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Safety and Tolerability of Recombinant Humanized Anti-PD-1 Monoclonal Antibody Toripalimab for Patients With Advanced Solid Tumors

Primary Purpose

Melanoma, Urological Cancer

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
humanized anti-PD-1 monoclonal antibody Toripalimab (JS001)
Sponsored by
Shanghai Junshi Bioscience Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring anti-PD-1 monoclonal antibody, advanced solid tumors, safety

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male and Female aged 18 to 70 years are eligible;
  • Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
  • Histologic diagnosis of unresectable melanoma or urological cancer. Have failed at least 1 prior routine regimen for metastatic disease, or failed to tolerate the toxicity, or lack of any routine regimens.
  • Providing with tumor specimen (for testing the expression of PD -L1 and the infiltrating lymphocytes);
  • At least 1 measurable lesion (only 1 measurable lymph node lesion is excluded) (routine CT scan >=20mm, spiral CT scan >=10mm, no prior radiation to measurable lesions) Predicted survival >=6 months;
  • Brain or meningeal metastases must be disposed with surgery or radiation, and be stable clinically for at least 8 weeks (prior systemic steroids was allowed, but concurrent administration of systemic steroids with the study drug is excluded).
  • Screening laboratory values must meet the following criteria(within past 14 days):

hemoglobin ≥ 9.0 g/dL neutrophils ≥ 1500 cells/ µL platelets ≥ 100 x 10^3/ µL total bilirubin ≤ 1.5 x upper limit of normal (ULN) aspartic transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 x ULN without, and ≤ 5 x ULN with hepatic metastasis serum creatinine ≤1╳ULN,creatinine clearance >50ml/min (Cockcroft-Gault equation)

  • Without systemic steroids within past 4 weeks
  • Males or female of childbearing potential must: agree to use using a reliable form of contraception (eg, oral contraceptives, intrauterine device, control sex desire, double barrier method of condom and spermicidal) during the treatment period and for at least 12 months after the last dose of study drug.
  • Must have read, understood, and provided written informed consent voluntarily. Willing to adhere to the study visit schedule and the prohibitions and restrictions specified in this protocol.

Exclusion Criteria:

  • Hypersensitivity to recombinant humanized anti-PD-1 monoclonal Ab or its components.
  • Prior treatment with mAb within past 3 months (locally administration excluded)
  • Prior antitumor therapy (including corticosteroids and immunotherapy) or participation in other clinical trials within past 4 weeks, or have not recovered from toxicities since the last treatment;
  • Pregnant or nursing
  • Abnormal Blood coagulation
  • Positive tests for HIV, HCV, HBsAg or HBcAb with positive test for HBV DNA (>500IU/ml)
  • History with pulmonary tuberculosis;
  • Patients with any active autoimmune disease or a documented history of autoimmune disease, or history of syndrome that required systemic steroids or immunosuppressive medications, such as hypophysitis, pneumonia, colitis, hepatitis, nephritis, hyperthyroidism or hypothyroidism.
  • Severe, uncontrolled medical condition that would affect patients' compliance or obscure the interpretation of toxicity determination or adverse events, including active severe infection, uncontrolled diabetes, angiocardiopathy (heart failure > class II NYHA, heart block >II grade, myocardial infarction, unstable arrhythmia or unstable angina within past 6 months, cerebral infarction within past 3 months) or pulmonary disease ( interstitial pneumonia, obstructive pulmonary disease or symptomatic bronchospasm).
  • Evidence with CNS disease.
  • Prior treatment with bone marrow stimulating factors,such as CSF (colony stimulating factor), EPO (erythropoietin), within past 1 weeks
  • Prior live vaccine therapy within past 4 weeks.
  • Prior major surgery within past 4 weeks (diagnostic surgery excluded).
  • Psychiatric medicines abuse without withdrawal, or history of psychiatric illness.
  • Prior malignancy active within the previous 5 years except for locally curable cancers that have been apparently cured, such as basal cell skin cancer or carcinoma in situ of the cervix.
  • Underlying medical condition that, in the Investigator's opinion, would increase the risks of study drug administration or obscure the interpretation of toxicity determination or adverse events.

Sites / Locations

  • Beijing Cancer Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

humanized anti-PD-1 monoclonal antibody Toripalimab

Arm Description

humanized anti-PD-1 monoclonal antibody is to be injected intravenously 1mg/kg or 3mg/kg or 10mg/kg until disease progresses or unacceptable tolerability occurs.

Outcomes

Primary Outcome Measures

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Secondary Outcome Measures

PD-1 receptor occupancy of blood
Objective Response Rate (ORR) by irRC and RECIST 1.1
Duration of Response (DOR) by irRC and RECIST 1.1
Disease Control Rate (DCR) by irRC and RECIST 1.1
Time to response (TTR) by irRC and RECIST 1.1
Progression-free survival(PFS) by irRC and RECIST 1.1
Overall survival (OS) by irRC and RECIST 1.1
Maximum Plasma Concentration (Cmax) after single dose injection of Anti-PD-1 Monoclonal Antibody (mAb)
Peak Time (Tmax) after single dose injection of Anti-PD-1 mAb
Area Under the Curve (AUC) after single dose injection of Anti-PD-1 mAb
t1/2 after single dose injection of Recombinant Humanized Anti-PD-1 mAb
Plasma clearance (CL) after single dose injection of Anti-PD-1 mAb
Apparent volume of distribution (V) after single dose injection of Anti-PD-1 mAb
Minimum Plasma Concentration (Cmin) of steady state after multiple dose injection of Anti-PD-1 mAb
Average Plasma Concentration (Cav) of steady state after multiple dose injection of Anti-PD-1 mAb
degree of fluctuation (DF) of steady state after multiple dose injection of Anti-PD-1 mAb
Apparent volume of distribution of steady state (Vss) after multiple dose injection of Anti-PD-1 mAb

Full Information

First Posted
July 11, 2016
Last Updated
October 21, 2019
Sponsor
Shanghai Junshi Bioscience Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02836795
Brief Title
Safety and Tolerability of Recombinant Humanized Anti-PD-1 Monoclonal Antibody Toripalimab for Patients With Advanced Solid Tumors
Official Title
A Phase I, Open Label, Single Center and Dose Escalation Study Investigating Tolerance and Pharmacokinetics of Single and Multiple Doses of Recombinant Humanized Anti-PD-1 Monoclonal Antibody for Injection in Patients With Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Unknown status
Study Start Date
April 2016 (Actual)
Primary Completion Date
September 2018 (Actual)
Study Completion Date
September 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai Junshi Bioscience Co., Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a mono-center, open-label, phase 1 study evaluating the humanized anti-PD-1 antibody JS001, as a monotherapy in patients with advanced melanoma or urological cancers who have failed in routine systemic treatment. The study will be conducted in 2 parts: dose escalation and cohort expansion to investigate tolerability and efficacy.
Detailed Description
This is a mono-center, open-label, phase 1 study evaluating the humanized anti-PD-1 antibody JS001, as a monotherapy in patients with advanced solid tumor (melanoma or urological cancers) who have failed in previous routine systemic treatment. The study will be conducted in 2 parts: dose escalation and cohort expansion. In the first part, nine patients are injected with different dosage of the humanized anti-PD-1 antibody (1mg/kg or 3mg/kg or 10mg/mg, three patients in one group ) once and observed carefully in the following 4 weeks. If no dose-limiting toxicity (DLT) occurs, then they are injected every 2 weeks until disease progresses or unacceptable toxicity occurs. This part is to confirm DLT, maximum tolerated dose (MTD) and recommended dose (RD). In the second part, 6-12 patients are enrolled in each dosage group and injected with the humanized anti-PD-1 antibody every 2 weeks until disease progresses or unacceptable toxicity occurs. This part is to further analyze safety and efficacy of the humanized anti-PD-1 antibody.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma, Urological Cancer
Keywords
anti-PD-1 monoclonal antibody, advanced solid tumors, safety

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
35 (Actual)

8. Arms, Groups, and Interventions

Arm Title
humanized anti-PD-1 monoclonal antibody Toripalimab
Arm Type
Experimental
Arm Description
humanized anti-PD-1 monoclonal antibody is to be injected intravenously 1mg/kg or 3mg/kg or 10mg/kg until disease progresses or unacceptable tolerability occurs.
Intervention Type
Biological
Intervention Name(s)
humanized anti-PD-1 monoclonal antibody Toripalimab (JS001)
Other Intervention Name(s)
JS001, TAB001
Intervention Description
humanized anti-PD-1 monoclonal antibody (JS001) is a programmed death-1 (PD-1) immune checkpoint inhibitor antibody, which selectively interferes with the combination of PD-1 with its ligands, PD-L1 and PD-L2, resulting in the activation of lymphocytes and elimination of malignancy theoretically.
Primary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
1.5 years
Secondary Outcome Measure Information:
Title
PD-1 receptor occupancy of blood
Time Frame
1.5 years
Title
Objective Response Rate (ORR) by irRC and RECIST 1.1
Time Frame
3 years
Title
Duration of Response (DOR) by irRC and RECIST 1.1
Time Frame
3 years
Title
Disease Control Rate (DCR) by irRC and RECIST 1.1
Time Frame
3 year
Title
Time to response (TTR) by irRC and RECIST 1.1
Time Frame
3 years
Title
Progression-free survival(PFS) by irRC and RECIST 1.1
Time Frame
3 years
Title
Overall survival (OS) by irRC and RECIST 1.1
Time Frame
3 years
Title
Maximum Plasma Concentration (Cmax) after single dose injection of Anti-PD-1 Monoclonal Antibody (mAb)
Time Frame
1.5 years
Title
Peak Time (Tmax) after single dose injection of Anti-PD-1 mAb
Time Frame
1.5 years
Title
Area Under the Curve (AUC) after single dose injection of Anti-PD-1 mAb
Time Frame
1.5 years
Title
t1/2 after single dose injection of Recombinant Humanized Anti-PD-1 mAb
Time Frame
1.5 years
Title
Plasma clearance (CL) after single dose injection of Anti-PD-1 mAb
Time Frame
1.5 years
Title
Apparent volume of distribution (V) after single dose injection of Anti-PD-1 mAb
Time Frame
1.5 years
Title
Minimum Plasma Concentration (Cmin) of steady state after multiple dose injection of Anti-PD-1 mAb
Time Frame
1.5 years
Title
Average Plasma Concentration (Cav) of steady state after multiple dose injection of Anti-PD-1 mAb
Time Frame
1.5 years
Title
degree of fluctuation (DF) of steady state after multiple dose injection of Anti-PD-1 mAb
Time Frame
1.5 years
Title
Apparent volume of distribution of steady state (Vss) after multiple dose injection of Anti-PD-1 mAb
Time Frame
1.5 years
Other Pre-specified Outcome Measures:
Title
correlation analysis of PD-L1 expression of tumor and ORR
Time Frame
3 years
Title
correlation analysis of PD-L1 expression of tumor and DOR
Time Frame
3 years
Title
correlation analysis of PD-L1 expression of tumor and DCR
Time Frame
3 years
Title
correlation analysis of PD-L1 expression of tumor and TTR
Time Frame
3 years
Title
correlation analysis of PD-L1 expression of tumor and PFS
Time Frame
3 years
Title
correlation analysis of PD-L1 expression of tumor and OS
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and Female aged 18 to 70 years are eligible; Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 Histologic diagnosis of unresectable melanoma or urological cancer. Have failed at least 1 prior routine regimen for metastatic disease, or failed to tolerate the toxicity, or lack of any routine regimens. Providing with tumor specimen (for testing the expression of PD -L1 and the infiltrating lymphocytes); At least 1 measurable lesion (only 1 measurable lymph node lesion is excluded) (routine CT scan >=20mm, spiral CT scan >=10mm, no prior radiation to measurable lesions) Predicted survival >=6 months; Brain or meningeal metastases must be disposed with surgery or radiation, and be stable clinically for at least 8 weeks (prior systemic steroids was allowed, but concurrent administration of systemic steroids with the study drug is excluded). Screening laboratory values must meet the following criteria(within past 14 days): hemoglobin ≥ 9.0 g/dL neutrophils ≥ 1500 cells/ µL platelets ≥ 100 x 10^3/ µL total bilirubin ≤ 1.5 x upper limit of normal (ULN) aspartic transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 x ULN without, and ≤ 5 x ULN with hepatic metastasis serum creatinine ≤1╳ULN,creatinine clearance >50ml/min (Cockcroft-Gault equation) Without systemic steroids within past 4 weeks Males or female of childbearing potential must: agree to use using a reliable form of contraception (eg, oral contraceptives, intrauterine device, control sex desire, double barrier method of condom and spermicidal) during the treatment period and for at least 12 months after the last dose of study drug. Must have read, understood, and provided written informed consent voluntarily. Willing to adhere to the study visit schedule and the prohibitions and restrictions specified in this protocol. Exclusion Criteria: Hypersensitivity to recombinant humanized anti-PD-1 monoclonal Ab or its components. Prior treatment with mAb within past 3 months (locally administration excluded) Prior antitumor therapy (including corticosteroids and immunotherapy) or participation in other clinical trials within past 4 weeks, or have not recovered from toxicities since the last treatment; Pregnant or nursing Abnormal Blood coagulation Positive tests for HIV, HCV, HBsAg or HBcAb with positive test for HBV DNA (>500IU/ml) History with pulmonary tuberculosis; Patients with any active autoimmune disease or a documented history of autoimmune disease, or history of syndrome that required systemic steroids or immunosuppressive medications, such as hypophysitis, pneumonia, colitis, hepatitis, nephritis, hyperthyroidism or hypothyroidism. Severe, uncontrolled medical condition that would affect patients' compliance or obscure the interpretation of toxicity determination or adverse events, including active severe infection, uncontrolled diabetes, angiocardiopathy (heart failure > class II NYHA, heart block >II grade, myocardial infarction, unstable arrhythmia or unstable angina within past 6 months, cerebral infarction within past 3 months) or pulmonary disease ( interstitial pneumonia, obstructive pulmonary disease or symptomatic bronchospasm). Evidence with CNS disease. Prior treatment with bone marrow stimulating factors,such as CSF (colony stimulating factor), EPO (erythropoietin), within past 1 weeks Prior live vaccine therapy within past 4 weeks. Prior major surgery within past 4 weeks (diagnostic surgery excluded). Psychiatric medicines abuse without withdrawal, or history of psychiatric illness. Prior malignancy active within the previous 5 years except for locally curable cancers that have been apparently cured, such as basal cell skin cancer or carcinoma in situ of the cervix. Underlying medical condition that, in the Investigator's opinion, would increase the risks of study drug administration or obscure the interpretation of toxicity determination or adverse events.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jun Guo, Phd MD
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Yes
Citations:
PubMed Identifier
26947879
Citation
Chen R, Peng PC, Wen B, Li FY, Xie S, Chen G, Lu J, Peng Z, Tang SB, Liang YM, Deng X. Anti-Programmed Cell Death (PD)-1 Immunotherapy for Malignant Tumor: A Systematic Review and Meta-Analysis. Transl Oncol. 2016 Feb;9(1):32-40. doi: 10.1016/j.tranon.2015.11.010.
Results Reference
background
PubMed Identifier
26115796
Citation
Ribas A, Puzanov I, Dummer R, Schadendorf D, Hamid O, Robert C, Hodi FS, Schachter J, Pavlick AC, Lewis KD, Cranmer LD, Blank CU, O'Day SJ, Ascierto PA, Salama AK, Margolin KA, Loquai C, Eigentler TK, Gangadhar TC, Carlino MS, Agarwala SS, Moschos SJ, Sosman JA, Goldinger SM, Shapira-Frommer R, Gonzalez R, Kirkwood JM, Wolchok JD, Eggermont A, Li XN, Zhou W, Zernhelt AM, Lis J, Ebbinghaus S, Kang SP, Daud A. Pembrolizumab versus investigator-choice chemotherapy for ipilimumab-refractory melanoma (KEYNOTE-002): a randomised, controlled, phase 2 trial. Lancet Oncol. 2015 Aug;16(8):908-18. doi: 10.1016/S1470-2045(15)00083-2. Epub 2015 Jun 23.
Results Reference
background
PubMed Identifier
30642373
Citation
Tang B, Yan X, Sheng X, Si L, Cui C, Kong Y, Mao L, Lian B, Bai X, Wang X, Li S, Zhou L, Yu J, Dai J, Wang K, Hu J, Dong L, Song H, Wu H, Feng H, Yao S, Chi Z, Guo J. Safety and clinical activity with an anti-PD-1 antibody JS001 in advanced melanoma or urologic cancer patients. J Hematol Oncol. 2019 Jan 14;12(1):7. doi: 10.1186/s13045-018-0693-2.
Results Reference
derived

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Safety and Tolerability of Recombinant Humanized Anti-PD-1 Monoclonal Antibody Toripalimab for Patients With Advanced Solid Tumors

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