Overview
Part 1 is a multiple ascending dose trial in healthy volunteers (HV) of LYT-100 to determine safety, tolerability, and pharmacokinetic (PK) profile under fed conditions.
Part 2 is a single dose safety, tolerability, and PK trial in HV of LYT-100 under fasted conditions.
Part 3 is a trial of up to 6-months duration for safety, tolerability, PK, biomarkers and exploratory clinical assessments in breast carcinoma patients with secondary lymphoedema
Description
Part 1: This is a randomised, double-blind, placebo-controlled, multiple ascending dose design to assess the safety, tolerability and PK profile of multiple doses of LYT-100 administered under fed conditions at steady state in healthy participants. Up to 4 dosing cohorts are planned.
Part 2: The dose level immediately below the maximally tolerated dose in Part 1 will be used in Part 2. Following a minimum 7-day washout of the cohort that received this dose, subjects in Part 2 will be administered a single dose of their assigned treatment under fasting conditions to permit a comparison of the rate and extent of absorption of LYT-100 under fasting conditions to the equivalent dose in a prior fed cohort.
Part 3: Once the optimal dose and regimen is determined with or without food, Part 3 will follow with an open-label, single treatment arm to assess the safety, tolerability, PK, biomarkers and effect on exploratory clinical endpoints of LYT-100 over a period of up to 6-months of dosing in breast carcinoma patients with secondary lymphoedema following sentinel lymph node biopsy and/or axillary node dissection, with or without radiation.
Eligibility
Main Inclusion Criteria:
Part 1 and 2: Healthy Volunteers
- Male or female between 18 and 75 years old (inclusive) at the time of screening.
- In good general health at screening, free from clinically significant unstable medical, surgical or psychiatric illness, at the discretion of the Investigator.
Part 3: Patients with BRCL
- Female or male between 18 and 80 years old (inclusive) at the time of informed consent.
- At least 6 months since any type of breast cancer surgery (excluding fine needle aspiration biopsy [FNA]), at the time of study screening. No intention to have breast reconstructive surgery, nipple reconstruction and/or tattooing during the course of the study.
- At least 3 months since completion of all types of treatment for breast cancer, including but not limited to neoadjuvant, radiotherapy, chemotherapy and immunotherapy, at the time of study screening.
- At least 3 months treatment of stable adjuvant treatment with hormonal or anti-HER2 therapy at the time of screening, with no planned changes to this therapy throughout the duration of the study.
- Diagnosis of primary breast cancer, and without evidence of recurrence of breast cancer and/or metastasis for at least 6 months since breast cancer surgery, as determined at screening and baseline.
- Documented evidence of Stage 1 or 2 lymphoedema.
- Receiving standard of care compression or agreeable to using care compression, or no compression at all 4 weeks prior to screening and throughout the study.
Main Exclusion Criteria:
Part 1 and 2: Healthy Volunteers
- History or presence of malignancy at screening or baseline, with the exception of adequately treated localised skin cancer (basal cell or squamous cell carcinoma) or carcinoma in-situ of the cervix.
- Clinically significant infection within 28 days of the start of dosing, or infections requiring parenteral antibiotics within the 6 months prior to screening.
- Chronic administration (defined as more than 14 consecutive days) of immunosuppressants or other immune-modifying drugs within 3 months prior to study drug administration; corticosteroids are permitted at the discretion of the Investigator).
- History or presence at screening or baseline of a condition associated with significant immunosuppression
Part 3: Patients with BRCL
- Bilateral lymphoedema or history of bilateral axillary lymph node removal (i.e., sentinel lymph node or axillary lymph node dissection), or primary lymphoedema or lymphatic or vascular malformation, determined at screening.
- Chronic administration (defined as more than 14 consecutive days) of immunosuppressants or other immune-modifying drugs within 3 months prior to study drug administration; corticosteroids are permitted at the discretion of the PI.
- Recent history (in the 8 weeks prior to screening) of cellulitis, lymphangitis, dermatitis, necrotising fasciitis, or current open wounds or sores in the affected extremity.
- Stage III lymphoedema, or history of clinically diagnosed secondary lymphoedema greater than 2 years, determined at screening.
- Initiated use of compression or manual lymphatic drainage or other lymphoedema therapies at the start of the study within 4 weeks of the screening visit. Rescreening is allowed following a course of stable compression regimen of > 4 weeks.