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A Study of the Intra-Patient Escalation Dosing Regimen With IMCgp100 in Patients With Advanced Uveal Melanoma

Phase 1
Completed
Conditions
Uveal Melanoma
Interventions
Drug: IMCgp100
Registration Number
NCT02570308
Lead Sponsor
Immunocore Ltd
Brief Summary

IMCgp100-102 is a Phase I/II study of the weekly intra-patient escalation dose regimen with IMCgp100 as a single agent in participants with metastatic uveal melanoma (mUM). According to this regimen, all participants in the trial received 2 weekly doses of IMCgp100 at a dose level below the identified weekly recommended Phase II dose (RP2D-QW) and then a dose escalation commenced at the third weekly dose at C1D15. The Phase I testing of the intra-patient escalation dosing regimen is designed to achieve a higher exposure and maximal plasma concentration of IMCgp100 after doses at Cycle 1 Day 15 (C1D15) and thereafter.

Detailed Description

This is a Phase I/II clinical study of IMCgp100 in participants with advanced uveal melanoma.

This is a Phase I/II study of IMCgp100 administered on a weekly basis with an intra-patient escalation dosing regimen. The intra-patient escalation occurred at the third weekly dose on Cycle 1 Day 15 (C1D15). According to this regimen, all participants in the trial received 2 weekly doses of IMCgp100 at a dose level below the identified weekly recommended Phase II dose (RP2D-QW), and then a dose escalation commenced at the third weekly dose at C1D15 with the goal to achieve a long-term dosing regimen at a dose higher than that identified for the weekly dosing regimen (RP2D-QW). The dose escalation identified the intra-patient escalation regimen (RP2D-IE).

The Phase I portion of the study was a standard 3+3 dose escalation design.The recommended Phase II dose of the intra-patient escalation dose regimen (RP2D-IE) was identified and expansion cohorts in metastatic uveal melanoma was accrued based on prior therapy.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
146
Inclusion Criteria
  1. Male or female participants age ≥ 18 years of age at the time of informed consent.
  2. Ability to provide and understand written informed consent prior to any study procedures.
  3. Histologically or cytologically confirmed diagnosis of metastatic uveal melanoma (mUM).
  4. Surgically sterile participants or participants of child-bearing potential who agree to use highly effective methods of contraception during study dosing and for 6 months after last dose of study drug.
  5. Human leukocyte antigen (HLA)-A*0201 positive.
  6. ECOG Performance Status of 0 or 1 at Screening.
  7. Phase 2 will include participants with previously treated uveal melanoma in the metastatic setting.
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Exclusion Criteria
  1. Presence of symptomatic or untreated central nervous system (CNS) metastases, or CNS metastases that require doses of corticosteroids.
  2. History of severe hypersensitivity reactions to other biologic drugs or monoclonal antibodies.
  3. Participants with any out-of-range laboratory values.
  4. Clinically significant cardiac disease or impaired cardiac function.
  5. Active infection requiring systemic antibiotic therapy.
  6. Known history of HIV infection.
  7. Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection per institutional protocol.
  8. Participants receiving systemic treatment with systemic steroid therapy or any other immunosuppressive medication at any dose level that would interfere with the action of the study drugs in the opinion of the investigator.
  9. Malignant disease, other than that being treated in this study.
  10. Any medical condition that would, in the investigator's judgment, prevent participation in the clinical study due to safety concerns, compliance with clinical study procedures or interpretation of study results.
  11. Presence of NCI CTCAE ≥ grade 2 toxicity (except alopecia, peripheral neuropathy and ototoxicity, which are excluded if ≥ NCI CTCAE grade 3) due to prior cancer therapy.
  12. Pregnant, likely to become pregnant, or lactating women.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Dose escalationIMCgp100Dose escalation cohorts of the intra-patient escalation regimen.
Dose expansionIMCgp100Dose expansion cohort with the recommended phase 2 dose of the intra-patient dose escalation regimen.
Primary Outcome Measures
NameTimeMethod
Number of Participants With a Dose Limiting Toxicity (DLT) in Phase 1Up to 49 months

Number of participants with a dose limiting toxicity, defined as an adverse event (AE) or abnormal laboratory value assessed as having a suspected relationship to study drug, and unrelated to disease, disease progression, inter-current illness, or concomitant medications that occurs within the first cycle of treatment and meets any of the pre-specified criteria.

Objective Response Rate in Phase 2Up to 38 months

Objective response rate (ORR) is defined as the percentage of participants with measurable disease with at least 1 visit response of complete response (CR) or partial response (PR) that is confirmed at least 4 weeks later, as defined in RECIST v.1.1 and assessed by an independent central review (ICR). The denominator in the calculation of the ORR is the number of participants in the full analysis set with measurable disease at baseline.

Secondary Outcome Measures
NameTimeMethod
Disease Control Rate24 weeks

Disease control rate (DCR) is defined as the percentage of participants with a best overall response of CR or PR or stable disease (SD) recorded at least 24 weeks (± 1 week) after commencement of study drug and prior to any progressive disease (PD) event, as assessed by RECIST v1.1 by the investigator for Phase 1 and ICR for Phase 2.

Duration of ResponseUp to 49 months

Duration of response (DOR) is defined as the time in months from the date of first documented objective response (CR or PR) until the date of documented disease progression or death by any cause in the absence of disease progression as assessed by RECIST v1.1 by the investigator for Phase 1 and ICR for Phase 2.

Progression-free SurvivalUp to 49 months

Progression-free survival is defined as the time in months from first dose of study drug until the date of disease progression or death (by any cause in the absence of disease progression) as assessed by RECIST v1.1 by the investigator for Phase 1 and ICR for Phase 2.

Time to ResponseUp to 49 months

Time to response (TTR) is defined as the time in months from the date of first dose of study drug until the date of first documented objective response as assessed by RECIST v1.1 by the investigator for Phase 1 and ICR for Phase 2.

Objective Response Rate in Phase 1Up to 49 months

ORR is defined as the percentage of participants with measurable disease with at least 1 visit response of CR or PR that is confirmed at least 4 weeks later, as defined in RECIST v.1.1 and assessed by an investigator. The denominator in the calculation of the ORR is the number of participants in the full analysis set with measurable disease at baseline.

Area Under the Plasma Concentration-Time Curve (AUC) of TebentafuspCycle 1 Day 1 and Cycle 1 Day 15: predose, end of infusion, and 4 and 8 hours postdose

The AUC was determined in in dose escalation cohorts.

Maximum Plasma Concentration (Cmax) of TebentafuspCycle 1 Day 1 and Cycle 1 Day 15: predose, end of infusion, and 4 and 8 hours postdose

The Cmax is determined in dose escalation cohorts.

Time to Maximum Plasma Concentration (Tmax) of TebentafuspCycle 1 Day 1 and Cycle 1 Day 15: predose, end of infusion, and 4 and 8 hours postdose

The Tmax of tebentafusp is determined in dose escalation cohorts.

Apparent Terminal Plasma Half-life (t½) of TebentafuspCycle 1 Day 1 and Cycle 1 Day 15: predose, end of infusion, and 4 and 8 hours postdose

The t½ of tebentafusp is reported in dose escalation cohorts.

Percentage of Participants With Anti-IMCgp100 Antibody FormationUp to 49 months

Overall antidrug antibody (ADA) is presented as number of ADA-positive participants relative to total number of participants with evaluable ADA results in each cohort

Overall SurvivalUp to 49 months

Overall survival (OS) is defined as the time in months from the date of first dose of study drug until death due to any cause in general.

Minor Response RateUp to 49 months

Rate of minor response (or better) is defined as the proportion of participants with a confirmed CR, PR, or minor response (MinR) as assessed by RECIST v1.1 by the investigator for Phase 1 or ICR for Phase 2, where MinR is a reduction from baseline in sum of diameters between 10%-29%. The sum of diameters is defined as per RECIST v1.1 as the sum of longest diameters or short axis of target lesions (mm).

Number of Participants With Treatment Dose Interruptions or ReductionsUp to 49 months

Tolerability of study treatment was assessed by summarizing the number of participants with dose interruptions or reductions that occurred during the treatment period.

Trial Locations

Locations (26)

The Angeles Clinic and Research Institute - W LA Office

🇺🇸

Los Angeles, California, United States

University of Miami Hospital Clinics/Sylvester Comprehensive Cancer Center

🇺🇸

Miami, Florida, United States

The University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Thomas Jefferson University Medical Oncology Clinic

🇺🇸

Philadelphia, Pennsylvania, United States

Princess Margaret Cancer Center

🇨🇦

Toronto, Ontario, Canada

University California, San Diego Moores Cancer Center

🇺🇸

La Jolla, California, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

California Pacific Medical Center

🇺🇸

San Francisco, California, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Charite Universitaetsmedizin Berlin - Campus Benjamin Franklin

🇩🇪

Berlin, Germany

Hospital General Universitario de Valencia

🇪🇸

Valencia, Spain

Mount Vernon Cancer Centre

🇬🇧

Northwood, Middlesex, United Kingdom

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital Universitario Virgen Macarena

🇪🇸

Sevilla, Spain

University of Colorado Denver Anschutz Medical Campus

🇺🇸

Aurora, Colorado, United States

H. Lee Moffitt Cancer Center and Research Institute, Inc

🇺🇸

Tampa, Florida, United States

The Clatterbridge Cancer Centre

🇬🇧

Wirral, Merseyside, United Kingdom

ICO l'Hospitalet - Hospital Duran i Reynals

🇪🇸

L'Hospitalet De Llobregat, Barcelona, Spain

Dean A. Mcgee Eye Institute

🇺🇸

Oklahoma City, Oklahoma, United States

Universitaetsklinikum Heidelberg

🇩🇪

Heidelberg, Baden Wuerttemberg, Germany

Providence Portland Medical Center

🇺🇸

Portland, Oregon, United States

Baylor Scott & White Health

🇺🇸

Temple, Texas, United States

Georgetown University - Lombardi Comprehensive Cancer Center

🇺🇸

Washington, District of Columbia, United States

Columbia University Medical Center - The New York Presbyterian Hospital

🇺🇸

New York, New York, United States

Memorial Sloan Kettering Hospital

🇺🇸

New York, New York, United States

Washington University, School of Medicine

🇺🇸

Saint Louis, Missouri, United States

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