Phase 1b Multi-indication Study of Anetumab Ravtansine in Mesothelin Expressing Advanced Solid Tumors
- Conditions
- Neoplasms
- Interventions
- Registration Number
- NCT03102320
- Lead Sponsor
- Bayer
- Brief Summary
The key purpose of the main part of the study is to assess efficacy and safety of anetumab ravtansine as monotherapy or combination therapy for mesothelin expressing advanced solid tumors.
The main purpose of the safety lead-in (dose-finding) part of the study is to determine the safety and tolerability of anetumab ravtansine in combination with cisplatin and in combination with gemcitabine, and to determine the MTD of anetumab ravtansine in combination with cisplatin for mesothelin expressing advanced cholangiocarcinoma and in combination with gemcitabine for mesothelin expressing advanced adenocarcinoma of the pancreas.
Patients will receive anetumab ravtansine every three weeks in monotherapy for most indications. In cholangiocarinoma and adenocarinoma of the pancreas, 3-weekly anetumab ravtansine is administered in combination with cisplatin or gemcitabine respectively (both administered in a 2 week on / 1 week off schedule).
Treatment will continue until disease progression or until another criterion for withdrawal is met. .Efficacy will be measured by evaluating the tumor's objective response rate. Radiological tumor assessments will be performed at defined time points until the patient's disease progresses.
Blood samples will be collected for safety, pharmacokinetic and biomarker analysis. Archival or fresh biopsy tissue will also be collected for mesothelin expression testing and biomarker analyses.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 173
- Availability of tumor tissue for mesothelin expression testing and for further biomarker analysis
- Histologically-confirmed, mesothelin-expressing metastatic or advanced non-metastatic disease (tumour type specific inclusion criteria)
- At least one measurable lesion according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1) (or for thymic carcinoma, at least one measurable lesion per International Thymic Malignancy Interest Group (ITMIG) modified RECIST 1.1 criteria
- Adequate bone marrow, liver, renal and coagulation function
- Left ventricular ejection fraction (LVEF) ≥ 50% of the lower limit of normal (LLN) according to local institutional ranges
- Eastern Cooperative Oncology Group (ECOG) 0 or 1
- Exposure to more than one prior anti-tubulin/microtubule agent
- Corneal epitheliopathy or any eye disorder that may predispose the patients to this condition
- Symptomatic Central nervous system (CNS) metastases and/or carcinomatous meningitis
- Contraindication to both CT and MRI contrast agents
- Active hepatitis B or C infection
- Pregnant or breast-feeding patients
- Tumor type specific exclusion criteria
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Adenocarcinoma of the pancreas Anetumab ravtansine (BAY94-9343) Safety lead-in phase will determine the MTD of anetumab ravtansine administered in combination with gemcitabine During the main study phase, anetumab ravtansine will be administered at the determined MTD in combination with gemcitabine Cholangiocarcinoma Anetumab ravtansine (BAY94-9343) Safety lead-in phase will determine the MTD of anetumab ravtansine administered in combination with cisplatin. Please note the study is no longer recruiting for the cholangiocarcinoma safety lead-in phase. During the main study phase anetumab ravtansine will be administered at the determined MTD in combination with cisplatin. Please note the main study phase for cholangiocarcinoma will no longer be going ahead. Other solid tumors Anetumab ravtansine (BAY94-9343) (Non-small cell adenocarcinoma of the lung (NSCLC adenocarcinoma), Adenocarcinoma of the breast - triple negative (TNBC), Gastric adenocarcinoma including gastroesophageal junction (GEJ Cancer, Thymic carcinoma) During the main study phase, anetumab ravtansine will be administered at dose of 6.5 mg/kg in solid tumors Cholangiocarcinoma Cisplatin Safety lead-in phase will determine the MTD of anetumab ravtansine administered in combination with cisplatin. Please note the study is no longer recruiting for the cholangiocarcinoma safety lead-in phase. During the main study phase anetumab ravtansine will be administered at the determined MTD in combination with cisplatin. Please note the main study phase for cholangiocarcinoma will no longer be going ahead. Adenocarcinoma of the pancreas Gemcitabine Safety lead-in phase will determine the MTD of anetumab ravtansine administered in combination with gemcitabine During the main study phase, anetumab ravtansine will be administered at the determined MTD in combination with gemcitabine
- Primary Outcome Measures
Name Time Method Number of patients in the safety lead-in (SLI) phase who completed Cycle 1 or had a DLT and were not replaced. At least 3 weeks after the last patient starts treatment During SLI, patients with cholangiocarcinoma received anetumab ravtansine in combination with cisplatin and patients with pancreatic adenocarcinoma received anetumab ravtansine in combination with gemcitabine. The highest dose of anetumab ravtansine that can be given so that not more than 1 out of 6 patients experiences a dose-limiting toxicity (DLT) during the DLT evaluation period were declared as the MTD for anetumab ravtansine in combination with cisplatin or with gemcitabine.
Objective response (qualitative improvement from baseline) of anetumab ravtansine for monotherapy and combination therapy in mesothelin expressing advanced solid tumors Up to approximately 26 months after patient starts treatment A patient is a responder if the patient has a best response compared to baseline of complete response (CR) or partial response (PR) among all post-baseline tumor assessments, as determined per RECIST 1.1 criteria (ITMIG modified RECIST 1.1 criteria for thymic carcinoma)
Durable disease control (lack of progression from baseline) of anetumab ravtansine in indications pancreatic and gastric cancer (co-primary endpoint) Up to approximately 26 months after patient starts treatment A patient experiences durable disease control if the patient has a tumor response compared to baseline of CR, PR or stable disease (SD) among the post-baseline tumor assessments made at least 180 days from first treatment, without prior disease progression
- Secondary Outcome Measures
Name Time Method Disease control rate (DCR) Up to approximately 24 months after last patient starts treatment, or until earlier disease progression [assessed every 6 weeks for the first 6 months, every 9 weeks until end of year 1 and every 12 weeks thereafter] The DCR is defined as the number of patients with disease control divided by the number of treated patients.
Durable disease control rate (DDCR) of anetumab ravtansine in indications other than pancreatic and gastric cancer Up to approximately 24 months after last patient starts treatment, or until earlier disease progression [assessed every 6 weeks for the first 6 months, every 9 weeks until end of year 1 and every 12 weeks thereafter] A patient experiences durable disease control if the patient has a tumor response of CR, PR or SD with CR, PR or SD assessed at least 180 days from first treatment, without prior progression.
Durable response rate (DRR) Up to approximately 24 months after last patient starts treatment, or until earlier disease progression [assessed every 6 weeks for the first 6 months, every 9 weeks until end of year 1 and every 12 weeks thereafter] A durable responder is defined as a responder (CR or PR) with a duration of response per RECIST 1.1 criteria (ITMIG modified RECIST 1.1 criteria for thymic carcinoma) of 180 days or more. The DRR is the number of durable responders divided by the number of treated patients.
Number of serious and non-serious adverse events (AEs) Approximately 26 months (Until 30 days after the last day of study treatment, or until later resolution of adverse events or determination by the investigator that the event will not improve) Include treatment-emergent AEs, SAEs, treatment-related AEs, AEs of special interest, and deaths.
Duration of response (DOR) Up to approximately 24 months after last patient starts treatment, or until earlier disease progression [assessed every 6 weeks for the first 6 months, every 9 weeks until end of year 1 and every 12 weeks thereafter] DOR is defined in responders as the time from documentation of tumor response (CR or PR) to earlier of disease progression or death
Progression free survival (PFS) Up to approximately 24 months after last patient starts treatment, or until earlier disease progression [assessed every 6 weeks for the first 6 months, every 9 weeks until end of year 1 and every 12 weeks thereafter] PFS is defined as time from start of treatment until disease progression according to RECIST 1.1 (ITMIG modified RECIST 1.1 criteria for thymic carcinoma) or death.
Trial Locations
- Locations (72)
UZ Antwerpen
🇧🇪Edegem, Belgium
CHU de Liège
🇧🇪Liege, Belgium
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
Centre Oscar Lambret - Lille
🇫🇷Lille Cedex, France
Leicester Royal Infirmary
🇬🇧Leicester, Leicestershire, United Kingdom
Fondazione IRCCS Istituto Nazionale dei Tumori
🇮🇹Milano, Lombardia, Italy
Maastricht UMC
🇳🇱Maastricht, Netherlands
Hôpital Erasme/Erasmus Ziekenhuis
🇧🇪Bruxelles - Brussel, Belgium
ASST Grande Ospedale Metropolitano Niguarda
🇮🇹Milano, Lombardia, Italy
Hospital del Mar
🇪🇸Barcelona, Spain
Centre Antoine Lacassagne
🇫🇷Nice Cedex 2, France
Ochsner Medical Center - New Orleans
🇺🇸New Orleans, Louisiana, United States
Nederlands Kanker Instituut
🇳🇱Amsterdam, Netherlands
National Cancer Center Singapore
🇸🇬Singapore, Singapore
Royal Marsden NHS Trust (Surrey)
🇬🇧Sutton, Surrey, United Kingdom
UZ Leuven Gasthuisberg
🇧🇪Leuven, Belgium
Hopital Jean Minjoz
🇫🇷Besancon, France
McGill University Health Center
🇨🇦Montreal, Quebec, Canada
Blacktown Cancer & Haematology Centre
🇦🇺Blacktown, New South Wales, Australia
Kinghorn Cancer Centre
🇦🇺Darlinghurst, New South Wales, Australia
Belfast City Hospital
🇬🇧Belfast, North Ireland, United Kingdom
Hospital Ramón y Cajal | Oncología
🇪🇸Madrid, Spain
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Ospedale Regionale Bellinzona
🇨🇭Bellinzona, Ticino, Switzerland
St John of God Healthcare
🇦🇺Subiaco, Western Australia, Australia
Sir Charles Gairdner Hospital
🇦🇺Nedlands, Western Australia, Australia
Kantonsspital Graubünden
🇨🇭Chur, Graubünden, Switzerland
Barbara Ann Karmanos Cancer Institute
🇺🇸Farmington Hills, Michigan, United States
Flinders Medical Centre
🇦🇺Adelaide, South Australia, Australia
Mayo Clinic Hospital
🇺🇸Phoenix, Arizona, United States
Vanderbilt University Medical Center
🇺🇸Nashville, Tennessee, United States
Mid North Coast Cancer Institute
🇦🇺Coffs Harbour, New South Wales, Australia
University of Southern California
🇺🇸Los Angeles, California, United States
Indiana University School of Medicine
🇺🇸Indianapolis, Indiana, United States
Texas Oncology, PA
🇺🇸Dallas, Texas, United States
University of Texas MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
Hospital Universitario Quirón de Madrid
🇪🇸Pozuelo de Alarcón, Madrid, Spain
Centre Léon Bérard
🇫🇷Lyon Cedex, France
C.H.U. Timone
🇫🇷Marseille, France
Centre Hospitalier Lyon Sud
🇫🇷Pierre Benite, France
Hôpital de la Milétrie
🇫🇷POITIERS cedex, France
Christie Hospital
🇬🇧Manchester, United Kingdom
Centro Integral Oncológico Clara Campal
🇪🇸Madrid, Spain
National Cancer Institute - Maryland
🇺🇸Bethesda, Maryland, United States
MedStar Georgetown University Hospital
🇺🇸Washington, District of Columbia, United States
Mayo Clinic - Rochester
🇺🇸Rochester, Minnesota, United States
Epworth HealthCare
🇦🇺Richmond, Victoria, Australia
Sir Mortimer B. Davis Jewish General Hospital
🇨🇦Montreal, Quebec, Canada
Princess Margaret Cancer Centre - UHN
🇨🇦Toronto, Ontario, Canada
Centre René Gauducheau
🇫🇷Nantes, France
Hôpital Pontchaillou
🇫🇷Rennes Cedex, France
A.O.U. di Modena - Policlinico
🇮🇹Modena, Emilia-Romagna, Italy
Istituto Clinico Humanitas - Humanitas Mirasole S.p.A.
🇮🇹Milano, Lombardia, Italy
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
A.O.U.I. Verona
🇮🇹Verona, Veneto, Italy
National University Hospital
🇸🇬Singapore, Singapore
Hospital Clínic i Provincial de Barcelona
🇪🇸Barcelona, Spain
Royal Marsden Hospital (London)
🇬🇧London, United Kingdom
Northern Cancer Institute
🇦🇺St Leonards, New South Wales, Australia
Hôpital Henri Mondor
🇫🇷Creteil, France
Stanford Health Care
🇺🇸Stanford, California, United States
Hospital General Universitario Gregorio Marañón | Oncología
🇪🇸Madrid, Spain
A.O.U. di Bologna Policlinico S.Orsola Malpighi
🇮🇹Bologna, Emilia-Romagna, Italy
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
Centre Eugène Marquis - Rennes Cedex
🇫🇷Rennes Cedex, France
Institut Gustave Roussy
🇫🇷Villejuif Cedex, France
Hospital Virgen de la Victoria
🇪🇸Málaga, Spain
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Ciutat Sanitària i Universitaria de la Vall d'Hebron
🇪🇸Barcelona, Spain
Guy's Hospital
🇬🇧London, United Kingdom