Primary: Phase 1: To estimate the RP2D and/or the MTD for PDR001.Phase II: To estimate the anti-tumor activity of PDR001.Secondary: Both phases: Safety and tolerability, PK profile, emergence of anti-PDR001 antibodies, other parameters for…
ID
Source
Brief title
Condition
- Miscellaneous and site unspecified neoplasms malignant and unspecified
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Phase I: DLTs.
Phase II: Overall response rate.
Secondary outcome
Both phases: Adverse events, dose interruptions and reductions, PK parameters,
anti-PDR001 antibodies, progression free survival, duration of response,
disease control rate.
Background summary
PDR001 is a high-affinity, ligand-blocking, humanized anti-PD-1 IgG4 antibody
that blocks the binding of PD-L1 and PD-L2 to PD-1. PDR001 shows functional
activity in vitro/ex vivo.
This first-in-humans study will characterize the safety, tolerability,
pharmacokinetics, pharmacodynamics and antitumor activity of PDR001
administered i.v. as a single agent. By blocking the interaction between PD-1
and its ligands, PD-L1 and PD-L2, PDR001 inhibits the PD-1 immune checkpoint,
resulting in activation of an antitumor immune response by activating effector
T-cells and inhibiting regulatory T-cells. From ongoing studies with anti-PD-1
antibodies, such as nivolumab and pembrolizumab, it is evident that PD-1
checkpoint inhibition results in clinically important anti-tumor
activity.
This study is designed both to establish a recommended dose and schedule for
PDR001, and to determine PDR001 antitumor activity in non-small cell lung
cancer (NSCLC) and melanoma, and in 3 exploratory indications: gastric cancer
and esophageal adenocarcinoma, colorectal cancer and anal cancer. This FIH
study is also designed to provide data to support future disease-specific
registration studies in cancers for which anti-PD-1 therapy has not yet been
explored.
Study objective
Primary:
Phase 1: To estimate the RP2D and/or the MTD for PDR001.
Phase II: To estimate the anti-tumor activity of PDR001.
Secondary:
Both phases: Safety and tolerability, PK profile, emergence of anti-PDR001
antibodies, other parameters for preliminary anti-tumor activity.
Study design
Multicenter phase I/II open-label dose escalation and dose expansion study of
PDR001 monotherapy.
During phase II prescreening for PD-L1 status for patients with gastric cancer
and esophageal adenocarcinoma, colorectal cancer and anal cancer.
The study treatment will be administered during 28-days cycles. PDR001
administration on days 1 and 15 or day 1 (once every 4 weeks). A once every 3
weeks schedule may be explored.
Treatment period until disease progression or unacceptable side effects.
Approx. 288 patients (58 for dose escalation and 230 for dose expansion) .
Independent DSMB.
Intervention
Treatment with PDR001.
Study burden and risks
Risk: Adverse effects of PDR001. First-in-human study.
Burden: Cycles of 4 weeks.
Screening visit, Cycle 1 and 3: 7 visits, cycle 2 2 visits, from cycle 4
onwards 2 visits (in case of a once per 4 weeks dosing schedule: 1 visit per
cycle. Duration mostly 1-4 hours.
IV infusions of PDR001 once per 2 weeks and once per 4 weeks (once per 3 weeks
may be explored). Duration 0,5-2 hours.
Physical examination: at screening, cycle 1: 3 times, cycle 2: 2 times, from
cycle 3 onwards: once per cycle.
Blood tests (4-30 ml/occasion): at screening, cycle 1-2-3: all visits. From
cycle 4 onwards: once per cycle.
ECG: At screening and cycles 1, 3 and 6 at day 1 prior and after administration
of PDR001, end of Study visit.
3 tumor biopsies: at screening and cycle 3 between Day 1 an d 15 and at
progression (only in patients who had a response)
CT-/MRIscan: At screening, cycle 3 and every 8 weeks (every 2nd cycle)
thereafter until cycle 11 and every 12 weeks thereafter.
Optional storage and use of the remaining blood and tissue for future research.
Raapopseweg 1
Arnhem 6824 DP
NL
Raapopseweg 1
Arnhem 6824 DP
NL
Listed location countries
Age
Inclusion criteria
* phase I part: Advanced/metastatic solid tumors, with (non)measurable disease, who have progressed despite standard therapy or are intolerant of standard therapy, or for whom no standard therapy exists.
* Phase II part: Advanced/metastatic solid tumors, with at least one measurable lesion, who have received standard therapy or are intolerant of standard therapy, have progressed following their last prior therapy, and fit into one of the following groups: *
Group 1: NSCLC
Patients with NSCLC must have had disease recurrence or progression during or after one
prior platinum doublet-based chemotherapy regimen for advanced or metastatic disease.
Prior maintenance therapy is allowed (e.g. pemetrexed, erlotinib, bevacizumab).
Patients must have been tested for mutations affecting EGFR and ALK. Patients with a known mutation in one gene need not be tested for the other. Patients with ALK or EGFR-positive NSCLC must have had recurrent or progressive disease after treatment with the corresponding inhibitor and platinum doublet-based chemotherapy, in any sequence.
Group 2: Melanoma
Patients with melanoma must have clinical or radiological evidence of disease progression during or after: For patients with BRAF wild type disease, at least one cycle of systemic treatment for
advanced melanoma.
For patients with BRAF V600 mutation positive disease, treatment with a BRAF inhibitor
(alone or in combination with other agents) and at least one other systemic treatment
Group 3: Triple negative breast cancer
* ECOG performance status 0-1-2.
* Disease amenable to biopsy and a candidate for tumor biopsy according to the treating institution*s guidelines. Patient must be willing to undergo a new tumor biopsy at baseline, and during therapy on this study.
Group 4: Anaplastic thyroid cancer
* Patients are not required to have received or progressed on a prior therapy.
* Patients in this indication must not be at short term risk for life threatening complications (such as airway compromise or bleeding from locoregional or metastatic disease).
* Chemoradiation and/or surgery should be considered prior to study entry for those patients with locally advanced disease if those therapies are considered to be in the best interest of the patient.
Exclusion criteria
* Symptomatic CNS metastases or CNS metastases that require local CNS-directed therapy or increasing doses of corticosteroids within the prior 2 weeks.
* Out of range laboratory values (see protocol section 5.3).
* Impaired cardiac function or clinically significant cardiac disease e.g. congestive heart failure NYHA * 2), QTcF > 470 msec
* Subjects with active, known or suspected autoimmune disease. Subjects with vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll.
* History of drug-induced pneumonitis or current pneumonitis.
* Active infection requirings ystemic antibiotic therapy
* HIV infection, active HBV or HCV infection
* Ocular melanoma
* Systemic anti-cancer therapy within 2-4 weeks of the first dose of study treatment.
Wash-out for anticancer immunotherapiessuch as CTLA-4 antagonists, 6 weeks is indicated
* Prior PD-1- or PD-L1-directed therapy.
* Treatment with systemic steroid therapy, other than in the setting of adrenal insufficiency, systemic immunosuppressive therapy.
* Vaccines against infectious diseases within 4 weeks of initiation of study treatment.
* Major surgery within 2 weeks. .
* Radiotherapy within 2 weeks, except for palliative radiotherapy to a limited field.
* CSF within 2 weeks.
Design
Recruitment
Medical products/devices used
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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 | EUCTR2014-003929-17-NL |
ClinicalTrials.gov | NCT02404441 |
CCMO | NL52948.058.15 |