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TSR-022 (Anti-TIM-3 Antibody) and TSR-042 (Anti-PD-1 Antibody) in Patients With Liver Cancer

Primary Purpose

Adult Primary Liver Cancer, Advanced Adult Primary Liver Cancer, Localized Unresectable Adult Primary Liver Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
TSR-022 and TSR-042
Sponsored by
University of Hawaii
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adult Primary Liver Cancer focused on measuring immunotherapy, PD-1, TIM-3

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed hepatocellular cancer
  • Barcelona Clinic Liver Cancer Stage B or C
  • Cirrhosis grade of Child-Pugh class A or B7
  • Subjects with HBV infection are required to be receiving effective antiviral therapy and have a viral load less than 100 IU/mL. Antiviral therapy is not required for subjects with HCV infection
  • Have at least one tumor lesion that can be accurately measured according to Response Evaluation Criteria in Solid Tumor (RECIST v1.1)
  • No prior systemic therapy for HCC
  • Age ≥ 18 years
  • ECOG performance status 0-1
  • Resolved acute effects of any prior therapy to baseline or Grade ≤1 NCI CTCAE
  • Have adequate hematologic function as documented by ANC ≥ 1000/μcl, platelet count ≥ 60,000/μcl, and hemoglobin ≥ 8.5 mg/dl
  • Have adequate renal function as determined by a measured or calculated creatinine clearance ≥ 40 mL/min using the Cockcroft-Gault formula
  • Have adequate hepatic function, as documented by ALT and AST ≤5x upper limit of normal, total bilirubin ≤3 mg/dL, and albumin ≥2.8 g/dL
  • International normalized ratio (INR) or prothrombin time (PT) ≤2× ULN unless patient is receiving anticoagulant therapy as long as PT or partial thromboplastin (PTT) is within therapeutic range of intended use of anticoagulants
  • Prior local therapy, such as surgery, radioembolization, chemoembolization, or radiofrequency ablation is allowed if the index lesion(s) remains outside of the treatment field or has progressed since prior treatment
  • Participants must agree to not donate blood during the study or for 90 days after the last dose of protocol therapy
  • Female participant has a negative urine or serum pregnancy test within 7 days prior to taking study treatment if of childbearing potential and agrees to abstain from activities that could result in pregnancy from screening through 180 days after the last dose of study treatment, or is of nonchildbearing potential.
  • Participant must be able to understand the study procedures and agree to participate in the study by providing written informed consent.

Exclusion Criteria:

  • Participant must not be simultaneously enrolled in any interventional clinical trial
  • Participant must not have had major surgery ≤ 3 weeks prior to initiating protocol therapy and participant must have recovered from any surgical effects
  • Participants must not have received investigational therapy ≤4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is shorter, prior to initiating protocol therapy.
  • Active or untreated central nervous system (CNS) and leptomeningeal metastases are excluded
  • Prior therapy with any medication targeting PD-1, PD-L1, or TIM-3
  • Participant must not have a known hypersensitivity to TSR-042 and TSR-022 components or excipients.
  • Participants with active malignancy (other than HCC) or a prior malignancy within the past 2 years are excluded. Participants with completely resected cutaneous melanoma (early stage), basal cell carcinoma, cutaneous squamous cell carcinoma, cervical carcinoma in-situ, breast carcinoma in-situ, and localized prostate cancer are eligible
  • Participant must not have serious, uncontrolled medical disorder, or nonmalignant systemic disease. Examples include, but are not limited to uncontrolled ventricular arrhythmia, uncontrolled major seizure disorder, unstable spinal cord compression, or superior vena cava syndrome.
  • Unstable angina, new onset angina within last 3 months, myocardial infarction within last 6 months and current congestive heart failure New York Heart Association Class II or higher
  • Known history of Human Immunodeficiency Virus (HIV) infection
  • Active tuberculosis infection or other microbial infection or any active systemic infection requiring parenteral antibiotic therapy. All prior infections must have resolved following optimal therapy.
  • Participant has an active autoimmune disease that has required systemic treatment in the past 2 years (.ie., with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  • History of idiopathic pulmonary fibrosis, interstitial lung disease, bronchial asthma, organizing pneumonia, bronchiolitis obliterans, drug-induced pneumonitis, or idiopathic pneumonitis
  • History of organ transplantation including allogeneic bone marrow transplantation
  • Participant has a diagnosis of immunodeficiency or has receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to initiating protocol therapy.
  • Participant has received a live vaccine within 7 days of initiating protocol therapy.
  • Psychiatric illness/social situations that would limit compliance with study requirements
  • Pregnant, lactating, breastfeeding, or intending to become pregnant during the study and for 180 days after the study

Sites / Locations

  • University of HawaiiRecruiting
  • Oregon Health & Science University Knight Cancer InstituteRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TSR-022 (Cobolimab) and TSR-042 (Dostarlimab)

Arm Description

Patients receive TSR-022 (cobolimab, TIM-3 binding antibody) and TSR-042 (dostarlimab, PD-1 binding antibody) via IV day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Objective Response Rate
Determined by RECIST v1.1 criteria

Secondary Outcome Measures

Objective Response Rate (irRC)
Objective response as determined by the immune related Response Criteria
Duration of Response
Time from tumor response to progression
Time to progression
Time from treatment to progression of cancer
Progression free survival
Time from treatment to progression of cancer or death
Overall survival
Time from treatment to death
AFP response
Percentage of AFP decrease from baseline to nadir
Incidence of Treatment-Emergent Adverse Events as assessed by CTCAE v4.0
Tabulation of adverse events, CTCAE v4.0

Full Information

First Posted
September 18, 2018
Last Updated
October 18, 2023
Sponsor
University of Hawaii
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT03680508
Brief Title
TSR-022 (Anti-TIM-3 Antibody) and TSR-042 (Anti-PD-1 Antibody) in Patients With Liver Cancer
Official Title
Phase II Study of TSR-022 (Cobolimab) in Combination With TSR-042 (Dostarlimab) for the Treatment of Advanced Hepatocellular Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 19, 2019 (Actual)
Primary Completion Date
October 2024 (Anticipated)
Study Completion Date
October 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Hawaii
Collaborators
GlaxoSmithKline

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
TSR-022 (cobolimab, TIM-3 binding antibody) and TSR-042 (dostarlimab, PD-1 binding antibody) may stop the growth of tumor cells by allowing the immune system to attack the cancer. This phase II trial is studying how well TSR-022 (cobolimab, TIM-3 binding antibody) and TSR-042 (dostarlimab, PD-1 binding antibody) work in combination in treating patients with locally advanced or metastatic liver cancer.
Detailed Description
PRIMARY OBJECTIVES: I. To assess the objective response rate (ORR) as determined by RECIST v1.1 of advanced hepatocellular cancer (HCC) patients treated with TSR-022 (cobolimab, TIM-3 binding antibody) and TSR-042 (dostarlimab, PD-1 binding antibody). SECONDARY OBJECTIVES: I. To determine the ORR as determined by the immune related Response Criteria (irRC), duration of response (DOR), time to progression (TTP), progression free survival (PFS), overall survival (OS), and alpha-fetoprotein (AFP) response of study participants. II. To evaluate the safety profile of treated patients. OUTLINE: Patients receive TSR-022 (cobolimab, TIM-3 binding antibody) and TSR-042 (dostarlimab, PD-1 binding antibody) on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients are followed every 9 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adult Primary Liver Cancer, Advanced Adult Primary Liver Cancer, Localized Unresectable Adult Primary Liver Cancer
Keywords
immunotherapy, PD-1, TIM-3

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
42 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
TSR-022 (Cobolimab) and TSR-042 (Dostarlimab)
Arm Type
Experimental
Arm Description
Patients receive TSR-022 (cobolimab, TIM-3 binding antibody) and TSR-042 (dostarlimab, PD-1 binding antibody) via IV day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
TSR-022 and TSR-042
Other Intervention Name(s)
cobolimab, TIM-3 binding antibody, dostarlimab, PD-1 binding antibody
Intervention Description
immunotherapy
Primary Outcome Measure Information:
Title
Objective Response Rate
Description
Determined by RECIST v1.1 criteria
Time Frame
From date of treatment until the date of best documented response, assessed up to 36 months
Secondary Outcome Measure Information:
Title
Objective Response Rate (irRC)
Description
Objective response as determined by the immune related Response Criteria
Time Frame
From date of treatment until the date of best documented response, assessed up to 36 months
Title
Duration of Response
Description
Time from tumor response to progression
Time Frame
From date of treatment until the date of progression, assessed up to 36 months
Title
Time to progression
Description
Time from treatment to progression of cancer
Time Frame
From date of treatment until the date of progression, assessed up to 36 months
Title
Progression free survival
Description
Time from treatment to progression of cancer or death
Time Frame
From date of treatment until the date of progression or death, assessed up to 36 months
Title
Overall survival
Description
Time from treatment to death
Time Frame
From date of treatment until the date of death, assessed up to 36 months
Title
AFP response
Description
Percentage of AFP decrease from baseline to nadir
Time Frame
From treatment start to documentation of AFP progression, assessed up to 36 months.
Title
Incidence of Treatment-Emergent Adverse Events as assessed by CTCAE v4.0
Description
Tabulation of adverse events, CTCAE v4.0
Time Frame
From treatment until cessation of study treatment and resolution of adverse events, assessed up to 36 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed hepatocellular cancer Barcelona Clinic Liver Cancer Stage B or C Cirrhosis grade of Child-Pugh class A or B7 Subjects with HBV infection are required to be receiving effective antiviral therapy and have a viral load less than 100 IU/mL. Antiviral therapy is not required for subjects with HCV infection Have at least one tumor lesion that can be accurately measured according to Response Evaluation Criteria in Solid Tumor (RECIST v1.1) No prior systemic therapy for HCC Age ≥ 18 years ECOG performance status 0-1 Resolved acute effects of any prior therapy to baseline or Grade ≤1 NCI CTCAE Have adequate hematologic function as documented by ANC ≥ 1000/μcl, platelet count ≥ 60,000/μcl, and hemoglobin ≥ 8.5 mg/dl Have adequate renal function as determined by a measured or calculated creatinine clearance ≥ 40 mL/min using the Cockcroft-Gault formula Have adequate hepatic function, as documented by ALT and AST ≤5x upper limit of normal, total bilirubin ≤3 mg/dL, and albumin ≥2.8 g/dL International normalized ratio (INR) or prothrombin time (PT) ≤2× ULN unless patient is receiving anticoagulant therapy as long as PT or partial thromboplastin (PTT) is within therapeutic range of intended use of anticoagulants Prior local therapy, such as surgery, radioembolization, chemoembolization, or radiofrequency ablation is allowed if the index lesion(s) remains outside of the treatment field or has progressed since prior treatment Participants must agree to not donate blood during the study or for 90 days after the last dose of protocol therapy Female participant has a negative urine or serum pregnancy test within 7 days prior to taking study treatment if of childbearing potential and agrees to abstain from activities that could result in pregnancy from screening through 180 days after the last dose of study treatment, or is of nonchildbearing potential. Participant must be able to understand the study procedures and agree to participate in the study by providing written informed consent. Exclusion Criteria: Participant must not be simultaneously enrolled in any interventional clinical trial Participant must not have had major surgery ≤ 3 weeks prior to initiating protocol therapy and participant must have recovered from any surgical effects Participants must not have received investigational therapy ≤4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is shorter, prior to initiating protocol therapy. Active or untreated central nervous system (CNS) and leptomeningeal metastases are excluded Prior therapy with any medication targeting PD-1, PD-L1, or TIM-3 Participant must not have a known hypersensitivity to TSR-042 and TSR-022 components or excipients. Participants with active malignancy (other than HCC) or a prior malignancy within the past 2 years are excluded. Participants with completely resected cutaneous melanoma (early stage), basal cell carcinoma, cutaneous squamous cell carcinoma, cervical carcinoma in-situ, breast carcinoma in-situ, and localized prostate cancer are eligible Participant must not have serious, uncontrolled medical disorder, or nonmalignant systemic disease. Examples include, but are not limited to uncontrolled ventricular arrhythmia, uncontrolled major seizure disorder, unstable spinal cord compression, or superior vena cava syndrome. Unstable angina, new onset angina within last 3 months, myocardial infarction within last 6 months and current congestive heart failure New York Heart Association Class II or higher Known history of Human Immunodeficiency Virus (HIV) infection Active tuberculosis infection or other microbial infection or any active systemic infection requiring parenteral antibiotic therapy. All prior infections must have resolved following optimal therapy. Participant has an active autoimmune disease that has required systemic treatment in the past 2 years (.ie., with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. History of idiopathic pulmonary fibrosis, interstitial lung disease, bronchial asthma, organizing pneumonia, bronchiolitis obliterans, drug-induced pneumonitis, or idiopathic pneumonitis History of organ transplantation including allogeneic bone marrow transplantation Participant has a diagnosis of immunodeficiency or has receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to initiating protocol therapy. Participant has received a live vaccine within 7 days of initiating protocol therapy. Psychiatric illness/social situations that would limit compliance with study requirements Pregnant, lactating, breastfeeding, or intending to become pregnant during the study and for 180 days after the study
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jared D Acoba, MD
Phone
8085318521
Email
jacoba@hawaii.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Jill Drucker, MS
Phone
8085643989
Email
IIT@cc.hawaii.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jared D Acoba, MD
Organizational Affiliation
University of Hawaii
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Hawaii
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96813
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jared D Acoba, MD
Phone
808-531-8521
Email
jacoba@hawaii.edu
Facility Name
Oregon Health & Science University Knight Cancer Institute
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Adel Kardosh, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

TSR-022 (Anti-TIM-3 Antibody) and TSR-042 (Anti-PD-1 Antibody) in Patients With Liver Cancer

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