Safety Study of GMDTC Injection in Participants With Solid Tumors and Cisplatin-Induced Renal Dysfunction

A Phase Ib Clinical Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of GMDTC in Participants With Solid Tumors Who Have Cisplatin-Induced Renal Insufficiency

This trial is a multicenter, combined hydration, multiple-dose, dose-escalation phase Ib clinical study, designed to evaluate the safety, tolerability, pharmacokinetic and pharmacodynamic characteristics of the injection product GMDTC in participants with solid tumors and cisplatin-induced mild renal impairment.

Study Overview

• Status: Not yet recruiting
• Conditions: Cisplatin Adverse Reaction; Cisplatin Nephrotoxicity
• Intervention / Treatment: Drug: GMDTC 1 mg/ml; Drug: GMDTC 2mg/ml; Drug: GMDTC 3mg/ml

Detailed Description

The primary objective of this study is to evaluate the safety and tolerability of GMDTC in a single-dose, dose-escalation study in participants with mild renal impairment who are scheduled to receive cisplatin-based chemotherapy for solid tumors, and to determine the recommended phase II dose (RP2D) for this drug. The secondary objective is to evaluate the pharmacokinetic (PK) characteristics, pharmacodynamic (PD) characteristics, and renal function improvement after single-dose multiple administration of GMDTC following cisplatin chemotherapy in this group of participants.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Phase 1

Contacts and Locations

• Study Contact: Name: Li Zhang, Doctor of Medicine; Phone Number: ＋86 020-87343458; Email: zhangli@syscc.org.cn

Study Locations

• China
  • Guangdong
    • Guangzhou, Guangdong, China, 510060
      • Sun Yat-sen University Cancer Center
      • Contact: Li Zhang, Doctor of Medicine; Phone Number: ＋86 020-87343458; Email: zhangli@syscc.org.cn

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. The subject is able to understand and voluntarily sign a written Informed Consent Form (ICF), agreeing to comply with the study protocol.
2. When signing the ICF, the participant must be at least 18 years of age, regardless of gender.
3. The expected survival period of the subjects is ≥ 6 months.
4. The subjects have an ECOG performance status score of 0 or 1.

5. Malignant solid tumors (excluding renal cell carcinoma) diagnosed by histological or cytological examination must simultaneously meet the following criteria:

   Participants who have previously received cisplatin-based chemotherapy and developed mild cisplatin-induced renal insufficiency, and who are still scheduled to undergo cisplatin-based chemotherapy; Mild renal insufficiency is defined as: during the screening phase, estimated glomerular filtration rate (eGFR) ≥ 60 and < 90 mL/min/1.73 m² (calculated using the CKD-EPI formula).

6. Within 7 days prior to the first administration, participants shall be assessed for adequate bone marrow function, as well as normal cardiac, pulmonary, hepatic, and coagulation function, based on the following laboratory tests (transfusion or administration of other growth factor-based supportive therapy is prohibited within 14 days prior to the first dose of the investigational product):

   Bone marrow function: Absolute neutrophil count (ANC) ≥ 1.5 × 10^9/L, platelet count ≥ 100 × 10^9/L, and hemoglobin ≥ 90 g/L; Liver function: Total bilirubin (TBIL) ≤ 1.5 × ULN, or total bilirubin (TBIL) ≤ 3 × ULN (in cases of Gilbert syndrome); Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.0 × ULN (≤ 5 × ULN if hepatic metastases are present); Serum albumin (ALB) ≥ 30 g/L; Coagulation function (in patients not receiving anticoagulant therapy): Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN; Prothrombin time (PT) or International Normalized Ratio (INR) ≤ 1.5 × ULN. Patients receiving long-term anticoagulant therapy may participate in the study provided they have been on a stable anticoagulant dose for at least one month prior to the first administration of the investigational product. Unless the anticoagulant is a factor Xa inhibitor, a stable dose must be maintained for at least one week.

7. Women of childbearing potential must agree to take reliable contraceptive measures or abstain from sexual activity from the moment they sign the informed consent form until 6 months after the last administration of the investigational drug. Women of childbearing age must have a negative serum pregnancy test within 7 days before the first dose.
8. Male participants must agree to take reliable contraceptive measures or abstain from sexual activity from the moment they signed the informed consent form until six months after the last administration of the investigational drug. Additionally, male participants must agree not to donate sperm during this period.

Exclusion Criteria:

1. Those who have participated in any other clinical trials within 4 weeks before the first administration of the investigational drug or within 5 half-lives (whichever is shorter);
2. Those who are known or suspected to be allergic to any active ingredient or excipient of this product, or who have a specific history of allergic reactions as determined by the investigator to be unsuitable for treatment with the investigational drug;
3. Those who are known or suspected to be allergic to any active ingredient or excipient of cisplatin or any other platinum-based drugs;
4. The researchers identified those participants who would require a dose adjustment of cisplatin upon their first administration after being included in the study.

5. Previous administration and toxicity recovery status:

   Before the first administration of the investigational drug, all adverse events (AEs) experienced by the participants during previous anti-tumor administration had not returned to baseline levels or were ≤ grade 1 (based on NCI CTCAE V6.0). Participants with the following conditions are allowed to be included: alopecia (any grade), participants with renal insufficiency (estimated glomerular filtration rate (eGFR) ≥ 45 ml/min/1.73 m2); participants with other AEs (≤ grade 2), and their inclusion is determined by the investigator;

6. Those who have taken any drugs or health supplements (such as SGLT2 inhibitors like dapagliflozin, canagliflozin, empagliflozin, englestat, canagliflozin, hexagliflozin, igliflozin, rugliflozin, togliflozin, and natural compounds like aesculin; GLUT2 inhibitors such as cytochalasin B, aesculin, Huoxiang Zhengqi San, luteolin and isofraxidin) that may have interactions with the investigational drug within 4 weeks before the first administration of the investigational drug or 5 half-lives (whichever is longer) are excluded from the study.
7. Those who have taken any drugs or health supplements (such as colchicine, probenecid, antihistamines, phenothiazine drugs, aminoglycoside antibiotics, amphotericin B, cephalothin, chloramphenicol or its furan benzenic acid or furoxan sodium, penicillamine or other chelating agents) that may have interactions with cisplatin within 4 weeks before the last cisplatin administration or 5 half-lives (whichever is longer) will be excluded from the screening.
8. Participants with a history of peripheral neuropathy caused by cisplatin.
9. Participants with chickenpox or shingles, except those who have been cured in the past.
10. Participants with gout and hyperuricemia.
11. Participants with a history of type 1 diabetes or type 2 diabetes accompanied by kidney disease.
12. Patients with severe hepatobiliary disorders, decompensated liver cirrhosis (Child-Pugh class B or C), portal hypertension-related complications (ascites, esophageal or gastric variceal bleeding, hepatic encephalopathy), or any form of cholestatic liver disease.
13. Patients who have previously undergone liver transplantation or are scheduled for liver transplantation.
14. Participants with meningeal metastasis.
15. Uncontrolled CNS metastases are excluded.However, Participants with symptomatic CNS metastases may be eligible if the metastases are limited to the supratentorial and/or cerebellar region (i.e., without metastasis to the midbrain, pons, medulla oblongata, or spinal cord), local treatment has been received, neurological symptoms have been stable for at least 2 weeks before the first dose, and the participant does not require hormone therapy or is receiving ≤ 10 mg/day prednisone (or equivalent).
16. Within 5 years prior to the first administration of the investigational drug, the subject had other malignant tumors (excluding the solid tumor diseases treated with cisplatin as part of this study, and excluding skin basal cell carcinoma, superficial bladder cancer, in situ cervical cancer, etc., which were considered eligible for inclusion by the investigators and had not recurred within the previous 5 years).
17. There is a history of previous administration of allogeneic organ transplantation or allogeneic peripheral blood stem cell (PBSC)/immune cell/marrow transplantation.
18. The subject had undergone major surgical procedures within 4 weeks prior to the first administration of the investigational drug, or had not yet fully recovered from any previous invasive procedures.

19. Clinically significant cardiovascular diseases include:

    1. Within 6 months prior to the first administration of the investigational drug, there was a myocardial infarction, unstable angina pectoris, viral myocarditis or other uncontrolled heart disease;
    2. Left ventricular ejection fraction (LVEF) < 50%, congestive heart failure with NYHA cardiac function classification of II-IV;
    3. Symptomatic orthostatic hypotension occurred within 6 months prior to the first administration of the investigational drug;
    4. Uncontrolled hypertension [after standard medication, systolic blood pressure (SBP) ≥ 160 mmHg and/or diastolic blood pressure (DBP) ≥ 100 mmHg or a history of hypertension crisis or hypertensive encephalopathy];
    5. QTc > 470 ms (female), QTc > 450 ms (male), or a known family history of long QT syndrome;
    6. History of cardiac surgery such as angioplasty or coronary artery bypass grafting within 6 months prior to the first administration of the investigational drug;
20. Uncontrolled seizures despite appropriate medical treatment.
21. Within 6 months prior to the first administration of the investigational drug, the subject had experienced cerebral infarction, cerebral hemorrhage or transient ischemic attack.
22. Those with interstitial pneumonia or interstitial lung disease, or those who have a history of interstitial pneumonia or interstitial lung disease that affects self-care daily activities or is accompanied by life-threatening respiratory disorders; or those with a history of pulmonary fibrosis, persistent pneumonia, pneumonia caused by drugs or radiotherapy, congenital pneumonia, or any evidence of active pneumonia found on chest CT scan. Or those with severe pulmonary diseases, including but not limited to pulmonary embolism that occurred within 3 months before the first administration, severe asthma, chronic obstructive pulmonary disease (COPD), restrictive lung disease, or active pneumonia, or those whose pulmonary function test indicates severe impairment of lung function.
23. Those with a history of acute or chronic renal disease due to causes other than cisplatin treatment, or with a history of kidney transplantation, or currently undergoing renal replacement therapy (such as dialysis), or having persistent hematuria for unknown reasons, etc.
24. Clinically uncontrolled serous cavity effusion (including pleural, pericardial, or peritoneal effusion), as determined by the investigator, is defined as requiring a drainage tube or drainage more than once weekly, and shall be excluded.
25. Participants who have received a live attenuated vaccine within 4 weeks prior to the first administration of the investigational drug, or who are expected to require such vaccination during the study, are excluded.
26. According to the researchers' assessment, there is a history or current condition of autoimmune diseases (such as myasthenia gravis or periodic hypokalemia), severe or uncontrolled systemic diseases, active bleeding disorders or active infections;
27. Participants with active hepatitis B (HBsAg positive and HBV-DNA ≥ 1000 copies/mL or 500 IU/mL or the lower limit of the center's detection), or active hepatitis C (HCV antibody positive and HCV-RNA above the upper limit of the normal value), or positive screening result for human immunodeficiency virus (HIV) antibody, or active syphilis infection, or active tuberculosis infection will be excluded during the screening process.
28. Female participants who are pregnant or breastfeeding;
29. Those who have a clear history of neurological or mental disorders, such as dementia, and have poor compliance.
30. Other serious diseases, or any other circumstances that the researcher deems may increase the risks for the participants or interfere with the test results, and any other condition that, in the investigator's judgment, makes the participant unsuitable for the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: GMDTC Group; All participants receive high-dose cisplatin chemotherapy (75mg/m2) on day 1 , followed by GMDTC administration via intravenous drip. The dosage is 0.5 grams per vial, in 1000 mg, 2000 mg, and 3000 mg once a day. The medication is administered once daily on Days 1-5 of each cycle. Among them, GMDTC starts to be administered 2 hours ± 15 minutes after the cisplatin administration on day 1. GMDTC is reconstituted and diluted with 0.9% sodium chloride injection before administration. The total volume of the liquid for the trial drug GMDTC infusion each day is 1000 ml.

Drug: GMDTC 1 mg/ml; Cohort 1: Participants will receive high-dose cisplatin chemotherapy (75mg/m2) on D1 each cycle. Subsequently, they received GMDTC at a concentration of 1 mg/ml via intravenous infusion, once daily for 5 days, over 2 cycles, and then underwent a 2-week follow-up after the last administration.; Drug: GMDTC 2mg/ml; Cohort 2: Participants will receive high-dose cisplatin chemotherapy (75mg/m2) on D1 each cycle. Subsequently, they received GMDTC at a concentration of 2 mg/ml via intravenous infusion, once daily for 5 days, over 2 cycles, and then underwent a 2-week follow-up after the last administration.; Drug: GMDTC 3mg/ml; Cohort 3: Participants will receive high-dose cisplatin chemotherapy (75mg/m2) on D1 each cycle. Subsequently, they received GMDTC at a concentration of 3 mg/ml via intravenous infusion, once daily for 5 days, over 2 cycles, and then underwent a 2-week follow-up after the last administration.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adverse events	Adverse events will be evaluated according to the NCI Common Terminology Criteria for Adverse Events (CTCAE, V6.0), which includes spontaneously reported adverse events as well as clinically significant changes in vital signs, physical examination, laboratory tests, electrocardiogram, and other examinations conducted during the trial.	Up to 90 days
DLT	DLT is defined as any TEAE (including those definitely related, likely related, and possibly related) to GMDTC that occurs during the DLT observation period (the severity of adverse events [Adverse events, AE] is evaluated according to NCI CTCAE V6.0) or any clinically significant abnormal laboratory test results.	21 days after the participant completes the first dose in the dose-escalation phase.
RP2D	RP2D is defined as the Recommended Phase 2 dose.	From first participant enrollment to the completion of the entire study, approximately 1 year.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pharmacokinetic parameters,Tmax	Peak time, reflecting the absorption, distribution, metabolism and excretion characteristics of drugs in the body.	Cycle 1 Days 1-5
Pharmacokinetic parameters, Cmax	Peak concentrations, reflecting the absorption, distribution, metabolism and excretion characteristics of drugs in the body.	Cycle 1 Days 1-5
Pharmacokinetic parameters, λz	The apparent terminal elimination rate constant, estimated by log-linear regression of the terminal portion of the concentration-time curve, reflecting the absorption, distribution, metabolism and excretion characteristics of drugs in the body.	Cycle 1 Days 1-5
Pharmacokinetic parameters, t1/2	The apparent terminal elimination half-life, calculated according to the following equation:t1/2= Ln(2)/ λz,reflecting the absorption, distribution, metabolism and excretion characteristics of drugs in the body.	Cycle 1 Days 1-5
Pharmacodynamic parameters, urine platinum	Urine platinum level before and after drug administration (μmol/mol creatinine)	Baseline (the day before first dose) and Day1 to Day5 of each cycle.
Pharmacodynamic parameters, amount of platinum excreted in urine over 24 hours	24-hour urine platinum excretion before and after drug administration	Baseline (the day before first dose) and Day1 to Day5 of each cycle.
Renal function indicators： creatinine clearance	creatinine clearance before and after administration.	Baseline(Within 3 days before Cycle 1 treatment),D6 after the last cisplatin treatment prior to enrollment,D15 after the last cisplatin treatment prior to enrollment,Day 6 of each Cycle ,Day 15 of each Cycle,Day 20 of each Cycle
Pharmacodynamic parameters,Urine platinum excretion rate	Cumulative urinary platinum excretion on Days 1 to 5 of each cycle as a percentage of the administered cisplatin dose.	Baseline (the day before first dose) and Day1 to Day5 of each cycle.
Renal function indicators：serum creatinine	serum creatinine before and after drug administration.	Baseline(Within 3 days before Cycle 1 treatment),D6 after the last cisplatin treatment prior to enrollment,D15 after the last cisplatin treatment prior to enrollment,Day 6 of each Cycle ,Day 15 of each Cycle,Day 20 of each Cycle
Renal function indicators：urea nitrogen/urea,	Urea nitrogen/urea before and after drug administration	Baseline(Within 3 days before Cycle 1 treatment),D6 after the last cisplatin treatment prior to enrollment,D15 after the last cisplatin treatment prior to enrollment,Day 6 of each Cycle ,Day 15 of each Cycle,Day 20 of each Cycle
Renal function indicators：estimated glomerular filtration rate (eGFR)	estimated glomerular filtration rate (eGFR) before and after drug administration.	Baseline(Within 3 days before Cycle 1 treatment),D6 after the last cisplatin treatment prior to enrollment,D15 after the last cisplatin treatment prior to enrollment,Day 6 of each Cycle ,Day 15 of each Cycle,Day 20 of each Cycle
Renal function indicators：cystatin C	Cystatin C before and after drug administration	Baseline(Within 3 days before Cycle 1 treatment),D6 after the last cisplatin treatment prior to enrollment,D15 after the last cisplatin treatment prior to enrollment,Day 6 of each Cycle ,Day 15 of each Cycle,Day 20 of each Cycle
Renal function indicators：24-hour urine protein quantification	24-hour urine protein quantification before and after drug administration.	Baseline (the day before first dose) ,Day 1of each Cycle

Collaborators and Investigators

• Sponsor: Guangdong Jianersheng Pharmaceutical Technology Co., Ltd.
• Collaborators: Sun Yat-Sen University Cancer Center

Publications and helpful links

General Publications

• Pabla N, Dong Z. Cisplatin nephrotoxicity: mechanisms and renoprotective strategies. Kidney Int. 2008 May;73(9):994-1007. doi: 10.1038/sj.ki.5002786. Epub 2008 Feb 13.
• Tang X, Zhu J, Zhong Z, Luo M, Li G, Gong Z, Zhang C, Fei F, Ruan X, Zhou J, Liu G, Li G, Olson J, Ren X. Mobilization and removing of cadmium from kidney by GMDTC utilizing renal glucose reabsorption pathway. Toxicol Appl Pharmacol. 2016 Aug 15;305:143-152. doi: 10.1016/j.taap.2016.06.001. Epub 2016 Jun 6.
• Yao X, Panichpisal K, Kurtzman N, Nugent K. Cisplatin nephrotoxicity: a review. Am J Med Sci. 2007 Aug;334(2):115-24. doi: 10.1097/MAJ.0b013e31812dfe1e.
• Esteban-Fernandez D, Verdaguer JM, Ramirez-Camacho R, Palacios MA, Gomez-Gomez MM. Accumulation, fractionation, and analysis of platinum in toxicologically affected tissues after cisplatin, oxaliplatin, and carboplatin administration. J Anal Toxicol. 2008 Mar;32(2):140-6. doi: 10.1093/jat/32.2.140.
• Astolfi L, Ghiselli S, Guaran V, Chicca M, Simoni E, Olivetto E, Lelli G, Martini A. Correlation of adverse effects of cisplatin administration in patients affected by solid tumours: a retrospective evaluation. Oncol Rep. 2013 Apr;29(4):1285-92. doi: 10.3892/or.2013.2279. Epub 2013 Feb 6.
• Kelland L. The resurgence of platinum-based cancer chemotherapy. Nat Rev Cancer. 2007 Aug;7(8):573-84. doi: 10.1038/nrc2167. Epub 2007 Jul 12.
• Miller RP, Tadagavadi RK, Ramesh G, Reeves WB. Mechanisms of Cisplatin nephrotoxicity. Toxins (Basel). 2010 Nov;2(11):2490-518. doi: 10.3390/toxins2112490. Epub 2010 Oct 26.
• Mandic A, Hansson J, Linder S, Shoshan MC. Cisplatin induces endoplasmic reticulum stress and nucleus-independent apoptotic signaling. J Biol Chem. 2003 Mar 14;278(11):9100-6. doi: 10.1074/jbc.M210284200. Epub 2002 Dec 31.
• Ge Y, Zheng N, Chen X, Zhu J, Sun W, Olson JR, Aga DS, Hu W, Tang X, Ren X. GMDTC Chelating Agent Attenuates Cisplatin-Induced Systemic Toxicity without Affecting Antitumor Efficacy. Chem Res Toxicol. 2019 Aug 19;32(8):1572-1582. doi: 10.1021/acs.chemrestox.9b00097. Epub 2019 Jul 9.

Helpful Links

• The resurgence of platinum-based cancer chemotherapy
• GMDTC Chelating Agent Attenuates Cisplatin-Induced Systemic Toxicity without Affecting Antitumor Efficacy
• Cisplatin induces endoplasmic reticulum stress and nucleus-independent apoptotic signaling
• Correlation of adverse effects of cisplatin administration in patients affected by solid tumours: a retrospective evaluation
• Mechanisms of Cisplatin nephrotoxicity
• Accumulation, fractionation, and analysis of platinum in toxicologically affected tissues after cisplatin, oxaliplatin, and carboplatin administration
• Cisplatin nephrotoxicity: a review
• Cisplatin nephrotoxicity: mechanisms and renoprotective strategies
• Mobilization and removing of cadmium from kidney by GMDTC utilizing renal glucose reabsorption pathway

Study record dates

Study Major Dates

• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): October 1, 2027
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: September 3, 2026
• First Submitted That Met QC Criteria: September 11, 2026
• First Posted (Actual): September 17, 2026

Study Record Updates

• Last Update Posted (Actual): September 17, 2026
• Last Update Submitted That Met QC Criteria: September 11, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Keywords: Cisplatin; Solid tumor; Investigational drugs; GMDTC; Mild renal dysfunction
• Other Study ID Numbers: JES-GMDTC-2-01

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: No
• Studies a U.S. FDA-regulated device product: No