A Safety and Pharmacokinetics Study of RC220 Combined With Doxorubicin in Adult Participants With Solid Tumours.

A Two-part Phase 1 Open-label Safety and Pharmacokinetic Study of Intravenous RC220 in Combination With Doxorubicin in Adult Patients With Solid Tumours.

This is a multi-centre, two-part, open-label, phase 1, first in human study of multiple ascending doses of RC220 bisantrene formulation alone and in combination with fixed dose doxorubicin to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) in adult patients with locally advanced unresectable or metastatic solid tumours where doxorubicin may be considered as a treatment option / or is indicated.

The study will consist of two parts: Part 1 - This part involves a fixed-dose doxorubicin (60 mg/m2) tolerability lead-in period, followed by dose-escalating doses of IV RC220 alone, and in combination, with fixed dose doxorubicin, to determine the maximum tolerated combined dose (MTCD) of RC220 with doxorubicin to be evaluated in Part 2. This dose-expansion cohort will enrol patients with solid tumours that are anthracycline treatment naïve and for whom treatment with doxorubicin is indicated. The objective of Part 2 will be to confirm the safety and tolerability and evaluate the preliminary cardioprotective and anti-tumour efficacy of the maximum tolerated combined dose (MTCD) of RC220 with doxorubicin.

Study Overview

• Status: Recruiting
• Conditions: Solid Tumours; Advanced Solid Tumours
• Intervention / Treatment: Drug: RC220; Drug: Doxorubicin (Adriamycin)

Detailed Description

This study is an open-label, Phase 1 dose escalation trial with expansion cohort to investigate the safety, tolerability, pharmacokinetics, pharmacodynamics and preliminary cardioprotective and antitumor activity of RC220 in combination with doxorubicin in patients with advanced solid tumours.

The study is divided into two parts:

Dose escalation (Part 1), and dose expansion (Part 2).

In Part 1(Dose Escalation), patients with locally advanced unresectable or metastatic solid tumours, where doxorubicin may be considered as a treatment option and/or is indicated will be enrolled. An initial fixed-dose doxorubicin (60 mg/m2) monotherapy 21-day cycle (cycle M1) will be conducted to confirm each patient's tolerability. Patients will be monitored for safety and tolerability, and samples will be collected for PK and PDx biomarker analysis.

Patients who meet the safety and tolerability criteria during cycle M1 will proceed to the RC220 monotherapy lead-in 21-day cycle (cycle M2).

Patients who are unable to tolerate 60 mg/m2 doxorubicin will not be eligible for the study, and those who received a doxorubicin containing regimen of ≥ 60 mg/m2 within 3 months prior to screening, may proceed directly to the RC220 monotherapy lead-in cycle.

During Cycle M2, each patient in a dose cohort will receive an intravenous (IV) infusion of RC220 on Day 1 of the lead-in 21-day cycle. Upon confirmation of safety and tolerability to the RC220 dose, patients will continue to the combination cycle, where patients will receive IV RC220 (at the same dose) followed by IV doxorubicin on Day 1 of a 21-day cycle.

New patients will be enrolled in each dose escalation cohort based on safety observed during the first 21 days of RC220 and doxorubicin combination treatment Cycle 1 until the MTCD is defined based on the recommendations of the Safety Review Committee (SRC). Patients will continue to be treated beyond the first combination cycle observation period until disease progression, unacceptable toxicity, withdrawal of consent or defined end of study, whichever occurs first.

An interim analysis of Part 1 may be undertaken after the last patient in the dose escalation (Part 1) has completed their end-of-study visit.

Part 2 of the study will evaluate the MTCD of RC220 in combination with doxorubicin in an exploratory expanded cohort of patients to assess the cardioprotective and anti-tumour efficacy in patients with solid tumours that are anthracycline treatment naïve and for whom treatment with doxorubicin is indicated.

• Study Type: Interventional
• Enrollment (Estimated): 53
• Phase: Phase 1

Contacts and Locations

• Study Contact: Name: Marinella Messina; Phone Number: +61 480 258 306; Email: marinella.messina@racuraoncology.com
• Study Contact Backup: Name: Corli Merry; Email: corli.merry@racuraoncology.com

Study Locations

• Australia
  • New South Wales
    • Gosford, New South Wales, Australia, 2250
      • Recruiting
      • Gosford Hospital
      • Contact: Maree Jarrett; Phone Number: 02 4320 3406; Email: maree.jarrett@health.nsw.gov.au
      • Principal Investigator: Dr. Craig Kukard
    • Miranda, New South Wales, Australia, 2228
      • Recruiting
      • Cancer Care Foundation
      • Principal Investigator: Dr Mahmood Alam
      • Contact: Kareena Young; Phone Number: 02 8556 9377; Email: kyoung@cancercarefoundation.org.au
    • Wyong, New South Wales, Australia, 2259
      • Recruiting
      • Wyong Hospital
      • Contact: Maree Jarrett; Phone Number: 02 4230 3406; Email: maree.jarrett@health.nsw.gov.au
      • Principal Investigator: Dr. Craig Kukard
• Hong Kong
  • Hong Kong, Hong Kong, 999077
    • Recruiting
    • Queen Mary Hospital
    • Contact: Dr. Roland Ching Yu Leung; Phone Number: +852 2255 3111; Email: rolandleung2003@yahoo.com
    • Principal Investigator: Dr. Roland Ching Yu Leung
  • Shatin, Hong Kong
    • Recruiting
    • Prince of Wales Hospital
    • Contact: Dr. Herbert Ho Fung Loong; Phone Number: +852 3505 1042; Email: H_loong@clo.cuhk.edu.hk
    • Principal Investigator: Dr. Herbert Loong
• South Korea
  • Seoul, South Korea
    • Not yet recruiting
    • Ewha Womans University Mokdong Hospital
    • Contact: HyeMin Choi; Phone Number: 82-2-2650-2811; Email: hyemmmmm@naver.com
    • Principal Investigator: Prof. JungMin Jo
  • Seoul, South Korea
    • Not yet recruiting
    • Asan Medical Centre
    • Contact: JiYoung Kang; Phone Number: 010-9984-7275; Email: rkdwldud1004@naver.com
    • Principal Investigator: Prof. JeongEun Kim
  • Seoul, South Korea
    • Not yet recruiting
    • Samsung Medical Centre
    • Contact: EunKyung Park; Phone Number: 82-2-2008-4390; Email: ekek.park@samsung.com
    • Principal Investigator: Prof JungYong Hong
  • Seoul, South Korea
    • Not yet recruiting
    • Severance Hospital, Yonsei University, Health System
    • Contact: YeJi Song; Phone Number: +82-10-2618-7610; Email: YJSONG@yuhs.ac
    • Principal Investigator: HyoSong Kim

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria (For Part 1 and Part 2):

1. Able to give voluntary informed consent and understand the study and are willing to follow and complete all the study required procedures.
2. Aged between 18 years to ≤ 80 years at the time of informed consent. Note: In Korea, only participants aged ≥19 years at the time of informed consent will be enrolled
3. Life expectancy ≥ 3 months.
4. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
5. Have measurable or evaluable disease per RECIST v1.1. The target lesions must not have prior radiation or other locally treated area unless imaging-based progression has been clearly documented following radiation or other local therapy.

6. Adequate haematological, liver, and kidney function as follows:

   a. Bone marrow reserve:

   • Absolute neutrophil count (ANC) ≥ 1.5 × 109/L without growth factor support in the 2 weeks prior to study entry.

   • Haemoglobin ≥ 90 g/L without transfusion and/or without growth factor support in 2 weeks prior to study entry.

   • Platelet count ≥ 100 × 109/L without transfusion in 2 weeks prior to study entry.

     b. Hepatic function:

   • Aspartate aminotransferase (AST), alanine aminotransferase (ALT) < 3 × upper limit of normal (ULN) (≤5 × ULN if liver metastases or hepatic cell carcinoma (HCC)).

     c. Renal function:

   • Serum creatinine < 1.5 × ULN or Serum creatinine clearance (CrCL) > 50 mL/min, as per the Cockcroft-Gault Equation Glomerular Filtration Rate: [(140-age in years) × weight in kg] / (7.2 × serum creatinine in mg/dL) (× 0.85 for females).
7. International normalised ratio (INR) /prothrombin time (PT) < 2 x ULN, activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN.

8. Practice adequate contraceptive measures as per below:

   Female patients must:

   • Be of nonchildbearing potential i.e., surgically sterilised or postmenopausal, or;

   • If of childbearing potential, must have a negative serum pregnancy test at Screening and a negative urine pregnancy test before the first study treatment administration and on Day 1 of each Cycle. They must agree not to attempt to become pregnant, must not donate ova, and must agree to use 2 forms of highly effective contraceptive method between signing consent, during the study, and at least 180 days after the last dose of study drug, OR use 1 form of highly effective contraceptive method, plus an additional barrier method of contraception between signing consent, during the study, and at least 180 days after the last dose of study drug.

   • Women of childbearing potential with same sex partners (abstinence from penile vaginal intercourse) are eligible when this is their preferred and usual lifestyle.

   Male patients must:

   • be willing not to donate sperm and if engaging in sexual intercourse with a female partner who could become pregnant, a willingness to use a condom in addition to having the female partner use a highly effective contraceptive method between signing consent, during the study, and at least 90 days after the last dose of the study treatment.

   PART 1 only - Dose Escalation Specific Inclusion Criteria

9. Histologically/cytologically confirmed, locally advanced unresectable or metastatic solid tumours for whom prior treatments have failed, and where an anthracycline may be considered as a treatment option or is indicated.

10. Adequate Hepatic function as per below:

    • Serum Total bilirubin (TBIL) as per below:

      1. Patients with documented Gilbert's syndrome - baseline TBIL < 3 × ULN,
      2. Patient with either HCC or liver metastases - baseline TBIL < 2 × ULN
      3. All other patients baseline TBIL < 2 × ULN.

PART 2 only - Exploratory Dose Expansion Specific Inclusion Criteria 8. Histologically/cytologically confirmed solid tumours of any stage for which the patient has not received prior treatment with an anthracycline and for whom treatment with doxorubicin is indicated.

9. Adequate Hepatic function as per below:

• Serum TBIL as per below:

1. Patients with documented Gilbert's syndrome - baseline TBIL < 3 × ULN,
2. Patient with either HCC or liver metastases - baseline TBIL < 3 × ULN
3. All other patients baseline TBIL < 2 × ULN.

Exclusion Criteria (for Part 1 and Part 2):

1. Females who are pregnant or nursing.

2. Received cancer-directed therapy within the following timeframes:

   1. Antitumour therapy (chemotherapy, antibody therapy, molecular targeted therapy, hormonal therapy or investigational agent) within 28 days prior to the first dose of study treatment (or 5 times the half-life if shorter than 28 days, there can be exceptions on a case-by-case as approved by Study Medical Monitor based on pharmacology). Note: concurrent use of hormone deprivation therapy for hormone-refractory prostate cancer, bisphosphonate or denosumab for skeletal related events per institution guideline is permitted.
   2. Wide-field radiation therapy within 28 days (or palliative radiation therapy within 7 days) prior to the first dose of study treatment or has not recovered from the side effects of radiation therapy in the opinion of the Investigator.
   3. Any other concurrent investigational device(s) or conventional agent(s) within 28 days (unless 5 times the half-life is shorter than 28 days) prior to the first dose of study treatment.
   4. Therapeutic radiopharmaceuticals must be stopped 8 weeks prior to the first dose of the study treatment.
3. Persisting Grade 2 or higher severity AEs from prior antitumour treatment as per CTCAE v5.0. Patients with pre-existing non-treatable Grade 2 toxicities may be eligible per discretion of the Investigator and with approval from Study Medical Monitor (e.g., Grade 2 chemotherapy induced neuropathy).

4. Patients with primary central nervous system (CNS) malignancy, symptomatic CNS metastases, meningeal metastases or leptomeningeal disease are not allowed.

   Note: Patients with asymptomatic CNS metastases are eligible if clinically controlled, which is defined as 1) ≥ 4 weeks of stable neurologic function following CNS-directed therapy prior to the first dose of study treatment 2) no evidence of CNS disease progression as determined by radiographic imaging ≥ 4 weeks prior to the first dose of study treatment, 3) ≥ 2 weeks from discontinuation of anti-seizure and steroid therapies (receiving prednisone ≤ 10 mg or equivalent steroid therapies is allowed) prior to the first dose of study treatment.

5. Had major surgery within 28-days of the Screening Visit. Note: Patients who have undergone a non-major surgical procedure within 28-days prior to Screening must have recovered adequately from the surgery before the administration of the first dose of study treatment. Exception: no waiting period applies following central venous catheter placement.
6. History of tissue or organ transplantation.
7. Treatment with systemic immunosuppressive medications within 4 weeks prior to the first dose of study treatment. Exceptions: Daily prednisone equivalent ≤10 mg/day; topical, inhaled, or intranasal corticosteroids.
8. History of severe infection deemed clinically significant by the Investigator or designee within 4 weeks or signs and symptoms of any active infection within 2 weeks prior to the first dose of study treatment.
9. Active hepatitis B or C. Note: Hepatitis B virus (HBV) carriers without active disease (HBV DNA titer < 1000 copies/mL or 200 IU/mL) or cured hepatitis C (negative HCV RNA test) with confirmed viral clearance that are not receiving ongoing treatment and without residual chronic liver disease may be enrolled.
10. Confirmed human immunodeficiency virus (HIV) infection and receiving anti-retroviral therapy (ART). Patients with well controlled HIV infection (i.e., CD4+ count >350 cells/μL and viral copies less than 400/mL after at least 4 weeks of ART) may be eligible per discretion of the Investigator and with approval from Study Medical Monitor.
11. Patients with any inherited predisposition to bleeding or to thrombosis (von Willebrand disease, haemophilia, etc.). Patients with a history of nontraumatic haemorrhage (i.e., end stage liver disease, any haemorrhage requiring medical intervention), thromboembolic event or any condition which may increase bleeding risk including clotting disorders, thrombocytopenia during the last 3 months prior to the first dose of study treatment administration.
12. Receiving immunosuppressive or myelosuppressive medications that would, in the opinion of the Investigator, increase the risk of serious neutropenic complications.
13. Any other disease or clinically significant abnormality in laboratory parameters, including serious medical or psychiatric illness/condition, which in the judgement of the Investigator might compromise the safety of the patient or integrity of the study, interfere with the patient's participation in the trial or compromise the trial objectives.
14. Known allergies, hypersensitivity, or intolerance to the study drug or its excipients.
15. Any known, documented, or suspected history of illicit substance abuse that would preclude patient from participation, unless clinically justified (i.e., will not interfere with study participation and/or will not compromise trial objectives) per judgement of the Investigator and with approval of Study Medical Monitor. Exception: Physician-prescribed medicinal opioids or cannabinoids are allowed for pain management.
16. Vaccinated with any live vaccine within 4 weeks prior to the first dose of study treatment.
17. Judgement by the Investigator that the patient is unlikely to comply with study procedures, restrictions and requirements.

18. Use of prescription or non-prescription medications, including complementary medicines, within 14 days or 5 half-lives (whichever is longer) if the medication is a potential inhibitor of cytochrome P450 (CYP) isoform 3A4 or 2D6, and/or P-glycoprotein (P-gp), or if the medication is an inducer of CYP3A4 or P-gp, prior to dosing and throughout study participation.

    PART 1 only - Dose Escalation Specific Criteria

19. A ≥ 20% decrease in serum albumin from baseline, sustained over two consecutive measurements taken more than 14 days apart during screening prior to the first administration of study treatment.
20. Severe or uncontrolled cardiac disease requiring treatment, CHF (New York Heart Association) NYHA III or IV, unstable angina pectoris even if medically controlled, history of myocardial infarction during the 6 months prior to screening, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia).
21. Treatment with prior anthracyclines exceeding the maximum equivalent cumulative lifetime dose.

PART 2 only -Dose Expansion Specific Criteria 19. Uncontrolled or severe cardiac disease that in the opinion of the Investigator would prevent treatment with doxorubicin.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Part 2: Dose Expansion; Participants will receive the tolerated and appropriate combination dosage of RC220 with doxorubicin on day 1 of the 21-day cycle and treatment repeats in the absence of disease progression or unacceptable toxicity. The aim is to provide additional safety and tolerability and potential benefits of the combined dosage.	Drug: RC220; The assigned dose will be administered by intravenous infusion over 60 minutes.; Drug: Doxorubicin (Adriamycin); 60 mg/m2 administered by intravenous infusion over 10 minutes on Day 1 of the monotherapy lead-in cycle (M1) and on Day 1 of each 21-day combination cycle following administration of intravenous RC220; Other Names: Doxorubicin Hydrochloride; Adriamycin®
Experimental: Part 1: Dose Escalation; Participants will receive; doxorubicin on Day 1 of a 21-day monotherapy lead-in cycle (M1); RC220 on Day 1 of a 21-day monotherapy lead-in cycle (M2); RC220 (at the same dose as M2) and doxorubicin combination on Day 1 of a 21-day cycle. Combination treatment repeats every 21-day cycle in the absence of disease progression or unacceptable toxicity. The aim is to determine safety, tolerability and maximum tolerated combination dosage level to evaluate in Part 2.	Drug: RC220; The assigned dose will be administered by intravenous infusion over 60 minutes.; Drug: Doxorubicin (Adriamycin); 60 mg/m2 administered by intravenous infusion over 10 minutes on Day 1 of the monotherapy lead-in cycle (M1) and on Day 1 of each 21-day combination cycle following administration of intravenous RC220; Other Names: Doxorubicin Hydrochloride; Adriamycin®

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Part 1. Incidence of dose limiting toxicities (DLTs)	Evaluated at each dose level RC220 combined with doxorubicin, as graded by National Cancer Institute (NCI) Common Terminology for Adverse Events (CTCAE) version 5.0.	During the first cycle of RC220 and doxorubicin treatment (1-21 days)
Part 1 and Part 2. Treatment emergent adverse events (TEAE) and serious adverse events (SAEs),	This includes clinically significant changes in vital signs, physical examination, electrocardiogram, echocardiogram and clinical laboratory tests, as graded by NCI CTCAE v5.0.	First dose up to 30 days post last combination dose (up to 12 months)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Part 1. Maximum tolerated combined dose (MTCD)	The MTCD is based on the incidence of Dose Limiting Toxicities (DLTs).	After the first dose of RC220 and doxorubicin treatment cycle (1-21 days)
Part 2. Change from baseline in cardiac blood biomarker levels (hs-troponins and NT-proBNP), as measured by laboratory tests		up to 12 months
Part 2. Change from baseline in 2D-echocardiogram measurements including GLS, LV volume, LV mass, transmitral flow, atrial volumes.	2D-echocardiograms are performed at specified timepoints. Each time a 2D-echocardiogram is performed, multiple measures will be collected, aggregated and reported on once by a single observer. Measures collected from each 2D-echocardiogram, and compared to baseline, include: global longitudinal strain; left ventricular mass; left ventricular volumes; transmitral flow; left atrial volume	Up to 12 months
Part 2. Change from baseline in cardiac magnetic resonance imaging (cMRI) cardiac function parameters (blood flow, global ventricular function, myocardial perfusion)	Each time a cMRI is performed, cMRI images are collected, assessed, compared and reported on in an aggregated manner by an independent cardiologist for changes in cardiac function measures (blood flow, global ventricular function, myocardial perfusion).	Up to 12 months
Part 2. Change from baseline in functional volume of peak oxygen uptake (VO2 peak). Defined as the highest amount of oxygen consumed at peak exercise.		Up to 12 months
Part 1 and Part 2. Best Overall Response (BOR)	Percentage of patients with best confirmed overall response of clinical response (CR) or partial response (PR) (evaluated by the investigator according to RECISTv1.1) until the time of disease progression.	Up to 12 months
Part 1 and Part 2. Duration of Response (DOR)	Defined as the time from the earliest date documented (CR or PR) (evaluated by the investigator according to RECISTv1.1) until disease progression or death (by any cause, in the absence of progression).	Up to 12 months
Part 1 and Part 2. Progression Free Survival (PFS)	Defined as the time of first treatment until disease progression or death (by any cause, in the absence of progression).	Up to 12 months

Collaborators and Investigators

• Sponsor: Racura Oncology Ltd
• Collaborators: Emerald Clinical
• Investigators: Study Director: Marinella Messina, Racura Oncology Ltd

Study record dates

Study Major Dates

• Study Start (Actual): April 2, 2025
• Primary Completion (Estimated): July 31, 2027
• Study Completion (Estimated): January 31, 2029

Study Registration Dates

• First Submitted: January 20, 2025
• First Submitted That Met QC Criteria: February 3, 2025
• First Posted (Actual): February 7, 2025

Study Record Updates

• Last Update Posted (Actual): June 2, 2026
• Last Update Submitted That Met QC Criteria: May 30, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Phase 1; Solid Tumours; Advanced Solid Tumours
• Additional Relevant MeSH Terms: Neoplasms; Organic Chemicals; Hydrocarbons; Hydrocarbons, Cyclic; Carbohydrates; Polycyclic Aromatic Hydrocarbons; Hydrocarbons, Aromatic; Polycyclic Compounds; Glycosides; Anthracyclines; Naphthacenes; Aminoglycosides; Daunorubicin; Doxorubicin
• Other Study ID Numbers: RAC-010

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Due to the small sample size of this Phase 1 study, individual participant data will not be shared openly to protect participant confidentiality.

Drug and device information, study documents

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