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GB1211 and Pembrolizumab Versus Pembrolizumab and Placebo in Patients With Metastatic Melanoma and Head and Neck Squamous Cell Carcinoma

Phase 2
Recruiting
Conditions
Metastatic Melanoma
Head and Neck Squamous Cell Carcinoma
Interventions
Registration Number
NCT05913388
Lead Sponsor
Providence Health & Services
Brief Summary

The purpose of this study is to determine the objective response of GB1211 and pembrolizumab versus pembrolizumab and placebo in patients with advance metastatic melanoma or head and neck squamous cell carcinoma.

Detailed Description

Eligible patients will be registered, stratified by diagnosis (melanoma versus oral, head and neck (OHN) cancer), and the number of prior systemic therapies, and randomized to receive either GB1211 + pembrolizumab or pembrolizumab + placebo.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
92
Inclusion Criteria
  • Patients with unresectable or metastatic melanoma including unknown primary or mucosal melanomas. Histological confirmation of melanoma will be required by previous biopsy or cytology. Patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) with disease progression during or after platinum-containing chemotherapy are eligible. PD-L1 testing is not needed for OHN cancers.
  • Patients who have received anti-PD1 or anti-PD-L1 in the past are eligible if it has been at least 6 months since the last anti-PD-1 or PD-L1 dose, they meet all other eligibility criteria and progression of malignancy has been documented on imaging. Progression for this patient subset is defined as the appearance of one or more new metastatic sites, or a 5% or greater increase in the sum of diameter of target lesions or an unequivocal increase in non-target site. Treatment naïve melanoma patients are eligible.
  • Patients must be ≥ 18 years of age.
  • ECOG performance status of 0-2.
  • Women of childbearing potential must have a serum or urine pregnancy test performed within 72 hours prior to the start of protocol treatment. The results of this test must be negative in order for the patient to be eligible. In addition, women of childbearing potential as well as male patients must agree to take appropriate precautions to avoid pregnancy.
  • No active bleeding.
  • Anticipated lifespan greater than 12 weeks.
  • Patients must sign a study-specific consent document.
Exclusion Criteria
  • Patients who have previously received a galectin antagonist.

  • Patients with active autoimmune disease except for autoimmune thyroiditis or vitiligo.

  • Patients with history of autoimmune colitis.

  • Patients with untreated brain metastases. Patients with treated brain metastases who demonstrate control of brain metastases with follow-up imaging 4 or more weeks after initial therapy are eligible.

  • Patients requiring other systemic oncologic therapy, including experimental therapies.

  • Patients who have received anti-cancer treatment within 3 weeks or 5 half-lives before first study drug dose.

  • Patients with Child-Pugh C hepatic impairment.

  • Patients with active infection requiring antibiotics.

  • Pregnant or lactating women, as treatment involves unforeseeable risks to the embryo or fetus.

  • Need for steroids at greater than physiologic replacement doses. Inhaled corticosteroids are acceptable.

  • Laboratory exclusions (to be performed within 28 days of enrollment):

    • WBC < 3.0 x 109/L
    • Hgb < 9.0 g/dL
    • AST or ALT > 1.5 times ULN
    • Total bilirubin > 1.9 g/dL, unless due to Gilbert's Syndrome. If Gilbert's Syndrome is present by clinical history, then direct bilirubin must by < 3.0 g/dl.
    • Active or known history of HIV
    • Active or known history of Hepatitis B
    • Active or known history of Hepatitis C
    • Platelet counts < 100 x 10E9 / L (100,000/ μL) without transfusion
    • INR > 1.5x ULN
  • Inability to give informed consent and comply with the protocol. Patients must be judged able to understand fully the investigational nature of the study and the risks associated with the therapy.

  • Any medical condition that in the opinion of the Principal Investigator would compromise the safety or conduct of the study procedures.

  • Unresolved immune-mediated pneumonitis, diarrhea, elevation of hepatocellular enzymes or other toxicities requiring greater than physiological replacement doses of steroids.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
GB1211 + PembrolizumabGB1211GB1211 will be administered orally twice a day at 400mg in combination with standard pembrolizumab treatment.
GB1211 + PembrolizumabPembrolizumabGB1211 will be administered orally twice a day at 400mg in combination with standard pembrolizumab treatment.
Pembrolizumab MonotherapyPembrolizumabPlacebo will have the same appearance as GB1211 and administered orally twice a day in combination with standard pembrolizumab treatment.
Pembrolizumab MonotherapyPlaceboPlacebo will have the same appearance as GB1211 and administered orally twice a day in combination with standard pembrolizumab treatment.
Primary Outcome Measures
NameTimeMethod
Overall response rate based on disease imagingFrom the date of randomization until the date of first documented progression, assessed up to 63 weeks.

Determine the response of Gal-3 inhibitor and pembrolizumab versus pembrolizumab monotherapy (plus placebo) in patients with metastatic melanoma or head and neck squamous cell carcinoma (HNSCC).

Secondary Outcome Measures
NameTimeMethod
Evaluation of Predictive BiomarkerDay 85

Characterize myeloid-derived suppressor cells (MDSC) expression over time as a predictive biomarker of response after GB1211 + pembrolizumab or pembrolizumab monotherapy

Frequency of Immune-mediated Adverse EventsFrom the time of informed consent to week 63

Compare the frequency of immune-mediated adverse events after GB1211 + pembrolizumab versus pembrolizumab + placebo

Evaluation of Antiviral ImmunityDay 85

Assess the biological activity of GB1211 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring tumor-specific T cells using autologous and/or HLA-matched tumor when available.

Evaluation of GAL-3 ExpressionScreening and Day 68

Compare Gal-3 expression in paired biopsies after GB1211 + pembrolizumab or pembrolizumab monotherapy

Trial Locations

Locations (1)

Providence Portland Medical Center

🇺🇸

Portland, Oregon, United States

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