First-in-Human Study of XMT-1536 in Cancers Likely to Express NaPi2b
Platinum Resistant Ovarian Cancer, Non Small Cell Lung Cancer Metastatic

About this trial
This is an interventional treatment trial for Platinum Resistant Ovarian Cancer
Eligibility Criteria
General Inclusion Criteria (for Dose Escalation, Expansion, and UPLIFT):
- ECOG performance status 0 or 1
- Measurable disease as per RECIST, version 1.1
- Resolution of all acute toxic effects of prior therapy or surgical procedures to ≤Grade 1 (except alopecia, stable immune-related toxicity such as hypothyroidism on hormone replacement, adrenal insufficiency on ≤10 mg daily prednisone [or equivalent], chronic Grade 2 peripheral sensory neuropathy after prior taxane therapy).
- Cardiac left ventricular ejection fraction (LVEF) ≥50% or ≥ the institution's lower limit of normal by either Echo or MUGA scan
Adequate organ function as defined by the following criteria:
- Absolute neutrophil count (ANC) ≥1500 cells/mm3
- Platelet count ≥100,000/mm3
- Hemoglobin ≥9 g/dL
- In patients not on anticoagulation therapy: INR, activated partial thromboplastin time (aPTT), and prothrombin time (PT) all within 1.2 times the institution's upper limit of normal (ULN). Patients on anticoagulation therapy are allowed if their relevant laboratory values are within the therapeutic window.
- Estimated glomerular filtration rate (GFR) ≥45 mL/min
- Total bilirubin ≤ULN
- g. Patients with asymptomatic elevations in unconjugated bilirubin due to Gilbert syndrome or stable chronic hemolytic anemia (e.g., hereditary spherocytosis, sickle cell disease, thalassemia intermedia) may be eligible after discussion with the Sponsor Medical Monitor.
- Aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT) ≤1.5 times the institutional ULN.
- Albumin ≥3.0 g/dL
- Able to provide informed consent.
General Exclusion Criteria (for Dose Escalation, Expansion, and UPLIFT) :
- Major surgery within 28 days of starting study treatment, systemic anti-cancer therapy within the lesser of 28 days or 5 half-lives of the prior therapy before starting study treatment, or recent radiation therapy with unresolved toxicity or within a time window of potential toxicity.
- Patients with untreated CNS metastases (including new and progressive brain metastases), history of leptomeningeal metastasis or carcinomatous meningitis.
- Current known active infection with HIV, hepatitis B virus, or hepatitis C virus.
- Prior history of liver disease such as liver cirrhosis, hepatic fibrosis
- Current severe, uncontrolled systemic disease (e.g., clinically significant cardiovascular, pulmonary, or metabolic disease) or intercurrent illness that could interfere with per-protocol evaluations.
- Current use of either constant or intermittent supplementary oxygen therapy.
- History of suspected pneumonitis or interstitial lung disease.
- Pregnant or nursing women.
- History of other malignancy within the last 2 years, except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or other malignancy with a similar expected curative outcome.
- Active corneal disease, or history of corneal disease within 12 months prior to enrollment
- Use of strong CYP450 3A inhibitors or inducers that cannot be discontinued while receiving study treatment
- Oxygen saturation on room air <93%
Ovarian Cancer Inclusion Criteria for UPLIFT:
- Histological diagnosis of high grade serous ovarian cancer, which includes fallopian tube, or primary peritoneal cancer, that is metastatic or recurrent.
Platinum-resistant disease
- Patients who have only had 1 line of platinum-based therapy must have received at least 4 cycles of platinum, must have had a response [complete response/remission (CR) or partial response/remission (PR)], and then progressed between 3 months and ≤ 6 months after the date of the last dose of platinum
- Patients who have received 2 to 4 lines of prior therapy must have received at least 4 cycles of platinum and then progressed within 6 months after the date of the last dose of platinum
One to 4 prior lines of systemic therapy for ovarian cancer
a. Prior treatment with bevacizumab is required for patients with 1 to 2 prior lines of therapy
- Patients must be willing to provide an archival tumor tissue block or slides or if not available, undergo procedure to obtain a new tumor biopsy using a low-risk, medically routine procedure
Ovarian Cancer Exclusion Criteria for UPLIFT:
- Low-grade, clear cell, endometrioid, mucinous, carcinosarcoma, germ-cell, mixed histology, or stromal tumors
- Prior treatment with mirvetuximab soravtansine or another ADC containing an antitubulin payload
- Primary platinum-resistant disease, defined by a lack of response or by progression within 3 months after completing front-line, platinum-containing therapy.
- Participation in DES or EXP segments of this study
Ovarian Cancer Inclusion Criteria for QTc sub-study:
Note: patients must meet all UPLIFT cohort inclusion criteria in order to participate in the QTc sub-study
• Study patient has agreed to remain in the clinic for the additional QTc related study activities on the Day 1 of Cycle 1 and Cycle 3.
Ovarian Cancer Exclusion Criteria for QTc sub-study:
- Use of strong CYP450 3A inducers.
- Uncontrolled cardiac arrhythmias, for example, atrial fibrillation with a ventricular response at rest > 100 beats per minute. left bundle branch block (LBBB)
- Known abnormality of any cardiac valve (either stenosis or regurgitation) that is greater than moderate in severity.
- Subjects not in sinus rhythm at screening with HR >45- <100
- Any ECG abnormality that can interfere with the measurement of the QT interval
Sites / Locations
- UAB Women & Infants Center
- University of Alabama at Birmingham
- Arizona Oncology Associates, PC - HAL
- Arizona Oncology Associates
- Highlands Oncology Group
- Cedars Sinai Medical Center
- Kaiser Permanente Medical Center - Oakland
- University of California - IrvineRecruiting
- Kaiser Permanente Medical Center - Roseville
- Kaiser Permanente Medical Center - Sacramento
- Kaiser Permanente Medical Center - South San Francisco
- Kaiser Permanente Medical Center - San Francisco
- Kaiser Permanente Medical Center - San Jose
- Kaiser Permanente Medical Center - San Leandro
- Sansum Clinic
- Kaiser Permanente Medical Center - Santa Clara
- Kaiser Permanente Medical Center - Vallejo
- Kaiser Permanente Medical Center - Walnut Creek
- University of Colorado
- Rocky Mountain Cancer Centers, LLP
- Holy Cross Hospital
- University of Florida
- Mayo Clinic - Jacksonville
- University of Miami - Miller School of Medicine
- Miami Cancer Institute
- H. Lee Moffitt Cancer Center
- Emory University
- Georgia Cancer Center at Augusta University
- University of Chicago
- Maryland Oncology and Hematology
- Massachusetts General Hospital
- Dana Farber Cancer Insititute
- Dana Farber Cancer Institute
- Lahey Clinic
- Baystate Medical Center
- Karmanos Cancer InstituteRecruiting
- Henry Ford Hospital
- QUEST Research Institute
- START - Midwest
- START-Midwest
- University of Minnesota
- Mayo Clinic - Rochester
- Washington University
- Billings Clinic
- Nebraska Methodist Hospital
- MD Anderson Cancer Center at Cooper - Camden
- Southwest Women's Oncology- Optimum Clinical Research GroupRecruiting
- Women's Cancer Care Associates, LLC
- NYU Langone Health
- Mount Sinai Hospital
- Levine Cancer Institute
- Novant Health Cancer Institute
- University of Cincinnati Medical Center
- The Ohio State University Wexner Medical CenterRecruiting
- Kattering Medical Center
- Stephenson Cancer Centre-University of Oklahoma
- Oklahoma Cancer Specialists and Research Institute
- Willamette Valley Cancer Institute
- Perelman Center for Advanced MedicineRecruiting
- Fox Chase Cancer Center
- Allegheny Health Network
- UPMC Cancer Pavillion
- Women & Infants Hospital of Rhode Island
- Medical University of South Carolina
- Institute of Transnational Oncology-Greenville Hospital System University Medical Center
- Avera Cancer Institute
- University of Tennessee
- Sarah Cannon Research Institute
- Texas Oncology, Austin
- Texas Oncology-Austin
- Texas Oncology- Bedford
- Mary Crowley Cancer Research CenterRecruiting
- Texas Oncology - Baylor Charles A. Sammons Cancer Center
- Texas Oncology Baylor Charles A. Sammons Cancer Center
- Texas Oncology, Fort Worth
- Texas Oncology-Fort Worth Cancer CenterRecruiting
- Texas Oncology P.A. - Harlingen
- Baylor College of Medicine
- Texas Oncology, HoustonRecruiting
- US Oncology Research/Investigational Product Center
- South Texas Accelerated Research Therapeutics (START)
- NEXT Oncology
- University of Utah Huntsman Cancer Institute
- University of Virginia- Emily Couric Clinical Cancer Center
- Virginia Cancer SpecialistRecruiting
- VCU Massey Cancer CenterRecruiting
- Virginia Commonwealth University Massey Cancer Center
- BlueRidge Cancer Care Physicians
- Oncology & Hematology Associates of Southwest Virginia, Inc. - Salem
- University of Washington
- Medical College Of Wisconsin
- Austin Health - Olivia Newton John Cancer Center
- Blacktown Road
- Chris OBrien Lifehouse
- Chris O'Brien Lifehouse
- Royal Brisbane and Women's Hospital
- Peter MacCallum Cancer Center
- Icon Cancer Centre South Brisbane
- University Hospital Graz
- University Hospital Innsbruck - Tyrolean Hospital
- Our Dear Lady Hospital, Aalst Campus
- Saint Luc University Hospital
- Campus Kennedylaan, President Kennedylaan 4
- Herestraat 49
- Avenue de l'Hopital 1
- Multiprofile Hospital for Active Treatment" Park Hospital EOOD
- Complex Oncology Center - Burgas
- Multiprofile Hospital for Active Treatment "Serdika", Sofia
- MHAT for Women's Health "Nadezhda"
- Multiprofile Hospital for Active Treatment "Sofiamed", Sofia
- Multiprofile Hospital for Active Treatment - Uni Hospital, Panagyurishte
- British Columbia Cancer Agency
- McGill University Health Centre - The Montreal General Hospital
- Tom Baker Cancer Center
- Sherbrooke University Hospital Centre
- Princess Margaret Cancer Centre
- University Hospital Brno
- General University Hospital in Prague
- University Hospital Bulovka
- Rigshospitalet - University Hospital Copenhagen
- Odense University Hospital
- Tampere University Hospital
- Francois Baclesse Center
- Leon Berard Center
- Montpellier Cancer Institute
- Confluent Private Hospital
- South Lyon Hospital Center, Department of Clinical Hematology
- Strasbourg Europe Institut of Cancerology
- Institute Claudius Regaud
- Gustave Roussy
- National Institute of Oncology
- University of Debrecen Clinical Center
- Petz Aladar University Teaching Hospital
- Polyclinic S. Orsola-Malpighi
- Hospital Cannizzaro - Catania
- Hospital San Raffaele, IRCCS
- National Cancer Institute - IRCCS "Fondazione G. Pascale"
- University Hospital Campus Bio-Medico
- National Cancer Institute Regina Elena, IRCCS
- University Polyclinic Foundation "Agostino Gemelli" - IRCCS
- Institute of Cancer Research and Treatment of Candiolo
- National Cancer Institute
- Vilnius University Hospital Santaros Klinikos
- Auckland District Health Board, Auckland City Hospital
- Oslo University Hospital, Rikshospitalet (The National Hospital)
- Maria Sklodowska-Curie Bialystok Oncology Center
- University Teaching Hospital in Bialystok
- University Clinical Center, Clinic of Gynecology
- Provincial Hospitals in Gdynia Sp. z o.o. (LLC)
- Heliodor Swiecicki Clinical Hospital at the Karol Marcinkowski Medical University in Poznan
- University Hospital Germans Trias i PujolRecruiting
- University Hospital Vall d'Hebron
- Hospital Clinic of Barcelona
- University Clinical Hospital Virgen de la Arrixaca
- Jaen Hospital ComplexRecruiting
- Clinica Univ di NavarraRecruiting
- Navarra University Clinic
- University Hospital Clinical San CarlosRecruiting
- University Hospital Foundation Jimenez DiazRecruiting
- Hospital Universitario La Paz
- La Paz University Hospital
- Clara Campal Comprehensive Cancer CenterRecruiting
- University Hospital Virgen del Rocio (HUVR)Recruiting
- University Clinical Hospital of ValenciaRecruiting
- Lund University, Department of Oncology
- Addenbrooke's Hospital
- Beatson West of Scotland Cancer Center
- University College London Hospitals NHS Foundation Trust
- Guy's Hospital
- Royal Marsden Hospital - London, Gynae Trials Unit
- The Christie NHS Foundation Trust
- Mount Vernon Hospital, Cancer Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Experimental
Experimental
Experimental
Experimental
Experimental
Dose Escalation
Dose Expansion - Ovarian Cancer
Dose Expansion - NSCLC adenocarcinoma
Pivotal Cohort (UPLIFT)
QTc Sub-Study
XMT-1536 (upifitamab rilsodotin) treatment is administered in groups of patients who will receive doses that increase over time. This cohort is closed to enrollment.
Once the maximum tolerated dose or recommended Phase 2 dose is achieved in dose escalation, new groups of patients will receive XMT-1536 (upifitamab rilsodotin) at this fixed-dose. This cohort is closed to enrollment.
Once the maximum tolerated dose or recommended Phase 2 dose is achieved in dose escalation, new groups of patients will receive XMT-1536 (upifitamab rilsodotin) at this fixed-dose. This cohort is closed to enrollment.
Patients with platinum-resistant ovarian cancer will receive XMT-1536 (upifitamab rilsodotin) to further confirm the efficacy
For sites participating in the sub-study, patients with platinum -resistant ovarian cancer will have the option to enroll in this sub-study to evaluate potential changes in the QTc interval following administration of XMT-1536.