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    Clinical Trial Results:
    A Phase 2, Multicenter, Open-label, Single-arm Study of AL101 Monotherapy in Patients with Notch-activated Triple Negative Breast Cancer

    Summary
    EudraCT number
    2020-001979-33
    Trial protocol
    GB   FR  
    Global end of trial date
    23 Mar 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Feb 2024
    First version publication date
    15 Feb 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    AL-TNBC-01
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04461600
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Ayala Pharmaceuticals, Inc.
    Sponsor organisation address
    Oppenheimer 4, Rehovot, Israel, 7670104
    Public contact
    Clinical Trial Information, Ayala Pharmaceuticals, Inc., clinicaltrials@ayalapharma.com
    Scientific contact
    Clinical Trial Information, Ayala Pharmaceuticals, Inc., clinicaltrials@ayalapharma.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    09 Sep 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    23 Mar 2022
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy of AL101 monotherapy in subjects with Notch-activated recurrent or metastatic TNBC
    Protection of trial subjects
    1. Hepatic function will be closely monitored throughout the study. 2. Signs and symptoms of colitis will be closely monitored. 3. In case of a Grade 3 or 4 allergic reaction, IP infusion will be stopped and infusion tubing from the subject will be disconnected. Glucocorticoids may be administered to treat infusion reactions and as premedication to prevent further reactions. 4. Subjects will be closely monitored for skin changes throughout the study. Subjects will be counseled to avoid excessive sun and UV exposure during the study.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    15 Dec 2020
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 5
    Country: Number of subjects enrolled
    Belgium: 1
    Country: Number of subjects enrolled
    Israel: 2
    Country: Number of subjects enrolled
    United States: 10
    Worldwide total number of subjects
    18
    EEA total number of subjects
    6
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    16
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Recruitment was conducted between January 2021 to March 2022 in 4 countries: Spain, Belgium, Israel and USA.

    Pre-assignment
    Screening details
    Patient must be at least 18 years old, have at least one measurable lesion, FFPE tissue available from a metastatic lesion, documented tumor progression following no more than 3 lines of therapy, histologically confirmed diagnosis of TNBC and documented Notch activation from tumor biopsy results from within the last 2 years

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    AL101 6mg
    Arm description
    This is a lead-in cohort with 6 subjects to ascertain the safety of AL101, 6 mg weekly (QW) intravenously (IV).
    Arm type
    Experimental

    Investigational medicinal product name
    AL101
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    6mg of AL101 was administered using an IV infusion pump over 60 minutes, once a week.

    Arm title
    AL101 4mg
    Arm description
    AL101, 4 mg weekly (QW) intravenously (IV).
    Arm type
    Experimental

    Investigational medicinal product name
    AL101
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    4mg of AL101 was administered using an IV infusion pump over 60 minutes, once a week.

    Number of subjects in period 1
    AL101 6mg AL101 4mg
    Started
    6
    12
    Completed
    0
    6
    Not completed
    6
    6
         Consent withdrawn by subject
    1
    -
         Death
    5
    6

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    AL101 6mg
    Reporting group description
    This is a lead-in cohort with 6 subjects to ascertain the safety of AL101, 6 mg weekly (QW) intravenously (IV).

    Reporting group title
    AL101 4mg
    Reporting group description
    AL101, 4 mg weekly (QW) intravenously (IV).

    Reporting group values
    AL101 6mg AL101 4mg Total
    Number of subjects
    6 12 18
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    6 11 17
        From 65-84 years
    0 0 0
        Above 85
    0 1 1
    Age continuous
    Units: years
        median (full range (min-max))
    45 (36 to 55) 48 (30 to 87) -
    Gender categorical
    Units: Subjects
        Female
    6 12 18
        Male
    0 0 0
    Race
    Units: Subjects
        Asian
    0 1 1
        Black or African American
    1 0 1
        White
    5 9 14
        Unknown or Not Reported
    0 2 2

    End points

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    End points reporting groups
    Reporting group title
    AL101 6mg
    Reporting group description
    This is a lead-in cohort with 6 subjects to ascertain the safety of AL101, 6 mg weekly (QW) intravenously (IV).

    Reporting group title
    AL101 4mg
    Reporting group description
    AL101, 4 mg weekly (QW) intravenously (IV).

    Primary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR) [1]
    End point description
    RR is defined as partial response (PR) + complete response (CR) as assessed by the investigator based on Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 for target lesions assessed by MRI. Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
    End point type
    Primary
    End point timeframe
    12 months
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The study was terminated prematurely and SAP was not finalized.
    End point values
    AL101 6mg AL101 4mg
    Number of subjects analysed
    3
    10
    Units: Participants
    0
    0
    No statistical analyses for this end point

    Secondary: Clinical Benefit Response Rate (CBR)

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    End point title
    Clinical Benefit Response Rate (CBR)
    End point description
    Clinical benefit response rate (CBR) is defined as complete response (CR) + partial response (PR) + stable disease (SD) by investigator review based on RECIST v1.1 for target lesions assessed by MRI. Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Stable Disease (SD): Neither sufficient shrinkage (at least 30%) to qualify for PR nor sufficient increase (more than 20%) to qualify for PD, taking as reference the smallest sum diameters.
    End point type
    Secondary
    End point timeframe
    12 months
    End point values
    AL101 6mg AL101 4mg
    Number of subjects analysed
    3
    10
    Units: Participants
    1
    3
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR)

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    End point title
    Duration of Response (DOR)
    End point description
    End point type
    Secondary
    End point timeframe
    Duration of response (DOR) is defined as the time from randomization to disease progression or death in patients who achieve complete or partial response.
    End point values
    AL101 6mg AL101 4mg
    Number of subjects analysed
    0 [2]
    0 [3]
    Units: month
        number (not applicable)
    Notes
    [2] - Duration of response data was not collected as there were no patients with either CR or PR.
    [3] - Duration of response data was not collected as there were no patients with either CR or PR.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    1 year and 3 months
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23
    Reporting groups
    Reporting group title
    AL101 6mg
    Reporting group description
    This is a lead-in cohort with 6 subjects to ascertain the safety of AL101, 6 mg weekly (QW) intravenously (IV).

    Reporting group title
    AL101 4mg
    Reporting group description
    AL101, 4 mg weekly (QW) intravenously (IV).

    Serious adverse events
    AL101 6mg AL101 4mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 6 (83.33%)
    2 / 12 (16.67%)
         number of deaths (all causes)
    5
    6
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Breast cancer metastatic
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Metastases to lung
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cardiac disorders
    Cardiac arrest
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory failure
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash maculo-papular
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bone pain
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    AL101 6mg AL101 4mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    6 / 6 (100.00%)
    12 / 12 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Cancer pain
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Flushing
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Hot flush
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    0 / 6 (0.00%)
    4 / 12 (33.33%)
         occurrences all number
    0
    8
    Chest pain
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Chills
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    2
    Device related thrombosis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Face oedema
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Fatigue
         subjects affected / exposed
    2 / 6 (33.33%)
    5 / 12 (41.67%)
         occurrences all number
    2
    9
    Gait disturbance
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Influenza like illness
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    2
    Localised oedema
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    2
    Mucosal dryness
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Mucosal inflammation
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    2
    Non-cardiac chest pain
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Pain
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    3
    Pyrexia
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 12 (25.00%)
         occurrences all number
    0
    3
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    2 / 6 (33.33%)
    3 / 12 (25.00%)
         occurrences all number
    2
    6
    Dry throat
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Dysphonia
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    2
    1
    Dyspnoea
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    3
    Epistaxis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Lower respiratory tract congestion
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Nasal congestion
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    3
    Nasal dryness
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 12 (16.67%)
         occurrences all number
    1
    3
    Oropharyngeal pain
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 12 (16.67%)
         occurrences all number
    1
    2
    Pleural effusion
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Productive cough
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Sneezing
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Upper-airway cough syndrome
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    2
    Psychiatric disorders
    Agitation
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Anxiety
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Insomnia
         subjects affected / exposed
    2 / 6 (33.33%)
    3 / 12 (25.00%)
         occurrences all number
    2
    4
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 12 (16.67%)
         occurrences all number
    3
    5
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 12 (16.67%)
         occurrences all number
    2
    8
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    1
    3
    Blood bilirubin increased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Blood creatine increased
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Blood phosphorus decreased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Blood potassium decreased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Blood triglycerides increased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Lymphocyte count decreased
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    4
    Neutrophil count decreased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Platelet count decreased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    2
    Transaminases increased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    2
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Palpitations
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Nervous system disorders
    Anosmia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Cerebral haemorrhage
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Dizziness
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 12 (25.00%)
         occurrences all number
    0
    3
    Dysgeusia
         subjects affected / exposed
    2 / 6 (33.33%)
    6 / 12 (50.00%)
         occurrences all number
    4
    8
    Dystonia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Headache
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    2
    Taste disorder
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Blood and lymphatic system disorders
    Lymph node pain
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Anaemia
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 12 (25.00%)
         occurrences all number
    0
    4
    Eye disorders
    Photophobia
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Dry eye
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    1
    4
    Abdominal pain
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    1
    2
    Abdominal pain upper
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 12 (16.67%)
         occurrences all number
    1
    2
    Constipation
         subjects affected / exposed
    2 / 6 (33.33%)
    1 / 12 (8.33%)
         occurrences all number
    2
    1
    Diarrhoea
         subjects affected / exposed
    5 / 6 (83.33%)
    5 / 12 (41.67%)
         occurrences all number
    10
    8
    Dry mouth
         subjects affected / exposed
    1 / 6 (16.67%)
    3 / 12 (25.00%)
         occurrences all number
    1
    4
    Dyspepsia
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    2
    Eructation
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Flatulence
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    2
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    1
    1
    Nausea
         subjects affected / exposed
    3 / 6 (50.00%)
    5 / 12 (41.67%)
         occurrences all number
    3
    10
    Odynophagia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    2
    Stomatitis
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    3
    2
    Vomiting
         subjects affected / exposed
    2 / 6 (33.33%)
    3 / 12 (25.00%)
         occurrences all number
    5
    3
    Skin and subcutaneous tissue disorders
    Dermatitis acneiform
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    1
    2
    Hyperhidrosis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Night sweats
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    1
    1
    Rash
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 12 (16.67%)
         occurrences all number
    1
    2
    Rash maculo-papular
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Skin odour abnormal
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Urinary incontinence
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Endocrine disorders
    Cushing's syndrome
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 12 (16.67%)
         occurrences all number
    2
    5
    Back pain
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 12 (16.67%)
         occurrences all number
    3
    3
    Muscular weakness
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    3
    Musculoskeletal pain
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    1
    2
    Neck pain
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Pain in extremity
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    1
    1
    Infections and infestations
    Acute sinusitis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Bronchitis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Cystitis
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    2
    Oral candidiasis
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Pharyngitis
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 12 (16.67%)
         occurrences all number
    0
    2
    Sinusitis
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Sputum purulent
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    4
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 6 (16.67%)
    3 / 12 (25.00%)
         occurrences all number
    3
    4
    Dehydration
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    2
    0
    Hyperglycaemia
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0
    Hypoalbuminaemia
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    2
    1
    Hypocalcaemia
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 12 (8.33%)
         occurrences all number
    2
    1
    Hypokalaemia
         subjects affected / exposed
    3 / 6 (50.00%)
    1 / 12 (8.33%)
         occurrences all number
    4
    1
    Hyponatraemia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    1
    Hypophosphataemia
         subjects affected / exposed
    3 / 6 (50.00%)
    3 / 12 (25.00%)
         occurrences all number
    4
    3
    Vitamin D deficiency
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 12 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    06 Apr 2020
    1. Modify study population (delete Notch activated endocrine refractory breast cancer). Rationale: Per FDA suggestion, this population may be included in the future once there is sufficient data on the response of subjects with TNBC. 2. Add a lead-in cohort with 6 subjects at dose level 6 mg QW and modify sample size. Rationale: Per FDA request, as a safety precaution, to allow safety evaluation of 6 mg QW in 6 subjects before proceeding to enroll the rest of the subjects. 3. Add PK assessment per FDA request. 4.Replace triglyceride with complete lipid panel as a safety precaution.
    12 Aug 2020
    1. Delete reference to ‘Early Discontinuation’. In this study end of study and early discontinuation are synonymous. 2. Update exclusion criterion 11f (creatinine) -creatinine clearance (CrCl) <50 mL/min (calculation of CrCl will be based on acceptable institution standard). Rationale: Allow inclusion based on normal creatinine values, as well as sufficient GFR, as AL101 is not expected to impact renal function. 3. Introduce change in regimen (2 weeks on / 1 week of) for first episode of Grade 2 or 3 diarrhea and Grade 2 Colitis before dose reduction on subsequent episodes. Rationale: To allow investigators to use a 2 weeks on 1 weeks off regime at 6 mg QW, before implementing dose reduction. The aim is to introduce a scheduled dose interruption to prevent recurrence of toxicity.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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