ARTEMIS-103: Phase 1b Study of HS-20093 Combinations in Patients with Bone and Soft Tissue Sarcoma.

Phase 1

Not yet recruiting

• Conditions: Osteosarcoma; Soft Tissue Sarcoma (STS)
• Interventions: Drug: HS-20093; Drug: Anlotinib; Drug: Epirubicin; Drug: Adebrelimab

• Registration Number: NCT06699576
• Lead Sponsor: Hansoh BioMedical R&D Company

Brief Summary

HS-20093 is a fully humanized IgG1 antibody-drug conjugate (ADC) which specifically binds to B7-H3, a target wildly expressed on bone and soft tissue sarcoma. The objectives of this study are to investigate the safety, tolerability, pharmacokinetics and anti-tumor activity of HS-20093 in combination with other anti-cancer agents in patients with advanced bone and soft tissue sarcoma.

Detailed Description

This is a phase 1b, open-label, multi-center, dose-escalation and expansion study in subjects with advanced bone and soft tissue sarcoma. This study is in design allowing assessment of safety, tolerability, pharmacokinetics and anti-tumor activity of HS-20093 in combination with other anti-cancer agents.

A total of 4 combination-treatments will be carried out in 2 cohorts. The target population in cohort 1 of dose escalation part is soft tissue sarcoma patients have progressed on or intolerant to available standard therapies, and the dose expansion part will enroll patients who have not received prior treatment for advanced/metastatic disease. The target population in cohort 2 will enroll patients with osteosarcoma have progressed on or intolerant to available standard therapies All patients will be carefully followed for adverse events during the study treatment and for 90 days after the last dose of study drug. Subjects will be permitted to continue therapy with assessments for progression if the product is well tolerated and sustained clinical benefit exists

Study Timeline

• Status Verified: 2024-11
• Study First Submitted: 2024-11-19
• Study First Submitted QC: 2024-11-19
• Last Update Submitted: 2024-11-19
• Study First Posted: 2024-11-21
• Last Update Posted: 2024-11-21
• Study Start: 2024-12-20
• Primary Completion: 2026-12-30
• Study Completion: 2028-12-30

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 448

Inclusion Criteria

• At least age of 18 years at screening;

• Histologically or cytologically confirmed, locally advanced or metastatic osteosarcoma and soft tissue sarcoma

  1. Cohort1: Dose escalation part will enroll advanced soft tissue sarcoma for which standard treatment has proven ineffective or unavailable or intolerable. Dose expansion part will enroll patients who have not received prior treatment for advanced/metastatic disease.
  2. Cohort2: Advanced osteosarcoma patients for which standard treatment has proven ineffective or unavailable or intolerable.

• least one extra-cranial measurable lesion according to RECIST 1

• Agree to provide fresh or archival tumor tissue

• Eastern Cooperative Oncology Group (ECOG) Performance Status of 0~1

• Life expectancy >= 12 weeks

• Agree to use medically accepted methods of contraception

• Men or women should be using adequate contraceptive measures throughout the study;

• Females subjects must not be pregnant at screening or have evidence of non-childbearing potential

• Signed and dated Informed Consent Form

Exclusion Criteria

• treatment with any of the following:

  1. Previous or current treatment with B7-H3 targeted therapy
  2. Previous or current treatment with TOP1i related treatment
  3. Previous or current treatment with PD-L1 inhibitor (Cohort2 )
  4. Intolerable for any Anlotinib(Cohort 1a/1c), Anthracyclines (Cohort 1b/1c) and PD-L1 inhibitor (Cohort2 )
  5. Cytotoxic chemotherapy, investigational agents and anticancer drugs within 14 days prior to the first scheduled dose of HS-20093
  6. Prior treatment with a monoclonal antibody within 28 days prior to the first scheduled dose of HS-20093
  7. Radiotherapy with a limited field of radiation for palliation within 2 weeks, or patients received more than 30% of the bone marrow irradiation, or large-scale radiotherapy within 4 weeks prior to the first scheduled dose of HS-20093
  8. Major surgery within 4 weeks prior to the first scheduled dose of HS-20093

• Subjects with previous or concurrent malignancies

• Inadequate bone marrow reserve or organ dysfunction

• Evidence of cardiovascular risk

• Evidence of current severe or uncontrolled systemic diseases

• Evidence of mucosal or internal bleeding within 1 month prior to the first scheduled dose of HS-20093

• Known active infection requiring antibodies treatment within 2 weeks, or severe infection within 4 weeks prior to the first scheduled dose of HS-20093

• Subjects with current infectious diseases

• History of neuropathy or mental disorders

• Pregnant or lactating female

• History of severe hypersensitivity reaction, severe infusion reaction or idiosyncrasy to drugs chemically related to HS-20093 or any of the components of HS-20093

• Unlikely to comply with study procedures, restrictions, and requirements in the opinion of the investigator

• Any disease or condition that, in the opinion of the investigator, would compromise subject safety or interfere with study assessments

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Cohort 1a	HS-20093	HS-20093 and Anlotinib
Cohort 1a	Anlotinib	HS-20093 and Anlotinib
Cohort 1b	HS-20093	HS-20093 and Epirubicin
Cohort 1b	Epirubicin	HS-20093 and Epirubicin
Cohort 1c	HS-20093	HS-20093, Epirubicin and Anlotinib
Cohort 1c	Anlotinib	HS-20093, Epirubicin and Anlotinib
Cohort 1c	Epirubicin	HS-20093, Epirubicin and Anlotinib
Cohort 2a	HS-20093	HS-20093 and Adebrelimab
Cohort 2a	Adebrelimab	HS-20093 and Adebrelimab

Primary Outcome Measures

Name	Time	Method
Maximum tolerated dose (MTD) for combination-treatments	Up to day 21 from the first dose	To determine the MTD for further evaluation of HS-20093 with other anti-cancer agents in subjects with advanced bone and soft tissue sarcoma.

Secondary Outcome Measures

Name	Time	Method
Objective response rate (ORR) determined by investigators	From the first dose up to PD or withdrawal from study, whichever came first, assessed up to 24 months	Objective tumor response for target lesions will be assessed by imaging/measurement compared with the overall tumor burden at baseline. ORR is evaluated by the number of participants with best overall response of CR and PR (Confirmed CR/PR assessment require at least 1 repeat).
Disease control rate (DCR) determined by investigators	From the first dose up to PD or withdrawal from study, whichever came first, assessed up to 24 months	Objective tumor response for target lesions will be assessed by imaging/measurement compared with the overall tumor burden at baseline. DCR was evaluated by the number of participants with best overall response of CR, PR and stable disease (SD) \[Confirmed CR/PR assessment require at least one repeat (≥4 weeks); SD shall be assessed at least 5 weeks after the first dose\].
Duration of response (DoR) determined by investigators	From the first dose up to PD or death, whichever came first, assessed up to 24 months	DoR was defined as the period from the first occurrence of CR or PR to PD or death from any cause. If no PD or death after CR/PR, the cut-off date of progression-free survival (PFS) would be used \[Confirmed CR/PR assessment require at least one repeat (≥4 weeks)\].
Progression-free survival (PFS) determined by investigators according to RECIST 1.1	From the first dose up to PD or death, whichever came first, assessed up to 24 months	PFS was defined as the time from random assignment or first dose to PD or death from any cause
Overall survival (OS)	From the first dose up to death, assessed up to 24 months	OS was defined as the time from random assignment or first dose to death from any cause.
Terminal half-life (T1/2) of HS-20093 following the first dose	From pre-dose to study completion, assessed up to 24 months	T1/2will be obtained after administration of the first dose of HS-20093
Area under plasma concentration versus time curve from zero to last sampling time (AUC0-t) following the first dose of HS-20093	From pre-dose to study completion, assessed up to 24 months	Area under the plasma concentration versus time curve from time zero to the last sampling time when the concentration was no less than the lower limit of quantification (LLQ). AUC0-t was calculated according to the mixed log-linear trapezoidal rule.
Percentage of participants with antibodies to HS-20093 in serum	From pre-dose to study completion, assessed up to 24 months	Serum samples were collected for the determination of anti-drug antibody (ADA) at designated time points.
Observed maximum plasma concentration (Cmax) of HS-20093	From pre-dose to study completion, assessed up to 24 months	Cmax will be obtained after administration of the first dose of HS-20093
Time to reach maximum plasma concentration (Tmax) of HS-20093	From pre-dose to study completion, assessed up to 24 months	Tmax will be obtained after administration of the first dose of HS-20093