Study of IMC-I109V in Non-cirrhotic HBeAg-negative Chronic HBV Infection
- Conditions
- Hepatitis B, Chronic
- Interventions
- Drug: IMC-I109V Multiple Ascending DosesDrug: IMC-I109V Single Ascending DoseDrug: HBV HCC Module MAD
- Registration Number
- NCT05867056
- Lead Sponsor
- Immunocore Ltd
- Brief Summary
IMC-I109V is an immune-mobilizing monoclonal T cell receptor (TCR) against viruses (ImmTAV®), a new class of bispecific protein therapeutics designed for the treatment of chronic hepatitis B virus (HBV) infection (CHB). This is the first in-human study of IMC-I109V in persons with CHB.
- Detailed Description
IMC-I109V-101 is a first-in-human (FIH) study designed to assess the safety, tolerability, and pharmacokinetic (PK) profile of IMC-I109V in single and multiple dose regimens and to provide a preliminary assessment of antiviral activity, when administered to virally suppressed hepatitis B e-antigen (HBeAg)-negative participants receiving long-term NA therapy. The aim of this study is to identify safe, tolerable, and clinically active dose (CAD) regimens of IMC-I109V for further clinical development. The IMC-I109V study is divided into 3 main parts: Part 1 - Single Ascending Dose (SAD); Part 2 - Multiple Ascending Dose (MAD), in HBeAg-negative CHB; Part 3 will evaluate safety, tolerability, antiviral activity, PK and anti-tumor efficacy of Multiple Ascending Doses of IMC-I109V in participants with HBV-associated hepatocellular carcinoma (HBV HCC) who are virally suppressed on NA therapy.
Recruitment & Eligibility
- Status
- WITHDRAWN
- Sex
- All
- Target Recruitment
- 180
Not provided
Parts 1 and 2:
- Pregnant or lactating persons
- Known co-infection with any of the following: HIV, Hepatitis C virus, OR Hepatitis D virus
- Changes in HBeAg status within 3 months prior to the screening visit
- Known HBV genotype A
- Gilbert's syndrome
- Any known pre-existing medical or psychiatric condition that could interfere with the participant's ability to provide informed consent or participate in study conduct, or that may confound study findings including, but not limited to: Immunologically-mediated disease, e.g. inflammatory bowel disease (Crohn's disease, ulcerative colitis), rheumatoid arthritis, idiopathic thrombocytopenic purpura, systemic lupus erythematosus, scleroderma, or sarcoidosis within 5 years of the screening visit.
- Current or history of any clinically significant cardiac abnormalities/dysfunction, e.g. congestive heart failure, myocardial infarction ≤6 months prior to the screening visit, pulmonary hypertension, complex congenital heart disease, significant arrhythmia, or active cardiac ischemia.
- Evidence of decompensated liver disease including, but not limited to, a history or presence of clinical ascites, bleeding esophageal varices, hepatorenal syndrome, or hepatic encephalopathy.
- Significant immunosuppression from, but not limited to immunodeficiency conditions such as common variable hypogammaglobulinemia
- Evidence of active or suspected malignancy, or a history of malignancy ≤3 years prior to the screening visit (except adequately treated carcinoma in situ, basal cell carcinoma of the skin, or stage 0 HCC that has been treated). NOTE: Participants under evaluation for malignancy are not eligible
- Receiving or planning to receive systemic immunosuppressive medications during the study or ≤ 2 months prior to Day1, including but not limited to prednisone >10 mg/day (or equivalent), methotrexate, cyclosporine, or interferon. NOTE: Local steroid therapy is allowed (eg, inhaled, otic, ophthalmic, or intra-articular medications)
- Use of any live vaccines against infectious diseases within 4 weeks of the first planned administration of study intervention or use of any non-live vaccines against infectious diseases within 2 weeks of the first planned administration of study intervention.
- Treatment with any investigational drug or enrollment in any other clinical study ≤ 3 months prior to Day1, or at any time during participation in the study.
- Clinical diagnosis of substance abuse with alcohol, narcotics, or cocaine ≤12 months prior to the screening visit, except for those participants monitored in an opioid substitution maintenance program.
Part 3:
- Pregnant or lactating persons
- Untreated or symptomatic CNS metastases
- Significant ongoing toxicity from prior anticancer treatment -
- Ascites requiring recurrent paracentesis
- Inadequate washout from prior anticancer therapy
- Prior cellular therapy for HBV-associated HCC
- Known HBV genotype A
- Decompensated liver disease
- Surgical intervention or local / loco-regional therapy for HBV HCC within 28 days of planned first dose of study treatment
- Active hepatitis C virus (HCV) infection
- Untreated HIV infection
- Significant secondary malignancy
- Clinically significant lung, heart, or autoimmune disease
- Ongoing requirement for immunosuppressive treatment
- Prior solid organ or bone marrow transplant
- Hypersensitivity to study drug or excipients, or pre-medications
- Systemic antibiotics, vaccines or major surgery within 2-4 weeks prior to the first dose of study intervention
- Out-of-range laboratory values, including ALT or AST > 3x upper limit of normal (ULN), total bilirubin and direct bilirubin > 1.5x ULN, Albumin ≤ 28 g/L, International normalized ratio (INR) > 1.3
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Part 2: Multiple Ascending Doses (MAD) IMC-I109V Multiple Ascending Doses MAD will be approximately 54 weeks for each participant, comprising a maximum 42-day screening period, a 24-week treatment period involving weekly administration of IMC-I109V, and a 24-week follow-up period, with a total of 29 visits. Visits will take place on Day -1 and Days 1, 3 and 8, Weeks 3 (Day 15) through 24, Weeks 28, 36, 48 and 49. Participants who have achieved HBsAg \<100 IU/mL at end of Week 24 may be considered for further study treatments of up to Week 48 and follow-up visits every 12 weeks to Week 72. Treatment will be discontinued at Week 16 in participants who have not shown evidence of a response to IMC-I109V, in order to minimize unnecessary drug exposure in participants who are unlikely to achieve reductions in viral biomarkers with further doses. Part 1: Single Ascending Dose (SAD) IMC-I109V Single Ascending Dose SAD will be approximately 10 weeks for each participant, comprising a maximum 42-day screening period, a 1-day treatment period involving a single administration of IMC-I109V and a 28-day follow-up period, for a total of 8 visits. Visits will take place on Day -1 and Days 1, 2, 3, 8, 15, 22, and 29. Follow-up may be extended in participants who achieve a decrease in HBsAg of \> 0.5 log10 IU/mL at Day 29. Part 3: HBV HCC Module MAD HBV HCC Module MAD Enrollment into Part 3 may begin at the discretion of the Sponsor and will involve a maximum 42-day screening period, a treatment period comprising weekly administration of the target dose until the criteria for treatment discontinuation are met. Visits will take place on Day 1-2 and Day 8, Week 3 (Day 15), with this cycle being repeated until treatment stops, then 30 and 90 days post-last dose, then every 3 months after last dose, after which there will be a safety follow-up period of 30 days.
- Primary Outcome Measures
Name Time Method Parts 1, 2, and 3: Changes in electrocardiogram Up to 30 days after the last infusion of study treatment QTcF interval absolute values and changes from baseline.
Parts 1, 2, and 3: Incidence and treatment-emergent adverse events (TEAEs) Up to 30 days after the last infusion of study treatment Parts 1, 2, and 3: Incidence of serious adverse events (SAEs) Up to 30 days after the last infusion of study treatment Parts 1, 2, and 3: Incidence of adverse events (AEs) leading to treatment discontinuation Up to 30 days after the last infusion of study treatment Parts 1, 2, and 3: Incidence of dose-limiting toxicities (DLTs) Up to 30 days after the last infusion of study treatment Parts 1, 2, and 3: Changes in Vital Signs Up to 30 days after the last infusion of study treatment Number of participants with, and rate of, Grade 1, Grade 2, Grade 3, and Grade 4 (as applicable per NCI CTCAE v5.0) vital sign abnormalities.
Parts 1, 2, and 3: Change in safety laboratory parameters Up to 30 days after the last infusion of study treatment Number of participants with, and rate of, Grade 1, Grade 2, Grade 3, and Grade 4 (as applicable per NCI CTCAE v5.0) laboratory abnormalities.
- Secondary Outcome Measures
Name Time Method Parts 1, 2, and 3: Antiviral Effects: HBsAb change from baseline Up to 280 days post-dose Parts 1, 2, and 3: The elimination half-life (t1/2) At designated timepoints up to 162 days post-dose Parts 1, 2, and 3: Antiviral Effects: HBcrAg change from baseline Up to 280 days post-dose Part 3 only: Objective response rate (ORR) as determined by RECIST v1.1 as assessed by the Investigator Up to ~52 months Parts 1, 2, and 3: Maximum drug concentration (Cmax) At designated timepoints up to 162 days post-dose Parts 1, 2, and 3: Area under the plasma concentration versus time curve (AUC) At designated timepoints up to 162 days post-dose Parts 1, 2, and 3: The time to reach maximum drug concentration (Tmax) At designated timepoints up to 162 days post-dose Part 3 only: Duration of response (DOR) as determined by RECIST v1.1 as assessed by the Investigator Up to ~52 months Parts 1, 2, and 3: Incidence of anti-IMC-109V antibody formations At designated timepoints up to 162 days post-dose Parts 1, 2, and 3: Antiviral Effects: HBsAg change from baseline Up to 280 days post-dose Part 3 only: Overall survival (OS) as determined by RECIST v1.1 as assessed by the Investigator Up to ~52 months Parts 1, 2, and 3: Antiviral Effects: HBV RNA change from baseline Up to 280 days post-dose Part 3 only: Progression-free survival (PFS) as determined by RECIST v1.1 as assessed by the Investigator Up to ~52 months
Trial Locations
- Locations (15)
University of Southern California Keck School of Medicine
🇺🇸Los Angeles, California, United States
University Hospitals Cleveland Medical Center Case Western Reserve
🇺🇸Cleveland, Ohio, United States
St. Vincent's Hospital
🇦🇺Fitzroy, Australia
The Alfred Centre
🇦🇺Melbourne, Australia
Aarhus University
🇩🇰Aarhus, Denmark
Queen Mary Hospital
🇭🇰Hong Kong, Hong Kong
Pusan National University Hospital
🇰🇷Busan, Korea, Republic of
ARENSIA Exploratory Medicine Research Clinic
🇷🇴Bucharest, Romania
Hospital Universitari Vall d'Hebron de Barcelona
🇪🇸Barcelona, Spain
Hospital Ramón and Cajal
🇪🇸Madrid, Spain
Kaohsiung Medical University Chung-Ho
🇨🇳Kaohsiung City, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei city, Taiwan
Guy's Hospital, Dept. of Infectious Disease
🇬🇧London, United Kingdom
Chelsea and Westminster Hospital, Research and Development, Clinical Trials Facility
🇬🇧London, United Kingdom
Nottingham University Hospitals NHS Trust Biomedical Research Centre
🇬🇧Nottingham, United Kingdom