Inclusion Criteria:
Phase I and Phase II
1. Adult (male or female) aged ≥18 years.
2. Signed informed consent prior to any study-specific procedures.
3. Patients who are willing to make themselves available for the duration of the study
and are willing to follow study procedures.
4. Have a performance status on the Eastern Cooperative Oncology Group (ECOG) scale of:
Phase I
- - 0 or 1; Phase II - 0-2.
5. Have an estimated life expectancy of ≥12 weeks.
6. Have adequate organ function including:
a. Hematologic:
- - Platelets ≥100 x 109/L.
Hepatic:
- - Bilirubin ≤1.5 times upper limit of normal (ULN)
- ALT and AST ≤2.5 x ULN.
If the liver has tumor involvement, AST and ALT ≤5 x
ULN are acceptable.
c. Renal:
- - Estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 d.
Blood
coagulation:
- - International Normalized Ratio (INR) or activated partial prothrombin time
(aPTT) <1.5 x ULN and > 0.8 x LLN lower limit of normal (LLN).
7. Have discontinued all chemotherapy, investigational therapy, molecularly targeted
therapy, and cancer-related hormonal therapy at least 30 days prior to study
enrollment (6 weeks for mitomycin-C or nitrosoureas).
8. Have discontinued biologic therapy and immunotherapy at least 21 days prior to study
enrollment.
9. Patients who have had radiation therapy must be fully recovered in the opinion of
the investigator prior to enrolling on study.
10. Are recovered or recovering from the acute adverse effects of any chemotherapy,
biologic therapy, immunotherapy, molecularly-targeted therapy, cancer-related
hormonal therapy, and investigational therapy (≤Grade 1 or baseline), with the
exception of alopecia or Grade 2 neuropathy.
11. Have received at least 1 but no more than 4 prior systemic therapies for CLL.
12. Patients who have had surgery must be fully recovered in the opinion of the
investigator prior to enrolling on study (but not less than 28 days for major
surgery and 14 days for minor surgery).
13. Female patients with reproductive potential must agree to use 2 forms of highly
effective contraception during the study and for at least 3 months following the
last dose of IMP. Sexually active male patients must use a barrier method of
contraception (condom) during the study and for at least 3 months following the last
dose of IMP.
14. Females with child-bearing potential must have had a negative pregnancy test result
≤28 days prior to the first dose of IMP, as well as ≤1 day prior to the first dose
of IMP.
15. Patients must be, in the judgment of the investigator, appropriate candidates for
experimental therapy, and no standard therapy would confer clinical benefit to the
patients.
16. Patients must have at least one lesion that is measurable by RECIST v.1.1.
Phase I 17. Patients must have histologically proven evidence of any type of metastatic
solid tumor (excluding primary brain tumor) that is evaluable and for whom no approved
therapy with demonstrated clinical benefit is available or patients who are intolerant or
have declined standard therapy.
Phase II 18. Patients must have histologically proven evidence of a solid tumor that is
locally advanced and/or metastatic and for whom no approved therapy with demonstrated
clinical benefit is available or patients who are intolerant or have declined standard
therapy as follows:
1. Cutaneous melanoma. 2. Prostate cancer. 3. Pancreatic cancer.Phase II
1. Adult (male or female) aged ≥18 years.
2. Signed informed consent prior to any study-specific procedures.
3. Patients who are willing to make themselves available for the duration of the study
and are willing to follow study procedures.
4. Subjects with confirmed diagnosis of per iwCLL 2008.
5. Documented disease progression that meets at least one of the iwCLL criteria for
requiring treatment.
6. Measurable disease defined by either absolute lymphocyte count (ALC ≥ 5 x 109/L) or
nodal lesion by computed tomography (CT).
7. Have a performance status on the Eastern Cooperative Oncology Group (ECOG) scale ≤
2.
8. Have an estimated life expectancy of ≥16 weeks.
9. Have adequate organ function including:
a. Adequate hematologic function in the absence of transfusions (within 6 weeks
prior to first dose of study medication) and independent of growth factor support
for at least 7 days with the exception of pegylated G-CSF which requires at least 14
days, defined as:
- - Platelets ≥50 x 109/L or ≥ 25 × 109/L if thrombocytopenia is related to CLL b.
Hepatic:
Subjects with known Gilbert's Syndrome or disease-related
hemolysis must have a total bilirubin ≤ 3 x ULN.
- - ALT and AST ≤2.5 x ULN.
c. Renal:
- - Estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 d.
Blood
coagulation:
- - International Normalized Ratio (INR) or activated partial prothrombin time
(aPTT) <1.5 x ULN and > 0.8 x LLN.
10. Have discontinued all chemotherapy, immunotherapy, investigational therapy, biologic
therapy, molecularly targeted therapy, and cancer-related hormonal therapy at least
30 days prior to study enrollment (6 weeks for mitomycin-C or nitrosoureas).
11. Are recovered or recovering from the acute adverse effects of any chemotherapy,
biologic therapy, immunotherapy, molecularly targeted therapy, cancer-related
hormonal therapy, and investigational therapy (≤Grade 1 or baseline), with the
exception of alopecia or Grade 2 neuropathy.
12. The subject must also agree to pretreatment and on-treatment bone marrow aspirates.
13. Have received at least 1, but not more than 3 prior lines of therapy according to
current guidelines.
14. Patients who have had surgery must be fully recovered in the opinion of the
investigator prior to enrolling on study (but not less than 28 days for major
surgery and 14 days for minor surgery).
15. Female patients with reproductive potential must agree to use 2 forms of highly
effective contraception during the study and for at least 3 months following the
last dose of IMP. Sexually active male patients must use a barrier method of
contraception (condom) during the study and for at least 3 months following the last
dose of IMP.
16. Females with child-bearing potential must have had a negative pregnancy test result
≤28 days prior to the first dose of IMP, as well as ≤1 day prior to the first dose
of IMP.
17. Patients must be, in the judgment of the investigator, appropriate candidates for
experimental therapy, and no standard therapy would confer clinical benefit to the
patients.
Exclusion Criteria:
1. Have another tumor of another location except basal cell carcinoma.
2. Have a history of organ transplant (e.g., heart, lungs, liver, bone marrow, or
kidney).
3. Females who are pregnant or breastfeeding.
4. Have symptomatic human immunodeficiency virus (HIV) infection, known HIV positive
test results or have chronic active hepatitis B or C (screening is not required).
5. Positive COVID-19 test or signs of coronavirus infections.
6. Have clinically significant cardiac disease including any of the following:
- - A history of congenital long QT syndrome, symptomatic bradycardia, ventricular
arrhythmia, uncontrolled atrial fibrillation, second- or third-degree heart
block, or other conduction abnormality that in the opinion of the investigator
would preclude safe participation in this study.
- - Congestive heart failure (New York Heart Association Class ≥3).
- - Unstable angina pectoris, acute myocardial infarction, or stroke ≤12 months
prior to enrollment.
- - QTcF prolongation >450 msec.
7. Currently taking medication known to prolong the QT interval or induce TdP, which
cannot be discontinued or substituted.
8. Uncontrolled type 1 or 2 diabetes with high risk of hypoglycemia.
9. Are a family member of the investigator or staff of the study site.
10. Are currently enrolled in another interventional clinical study of an
investigational therapy.
11. Hypersensitivity to any components of KLS-1. Additional exclusion criterion for
patients enrolled in Phase II to CLL cohort. 12. History of Richter's transformation or prolymphocytic leukemia.
