An Exploratory Biomarker Study of ARQ 501 in Patients With Advanced Solid Tumors

ARQ 501 is an investigational anticancer agent that consists of a fully synthetic small molecule version of β-lapachone (3,4-dihydro-2,2-dimethyl-2H-naphtho[1,2-b]pyran-5,6-dione) in a stable formulation for intravenous (IV) administration. ARQ 501 selectively induces apoptosis in cancer cells by the direct activation of the cellular checkpoints without damaging deoxyribonucleic acid (DNA) or microtubules. This therapeutic approach is known as Activated Checkpoint Therapy (ACT)sm. ACTsm is a novel strategy for treating and preventing cancers. Cell cycle checkpoints constitute an internal surveillance system that detects cellular, especially genetic, damage and either allows the cells to repair the damage, or induces apoptosis when damage is not repairable. Cancer cells are selectively eliminated upon checkpoint activation due to presence of irreparable DNA damage. It is believed that the rapid and selective induction of apoptosis in cancer cells by ARQ 501 is caused by a correspondingly rapid and sustained increase of the pro-apoptotic protein E2F1.

Preclinical studies have shown that exposure to ARQ 501 results in the activation or inactivation of a panel of 5 biomarkers. Time course changes in human tumor xenograft biomakers in athymic mice after exposure to ARQ 501 can be classified into 3 biomarker groups: those that changed shortly after exposure and returned to normal within 24 hours; those that changed shortly after exposure and remained for 24 hours or longer; and those that changed after 24 hours or later.

The primary objective is to evaluate the response of biomarkers in patients treated with ARQ 501. The exploratory study will help to illuminate the pharmacodynamics of these biomarkers, their roles in the cancer growth control, and their potential predictive or prognostic values for the disease and treatment of ARQ 501 in humans.

Inclusion criteria

• Able to provide signed and dated informed consent prior to study-specific screening procedures.
• Patients must have histologically or cytologically confirmed advanced solid tumor(s).
• Measurable disease as defined by RECIST (see Section 9.0).
• Patients must have Karnofsky performance status (KPS) ≥ 70%.
• Male or female patients of child-producing potential must agree to contraception or avoidance of pregnancy measures during the study and for 30 days after the infusion of ARQ 501.
• Females of childbearing potential must have a negative serum pregnancy test within seven days prior to the administration of study drug.
• ≥ 18 years old.
• Hemoglobin ≥ 10 g/dL
• Absolute neutrophil count (ANC) ≥ 1.5 x 10 9/L (≥1,500/mm3).
• Platelets ≥ 100 x 10 9/L (≥ 100,000/mm3).
• Total bilirubin ≤ 1.5 x upper limit of normal (ULN) or ≤ 3.0 x ULN with metastatic liver disease.
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN or ≤ 5.0 x ULN with metastatic liver disease.
• Creatinine ≤ 1.5 × ULN

Exclusion criteria

• Active, uncontrolled systemic infection considered opportunistic, life threatening or clinically significant at the time of treatment
• Received anticancer chemotherapy, immunotherapy, radiotherapy, surgery or investigational agents within four weeks of first infusion
• Symptomatic or untreated central nervous system (CNS) involvement
• Previous exposure to ARQ 501