A Multicenter, Open-label, Phase Ib/II Study of AK104, a PD-1/CTLA-4 Bispecific Antibody, in Subjects With Advanced Solid Tumors or AK104 in Combination With Oxaliplatin and Capecitabine As First-line Therapy in Subjects With Advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma
Overview
- Phase
- Phase 1
- Status
- Completed
- Sponsor
- Akeso
- Enrollment
- 338
- Locations
- 1
- Primary Endpoint
- Anti-tumor activity of AK104 using objective response rate (ORR) based on RECIST v1.1 as assessed by the investigator (Phase II)
Overview
Brief Summary
The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics (PK), immunogenicity, pharmacodynamics (PD) and anti-tumor activities of AK104，a PD-1/CTLA-4 bispecific antibody, when administered as a single agent in adults subjects with advanced or metastatic solid tumors, or combined with oxaliplatin and capecitabine as first-line therapy in adult subjects with advanced unresectable or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma.
Detailed Description
The study consists of a dose escalation and expansion phase (Phase Ib) to determine the recommended Phase 2 dose (RP2D) for AK104 in combination with oxaliplatin and capecitabine, and a dose confirmation phase (Phase II) which will further characterize the treatment of AK104 in combination at the RP2D.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 75 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Written and signed informed consent.
- •Eastern Cooperative Oncology Group (ECOG) Performance Score of 0 or
- •Estimated life expectancy of ≥3 months.
- •For Phase Ib Cohort 1, histologically or cytologically documented advanced or metastatic solid tumor that is refractory/relapsed to standard therapies, or for which no effective standard therapy is available. For other cohorts in Phase Ib and Phase II, histologically or cytologically documented advanced unresectable or metastatic gastric adenocarcinoma or gastroesophageal Junction (GEJ) adenocarcinoma.
- •For cohorts other than cohort 1 in Phase Ib and Phase II: No prior systemic chemotherapy for advanced or metastatic gastric or GEJ adenocarcinoma. Subjects who have received prior adjuvant chemotherapy or neoadjuvant chemotherapy with curative intent, or definitive chemoradiotherapy for advanced disease, will be eligible provided that progression has occurred \>6 months from last treatment.
- •Subjects must have at least one measurable lesion in accordance with RECIST v1.
- •A lesion previously treated with local therapies such as radiotherapy can be considered a target lesion if there is objective evidence of progression in the lesion.
- •For cohorts other than cohort 1 in Phase Ib and Phase II: Subjects must provide an available tumor tissue samples taken \< 6 months prior to first dose of study treatment.
- •Adequate organ function.
- •Females of childbearing potential who are sexually active with a nonsterilized male partner must use at least one highly effective method of contraception.
Exclusion Criteria
- •Subjects with known HER2-positive gastric or GEJ adenocarcinoma (not applicable for Cohort 1 in Phase Ib).
- •Subjects squamous cell, undifferentiated or other histological types of with gastric or GEJ cancer (not applicable for Cohort 1 in Phase Ib).
- •Other invasive malignancies within 2 years, except for locally treatable (manifested as cured) malignancies, such as basal or skin squamous cell carcinoma, superficial bladder cancer, cervical or breast carcinoma in situ.
- •Receipt of last radiotherapy or any anti-tumor treatment \[chemotherapy, targeted therapy, immunotherapy, Chinese patent drugs with antitumor indications, or immunomodulators or tumor embolization\] within 4 weeks prior to the first dose of study treatment.
- •Prior exposure to any anti-PD-1, anti-PD-L1, anti-CTLA-4 antibody, or any other antibody or drug therapy for T cell co-stimulatory or checkpoint pathways, such as ICOS or agonists (e.g. CD40, CD137, GITR and OX40 etc).
- •Subjects with active, known or suspected autoimmune disease, or a medical history of autoimmune disease, with the exceptions of the following: vitiligo, alopecia, Grave disease, psoriasis or eczema not requiring systemic treatment within the last 2 years, hypothyroidism (caused by autoimmune thyroiditis) only requiring steady doses of hormone replacement therapy and type I diabetes only requiring steady doses of insulin replacement therapy, or completely relieved childhood asthma that requires no intervention in adulthood, or primary diseases that will not relapse unless triggered by external factors.
- •Active or previously documented inflammatory bowel disease (e.g. Crohn's disease, ulcerative colitis or chronic diarrhea). Inability to swallow, malabsorption syndrome, uncontrollable nausea, vomiting, diarrhea, or other gastrointestinal diseases which significantly affect the absorption of administered drug.
- •Known history of primary immunodeficiency virus infection.
- •Known history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.
- •Known history of interstitial lung disease.
Arms & Interventions
AK104
AK104 IV every 2 weeks (q2w)
Intervention: AK104 (Biological)
AK104 and chemotherapy
AK104 IV Q2W or Q3W，oxaliplatin IV 85 mg/m2 Q2W or 130mg/m2 Q3W，capecitabine 1000 mg/m2#twice a day (bid) for day 1to day 10 or day 1 to day 14 per cycle
Intervention: AK104 (Biological)
AK104 and chemotherapy
AK104 IV Q2W or Q3W，oxaliplatin IV 85 mg/m2 Q2W or 130mg/m2 Q3W，capecitabine 1000 mg/m2#twice a day (bid) for day 1to day 10 or day 1 to day 14 per cycle
Intervention: Oxaliplatin (Drug)
AK104 and chemotherapy
AK104 IV Q2W or Q3W，oxaliplatin IV 85 mg/m2 Q2W or 130mg/m2 Q3W，capecitabine 1000 mg/m2#twice a day (bid) for day 1to day 10 or day 1 to day 14 per cycle
Intervention: Capecitabine (Drug)
Outcomes
Primary Outcomes
Anti-tumor activity of AK104 using objective response rate (ORR) based on RECIST v1.1 as assessed by the investigator (Phase II)
Time Frame: From the first dose of study drug through the date of first documented progression, end of study, date of death, or one year after the last patient starts treatment, whichever should occur first
The ORR is defined as the proportion of subjects with confirmed CR or confirmed PR, based on RECIST Version 1.1.
The number of subjects experiencing dose-limiting toxicities (DLTs) (Phase Ib)
Time Frame: During the first 4 weeks
DLTs will be assessed during the first 4 weeks of treatment for dose-escalation phase and are defined as toxicities that meet pre-defined severity criteria, and 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 (4 weeks) of treatment.
The number of subjects experiencing adverse events (AEs) (Phase Ib)
Time Frame: From the time of informed consent through 90 days following termination of treatment with investigational product
An AE is defined as any untoward medical occurrence in a participant administered a pharmaceutical product temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Secondary Outcomes
- Disease control rate (DCR)(Up to 2 years)
- Duration of response (DoR)(Up to 2 years)
- Progression-free survival (PFS)(Up to 2 years)
- Overall survival (OS)(Up to 2 years)
- Maximum observed concentration (Cmax) of AK104(From first dose of AK104 through to 90 days after last dose of AK104)
- Minimum observed concentration (Cmin) of AK104 at steady state(From first dose of AK104 through to 90 days after last dose of AK104)
- Area under the curve (AUC) of AK104(From first dose of AK104 through to 90 days after last dose of AK104)
- Number of subjects who develop detectable anti-drug antibodies (ADAs)(From first dose of AK104 through 90 days after last dose of AK104)