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A Study to Evaluate the Safety and Efficacy of Gocatamig (MK-6070) and Ifinatamab Deruxtecan (I-DXd) in Participants With Relapsed/Refractory Extensive-Stage Small Cell Lung Cancer (MK-6070-002)

Phase 1
Recruiting
Conditions
Small Cell Lung Cancer
Interventions
Biological: Ifinatamab Deruxtecan (I-DXd)
Registration Number
NCT06780137
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

Researchers are looking for new ways to treat people with extensive-stage small cell lung cancer (SCLC) that has relapsed or is refractory. Gocatamig is a new type of immunotherapy that uses a person's immune system to find and destroy cancer cells. Ifinatamab deruxtecan (also known as I-DXd) is a drug which binds to a specific target on cancer cells and delivers treatment to destroy those cells. Researchers want to know if giving gocatamig and/or I-DXd can treat SCLC that did not respond or stopped responding to a prior treatment.

The goals of this study are to learn:

* If gocatamig and I-DXd are safe and well tolerated

* If people who receive gocatamig and I-DXd have their SCLC get smaller or go away

Detailed Description

This study will consist of two parts. Part 1 will assess the safety, tolerability, and efficacy of gocatamig and I-DXd at dosing intervals of once every 2 weeks (Q2W) and/or once every 3 weeks (Q3W) at doses determined in study MK-6070-001 (NCT: NCT04471727). Part 2 will assess the safety and tolerability of gocatamig in Japanese participants.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
138
Inclusion Criteria
  • Has histologically or cytologically confirmed SCLC that is extensive stage (defined as Stage IV (T any, N any, M1a/b/c) following at least 1 prior line of systemic therapy that included platinum-based chemotherapy
  • Must be able to provide archival tissue sample or fresh biopsy tissue sample
  • Human immunodeficiency virus (HIV) infected participants must have well controlled HIV on antiretroviral therapy (ART)
Exclusion Criteria
  • Pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedure
  • History of (noninfectious) pneumonitis/interstitial lung disease (ILD) that required steroids or has current pneumonitis/ILD, and or suspected ILD/pneumonitis
  • Has clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses
  • History of clinically significant intracranial bleeding or spinal cord bleeding
  • Active neurologic paraneoplastic syndrome
  • Active or history of immune deficiency with the exception of HIV-infected participants with well controlled HIV on ART
  • History within 6 months before the first dose of study intervention of coronary/peripheral artery bypass graft and/or any coronary/peripheral angioplasty or clinically significant cardiovascular disease such as myocardial infarction, symptomatic congestive heart failure (CHF) (New York Heart Association > class II), and/or uncontrolled cardiac arrhythmia
  • Has other uncontrolled or significant protocol-specified cardiovascular disease
  • History of arterial thrombosis (eg, stroke or transient ischemic attack) within 6 months before the first dose of study intervention
  • Chronic liver disease, including liver cirrhosis of Child-Pugh class B or C
  • Active clinically significant infection requiring systemic therapy
  • History of allogeneic tissue/solid organ transplant
  • History of leptomeningeal disease
  • Received prior radiotherapy within 2 weeks of start of study intervention, or has radiation-related toxicities, requiring corticosteroids
  • Ongoing treatment with immunosuppressive medications, with protocol-specified exceptions
  • Known additional malignancy that is progressing or has required active treatment within the past 3 years
  • Untreated or symptomatic brain metastases
  • Active viral hepatitis, defined as hepatitis A (hepatitis A virus immunoglobulin M [IgM] positive in the setting of associated signs/symptoms), hepatitis B (hepatitis B virus surface antigen [HbsAg] positive and/or detectable hepatitis B virus (HBV) deoxyribonucleic acid [DNA]), or hepatitis C (hepatitis C virus [HCV] antibody positive and detectable HCV ribonucleic acid). Participants with HBV with undetectable viral load after treatment are eligible. Participants with HCV with undetectable virus after treatment are eligible.
  • Part 1 only: Radiation therapy to the lung >30 Gy within 6 months before the start of study intervention
  • Part 1 only: Abdominal radiation within 4 weeks before start of study intervention
  • Part 1 only: Other anticancer therapy, including cytotoxic agents, targeted agents, immunotherapies, antibody, retinoid, transplant, or anticancer hormonal treatment (except luteinizing hormone-releasing hormone [LHRH]) within 2 weeks before start of study intervention
  • Part 1 only: Antibody-based cancer therapy within 3 weeks before start of study intervention
  • Part 1 only: Chloroquine/hydroxychloroquine within 2 weeks before start of study intervention
  • Part 1 only: Clinically significant corneal disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part 1 Arm 1: Gocatamig and I-DXd Q3WGocatamigParticipants will receive gocatamig and I-DXd Q3W at the determined dose until documented disease progression or discontinuation criteria are met.
Part 1 Arm 1: Gocatamig and I-DXd Q3WIfinatamab Deruxtecan (I-DXd)Participants will receive gocatamig and I-DXd Q3W at the determined dose until documented disease progression or discontinuation criteria are met.
Part 1 Arm 2: Gocatamig Q2W and I-DXd Q3WGocatamigParticipants will receive gocatamig Q2W and I-DXd Q3W at the determined dose until documented disease progression or discontinuation criteria are met.
Part 1 Arm 2: Gocatamig Q2W and I-DXd Q3WIfinatamab Deruxtecan (I-DXd)Participants will receive gocatamig Q2W and I-DXd Q3W at the determined dose until documented disease progression or discontinuation criteria are met.
Part 1 Arm 3a: I-DXd Monotherapy Q2WIfinatamab Deruxtecan (I-DXd)Participants will receive I-DXd Q2W until documented disease progression or discontinuation criteria are met.
Part 1 Arm 3b: Gocatamig and I-DXd Q2WGocatamigParticipants will receive gocatamig and I-DXd Q2W at the determined dose until documented disease progression or discontinuation criteria are met.
Part 1 Arm 3b: Gocatamig and I-DXd Q2WIfinatamab Deruxtecan (I-DXd)Participants will receive gocatamig and I-DXd Q2W at the determined dose until documented disease progression or discontinuation criteria are met.
Part 2 Arm 4: Gocatamig MonotherapyGocatamigParticipants in Japan will receive escalating doses of gocatamig until documented disease progression or discontinuation criteria are met.
Primary Outcome Measures
NameTimeMethod
Number of Participants Who Experience an Adverse Event (AE)Up to approximately 44 months

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The number of participants who experience an AE in the study will be presented.

Number of Participants Who Experience One or More Dose-Limiting Toxicities (DLTs)Up to approximately 3 weeks

A DLT is defined as any drug-related adverse event (AE) observed during the DLT evaluation period that meet pre-defined DTL criteria. Toxicities will be graded using National Cancer Institute Common Terminology for Adverse Events (NCI CTCAE) version 5.0, or the American Society for Transplant and Cellular Therapy (ASTCT) criteria. The number of participants who experience at least one DLT will be presented.

Number of Participants Who Discontinue Study Intervention Due to an AEUp to approximately 44 months

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The number of participants who discontinue the study intervention due to an AE in the study will be presented.

Part 1: Objective Response Rate (ORR)Up to approximately 44 months

ORR is defined as the percentage of participants with Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: at least a 30% decrease in the sum of diameters of target lesions) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1). The percentage of participants who experience CR or PR as assessed by the investigator will be presented.

Secondary Outcome Measures
NameTimeMethod
Part 1: Duration of Response (DOR)Up to approximately 44 months

For participants who demonstrate a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR is defined as the time from first documented evidence of CR or PR until progressive disease (PD) or death. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. DOR as assessed by the investigator will be presented.

Part 1: Progression-Free Survival (PFS)Up to approximately 44 months

PFS is defined as the time from randomization to the first documented PD or death due to any cause, whichever occurs first as assessed by RECIST 1.1. PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. PFS as assessed by the investigator will be presented.

Maximum Concentration (Cmax) of gocatamigAt designated timepoints (up to approximately 44 months)

Cmax is the maximum concentration of the study drug observed in plasma. Blood samples collected pre dose and at multiple timepoints post dose will be used to determine Cmax of the drug gocatamig.

Cmax of ifinatamab deruxtecan (I-DXd)At designated timepoints (up to approximately 44 months)

Cmax is the maximum concentration of the study drug observed in plasma. Blood samples collected pre dose and at multiple timepoints post dose will be used to determine Cmax of the drug I-DXd.

Cmax of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

Cmax is the maximum concentration of the study drug observed in plasma. Blood samples collected pre dose and at multiple timepoints post dose will be used to determine Cmax of the anti-B7-H3 antibody.

Cmax of Deruxtecan (DXd)At designated timepoints (up to approximately 44 months)

Cmax is the maximum concentration of the study drug observed in plasma. Blood samples collected pre dose and at multiple timepoints post dose will be used to determine Cmax of the drug payload deruxtecan (DXd).

Time to maximum concentration (Tmax) of gocatamigAt designated timepoints (up to approximately 44 months)

Tmax is the amount of time that a drug is present at the maximum concentration is observed in plasma. Blood samples will be collected to determine the Tmax of the drug gocatamig.

Tmax of I-DXdAt designated timepoints (up to approximately 44 months)

Tmax is the amount of time that a drug is present at the maximum concentration is observed in plasma. Blood samples will be collected to determine the Tmax of the drug I-DXd.

Tmax of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

Tmax is the amount of time that the drug is present at the maximum concentration is observed in plasma. Blood samples will be collected to determine the Tmax of the anti-B7-H3 antibody.

Tmax of DXdAt designated timepoints (up to approximately 44 months)

Tmax is the amount of time that the drug is present at the maximum concentration is observed in plasma. Blood samples will be collected to determine the Tmax of the drug payload DXd.

Area Under the Concentration-Time Curve Over the Dosing Interval t (AUCt) of gocatamigAt designated timepoints (up to approximately 44 months)

AUCt is a measure of plasma drug concentration and time and is estimated as the area under the plot of plasma concentration against time after drug administration. Blood samples will be collected to determine the AUCt of the drug gocatamig.

AUCt of I-DXdAt designated timepoints (up to approximately 44 months)

AUCt is a measure of plasma drug concentration and time and is estimated as the area under the plot of plasma concentration against time after drug administration. Blood samples will be collected to determine the AUCt of the drug I-DXd.

AUCt of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

AUCt is a measure of plasma drug concentration and time and is estimated as the area under the plot of plasma concentration against time after drug administration. Blood samples will be collected to determine the AUCt of the anti-B7-H3 antibody.

AUCt of DXdAt designated timepoints (up to approximately 44 months)

AUCt is a measure of plasma drug concentration and time and is estimated as the area under the plot of plasma concentration against time after drug administration. Blood samples will be collected to determine the AUCt of the drug payload Dxd.

Terminal Half-Life (t1/2) of gocatamigAt designated timepoints (up to approximately 44 months)

t½ is defined as the time required for plasma drug concentration of study drug to decrease by 50% from peak. Blood samples will be collected to determine the t1/2 of the drug gocatamig.

t1/2 of I-DXdAt designated timepoints (up to approximately 44 months)

t½ is defined as the time required for plasma drug concentration of study drug to decrease by 50% from peak. Blood samples will be collected to determine the t1/2 of the drug I-DXd.

t1/2 of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

t½ is defined as the time required for plasma drug concentration of study drug to decrease by 50% from peak. Blood samples will be collected to determine the t1/2 of the anti-B7-H3 antibody.

t1/2 of DXdAt designated timepoints (up to approximately 44 months)

t½ is defined as the time required for plasma drug concentration of study drug to decrease by 50% from peak. Blood samples will be collected to determine the t1/2 of the drug payload DXd.

Steady State Maximum Concentration (Cmax,ss) of gocatamigAt designated timepoints (up to approximately 44 months)

Cmax,ss is a measure of the maximum level of drug in the blood, measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Cmax,ss of the drug gocatamig.

Cmax,ss of I-DXdAt designated timepoints (up to approximately 44 months)

Cmax,ss is a measure of the maximum level of drug in the blood, measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Cmax,ss of the drug I-DXd.

Cmax,ss of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

Cmax,ss is a measure of the maximum level of drug in the blood, measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Cmax,ss of the anti-B7-H3 antibody.

Cmax,ss of DXdAt designated timepoints (up to approximately 44 months)

Cmax,ss is a measure of the maximum level of drug in the blood, measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Cmax,ss of the drug payload DXd.

Steady State Ctrough (Ctrough,ss) of gocatamigAt designated timepoints (up to approximately 44 months)

Ctrough,ss is defined as the trough concentration measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Ctrough,ss of the drug gocatamig.

Ctrough,ss of I-DXdAt designated timepoints (up to approximately 44 months)

Ctrough,ss is defined as the trough concentration measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Ctrough,ss of the drug I-DXd.

Ctrough,ss of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

Ctrough,ss is defined as the trough concentration measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Ctrough,ss of the anti-B7-H3 antibody.

Ctrough,ss of DXdAt designated timepoints (up to approximately 44 months)

Ctrough,ss is defined as the trough concentration measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Ctrough,ss of the drug payload DXd.

Steady State Time to Maximum Concentration (Tmax,ss) of gocatamigAt designated timepoints (up to approximately 44 months)

Tmax,ss is the amount of time that a drug is present at the maximum concentration is observed in plasma measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Tmax,ss of the drug gocatamig.

Tmax,ss of I-DXdAt designated timepoints (up to approximately 44 months)

Tmax,ss is the amount of time that a drug is present at the maximum concentration is observed in plasma measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Tmax,ss of the drug I-DXd.

Tmax,ss of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

Tmax,ss is the amount of time that a drug is present at the maximum concentration is observed in plasma measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Tmax,ss of the anti-B7-H3 antibody.

Tmax,ss of DXdAt designated timepoints (up to approximately 44 months)

Tmax,ss is the amount of time that a drug is present at the maximum concentration is observed in plasma measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the Tmax,ss of the drug payload DXd.

Area Under the Steady State Concentration-Time Curve Over Dosing Interval t (AUCt,ss) of gocatamigAt designated timepoints (up to approximately 44 months)

AUCt,ss is a measure of plasma drug concentration and time and is estimated as the area under the plot of plasma concentration against time after drug administration measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the AUCt,ss of the drug gocatamig.

AUCt,ss of I-DXdAt designated timepoints (up to approximately 44 months)

AUCt,ss is a measure of plasma drug concentration and time and is estimated as the area under the plot of plasma concentration against time after drug administration measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the AUCt,ss of the drug I-DXd.

AUCt,ss of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

AUCt,ss is a measure of plasma drug concentration and time and is estimated as the area under the plot of plasma concentration against time after drug administration measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the AUCt,ss of the anti-B7-H3 antibody.

AUCt,ss of DXdAt designated timepoints (up to approximately 44 months)

AUCt,ss is a measure of plasma drug concentration and time and is estimated as the area under the plot of plasma concentration against time after drug administration measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the AUCt,ss of the drug payload DXd.

Steady state t1/2 (t1/2,ss) of gocatamigAt designated timepoints (up to approximately 44 months)

t1/2,ss is defined as the time required for plasma drug concentration of study drug to decrease by 50% from peak measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the t1/2,ss of the drug gocatamig.

t1/2,ss of I-DXdAt designated timepoints (up to approximately 44 months)

t1/2,ss is defined as the time required for plasma drug concentration of study drug to decrease by 50% from peak measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the t1/2,ss of the drug I-DXd.

t1/2,ss of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

t1/2,ss is defined as the time required for plasma drug concentration of study drug to decrease by 50% from peak measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the t1/2,ss of the anti-B7-H3 antibody.

t1/2,ss of DXdAt designated timepoints (up to approximately 44 months)

t1/2,ss is defined as the time required for plasma drug concentration of study drug to decrease by 50% from peak measured at steady state (time at which the amount of drug eliminated by the body is in equilibrium with the amount taken in). Blood samples will be collected to determine the t1/2,ss of the drug payload DXd.

Accumulation Ratio (AC) of gocatamigAt designated timepoints (up to approximately 44 months)

Blood samples will be collected to determine the AC of the drug gocatamig.

AC of I-DXdAt designated timepoints (up to approximately 44 months)

Blood samples will be collected to determine the AC of the drug I-DXd.

AC of Anti-B7-H3 AntibodyAt designated timepoints (up to approximately 44 months)

Blood samples will be collected to determine the AC of the anti-B7-H3 antibody.

AC of DXdAt designated timepoints (up to approximately 44 months)

Blood samples will be collected to determine the AC of the drug payload DXd.

Incidence of Anti-Drug Antibodies (ADAs) Against gocatamigAt designated timepoints (up to approximately 44 months)

Blood samples collected at designated timepoints will be used to determine the ADA response to gocatamig. The incidence of ADAs for gocatamig will be presented.

Incidence of Anti-Drug Antibodies (ADAs) Against I-DXdAt designated timepoints (up to approximately 44 months)

Blood samples collected at designated timepoints will be used to determine the ADA response to I-DXd. The incidence of ADAs for I-DXd will be presented.

Trial Locations

Locations (12)

Dana Farber Cancer Institute ( Site 1105)

🇺🇸

Boston, Massachusetts, United States

John Theurer Cancer Center at Hackensack University Medical Center ( Site 1103)

🇺🇸

Hackensack, New Jersey, United States

Sarah Cannon Research Institute ( Site 7001)

🇺🇸

Nashville, Tennessee, United States

FALP ( Site 2100)

🇨🇱

Santiago., Region M. De Santiago, Chile

Rambam Health Care Campus ( Site 3202)

🇮🇱

Haifa, Israel

Shaare Zedek Medical Center ( Site 3200)

🇮🇱

Jerusalem, Israel

Sheba Medical Center ( Site 3201)

🇮🇱

Ramat Gan, Israel

Seoul National University Hospital ( Site 5100)

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center ( Site 5101)

🇰🇷

Seoul, Korea, Republic of

HOSPITAL CLÍNIC DE BARCELONA ( Site 3310)

🇪🇸

L Eixample, Barcelona, Spain

Hospital Universitari Vall d'Hebron ( Site 3311)

🇪🇸

Barcelona, Spain

Hospital Universitario Virgen de la Victoria ( Site 3312)

🇪🇸

Malaga, Spain

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