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A Dose Escalation and Cohort Expansion Study of Subcutaneously-Administered Cytokine ALKS 4230 (Nemvaleukin Alfa) as a Single Agent and in Combination With Anti-PD-1 Antibody (Pembrolizumab) in Subjects With Select Advanced or Metastatic Solid Tumors (ARTISTRY-2)

Phase 1
Completed
Conditions
Advanced Solid Tumors
Interventions
Biological: ALKS 4230
Biological: Pembrolizumab
Registration Number
NCT03861793
Lead Sponsor
Mural Oncology, Inc
Brief Summary

This study will characterize the safety and tolerability and identify the recommended Phase 2 dose (RP2D) of subcutaneous (SC) ALKS 4230 as monotherapy and in combination with pembrolizumab.

Detailed Description

This study will evaluate ALKS 4230 administered SC as lead-in monotherapy and in combination with pembrolizumab in subjects with advanced solid tumors.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
116
Inclusion Criteria
  • For Phase I the subject has histological or cytological evidence of a solid tumor. For Phase II the subject must have 1 of the specified adult solid tumor types: gastric, ovarian, lung, head and neck.
  • Subject must have at least one target lesion based on RECIST
  • Subject has an Eastern Cooperative Oncology Group Performance Status (ECOG PS) score of 0 or 1
  • Subjects must have adequate liver function
  • Subjects must have adequate kidney function
  • Subjects must be recovered from the effects of any prior chemotherapy, immunotherapy, other prior systemic anticancer therapy, radiotherapy or surgery
  • Subjects who have received radiation therapy must wait at least 4 weeks after their last radiation treatment before enrollment into the study
  • Females of childbearing potential must have a negative pregnancy test within 7 days of the start of treatment and on Day 1 before the first dose is administered
  • Subject will agree to follow contraceptive requirements defined in the protocol
  • Additional criteria may apply
Exclusion Criteria
  • Subject is currently pregnant, planning to become pregnant, or breastfeeding
  • Subjects with an active infection or with a fever ≥ 38.5°C within 3 days of the first scheduled day of dosing for Cycle 1
  • Subjects with active or symptomatic central nervous system metastases are excluded. Subjects with central nervous system metastases are eligible for the study if the metastases have been treated by surgery and/or radiation therapy, the subject is off corticosteroids for at least 2 weeks, and the subject is neurologically stable
  • Subjects with known hypersensitivity to any components of ALKS 4230 or to pembrolizumab or any of its excipients
  • Subjects who require pharmacologic doses of systemic corticosteroids are excluded; replacement doses, topical, ophthalmologic, and inhalational steroids are permitted
  • Subjects who developed autoimmune disorders while on prior immunotherapy, including pneumonitis, nephritis, and/or neuropathy
  • Subjects with any other concurrent uncontrolled illness, including mental illness or substance abuse, which may interfere with the ability of the subjects to cooperate and participate in the study
  • The subject is known to be positive for human immunodeficiency virus (HIV), hepatitis B or C, or active tuberculosis, or has a known history of tuberculosis
  • Additional criteria may apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ALKS 4230 + pembrolizumabPembrolizumabALKS 4230 will be administered via SC injection once every 7 or 21 days at escalating doses or at the recommended phase 2 dose and schedule; pembrolizumab will be administered as an intravenous infusion given over 30 minutes; the dose level for pembrolizumab will be 200 mg per the approved label. In December 2020, an RP2D of 3 mg with an administration schedule of q7d was determined for SC ALKS 4230.
ALKS 4230ALKS 4230Administered via SC injection once every 7 days or once every 21 days at escalating doses
ALKS 4230 + pembrolizumabALKS 4230ALKS 4230 will be administered via SC injection once every 7 or 21 days at escalating doses or at the recommended phase 2 dose and schedule; pembrolizumab will be administered as an intravenous infusion given over 30 minutes; the dose level for pembrolizumab will be 200 mg per the approved label. In December 2020, an RP2D of 3 mg with an administration schedule of q7d was determined for SC ALKS 4230.
Primary Outcome Measures
NameTimeMethod
Incidence of Adverse Events (AEs), and identify the RP2D of ALKS 4230 in Part AFrom time of initiation of therapy until 30 days after last dose of study drug, assessed up to 24 months

Includes AEs that are both serious and drug-related

Number of subjects experiencing AEs that are both serious and drug-related in Part BFrom time of initiation of therapy until 30 days after last dose of study drug, assessed up to 24 months

Includes AEs that are both serious and drug-related

Clinical Activity of combination treatment with ALKS 4230 and pembrolizumab in each Part B tumor type.From time of therapy until the date of first documented tumor progression, assessed up to 24 months

Overall Response rate (ORR) will be based on investigator review of radiographic and photographic images

Secondary Outcome Measures
NameTimeMethod
Duration of response in subjects with CR/iCRTime from the first documentation of complete response, measured approximately every 6 weeks, to the first documentation of objective tumor progression or death due to any cause (estimated up to 24 months)

CR/iCR duration

Duration of response in subjects with PR/iPRTime from the first documentation of complete response, measured approximately every 6 weeks, to the first documentation of objective tumor progression or death due to any cause (estimated up to 24 months)

PR/iPR duration

Overall survival for Part BAssessed up to 24 months

Time from first dose of SC ALKS 4230 to the time of death

Proportion of subjects with objective evidence of Complete Response (CR)/immune CR (iCR)From time of initiation of therapy until the date of first documented tumor progression, assessed up to 24 months

Overall response rate (ORR) will be based on investigator review of radiographic or photographic images

Serum concentrations of ALKS 4230 will be determined at various time pointsFrom time of initiation of therapy until the last treatment cycle (each cycle is 21 days), assessed up to 24 months

Concentration vs time and standard pharmacokinetic (PK) parameters will be summarized by dose level

Serum concentrations of proinflammatory cytokines will be assessed using a multiplex method at various time pointsFrom time of initiation of therapy until the last treatment cycle (each cycle is 21 days), assessed up to 24 months

Results will be summarized by dose level

Proportion of subjects with objective evidence of Partial Response (PR)/immune PR (iPR)From time of initiation of therapy until the date of first documented tumor progression, assessed up to 24 months

ORR will be based on investigator review of radiographic or photographic images

Non-progression for Part BAssessed up to 24 months

Time from first dose of SC ALKS 4230 to the time of progression or death

Serum will be assayed for the presence of anti-ALKS 4230 antibodiesFrom time of initiation of therapy until the last treatment cycle (each cycle is 21 days), assessed up to 24 months

Results will be summarized by dose level

Immunophenotyping of peripheral blood mononuclear cells will be performed by flow cytometry at various time pointsFrom time of initiation of therapy until the last treatment cycle (each cycle is 21 days), assessed up to 24 months

Results will be summarized by dose level

Trial Locations

Locations (10)

Inha University Hospital

🇰🇷

Incheon, Korea, Republic of

Seoul National University Bundang Hospital

🇰🇷

Seongnam, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Yonsei University Health System - Severance Hospital

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

The Catholic University of Korea St. Vincent's Hospital

🇰🇷

Suwon, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Mural Oncology Investigational Sites

🇨🇦

Montréal, Quebec, Canada

National Cancer Center

🇰🇷

Goyang, Korea, Republic of

Mural Oncology Investigational Site

🇨🇳

Taipei, Taiwan

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