Investigation of the Anti-tumor Effect of 2X-121 in Patients With Recurrent, Advanced Ovarian Cancer (PREDICT 2X-121)

Phase 2, Randomized, Prospective, Open-Label, Parallel-Arm, Dose Optimization Study to Investigate the Safety, Tolerability, PK/PD, and Anti- Tumor Effect of 2X-121 in Patients With Recurrent, Advanced Ovarian Cancer.

The purpose of this study is to evaluate the optimal dose of 2X-121 as single agent therapy at 600 mg daily (split BID 200 mg morning + 400 mg evening) compared to 800 mg daily (split BID 400 mg morning + 400 mg evening) in recurrent, advanced ovarian cancer patients that have platinum-resistant disease, defined as progression within 6 months after the last dose of platinum-based chemotherapy, or are platinum ineligible. The optimal dose will be selected based on an integrated analysis of PK/PD, safety, and efficacy data.

Study Overview

• Status: Recruiting
• Conditions: Advanced Ovarian Cancer
• Intervention / Treatment: Drug: 2X-121; Drug: 2X-121

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Kush Dhody, MD, MS; Phone Number: +1-301-528-7000 ext. 716; Email: kushd@amarexcro.com

Study Locations

• United States
  • Oklahoma
    • Oklahoma City, Oklahoma, United States, 73104
      • Recruiting
      • OU Health Stephenson Cancer
      • Principal Investigator: Kathleen Moore, MD
      • Contact: Christine Pappaterra; Phone Number: 405-271-8707; Email: Christine-Pappaterra@ouhsc.edu
  • Washington
    • Seattle, Washington, United States, 98122
      • Recruiting
      • Swedish Center for Research and Innovation
      • Principal Investigator: Fernanda Baptista Musa, MD
      • Contact: Karina Sills; Phone Number: 1.206.386.2227; Email: karina.sills@swedish.org

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Signed informed consent form.
2. Age 18 years or older.
3. Histologically or cytologically documented epithelial ovarian, fallopian tube, or primary peritoneal tumors, with high-grade serous or endometrioid, or predominantly serous/endometrioid histology (independent of BRCA1 and HRD status).
4. Patients must have platinum-resistant disease, defined as progression within 6 months after the last dose of platinum-based chemotherapy, or are platinum ineligible.
5. Patients have received no more than one line of therapy in the platinum resistant or platinum ineligible setting. Note: Prior ADCs therapy (e.g., Elahere) will not count towards this previous line of therapy.
6. Measurable disease by CT scan or MRI. Note: Baseline tumor assessment will be performed within 4 weeks prior to Day 1 Cycle 1
7. Performance status of ECOG ≤ 1.
8. Patients must have a life expectancy of >16 weeks.
9. Recovered to Grade 1 or less from prior surgery or acute toxicities of prior radiotherapy, or treatment with cytotoxic, hormonal, or biologic agents.

10. Adequate conditions as evidenced by the following clinical laboratory values:

    1. Absolute neutrophils count (ANC) ≥ 1.5 x 103 μL
    2. Hemoglobin > 9.0 g/dL
    3. Platelets ≥ 100 x 103 μL
    4. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase ≤ 2.5 x ULN, unless liver metastases are present, in which case they must be ≤5 x ULN
    5. Serum bilirubin ≤ 1.5 ULN
    6. Creatinine ≤ 1.5 ULN
    7. Blood urea nitrogen (BUN) ≤2X ULN.
11. FFPE tumor tissue should be available from the current relapse, if obtainable, otherwise the most recent archival tumor tissue. Note: Patients treated with a PARP inhibitor must have a new biopsy unless there is an archival biopsy that was done after the PARP inhibitor treatment was discontinued.
12. Negative serum pregnancy test in women of childbearing potential (WOCBP). WOCBP is defined as premenopausal women or less than 12 months of amenorrhea post-menopause, and women who have not undergone surgical sterilization or hysterectomy or bilateral salpingo-oophorectomy.
13. Sexually active females of childbearing potential must use adequate contraception (oral contraceptives, intrauterine device or barrier method of contraception) for the study duration and at least six months afterwards.

Exclusion Criteria:

1. Patients who have platinum-refractory disease, defined as progression during the last platinum-based chemotherapy.
2. Concurrent chemotherapy, antibody therapies radiotherapy,hormonal therapy, or other investigational drug except non-disease related conditions (e.g. insulin for diabetes) during study period.
3. Other malignancy with exception of any stage I and II cancer that is deemed cured by the Investigator.
4. Any active infection requiring parenteral or oral antibiotic treatment.
5. Known HIV positivity.
6. Known active hepatitis B or C.

7. Clinically significant cardiovascular disease:

   1. Stroke within ≤ 12 months prior to day 1
   2. Transient ischemic attach (TIA) within ≤ 12 months prior to day 1
   3. Myocardial infarction within ≤ 12 months prior to day 1
   4. Unstable angina
   5. New York Heart Association (NYHA) Class II or greater congestive heart failure (CHF)
   6. Uncontrolled cardiac arrhythmia requiring medication
8. Other medications or conditions that in the Investigator's opinion would contraindicate study participation for safety reasons or interfere with the interpretation of study results.
9. Inability to take oral medication, or malabsorption syndrome or any other uncontrolled gastrointestinal condition (e.g., nausea, diarrhea, or vomiting) that might impair the bioavailability of 2X-121.
10. Requiring immediate palliative treatment of any kind including surgery and/or radiotherapy.
11. Patients unable to be regularly followed for any reason (geographic, familiar, social, psychological, housed in an institution e.g., prison because of a court agreement or administrative order).
12. Patients, who are close colleagues, associates, or family members of, or in any way dependent on the sponsor or the investigator.
13. Ascites requiring drainage >500cc in the 2 weeks prior to enrolment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Drug: 2X-121 600 mg; 2X-121 will be administered daily as 600 mg (200 mg 2X-121 morning dose + 400 mg (2 x 200 mg) 2X-121 evening dose) hard gelatin capsules in a 28 days cycle.	Drug: 2X-121; 2X-121 will be administered daily as 600 mg (200 mg 2X-121 morning dose + 400 mg (2 x 200 mg) 2X-121 evening dose) hard gelatin capsules in a 28 days cycle.; Other Names: E7449, MGI25036; Drug: 2X-121; 2X-121 will be administered daily as 800 mg (400 mg (2 x 200 mg) 2X-121 morning dose + 400 mg (2 x 200 mg) 2X-121 evening dose) hard gelatin capsules in a 28 days cycle.
Experimental: Drug: 2X-121 800 mg; 2X-121 will be administered 800 mg (400 mg (2 x 200 mg) 2X-121 morning dose + 400 mg (2 x 200 mg) 2X-121 evening dose) hard gelatin capsules in a 28 days cycle.	Drug: 2X-121; 2X-121 will be administered daily as 600 mg (200 mg 2X-121 morning dose + 400 mg (2 x 200 mg) 2X-121 evening dose) hard gelatin capsules in a 28 days cycle.; Other Names: E7449, MGI25036; Drug: 2X-121; 2X-121 will be administered daily as 800 mg (400 mg (2 x 200 mg) 2X-121 morning dose + 400 mg (2 x 200 mg) 2X-121 evening dose) hard gelatin capsules in a 28 days cycle.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluate the optimal dose of 2X-121 as single agent therapy	To evaluate the optimal dose of 2X-121 as single agent therapy at 600 mg daily compared to 800 mg daily.	From enrollment up to approximately 2 years

Secondary Outcome Measures

Outcome Measure	Time Frame
Clinical benefit rate (CBR)	From enrollment up to approximately 2 years
Progression free survival	From enrollment up to approximately 2 years
Overall survival	From enrollment up to approximately 2 years
Evaluate disease control rate (DCR)	At baseline and start of each cycle, up to approximately 2 years
Evaluate objective response rate (ORR)	From enrollment up to approximately 2 years

Collaborators and Investigators

• Sponsor: Allarity Therapeutics
• Collaborators: Amarex Clinical Research; Alcedis GmbH

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2019
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): September 1, 2027

Study Registration Dates

• First Submitted: March 8, 2019
• First Submitted That Met QC Criteria: March 14, 2019
• First Posted (Actual): March 18, 2019

Study Record Updates

• Last Update Posted (Estimated): August 28, 2025
• Last Update Submitted That Met QC Criteria: August 22, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Genital Diseases; Endocrine System Diseases; Urogenital Neoplasms; Neoplasms by Site; Neoplasms; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Neoplasms by Histologic Type; Genital Diseases, Female; Endocrine Gland Neoplasms; Neoplasms, Glandular and Epithelial; Ovarian Diseases; Adnexal Diseases; Genital Neoplasms, Female; Gonadal Disorders; Carcinoma; Carcinoma, Ovarian Epithelial; Ovarian Neoplasms; stenoparib
• Other Study ID Numbers: (PARPi) 2X-1002; 2020-000539-31 (EudraCT Number)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No