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A Dose-escalation, Expansion Study of ARX788, in Advanced Solid Tumors Subjects With HER2 Expression (ACE-Pan Tumor 01)

Primary Purpose

Breast Neoplasms, Gastric Neoplasm, Solid Tumors

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
ARX788
Sponsored by
Ambrx, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Neoplasms focused on measuring HER2, antibody drug conjugate, breast cancer, gastric cancer, advanced solid tumors, HER2-overexpression, HER2-mutations

Eligibility Criteria

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

Inclusion Criteria:

  • Age >18 years
  • Life expectancy >3 months.
  • Female or male subjects whose advanced HER2 expressing cancer has failed standard of care treatments, or for whom such therapy is not acceptable to the subject. Subjects with advanced breast, gastric cancer, or other solid tumor who test positive for HER2 by ASCO/CAP criteria (either IHC or FISH) must have received prior treatment with a trastuzumab containing therapy. Subjects who have been previously treated with pertuzumab, TDM-1, lapatinib, or other available and accessible HER2-directed therapies or investigational therapies are eligible.
  • Disease measurability:

    • Phase 1a: measurable or non-measurable disease per RECIST v 1.1.
    • Phase 1b: measurable disease per RECIST v 1.1 (subjects with non-measurable disease are not eligible for Phase 1b).
  • Histopathologic evidence of cancer based upon pathology report.
  • Tumor tissue local laboratory HER2 testing results, adequate tumor sample available for confirmation of HER2 status. Subjects with other types of cancer must have previously tested locally for HER2 status by HER2 IHC or ISH assay.

    • Phase 1a: ISH positive or IHC 3+ advanced cancer (including breast or gastric/esophageal or other solid tumors).
    • Phase 1b: Cohort 8 advanced breast cancer (IHC 3+ or IHC 2+/ISH); Cohort 9 advanced breast cancer (IHC 2+ / ISH-); Cohort 10 advanced gastric cancer (IHC 3+ or IHC 2+/ISH+) or gastroesophageal junction adenocarcinoma; Cohort 11 other advanced solid tumor cancers with HER2-overexpression (HER2 IHC 3+ or IHC 2+/IHS+); Cohort 12 advanced solid tumor cancers with HER2 activating mutation.
  • Eastern Cooperative Oncology Group Performance Status of 0 to 1.
  • Acute toxicities from any prior therapy, surgery, or radiotherapy must have resolved to Grade 0 or 1 as per the NCI-CTCAE v 4.03 (phase 1a) and v 5.0 ( Phase 1b).
  • Adequate organ functions.
  • Willing and able to understand and sign an informed consent inform and to comply with all aspects of the protocol.
  • Female subjects must be surgically sterile, or have a monogamous partner who is surgically sterile, or at least 2 years postmenopausal, or who commits to use an acceptable form of birth control (defined as the use of an intrauterine device, a barrier method with spermicide, condoms, any form of hormonal contraceptives, or abstinence) for the duration of the study and for 3 months following the last dose of study treatment.
  • Male subjects must be sterile (biologically or surgically) or commit to the use of a reliable method of birth control (condoms with spermicide) for the duration of the study.

Exclusion Criteria:

  • History of allergic reactions to any component of ARX788.
  • History of ocular events, or any current ongoing active ocular infections.
  • History of congestive heart failure, unstable angina pectoris, unstable atrial fibrillation, or cardiac arrhythmia within 12 months prior to enrollment
  • Grade 2 to 4 peripheral neuropathy (NCI CTCAE v 5.0)
  • History of unstable central nervous system (CNS) metastases
  • Current severe, uncontrolled systemic disease (eg, clinical significant cardiovascular, pulmonary, or metabolic diseases)
  • Any uncontrollable intercurrent illness, infection (including subjects with active, symptomatic Covid-19 infections), or other conditions that could limit study compliance or interfere with assessments.
  • Exposure to any other investigational or commercial anticancer agents or therapies administered with the intention to treat malignancy within 14 days before the first dose of ARX788.
  • Clinically significant surgical intervention (excluding diagnostic biopsy) within 21 days of the first dose of ARX788
  • Radiotherapy administered less than 21 days prior to the first dose of ARX788, or localized palliative radiotherapy administered less than 7 days prior to the first dose of ARX788, or radiotherapy-induced toxicity of Grade 2 or greater based on NCI-CTCAE v 5.0.
  • Pregnancy or breast feeding.
  • Known active HCV, HBV, and/or HIV infection.

Sites / Locations

  • USC Norris Cancer Hospital
  • UCLA Hematology-Oncology
  • Washington University School of Medicine
  • Cleveland Clinic
  • Baylor Sammons Cancer Center
  • Research Site
  • Research Site
  • Mater Misericordiae Limited
  • Princess Alexandria Hospital
  • Monash Health
  • Research Site
  • Research Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

ARX788 Phase 1a (Dose Escalation)

ARX788 Phase 1b (Dose Expansion)

Arm Description

ARX788 will be administered every 3 weeks (Q3W) or every 4 weeks (Q4W) via intravenous (IV) infusion. Patients will be enrolled into escalating dose levels during Dose Escalation period.

ARX788 will be administered every 3 weeks (Q3W) via intravenous (IV) infusion. Patients will receive the maximum tolerated dose during the Dose Expansion period of the study.

Outcomes

Primary Outcome Measures

Number of subjects experiencing adverse events, frequency and seriousness of treatment emergent adverse events (TEAEs)
To assess the safety, tolerability, and immunogenicity profile
Phase 1b: Objective response rate (ORR: complete response + partial response) per imaging assessment based on RECIST version 1.1.
Number of subjects with objective response is assessed every 6-8 weeks from Cycle 1 Day 1 through disease progression.

Secondary Outcome Measures

Number of subjects with tumor response per imaging assessment based on RECIST version 1.1.
The objective response rate (ORR: CR+PR) based on RECIST v1.1 will be assessed as the primary endpoint to determine the anticancer activity of ARX788 as well as best overall response.
Area under the concentration-time curve (AUC) from first infusion to subject end of study.
Pharmacokinetic (PK) characteristics: ARX788 (intact ADC), total mAb, and metabolites
Half-life of ARX788 from first infusion to end of study.
Pharmacokinetic (PK) characteristics: ARX788 from first infusion to subject end of study
Immunogenicity profile of ARX788
Number of subjects who develop anti-ARX788 antibody

Full Information

First Posted
August 14, 2017
Last Updated
April 6, 2023
Sponsor
Ambrx, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03255070
Brief Title
A Dose-escalation, Expansion Study of ARX788, in Advanced Solid Tumors Subjects With HER2 Expression (ACE-Pan Tumor 01)
Official Title
A Phase 1, Multicenter, Open-label, Multiple Dose-escalation and Expansion Study of ARX788, as Monotherapy in Advanced Solid Tumors With HER2 Expression
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 20, 2018 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ambrx, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This 2-part, Phase 1, open-label study will determine the recommended Phase 2 dose (RP2D) of ARX788 in subjects with advanced HER2 positive cancers and will assess the safety and anticancer activity in breast, gastric and other advanced HER2 positive solid tumors.
Detailed Description
Phase 1a will determine the recommended Phase 2 dose (RP2D) in subjects with advanced cancer whose HER2 test results are in situ hybridization (ISH) positive or immunohistochemistry (IHC) 3+, based on safety, tolerability, PK findings and antitumor activity. Phase 1b will assess the safety, tolerability, and PK and anticancer activity in five expansion cohorts, including breast cancer, gastric cancer / gastroesophageal adenocarcinoma, and other advanced HER2-positive solid tumors.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Neoplasms, Gastric Neoplasm, Solid Tumors
Keywords
HER2, antibody drug conjugate, breast cancer, gastric cancer, advanced solid tumors, HER2-overexpression, HER2-mutations

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
This is a 2-part, Phase 1, open-label study will administer the IMP, ARX788 by IV infusion every 3, 4 or 6 weeks. Sequential dose escalation cohorts are planned using a 3+3 design. A cohort may be expanded to collect additional data if recommended by Safety Monitoring Committee based on comprehensive reviews of safety, tolerability and PK data to determine RP2D. Phase 1a will determine the recommended Phase 2 dose (RP2D) in subjects with advanced cancer whose HER2 test results are in situ hybridization (ISH) positive or immunohistochemistry (IHC) 3+. Phase 1b will assess anticancer activity and safety in advanced cancer.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
106 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ARX788 Phase 1a (Dose Escalation)
Arm Type
Experimental
Arm Description
ARX788 will be administered every 3 weeks (Q3W) or every 4 weeks (Q4W) via intravenous (IV) infusion. Patients will be enrolled into escalating dose levels during Dose Escalation period.
Arm Title
ARX788 Phase 1b (Dose Expansion)
Arm Type
Experimental
Arm Description
ARX788 will be administered every 3 weeks (Q3W) via intravenous (IV) infusion. Patients will receive the maximum tolerated dose during the Dose Expansion period of the study.
Intervention Type
Drug
Intervention Name(s)
ARX788
Other Intervention Name(s)
antibody drug conjugate (ADC)
Intervention Description
An antibody drug conjugate
Primary Outcome Measure Information:
Title
Number of subjects experiencing adverse events, frequency and seriousness of treatment emergent adverse events (TEAEs)
Description
To assess the safety, tolerability, and immunogenicity profile
Time Frame
Day 1 through 30 days after last dose
Title
Phase 1b: Objective response rate (ORR: complete response + partial response) per imaging assessment based on RECIST version 1.1.
Description
Number of subjects with objective response is assessed every 6-8 weeks from Cycle 1 Day 1 through disease progression.
Time Frame
36 months
Secondary Outcome Measure Information:
Title
Number of subjects with tumor response per imaging assessment based on RECIST version 1.1.
Description
The objective response rate (ORR: CR+PR) based on RECIST v1.1 will be assessed as the primary endpoint to determine the anticancer activity of ARX788 as well as best overall response.
Time Frame
18 months
Title
Area under the concentration-time curve (AUC) from first infusion to subject end of study.
Description
Pharmacokinetic (PK) characteristics: ARX788 (intact ADC), total mAb, and metabolites
Time Frame
36 months
Title
Half-life of ARX788 from first infusion to end of study.
Description
Pharmacokinetic (PK) characteristics: ARX788 from first infusion to subject end of study
Time Frame
36 months
Title
Immunogenicity profile of ARX788
Description
Number of subjects who develop anti-ARX788 antibody
Time Frame
36 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age >18 years Life expectancy >3 months. Female or male subjects whose advanced HER2 expressing cancer has failed standard of care treatments, or for whom such therapy is not acceptable to the subject. Subjects with advanced breast, gastric cancer, or other solid tumor who test positive for HER2 by ASCO/CAP criteria (either IHC or FISH) must have received prior treatment with a trastuzumab containing therapy. Subjects who have been previously treated with pertuzumab, TDM-1, lapatinib, or other available and accessible HER2-directed therapies or investigational therapies are eligible. Disease measurability: Phase 1a: measurable or non-measurable disease per RECIST v 1.1. Phase 1b: measurable disease per RECIST v 1.1 (subjects with non-measurable disease are not eligible for Phase 1b). Histopathologic evidence of cancer based upon pathology report. Tumor tissue local laboratory HER2 testing results, adequate tumor sample available for confirmation of HER2 status. Subjects with other types of cancer must have previously tested locally for HER2 status by HER2 IHC or ISH assay. Phase 1a: ISH positive or IHC 3+ advanced cancer (including breast or gastric/esophageal or other solid tumors). Phase 1b: Cohort 8 advanced breast cancer (IHC 3+ or IHC 2+/ISH); Cohort 9 advanced breast cancer (IHC 2+ / ISH-); Cohort 10 advanced gastric cancer (IHC 3+ or IHC 2+/ISH+) or gastroesophageal junction adenocarcinoma; Cohort 11 other advanced solid tumor cancers with HER2-overexpression (HER2 IHC 3+ or IHC 2+/IHS+); Cohort 12 advanced solid tumor cancers with HER2 activating mutation. Eastern Cooperative Oncology Group Performance Status of 0 to 1. Acute toxicities from any prior therapy, surgery, or radiotherapy must have resolved to Grade 0 or 1 as per the NCI-CTCAE v 4.03 (phase 1a) and v 5.0 ( Phase 1b). Adequate organ functions. Willing and able to understand and sign an informed consent inform and to comply with all aspects of the protocol. Female subjects must be surgically sterile, or have a monogamous partner who is surgically sterile, or at least 2 years postmenopausal, or who commits to use an acceptable form of birth control (defined as the use of an intrauterine device, a barrier method with spermicide, condoms, any form of hormonal contraceptives, or abstinence) for the duration of the study and for 3 months following the last dose of study treatment. Male subjects must be sterile (biologically or surgically) or commit to the use of a reliable method of birth control (condoms with spermicide) for the duration of the study. Exclusion Criteria: History of allergic reactions to any component of ARX788. History of ocular events, or any current ongoing active ocular infections. History of congestive heart failure, unstable angina pectoris, unstable atrial fibrillation, or cardiac arrhythmia within 12 months prior to enrollment Grade 2 to 4 peripheral neuropathy (NCI CTCAE v 5.0) History of unstable central nervous system (CNS) metastases Current severe, uncontrolled systemic disease (eg, clinical significant cardiovascular, pulmonary, or metabolic diseases) Any uncontrollable intercurrent illness, infection (including subjects with active, symptomatic Covid-19 infections), or other conditions that could limit study compliance or interfere with assessments. Exposure to any other investigational or commercial anticancer agents or therapies administered with the intention to treat malignancy within 14 days before the first dose of ARX788. Clinically significant surgical intervention (excluding diagnostic biopsy) within 21 days of the first dose of ARX788 Radiotherapy administered less than 21 days prior to the first dose of ARX788, or localized palliative radiotherapy administered less than 7 days prior to the first dose of ARX788, or radiotherapy-induced toxicity of Grade 2 or greater based on NCI-CTCAE v 5.0. Pregnancy or breast feeding. Known active HCV, HBV, and/or HIV infection.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ambrx
Organizational Affiliation
Ambrx, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
USC Norris Cancer Hospital
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
UCLA Hematology-Oncology
City
Santa Monica
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Baylor Sammons Cancer Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
Research Site
City
East Albury
State/Province
New South Wales
ZIP/Postal Code
2640
Country
Australia
Facility Name
Research Site
City
North Sydney
State/Province
New South Wales
ZIP/Postal Code
2640
Country
Australia
Facility Name
Mater Misericordiae Limited
City
South Brisbane
State/Province
Queensland
ZIP/Postal Code
4101
Country
Australia
Facility Name
Princess Alexandria Hospital
City
Woolloongabba
State/Province
Queensland
ZIP/Postal Code
4102
Country
Australia
Facility Name
Monash Health
City
Clayton
State/Province
Victoria
ZIP/Postal Code
3168
Country
Australia
Facility Name
Research Site
City
Frankston
State/Province
Victoria
ZIP/Postal Code
3199
Country
Australia
Facility Name
Research Site
City
Nedlands
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia

12. IPD Sharing Statement

Learn more about this trial

A Dose-escalation, Expansion Study of ARX788, in Advanced Solid Tumors Subjects With HER2 Expression (ACE-Pan Tumor 01)

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