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Ivosidenib, Nivolumab, and Ipilimumab Combination in Previously Treated Subjects With Nonresectable or Metastatic IDH1 Mutant Cholangiocarcinoma

Phase 1
Completed
Conditions
IDH1-mutant Cholangiocarcinoma
Interventions
Drug: Recommended Combination Dose (RCD) of ivosidenib
Registration Number
NCT05921760
Lead Sponsor
Servier Bio-Innovation LLC
Brief Summary

This is a Phase 1/2 study evaluating the safety, tolerability, and activity of ivosidenib in combination with immunotherapy in participants with nonresectable or metastatic cholangiocarcinoma. The study includes two phases: the safety lead-in phase to determine the recommended combination dose (RCD) of ivosidenib in combination with immunotherapy and the dose expansion phase to assess the efficacy of ivosidenib in combination with immunotherapy. Study treatment will be administered until participant experiences unacceptable toxicity, disease progression, or other discontinuation criteria are met.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
7
Inclusion Criteria
  • Male of female participant age ≥ 18 years old
  • Have documented IDH1 gene-mutated disease based on local testing procedure (R132C/L/G/H/S mutations variants tested)
  • Eastern Cooperative Oncology Group performance status (ECOG PS) score of 0 or 1
  • Has a histopathological diagnosis consistent with nonresectable or metastatic cholangiocarcinoma and are not eligible for curative resection, transplantation, or ablative therapies
  • Participants must have at least one measurable lesion as defined by RECIST Version 1.1. Subjects who have received prior local therapy (including but not limited to embolization, chemoembolization, radiofrequency ablation, or radiation therapy) are eligible provided measurable disease falls outside of the treatment field or if within the field but has shown ≥ 20% growth in size post-treatment assessment.
Exclusion Criteria
  • Received prior treatment with an IDH inhibitor or prior treatment with an immune checkpoint inhibitor other than anti-PD1/L1
  • Have active autoimmune disease or any condition requiring systemic treatment with either corticosteroids (> 10 mg daily of prednisone equivalents) or other immunosuppressive medications within 14 days of study treatment
  • Participants who have not recovered from toxicity of previous anticancer therapy, including Grade ≥ 1 non-hematologic toxicity, according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0, prior to the first IMP administration. Residual Grade ≤ 2 toxicity from chemotherapy (e.g., alopecia, neuropathy) may be allowed.
  • Have known symptomatic brain metastases requiring steroids. Subjects with previously diagnosed brain metastases are eligible if they have completed their treatment and have recovered from the acute effects of radiation therapy or surgery prior to study entry, have discontinued corticosteroid treatment for these metastases for at least 4 weeks, and have radiographically stable disease for at least 3 months prior to study entry. Note: Up to 10 mg per day of prednisone equivalent will be allowed.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimental Phase - Cohort 1NivolumabSecond phase of the study. Cohort 1 will include the anti-PD1/L1-naïve subpopulation.
Experimental Phase - Cohort 1IpilimumabSecond phase of the study. Cohort 1 will include the anti-PD1/L1-naïve subpopulation.
Experimental Phase - Cohort 2Recommended Combination Dose (RCD) of ivosidenibSecond phase of the study. Cohort 2 will include the anti-PD1/L1 previously treated subpopulation.
Safety Lead-In Phase - ivosidenibIvosidenibFirst phase of the study.
Safety Lead-In Phase - ivosidenibNivolumabFirst phase of the study.
Experimental Phase - Cohort 1Recommended Combination Dose (RCD) of ivosidenibSecond phase of the study. Cohort 1 will include the anti-PD1/L1-naïve subpopulation.
Experimental Phase - Cohort 2NivolumabSecond phase of the study. Cohort 2 will include the anti-PD1/L1 previously treated subpopulation.
Experimental Phase - Cohort 2IpilimumabSecond phase of the study. Cohort 2 will include the anti-PD1/L1 previously treated subpopulation.
Safety Lead-In Phase - ivosidenibIpilimumabFirst phase of the study.
Primary Outcome Measures
NameTimeMethod
Safety Phase: To determine the recommended combination dose (RDC) of ivosidenib in combination of immunotherapyThrough the end of Cycle 2, day 42 (Cycle 1 and 2 are each 21 days)

Occurring during the safety lead-in phase

Safety Phase: Number of Adverse Events of Special Interests (AESIs)Up to 3 years

Occurring during the safety lead-in phase

Expansion Phase: To assess the Objective Response (confirmed complete response [CR] or confirmed partial response [PR]) of antitumor activity using RECIST v1.1)up to 3 years

To assess the Objective Response (confirmed complete response \[CR\] or confirmed partial response \[PR\]) of antitumor activity using RECIST v1.1)

Safety Phase: Number of Adverse Events (AEs)Up to 3 years

Occurring during the safety lead-in phase

Safety Phase: Number of Serious Adverse Events (SAEs)Up to 3 years

Occurring during the safety lead-in phase

Safety Phase: Number of dose limiting toxicities (DLTs) associated with study drug regimen, during the first 2 cycles of treatmentThrough the end of Cycle 2, day 42 (Cycle 1 and 2 are each 21 days)

Occurring during the safety lead-in phase

Secondary Outcome Measures
NameTimeMethod
Expansion Phase: time to maximum concentration (Tmax)Up to 3 years

Occurring during the expansion phase

Safety Phase: area under the concentration-vs-time curve (AUC) from 0 to time of last measurable concentration (AUC0-t)Up to 3 years

Occurring during the safety lead-in phase

Expansion Phase: progression-free survival (PFS)up to 3 years

Occurring during the expansion phase

Expansion Phase: time to response (TTR) according to RECIST v1.1up to 3 years

Occurring during the expansion phase

Expansion Phase: Duration of response (DOR)up to 3 years

Occurring during the expansion phase

Expansion Phase: Overall survival (OS)up to 3 years

Occurring during the expansion phase

Safety Phase: apparent clearance (CL/F)Up to 3 years

Occurring during the safety lead-in phase

Expansion Phase: Number of Serious Adverse Events (SAEs)Up to 3 years

Occurring during the expansion phase

Expansion Phase: Number of Adverse Events (AEs)Up to 3 years

Occurring during the expansion phase

Expansion Phase: disease control (DC) (complete response-CR, partial response-PR, or stable disease-SD)up to 3 years

Occurring during the expansion phase

Safety Phase: time to maximum concentration (Tmax)Up to 3 years

Occurring during the safety lead-in phase

Safety Phase: apparent volume of distribution (Vd/F)Up to 3 years

Occurring during the safety lead-in phase

Expansion Phase: trough concentration (Ctrough)Up to 3 years

Occurring during the expansion phase

Safety Phase: Plasma 2-hydroxyglutarate (2-HG) concentrationup to 3 years

Occurring during the safety lead-in phase

Safety Phase: AUC over 1 dosing interval at steady state (AUCtau,ss)Up to 3 years

Occurring during the safety lead-in phase

Expansion Phase: maximum concentration (Cmax)Up to 3 years

Occurring during the expansion phase

Expansion Phase: apparent volume of distribution (Vd/F)Up to 3 years

Occurring during the expansion phase

Expansion Phase: apparent clearance (CL/F)Up to 3 years

Occurring during the expansion phase

Expansion Phase : area under the concentration-vs-time curve (AUC) from 0 to time of last measurable concentration (AUC0-t)Up to 3 years

Occurring during the expansion phase

Expansion Phase: Plasma 2-hydroxygluturate (2-HG) concentrationup to 3 years

Occurring during the expansion phase

Safety Phase: maximum concentration (Cmax)Up to 3 years

Occurring during the safety lead-in phase

Safety Phase: trough concentration (Ctrough)Up to 3 years

Occurring during the safety lead-in phase

Expansion Phase: Number of Adverse Events of Special Interests (AESIs)Up to 3 years

Occurring during the expansion phase

Expansion Phase: AUC over 1 dosing interval at steady state (AUCtau,ss)Up to 3 years

Occurring during the expansion phase

Trial Locations

Locations (5)

UCSF - Medical Center at Mission Bay

🇺🇸

San Francisco, California, United States

Ucsf Helen Diller Family Comprehensive Cancer Center

🇺🇸

San Francisco, California, United States

Sidney Kimmel Comprehensive Cancer Center At Johns Hopkins

🇺🇸

Baltimore, Maryland, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

UCLH

🇬🇧

London, United Kingdom

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