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 lesions and overall disease control in Stage 2, along with safety, pharmacokinetics, and exploratory immunologic and microenvironmental effects.

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 injectable lesion accessible by palpation or ultrasound guidance. ECOG 0–2, life expectancy >12 weeks, adequate hepatic/renal function. Excludes lesions abutting major vessels, recent major surgery, recent systemic anticancer therapy or investigational agents without adequate washout, planned local therapies to injected lesions, active brain metastases or carcinomatous meningitis (treated/stable allowed), significant bleeding risk, and severe hypersensitivity to study drug/excipients.

Design: Phase IIa, single‑arm, open‑label study with two stages. Allocation is not applicable. Approximately 40 patients will receive intratumoural therapy with predefined assessments at 3 and 6 months for efficacy (RECIST in Stage 2) and 6 months for local ablation and safety.

Treatments: Intratumoural tigilanol tiglate administered as single or multiple injections up to a fixed dose of 3.6 mg/m2 per treatment. Tigilanol tiglate (EBC‑46) is a plant‑derived small molecule and potent modulator of protein kinase C that causes rapid, PKC‑dependent vascular disruption and hemorrhagic necrosis leading to local tumor ablation; preclinical and early clinical data suggest immunogenic cell death and immune infiltration. In a first‑in‑human pan‑tumor Phase I study, responses were observed including complete responses, and dose was escalated without reaching a maximum tolerated dose at or below 3.6 mg/m2. Company communications from Stage 1 of this sarcoma program report high rates of ablation in injected tumors with predominantly local, mechanism‑consistent toxicities; peer‑reviewed confirmation is pending.

Outcomes: Primary: proportion of participants achieving partial or complete ablation of treated tumors/tumor segments at 6 months; in Stage 2, overall objective response rate by RECIST v1.1 at 3 and 6 months. Secondary: incidence of AEs/SAEs and relatedness; systemic exposure via PK after a single injection up to 24 hours. Exploratory: changes in tumor microenvironment and immune infiltration in injected and/or non‑injected tumors, PBMC immunologic assessments, local recurrence rate 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, necrosis, and wound care needs. Safety monitoring and standard imaging at baseline and at 3 and 6 months are required. Stage 2 includes paired tumor biopsies to assess microenvironmental changes, adding procedure‑related visits and risks. Pharmacokinetic sampling occurs over the first 24 hours after the initial dose, necessitating extended on‑site time or an inpatient/observation period with multiple blood draws. Additional blood collections for immune monitoring and follow‑up visits through 6 months increase visit frequency beyond typical palliative sarcoma care. Travel demands will vary with injection schedule and follow‑up, but overall intensity is less than cytotoxic regimens yet higher than purely observational protocols due to procedures, PK, and biopsies.

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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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