palpation- or ultrasound-guided intratumoural injection. ECOG performance status ≤2 and adequate organ function are required. Key exclusions include lesions abutting major vessels, recent systemic anticancer therapy or investigational agents without appropriate washout, recent major surgery, active brain metastases or carcinomatous meningitis, significant bleeding diathesis or therapeutic warfarin use, and severe hypersensitivity to study drug.

Design: Phase IIa, single-arm, open-label study with staged objectives. Approximately 40 participants will receive protocol-defined intratumoural treatment and undergo efficacy, safety, PK, and translational assessments. No randomization or comparator.

Treatments: Single or multiple intratumoural injections of tigilanol tiglate up to a fixed dose of 3.6 mg/m2 per treatment. Tigilanol tiglate (EBC-46) is a plant-derived small molecule and a potent modulator of protein kinase C that induces rapid vascular disruption and hemorrhagic necrosis leading to local tumor ablation, with signals of immunogenic cell death and immune infiltration. First-in-human data across refractory injectable solid tumors showed responses, including complete responses, with primarily local, mechanism-consistent adverse events; dose-limiting toxicity was uncommon and the maximum tolerated dose was not reached up to 3.6 mg/m2. Company-reported Stage 1 data in STS suggest high rates of ablation of injected lesions, with generally local and manageable toxicity; peer-reviewed confirmation is pending.

Outcomes: Primary: proportion of participants achieving partial or complete ablation of injected tumors/segments within 6 months; in Stage 2, objective response rate by RECIST v1.1 at 3 and 6 months to evaluate overall disease control. Secondary: incidence of adverse events and serious adverse events over 6 months; systemic exposure by pharmacokinetics up to 24 hours after first injection. Exploratory: changes in tumor microenvironment and immune cell infiltration in injected and/or non-injected tumors, peripheral blood mononuclear cell analyses, local recurrence at injection sites at 6 months, and metabolite profiling after a single injection (Stage 2).

Burden on patient: Moderate. Patients undergo intratumoural injections that can cause local pain, swelling, and necrosis requiring wound care and follow-up visits. Safety monitoring includes regular clinical assessments and laboratory tests. Pharmacokinetic sampling within the first 24 hours after the initial dose entails multiple blood draws and likely at least one prolonged on-site visit. Imaging at 3 and 6 months and protocol tumor biopsies for microenvironment and immune analyses (including potential biopsies of injected and non-injected lesions) add procedural burden and travel. Overall intensity is higher than standard surveillance due to procedures, PK draws, and translational biopsies, but treatment is localized and systemic therapy is not mandated within the study, which may mitigate systemic toxicity-related burden.

Last updated: Oct 2025

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Memorial Sloan Kettering Cancer Centre

New York, New York, 10065, United States

No email / No phone

Status: Recruiting

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