Condition or disease | Intervention/treatment | Phase |
---|---|---|
ER+ Breast Cancer Ovarian Cancer Cervical Squamous Cell Carcinoma Pancreatic Adenocarcinoma Endometrial Cancer Renal Cell Carcinoma Urothelial Cancer Head and Neck Squamous Cell Carcinoma Mesothelioma Melanoma Hepatocellular Carcinoma Prostate Cancer NSCLC HER2-negative Breast Cancer Triple Negative Breast Cancer Bladder Cancer Colorectal Cancer Metastatic GastroEsophageal Cancer NSCL2 Gene Mutation | Combination Product: Obinutuzumab pretreatment (Gazyva®) Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736) Combination Product: Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736) | Phase 1 |
This Phase 1b, open-label, multicenter (n=3-5), prospective, dose-finding and MTD cohort expansion study, will accrue patients with previously treated solid tumors known with high likelihood of 5T4 antigen expression on tumor cells.
Patients in the dose-escalation part will be treated with the combination of NAP and durvalumab using a fixed dose of durvalumab and the 3+3 design for NAP dose escalations. The (Maximum Tolerated Dose (MTD) of NAP for the combination treatment will be established based on Dose Limiting Toxicities (DLTs) occurring during the first cycle of the treatment.
A second dose escalation part is performed at the second highest safe dose in the dose escalation phase, pre-treated with obinutuzumab (anti-CD20), for elimination of anti-drug antibodies (ADAs) to NAP. In this part, the safety of the NAP-durvalumab combination will be assessed with obinutuzumab given prior to the initiation of that regimen. If safety and successful elimination of ADAs is confirmed, pretreatment with obinutuzumab will be tested further in the MTD expansion cohort.
MTD expansion part, in which 10-15 patients will be treated at the confirmed MTD of NAP. This cohort will accrue patients with the same tumor types as in the escalation part, as well as 5T4-positive colorectal cancer (CRC) and gastro-esophageal cancer (GE). Measurable disease, available tumor deposit and repeat biopsy are required. This expansion cohort will help assess the biologic activity of the combination and to gain some preliminary insights on its potential antitumor activity.
The following solid tumors known to have > 80% probability of 5T4 expression and thus may be included in both the dose escalation phase and the MTD expansion: breast cancer, epithelial ovarian cancer, cervical and endometrial cancer, pancreatic cancer, renal and urothelial cancer, head and neck, mesothelioma, melanoma, hepatic carcinoma, prostate cancer, and Non-Small Cell Lung Cancer (NSCLC). Prior PD-1 or PD-L1 therapy is acceptable.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 45 participants |
Allocation: | Non-Randomized |
Intervention Model: | Sequential Assignment |
Intervention Model Description: | NAP dose-escalation cohorts will be run with a standard 3+3 design. A sentinel patient will be recruited at each dose level in the first dose-escalation part. NAP will be given for up to 3 cycles in the dose escalation parts and up to 6 cycles in the MTD expansion part. |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Phase 1B, Open-Label, Dose Escalation and Cohort Expansions Trial of Naptumomab Estafenatox (NAP, ABR-217620) in Combination With Durvalumab (MEDI4736) in Subjects With Selected Advanced or Metastatic Solid Tumors |
Actual Study Start Date : | October 10, 2019 |
Estimated Primary Completion Date : | November 1, 2021 |
Estimated Study Completion Date : | February 28, 2022 |
Arm | Intervention/treatment |
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Experimental: Naptumomab estafenatox 2 µg/kg and durvalumab
NAP is to be administered on the first four days of each 21-day cycle, at daily doses of 2 µg/kg. Durvalumab (1120 mg, IV, 1- 1.5 hours after completion of the administration of NAP) will be administered on the second day of each 21-day cycle. After cycle 3, patients will continue to receive durvalumab alone at a dose of 1500 mg delivered once every 28 days, until confirmed disease progression or unacceptable toxicity for a maximum of up to 24 months.
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Combination Product: Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736)
NAP is given as an intravenous (I.V.) bolus injection at multiple doses. Durvalumab is given at a dose of 1120 mg, I.V, 1- 1.5 hours after completion of the administration of NAP on the second day of each 21-day cycle, and when administered as monotherapy at a dose of 1500 mg delivered once every 28 days.
|
Experimental: Naptumomab estafenatox 5 µg/kg and durvalumab
NAP is to be administered on the first four days of each 21-day cycle, at daily doses of 5 µg/kg. Durvalumab (1120 mg, IV, 1- 1.5 hours after completion of the administration of NAP) will be administered on the second day of each 21-day cycle. After cycle 3, patients will continue to receive durvalumab alone at a dose of 1500 mg delivered once every 28 days, until confirmed disease progression or unacceptable toxicity for a maximum of up to 24 months.
|
Combination Product: Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736)
NAP is given as an intravenous (I.V.) bolus injection at multiple doses. Durvalumab is given at a dose of 1120 mg, I.V, 1- 1.5 hours after completion of the administration of NAP on the second day of each 21-day cycle, and when administered as monotherapy at a dose of 1500 mg delivered once every 28 days.
|
Experimental: Naptumomab estafenatox 10 µg/kg and durvalumab
NAP is to be administered on the first four days of each 21-day cycle, at daily doses of 10 µg/kg. Durvalumab (1120 mg, IV, 1- 1.5 hours after completion of the administration of NAP) will be administered on the second day of each 21-day cycle. After cycle 3, patients will continue to receive durvalumab alone at a dose of 1500 mg delivered once every 28 days, until confirmed disease progression or unacceptable toxicity for a maximum of up to 24 months.
|
Combination Product: Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736)
NAP is given as an intravenous (I.V.) bolus injection at multiple doses. Durvalumab is given at a dose of 1120 mg, I.V, 1- 1.5 hours after completion of the administration of NAP on the second day of each 21-day cycle, and when administered as monotherapy at a dose of 1500 mg delivered once every 28 days.
|
Experimental: Naptumomab estafenatox 15 µg/kg and durvalumab
NAP is to be administered on the first four days of each 21-day cycle, at daily doses of 15 µg/kg. Durvalumab (1120 mg, IV, 1- 1.5 hours after completion of the administration of NAP) will be administered on the second day of each 21-day cycle. After cycle 3, patients will continue to receive durvalumab alone at a dose of 1500 mg delivered once every 28 days, until confirmed disease progression or unacceptable toxicity for a maximum of up to 24 months.
|
Combination Product: Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736)
NAP is given as an intravenous (I.V.) bolus injection at multiple doses. Durvalumab is given at a dose of 1120 mg, I.V, 1- 1.5 hours after completion of the administration of NAP on the second day of each 21-day cycle, and when administered as monotherapy at a dose of 1500 mg delivered once every 28 days.
|
Experimental: Naptumomab estafenatox 20 µg/kg and durvalumab
NAP is to be administered on the first four days of each 21-day cycle, at daily doses of 15 µg/kg. Durvalumab (1120 mg, IV, 1- 1.5 hours after completion of the administration of NAP) will be administered on the second day of each 21-day cycle. After cycle 3, patients will continue to receive durvalumab alone at a dose of 1500 mg delivered once every 28 days, until confirmed disease progression or unacceptable toxicity for a maximum of up to 24 months.
|
Combination Product: Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736)
NAP is given as an intravenous (I.V.) bolus injection at multiple doses. Durvalumab is given at a dose of 1120 mg, I.V, 1- 1.5 hours after completion of the administration of NAP on the second day of each 21-day cycle, and when administered as monotherapy at a dose of 1500 mg delivered once every 28 days.
|
Experimental: Dose escalation, obinutuzumab pretreatment followed by NAP 10 µg/kg and durvalumab
Obinutuzumab (1000 mg/day) will be administered on days 13 and 12 prior to the first day of NAP. NAP is to be administered on the first four days of each 21-day cycle, at daily doses of 10 µg/kg. Durvalumab (1120 mg, IV, 1- 1.5 hours after completion of the administration of NAP) will be administered on the second day of each 21-day cycle. After cycle 3, patients will continue to receive durvalumab alone at a dose of 1500 mg delivered once every 28 days, until confirmed disease progression or unacceptable toxicity for a maximum of up to 24 months.
|
Combination Product: Obinutuzumab pretreatment (Gazyva®) Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736)
Obinutuzumab is given intravenous (I.V.) 1,000 mg concentrate for solution for infusion. NAP is given as an intravenous (I.V.) bolus injection at multiple doses. Durvalumab is given at a dose of 1120 mg, I.V, 1- 1.5 hours after completion of the administration of NAP on the second day of each 21-day cycle, and when administered as monotherapy at a dose of 1500 mg delivered once every 28 days. |
Experimental: Dose escalation, obinutuzumab pretreatment followed by NAP 15 µg/kg and durvalumab
Obinutuzumab (1000 mg/day) will be administered on days 13 and 12 prior to the first day of NAP. NAP is to be administered on the first four days of each 21-day cycle, at daily doses of 15 µg/kg. Durvalumab (1120 mg, IV, 1- 1.5 hours after completion of the administration of NAP) will be administered on the second day of each 21-day cycle. After cycle 3, patients will continue to receive durvalumab alone at a dose of 1500 mg delivered once every 28 days, until confirmed disease progression or unacceptable toxicity for a maximum of up to 24 months.
|
Combination Product: Obinutuzumab pretreatment (Gazyva®) Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736)
Obinutuzumab is given intravenous (I.V.) 1,000 mg concentrate for solution for infusion. NAP is given as an intravenous (I.V.) bolus injection at multiple doses. Durvalumab is given at a dose of 1120 mg, I.V, 1- 1.5 hours after completion of the administration of NAP on the second day of each 21-day cycle, and when administered as monotherapy at a dose of 1500 mg delivered once every 28 days. |
Experimental: MTD expansion, obinutuzumab pretreatment with NAP at MTD and durvalumab
NAP at MTD and durvalumab (1120 mg) will be given for 6 cycles after pre-treatment of obinutuzumab (1000 mg/day) on D-13 and D-12. After cycle 6, patients will continue to receive durvalumab alone at a dose of 1500 mg delivered once every 28 days, until confirmed disease progression or unacceptable toxicity for a maximum of up to 24 months.
|
Combination Product: Obinutuzumab pretreatment (Gazyva®) Naptumomab estafenatox (ABR-217620; NAP) and durvalumab (IMFINZI; MEDI4736)
Obinutuzumab is given intravenous (I.V.) 1,000 mg concentrate for solution for infusion. NAP is given as an intravenous (I.V.) bolus injection at multiple doses. Durvalumab is given at a dose of 1120 mg, I.V, 1- 1.5 hours after completion of the administration of NAP on the second day of each 21-day cycle, and when administered as monotherapy at a dose of 1500 mg delivered once every 28 days. |
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Histologically and/or cytologically confirmed solid tumor from the following list, that is metastatic/advanced, for which no curative therapy exists:
a. All patients must provide signed informed consent prior to any study specific procedures that are not part of standard medical care.
b. Patients in the MTD expansion cohort must also provide their consent to undergo 2 tumor biopsies: one prior to treatment (during screening) and the second on cycle 1 day 4. An archival biopsy will be acceptable as baseline biopsy if it was collected within the 3 months preceding screening. Otherwise, a fresh biopsy is required. Patients enrolled in the MTD expansion cohort after prior exposure to a checkpoint inhibitor should have a baseline biopsy obtained after completion of the last prior checkpoint inhibitor therapy.
Presence of clinically and/or radiologically documented disease. All radiology studies must be performed within 28 days prior to subject enrolment (subject enrolment=Day 1)
a. Dose escalation part: patients do not need to have measurable disease by RECIST 1.1 b. MTD dose expansion part: patients must have measurable disease by RECIST 1.1 and at least one additional accessible lesion for biopsy. Previously irradiated lesions may be considered measurable if there has been demonstrated progression in these lesions.
Previous therapy:
i. All patients must have received at least 1 standard systemic cancer therapy for their tumor type and progressed following their most recent regimen. There is no limit to the number of prior cytotoxic regimens received.
ii. Treatment-naïve patients will be eligible only if they refused standard treatment.
iii. Patients with prior anti-PD-1, anti PD-L1 or anti CTLA4 therapy are eligible if they have received such therapy for a minimum of 6 months and if they have documented progression of their disease on or off such therapy.
Exclusion criteria:
Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [e.g. colitis or Crohn's disease], or other serious gastrointestinal chronic conditions associated with diarrhea), systemic lupus erythematosus, or Wegener syndrome (granulomatosis with polyangiitis), rheumatoid arthritis, uveitis, etc., within the past 2 years prior to the start of treatment. The following are exceptions to this criterion:
History of primary immunodeficiency, history of allogenic organ transplant that requires therapeutic immunosuppression and the use of immunosuppressive agents within 28 days of enrollment.
NOTE: Intranasal/inhaled corticosteroids or systemic steroids that do not exceed 10 mg/day of prednisone or equivalent dose of an alternative corticosteroid are permissible
Recent history of live attenuated vaccine within 30 days prior to the first dose of study drug.
NOTE: Patients, once enrolled, should not receive live vaccine whilst receiving study drug and up to 30 days after the last dose of study drug.
Female patients who are pregnant or breastfeeding or male or female patients of reproductive potential who are not willing to employ effective birth control from screening to 90 days after the last dose of study treatment (either durvalumab monotherapy or durvalumab + Nap combination therapy).
* Highly effective methods of contraception are defined as one that results in a low failure rate (e.g., less than 1% per year) when used consistently and correctly. Note that some contraception methods are not considered highly effective (e.g., male or female condom with or without spermicide; female cap, diaphragm, or sponge with or without spermicide; non-copper containing intrauterine device; progestogen-only oral hormonal contraceptive pills where inhibition of ovulation is not the primary mode of action [excluding Cerazette/desogestrel which is considered highly effective]; and triphasic combined oral contraceptive pills).
Patients who have received prior anti-PD-1, anti PD-L1 or anti CTLA-4:
Contact: Ilana Lorber, MD | 97239125853 ext 213 | ilanal@neotx.com | |
Contact: Lori Michaeli, MA | 972722154556 | lori@novatrials.com |
Israel | |
Rambam Medical Center | Recruiting |
Haifa, Israel, 3109601 | |
Contact: Anna Isakovich 972-4-7776744 a_isakovitch@rambam.health.gov.il | |
Sheba Medical Center | Recruiting |
Ramat Gan, Israel, 52621 | |
Contact: Aliza Ackerstein 972-3-5304498 Aliza.Ackerstein@sheba.health.gov.il | |
Tel Aviv Sourasky Medical Center | Recruiting |
Tel Aviv, Israel, 6423906 | |
Contact: Shirlee Sagiv 972-3-6972969 shirlees@tlvmc.gov.il |
Study Director: | Ilana Lorber, MD | NeoTX Therapeutics Ltd. |
Tracking Information | |||||||||
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First Submitted Date ICMJE | May 27, 2019 | ||||||||
First Posted Date ICMJE | June 12, 2019 | ||||||||
Last Update Posted Date | October 26, 2020 | ||||||||
Actual Study Start Date ICMJE | October 10, 2019 | ||||||||
Estimated Primary Completion Date | November 1, 2021 (Final data collection date for primary outcome measure) | ||||||||
Current Primary Outcome Measures ICMJE |
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Original Primary Outcome Measures ICMJE |
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Change History | |||||||||
Current Secondary Outcome Measures ICMJE |
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Original Secondary Outcome Measures ICMJE | Not Provided | ||||||||
Current Other Pre-specified Outcome Measures | Not Provided | ||||||||
Original Other Pre-specified Outcome Measures | Not Provided | ||||||||
Descriptive Information | |||||||||
Brief Title ICMJE | Naptumomab Estafenatox in Combination With Durvalumab in Subjects With Selected Advanced or Metastatic Solid Tumors | ||||||||
Official Title ICMJE | Phase 1B, Open-Label, Dose Escalation and Cohort Expansions Trial of Naptumomab Estafenatox (NAP, ABR-217620) in Combination With Durvalumab (MEDI4736) in Subjects With Selected Advanced or Metastatic Solid Tumors | ||||||||
Brief Summary | This is a dose escalation, MTD expansion (Phase 1b) and cohort expansions (Phase 2) study to assess the safety and tolerability of a combination of NAP with durvalumab in subjects with selected advanced or metastatic solid tumors. | ||||||||
Detailed Description |
This Phase 1b, open-label, multicenter (n=3-5), prospective, dose-finding and MTD cohort expansion study, will accrue patients with previously treated solid tumors known with high likelihood of 5T4 antigen expression on tumor cells. Patients in the dose-escalation part will be treated with the combination of NAP and durvalumab using a fixed dose of durvalumab and the 3+3 design for NAP dose escalations. The (Maximum Tolerated Dose (MTD) of NAP for the combination treatment will be established based on Dose Limiting Toxicities (DLTs) occurring during the first cycle of the treatment. A second dose escalation part is performed at the second highest safe dose in the dose escalation phase, pre-treated with obinutuzumab (anti-CD20), for elimination of anti-drug antibodies (ADAs) to NAP. In this part, the safety of the NAP-durvalumab combination will be assessed with obinutuzumab given prior to the initiation of that regimen. If safety and successful elimination of ADAs is confirmed, pretreatment with obinutuzumab will be tested further in the MTD expansion cohort. MTD expansion part, in which 10-15 patients will be treated at the confirmed MTD of NAP. This cohort will accrue patients with the same tumor types as in the escalation part, as well as 5T4-positive colorectal cancer (CRC) and gastro-esophageal cancer (GE). Measurable disease, available tumor deposit and repeat biopsy are required. This expansion cohort will help assess the biologic activity of the combination and to gain some preliminary insights on its potential antitumor activity. The following solid tumors known to have > 80% probability of 5T4 expression and thus may be included in both the dose escalation phase and the MTD expansion: breast cancer, epithelial ovarian cancer, cervical and endometrial cancer, pancreatic cancer, renal and urothelial cancer, head and neck, mesothelioma, melanoma, hepatic carcinoma, prostate cancer, and Non-Small Cell Lung Cancer (NSCLC). Prior PD-1 or PD-L1 therapy is acceptable. |
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Study Type ICMJE | Interventional | ||||||||
Study Phase ICMJE | Phase 1 | ||||||||
Study Design ICMJE | Allocation: Non-Randomized Intervention Model: Sequential Assignment Intervention Model Description: NAP dose-escalation cohorts will be run with a standard 3+3 design. A sentinel patient will be recruited at each dose level in the first dose-escalation part. NAP will be given for up to 3 cycles in the dose escalation parts and up to 6 cycles in the MTD expansion part. Masking: None (Open Label)Primary Purpose: Treatment |
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Condition ICMJE |
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Intervention ICMJE |
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Study Arms ICMJE |
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Publications * | Not Provided | ||||||||
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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Recruitment Information | |||||||||
Recruitment Status ICMJE | Recruiting | ||||||||
Estimated Enrollment ICMJE |
45 | ||||||||
Original Estimated Enrollment ICMJE | Same as current | ||||||||
Estimated Study Completion Date ICMJE | February 28, 2022 | ||||||||
Estimated Primary Completion Date | November 1, 2021 (Final data collection date for primary outcome measure) | ||||||||
Eligibility Criteria ICMJE |
Inclusion Criteria:
Exclusion criteria:
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Sex/Gender ICMJE |
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Ages ICMJE | 18 Years and older (Adult, Older Adult) | ||||||||
Accepts Healthy Volunteers ICMJE | No | ||||||||
Contacts ICMJE |
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Listed Location Countries ICMJE | Israel | ||||||||
Removed Location Countries | |||||||||
Administrative Information | |||||||||
NCT Number ICMJE | NCT03983954 | ||||||||
Other Study ID Numbers ICMJE | 127-CL-01 | ||||||||
Has Data Monitoring Committee | No | ||||||||
U.S. FDA-regulated Product |
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IPD Sharing Statement ICMJE |
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Responsible Party | NeoTX Therapeutics Ltd. | ||||||||
Study Sponsor ICMJE | NeoTX Therapeutics Ltd. | ||||||||
Collaborators ICMJE | AstraZeneca | ||||||||
Investigators ICMJE |
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PRS Account | NeoTX Therapeutics Ltd. | ||||||||
Verification Date | October 2020 | ||||||||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |