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Trial registered on ANZCTR
Registration number
ACTRN12625000142437
Ethics application status
Approved
Date submitted
4/12/2024
Date registered
7/02/2025
Date last updated
6/04/2025
Date data sharing statement initially provided
7/02/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
A Study to Evaluate the Safety, Pharmacokinetics, Pharmacodynamics, and Efficacy of Cavrotolimod in Subjects with Chronic Hepatitis B Infection
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Scientific title
A Phase 1b/2 Study to Evaluate the Safety, Pharmacokinetics, Pharmacodynamics, and Efficacy of Cavrotolimod Alone and in Combinations in Participants with Chronic Hepatitis B Infection- Part C
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Secondary ID [1]
313327
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BJT-008-001
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
This registration is linked to ACTRN12624000809538 (Part B of the study) and ACTRN12624000808549 (Part A of the study). The study has been expanded to include Part C (this registration) and Part D (registered separately) via a protocol amendment.
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Health condition
Health condition(s) or problem(s) studied:
Chronic Hepatitis B Infection
335686
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Condition category
Condition code
Infection
332246
332246
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0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Investigational Product (IP): Cavrotolimod and Nivolumab
Dosage Form: Vial
Method of administration: Sub cutaneous injection
Dose: Cavrotolimod will be supplied as 2mL vial and Nivolumab will be supplied as 4mL vial
This study consists of 4 parts (Part A, B, C and D). This registration is for Part C. Part C will evaluate open-label cavrotolimod plus low-dose nivolumab, a mAb targeting PD-1, in combination. Low dose of Nivolumab (0.3 mg/kg) given IV will also be administered only on day 1 for Part C. The study design has 3 cohorts with approximately 20 participants per cohort. Part C may begin once one or more cavrotolimod dose has been deemed safe in Part A (ACTRN12624000808549) by the SRC.
- Cohort 1, Arm 1 and Expansion Arm 1a will receive Cavrotolimod (less than equal to 24 mg) for 4 weeks + low dose nivolumab (0.3 mg/kg) given IV on Day 1
- Optional Cohort 2, Arm 1 and Expansion Arm 1a will receive Cavrotolimod (less than equal to 24 mg) for 4 weeks + low dose nivolumab (0.3 mg/kg) given IV on Day 1
- Optional Cohort 3, Arm 1 and Expansion Arm 1a will receive Cavrotolimod (less than equal to 24 mg) for 4 weeks + low-dose nivolumab (0.3 mg/kg) given IV on Day 1
Participants will be followed for 12 weeks after the last dose of study medications. Participants who achieve HBsAg loss (HBsAg <LLOQ) at the end of follow up will continue to be followed for an additional 12 weeks (total 24 weeks of follow up). The difference between these cohorts will be determined by the SRC at the time of opening. Cohorts 2 and 3 are optional cohorts and may open upon SRC decision.
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Intervention code [1]
329909
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Treatment: Drugs
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Comparator / control treatment
None .
All assessments before the first dose of study medication will be considered as baseline. If there are multiple baseline assessments, the most recent one will be used for statistical analysis.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To evaluate the safety and tolerability of cavrotolimod alone and in combinations. - Incidence and severity of treatment-emergent adverse events (TEAEs) will be assessed for severity and causality (relationship of event to the investigational product) by the study investigator using the specified definitions. AEs/SAEs will be coded and tabulated using the Medical Dictionary for Regulatory Activities (current version at study start). - Changes in clinical laboratory parameters including blood tests for complete blood count. coagulation, serum chemistry, and urinalysis. - Change in vital signs measurements. Vital signs include measurement of heart rate (HR) respiration rate (RR), systolic and diastolic blood pressure (BP) and body temperature. BP and HR will be measured by an automated BP Machine, RR is a manual calculation where the staff member will count the rise/fall of the chest and temperature will be measured by a digital tympanic thermometer - Changes in the electrocardiogram (ECG) findings). ECG will be used to assess baseline cardiac status or exclusion criteria 12. Symptoms-driven ECGs may be collected at any time during the study for cardiac evaluation/assessment. Any symptoms-driven ECG that has clinically significant changes will be captured as an AE. All measures will be assessed as a composite outcome
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Assessment method [1]
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- Incidence and severity of treatment-emergent adverse events (TEAEs) will be assessed for severity and causality (relationship of event to the investigational product) by the study investigator using the specified definitions. Common Terminology Criteria for Adverse Events (CTCAE) (V5.0) as 5 grades. - Changes in clinical laboratory parameters including blood tests for complete blood count. coagulation, serum chemistry, and urinalysis. - Change in vital signs measurements. Vital signs include measurement of heart rate (HR) respiration rate (RR), systolic and diastolic blood pressure (BP) and body temperature. BP and HR will be measured by an automated BP Machine, RR is a manual calculation where the staff member will count the rise/fall of the chest and temperature will be measured by a digital tympanic thermometer. - Change in ECG parameters assessed including change in rhythm, PR interval, heart rate, QRS interval, QT interval, QTcF interval, and QRS axis. All measures will be assessed as a composite outcome
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Timepoint [1]
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- Adverse events monitored once in 4 weeks from screening to end of study (EOS) 28 weeks post first dose administration. - Safety Lab parameters will be checked on screening, Day 1, Day 29, FU12, FU24, and First and Last dose of Cavrotolimod and 1st dose of Nivolumab and at 14days post dose. - Vitals are also taken on each Cavrotolimod dose and at +24h and +48h post dose. Relative to Nivolumab dosing day vitals are taken on day 1, 7days post dose and 14days post dose. - ECG will be checked on screening.
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Secondary outcome [1]
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To evaluate efficacy of cavrotolimod combination treatment
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Assessment method [1]
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Proportion of subjects who achieve more than 1 log10 IU/mL HBsAg decline at the end of treatment and during follow up
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Timepoint [1]
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Blood samples will be collected on screening, Day 1, Day 29, follow up week 4, follow up week 8, follow up week 12 and follow up week 24 post first dose administration.
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Secondary outcome [2]
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To evaluate the anti-hepatitis B virus (HBV) activity of cavrotolimod alone and in combinations.
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Assessment method [2]
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This is evaluated by following - -Absolute and change from baseline in HBsAg over time -Maximum reduction from baseline of HBsAg levels during treatment -HBsAg loss {
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Timepoint [2]
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Blood samples will be collected on screening, Day 1, Day 29, follow up week 4, follow up week 8, follow up week 12 and follow up week 24 post first dose administration.
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Secondary outcome [3]
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To evaluate the pharmacodynamics (PD) of cavrotolimod alone and in combinations
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Assessment method [3]
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•Absolute and change from baseline of key cytokines/chemokines over time • Absolute and change from baseline in HBsAg (Hepatitis B surface antigen) over time. • Maximum reduction from baseline of HBsAg levels during treatment
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Timepoint [3]
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Blood samples will be collected on Day1 and day 29 post first dose administration. Also, at each Cavrotolimod dose and at +24h and +48 h post dose. Relative to Nivolumab dosing PD samples are collected at 1st dose, 7days after 1st dose and 14days after 1st dose.
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Secondary outcome [4]
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To evaluate the plasma pharmacokinetics (PK) of cavrotolimod alone, in combinations, and/or other study medication(s) (e.g. Nivolumab)
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Assessment method [4]
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Assessments of the following PK parameters- Cmax: Maximum Plasma Concentration Tmax: Time of the maximum measured plasma concentration AUC (0 to t): Area Under the Plasma Concentration. AUC (Inf): Area Under the Plasma Concentration T 1/2: Apparent first-order terminal elimination half life Vd: Volume of dosctribution
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Timepoint [4]
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Blood samples will be collected on Day 1 at Predose (within 4 hours prior to dose), 2-hour (±10 minutes), 4 hours (±15 minutes), and 8 hours (±15 minutes) post dose.
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Eligibility
Key inclusion criteria
1. Male or female adults between 18 and 65 years of age, inclusive
2. Chronic HBV infection greater than or equal to 6 months (e.g., positive for serum HBsAg greater than or equal to 6 months)
3. Taking a commercially available nucleos(t)ide analogs for at least 2 months prior to Screening, and willing to remain on stable treatment for the duration of the study, unless they achieve nucleos(t)ide stopping criteria.
4. HBV DNA less than 100 IU/mL in blood at Screening
5. HBsAg at Screening:
a. Part C: Cohort 1: >LLOQ to 3000 IU/mL. Optional cohorts and expansion participants/cohorts (including Cohort 1), the upper limit of 3000 IU/mL may be removed based on emerging data.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Pregnant or nursing females
2. Male or female participants of childbearing potential unwilling to comply with contraception requirements during the study
3. Fibroscan greater than or equal to 8.5 kPa within 1 year of Screening
4. History of and/or current decompensated liver disease as evidenced by ascites, hepatic encephalopathy, and/or gastric or esophageal variceal bleeding
5. Presence of liver disease, not including chronic HBV infection, such as nonalcoholic steatohepatitis (NASH), alcohol-associated hepatitis, cholestatic liver disease, other viral (e.g., HCV or HDV) or non-viral hepatitis that has the potential to impact interpretation
of data. Exceptions to this criterion include fatty liver without any signs of steatohepatitis or past HCV infection that was successfully treated greater than or equal to 6 months prior to Screening.
6. Positive for HIV, HDV, or HCV infection at Screening
7. Received solid organ or bone marrow transplant
8. Chronic systemic immunosuppressive therapy (e.g., prednisone) within 1 month of Screening or require the use of during the study.
9. Prior or current history of hepatocellular carcinoma (HCC) or suspected HCC as evidenced by screening alpha-fetoprotein greater than or equal to 20 ng/mL
10. History of hypersensitivity to any of the components in the cavrotolimod, BJT-778 or nivolumab formulation components or severe reactions to injections
11. Screening laboratory results as follows, or any other clinically significant abnormalities in screening laboratory values that would render a participant unsuitable for inclusion:
a. Presence of anti-thyroid antibodies (anti-thyroid-stimulating hormone receptor, anti-thyroglobulin [TG], or anti- thyroid peroxidase [TPO])
b. Abnormal thyroid stimulating hormone
c. Anti-nuclear antibody greater than 1:160
d. ALT or aspartate aminotransferase (AST) greater than 2× upper limit of normal (ULN)
e. Total bilirubin greater than 1.2× ULN, except for participants with Gilbert’s (normal direct bilirubin)
f. Serum albumin less than .5 g/dL
g. International normalized ratio (INR) greater than 1.2
h. Platelet count less than 140 K/mm3
i. Hemoglobin less than 12.0 g/dL for males and <11.0 g/dL for females
j. Absolute neutrophil count less than 1000/mm3
k. Estimated glomerular filtration rate less than 50 mL/min/1.73 m2 by Cockcroft-Gualt
12. 12-lead electrocardiogram (ECG) showing the following: having a corrected QTc interval greater than 450 msec for males and greater than 470 msec for females or <340 msec (Fridericia’s correction)
13. Clinically significant medical history of:
a. Cardiac diseases (e.g., myocardial infarctions, stroke, arrhythmia, heart failure, and coronary heart disease)
b. Autoimmune diseases (e.g., lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, sarcoidosis, moderate or severe psoriasis, thyroiditis), or
c. Malignancies within 3 years. Malignancy that has been successfully surgically resection and considered cured would not exclude the participant
14. Treatment with an investigational drug, biological agent or device within 4 weeks or 5 half-lives prior to Screening, whichever is longer.
15. History of excess alcohol consumption within 1 year of Screening, defined as weekly intake of greater than or equal to 14 drinks per week (average of greater than or equal to 2 drinks per day)
16. History of drug abuse/addiction within 6 months of Screening (except cannabis)
17. Have any other conditions (medical, social, psychiatric, or other), which in the opinion of the investigator would make the participant unsuitable for inclusion, or could interfere with the individual participating in or completing the study
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
16/06/2025
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Actual
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Date of last participant enrolment
Anticipated
11/08/2025
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Actual
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Date of last data collection
Anticipated
30/09/2027
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment outside Australia
Country [1]
26689
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Hong Kong
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State/province [1]
26689
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Country [2]
26690
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Moldova, Republic Of
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State/province [2]
26690
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Country [3]
26688
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New Zealand
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State/province [3]
26688
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Auckland
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Country [4]
26691
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Taiwan, Province Of China
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State/province [4]
26691
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Country [5]
26692
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Ukraine
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State/province [5]
26692
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Country [6]
26950
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Philippines
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State/province [6]
26950
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Bluejay Therapeutics, Inc
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Address [1]
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Country [1]
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United States of America
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Primary sponsor type
Commercial sector/Industry
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Name
Bluejay Therapeutics, Inc
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Address
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Country
United States of America
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
320095
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Other collaborator category [1]
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Commercial sector/Industry
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Name [1]
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Novotech(Australia) Pty Limited
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Address [1]
283292
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Country [1]
283292
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316464
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Bellberry Human Research Ethics Committee A
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Ethics committee address [1]
316464
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https://bellberry.com.au/
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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04/12/2024
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Approval date [1]
316464
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Ethics approval number [1]
316464
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Ethics committee name [2]
316553
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Northern A Health and Disability Ethics CommitteeÂ
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Ethics committee address [2]
316553
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https://ethics.health.govt.nz/about/northern-a-health-and-disability-ethics-committee/
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Ethics committee country [2]
316553
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New Zealand
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Date submitted for ethics approval [2]
316553
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29/11/2024
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Approval date [2]
316553
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30/01/2025
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Ethics approval number [2]
316553
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Ethics committee name [3]
316552
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St Vincent’s Hospital Human Research Ethics Committee
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Ethics committee address [3]
316552
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https://svhs.org.au/home/research-education/research-office
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Ethics committee country [3]
316552
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Australia
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Date submitted for ethics approval [3]
316552
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06/12/2024
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Approval date [3]
316552
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21/03/2025
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Ethics approval number [3]
316552
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HREC 120/24
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Summary
Brief summary
This is a Phase 1b study to evaluate the safety and tolerability, PK/PD, and antiviral activity/efficacy of cavrotolimod and cavrotolimod-containing combinations in CHB infected subjects who are on nucleos(t)ide therapy. Cavrotolimod ±Nivolumab is being developed to address the high unmet medical need with possible benefits for participants with Chronic Hepatis B virus infection (CHB). This study will enroll non-cirrhotic, chronic hepatitis B (CHB) infected adults aged 18-65 years of age, inclusive, on nucleos(t)ide therapy. The study consists of four parts (Part A, Part B, Part C and Part D). Part C is an open label study with 3 cohorts. Each cohort will enroll a total of approximately 20 participants.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Edward Gane
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Address
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New Zealand Clinical Research, Grd floor, 3 Ferncroft St, Grafton Auckland 1010 New Zealand
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Country
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New Zealand
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Phone
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+64 21 548 371
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Ms. Carole Ann Moore
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Address
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Bluejay Therapeutics Inc., 255 Shoreline Drive, Suite 450, Redwood City, CA 94065, USA
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Country
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United States of America
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Phone
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+1 650 796 5003
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Susanna Tan, Senior Director, Clinical Development
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Address
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Bluejay Therapeutics Inc., 255 Shoreline Drive, Suite 450, Redwood City, CA 94065, USA
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Country
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United States of America
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Phone
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+1 925 998 6824
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Fax
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Email
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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