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Study of A166 in Patients With Relapsed/Refractory Cancers Expressing HER2 Antigen or Having Amplified HER2 Gene

Primary Purpose

HER2-positive Breast Cancer, HER2 Gene Mutation, HER-2 Gene Amplification

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
A166
Sponsored by
Klus Pharma Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HER2-positive Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

Phase I

Patients must meet the following criteria for inclusion into the study:

  1. Patients must be able to provide documented voluntary informed consent.
  2. Male or female patient ≥ 18 years.
  3. Histologically documented, incurable, locally advanced or metastatic cancer.
  4. Evaluable or measurable HER2 positive (by ISH or NGS) disease or HER2 expressing disease. HER2 expressing is defined in this protocol as HER2 expression of ≥ 1+ determined by validated IHC.
  5. Patients should have no available therapy likely to convey clinical benefit.
  6. Granulocyte count ≥ 1,500/μL, platelet count ≥ 100,000/μL, and hemoglobin ≥ 9 g/dL.
  7. Serum bilirubin ≤ 1.5 mg/dL, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase ≤ 2.5 × upper limit of normal (ULN), with the exception of patients with hepatic metastases (ALT and AST ≤ 5 × ULN) and patients with hepatic and/or bone metastases (alkaline phosphatase ≤ 5 × ULN).
  8. Creatinine clearance ≥ 50 mL/min calculated by Cockroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), or Modification of Diet in Renal Disease (MDRD) formulas. Note that 24 hour urine collection is not required but is allowed.
  9. ECOG Performance Status ≤ 1.
  10. Women of childbearing potential and men must agree to use an approved method of birth control (e.g., hormonal, barrier) while receiving study drug, and for at least 7 months after the last dose of study drug. Women are excluded from birth control if they had had tubal ligation or a hysterectomy.
  11. Patients must have recovered (i.e., improvement to Grade 1 or better) from all acute toxicities from previous therapy, excluding alopecia and vitiligo.

Exclusion Criteria:

Phase I:

  1. Severe or uncontrolled cardiac disease requiring treatment, congestive heart failure (New York Heart Association) III or IV, unstable angina pectoris even if medically controlled, history of myocardial infarction during the last 6 months, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia).
  2. History of Grade ≥ 3 hypersensitivity reaction to trastuzumab.
  3. History of any toxicity to trastuzumab that resulted in trastuzumab being permanently discontinued.
  4. Symptomatic brain metastases or any radiation or surgery for brain metastases within 3 months of first infusion of study drug.
  5. Require supplemental oxygen for daily activities.
  6. Documented Grade ≥ 2 peripheral neuropathy.
  7. Any chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or biologic therapy treatment within 4 weeks of first infusion of study drug.
  8. Any experimental therapy within 4 weeks of first infusion of study drug.
  9. Any major surgical procedure within 4 weeks of first infusion of study drug.
  10. Diagnosed active liver disease, including viral or other hepatitis, current or history of alcoholism, or cirrhosis. Patients who have positive hepatitis B virus test results due to having been previously vaccinated against hepatitis B, as evidenced by negative hepatitis B surface antigen (HBsAg), negative anti hepatitis B core protein, and positive antibody to the HBsAg (anti-HBs) are not excluded.
  11. Have known prior positive test results for human immunodeficiency virus.
  12. Uncontrolled hypertension or diabetes.
  13. Pregnancy or lactation.
  14. Resting corrected QT interval (QTc) > 470 ms at baseline.
  15. Left ventricular ejection fraction (LVEF) < 45% determined by echocardiogram (ECHO) or multigated acquisition (MUGA) scan.
  16. Prior cumulative doxorubicin dose of > 360 mg/m2 or equivalent.

Sites / Locations

  • Florida Cancer Specialists & Research Institute
  • Beth Israel Deaconess Medical Center Cancer Center
  • Karmanos Cancer Institute
  • Clinical Research Alliance, Inc.
  • Stephenson Cancer Center
  • Providence Cancer Institute
  • Mary Crowley Cancer Research Centers - Medical City
  • The University of Texas MD Anderson Cancer Center
  • South Texas Accelerated Research Therapeutics, LLC (START)
  • Virginia Cancer Specialist

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Phase I: Dose Escalation

Phase II: • Cohort 1

Phase II: • Cohort 2

Phase II: • Cohort 3

Phase II: • Cohort 4

Arm Description

Six dose levels have been selected for evaluation in the Phase I part of the study: 0.3, 0.6, 1.2, 2.4, 3.6, and 4.8 mg/kg of A166

HER2 positive (Immunohistochemistry (IHC) 2+ with fluorescence in situ hybridization (FISH) confirmation and Immunohistochemistry (IHC) 3+) breast cancer. Treatment with A166 at recommended Phase II dose.

HER2 positive (Immunohistochemistry (IHC) 2+ with fluorescence in situ hybridization (FISH) confirmation and Immunohistochemistry (IHC) 3+) gastric cancer. Treatment with A166 at recommended Phase II dose.

HER2 low expressing (Immunohistochemistry (IHC) 1+ and IHC 2+ without fluorescence in situ hybridization (FISH) confirmation) breast cancer. Treatment with A166 at recommended Phase II dose.

All cancers other than breast cancer with low HER2 expression (Immunohistochemistry (IHC) 1+ and IHC 2+ without fluorescence in situ hybridization (FISH) confirmation) and HER2 positive (IHC2+ with FISH confirmation and Immunohistochemistry (IHC) 3+) cancers other than breast and gastric cancer. Treatment with A166 at recommended Phase II dose.

Outcomes

Primary Outcome Measures

Phase I: Maximum Tolerated Dose
Number of patients with dose limiting toxicities

Secondary Outcome Measures

Phase I: Number of patients with Dose Limiting Toxicities
Phase I: Number of participants with treatment-related adverse events as assessed by CTCAE v4.03.
Phase I: Number of participants who developed measurable anti-drug antibodies
Phase I Maximum observed serum or plasma concentration (Cmax).
Phase I Clearance (CL).
Phase I Area under the serum or plasma concentration time curve from 0 to infinity (AUC[0-∞]).
Phase I Terminal phase elimination half life (t½).
Phase I Volume of distribution at terminal phase (Vz).
Phase I Volume of distribution at steady state (Vss).

Full Information

First Posted
July 6, 2018
Last Updated
August 2, 2023
Sponsor
Klus Pharma Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03602079
Brief Title
Study of A166 in Patients With Relapsed/Refractory Cancers Expressing HER2 Antigen or Having Amplified HER2 Gene
Official Title
A Phase I-II, FIH Study of A166 in Locally Advanced/Metastatic Solid Tumors Expressing Human Epidermal Growth Factor Receptor 2 (HER2) or Are HER2 Amplified That Did Not Respond or Stopped Responding to Approved Therapies
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
July 16, 2018 (Actual)
Primary Completion Date
January 12, 2022 (Actual)
Study Completion Date
January 12, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Klus Pharma 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
Open-label, Phase I-II, first-in-human (FIH) study for A166 monotherapy in HER2-expressing or amplified patients who progressed on or did not respond to available standard therapies. Patients must have documented HER2 expression or amplification. The patient must have exhausted available standard therapies. Patients will receive study drug as a single IV infusion. Cycles will continue until disease progression or unacceptable toxicity.
Detailed Description
This is an open-label, Phase I-II, first-in-human (FIH) study for A166 as monotherapy in HER2-expressing patients who progressed on or did not respond to available standard therapies. Patients enrolled in this Phase III study must have documented HER2 positivity defined as positive on in situ hybridization (ISH) or next-generation sequencing (NGS) or HER2 expression, defined as at least 1+ by validated immunohistochemistry (IHC) test. The patient must be, in the judgment of the investigator, an appropriate candidate for experimental therapy after available standard therapies have ceased to provide clinical benefit for their disease. Patients will receive study drug as a single IV infusion at the prescribed dose level in each treatment cycle. Cycles will continue until disease progression or unacceptable toxicity. The study is divided into 2 parts (Phase I and Phase II).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HER2-positive Breast Cancer, HER2 Gene Mutation, HER-2 Gene Amplification, HER2 Positive Gastric Cancer, Salivary Gland Cancer, Salivary Gland Tumor, Salivary Gland Carcinoma, Salivary Gland Neoplasms, Lung Cancer, Colo-rectal Cancer, Rare Diseases, Solid Tumor, Recurrent Gastric Cancer, Recurrent Colon Cancer, Recurrent Breast Cancer, Head and Neck Cancer, Head and Neck Carcinoma, Bladder Cancer, Cervical Cancer, Liver Cancer, Bile Duct Cancer, Urologic Cancer, Pancreatic Cancer, Prostate Cancer, Recurrent Prostate Cancer, Rectal Cancer, Recurrent Ovarian Carcinoma, Recurrent Renal Cell Cancer, Rectal Cancer Stage II, Rectal Cancer Stage I, Rectal Cancer Stage III, Skin Cancer, Mouth Cancer, Lip Cancer Stage I, Tongue Cancer, Breast Neoplasm Malignant Primary, Larynx Cancer, Tonsil Cancer, Palate Cancer, Mucoepidermoid Carcinoma, Primary Peritoneal Carcinoma, Mucinous Adenocarcinoma Gastric, Mucinous Breast Cancer Recurrent, Cholangiocarcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
49 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Phase I: Dose Escalation
Arm Type
Experimental
Arm Description
Six dose levels have been selected for evaluation in the Phase I part of the study: 0.3, 0.6, 1.2, 2.4, 3.6, and 4.8 mg/kg of A166
Arm Title
Phase II: • Cohort 1
Arm Type
Experimental
Arm Description
HER2 positive (Immunohistochemistry (IHC) 2+ with fluorescence in situ hybridization (FISH) confirmation and Immunohistochemistry (IHC) 3+) breast cancer. Treatment with A166 at recommended Phase II dose.
Arm Title
Phase II: • Cohort 2
Arm Type
Experimental
Arm Description
HER2 positive (Immunohistochemistry (IHC) 2+ with fluorescence in situ hybridization (FISH) confirmation and Immunohistochemistry (IHC) 3+) gastric cancer. Treatment with A166 at recommended Phase II dose.
Arm Title
Phase II: • Cohort 3
Arm Type
Experimental
Arm Description
HER2 low expressing (Immunohistochemistry (IHC) 1+ and IHC 2+ without fluorescence in situ hybridization (FISH) confirmation) breast cancer. Treatment with A166 at recommended Phase II dose.
Arm Title
Phase II: • Cohort 4
Arm Type
Experimental
Arm Description
All cancers other than breast cancer with low HER2 expression (Immunohistochemistry (IHC) 1+ and IHC 2+ without fluorescence in situ hybridization (FISH) confirmation) and HER2 positive (IHC2+ with FISH confirmation and Immunohistochemistry (IHC) 3+) cancers other than breast and gastric cancer. Treatment with A166 at recommended Phase II dose.
Intervention Type
Drug
Intervention Name(s)
A166
Intervention Description
A166 is an Antibody Drug Conjugate (ADC) targeting HER2 expressing cancer cells.
Primary Outcome Measure Information:
Title
Phase I: Maximum Tolerated Dose
Description
Number of patients with dose limiting toxicities
Time Frame
Minimum of 21 days from date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 24 months
Secondary Outcome Measure Information:
Title
Phase I: Number of patients with Dose Limiting Toxicities
Time Frame
Minimum of 21 days from date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 24 months
Title
Phase I: Number of participants with treatment-related adverse events as assessed by CTCAE v4.03.
Time Frame
Every 3 weeks from date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 24 months
Title
Phase I: Number of participants who developed measurable anti-drug antibodies
Time Frame
Minimum of 21 days from date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 24 months
Title
Phase I Maximum observed serum or plasma concentration (Cmax).
Time Frame
84 Days from date of first dose
Title
Phase I Clearance (CL).
Time Frame
84 Days from date of first dose
Title
Phase I Area under the serum or plasma concentration time curve from 0 to infinity (AUC[0-∞]).
Time Frame
84 Days from date of first dose
Title
Phase I Terminal phase elimination half life (t½).
Time Frame
84 Days from date of first dose
Title
Phase I Volume of distribution at terminal phase (Vz).
Time Frame
84 Days from date of first dose
Title
Phase I Volume of distribution at steady state (Vss).
Time Frame
84 Days from date of first dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Phase I Patients must meet the following criteria for inclusion into the study: Patients must be able to provide documented voluntary informed consent. Male or female patient ≥ 18 years. Histologically documented, incurable, locally advanced or metastatic cancer. Evaluable or measurable HER2 positive (by ISH or NGS) disease or HER2 expressing disease. HER2 expressing is defined in this protocol as HER2 expression of ≥ 1+ determined by validated IHC. Patients should have no available therapy likely to convey clinical benefit. Granulocyte count ≥ 1,500/μL, platelet count ≥ 100,000/μL, and hemoglobin ≥ 9 g/dL. Serum bilirubin ≤ 1.5 mg/dL, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase ≤ 2.5 × upper limit of normal (ULN), with the exception of patients with hepatic metastases (ALT and AST ≤ 5 × ULN) and patients with hepatic and/or bone metastases (alkaline phosphatase ≤ 5 × ULN). Creatinine clearance ≥ 50 mL/min calculated by Cockroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), or Modification of Diet in Renal Disease (MDRD) formulas. Note that 24 hour urine collection is not required but is allowed. ECOG Performance Status ≤ 1. Women of childbearing potential and men must agree to use an approved method of birth control (e.g., hormonal, barrier) while receiving study drug, and for at least 7 months after the last dose of study drug. Women are excluded from birth control if they had had tubal ligation or a hysterectomy. Patients must have recovered (i.e., improvement to Grade 1 or better) from all acute toxicities from previous therapy, excluding alopecia and vitiligo. Exclusion Criteria: Phase I: Severe or uncontrolled cardiac disease requiring treatment, congestive heart failure (New York Heart Association) III or IV, unstable angina pectoris even if medically controlled, history of myocardial infarction during the last 6 months, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia). History of Grade ≥ 3 hypersensitivity reaction to trastuzumab. History of any toxicity to trastuzumab that resulted in trastuzumab being permanently discontinued. Symptomatic brain metastases or any radiation or surgery for brain metastases within 3 months of first infusion of study drug. Require supplemental oxygen for daily activities. Documented Grade ≥ 2 peripheral neuropathy. Any chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or biologic therapy treatment within 4 weeks of first infusion of study drug. Any experimental therapy within 4 weeks of first infusion of study drug. Any major surgical procedure within 4 weeks of first infusion of study drug. Diagnosed active liver disease, including viral or other hepatitis, current or history of alcoholism, or cirrhosis. Patients who have positive hepatitis B virus test results due to having been previously vaccinated against hepatitis B, as evidenced by negative hepatitis B surface antigen (HBsAg), negative anti hepatitis B core protein, and positive antibody to the HBsAg (anti-HBs) are not excluded. Have known prior positive test results for human immunodeficiency virus. Uncontrolled hypertension or diabetes. Pregnancy or lactation. Resting corrected QT interval (QTc) > 470 ms at baseline. Left ventricular ejection fraction (LVEF) < 45% determined by echocardiogram (ECHO) or multigated acquisition (MUGA) scan. Prior cumulative doxorubicin dose of > 360 mg/m2 or equivalent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jordi Rodon Ahnert, MD, PhD
Organizational Affiliation
MD Anderson
Official's Role
Study Chair
Facility Information:
Facility Name
Florida Cancer Specialists & Research Institute
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34232
Country
United States
Facility Name
Beth Israel Deaconess Medical Center Cancer Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Clinical Research Alliance, Inc.
City
Lake Success
State/Province
New York
ZIP/Postal Code
11042
Country
United States
Facility Name
Stephenson Cancer Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Providence Cancer Institute
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States
Facility Name
Mary Crowley Cancer Research Centers - Medical City
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
South Texas Accelerated Research Therapeutics, LLC (START)
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Virginia Cancer Specialist
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of A166 in Patients With Relapsed/Refractory Cancers Expressing HER2 Antigen or Having Amplified HER2 Gene

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