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NAP in Combination With Docetaxel Following Obinutuzumab Pretreatment in Subjects With Checkpoint Inhibitor Pretreated Advanced or Metastatic NSCLC

Phase 2
Completed
Conditions
Non-small Cell Lung Cancer
Interventions
Drug: NAP (Naptumomab estafenatox)
Registration Number
NCT04880863
Lead Sponsor
NeoTX Therapeutics Ltd.
Brief Summary

Phase 2a Open-Label, Multicenter Trial of Naptumomab Estafenatox (NAP), following Obinutuzumab Pretreatment, on Days -13 and -12. NAP will be administered on Days 1-4 of treatment cycles 1-6, followed by docetaxel on Day 5. Starting cycle 7, NAP at a higher dose will be administered on Day 1 only and docetaxel on Day 2, in 21 days treatment cycles. When NAP is administered as monotherapy and not earlier than cycle 7, NAP will be administered on Day 1 only and cycles will be of 28 days treatment cycle.

Detailed Description

Patients must have received at least 1 and no more than 2 prior systemic regimens for the treatment of advanced/metastatic NSCLC. Patients were required to have progressed following treatment with both platinum-based chemotherapy and an anti-PD-(L)1 antibody administered either sequentially or concurrently. Entry into this trial was restricted to patients with incurable disease, including those whose disease had relapsed within 6 months after chemoradiotherapy for Stage III disease. Patients were to have available archival or fresh tissue collected for the retrospective determination of tumoral 5T4 levels.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
38
Inclusion Criteria
  1. Subjects must be at least 18 years of age
  2. Subjects must have histologically and/or cytologically confirmed NSCLC
  3. Subjects must have incurable (advanced or metastatic) disease at the time of enrolment
  4. Subjects must have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
  5. Subjects must provide signed informed consent prior to any study specific procedures that are not part of standard medical care.
  6. Subjects must have measurable neoplastic disease based on the iRECIST criteria
  7. Subjects must have received as least 1 and no more than 2 prior systemic regimens for the treatment of advanced/metastatic NSCLC. Patients are required to have progressed following treatment with both platinum-based chemotherapy and an anti-PD-(L)1 antibody administered either sequentially or concurrently. A prior PD-1/PD-L1 inhibitor is, however, not required if there was prior exposure to targeted therapies for a driver mutation positive tumors (e.g. EGFR or ALK inhibitors).

Main

Exclusion Criteria
  1. Subjects with active infection requiring treatment within 3 days of C1D1.

  2. Subjects with other active neoplastic disease requiring concurrent anti-neoplastic treatment

  3. Subjects with known, suspected or documented parenchymal brain metastases unless treated with surgery and/or radiation, with the subject neurologically stable and off pharmacologic doses of systemic glucocorticoids; subjects with leptomeningeal metastases are not eligible. Patients should have completed brain radiation for at least 14 days and be off steroids.

  4. Active or previously documented autoimmune or inflammatory disorders such as, but not limited to rheumatoid arthritis, systemic lupus erythematosus, uveitis, ulcerative colitis, Crohn's syndrome, Wegener's syndrome, multiple sclerosis, myasthenia gravis, scleroderma and sarcoidosis. The following are exceptions to this criterion:

    • Vitiligo or psoriasis not requiring systemic treatment (within the last 2 years)
    • Subjects with endocrinopathies (e.g. following Hashimoto syndrome) stable on hormone replacement or do not require any therapy.
  5. History of primary immunodeficiency

  6. Subjects with a history or prior allogeneic organ transplant

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
NAP in combination with docetaxel following obinutuzumab pretreatmentNAP (Naptumomab estafenatox)Subjects receive obinutuzumab, 1,000 mg, administered by IV infusion on Days -13 and -12 of the first treatment cycle in order to reduce the titer of anti-drug antibodies to NAP. NAP is administered by IV bolus on Days 1 - 4 of treatment cycles 1-6, followed by docetaxel on Day 5. Treatment cycles with the combination NAP/docetaxel are of 21 days in duration. Starting cycle 7, NAP at a higher dose is administered on Day 1 and docetaxel on Day 2, in 21 days treatment cycles. Once NAP is given as monotherapy and not earlier than C7, cycles are of 28 days of duration.
NAP in combination with docetaxel following obinutuzumab pretreatmentDocetaxelSubjects receive obinutuzumab, 1,000 mg, administered by IV infusion on Days -13 and -12 of the first treatment cycle in order to reduce the titer of anti-drug antibodies to NAP. NAP is administered by IV bolus on Days 1 - 4 of treatment cycles 1-6, followed by docetaxel on Day 5. Treatment cycles with the combination NAP/docetaxel are of 21 days in duration. Starting cycle 7, NAP at a higher dose is administered on Day 1 and docetaxel on Day 2, in 21 days treatment cycles. Once NAP is given as monotherapy and not earlier than C7, cycles are of 28 days of duration.
NAP in combination with docetaxel following obinutuzumab pretreatmentObinutuzumabSubjects receive obinutuzumab, 1,000 mg, administered by IV infusion on Days -13 and -12 of the first treatment cycle in order to reduce the titer of anti-drug antibodies to NAP. NAP is administered by IV bolus on Days 1 - 4 of treatment cycles 1-6, followed by docetaxel on Day 5. Treatment cycles with the combination NAP/docetaxel are of 21 days in duration. Starting cycle 7, NAP at a higher dose is administered on Day 1 and docetaxel on Day 2, in 21 days treatment cycles. Once NAP is given as monotherapy and not earlier than C7, cycles are of 28 days of duration.
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR)From the first treatment to first CR or PR (estimated about 24 months)

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) and iRECIST for target lesions and assessed by CT scans or MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

Secondary Outcome Measures
NameTimeMethod
Disease Control Rate (DCR)From the first administration of treatment till study completion (estimated about 24 months).

The proportion of subjects who achieve a best response of CR, PR or SD per Response Evaluation in Solid Tumors (iRECIST).

Duration of Response (DOR)estimated about 24 months.

Duration from first documentation of CR or PR (whichever occurs first) after the first administration of obinutuzumab pretreatment until death or progressive disease (PD)

Progression-free Survival (PFS)From the first administration of treatment to the date of first documentation of disease progression, or death due to any cause, whichever occurs first (estimated about 24 months).

PFS per Response Evaluation in Solid Tumors (iRECIST)

Overall Survival (OS)estimated about 24 months.

The time from first day of study drug treatment to death for any cause

Treatment-Emergent Adverse Events (TEAEs)From the first administration of obinutuzumab pretreatment till study completion (estimated about 24 months).

Number of subjects with treatment emergent adverse events as assessed by CTCAE v5.0

Trial Locations

Locations (11)

NeoTX - 10312

🇺🇸

El Paso, Texas, United States

NeoTX - 10310

🇺🇸

Tyler, Texas, United States

NeoTX - 10308

🇺🇸

Austin, Texas, United States

NeoTX - 10302

🇺🇸

Scottsdale, Arizona, United States

NeoTX - 10100

🇺🇸

Morristown, New Jersey, United States

NeoTX - 10307

🇺🇸

Daphne, Alabama, United States

NeoTX - 10306

🇺🇸

Lone Tree, Colorado, United States

NeoTX - 10303

🇺🇸

Tucson, Arizona, United States

NeoTX - 10309

🇺🇸

Dallas, Texas, United States

NeoTX - 10304

🇺🇸

Minneapolis, Minnesota, United States

NeoTX - 10311

🇺🇸

Fairfax, Virginia, United States

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