Safety Study of Anti-Programmed Death-Ligand 1 in Hematologic Malignancy

Phase 1

Withdrawn

Conditions: Non-Hodgkin's Lymphoma
Hodgkin Lymphoma
Multiple Myeloma
Chronic Myelogenous Leukemia

Interventions: Biological: BMS-936559 (Anti PD-L1)

Registration Number: NCT01452334

Lead Sponsor: Bristol-Myers Squibb

Brief Summary: The purpose of this study is to determine the side effects of treatment with the monoclonal antibody anti-PD-L1 (BMS-936559) in subjects with compromised bone marrow function and the dose that should be recommended for use in future studies.

Detailed Description: Not available

Recruitment & Eligibility

Status: WITHDRAWN

Sex: All

Target Recruitment: Not specified

Inclusion Criteria

Eastern Cooperative Oncology Group (ECOG) Performance of 0 or 1
Subjects must have histological confirmation of relapsed or refractory hematologic malignancy
Subjects with non-Hodgkin's lymphoma or Hodgkin lymphoma must have at least one measureable lesion as defined by lymphoma response criteria. Tumor sites that are considered measureable must not have received prior radiation therapy
Subjects with multiple myeloma (MM) must have detectable disease as measured by presence of monoclonal immunoglobulin protein in a serum electrophoresis: IgG, IgA, IgM, (M-protein ≥ 0.5 g/dl or serum IgD M-protein ≥ 0.05 g/dl) or serum free-light chain or 24 hour urine with free light chain. Excluded are subjects with only plasmacytomas, plasma cell leukemia, or non-secretory myeloma
Subjects with chronic myelogenous leukemia (CML) must have evidence of the Philadelphia chromosome by polymerase chain reaction (PCR) or chromosome analysis
Life expectancy of at least 3 months
For subjects with lymphoma, either a formalin fixed tissue block or 7 to 15 slides of tumor sample (archival or fresh) must be available for performance of correlative studies
Subjects must have received at least one prior chemotherapy regimen. Subjects must be off therapy for at least 4 weeks ( 2 weeks for oral agents) prior to Day 1
Prior palliative radiation must have been completed at least 2 weeks prior to study Day 1
Toxicities related to prior therapy must have returned to Grade 1 or less, except for alopecia. Peripheral neuropathy must be Grade 2 or less
Adequate bone marrow function defined as:
1. Absolute neutrophil count ≥ 1000/μl (stable off any growth factor within 1 week of study drug administration)
2. Hemoglobin ≥ 9 g/dL (transfusion to achieve this level is permitted)
3. Platelet count ≥ 50 X 103/ μl (transfusion to achieve this level is not permitted)
Adequate renal parameters defined as Creatinine clearance (CrCl) > 40 ml/min (Cockcroft-Gault formula)
Adequate hepatic parameters defined as:
1. Aspartate aminotransferase (AST) ≤ 3 x ULN
2. Alanine aminotransferase (ALT) ≤ 3 x ULN
3. Bilirubin ≤ 1.5 x ULN (except subjects with Gilbert's Syndrome, who must have total bilirubin < 3.0 mg/dL and direct bilirubin < 0.5 mg/dL)
Women of child bearing potential (WOCBP) and for at least 70 days after the last dose of investigational product
Men and women ≥ 18 years of age

Exclusion Criteria

Subjects with acute leukemias, blast phase CML, T cell lymphoblastic or Burkitt lymphoma
Subjects with a history of central nervous system involvement by hematologic malignancy or symptoms suggestive of central nervous system involvement
Subjects with concomitant second malignancies (except adequately treated nonmelanomatous skin cancers, ductal carcinoma in situ, treated superficial bladder cancer or prostate cancer or in situ cervical cancers) are excluded unless a complete remission was achieved at least 3 years prior to study entry and no additional therapy is required or anticipated to be required during the study period
Subjects with any active autoimmune disease or a history of known or suspected autoimmune disease, or history of syndrome that requires systemic corticosteroids or immunosuppressive medications, except for subjects with vitiligo or resolved childhood asthma/atopy
A serious uncontrolled medical disorder or active infection which would impair the ability of the subject to receive protocol therapy or whose control may be jeopardized by the complications of this therapy
Prior therapy with an anti programmed death-1 (anti-PD-1), anti Programmed death ligand 1 (anti-PD-L1), anti Programmed death ligand 2 (anti-PD-L2), anti-CD137 or anti Cytotoxic T lymphocyte-associated antigen 4 (anti-CTLA-4) antibody (or any other antibody or drug specifically targeting T-cell costimulation or checkpoint pathways)
Non-oncology vaccine therapies for prevention of infectious diseases (eg seasonal flu vaccine, Human Papilloma Virus (HPV) vaccine) within 4 weeks of study drug administration Vaccination while on study is also prohibited except for administration of the inactivated influenza vaccine
Prior organ allograft or allogeneic bone marrow transplantation
Positive for human immunodeficiency virus (HIV 1/2) or known acquired immunodeficiency syndrome (AIDS)
Positive tests for hepatitis B virus surface antigen (HBsAg), or antibody to hepatitis B core Ag or hepatitis C virus antibody (confirmed by Western Blot) or hepatitis C ribonucleic acid (RNA) in serum
Ejection fraction less than 45% in subjects with prior anthracycline exposure
History of Grade 4 anaphylactic reaction to monoclonal antibody therapy
Women who are pregnant or breastfeeding

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Arm 1: BMS-936559	BMS-936559 (Anti PD-L1)	-

Primary Outcome Measures

Name	Time	Method
Safety and tolerability of BMS-936559 as measured by the incidence of adverse events (AEs), serious AEs, dose-limiting toxicities, laboratory test abnormalities, and changes in vital signs	Every 2 weeks until 70 days after last treatment

Secondary Outcome Measures

Name	Time	Method
Pharmacokinetics of BMS-936559 as measured by maximum observed serum concentration (Cmax)	Within the first 22 weeks, weeks 34, weeks 46, and at follow-up (35 ± 7 days after last treatment and 70-90 days since last treatment)
Pharmacokinetics of BMS-936559 as measured by time of maximum observed serum concentration (Tmax)	Within the first 22 weeks, weeks 34, weeks 46, and at follow-up (35 ± 7 days after last treatment and 70-90 days since last treatment)
Pharmacokinetics of BMS-936559 as measured by area under the serum concentration time curve in the dosing interval [AUC(TAU)]	Within the first 22 weeks, weeks 34, weeks 46, and at follow-up (35 ± 7 days after last treatment and 70-90 days since last treatment)
Pharmacokinetics of BMS-936559 as measured by accumulation index (AI) calculated ar ratio of the AUC(TAU) at steady state and first dose	Within the first 22 weeks, weeks 34, weeks 46, and at follow-up (35 ± 7 days after last treatment and 70-90 days since last treatment)
Pharmacokinetics of BMS-936559 as measured by serum concentration achieved at the end of dosing interval (trough concentration) (Cmin)	Within the first 22 weeks, weeks 34, weeks 46, and at follow-up (35 ± 7 days after last treatment and 70-90 days since last treatment)
Pharmacokinetics of BMS-936559 as measured by serum concentration achieved at the end of the infusion (Ceoinf)	Within the first 22 weeks, weeks 34, weeks 46, and at follow-up (35 ± 7 days after last treatment and 70-90 days since last treatment)
Antitumor activity of BMS-936559 as measured by the objective response rate, duration of response, and progression free survival	Week 4, week 12, week 20, and every 16 weeks until confirmed disease progression assessed up to Week 214
Immunogenicity of BMS-936559 as measured by the frequency of subjects with an increase in anti-drug antibody levels from baseline	Baseline, weeks 3, weeks 12, weeks 20, weeks 34, weeks 46, and at follow-up (35 ± 7 days after last treatment and 70-90 days since last treatment)
Programmed death ligand 1 (PD-L1) receptor occupancy levels as measured by changes from baseline	Baseline and within the first 3 weeks

Safety Study of Anti-Programmed Death-Ligand 1 in Hematologic Malignancy

Recruitment & Eligibility

Study & Design

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