QUILT-3.090: NANT Squamous Cell Carcinoma (SCC) Vaccine: Subjects With SCC Who Have Progressed
Primary Purpose
Squamous Cell Carcinoma
Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Aldoxorubicin HCl
ETBX-011
ETBX-021
ETBX-051
ETBX-061
GI-4000
GI-6207
GI-6301
haNK for infusion
Avelumab
bevacizumab
Capecitabine
Cetuximab
Cisplatin
Cyclophosphamide
Fluorouracil
Leucovorin
nab-Paclitaxel
Necitumumab
SBRT
N-803
Sponsored by
About this trial
This is an interventional treatment trial for Squamous Cell Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years.
- Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.
- Histologically-confirmed HNSCC or squamous NSCLC with progression on or after platinum-based chemotherapy and anti-PD-1/PD-L1 therapy.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
- Have at least 1 measurable lesion of ≥ 1.0 cm.
- Must have a recent formalin-fixed, paraffin-embedded (FFPE) tumor biopsy specimen following the conclusion of the most recent anticancer treatment. If an historic specimen is not available, the subject must be willing to undergo a biopsy during the screening period, if considered safe by the Investigator. If safety concerns preclude collection of a biopsy during the screening period, a tumor biopsy specimen collected prior to the conclusion of the most recent anticancer treatment may be used.
- Must be willing to provide blood samples prior to the start of treatment on this study.
- Must be willing to provide a tumor biopsy specimen 8 weeks after the start of treatment, if considered safe by the Investigator.
- Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
- Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception for up to 1 year after completion of therapy, and non-sterile male subjects must agree to use a condom for up to 4 months after treatment. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, intrauterine devices (IUDs), and abstinence.
Exclusion Criteria:
- Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.
- Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, or autoimmune disease associated with lymphoma).
- History of organ transplant requiring immunosuppression.
- History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
Inadequate organ function, evidenced by the following laboratory results:
- Absolute neutrophil count < 1,000 cells//mm^3.
- Uncorrectable grade 3 anemia (hemoglobin < 8 g/dL).
- Platelet count < 75,000 cells/mm^3.
- Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome).
- Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases).
- Alkaline phosphatase levels > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases).
- Serum creatinine > 2.0 mg/dL or 177 μmol/L.
- Serum anion gap > 16 mEq/L or arterial blood with pH < 7.3.
- Uncontrolled hypertension (systolic > 160 mm Hg and/or diastolic > 110 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication. Subjects with uncontrolled hypertension should be medically managed on a stable regimen to control hypertension prior to study entry.
- Serious myocardial dysfunction defined by ECHO as absolute left ventricular ejection fraction (LVEF) 10% below the institution's lower limit of predicted normal.
- Dyspnea at rest due to complications of advanced malignancy or other disease requiring continuous oxygen therapy.
- Positive results of screening test for human immunodeficiency virus (HIV).
- Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.
- Known hypersensitivity to any component of the study medication(s).
- Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.
- Concurrent or prior use of a strong cytochrome P450 (CYP)3A4 inhibitor (including ketoconazole, itraconazole, posaconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, and grapefruit products) or strong CYP3A4 inducers (including phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St John's Wort) within 14 days before study day 1.
- Concurrent or prior use of a strong CYP2C8 inhibitor (gemfibrozil) or moderate CYP2C8 inducer (rifampin) within 14 days before study day 1.
- Participation in an investigational drug study or history of receiving any investigational treatment within 30 days prior to screening for this study, except for testosterone-lowering therapy in men with prostate cancer.
- Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
- Concurrent participation in any interventional clinical trial.
- Pregnant and nursing women.
Sites / Locations
- Chan Soon-Shiong Institute for Medicine
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
NANT Squamous Cell Carcinoma (SCC) Vaccine
Arm Description
Combination of agents will be administered in this study: Aldoxorubicin HCl, ETBX-011, ETBX-021, ETBX-051, ETBX-061, GI-4000, GI-6207, GI-6301, haNK, N-803, avelumab, bevacizumab, capecitabine, cetuximab, cisplatin, cyclophosphamide, fluorouracil, leucovorin, nab-paclitaxel, necitumumab, SBRT.
Outcomes
Primary Outcome Measures
Incidence of treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs), graded using the NCI CTCAE Version 4.03.
Phase 1b primary endpoint
Objective response rate by RECIST
Phase 2 primary endpoint
Secondary Outcome Measures
Objective response rate by RECIST
Phase 1b secondary endpoint
Objective response rate by irRC
Phase 1b secondary endpoint
Progression-free survival by RECIST during Phase 1b
Phase 1b secondary endpoint
Progression-free survival by irRC during Phase 1b
Phase 1b secondary endpoint
Overall survival
Phase 1b secondary endpoint
Duration of response by RECIST and irRC
Phase 1b secondary endpoint
Disease control rate (confirmed complete response, partial response, or stable disease lasting for at least 2 months) by RECIST and irRC.
Phase 1b secondary endpoint
Patient-reported outcomes of pancreatic cancer symptoms
Phase 1b secondary endpoint
Objective response rate by irRC
Phase 2 secondary endpoint
Progression-free survival by RECIST during Phase 2
Phase 2 secondary endpoint
Progression-free survival by irRC during Phase 2
Phase 2 secondary endpoint
Overall survival
Phase 2 secondary endpoint
Duration of response by RECIST and irRC
Phase 2 secondary endpoint
Disease control rate (confirmed complete response, partial response, or stable disease lasting for at least 2 months) by RECIST and irRC.
Phase 2 secondary endpoint
Patient-reported outcomes of pancreatic cancer symptoms
Phase 2 secondary endpoint
Incidence of treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs), graded using the NCI CTCAE Version 4.03.
Phase 2 secondary endpoint
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03387111
Brief Title
QUILT-3.090: NANT Squamous Cell Carcinoma (SCC) Vaccine: Subjects With SCC Who Have Progressed
Official Title
QUILT-3.090: NANT Squamous Cell Carcinoma (SCC) Vaccine: Molecularly Informed Integrated Immunotherapy Combining (haNK) Cell Therapy With Adenoviral and Yeast-based Vaccines to Induce T-cell Responses in Subjects With SCC Who Have Progressed on or After Platinum-based Chemotherapy and Anti-programmed Cell Death Protein 1 (PD-1)/Programmed Death-ligand 1 (PD-L1) Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
August 2020
Overall Recruitment Status
Unknown status
Study Start Date
January 13, 2018 (Actual)
Primary Completion Date
January 2021 (Anticipated)
Study Completion Date
April 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ImmunityBio, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a phase 1b/2 study to evaluate the safety and efficacy of metronomic combination therapy in subjects with SCC who have progressed on or after previous platinum-based chemotherapy and anti-PD-1/PD-L1 therapy. Phase 2 will be based on Simon's two-stage optimal design.
Detailed Description
Treatment will be administered in 2 phases, an induction and a maintenance phase, as described below. Subjects will continue induction treatment for up to 1 year. Treatment in the study will be discontinued if the subject experiences progressive disease (PD) or unacceptable toxicity (not corrected with dose reduction), withdraws consent, or if the Investigator feels it is no longer in the subject's best interest to continue treatment. Those who have a complete response (CR) in the induction phase will enter the maintenance phase of the study. Subjects who experience ongoing stable disease (SD) or an ongoing partial response (PR) at 1 year may enter the maintenance phase at the Investigator's and Sponsor's discretion. Subjects may remain in the maintenance phase of the study for up to 1 year. The duration of the maintenance phase can exceed 1 year if the subject continues to benefit, per the Investigator's and Sponsor's discretion. Treatment will continue in the maintenance phase until the subject experiences PD or unacceptable toxicity (not corrected with dose reduction), withdraws consent, or if the Investigator feels it is no longer in the subject's best interest to continue treatment. The time on study treatment, including both the induction and maintenance phases, is up to 2 years. The duration of the study may exceed 2 years if the subject remains in the maintenance phase for more than 1 year, as described above.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Squamous Cell Carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
65 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
NANT Squamous Cell Carcinoma (SCC) Vaccine
Arm Type
Experimental
Arm Description
Combination of agents will be administered in this study: Aldoxorubicin HCl, ETBX-011, ETBX-021, ETBX-051, ETBX-061, GI-4000, GI-6207, GI-6301, haNK, N-803, avelumab, bevacizumab, capecitabine, cetuximab, cisplatin, cyclophosphamide, fluorouracil, leucovorin, nab-paclitaxel, necitumumab, SBRT.
Intervention Type
Drug
Intervention Name(s)
Aldoxorubicin HCl
Intervention Description
Aldoxorubicin hydrochloride
Intervention Type
Biological
Intervention Name(s)
ETBX-011
Intervention Description
Ad5 [E1-, E2b-]-CEA
Intervention Type
Biological
Intervention Name(s)
ETBX-021
Intervention Description
Ad5 [E1-, E2b-]-HER2
Intervention Type
Biological
Intervention Name(s)
ETBX-051
Intervention Description
Ad5 [E1-, E2b-]-Brachyury vaccine
Intervention Type
Biological
Intervention Name(s)
ETBX-061
Intervention Description
Ad5 [E1-, E2b-]-MUC1
Intervention Type
Biological
Intervention Name(s)
GI-4000
Intervention Description
Vaccine derived from recombinant Saccharomyces cerevisiae yeast expressing mutant Ras proteins
Intervention Type
Biological
Intervention Name(s)
GI-6207
Intervention Description
Vaccine derived from recombinant Saccharomyces cerevisiae yeast expressing mutant CEA proteins
Intervention Type
Biological
Intervention Name(s)
GI-6301
Intervention Description
Vaccine derived from recombinant Saccharomyces cerevisiae yeast expressing mutant Brachyury yeast proteins
Intervention Type
Biological
Intervention Name(s)
haNK for infusion
Intervention Description
NK-92 [CD16.158V, ER IL-2]
Intervention Type
Drug
Intervention Name(s)
Avelumab
Intervention Description
Recombinant human anti-PD-L1 IgG1 monoclonal antibody
Intervention Type
Drug
Intervention Name(s)
bevacizumab
Intervention Description
Recombinant human anti-VEGF IgG1 monoclonal
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
5'-deoxy-5-fluoro-N-[(pentyloxy) carbonyl]-cytidine
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Intervention Description
Cetuximab is an epidermal growth factor receptor (EGFR) antagonist.
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
cis-diamminedichloroplatinum(II)
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
2-[bis(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate
Intervention Type
Drug
Intervention Name(s)
Fluorouracil
Intervention Description
5-fluoro-2,4 (1H,3H)-pyrimidinedione
Intervention Type
Drug
Intervention Name(s)
Leucovorin
Intervention Description
L-Glutamic acid, N-[4-[[(2-amino-5-formyl-1,4,5,6,7,8-hexahydro-4-oxo-6-pteridinyl)methyl]amino]benzoyl]-, calcium salt
Intervention Type
Drug
Intervention Name(s)
nab-Paclitaxel
Intervention Description
Benzenepropanoic acid, β-(benzoylamino)-α-hydroxy-(2aR, 4S, 4aS, 6R, 9S, 11S, 12S, 12aR, 12bS)-6,12b-bis(acetyloxy)-12-(benzoyloxy)-2a, 3, 4, 4a, 5, 6, 9, 10, 11, 12, 12a, 12b-dodecahydro-4,11-dihydroxy-4a, 8, 13, 13-tetramethyl-5-oxo-7,11-methano-1H-cyclodeca[3,4]benz[1,2-b]oxet-9-y1ester,(αR,βS)-(9CI) bound to albumin
Intervention Type
Drug
Intervention Name(s)
Necitumumab
Intervention Description
Necitumumab is a recombinant human lgG1 monoclonal antibody.
Intervention Type
Procedure
Intervention Name(s)
SBRT
Intervention Description
Stereotactic Body Radiation Therapy
Intervention Type
Biological
Intervention Name(s)
N-803
Other Intervention Name(s)
Formerly known as ALT-803
Intervention Description
Recombinant human superagonist interleukin-15 (IL-15) complex [also known as IL-15N72D:IL-15RuSu/IgGI Fe complex1)
Primary Outcome Measure Information:
Title
Incidence of treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs), graded using the NCI CTCAE Version 4.03.
Description
Phase 1b primary endpoint
Time Frame
8 weeks
Title
Objective response rate by RECIST
Description
Phase 2 primary endpoint
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Objective response rate by RECIST
Description
Phase 1b secondary endpoint
Time Frame
8 weeks
Title
Objective response rate by irRC
Description
Phase 1b secondary endpoint
Time Frame
8 weeks
Title
Progression-free survival by RECIST during Phase 1b
Description
Phase 1b secondary endpoint
Time Frame
8 weeks
Title
Progression-free survival by irRC during Phase 1b
Description
Phase 1b secondary endpoint
Time Frame
8 weeks
Title
Overall survival
Description
Phase 1b secondary endpoint
Time Frame
8 weeks
Title
Duration of response by RECIST and irRC
Description
Phase 1b secondary endpoint
Time Frame
1 year
Title
Disease control rate (confirmed complete response, partial response, or stable disease lasting for at least 2 months) by RECIST and irRC.
Description
Phase 1b secondary endpoint
Time Frame
1 year
Title
Patient-reported outcomes of pancreatic cancer symptoms
Description
Phase 1b secondary endpoint
Time Frame
8 weeks
Title
Objective response rate by irRC
Description
Phase 2 secondary endpoint
Time Frame
1 year
Title
Progression-free survival by RECIST during Phase 2
Description
Phase 2 secondary endpoint
Time Frame
1 year
Title
Progression-free survival by irRC during Phase 2
Description
Phase 2 secondary endpoint
Time Frame
1 year
Title
Overall survival
Description
Phase 2 secondary endpoint
Time Frame
1 year
Title
Duration of response by RECIST and irRC
Description
Phase 2 secondary endpoint
Time Frame
1 year
Title
Disease control rate (confirmed complete response, partial response, or stable disease lasting for at least 2 months) by RECIST and irRC.
Description
Phase 2 secondary endpoint
Time Frame
1 year
Title
Patient-reported outcomes of pancreatic cancer symptoms
Description
Phase 2 secondary endpoint
Time Frame
1 year
Title
Incidence of treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs), graded using the NCI CTCAE Version 4.03.
Description
Phase 2 secondary endpoint
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥ 18 years.
Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.
Histologically-confirmed HNSCC or squamous NSCLC with progression on or after platinum-based chemotherapy and anti-PD-1/PD-L1 therapy.
Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
Have at least 1 measurable lesion of ≥ 1.0 cm.
Must have a recent formalin-fixed, paraffin-embedded (FFPE) tumor biopsy specimen following the conclusion of the most recent anticancer treatment. If an historic specimen is not available, the subject must be willing to undergo a biopsy during the screening period, if considered safe by the Investigator. If safety concerns preclude collection of a biopsy during the screening period, a tumor biopsy specimen collected prior to the conclusion of the most recent anticancer treatment may be used.
Must be willing to provide blood samples prior to the start of treatment on this study.
Must be willing to provide a tumor biopsy specimen 8 weeks after the start of treatment, if considered safe by the Investigator.
Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception for up to 1 year after completion of therapy, and non-sterile male subjects must agree to use a condom for up to 4 months after treatment. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, intrauterine devices (IUDs), and abstinence.
Exclusion Criteria:
Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.
Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, or autoimmune disease associated with lymphoma).
History of organ transplant requiring immunosuppression.
History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
Inadequate organ function, evidenced by the following laboratory results:
Absolute neutrophil count < 1,000 cells//mm^3.
Uncorrectable grade 3 anemia (hemoglobin < 8 g/dL).
Platelet count < 75,000 cells/mm^3.
Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome).
Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases).
Alkaline phosphatase levels > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases).
Serum creatinine > 2.0 mg/dL or 177 μmol/L.
Serum anion gap > 16 mEq/L or arterial blood with pH < 7.3.
Uncontrolled hypertension (systolic > 160 mm Hg and/or diastolic > 110 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication. Subjects with uncontrolled hypertension should be medically managed on a stable regimen to control hypertension prior to study entry.
Serious myocardial dysfunction defined by ECHO as absolute left ventricular ejection fraction (LVEF) 10% below the institution's lower limit of predicted normal.
Dyspnea at rest due to complications of advanced malignancy or other disease requiring continuous oxygen therapy.
Positive results of screening test for human immunodeficiency virus (HIV).
Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.
Known hypersensitivity to any component of the study medication(s).
Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.
Concurrent or prior use of a strong cytochrome P450 (CYP)3A4 inhibitor (including ketoconazole, itraconazole, posaconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, and grapefruit products) or strong CYP3A4 inducers (including phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St John's Wort) within 14 days before study day 1.
Concurrent or prior use of a strong CYP2C8 inhibitor (gemfibrozil) or moderate CYP2C8 inducer (rifampin) within 14 days before study day 1.
Participation in an investigational drug study or history of receiving any investigational treatment within 30 days prior to screening for this study, except for testosterone-lowering therapy in men with prostate cancer.
Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
Concurrent participation in any interventional clinical trial.
Pregnant and nursing women.
Facility Information:
Facility Name
Chan Soon-Shiong Institute for Medicine
City
El Segundo
State/Province
California
ZIP/Postal Code
90245
Country
United States
12. IPD Sharing Statement
Learn more about this trial
QUILT-3.090: NANT Squamous Cell Carcinoma (SCC) Vaccine: Subjects With SCC Who Have Progressed
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