MedPath

GEN1046 Safety Trial in Patients With Malignant Solid Tumors

Phase 1
Active, not recruiting
Conditions
Urothelial Carcinoma
Solid Tumors
Squamous Cell Carcinoma of the Head and Neck
Non-small Cell Lung Cancer
Triple Negative Breast Cancer
Cervical Cancer
Endometrial Carcinoma
Interventions
Registration Number
NCT03917381
Lead Sponsor
Genmab
Brief Summary

The goal of this trial is to learn about the antibody acasunlimab (an antibody also known as GEN1046) when it is used alone and when it is used together with standard of care treatment (docetaxel) or another antibody cancer drug, pembrolizumab (with or without chemotherapy), for treatment of patients with certain types of cancer. All subjects will receive active drug; no one will receive placebo.

This trial has 2 parts. The purpose of the first part is to find out if acasunlimab is safe and to find out the best doses of acasunlimab to use. The purpose of the second part is to give acasunlimab to more subjects to see how well the doses of acasunlimab selected in the first part work against cancer when given alone and how well they work when given with pembrolizumab (with or without other chemotherapy) or docetaxel.

Trial details include:

* The average trial duration for an individual subject will be about 74 weeks.

* The average treatment duration for an individual subject will be about 21 weeks.

* The visit frequency will be weekly at first and lessening over time until visits are only once every 3 weeks.

Detailed Description

The trial is an open-label, multi-center safety trial of acasunlimab (GEN1046). The trial consists of two parts, a dose escalation part (phase 1, first-in-human \[FIH\] and an expansion part \[phase 2a\]). The expansion part of the trial will be initiated once the Recommended Phase 2 Dose (RP2D) has been determined.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
429
Inclusion Criteria

For Dose Escalation:

• Have a histologically or cytologically confirmed non-CNS solid tumor that is metastatic or unresectable and for whom there is no available standard therapy

For Expansion:

• Have histologically or cytological confirmed diagnosis of relapsed or refractory, advanced and/or metastatic NSCLC, EC, UC, TNBC, SCCHN, or cervical cancer who are not anymore candidates for standard therapy For separate expansion cohorts: metastatic NSCLC without prior systemic treatment regimens for metastatic disease.

For Both Dose Escalation and Expansion

  • Have measurable disease according to RECIST 1.1
  • Have Eastern Cooperative Oncology Group (ECOG) 0-1
  • Have an acceptable hematological status
  • Have acceptable liver function
  • Have an acceptable coagulation status
  • Have acceptable renal function

Key

Exclusion Criteria
  • Have uncontrolled intercurrent illness, including but not limited to:

    • Ongoing or active infection requiring intravenous treatment with anti-infective therapy, or any ongoing systemic inflammatory condition requiring further diagnostic work-up or management during screening.
    • Symptomatic congestive heart failure (Grade III or IV as classified by the New York Heart Association), unstable angina pectoris or cardiac arrhythmia
    • Uncontrolled hypertension defined as systolic blood pressure ≥ 160 mmHg and/or diastolic blood pressure ≥ 100 mmHg, despite optimal medical management
    • Ongoing or recent evidence of autoimmune disease
    • History of irAEs that led to prior checkpoint treatment discontinuation
    • Prior history of myositis, Guillain-Barré syndrome, or myasthenia gravis of any grade
    • History of chronic liver disease or evidence of hepatic cirrhosis
    • History of non-infectious pneumonitis that has required steroids or currently has pneumonitis
    • History of organ allograft (except for corneal transplant) or autologous or allogeneic bone marrow transplant, or stem cell rescue within 3 months prior to the first dose of acasunlimab
    • Serious, non-healing wound, skin ulcer (of any grade), or bone fracture
  • Any history of intracerebral arteriovenous malformation, cerebral aneurysm, new (younger than 6 months) or progressive brain metastases or stroke

  • Prior therapy:

    • Radiotherapy within 14 days prior to first dose of acasunlimab. Note: palliative radiotherapy will be allowed.
    • Treatment with an anti-cancer agent (within 28 days or after at least 5 half-lives of the drug, whichever is shorter), prior to acasunlimab administration. Accepted exceptions are bisphosphonates (e.g., pamidronate, zoledronic acid, etc.) and denosumab
  • Toxicities from previous anti-cancer therapies that have not adequately resolved

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Dose EscalationAcasunlimabAcasunlimab will be administered as monotherapy.
ExpansionAcasunlimabAcasunlimab will be administered as monotherapy or in combination with either docetaxel, pembrolizumab, or pembrolizumab + standard chemotherapy in separate expansion cohorts.
ExpansionAcasunlimab in combination with docetaxel (in a single expansion cohort)Acasunlimab will be administered as monotherapy or in combination with either docetaxel, pembrolizumab, or pembrolizumab + standard chemotherapy in separate expansion cohorts.
ExpansionAcasunlimab in combination with pembrolizumab (in a separate expansion cohort)Acasunlimab will be administered as monotherapy or in combination with either docetaxel, pembrolizumab, or pembrolizumab + standard chemotherapy in separate expansion cohorts.
ExpansionAcasunlimab in combination with pembrolizumab and standard chemotherapy (in separate expansion cohorts)Acasunlimab will be administered as monotherapy or in combination with either docetaxel, pembrolizumab, or pembrolizumab + standard chemotherapy in separate expansion cohorts.
Primary Outcome Measures
NameTimeMethod
Dose Escalation: Number of Participants With Dose Limiting Toxicity (DLT)During first cycle (21 days) for each cohort

Toxicities will be graded for severity according to Common Terminology Criteria for Adverse Events (CTCAE) criteria version 5.0.

Dose Escalation and Monotherapy Expansion Cohorts: Number of Participants With Adverse Events (AEs)From first dose until the end of the study (up to 60 days after the last dose)
Dose Escalation and Monotherapy Expansion Cohorts: Number of Participants With Shifts From Baseline in Safety Laboratory ParametersFrom first dose until the end of the study (up to 60 days after the last dose)
Expansion Cohort 1: Objective Response Rate (ORR)Up to 3 years

ORR is defined as the percentage of participants with best overall response (BOR) of complete response (CR) or partial response (PR) based on response evaluation criteria in solid tumours (RECIST).

Secondary Outcome Measures
NameTimeMethod
Expansion Cohort 1: Number of Participants With AEsFrom first dose until the end of the study (up to 60 days after the last dose)
Expansion Cohort 1: Number of Participants With Shifts From Baseline in Safety Laboratory ParametersFrom first dose until the end of the study (up to 60 days after the last dose)
Combination Therapy Expansion Cohorts: Number of Participants With AEsFrom first dose until the end of the study (up to 60 days after the last dose)
Combination Therapy Expansion Cohorts: Number of Participants With Shifts From Baseline in Safety Laboratory ParametersFrom first dose until the end of the study (up to 60 days after the last dose)
All Parts: Total Body Clearance (CL) of GEN1046Predose and postdose at multiple timepoints up to end of safety follow up (up to 60 days after last dose)
All Parts: Volume of Distribution (Vd) of GEN1046Predose and postdose at multiple timepoints up to end of safety follow up (up to 60 days after last dose)
All Parts: Area Under the Concentration-Time Curve from Time Zero to Day 21 (AUC21days) of GEN1046Predose and postdose at multiple timepoints for 21 days up to end of safety follow up (up to 60 days after last dose)
All Parts: Area Under the Concentration-Time Curve from Time Zero to Infinity (AUCinf) of GEN1046Predose and postdose at multiple timepoints up to end of safety follow up (up to 60 days after last dose)
All Parts: Area Under the Concentration-Time Curve from Time Zero to Last Quantifiable Concentration (AUClast) of GEN1046Predose and postdose at multiple timepoints up to end of safety follow up (up to 60 days after last dose)
All Parts: Maximum Observed Plasma Concentration (Cmax) of GEN1046Predose and postdose at multiple timepoints up to end of safety follow up (up to 60 days after last dose)
All Parts: Time to Reach Cmax (Tmax) of GEN1046Predose and postdose at multiple timepoints up to end of safety follow up (up to 60 days after last dose)
All Parts: Elimination Half-life (t½) of GEN1046Predose and postdose at multiple timepoints up to end of safety follow up (up to 60 days after last dose)
All Parts: Number of Participants with Anti-drug Antibodies (ADAs)Up to 3 years

Venous blood samples will be collected for measurement of serum concentrations of ADAs.

Dose Escalation and Expansion Cohorts 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13: ORRUp to 3 years

ORR is defined as the percentage of participants with BOR of CR or PR based on RECIST v1.1.

Dose Escalation and Expansion Cohorts 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13: Disease Control Rate (DCR)Up to 3 years

The DCR is defined as the percentage of participants with confirmed BOR of CR, PR, or Stable Disease (SD) according to RECIST v1.1.

All Parts: Duration of Response (DoR)Up to 3 years

DOR is defined as the time from first documentation of response (CR or PR) to the date of the first documented progression or death whichever occurs earlier based on RECIST v1.1.

Expansion Cohort 1: Progression Free Survival (PFS)Up to 3 years

PFS is defined as the number of days from Day 1 in Cycle 1 to the first documented progression or death due to any cause, whichever occurs first based on RECIST version 1.1.

Expansion Cohort 1: Overall survival (OS)Up to 3 years

OS is defined as the number of days from Day 1 in Cycle 1 to death due to any cause.

Trial Locations

Locations (55)

LTD Consilium Medulla

🇬🇪

Tbilisi, Georgia

IOB-Hospital Quironsalud Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Medical Point Izmir Hospital

🇹🇷

Karsiyaka, Turkey

University of Iowa Hospitals

🇺🇸

Iowa City, Iowa, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

Levine Cancer Institute, Atrium Health

🇺🇸

Charlotte, North Carolina, United States

START Midwest

🇺🇸

Grand Rapids, Michigan, United States

University Hospitals Cleveland Medical Center

🇺🇸

Cleveland, Ohio, United States

NYU Langone

🇺🇸

New York, New York, United States

University Hospital Brno

🇨🇿

Brno, Czechia

Fakultni nemocnice Brno

🇨🇿

Brno, Czechia

Fakultni nemocnice Olomouc

🇨🇿

Olomouc, Czechia

LLC "TIM - Tbilisi Institute of Medicine"

🇬🇪

Tbilisi, Georgia

Nemocnice AGEL Ostrava-Vítkovice a.s.

🇨🇿

Nový Jičín, Czechia

Onkologiai Klinika

🇭🇺

Debrecen, Hungary

High Technology Hospital Medcenter

🇬🇪

Batumi, Georgia

Tbilisi State Medical University and Ingorovka High Medical Technology University Clinic Ltd

🇬🇪

Tbilisi, Georgia

BKMK Hospital

🇭🇺

Kecskemét, Hungary

Pulmonology Hospital Törökbálinti

🇭🇺

Törökbálint, Hungary

Rambam Health Care Campus RHCC - Rambam Medical Center

🇮🇱

Haifa, Israel

Hadassah Medical Organization HMO - Sharett Institute of Oncology

🇮🇱

Jerusalem, Israel

Policlinico San'Orsola

🇮🇹

Bologna, Italy

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

IRCCS - Istituto Europeo di Oncologia IEO

🇮🇹

Milan, Italy

Istituto Nazionale Tumori - Fondazione Pascale Italy

🇮🇹

Napoli, Italy

Sheba Medical Center, Ramat Gan

🇮🇱

Tel HaShomer, Israel

Azienda Ospedaliero Universitaria di Parma

🇮🇹

Parma, Italy

Regina Elena National Cancer Institute

🇮🇹

Rome, Italy

AUSL Romagno-Ravenna

🇮🇹

Ravenna, Italy

Policlinico Uni. Campus Bio-Medico

🇮🇹

Roma, Italy

Uniwersyteckie Centrum Kliniczne

🇵🇱

Gdańsk, Poland

ASST Sette Laghi "Ospedale di Circolo e Fondazione Macchi "

🇮🇹

Varese, Italy

Specialist Hospital in Prabuty

🇵🇱

Prabuty, Poland

Medpolonia Sp. z o.o.

🇵🇱

Poznań, Poland

Maria Sklodowska Curie National Research Instutute of Oncology

🇵🇱

Warsaw, Poland

Dom Lekarski SA

🇵🇱

Szczecin, Poland

Hospital Universitario Vall dHebron

🇪🇸

Barcelona, Spain

START Madrid-FJD, Hospital Fundación Jiménez Díaz

🇪🇸

Madrid, Spain

Hospital Universitario Virgen de la Victoria

🇪🇸

Málaga, Spain

START Madrid-CIOCC

🇪🇸

Madrid, Spain

MD Anderson Cancer Center Madrid

🇪🇸

Madrid, Spain

NEXT Oncology Madrid

🇪🇸

Madrid, Spain

Hospital Universitario La Princesa

🇪🇸

Madrid, Spain

Clinica Universidad de Navarra

🇪🇸

Pamplona, Spain

Hospital Clinico De Valencia

🇪🇸

Valencia, Spain

Trakya University Hospital

🇹🇷

Edirne, Turkey

ARENSIA Exploratory Medicine LLC

🇺🇦

Kyiv, Ukraine

Gulhane Training and Research Hospital

🇹🇷

Ankara, Turkey

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Yale University Cancer Center

🇺🇸

New Haven, Connecticut, United States

Norton Healthcare Inc

🇺🇸

Louisville, Kentucky, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

UNC Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

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