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Safety and Efficacy Study of AVB-S6-500 (Batiraxcept) in Patients With Advanced or Metastatic Clear Cell Renal Cell Carcinoma

Phase 1
Terminated
Conditions
Clear Cell Renal Cell Carcinoma
Interventions
Registration Number
NCT04300140
Lead Sponsor
Aravive, Inc.
Brief Summary

This is a Phase 1b/2 study of AVB-S6-500 designed to evaluate the safety and efficacy of AVB-S6-500 in combination with cabozantinib, AVB-S6-500 in combination with cabozantinib and nivolumab and AVB-S6-500 monotherapy in subjects with advanced or metastatic clear cell renal cell carcinoma (ccRCC). The phase 1b portion of the study is open label and patients with advanced ccRCC who had progressed on or after at least one prior line of treatment will receive AVB-S6-500 + cabozantinib. Two dose levels will be evaluated. The Phase 2 portion of the study is open-label 3-part study to evaluate efficacy and tolerability of AVB-S6-500 + cabozantinib, AVB-S6-500 + cabozantinib + nivolumab, and AVB-S6-500 alone.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
72
Inclusion Criteria
  • Age 18 years or older
  • Histologically confirmed advanced or metastatic clear cell Renal Cell Carcinoma confirmed by imaging. Phase 1b and Phase 2 Part A: has progressed on/after at least one front-line of treatment; Phase 2 Part B: No prior systemic treatment; Phase 2 Part C: not amenable to curative intent therapy.
  • Must have radiologic imaging with a computed tomography (CT) scan or magnetic resonance imaging (MRI) within 28 days of enrollment
  • Must have at least one measurable lesion according to RECIST 1.1
  • ECOG performance status of 0-1
  • Adequate bone marrow, liver and kidney function
  • Life expectancy of >12 weeks
  • At least 28 days between termination of prior major surgery or anticancer therapy or 14 days from last radiation therapy and administration of AVB-S6-500
Exclusion Criteria
  • Received prior treatment with cabozantinib (Phase1b and Phase 2 Part A)
  • Received prior treatment with nivolumab (Phase 2 Part B)
  • Concurrent anti-cancer therapy or any other interventional treatment or other interventional research trial
  • History of prior malignancy within the past 3 years except adequately treated basal or squamous cell skin cancer, superficial bladder cancer or carcinoma in situ of the prostate, cervix or breast
  • Symptomatic CNS metastasis or metastases
  • Active GI disease that would impact absorption of cabozantinib
  • Nephrotic range proteinuria at screening
  • Evidence of pleural effusion, ascites etc that requires therapeutic intervention within 28 days prior to AVB-S6-500 administration
  • Phase 2 Part A and Part B: Has had a major bleed in the last 3 months, uncontrolled hypertension despite treatment with antihypertensives or is not appropriate for treatment with cabozantinib in the Investigator's opinion
  • Serious active infection requiring IV antibiotics and/or hospitalization at study entry
  • Phase 2 Part B: Has active, known or suspected autoimmune disease, defined as requiring systemic treatment
  • Active COVID-19, HIV, Hepatitis B or Hepatitis C virus.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Phase 1b: Batiraxcept + cabozantinibBatiraxceptTwo dose levels of batiraxcept administered Q2W (once every two weeks) in combination with QD (once a day) cabozantinib will be evaluated.
Phase 1b: Batiraxcept + cabozantinibCabozantinib (Cabo)Two dose levels of batiraxcept administered Q2W (once every two weeks) in combination with QD (once a day) cabozantinib will be evaluated.
Phase 2 Part A: batiraxcept + cabozantinibBatiraxceptOne dose level of batiraxcept administered Q2W in combination with QD cabozantinib will be evaluated.
Phase 2 Part A: batiraxcept + cabozantinibCabozantinib (Cabo)One dose level of batiraxcept administered Q2W in combination with QD cabozantinib will be evaluated.
Phase 2 Part B: batiraxcept + cabozantinib + nivolumabBatiraxceptOne dose level of batiraxcept administered Q2W in combination with QD cabozantinib and nivolumab.
Phase 2 Part B: batiraxcept + cabozantinib + nivolumabCabozantinib (Cabo)One dose level of batiraxcept administered Q2W in combination with QD cabozantinib and nivolumab.
Phase 2 Part B: batiraxcept + cabozantinib + nivolumabNivolumabOne dose level of batiraxcept administered Q2W in combination with QD cabozantinib and nivolumab.
Phase 2 Part C: batiraxcept aloneBatiraxceptOne dose level of batiraxcept administered Q2W will be evaluated.
Primary Outcome Measures
NameTimeMethod
Identify the recommended Phase 2 dose of AVB-S6-500 in combination with cabozantinib10 months

Measured by dose limiting toxicities experienced in Phase 1b

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib (ORR)30 months

Measured by objective response rate (ORR) in patients receiving AVB-S6-500 + cabozantinib in Phase 1b and Phase 2 Part A. ORR is proportion of subjects who have a partial or complete confirmed response to therapy relative to baseline as assessed per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib and nivolumab (ORR)30 months

Measured by objective response rate (ORR) in patients receiving AVB-S6-500 + cabozantinib + nivolumab in Phase 2 Part B. ORR is proportion of subjects who have a partial or complete confirmed response to therapy relative to baseline as assessed per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.

Anti-tumor activity of AVB-S6-500 alone (DOR)30 months

Measured by duration of response (DOR) in patients receiving AVB-S6-500 in Phase 2 Part C. DOR is measured from the date of partial or complete response to therapy until the cancer progresses.

Anti-tumor activity of AVB-S6-500 alone (CBR)30 months

Measured by clinical benefit rate (CBR) in patients receiving AVB-S6-500 in Phase 2 Part C. CBR is the proportion of subjects who have a complete or partial response to therapy or maintain stable disease.

Anti-tumor activity of AVB-S6-500 alone (PFS)30 months

Measured by progression-free survival (PFS) in patients receiving AVB-S6-500 in Phase 2 Part C. PFS is the time from treatment until radiological disease progression or death.

Incidence of adverse events in Phase 1b as graded by NCI-CTCAE version 5.010 months

Safety and tolerability of AVB-S6-500 in combination with cabozantinib.

Anti-tumor activity of AVB-S6-500 alone (ORR)30 months

Measured by objective response rate (ORR) in patients receiving AVB-S6-500 in Phase 2 Part C. ORR is proportion of subjects who have a partial or complete confirmed response to therapy relative to baseline as assessed per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.

Anti-tumor activity of AVB-S6-500 alone (OS)60 months

Measured by overall survival (OS) in patients receiving AVB-S6-500 in Phase 2 Part C. OS is the time from the start of the treatment until death.

Secondary Outcome Measures
NameTimeMethod
Pharmacokinetics: Tmax30 months

Time of maximum observed AVB-S6-500 concentration.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib and nivolumab (CBR)30 months

Measured by clinical benefit rate (CBR) in patients receiving AVB-S6-500, cabozantinib and nivolumab in Phase 2 Part B. CBR is the proportion of subjects who have a complete or partial response to therapy or maintain stable disease.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib (OS)60 months

Measured by overall survival (OS) in patients receiving AVB-S6-500 in Phase 1b and Phase 2 Part A. OS is the time from the start of the treatment until death.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib and nivolumab (DOR)30 months

Measured by duration of response (DOR) in patients receiving AVB-S6-500, cabozantinib and nivolumab in Phase 2 Part B. DOR is measured from the date of partial or complete response to therapy until the cancer progresses.

Incidence of adverse events in Phase 2 Part C as graded by NCI-CTCAE version 5.030 months

Safety and tolerability of AVB-S6-500 alone

Incidence of adverse events in Phase 2 Part B as graded by NCI-CTCAE version 5.030 months

Safety and tolerability of AVB-S6-500 in combination with cabozantinib and nivolumab

Pharmacokinetics: Cmax30 months

Maximum observed AVB-S6-500 concentration.

Pharmacokinetics: AUC30 months

Area under the AVB-S6-500 concentration-time curve.

Pharmacodynamic marker assessment30 months

Change from the baseline in GAS6 serum levels.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib (CBR)30 months

Measured by clinical benefit rate (CBR) in patients receiving AVB-S6-500 + cabozantinib in Phase 1b and Phase 2 Part A. CBR is the proportion of subjects who have a complete or partial response to therapy or maintain stable disease.

Pharmacokinetics: t1/230 months

Apparent terminal half-life of AVB-S6-500.

Anti-drug antibody (ADA) titers30 months

Change from baseline in ADA titer.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib (DOR)30 months

Measured by duration of response (DOR) in patients receiving AVB-S6-500 in Phase 1b and Phase 2 Part A. DOR is measured from the date of partial or complete response to therapy until the cancer progresses.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib and nivolumab (PFS)30 months

Measured by progression-free survival (PFS) in patients receiving AVB-S6-500, cabozantinib and nivolumab in Phase 2 Part B. PFS is the time from treatment until radiological disease progression or death.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib (PFS)30 months

Measured by progression-free survival (PFS) in patients receiving AVB-S6-500 in Phase 1b and Phase 2 Part A, PFS is the time from treatment until radiological disease progression or death.

Anti-tumor activity of AVB-S6-500 in combination with cabozantinib and nivolumab (OS)60 months

Measured by overall survival (OS) in patients receiving AVB-S6-500, cabozantinib and nivolumab in Phase 2 Part B. OS is the time from the start of the treatment until death.

Trial Locations

Locations (17)

University of Pennsylvania Abramson Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

University of Texas Southwestern

🇺🇸

Dallas, Texas, United States

University of Maryland Greenebaum Comprehensive Cancer Center

🇺🇸

Baltimore, Maryland, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Froedtert Hospital and the Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Comprehensive Cancer Care of Nevada

🇺🇸

Las Vegas, Nevada, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

Allegheny Health Network

🇺🇸

Pittsburgh, Pennsylvania, United States

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

OU Health Stephenson Cancer Center

🇺🇸

Oklahoma City, Oklahoma, United States

Hollings Cancer Center (HCC)

🇺🇸

Charleston, South Carolina, United States

UT MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Vanderbilt-Ingram Cancer Center (VICC)

🇺🇸

Nashville, Tennessee, United States

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