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Study of STRO-002, an Anti-Folate Receptor Alpha (FolRα) Antibody Drug Conjugate in Ovarian & Endometrial Cancers

Phase 1
Completed
Conditions
Endometrioid Adenocarcinoma
Ovarian Cancer
Ovarian Carcinoma
Primary Peritoneal Carcinoma
Ovary Cancer
Endometrial Cancer
Fallopian Tube Cancer
Interventions
Registration Number
NCT03748186
Lead Sponsor
Sutro Biopharma, Inc.
Brief Summary

Phase 1 trial to study the safety, pharmacokinetics and preliminary efficacy of STRO-002 given intravenously every 3 weeks.

Detailed Description

This study is a phase 1, open-label, multicenter, dose-escalation study with dose expansion to identify the maximum tolerated dose (MTD), the recommended phase 2 dose (RP2D) and to evaluate the safety, tolerability, and preliminary antitumor activity of STRO-002 in adult subjects with advanced epithelial ovarian cancer (EOC), including fallopian or primary peritoneal cancer, and endometrial cancer. Fallopian tube and primary peritoneal cancers are treated in the same manner as epithelial ovarian cancers and are thus included in this phase 1 study. Subjects enrolled in the study will be required to have progressive or recurrent disease after standard approved therapy as defined in the study eligibility criteria. The study has completed dose escalation and is currently in dose expansion, enrolling endometrial and ovarian cancer subjects.

All subjects enrolled on the study are required to have tumor tissue for determining folate receptor alpha (FolRα) expression levels, either from a prior surgery or tumor biopsy or from a biopsy performed during study screening. The testing for FolRα is done via an ICH assay. A minimum level of FolRα expression is required for enrollment for endometrial cancer but not for ovarian cancer.

Study drug, STRO-002, is administered by intravenous (IV) infusion on day 1 of 21-day cycles. Clinical evaluations and/or laboratory tests will be performed at a pre-specified schedule-weekly for cycles 1-4, and at the beginning of every cycle starting with cycle 5 as described in the schedule of assessments. Samples for PK analysis will occur at specific times on days 1, 8, and 15 of cycles 1 and 4, Day 1 of cycles 2, 3, and 5 and at the end of treatment (EOT) visit. The study requires imaging with a CT or MRI scan of the chest abdomen and pelvis at screening, every 6 weeks after enrollment for the first 18 weeks, then every 9 weeks, and at the end of treatment (EOT) visit. Additional X-rays may be required to confirm disease responses and per local institution standard of care.

Additional clinical evaluations and lab testing may occur at the discretion of the investigator.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
136
Inclusion Criteria
  1. Age ≥ 18 years

  2. Measurable disease per RECIST 1.1

  3. ECOG performance status (0-1)

  4. Life expectancy > 3 months

  5. Pathological confirmation of disease under study (historical information, diagnosis, pathology report, etc)

    1. Expansion Cohorts A and C: High-grade serous EOC, fallopian tube cancer or primary peritoneal cancer
    2. Expansion Cohort B: Histologically diagnosed epithelial endometrial cancer (endometrioid and serous adenocarcinomas; undifferentiated carcinoma; mixed epithelial carcinoma; or adenocarcinoma NOS)
  6. Relapsed and/or progressive disease

    1. Dose Expansion Cohorts A and C (Ovarian Cancer):

      • Platinum resistant and received 1-3 prior regimens or
      • Platinum sensitive and either:
      • Progressed after 2 prior lines of platinum therapy (regardless of platinum status)and received 2-3 prior regimens or
      • Progressed after 1 line of platinum therapy and 1 line of non-platinum therapy and received a total of 2-3 prior regimens if contraindicated to receive second platinum regimen.
    2. Dose Expansion Cohort B (Endometrial Cancer):

      • Relapsed or progression after at least 1 platinum-based chemotherapy regimen or 1 immunotherapy-based regimen but not to exceed more than 3 prior regimens.
  7. Fresh or archival tumor tissue samples

Exclusion Criteria
  1. Low grade (grade 1) ovarian carcinoma, clear cell, mucinous and sarcomatous ovarian carcinomas (Cohort A).
  2. Endometrial carcinosarcomas, leiomyosarcoma and stromal sarcomas (Cohort B).
  3. Prior treatment with a FolRα-targeting ADCs or FolRα-targeting vaccines
  4. Platinum-refractory during frontline treatment (Cohorts A and C)
  5. Greater than 3 lines of prior treatment
  6. History of severe allergic or anaphylactic reactions to monoclonal antibody therapy or to antibody-related fusion protein treatment
  7. Preexisting clinically significant ocular disorders, clinically significant pre-exisiting ocular disorders, severe chronic obstructive pulmonary disease or asthma, clinically significant cardiac or cerebrovascular disease, or other significant concurrent, uncontrolled medical condition
  8. Metastatic central nervous system or meningeal disease
  9. Concurrent participation in another therapeutic treatment trial

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
STRO-002 treatmentSTRO-002Dose Escalation: STRO-002 at increasing dose levels Dose Expansion: STRO-002 at 4.3 mg/kg and 5.2 mg/kg
Primary Outcome Measures
NameTimeMethod
Part 1: Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability of STRO-002)18 months

Incidence of adverse events (AEs) observed across STRO-002 dose levels

Part 1: Define the recommended phase 2 dose (RP2D) of STRO-00218 months

Frequency of dose-limiting toxicity and exposure across STRO-002 dose levels

Part 1: Define the maximum tolerated dose (MTD) of STRO-00218 months

Frequency of dose-limiting toxicity and exposure across STRO-002 dose levels

Part 2: Evaluate preliminary anti-tumor activity (ovarian, Fallopian and primary peritoneal cancer patients)24 months

Objective response rate per RECIST 1.1

Part 2: Evaluate preliminary anti-tumor activity (endometrial cancer patients)24 months

Objective response rate per RECIST 1.1

Secondary Outcome Measures
NameTimeMethod
Part 1: Assess the formulation of anti-drug antibodies to STRO-00218 months

Circulating anti-drug antibodies (ADAs) formed to STRO-002

Part 2: Evaluate preliminary anti-tumor efficacy with a time-to-event analysis of duration of response (DOR) in patients treated with STRO-00224 months

Duration of response per RECIST 1.1

Part 2: Characterize the PK of STRO-002 by measuring the area under the plasma concentration versus time curve (AUC)24 months

Measurement of AUC to infinity (AUC inf)

Part 2: Characterize the PK of STRO-002 by measuring the clearance (CL)24 months

Measurement of total body clearance

Part 1: Characterize the pharmacokinetics (PK) of STRO-002 by measuring the maximum plasma concentration (Cmax)18 months

Measurement of maximum plasma concentration after the administration of STRO-002

Part 1: Characterize the PK of STRO-002 measuring the total area under the concentration versus time curve from zero to infinity (AUCinf)18 months

Measurement of AUC to infinity (AUCinf)

Part 2: Evaluate preliminary anti-tumor efficacy with a time-to-event analysis of progression-free survival (PFS) in patients treated with STRO-00224 months

Progression-free survival per RECIST 1.1

Part 2: Characterize the PK of STRO-002 by measuring the maximum plasma concentration (Cmax)24 months

Measurement of maximum plasma concentration (Cmax) after the administration of STRO-002

Part 1: Characterize the PK of STRO-002 by measuring the half-life (t1/2) of STRO-00218 months

Measurement of terminal half-life of STRO-002 after the administration of STRO-002

Part 1: Characterize the PK of STRO-002 by measuring the clearance (CL)18 months

Measurement of total body clearance

Part 1: Characterize the PK of STRO-002 by measuring the the steady state volume of distribution (Vss)18 months

Measurement of steady state volume of distribution

Part 2: Evaluate preliminary effect of STRO-002 treatment on CA-125 levels24 months

Response assessment based on the Gynecologic Cancer Intergroup (GCIG) criteria

Part 2: Further evaluate the incidence of Treatment-Emergent Adverse Events (Safety and Tolerability of STRO-002)24 months

Number of patients with abnormal laboratory values and/or adverse events related to STRO-002 treatment

Trial Locations

Locations (27)

Miami Cancer Institue, Baptist Health South Florida

🇺🇸

Miami, Florida, United States

Comprehensive Cancer Centers of Nevada

🇺🇸

Las Vegas, Nevada, United States

Minnesota Oncology Hematology

🇺🇸

Minneapolis, Minnesota, United States

Sarah Cannon Research Institute

🇺🇸

Nashville, Tennessee, United States

Arizona Oncology - Tucson

🇺🇸

Tucson, Arizona, United States

UCLA Jonsson Comprehensive Cancer Center Clinical Research Unit

🇺🇸

Los Angeles, California, United States

Yale School of Medicine

🇺🇸

New Haven, Connecticut, United States

Sutter Health- Palo Alto Medical Foundation

🇺🇸

San Francisco, California, United States

Rocky Mountain Cancer Center

🇺🇸

Aurora, Colorado, United States

University of South Florida

🇺🇸

Tampa, Florida, United States

Augusta Oncology

🇺🇸

Augusta, Georgia, United States

University of Chicago

🇺🇸

Chicago, Illinois, United States

Maryland Oncology Hematology

🇺🇸

Rockville, Maryland, United States

Levine Cancer Institute

🇺🇸

Charlotte, North Carolina, United States

NYU Langone Medical Center

🇺🇸

New York, New York, United States

University of Cincinnati Cancer Institute

🇺🇸

Cincinnati, Ohio, United States

Cancer Care Northwest-South Spokane

🇺🇸

Spokane, Washington, United States

Ohio State University, James Cancer Center

🇺🇸

Columbus, Ohio, United States

Prisma Health

🇺🇸

Greenville, South Carolina, United States

Clínica Universidad de Navarra -Madrid

🇪🇸

Madrid, Spain

Vall d'Hebron Institut d'Oncologia

🇪🇸

Barcelona, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital Universitario HM Sanchinarro - CIOCC

🇪🇸

Madrid, Spain

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Virginia Cancer Specialists

🇺🇸

Fairfax, Virginia, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

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