A Phase 1a/1b Dose Escalation and Expansion Trial of TTI-621, a Novel Biologic Targeting CD47, in Subjects With Relapsed or Refractory Hematologic Malignancies and Selected Solid Tumors
Trial Snapshot
- Phase
- Phase 1
- Status
- Terminated
- Sponsor
- Pfizer
- Enrollment
- 249
- Locations
- 50
- Primary Endpoint
- Part 4: Number of Participants With TEAEs and TESAEs
Study Overview
Brief Summary
Multicenter, open-label, phase 1a/1b trial of PF-07901800 (TTI-621) in subjects with relapsed or refractory hematologic malignancies and selected solid tumors.
Detailed Description
This is a trial of PF-07901800 (TTI-621) in subjects with relapsed or refractory hematologic malignancies and selected solid tumors.
TTI-621 (SIRPαFc) is a soluble recombinant fusion protein created by directly linking the sequences encoding the N-terminal CD47 binding domain of human SIRPα with the Fc domain of human immunoglobulin (IgG1). TTI-621 acts by binding human CD47 and preventing it from delivering an inhibitory "do not eat" (anti phagocytic) signal to macrophages.
This trial will be conducted in 2 phases and 4 parts: Phase 1a Part 1 (escalation phase) and Phase 1b Parts 2-4 (expansion phase).
In the dose Escalation Phase (phase 1a Part 1), subjects with lymphoma will be enrolled in sequential dose cohorts to receive TTI-621 to characterize safety, tolerability, pharmacokinetics, and the maximum-tolerated dose (MTD).
In the Expansion Phase (phase 1b Parts 2-4), TTI-621 will be given to subjects with a variety of hematologic malignancies and selected solid tumors to further define safety and to characterize efficacy. In the Expansion Phase Part 2, the safety and efficacy of TTI-621 will also be assessed when it is given in combination with other anti-cancer drugs. The dose of TTI-621 to be delivered in the Expansion Phase Parts 2-3 of the study may be increased or decreased based on the subject's tolerability and on the subject's response to treatment.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Treatment
- Masking
- None
Masking Description
Open label
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Not provided
Exclusion Criteria
- •Known current central nervous system disease involvement or untreated brain metastases
- •Allogeneic transplant within 30 days prior to the planned start of treatment or subjects with active graft-vs-host disease with the exception of Grade 1 skin involvement
- •History of hemolytic anemia or bleeding diathesis
Arms & Interventions
PF-07901800 (TTI-621) Escalation Phase - R/R Lymphoma
The Escalation Phase will include multiple doses of PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Indolent B-Cell Lymphoma
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Acute Myeloid Leukemia
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Aggressive B-Cell Lymphoma
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
T-Cell Lymphoma
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Hodgkin Lymphoma
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Chronic Lymphocytic Leukemia
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Multiple Myeloma
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Myelodysplastic Syndrome
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Myeloproliferative Neoplasms
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Small Cell Lung Cancer
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Rituximab Combination
Combination therapy expansion cohort with PF-07901800 (TTI-621) plus Rituximab for CD20 positive malignancies
Intervention: PF-07901800 (TTI-621) plus Rituximab (Drug)
Nivolumab Combination
Combination therapy expansion cohort with PF-07901800 (TTI-621) plus Nivolumab for Hodgkin Lymphoma
Intervention: PF-07901800 (TTI-621) plus Nivolumab (Drug)
Cutaneous T-Cell Lymphoma (CTCL)
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Peripheral T-Cell Lymphoma (PTCL)
Monotherapy expansion cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Part 4: Cutaneous T-Cell Lymphoma (CTCL)
Monotherapy expansion Part 4 (Dose Optimization) cohort with PF-07901800 (TTI-621)
Intervention: PF-0791800 (TTI-621) (Drug)
Outcomes
Primary Outcomes
Part 4: Number of Participants With TEAEs and TESAEs
Time Frame: Part 4: Day 1 of dosing up to 1 year of safety follow-up visit after the last dose (maximum treatment exposure for Part 4 was 667 days)
An AE was any untoward medical occurrence in administered medicinal product, event need not necessarily have a causal relationship with product treatment or usage. A SAE event was any untoward medical occurrence in a participant administered a medicinal or nutritional product (including pediatric formulas) at any dose that: resulted in death; was life-threatening; required inpatient hospitalization or prolongation of hospitalization; resulted in persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); resulted in congenital anomaly/birth defect. Treatment emergent AEs were events emerged during treatment period and were absent before treatment or that worsened relative to pretreatment state.
Part 1: Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs)
Time Frame: Part 1: Day 1 of dosing up to 30 days of safety follow-up visit after the last dose (maximum treatment exposure for Part 1 was 414 days)
An adverse event (AE) was any untoward medical occurrence in administered medicinal product, event need not necessarily have a causal relationship with product treatment or usage. A serious adverse event (SAE) was any untoward medical occurrence in a participant administered a medicinal or nutritional product (including pediatric formulas) at any dose that: resulted in death; was life-threatening; required inpatient hospitalization or prolongation of hospitalization; resulted in persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); resulted in congenital anomaly/birth defect. Treatment emergent AEs were events emerged during treatment period and were absent before treatment or that worsened relative to pretreatment state.
Part 1: Number of Participants With Dose Limiting Toxicities (DLTs)
Time Frame: Part 1: Day 1 of dosing up to Pre-dose on Day 22
DLT was defined as any of the protocol specified TEAEs that occurred during the 21-day. DLT treatment/observation period (including the pre-dose tests on Day 22/Week 4 Day 1) and that were considered at least possibly related to study treatment by the investigator. Protocol specified DLT TEAE criteria: Grade 4 thrombocytopenia; Grade 3 thrombocytopenia with bleeding (with the exception of brief, easily-controlled epistaxis, mild gum bleeding or normal menses) or with any requirement for platelet transfusions; Grade 4 anemia, unexplained by underlying disease; Grade 4 neutropenia lasting more than 5 days; Febrile neutropenia of any duration ( Absolute Neutrophil Count (ANC) less than (\<) 1.0 \* 10\^9/L. fever greater than (\>) 38.5° Degree Celsius (C); Grade 3 or higher non-hematologic toxicity except for alopecia and nausea controlled by medical management; Grade 3 or 4 hemorrhage.
Part 2 and 3: Number of Participants With TEAEs and TESAEs
Time Frame: Day 1 of dosing up to 30 days of safety follow-up visit after the last dose (maximum treatment exposure for Part 2 was 1793 days and for Part 3 was 938 days)
An AE was any untoward medical occurrence in administered medicinal product, event need not necessarily have a causal relationship with product treatment or usage. A SAE was any untoward medical occurrence in a participant administered a medicinal or nutritional product (including pediatric formulas) at any dose that: resulted in death; was life-threatening; required inpatient hospitalization or prolongation of hospitalization; resulted in persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); resulted in congenital anomaly/birth defect. Treatment emergent AEs were events emerged during treatment period and were absent before treatment or that worsened relative to pretreatment state.
Part 4: Number of Participants With Dose Limiting Toxicities (DLTs)
Time Frame: Part 4: Day 1 of dosing up to Pre-dose on Day 22
DLT was defined as any of the protocol specified TEAEs that occurred during the 21-day. DLT treatment/observation period (including the pre-dose tests on Day 22/Week 4 Day 1) and that were considered at least possibly related to study treatment by the investigator. Protocol specified DLT TEAE criteria: Grade 4 thrombocytopenia; Grade 3 thrombocytopenia with bleeding (with the exception of brief, easily-controlled epistaxis, mild gum bleeding or normal menses) or with any requirement for platelet transfusions; Grade 4 anemia, unexplained by underlying disease; Grade 4 neutropenia lasting more than 5 days; Febrile neutropenia of any duration (ANC \< 1.0 x 109/L, fever \> 38.5°C); Grade 3 or higher non-hematologic toxicity except for alopecia and nausea controlled by medical management; Grade 3 or 4 hemorrhage.
Secondary Outcomes
- Part 2 and 3: Number of Participants With Positive Anti-Drug Antibody (ADA) and Neutralizing Antibodies (NAb)(Part 2 and 3: From pre-infusion on day 1 up to end of study treatment (maximum treatment exposure for Part 2 was 1793 days and for Part 3 was 938 days))
- Part 1: Maximum Plasma Concentration (Cmax) of TTI-621(Part 1: Pre-dose, end of infusion (EOI), 2, 4, 24, 72, 168 hours post dose on Week 1)
- Part 1: Area Under the Plasma Concentration Time Curve From Time Zero to 168 (AUC[0-168]) of TTI-621(Part 1: Pre-dose, end of infusion (EOI), 2, 4, 24, 72, 168 hours post dose on Week 1)
- Part 4: Area Under the Plasma Concentration Time Curve From Time Zero to 168 (AUC[0-168]) of TTI-621(Part 4: Pre-dose, end of infusion (EOI), 2, 4, 24, 72, 168 hours post dose on Week 1)
- Part 1: Percentage of CD47 Receptor Occupancy on Peripheral Blood CD3+ Cells(Part 1: Week 1 end of infusion (EOI))
- Part 1: Number of Participants With Positive Anti-Drug Antibody (ADA) and Neutralizing Antibodies (NAb)(Part 1: From pre-infusion on day 1 up to end of study treatment (maximum treatment exposure for Part 1 was 414 days))
- Part 2 and 3 Combined: Area Under the Plasma Concentration Time Curve From Time Zero to 168 (AUC[0-168]) of TTI-621(Part 2 and 3: Pre-dose, end of infusion (EOI), 2, 4, 24, 72, 168 hours post dose on Week 1)
- Part 2 and 3 Combined: Percentage of CD47 Receptor Occupancy on Peripheral Blood CD3+ Cells(Part 2 and 3: Week 1 end of infusion (EOI))
- Part 4: Maximum Plasma Concentration (Cmax) of TTI-621(Part 4: Pre-dose, end of infusion (EOI), 2, 4, 24, 72, 168 hours post dose on Week 1)
- Part 2 and 3 Combined: Maximum Plasma Concentration (Cmax) of TTI-621(Part 2 and 3: Pre-dose, end of infusion (EOI), 2, 4, 24, 72, 168 hours post dose on Week 1)
- Part 2: Overall Response Rate (ORR)-Savona 2015- Disease Indication(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Part 4: Overall Response Rate (ORR) in Cutaneous T-Cell Lymphoma (CTCL) Both Fungoides and Sezary Syndrome(From first dose of study till the progressive disease/death or withdrawal (maximum observation 6 years 10 months))
- Part 2 and 3: Overall Response Rate (ORR) - Lugano Classification (Cheson 2014) and Refinement (Cheson 2016) Disease Indications and Nivolumab/Rituximab Combinations(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Part 2: Overall Response Rate (ORR)- Durie 2006- Disease Indication(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Parts 2 and 3: Overall Response Rate (ORR)-Olsen 2011-Disease Indication(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Part 2: Overall Response Rate (ORR)- Hallek 2008- Disease Indication(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Part 2: Overall Response Rate (ORR)- Cheson 2003- Disease Indication(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Part 2: Overall Response Rate (ORR)- Bohnsack 2014- Disease Indication(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Parts 2 and 3: Progression Free Survival (PFS)(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Part 4: Duration of Response (DoR)(From first dose of study till the progressive disease/death or withdrawal (maximum observation 6 years 10 months))
- Parts 2 and 3: Duration of Response (DoR)- Disease Indication and Nivolumab/Rituximab Combinations(From first dose of study till the progressive disease/ death or withdrawal (maximum observation 6 years 10 months))
- Part 4: Percentage of CD47 Receptor Occupancy on Peripheral Blood CD3+ Cells(Part 4: Week 1 end of infusion (EOI))
- Part 4: Number of Participants With Positive Anti-Drug Antibody (ADA) and Neutralizing Antibodies (NAb)(Part 4: From pre-infusion on day 1 up to end of study treatment (maximum treatment exposure for Part 4 was 667 days))
- Part 4: Overall Response Rate (ORR)(From first dose of study till the progressive disease/death or withdrawal (maximum observation 6 years 10 months))
