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Phase 1b DV281 With an Anti-PD-1 Inhibitor in NSCLC

Primary Purpose

Advanced Non Small Cell Lung Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
DV281
Breath Actuated Nebulizer
DV281 (RP2D)
Approved Anti-PD-1 Inhibitor
Sponsored by
Dynavax Technologies Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Non Small Cell Lung Cancer focused on measuring Cancer, Lung Cancer, NSCLC, Anti-PD-1 inhibitor, Immuno-oncology, Toll-Like Receptor (TLR) agonist

Eligibility Criteria

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

Inclusion Criteria:

  • Have documented histologically or cytologically confirmed advanced NSCLC as the dominant histology.
  • If confirmed EGFR or ALK directed testing warrants actionable targeted therapy, must have confirmed disease progression on targeted therapy or cannot tolerate targeted therapy.
  • Aged 18 years and older on the day of signing informed consent
  • Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 to 2 for Dose Escalation phase and ECOG PS 0 to 1 for Dose Expansion phase
  • Adequate organ function as indicated by laboratory values
  • Life expectancy, in the opinion of the investigator, of at least 3 months

Exclusion Criteria

  • Condition of the subjects lung anatomy is such that proper delivery of inhaled DV281 to the specific location of intra-thoracic tumor(s) could be compromised
  • Any known additional malignancy that is progressing or required active treatment in the last 3 years
  • Current or history of clinically significant non-infectious pneumonitis
  • History of clinically severe lung disease, asthma, or chronic obstructive pulmonary disease (COPD) requiring emergency management and/or hospitalization in the last year
  • Received more than 30 Gy of conventional radiation therapy in the thoracic region within 26 weeks prior to study enrollment
  • Is expected to require any other form of anti-cancer therapy while in the trial. Zoledronic acid or denosumab as supportive care for bone metastases will be allowed if started prior to study enrollment
  • Diagnosis of immunodeficiency or is receiving systemic steroid therapy (>10 mg of prednisone or equivalent) or any other form of immunosuppressive therapy (including immune modulators or systemic corticosteroids) that cannot be discontinued safely within 14 days prior to study enrollment
  • Has a medical condition that requires immunosuppression
  • Active autoimmune disease requiring systemic treatment in the past 2 years or a disease that requires immunosuppressive medication including systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, or autoimmune thrombocytopenia. Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment.
  • Known central nervous system metastases, brain metastases, or carcinomatous meningitis

Sites / Locations

  • Moores UC San Diego Cancer Center
  • Ronald Reagan University of California Los Angeles Medical Center
  • Allina Health, Virginia Piper Cancer Institute
  • Sarah Cannon Research Institute
  • Virginia Cancer Specialists
  • Seattle Cancer Care Alliance

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Dose Escalation Cohort 1-5

Dose Expansion (RP2D)

Arm Description

Cohort 1-4 DV281 - Dose Level 1-5 DV281 in combination with nivolumab DV281 is administered via a breath actuated nebulizer

4 Cohorts Preliminary Recommended Phase 2 dosing of DV281 in combination with nivolumab Cohort 1: Non-squamous and non-EGFR/ ALK mutation and progressed on anti-PD-1/L1 therapy Cohort 2: Non-squamous and EGFR/ ALK mutation and progressed on targeted therapy Cohort 3: Squamous and anti-PD-1/ L1 therapy experienced Cohort 4: Squamous and anti-PD-1/L1 therapy naive DV281 is administered via a breath actuated nebulizer.

Outcomes

Primary Outcome Measures

Dose Escalation
Incidence of dose-limiting toxicities (DLTs)
Dose Expansion
Objective response rate (ORR) of dosing regimen established during the Dose Escalation
Dose Expansion
Duration of Response (DOR) and time to response.

Secondary Outcome Measures

Dose Escalation
Assess IFN-a induced gene expression in blood when DV281 is administered as a monotherapy and in combination with an approved anti-PD-1 inhibitor
Dose Expansion
Incidence of treatment related AE's as assessed by CTCAE Version 4.03

Full Information

First Posted
October 19, 2017
Last Updated
June 15, 2020
Sponsor
Dynavax Technologies Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT03326752
Brief Title
Phase 1b DV281 With an Anti-PD-1 Inhibitor in NSCLC
Official Title
Phase 1b Dose Escalation and Dose Expansion Trial of DV281 in Combination With an Approved Anti-PD-1 Inhibitor in Subjects With Advanced Non-Small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Completed
Study Start Date
September 20, 2017 (Actual)
Primary Completion Date
September 19, 2019 (Actual)
Study Completion Date
September 19, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Dynavax Technologies Corporation

4. Oversight

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

5. Study Description

Brief Summary
This open-label, multicenter, dose-escalation and expansion trial is designed to evaluate the safety and preliminary efficacy of inhaled DV281 in combination with nivolumabfor the treatment of NSCLC and to select a recommended phase 2 dose (RP2D).
Detailed Description
Pre-clinical studies support the proposed dosing schema to be tested and a potential benefit of the combination of inhaled DV281 with nivolumab for subjects with advanced NSCLC. This study (DV9-NSC-01) is designed for establishing an immunologically optimal RP2D for inhaled DV281 in combination with an approved anti-PD-1 inhibitor. This trial, studying the potential to enhance the efficacy of an approved anti-PD-1 inhibitor in subjects with advanced NSCLC, addresses an unmet need for NSCLC patients having tumors that do not respond or do not respond adequately to anti-PD-1 inhibitor monotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Non Small Cell Lung Cancer
Keywords
Cancer, Lung Cancer, NSCLC, Anti-PD-1 inhibitor, Immuno-oncology, Toll-Like Receptor (TLR) agonist

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
In the Dose Escalation phase of the study, 5 DV281 dose cohorts will be evaluated in combination with an approved anti-PD-1 Inhibitor. The Dose Expansion phase of the study will establish the Recommended Phase 2 Dose of DV281 in combination with an approved anti-PD-1 inhibitor.
Masking
None (Open Label)
Masking Description
N/A - There is no masking in this study.
Allocation
Non-Randomized
Enrollment
26 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation Cohort 1-5
Arm Type
Experimental
Arm Description
Cohort 1-4 DV281 - Dose Level 1-5 DV281 in combination with nivolumab DV281 is administered via a breath actuated nebulizer
Arm Title
Dose Expansion (RP2D)
Arm Type
Experimental
Arm Description
4 Cohorts Preliminary Recommended Phase 2 dosing of DV281 in combination with nivolumab Cohort 1: Non-squamous and non-EGFR/ ALK mutation and progressed on anti-PD-1/L1 therapy Cohort 2: Non-squamous and EGFR/ ALK mutation and progressed on targeted therapy Cohort 3: Squamous and anti-PD-1/ L1 therapy experienced Cohort 4: Squamous and anti-PD-1/L1 therapy naive DV281 is administered via a breath actuated nebulizer.
Intervention Type
Drug
Intervention Name(s)
DV281
Intervention Description
- Dose Escalation will be the preliminary dose finding phase of the study. Subjects will be enrolled to available Dosing Cohorts.
Intervention Type
Device
Intervention Name(s)
Breath Actuated Nebulizer
Other Intervention Name(s)
Nebulizer
Intervention Description
Breath-actuated, electronic system designed to aerosolize liquid medication.
Intervention Type
Drug
Intervention Name(s)
DV281 (RP2D)
Intervention Description
- Dose Expansion will be enrolled into 4 groups based on NSCLC characteristics.
Intervention Type
Drug
Intervention Name(s)
Approved Anti-PD-1 Inhibitor
Other Intervention Name(s)
nivolumab
Intervention Description
FDA approved Anti-PD-1 Inhibitor
Primary Outcome Measure Information:
Title
Dose Escalation
Description
Incidence of dose-limiting toxicities (DLTs)
Time Frame
DLT assessment period - Day 1 through Day 28.
Title
Dose Expansion
Description
Objective response rate (ORR) of dosing regimen established during the Dose Escalation
Time Frame
1 year after last subject is enrolled in the Dose Expansion phase of study
Title
Dose Expansion
Description
Duration of Response (DOR) and time to response.
Time Frame
1 year after last subject is enrolled in the Dose Expansion phase of the Study
Secondary Outcome Measure Information:
Title
Dose Escalation
Description
Assess IFN-a induced gene expression in blood when DV281 is administered as a monotherapy and in combination with an approved anti-PD-1 inhibitor
Time Frame
IFN response assessment period - Day 1 through Day 21
Title
Dose Expansion
Description
Incidence of treatment related AE's as assessed by CTCAE Version 4.03
Time Frame
1 year after last subject is enrolled in the Dose Expansion phase of study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have documented histologically or cytologically confirmed advanced NSCLC as the dominant histology. If confirmed EGFR or ALK directed testing warrants actionable targeted therapy, must have confirmed disease progression on targeted therapy or cannot tolerate targeted therapy. Aged 18 years and older on the day of signing informed consent Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 to 2 for Dose Escalation phase and ECOG PS 0 to 1 for Dose Expansion phase Adequate organ function as indicated by laboratory values Life expectancy, in the opinion of the investigator, of at least 3 months Exclusion Criteria Condition of the subjects lung anatomy is such that proper delivery of inhaled DV281 to the specific location of intra-thoracic tumor(s) could be compromised Any known additional malignancy that is progressing or required active treatment in the last 3 years Current or history of clinically significant non-infectious pneumonitis History of clinically severe lung disease, asthma, or chronic obstructive pulmonary disease (COPD) requiring emergency management and/or hospitalization in the last year Received more than 30 Gy of conventional radiation therapy in the thoracic region within 26 weeks prior to study enrollment Is expected to require any other form of anti-cancer therapy while in the trial. Zoledronic acid or denosumab as supportive care for bone metastases will be allowed if started prior to study enrollment Diagnosis of immunodeficiency or is receiving systemic steroid therapy (>10 mg of prednisone or equivalent) or any other form of immunosuppressive therapy (including immune modulators or systemic corticosteroids) that cannot be discontinued safely within 14 days prior to study enrollment Has a medical condition that requires immunosuppression Active autoimmune disease requiring systemic treatment in the past 2 years or a disease that requires immunosuppressive medication including systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, or autoimmune thrombocytopenia. Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment. Known central nervous system metastases, brain metastases, or carcinomatous meningitis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Edward Garon, MD
Organizational Affiliation
University of California, Los Angeles
Official's Role
Principal Investigator
Facility Information:
Facility Name
Moores UC San Diego Cancer Center
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Ronald Reagan University of California Los Angeles Medical Center
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Allina Health, Virginia Piper Cancer Institute
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55407
Country
United States
Facility Name
Sarah Cannon Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37201
Country
United States
Facility Name
Virginia Cancer Specialists
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
Facility Name
Seattle Cancer Care Alliance
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Phase 1b DV281 With an Anti-PD-1 Inhibitor in NSCLC

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