Study to Evaluate the Efficacy/Safety of IPI-549 in Combination With Nivolumab in Patients With Advanced Urothelial Carcinoma (MARIO-275)
- Conditions
- Advanced CancerBladder CancerUrothelial CarcinomaSolid Tumor
- Interventions
- Registration Number
- NCT03980041
- Lead Sponsor
- Infinity Pharmaceuticals, Inc.
- Brief Summary
The purpose of this study is to measure the effect of IPI-549 in combination with nivolumab when compared to nivolumab monotherapy in advanced urothelial cancer patients.
- Detailed Description
Study IPI-549-02 is a multi-national, prospective, randomized, active-control Phase II trial to evaluate the efficacy and safety of IPI 549 administered in combination with nivolumab compared to nivolumab monotherapy.
The study will enroll approximately 160 checkpoint-naïve, advanced urothelial cancer patients who have progressed or recurred following treatment with platinum-based chemotherapy. Patients will be randomized 2:1 to receive intravenous (IV) nivolumab 480 mg every 4 weeks (Q4W) in combination with oral (PO) IPI 549 40 mg once daily (QD) or IV nivolumab 480 mg Q4W in combination with placebo PO QD.
Eligible patients who have confirmed progression of disease during treatment with nivolumab monotherapy may crossover to the combination treatment arm.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 49
- Histologically or cytologically confirmed urothelial carcinoma of the renal pelvis, ureter, bladder, or urethra
- Measurable disease by CT or MRI as defined by RECIST v1.1
- Disease progression or recurrence after treatment:
- i) With at least 1 platinum-based chemotherapy regimen for the treatment of metastatic (Stage IV) or locally advanced unresectable disease; or
- ii) With disease recurrence within 1 year of completing a platinum-based neoadjuvant or adjuvant therapy
- Subject that have received more than 2 prior lines of chemotherapy must not have liver metastases
- Tumor tissues (archived or new biopsy) must be provided for biomarker analysis
- Eastern Cooperative Oncology Group (ECOG) performance status ≤1
- Blood sample must be provided for mMDSC levels for randomization into the study
- Active brain metastases or leptomeningeal metastases
- Any serious or uncontrolled medical disorder that may interfere with study treatment/interpretation
- Prior malignancy active within the previous 3 years except for local or organ confined early stage cancer that has been apparently cured
- Active, known, or suspected autoimmune disease
- A condition requiring systemic treatment with either corticosteroids (>10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 day of study drug administration
- Prior therapy with anti-tumor vaccines, any T cell co-stimulation or checkpoint pathways, or IPI-549
- Prior surgery or gastrointestinal dysfunction that may affect drug absorption
- Past medical history of interstitial lung disease
- History of stroke, unstable angina, myocardial infarction, or ventricular arrhythmia requiring medication or mechanical control
- Positive test for hepatitis B, C or HIV
- Dependent on continuous supplemental oxygen
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description IPI-549 + Nivolumab IPI-549 (eganelisib) Participants receive IPI-549 orally (PO) daily in combination with nivolumab IV infusion every 4 weeks Placebo + Nivolumab Placebos Participants receive placebo orally (PO) daily in combination with nivolumab IV infusion every 4 weeks IPI-549 + Nivolumab Nivolumab Participants receive IPI-549 orally (PO) daily in combination with nivolumab IV infusion every 4 weeks Placebo + Nivolumab Nivolumab Participants receive placebo orally (PO) daily in combination with nivolumab IV infusion every 4 weeks
- Primary Outcome Measures
Name Time Method Objective Response Rate (ORR) per RECISTv1.1 First dosing date to date of confirmed disease progression, assessed up to 24 months ORR is defined as best response of complete response (CR) or partial response (PR) as measured by RECIST v1.1.
RECIST 1.1 = Response Evaluation Criteria in Solid Tumors. CR= Disappearance of all extranodal target lesions. All pathological lymph nodes must have decreased to \<10 mm in short axis. PR= At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
- Secondary Outcome Measures
Name Time Method Duration of Response (DOR) Date of first objective response to date of confirmed disease progression, assessed up to 24 months DOR is defined as the time from the first objective response (CR or PR) to documented disease progression in patients with CR or PR.
Changes from baseline in respiration rate Screening to date of confirmed disease progression, assessed up to 24 months Respiration rate as measured in breaths per minute.
Changes from baseline in thyroid stimulating hormone (TSH) Pre-treatment (within 7 days of first dose) to date of confirmed disease progression, assessed up to 24 months If TSH result is abnormal, subsequent testing of Free T3 and free T4 required.
Population Pharmacokinetics (PK) of IPI-549-01 Pre-dose, 0.5, 1.5, 3 and 6 hours following administration on Day 1 of Cycles 1 and 2 (each cycle is 28 days) IPI-549 blood concentrations in ng/mL.
Pharmacokinetics (PK) of Nivolumab Pre-infusion and within 2 minutes of end of infusion on Day 1 of Cycles 1 and 4; Pre-infusion on Day 1 of Cycles 2 and 3, and every 4 cycles starting at Cycle 5 (each cycle is 28 days) Nivolumab blood concentrations will be assayed in ug/mL.
Time to Response (TTR) First dosing date to date of first objective response, assessed up to 24 months TTR is defined as the time from the first dose of study treatment to first objective response \[complete response (CR) or partial response (PR)\] in patients with CR or PR.
Changes from baseline in temperature Screening to date of confirmed disease progression, assessed up to 24 months Temperature as measured in celsius.
Changes from baseline in pulse rate Screening to date of confirmed disease progression, assessed up to 24 months Pulse rate as measured in beats per minute (bpm)
Progression-Free Survival (PFS) First dosing to date to confirmed disease progression or death, assessed up to 48 months PFS is defined as the time from the first dose of study treatment to documented disease progression or death due to any cause.
Changes from baseline in electrocardiograms (ECGs) Screening to date of confirmed disease progression, assessed up to 24 months ECGs assess heart problems by measuring the electrical activity generated by the heart as it contracts. The components that will be assessed during the ECG are P wave, QRS complex, ST segment, and T wave.
Changes from baseline in Eastern Cooperative Oncology Group (ECOG) performance Screening to date of confirmed disease progression, assessed up to 24 months ECOG performance status describes the level of impact that disease has on the patient's daily living abilities. Scale ranges from 0 (Fully active and able to carry on all pre-disease performance without restriction) to 5 (Dead).
Changes from baseline in blood pressure Screening to date of confirmed disease progression, assessed up to 24 months Systolic and diastolic blood pressure as measured in mmHg.
Trial Locations
- Locations (29)
Centre Antoine Lacassagne
🇫🇷Nice, France
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
🇮🇹Meldola, Italy
Bon Secours St. Francis Cancer Center
🇺🇸Greenville, South Carolina, United States
Centre Oscar Lambret
🇫🇷Lille, France
Institute for Oncology of Vojvodina
🇷🇸Sremska Kamenica, Serbia
Istituto per la Ricerca e la Cura del Cancro (IRCC)
🇮🇹Candiolo, Italy
Clinical Centre of Serbia
🇷🇸Belgrade, Serbia
Institut Claudius Regaud
🇫🇷Toulouse, France
Hospital Universitario Central de Asturias
🇪🇸Oviedo, Spain
Hospital Universitatio HM Sanchinarro
🇪🇸Madrid, Spain
EXAMEN sp
🇵🇱Skorzewo, Poland
Parkview Physicians
🇺🇸Fort Wayne, Indiana, United States
University of MD - Greenebaum Comprehensive Cancer Center
🇺🇸Baltimore, Maryland, United States
Karmanos Cancer Center
🇺🇸Detroit, Michigan, United States
Coborn Cancer Center
🇺🇸Saint Cloud, Minnesota, United States
Sarah Cannon Tennessee Oncology
🇺🇸Nashville, Tennessee, United States
Onkologicka Klinika
🇨🇿Praha, Czechia
Institut Paoli-Calmettes
🇫🇷Marseille, France
CHU de Strasbourg
🇫🇷Strasbourg, France
Istituto Nazionale dei Tumori
🇮🇹Napoli, Italy
Dzienny Oddzial Chemioterapii
🇵🇱Racibórz, Poland
Oddzial Chorob Rozrostowych Wojewodzki Szpital
🇵🇱Łódź, Poland
ICO Institute Catalan of Oncology
🇪🇸Barcelona, Spain
Hospital de Sant Creu i Sant Pau
🇪🇸Barcelona, Spain
MD Anderson Cancer Center Madrid
🇪🇸Madrid, Spain
IMQ Zorrotzaurre
🇪🇸Bilbao, Spain
Hospital Ramón y Cajal
🇪🇸Madrid, Spain
Hospital Universitario
🇪🇸Sevilla, Spain
Montefiore Medical Center
🇺🇸Bronx, New York, United States