A Phase I/IIa, First-In-Human, Multi-Center, Monotherapy and Combination-Therapy With Nivolumab, Dose-Finding and Dose-Expansion Study of [212Pb]VMT01 Melanocortin-1 Receptor-Targeted, Image-Guided Alpha-Particle Therapy in Subjects With Previously Treated Unresectable or Metastatic Melanoma
试验速览
- 阶段
- 1 期
- 状态
- 招募中
- 入组人数
- 300
- 试验地点
- 17
- 主要终点
- Number of subjects with dose-limiting toxicities (DLTs) after the first administration of [212Pb]VMT01 as a monotherapy or in combination with nivolumab.
研究概览
简要总结
In this first-in human, phase I/IIa study, the safety and efficacy of [212Pb]VMT01, an alpha-particle emitting therapeutic agent targeted to melanocortin sub-type 1 receptor (MC1R) is being evaluated as a monotherapy and in combination with nivolumab in subjects with unresectable and metastatic melanoma.
详细描述
This is a prospective, multi-center open-label dose-finding, dose-expansion study of [212Pb]VMT01 as a monotherapy or in combination with nivolumab in up to 300 subjects with histologically confirmed melanoma and a positive MC1R imaging scan with imaging agents [203Pb]VMT01 or [68Ga]VMT02.
MC1R is a receptor that is expressed on the surface of melanoma cells and therefore is an attractive therapeutic target for melanoma treatment. Lead-212 ([212Pb]-) based peptide-radiopharmaceuticals are an emerging class of targeted alpha-particle cancer therapies that have potential to improve delivery of a highly effective form of radiation.
This study will be conducted in 3 parts:
Part 1: Monotherapy Dose-Finding
Part 2: Combination-Therapy Dose-Finding
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 90 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Ability to understand and willingness to provide informed consent, willingness to comply with all study procedures for the duration of the study
- •Aged ≥ 18 years
- •Diagnosed with unresectable Stage III or Stage IV metastatic or recurrent melanoma
- •Previously progressed (radiological progression) on at least one approved systemic therapy for advanced melanoma
- •Uptake of [68Ga]VMT02 or [203Pb]VMT01 by PET or SPECT imaging observed in at least one melanoma tumor site using quantitative imaging analysis compared to reference normal tissue
- •Subjects on prior intravenous therapy (e.g., chemotherapy or checkpoint inhibitors), or prior oral therapy (e.g.,proto-oncogene B-RAF or mitogen-activated extracellular signal-regulated kinase inhibitors) who demonstrate MC1R positivity during screening are eligible for enrollment, provided that they undergo a wash-out period of 21 days, or 7 days, respectively, prior to Cycle 1 Day 1 treatment with [212Pb]VMT
- •Presence of measurable disease by RECIST v1.1 assessed within 45 days prior to the first dose of [212Pb]VMT01 on Cycle 1 Day 1
- •Ability to lie flat and still for up to two hours for imaging scans; moderate conscious sedation allowed if indicated
- •For females of reproductive potential: agree to use of highly effective contraception and refrain from donating eggs (ova, oocytes) for the purpose of reproduction starting from screening, during treatment with [212Pb]VMT01 and/or nivolumab, and for at least 6 months after the last dose of [212Pb]VMT01 and/or nivolumab, whichever is administered last
- •For males of reproductive potential: agree to use of condoms or other methods to ensure effective contraception and refrain from donating sperm starting from screening, during treatment with [212Pb]VMT01 and/or nivolumab, and for at least 6 months after the last dose of [212Pb]VMT01 and/or nivolumab, whichever is administered last
- •Eastern Cooperative Oncology Group performance score of < 2 at Screening
- •Life expectancy of at least 3 months after Cycle 1 Day 1
- •Satisfactory organ function determined by laboratory testing
排除标准
- •Active secondary malignancy
- •Prior systematic treatment with radioactive nuclides. Subjects who had localized treatment with radioactive nuclides or imaging using radioactive imaging agents may be enrolled
- •Pregnancy or breastfeeding a child
- •Any serious/active/uncontrolled infection requiring parenteral antibiotics within 2 weeks before the first administration of [212Pb]VMT01
- •Febrile illness within 48 hours of any scheduled investigational product ([212Pb]VMT01, [203Pb]VMT01, or [68Ga]VMT02) administration; subjects should be rescheduled > 48 hours after resolution of fever
- •Treatment with another investigational drug product (therapeutic IND agents) within the last 45 days before the first dose of [212Pb]VMT01 on C1D
- •Current abuse of alcohol or illicit drugs
- •Existence of any medical or social issues likely to interfere with study conductor that may cause increased risk to the subject or to others, e.g., lack of ability to follow radiation safety precautions
- •Additional exclusion criteria for subjects who will receive combination therapy with nivolumab:
- •Untreated central nervous system (CNS) metastasis or metastasis requiring acute therapy of any modality. Subjects must have been either off corticosteroids, or on a stable or decreasing dose of prednisone (or equivalent) for at least 2 weeks prior to the first dose of [212Pb]VMT01
- •Subjects with an active, known, or suspected autoimmune disease
- •Subjects with a condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications
- •Acute or chronic hepatitis B (e.g., Hepatitis B surface antigen reactive), hepatitis C (e.g., HCV RNA [qualitative] is detected) or known history of Human Immunodeficiency Virus (HIV) with an acquired immunodeficiency syndrome
- •Treatment with complementary medications (e.g., herbal supplements or traditional Chinese medicines)
- •Existence of abnormal laboratory values in hematology, liver, and renal function
- •Treatment with any live/attenuated vaccine within 30 days prior to the first dose of [212Pb]VMT01
- •Any treatment-related toxicities from prior systemic immune therapy with the exception of those unlikely to re-occur with standard countermeasures
- •History of allergy or hypersensitivity to nivolumab or its components
研究组 & 干预措施
Monotherapy-Dose Finding
Enrolled subjects will be treated with [212Pb]VMT01 to determine optimal biological dose (OBD).
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: [203Pb]VMT01 (Drug)
Combination Therapy-Dose Finding
Enrolled subjects will be treated with [212Pb]VMT01 in combination with nivolumab to determine OBD.
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: [203Pb]VMT01 (Drug)
Monotherapy - Dose Expansion
Subjects will be enrolled at previously identified recommended phase 2 dose (RP2D) for confirmation of the RP2D and regimen for the Phase 2 dose-expansion cohort.
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: [212Pb]VMT01 (Drug)
Combination Therapy - Dose Expansion
Subjects will be enrolled at previously identified RP2D for its confirmation and verification of regimen for the Phase 2 dose-expansion cohort.
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: Nivolumab (Drug)
Combination Therapy - Dose Expansion
Subjects will be enrolled at previously identified RP2D for its confirmation and verification of regimen for the Phase 2 dose-expansion cohort.
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: [203Pb]VMT01 (Drug)
Combination Therapy - Dose Expansion
Subjects will be enrolled at previously identified RP2D for its confirmation and verification of regimen for the Phase 2 dose-expansion cohort.
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: [212Pb]VMT01 (Drug)
Monotherapy-Dose Finding
Enrolled subjects will be treated with [212Pb]VMT01 to determine optimal biological dose (OBD).
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: [212Pb]VMT01 (Drug)
Monotherapy - Dose Expansion
Subjects will be enrolled at previously identified recommended phase 2 dose (RP2D) for confirmation of the RP2D and regimen for the Phase 2 dose-expansion cohort.
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: [203Pb]VMT01 (Drug)
Combination Therapy-Dose Finding
Enrolled subjects will be treated with [212Pb]VMT01 in combination with nivolumab to determine OBD.
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: [212Pb]VMT01 (Drug)
Combination Therapy-Dose Finding
Enrolled subjects will be treated with [212Pb]VMT01 in combination with nivolumab to determine OBD.
A dosimetry sub-set utilizing [203Pb]VMT01 has been incorporated.
干预措施: Nivolumab (Drug)
结局指标
主要结局
Number of subjects with dose-limiting toxicities (DLTs) after the first administration of [212Pb]VMT01 as a monotherapy or in combination with nivolumab.
时间窗: Incidence of DLTs during the first 42 days of study Treatment will be assessed.
DLTs describe side effects of a drug that are serious enough to prevent an increase in dose
Incidence and severity of adverse events (AEs) and serious adverse events (SAEs) following administration of [212Pb]VMT01 as a monotherapy or in combination with nivolumab
时间窗: Up to approximately 2 years
Any untoward medical occurrence in a clinical investigational participant administered \[212Pb\]VMT01 as a monotherapy or in combination with nivolumab. Associated AE or SAE is assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0
Objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
时间窗: Up to approximately 2 years
Percentage of subjects with complete responses (CRs) or partial responses (PRs) to at least 1 administration of \[212Pb\]VMT01 as a monotherapy or in combination with nivolumab
次要结局
- Duration of response (DOR) following treatment with [212Pb]VMT01 as a monotherapy and in combination with nivolumab as assessed by RECIST v1.1 criteria(Up to approximately 2 years)
- Progression free survival (PFS) for subjects receiving at least one administration of [212Pb]VMT01 as a monotherapy and in combination with nivolumab, as assessed by RECIST v1.1 criteria(Up to approximately 2 years)
- Determination of pharmacokinetic properties (PK) of [212Pb]VMT01: Area under the concentration versus time curve(Up to week 16)
- Determination of pharmacokinetic properties of [212Pb]VMT01]: Apparent terminal elimination half-life (T1/2)(Up to week 16)
