The primary objectives of this study are:* To describe the safety and tolerability of cergutuzumab amunaleukin in combination with atezolizumab* To determine the MTD, if achieved, of cergutuzumab amunaleukin in combination with atezolizumab* To…
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Synonym
Health condition
gevorderde en/of gemetastaseerde solide tumoren
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary objectives of this study are:
* To describe the safety and tolerability of cergutuzumab amunaleukin in
combination with atezolizumab
* To determine the MTD, if achieved, of cergutuzumab amunaleukin in combination
with atezolizumab
* To identify a recommended Phase II dose of cergutuzumab amunaleukin in
combination with atezolizumab.
Secondary outcome
The secondary objectives for this study are as follows:
* To obtain preliminary anti-tumor activity data of cergutuzumab amunaleukin in
combination with atezolizumab in patients with locally advanced and/or
metastatic solid tumors
* To describe the pharmacodynamic (PD) effects of cergutuzumab amunaleukin in
combination with atezolizumab
* To describe the pharmacokinetics (PK) of cergutuzumab amunaleukin and
atezolizumab when they are administered in combination
Background summary
Cancer is the leading cause of death in economically developed countries and
the second leading cause of death in developing countries. Based on the
GLOBOCAN estimates, there were 14.1 million new cancer cases, 8.2 million
cancer deaths, and 32.6 million people living with cancer (within 5 years of
diagnosis) in 2012 worldwide
(http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx#). A large percentage
of patients with cancer are diagnosed with advanced disease and are considered
to be incurable by surgery and/or radiation. Despite the advances in
chemotherapy and the development of agents targeted at the molecular level to
interfere with the transduction and regulation of growth signals in cancer
cells, the prognosis of patients with advanced cancer remains poor in general.
Consequently, there is a persisting and urgent medical need to develop new
therapies that can be added to existing treatments to increase survival without
causing unacceptable toxicity.
Study objective
The primary objectives of this study are:
* To describe the safety and tolerability of cergutuzumab amunaleukin in
combination with atezolizumab
* To determine the MTD, if achieved, of cergutuzumab amunaleukin in combination
with atezolizumab
* To identify a recommended Phase II dose of cergutuzumab amunaleukin in
combination with atezolizumab.
The secondary objectives for this study are as follows:
* To obtain preliminary anti-tumor activity data of cergutuzumab amunaleukin in
combination with atezolizumab in patients with locally advanced and/or
metastatic solid tumors
* To describe the pharmacodynamic (PD) effects of cergutuzumab amunaleukin in
combination with atezolizumab
* To describe the pharmacokinetics (PK) of cergutuzumab amunaleukin and
atezolizumab when they are administered in combination
Study design
This is an open-label, multi-center, dose escalation Phase Ib clinical study of
cergutuzumab amunaleukin in combination with atezolizumab, with an expansion
part. The study will be conducted in two parts.
Part I: Dose Escalation
Based on safety, PK and PD emerging data from this trial, administration of
cergutuzumab amunaleukin at dosing intervals of qW q2W may be explored. For
atezolizumab, there are two dose-equivalent schedules: doses of 840 mg (q2W)
and 1200 mg (q3W).
Part II: MTD (or recommended dose) expansion
The expansion part of this study will be initiated once the MTD (or recommended
dose) of one or more schedules has have been determined, with the purpose to
better characterize the safety, tolerability, PD, PK, and preliminary efficacy
of of cergutuzumab amunaleukin in combination with atezolizumab. Two different
dose levels (not exceeding the MTD) or doses below MTD ofin different schedules
might be explored in the expansion part.
Intervention
Patients who are eligible will be treated with cergutuzumab amunaleukin in
combiantion with atezolizumab according the study specific schedule as shown in
appendix 1 of the protocol.
Study burden and risks
There are risks, discomforts and inconveniences associated with any research
study. These deserve careful thought before agreeing to participate in any
scientific trial.
The following problems may be caused by cergutuzumab amunaleukin or
atezolizumab:
Infusion related reaction, allergic and hypersensitivity reactions, Development
of antibodies to the study drug, Vascular Leak Syndrome (VLS) and Edema
Common site effects with atezolizumab (occurs in more than 10% of patients) are:
* Fatigue
* Joint pain (arthralgia)
* Lack of energy (asthenia)
* Back pain
* Decreased appetite
* Diarrhea
* Shortness of breath (dyspnea)
* Stomach area pain (abdominal pain)
* Headache
* Itching of the skin
* Nausea
* Fever
* Rash
* Vomiting
For more information about the site effect we refer you to section 7 and
appendix II of the informed consent form
Beneluxlaan 2a
Woerden 3446 GR
NL
Beneluxlaan 2a
Woerden 3446 GR
NL
Listed location countries
Age
Inclusion criteria
Adult patients, * 18 years of age;* Confirmed locally advanced and/or metastatic solid tumor, with at least one tumor lesion of non-critical location accessible to biopsy (with exception to NSCLC patients), and with confirmed progression at baseline that has progressed on, or patient is intolerant to, the standard of care therapy;* Radiologically measurable and clinically evaluable disease (as per response evaluation criteria in Solid Tumors [RECIST] v1.1) ;* Life expectancy, in the opinion of the investigator, of * 12 weeks;* Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0-1;* All acute toxic effects of any prior radiotherapy, chemotherapy, or surgical procedure must have resolved to Grade * 1, except alopecia (any grade) and Grade 2 peripheral neuropathy;* Adequate hematological, liver and renal function test results;* Negative serum pregnancy test within 7 days prior to study treatment in premenopausal women and women <<= 2 years after menopause.;* For women who are not postmenopausal and have not undergone surgical sterilization agreement to remain abstinent or use two adequate non-hormonal methods of contraception, including at least one method with a failure rate of <1% per year during the treatment period and for at least 5 months after the last dose of atezolizumab, and at least four months after the last dose of cergutuzumab amunaleukin, whichever is the longest.;*For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom plus an additional contraceptive method that together result in a failure rate of <1% per year during the treatment period and for at least 2 months after the last dose of cergutuzumab amunaleukin. Men must refrain from donating sperm during this same period;* Locally or centrally confirmed CEA expression in archival tumor tissue (><=20% of tumor cells staining with at least moderate intensity). If no archival tumor tissue is available the fresh biopsy is collected for centrally confirmed CEA expression;* Patients with unilateral pleural effusion (other than lung cancer indication) should fulfill the following criteria for pulmonary and cardiac functions as: GOLD classification 0-1 level and NYHA classification class 1.;*Gilbert*s syndrome: Patients with Gilbert*s syndrome will be eligible for the study. The diagnosis of Gilbert*s syndrome is suspected in people who have persistent, slightly elevated levels of unconjugated bilirubin without any other apparent cause
Exclusion criteria
* Active or untreated central nervous system (CNS) metastases as determined by CT or MRI evaluation during screening and prior radiographic assessments
* Spinal cord compression not definitively treated with surgery and/or radiation or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for >= 2 weeks prior to enrollment.
* Leptomeningeal disease;* Patients with an active second malignancy . Patients who have a history of malignancy are not considered to have an active malignancy if they have completed therapy and are considered by their treating physician to be at <=30% risk for relapse.;* Evidence of significant, uncontrolled concomitant diseases which could affect compliance with the protocol or interpretation of results, including diabetes mellitus, history of relevant pulmonary disorders, and known autoimmune diseases
* Patients (all indications) with bilateral pleural effusion and lung cancer patients with unilateral of bilateral effusion confirmed at screening by X-ray;* Uncontrolled hypertension, unstable angina, congestive heart failure (CHF) New York Heart Association (NYHA) classification stage >2, serious cardiac arrhythmia requiring treatment (except for patients with pleural effusion, who should have NYHA =<1 serious cardiac arrhythmia requiring treatment, history of myocardial infarction within 6 months of enrollment)
*Administration of a live, attenuated vaccine within 4 weeks before cycle 1 day 1 or anticipated that such a live attenuated vaccine will be required during the study or 5 months after the last dose atezolizumab.
* Known HIV or Active HBV or HCV infection, patients with past or resolved hepatitis B are eligible.
*Severe infections within 4 weeks prior to cycle 1 day 1.
*Received oral of intravenous antibiotics within 2 weeks prior to cycle 1 day 1. Patients receiving prophylactic antibiotics are eligible.;* Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that would contraindicate the use of an investigational drug
*Major surgery of significant traumatic injury <28 days prior to Cycle 1 Day 1 or anticipation of the need for major surgery during study treatment.
*Dementia or altered mental status that would prohibit informed consent.
* History or risk of autoimmune disease,
*History of idiopathic pulmonary firbrosis, pneumonitis organizing pneumonia, or evidence of active pneumonitis on screening chest CT scan. History of radiation pneumonitis in the radiation field is permitted
* Baseline QTc interval of >470 ms, baseline resting bradycardia <45 beats per minute, or baseline resting tachycardia > 100 beats per minute.
*Pregnant or breast-feeding women.;* Known hypersensitivity to any of the components of, cergutuzumab amunaleukin en atezolizumab, hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies.
*Investigational therapy (defined as treatment for which there is no regulatory authority approved indication) within 28 days prior to Cycle 1 Day 1.
*Last dose with any of the following agents including but not limited to: etanercept, infliximab, tacrolimus, cyclosporine, mycophenolic acid, alefacept, or efalizumab <28 dyas prior to Cycle 1 Day 1.;* Last dose of prior immunotherapies including but not limited to: interferon alpha (IFN-a), interferon-beta (IFN-b), IL-2, conjugated IL-2, CEA-IL2v, cytokines, anti*CTLA4, anti-PD-L1, or anti-PD-1 <28 days prior to Cylce 1 Day 1
*History of severe immune-related adverse effects from, cerhutuzumab amunaleukin or anti-PD-1 or anti-PD-L1 therapies;* Regular immunosuppressive therapy (i.e., for organ transplantation, chronic rheumatologic disease);* Treatment with systemic immunosuppressive medications within 2 weeks prior to cycle 1 day 1
* Radiotherapy within the last 4 weeks before start of study drug treatment with the exception of limited field palliative radiotherapy for bone pain relief.
*History of progressive multifocal leukoencephalopathy
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2014-000948-14-NL |
CCMO | NL51581.031.15 |