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A Clinical Study of PD-L1 Antibody ZKAB001(Drug Code) in Recurrent or Metastatic Cervical Cancer

Primary Purpose

Cervical Cancer

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
ZKAB001 5mg/kg
ZKAB001 10mg/kg
ZKAB001 15mg/kg
Sponsored by
Lee's Pharmaceutical Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. The subject voluntarily gives written informed consent to participate in the study.
  2. Female subjects aged≥18 years.
  3. Recurrent or metastatic cervical cancer was diagnosed by histopathology or cytology and received first-line platinum-containing regimens that failed or could not be tolerated. The definition of first-line failure: progress during adjuvant therapy or within 6 months after the end of treatment, and the first progress after palliative treatment.
  4. Based on RECIST1.1, imaging evaluation confirmed that there was at least one measurable disease.
  5. Eastern Cooperative Oncology Group(ECOG) performance status of 0 or 1, with estimated life expectancy of at least 3 months.
  6. Adequate blood routine, hepatic and renal function:

1) Absolute neutrophil count(ANC)≥109/L 2) Platelets ≥100x109/L 3) Hemoglobin ≥9g/dL 4) Serum albumin ≥2.8g/dL 5) Bilirubin ≤1.5x Upper limit of normal(ULN) 6) ALT and AST ≤1.5xULN, if If liver metastases are present, alanine transaminase(ALT) and aspartate transaminase(AST) should be ≤5xULN 7) Creatinine clearance rate ≥50ml/min (Cockcroft-Gault equation) 7.Female reproductive subjects should take effective contraception during the study period and within 3 months after the study treatment period. The serum or urine human chorionic gonadotropin (HCG)examination must be negative within 7 days before the subject is enrolled.

Exclusion Criteria:

  1. There are known active or suspected autoimmune diseases. Those who are in a stable state and do not need systemic immunosuppressive therapy can be included.
  2. Patients are using immunosuppressive agents, or systemic, or absorbable topical corticosteroid medications to achieve immunosuppressive purposes (doses >10mg/day prednisone or equivalent), which is ongoing 2 weeks before enrollment.
  3. Have received any form of organ transplantation, including allogeneic stem cell transplantation.
  4. Known allergy to macromolecular protein inhibitors or any of the components of ZKAB001.
  5. Suffering from other malignant tumors other than this diseases in 5 years except for skin basal cell and squamous cell carcinoma.
  6. Central nervous system metastases with clinical symptoms (such as cerebral edema and brain metastases requiring corticosteroid intervention). Previous treatment with brain or meningeal metastasis, such as clinical stabilization (MRI) less than 2 months, or systemic corticosteroid (dose >10mg/day prednisone or equivalent) less than 2 weeks.
  7. Patients with clinical symptoms or diseases of the heart that cannot be well controlled, such as heart failure above New York Heart Association ( NYHA ) 2 grade, unstable angina pectoris, myocardial infarction in 1 year, and clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention, have left ventricular ejection fraction < 50% at rest in the ultrasound cardiogram.
  8. Patients who had received radiotherapy, chemotherapy, surgery or molecular targeted therapy before, were given less than 4 weeks.
  9. Within 14 days before the first use of the drug, any active infection requiring systematic anti-infective treatment.
  10. Human immunodeficiency virus (HIV) positive, untreated active hepatitis (hepatitis B surface antigen positive and peripheral blood HBV-DNA titer ≥ 500IU/ml or positive copy number detected by the research center; hepatitis C virus antibody positive)
  11. There is a history of active pulmonary tuberculosis within 1 year before entering the group.
  12. The patient is participating in other clinical studies or is less than 1 month away from the end of the previous clinical study.
  13. Patients may need to receive other systemic cancer treatment during study period.
  14. Received blood transfusion and hematopoietic stimulating factors, such as colony stimulating factor, erythropoietin, thrombopoietin, etc., within 14 days before screening.
  15. Prior therapy with an anti-PD 1, anti-PD L1, or anti-CTLA-4 (Cytotoxic T lymphocyte Antigen-4) antibody (or any other agents that target immunoregulatory receptor).
  16. Subjects who received live vaccine within 4 weeks before screening.
  17. History of mental drug abuse, alcohol abuse or drug abuse.
  18. Pregnant or lactating women.
  19. Any mental condition that prevents the understanding or provision of an informed consent.
  20. It is determined by the investigator that the patient has other factors that may lead to the termination of the study, such as other serious diseases or serious laboratory test abnormalities or other factors that may affect the safety of the patients, family or social factors that may affect the study data and sample collection.

Sites / Locations

  • Chinese Academy of Medical Sciences and Peking Union Medical CollegeRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

ZKAB001 5mg/kg

ZKAB001 10 mg/kg

ZKAB001 15 mg/kg

Arm Description

Three or six patients will be treated with the dose of 5 mg/kg/time of ZKAB001 IV bi-weekly. DLT will be observed within 28 days after administration.

Three or six patients will be treated with the dose of 10 mg/kg/time of ZKAB001 IV bi-weekly. DLT will be observed within 28 days after administration.

Three or six patients will be treated with the dose of 15 mg/kg/time of ZKAB001 IV bi-weekly. DLT will be observed within 28 days after administration.

Outcomes

Primary Outcome Measures

RP2D
Recommended phase II dose.
Objective response rate
The proportion of subjects who achieved the best objective response rate (PR or CR).
Tolerance
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Secondary Outcome Measures

Effect of ZKAB001 on T cell function and cytokine expression
The response of CD4+ and CD8+ cells to tumor at baseline and after each administration will be detected by flow cytometry.
The number of subjects presenting detectable anti drug antibodies (ADAs)
To evaluated the number of subjects presenting detectable anti drug antibodies (ADAs).
Receptor occupancy
Monocytes will be isolated from peripheral blood before each cycle of administration, and the receptor occupancy of PD-L1 on CD3+T cells will be determined.
PD-L1 expression
Detection of PD-L1 expression in tumor tissues.
progression free survival(PFS)
Evaluate the PFS of the study population
overall survival
Evaluate the OS of the study population
duration of response
Evaluate the DOR of the study population
best of response
Evaluate the BOR of the study population

Full Information

First Posted
September 12, 2018
Last Updated
May 10, 2021
Sponsor
Lee's Pharmaceutical Limited
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1. Study Identification

Unique Protocol Identification Number
NCT03676959
Brief Title
A Clinical Study of PD-L1 Antibody ZKAB001(Drug Code) in Recurrent or Metastatic Cervical Cancer
Official Title
An Open-label, Dose-escalation, Bi-weekly Phase I Clinical Trial in Treating Patients With Recurrent or Metastatic Cervical Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Unknown status
Study Start Date
August 16, 2018 (Actual)
Primary Completion Date
May 15, 2022 (Anticipated)
Study Completion Date
October 15, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lee's Pharmaceutical Limited

4. Oversight

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

5. Study Description

Brief Summary
This is a Phase 1, open-label, dose-escalation, and multidose study, aiming to investigate the safety, tolerability and pharmacokinetics(PK) of ZKAB001 (a fully human monoclonal antibody targeting the Programmed Death - Ligand 1 (PD-L1) membrane receptor on T lymphocytes and other cells of the immune system) administered every 14 days in subjects with recurrent or metastatic cervical cancer.
Detailed Description
The study will consist of 4 periods: Screening (up to 28 days), Lead-in period (Day -28), Treatment (up to 24 cycles or 1 year, whichever occurs first), and Follow-up (up to 1 year). There will be a lead-in period on Day -28 for each dose escalation cohort in which the single-dose pharmacokinetics of ZKAB001 will be characterized prior to initiation of continuous dosing in the first cycle of treatment. The lead-in period duration, PK time-points, doses and/or regimens used in subsequent cohorts may be modified based on the exposure (AUC) observed during the lead-in period (although the number of PK samples will not be increased). Treatment of continuous dosing is up to 24 cycles or 1 year, until as per investigator's opinion, subjects experience disease progression (evaluated by RECIST 1.1 and immune-related response criteria irRECIST), no clinical benefit, or intolerable toxicity. If investigators suspect subjects experience pseudoprogression or has evidence to prove "mixed response", subjects can continue to accept treatment as investigator decided. The study was divided into two stages. After the recommended phase II dose (RP2D) is determined in the first stage, the sample size will be amplified with RP2D in the second stage. When a total of 15 cases are included in the two stages, an interim analysis will be conducted to decide whether to expand the total number of cases to 60 based on the results of the analysis. If more than 2 cases of response will be observed in 15 cervical cancer subjects, 45 cases (with a total sample size of 60 cases) could be included to further observe the safety and efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cervical Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
101 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ZKAB001 5mg/kg
Arm Type
Experimental
Arm Description
Three or six patients will be treated with the dose of 5 mg/kg/time of ZKAB001 IV bi-weekly. DLT will be observed within 28 days after administration.
Arm Title
ZKAB001 10 mg/kg
Arm Type
Experimental
Arm Description
Three or six patients will be treated with the dose of 10 mg/kg/time of ZKAB001 IV bi-weekly. DLT will be observed within 28 days after administration.
Arm Title
ZKAB001 15 mg/kg
Arm Type
Experimental
Arm Description
Three or six patients will be treated with the dose of 15 mg/kg/time of ZKAB001 IV bi-weekly. DLT will be observed within 28 days after administration.
Intervention Type
Drug
Intervention Name(s)
ZKAB001 5mg/kg
Other Intervention Name(s)
PD-L1 monoclonal antibody
Intervention Description
5mg/kg/times bi-week IV administration of ZKAB001
Intervention Type
Drug
Intervention Name(s)
ZKAB001 10mg/kg
Other Intervention Name(s)
PD-L1 monoclonal antibody
Intervention Description
10mg/kg/times bi-week IV administration of ZKAB001
Intervention Type
Drug
Intervention Name(s)
ZKAB001 15mg/kg
Other Intervention Name(s)
PD-L1 monoclonal antibody
Intervention Description
15mg/kg/times bi-week IV administration of ZKAB001
Primary Outcome Measure Information:
Title
RP2D
Description
Recommended phase II dose.
Time Frame
28 days after first dose
Title
Objective response rate
Description
The proportion of subjects who achieved the best objective response rate (PR or CR).
Time Frame
2 years
Title
Tolerance
Description
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Effect of ZKAB001 on T cell function and cytokine expression
Description
The response of CD4+ and CD8+ cells to tumor at baseline and after each administration will be detected by flow cytometry.
Time Frame
through study completion, an average of 2 years
Title
The number of subjects presenting detectable anti drug antibodies (ADAs)
Description
To evaluated the number of subjects presenting detectable anti drug antibodies (ADAs).
Time Frame
through study completion, an average of 2 years
Title
Receptor occupancy
Description
Monocytes will be isolated from peripheral blood before each cycle of administration, and the receptor occupancy of PD-L1 on CD3+T cells will be determined.
Time Frame
through study completion, an average of 2 years
Title
PD-L1 expression
Description
Detection of PD-L1 expression in tumor tissues.
Time Frame
through study completion, an average of 2 years
Title
progression free survival(PFS)
Description
Evaluate the PFS of the study population
Time Frame
through study completion, an average of 2 years
Title
overall survival
Description
Evaluate the OS of the study population
Time Frame
through study completion, an average of 2 years
Title
duration of response
Description
Evaluate the DOR of the study population
Time Frame
through study completion, an average of 2 years
Title
best of response
Description
Evaluate the BOR of the study population
Time Frame
through study completion, an average of 2 years

10. Eligibility

Sex
Female
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject voluntarily gives written informed consent to participate in the study. Female subjects aged≥18 years. Recurrent or metastatic cervical cancer was diagnosed by histopathology or cytology and received first-line platinum-containing regimens that failed or could not be tolerated. The definition of first-line failure: progress during adjuvant therapy or within 6 months after the end of treatment, and the first progress after palliative treatment. Based on RECIST1.1, imaging evaluation confirmed that there was at least one measurable disease. Eastern Cooperative Oncology Group(ECOG) performance status of 0 or 1, with estimated life expectancy of at least 3 months. Adequate blood routine, hepatic and renal function: 1) Absolute neutrophil count(ANC)≥109/L 2) Platelets ≥100x109/L 3) Hemoglobin ≥9g/dL 4) Serum albumin ≥2.8g/dL 5) Bilirubin ≤1.5x Upper limit of normal(ULN) 6) ALT and AST ≤1.5xULN, if If liver metastases are present, alanine transaminase(ALT) and aspartate transaminase(AST) should be ≤5xULN 7) Creatinine clearance rate ≥50ml/min (Cockcroft-Gault equation) 7.Female reproductive subjects should take effective contraception during the study period and within 3 months after the study treatment period. The serum or urine human chorionic gonadotropin (HCG)examination must be negative within 7 days before the subject is enrolled. Exclusion Criteria: There are known active or suspected autoimmune diseases. Those who are in a stable state and do not need systemic immunosuppressive therapy can be included. Patients are using immunosuppressive agents, or systemic, or absorbable topical corticosteroid medications to achieve immunosuppressive purposes (doses >10mg/day prednisone or equivalent), which is ongoing 2 weeks before enrollment. Have received any form of organ transplantation, including allogeneic stem cell transplantation. Known allergy to macromolecular protein inhibitors or any of the components of ZKAB001. Suffering from other malignant tumors other than this diseases in 5 years except for skin basal cell and squamous cell carcinoma. Central nervous system metastases with clinical symptoms (such as cerebral edema and brain metastases requiring corticosteroid intervention). Previous treatment with brain or meningeal metastasis, such as clinical stabilization (MRI) less than 2 months, or systemic corticosteroid (dose >10mg/day prednisone or equivalent) less than 2 weeks. Patients with clinical symptoms or diseases of the heart that cannot be well controlled, such as heart failure above New York Heart Association ( NYHA ) 2 grade, unstable angina pectoris, myocardial infarction in 1 year, and clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention, have left ventricular ejection fraction < 50% at rest in the ultrasound cardiogram. Patients who had received radiotherapy, chemotherapy, surgery or molecular targeted therapy before, were given less than 4 weeks. Within 14 days before the first use of the drug, any active infection requiring systematic anti-infective treatment. Human immunodeficiency virus (HIV) positive, untreated active hepatitis (hepatitis B surface antigen positive and peripheral blood HBV-DNA titer ≥ 500IU/ml or positive copy number detected by the research center; hepatitis C virus antibody positive) There is a history of active pulmonary tuberculosis within 1 year before entering the group. The patient is participating in other clinical studies or is less than 1 month away from the end of the previous clinical study. Patients may need to receive other systemic cancer treatment during study period. Received blood transfusion and hematopoietic stimulating factors, such as colony stimulating factor, erythropoietin, thrombopoietin, etc., within 14 days before screening. Prior therapy with an anti-PD 1, anti-PD L1, or anti-CTLA-4 (Cytotoxic T lymphocyte Antigen-4) antibody (or any other agents that target immunoregulatory receptor). Subjects who received live vaccine within 4 weeks before screening. History of mental drug abuse, alcohol abuse or drug abuse. Pregnant or lactating women. Any mental condition that prevents the understanding or provision of an informed consent. It is determined by the investigator that the patient has other factors that may lead to the termination of the study, such as other serious diseases or serious laboratory test abnormalities or other factors that may affect the safety of the patients, family or social factors that may affect the study data and sample collection.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
lingying Wu, M.D
Phone
13910865483
Email
wulingying@csco.org.cn
First Name & Middle Initial & Last Name or Official Title & Degree
hong Fang, master
Phone
010-87788714
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
lingying Wu, M.D
Organizational Affiliation
Tumor Hospital of the Chinese Academy of Medical Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Chinese Academy of Medical Sciences and Peking Union Medical College
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100000
Country
China
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
36136294
Citation
An J, Tang J, Li BX, Xiong H, Qiu H, Luo L, Wang L, Wang D, Zhou Q, Xu Q, Song H, Zhang Y, Zhang H, Li Y, Yu X, Zhang J, Ng R, Zhao W, Wong M, Dai X, Li G, Wu L. Efficacy and Safety of the Anti-PD-L1 mAb Socazolimab for Recurrent or Metastatic Cervical Cancer: a Phase I Dose-Escalation and Expansion Study. Clin Cancer Res. 2022 Dec 1;28(23):5098-5106. doi: 10.1158/1078-0432.CCR-22-1280.
Results Reference
derived

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A Clinical Study of PD-L1 Antibody ZKAB001(Drug Code) in Recurrent or Metastatic Cervical Cancer

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