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Assessment of Safety and Efficacy of OPM-101 Combined With Anti-PD-1 in Patients With Advanced Melanoma Showing Resistance to Anti-PD-1

Not Applicable
Not yet recruiting
Conditions
Advanced Melanoma
Interventions
Registration Number
NCT07040436
Lead Sponsor
Oncodesign Precision Medicine
Brief Summary

This is a phase 1b/2a study including a dose escalation part (Phase 1b) and an extension part (Phase 2a).

Both parts will be open-label, multicenter study of OPM-101 combined with the anti-PD-1 pembrolizumab as per standard of care in patients with MM who have been receiving an anti-PD-1-based treatment and have shown resistance to it, as defined by the Society for Immunotherapy of Cancer (SITC) criteria (Kluger, 2020). The objective of the study is to assess whether the addition of OPM-101 will resensitisze the tumour to the anti-PD-1-based treatment.

Potential patients will be screened for this study during the period between initial evidence of disease progression on anti-PD-1 treatment and the required radiographic confirmation of disease progression. The intent is to initiate treatment with OPM-101 once the suspicion of disease progression on anti-PD-1-based therapy is confirmed, and the patient has signed the study Information and Consent Form. No anti-PD-1-based treatment should be administered within 4 weeks prior to study treatment initiation.

In the dose escalation part (Phase 1b) of the study, two different doses of OPM-101 will be evaluated (75 mg bid and 150 mg bid) in combination with pembrolizumab. Patients will receive the dose and regimen of pembrolizumab, as per the authorised product SmPC, in sequential cohorts using a 3 + 3 design, escalating if 0 of 3 (or 1 of 6) patients experience a dose-limiting toxicity (DLT) during the first 6 weeks of treatment and not escalating if 2 of 6 patients experience a DLT.

The RP2D of OPM-101 for the second part of the study (Phase 2a) in combination with pembrolizumab will be based on the rate of DLTs, incidence and severity of Treatment-Related AEs (AEs) and SAEs, and frequency of dose holds, reductions and discontinuations.

A Data and Safety Monitoring Board (DSMB) will assess the safety criteria and make recommendations about dose escalation/de-escalation during the Phase 1b part, and on the RP2D to be used for further patients in the Phase 2a. The selection of the dose level for the Phase 2a will be based on safety and on preliminary PK/PD or even trends of efficacy. The DSMB will also review periodically the data during the Phase 2a and make recommendations about the continuation of the study.

The cohort expansion part (Phase 2a) of the study will be conducted once the Phase 1b is completed and a safe and tolerated dose (potentially 150 mg bid) has been determined. Patients will receive daily oral treatment with OPM-101, while taking pembrolizumab for at least 12 weeks, i.e., at the time of the radiographic assessment of the disease for the primary endpoint evaluation. Patients who show a treatment response with Disease Control (CR, PR or SD) at 12 weeks will continue treatment with \[OPM-101 + pembrolizumab\] up to 24 weeks, when the second radiographic disease assessment is performed.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
41
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
OPM-101 (in combination with pembrolizumab)OPM-101OPM-101 will be administered as hard gelatin capsules twice a day for 24 weeks. In the Phase 1b, 2 doses of OPM-101 will be considered: 75 mg bid and 150 mg bid. At the end of this Phase 1b, a recommended dose for Phase 2a will be determined. During the Phase 2a, the recommended dose of OPM-101 will be administered bid over 24 weeks. OPM-101 will be administered in combination with authorized regimen of Pembrolizumab.
Primary Outcome Measures
NameTimeMethod
Determination of the recommended dose6 weeks

In the phase 1b: the recommended dose for phase 2a will be based on the independent assessement of safety of OPM-101 by the DSMB

Determination of the Disease Control Rate (DCR)12 weeks

In phase 2a, Disease Control Rate defined as CR, PR or SD as per RECIST v.1.1 criteria

Secondary Outcome Measures
NameTimeMethod
Determination of the Disease Control Rate24 weeks

In Phase 1b and Phase 2a: Disease Control Rate (DCR= CR+PR+SD) per RECIST v.1.1 criteria.

Determination of the objective response rate (ORR)Week 12 and Week 24

In the phase 1b and Phase 2a, the objective response rate (ORR = CR + PR) will be evaluated using RECIST v1.1 criteria

Determination of the frequency of dose reduction, and discontinuations24 weeks

In Phase 1b and Phase 2a

Safety assessments24 weeks

Phase 2a: determine the incidence and severity of adverse events (AEs) and serious adverse events (SAEs

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