Dose Escalation Study of Safety and Tolerability of AT-406 in Patients With Advanced Solid Tumors and Lymphomas

Ascenta Therapeutics, Inc. is conducting a clinical trial of the compound Debio 1143
(AT-406), a small molecule second mitochondria-derived activator of caspase C (Smac) mimetic.
In vivo and in vitro studies have demonstrated that Debio 1143 (AT-406) induces cell death in
several tumor models by inhibiting XIAP (X linked IAP), cIAP-1 (cellular IAP-1) and cIAP-2
(cellular IAP-2), thus releasing initiator and effector caspases to promote apoptosis. This
protocol is a Phase I, dose-escalation, open-label, multi-center study conducted in patients
with advanced solid tumors and lymphomas to evaluate the safety, tolerability and
pharmacology of Debio 1143 (AT-406) in humans when administered orally.

Inclusion Criteria:

- Histologically confirmed solid tumor or lymphoma;

- Locally advanced or metastatic disease for which no life prolonging therapy is
available and no standard therapy is judged appropriate by the investigator;

- Eastern Cooperative Oncology Group Performance Status ≤ 1;

- Adequate hematologic function as indicated by, ANC ≥ 1,500/mm3, Hgb >9.0 g/dL,
platelet count ≥ 100,000/mm3

- Adequate renal and liver function as indicated by serum creatinine ≤ 1.0 x ULN or
creatinine clearance of > 60 cc/min, serum albumin ≥ 3.0 gm/dL, total bilirubin < 1.0
x ULN, AST and ALT ≤ 2.5 x ULN ; Alkaline phosphatase ≤2.5 x ULN

- Negative Hepatitis B and Hepatitis C testing;

- QTc interval ≤450ms.

Exclusion Criteria:

- Radiation within 14 days of study entry, thoracic radiation within 28 days of study
entry. Patients who have received prior radiotherapy must have discontinued steroids
for 14 days prior to study entry and be clinically stable;

- Not recovered to ≤ Grade 1 toxicity from prior radiotherapy or chemotherapy agents;

- Use or requirement for use of aspirin or aspirin containing products with >81 mg of
aspirin per day;

- History of gastrointestinal bleeding within 1 year;

- History of diabetes mellitus requiring treatment with oral agents or insulin;

- Active rheumatoid arthritis, active inflammatory bowel disease, chronic infections, or
any other disease or condition associated with chronic inflammation;

- Known or suspected Wilson's Disease, or other conditions that affect copper
accumulation or regulation;

- Prior treatment with IAP inhibitors.