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A Phase 1/2a Study of DB-1303/BNT323 in Advanced/Metastatic Solid Tumors

Phase 1
Recruiting
Conditions
HER2-positive Advanced Solid Tumor
Interventions
Registration Number
NCT05150691
Lead Sponsor
DualityBio Inc.
Brief Summary

This is a dose-escalation and dose-expansion Phase 1/2a trial to evaluate the safety and tolerability of DB-1303/BNT323 in subjects with advanced solid tumors that express HER2.

Detailed Description

This is a multicenter, non-randomized (Except for Dose Expansion 1 and Dose Expansion 9 cohorts), open-label, multiple-dose, FIH study. The study consists of two parts: Part 1 adopts an accelerated titration at first dose level followed with classic "3+3" design to identify the MTD/RP2D; Part 2 is a dose expansion phase to confirm the safety, tolerability and explore efficacy in selected malignant solid tumors at the MTD/the RP2D. This study will enroll subjects with advanced/unresectable, recurrent, or metastatic HER2-expressing malignant solid tumors.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
796
Inclusion Criteria
  • Has a pathologically documented HER2-positive or HER2-expressing (except for cohort 2h where the requirement is HER2-null), advanced/unresectable, recurrent, or metastatic malignant solid tumor that is refractory to or intolerable with standard treatment, or for which no standard treatment is available.
  • At least 1 measurable lesion (per RECIST 1.1)
  • Provide signed informed consent
  • ECOG performance status (PS) of 0-1.
  • LVEF ≥ 50% by ECHO or MUGA
  • Adequate organ functions
  • Provide pre-existing diagnosis of HER2 status or resected tumor samples or undergo fresh tumor biopsy for HER2 testing.
  • Life expectancy of ≥ 3 months.

Additional Inclusion Criteria for Part 2 Expansion Group 9:

  1. Has pathologically documented advanced/unresectable, recurrent, or metastatic EC (including UCS and USPC) and has progressed on or after at least 1 line of systemic treatment including platinum-based therapy and exposure to ICI but no more than prior 3 lines of therapy for advanced/unresectable, or metastatic disease. Note: endocrine therapy will not qualify as a systemic therapy line.
Exclusion Criteria
  • History of symptomatic CHF (New York Heart Association [NYHA] classes II-IV) or serious cardiac arrhythmia requiring treatment.
  • History of myocardial infarction or unstable angina within 6 months before Day 1.
  • Average QTcF > 450 ms in males and > 470 ms in females
  • History of clinically significant lung diseases
  • Uncontrolled infection requiring IV antibiotics, antivirals, or antifungals.
  • HIV infection with AIDS defining illness or active viral hepatitis.
  • Clinically active brain metastases
  • Unresolved toxicities from previous anticancer therapy, defined as toxicities not yet resolved to NCI-CTCAE version 5.0, Grade ≤ 1 or baseline.
  • A known hypersensitivity to either the drug substances or inactive ingredients in the drug product.
  • Part 2 (expansion) Only:Multiple primary malignancies within 3 years, except adequately resected non- melanoma skin cancer, curatively treated in-situ disease, other solid tumors curatively treated, or contralateral breast cancer.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DB-1303/BNT323 Dose Level 1DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 at Dose Level 1 on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Level 2DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 at Dose Level 2 on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Level 3DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 at Dose Level 3 on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Level 4DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 at Dose Level 4 on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Level 5DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 at Dose Level 5 on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 1DB-1303/BNT323Enrolled Subjects will be randomized to receive a single-dose of DB-1303/BNT323 on a selected dose level 1 or dose level 2 Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 2DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 3DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 4DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 5DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Level 6DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 at Dose Level 6 on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Level 7DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 at Dose Level 7 on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 6DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 7DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 8DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 9DB-1303/BNT323Enrolled Subjects will be randomized to receive a single-dose of DB-1303/BNT323 on a selected dose level 1 or dose level 2 on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 10DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W along with ritonavir or itraconazole to assess the DDI potential
DB-1303/BNT323 Dose Expansion 10RitonavirEnrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W along with ritonavir or itraconazole to assess the DDI potential
DB-1303/BNT323 Dose Expansion 10ItraconazoleEnrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W along with ritonavir or itraconazole to assess the DDI potential
DB-1303/BNT323 Dose Expansion 11DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 12DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level 1 or dose level 2 in combination with Pertuzumab on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 12Pertuzumab InjectionEnrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level 1 or dose level 2 in combination with Pertuzumab on Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 13DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 14DB-1303/BNT323China Only:Subjects who were previously treated with trastuzumab and taxane will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 15DB-1303/BNT323China Only: Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 16DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
DB-1303/BNT323 Dose Expansion 17DB-1303/BNT323Enrolled Subjects will receive a single-dose of DB-1303/BNT323 on a selected dose level (RP2D) Day 1 of each cycle Q3W
Primary Outcome Measures
NameTimeMethod
Phase 1: Percentage of Participants with Dose-Limiting Toxicities (DLTs) as assessed by CTCAE v5.0.up to 21 days after C1D1

Percentage of participants in Part 1 with DLTs

Phase 1: Maximum Tolerated Dose (MTD) of DB-1303Up to Safety Follow-Up visit, approximately 35 days post-treatment

MTD on the data collected during Part 1

Phase 1: Recommended Phase 2 Dose (RP2D) of DB-1303Up to Safety Follow-Up visit, approximately 35 days post-treatment

RP2D of DB-1303 based on the data collected during Part 1

Phase 1: Percentage of participants with AEs in Part 1 graded according to NCI CTCAE v5.0Up to Safety Follow-Up visit, approximately 35 days post-treatment

Percentage of Participants with Treatment Emergent Adverse Events (TEAEs) or Treatment Emergent Adverse Event of Special Interest include those \>/= G3 leading to dose reduction, interruption or discontinuation as assessed by CTCAE v5.0, abnormal vital signs, abnormal 12-lead ECGs, abnormal safety laboratory tests, abnormal ECOG PS, abnormal ECHO/MUGA (LVEF).

Phase 1: Percentage of Participants with Serious Adverse Events (SAEs) as assessed by CTCAE v5.0.Up to follow-up period, approximately 1 year post-treatment

Percentage of Participants with SAEs in Part 1 graded according to NCI CTCAE v5.0

Phase 2: Percentage participants with Serious Adverse Events (SAEs) as assessed by CTCAE v5.0.Up to follow-up period, approximately 1 year post-treatment

Percentage of participants with SAEs in Part 2 graded according to NCI CTCAE v5.0

Phase 2 (Dose Expansion 10 only): To evaluate the effect of ritonavir on DB-1303 and P1003 PK in subjects with HER2-expressing, HER2-amplified, or HER2-mutated advanced solid malignant tumorsup to safety follow-up visit, approx. 35 days post-treatment

Maximum observed plasms concentration (Cmax) and Area under the concentration-time curve from 0 to infinity of DB-1303 and P1003 (+/- Ritonavir)

Phase 2 (Dose Expansion 10 only): To evaluate the effect of itraconazole on DB-1303 and P1003 PK in subjects with HER2-expressing, HER2-amplified, or HER2-mutated advanced solid malignant tumors.up to safety follow-up visit, approx. 35 days post-treatment

Maximum observed plasms concentration (Cmax) and Area under the concentration-time curve from 0 to infinity of DB-1303 and P1003 (+/- Itraconazole)

Phase 2: Percentage of Objective Response Rate (ORR) as assessed by RECIST 1.1.Up to follow-up period, approximately 1 year post-treatment

The percentage of subjects who had a best response of CR or PR, for Part 2 only which was maintained ≥4 weeks.

Percentage of participants with AEs in Part 2 graded according to NCI CTCAE v5.0Up to follow-up period, approximately 1 year post-treatment

Phase 2: Percentage of Participants with Treatment Emergent Adverse Events (TEAEs) or Treatment Emergent Adverse Event of Special Interest include those \>/= G3 leading to dose reduction, interruption or discontinuation as assessed by CTCAE v5.0, abnormal vital signs, abnormal 12-lead ECGs, abnormal safety laboratory tests, abnormal ECOG PS, abnormal ECHO/MUGA (LVEF).

Secondary Outcome Measures
NameTimeMethod
Phase 1 & Phase 2: Pharmacokinetic-TmaxUp to safety follow up visit, approx. 35 days post-treatment

Time to Cmax of DB-1303

Phase 1 & Phase 2: Pharmacokinetic-CtroughUp to safety follow up visit, approx. 35 days post-treatment

Trough concentration of DB-1303

Phase 1 & Phase 2: Pharmacokinetic-AUCUp to safety follow up visit, approx. 35 days post-treatment

Area under the concentration-time curve from time 0 to infinity of DB-1303

Phase 1 & Phase 2: Pharmacokinetic-CmaxUp to safety follow up visit, approx. 35 days post-treatment

Maximum observed plasma concentration (Cmax) of DB-1303

Phase 1 & Phase 2: Pharmacodynamics-ADAUp to safety follow up visit, approx. 35 days post-treatment

Data gathered from blood to determine Levels of anti-drug antibody (ADA) against DB 1303 in serum compared to baseline.

Phase 2: Percent change in target lesions as assessed by RECIST 1.1Up to follow-up period, approximately 1 year post-treatment

The percent change in the participant's target lesions from baseline to last study scan using RECIST V1.1

Phase 2 Cohort b Only: Percentage of ORR as assessed by IRC and as assessed by investigator based on RECIST 1.1 for HER2-expressing subjects and in subjects with prior ICI treatmentUp to follow-up period, approximately 1 year post-treatment

The percentage of subjects who had a best response of CR or PR, for Cohort 2b only

To evaluate the safety of DB-1303 with/without ritonavir or itraconazoleUp to follow-up period, approximately 1 year post-treatment

Percentage of Participants with Serious Adverse Events (SAEs), Treatment Emergent Adverse Events (TEAE), TEAEs \>/= G3, or TEAEs leading to dose reduction, interruption or discontinuation, Adverse Events of Special Interest, (AESIs), abnormal vital signs, abnormal 12-lead ECGs, abnormal safety laboratory tests, abnormal ECOG PS, abnormal ECHO/MUGA (LVEF).

Phase 1 & Phase 2: Pharmacokinetic-T1/2Up to safety follow up visit, approx. 35 days post-treatment

Terminal elimination half-life

Phase 1 & 2: Duration of Response (DoR) as assessed by RECIST 1.1Up to follow-up period, approximately 1 year post-treatment

The duration of time from date of first CR or PR to date of progressive disease or death due to any cause, whichever comes first using RECIST V1.1

Phase 1 and 2 Cohort b only: Progression-Free SurvivalUp to follow-up period, approximately 1 year post-treatment

Time from subject receiving the first dose to disease progression or death by any cause

Phase 1 & 2: Disease Control Rate (DCR) as assessed by RECIST 1.1Up to follow-up period, approximately 1 year post-treatment

Proportion of participants who had a best response rating of CR or PR, or SD using RECIST V1.1.

Phase 1 and 2 Cohort b only: Overall SurvivalUp to follow-up period, approximately 1 year post-treatment

Time from subject receiving the first dose to death by any cause

Phase I: Percentage of Objective Response Rate (ORR) as assessed by investigator based on RECIST 1.1Up to follow-up period, approximately 1 year post-treatment

The percentage of subjects who had a best response of CR or PR

Phase 1 & 2: Time to Response (TTR) as assessed by RECIST 1.1Up to follow-up period, approximately 1 year post-treatment

The duration of time when receiving the first dose of study drug to the first date that is evaluated as either CR or PR using RECIST V1.1

Phase 2: Time on TherapyUp to 21 days after the participant's last dose

The duration of time from participant receiving first dose of study drug to the last dose + 21 days

Trial Locations

Locations (89)

TOI Clinical Research

🇺🇸

Cerritos, California, United States

California Research Institute

🇺🇸

Los Angeles, California, United States

Sharp Memorial Hospital

🇺🇸

San Diego, California, United States

Washington Cancer Institute at MedStar Washington Hospital Center

🇺🇸

Washington, District of Columbia, United States

Advanced Research LLC

🇺🇸

Coral Springs, Florida, United States

The Oncology Institute of Hope and Innovation

🇺🇸

Lakeland, Florida, United States

D&H Cancer Research Center LLC

🇺🇸

Margate, Florida, United States

HCA Mercy Hospital

🇺🇸

Miami, Florida, United States

BRCR Medical Center Inc.

🇺🇸

Tamarac, Florida, United States

Southeastern Regional Medical Center, LLC

🇺🇸

Newnan, Georgia, United States

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TOI Clinical Research
🇺🇸Cerritos, California, United States

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