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Study of PI3Kinase Inhibition (Copanlisib) and Anti-PD-1 Antibody Nivolumab in Relapsed/Refractory Solid Tumors With Expansions in Mismatch-repair Proficient (MSS) Colorectal Cancer

Primary Purpose

Unresectable or Metastatic Microsatellite Stable (MSS) Solid Tumor Along With Microsatellite Stable (MSS) Colon Cancer, Colon Cancer

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Copanlisib
Nivolumab
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Unresectable or Metastatic Microsatellite Stable (MSS) Solid Tumor Along With Microsatellite Stable (MSS) Colon Cancer focused on measuring Immunotherapy, Nivolumab, Copanlisib, Unresectable, Metastatic, PD-1, P13K, Antibody, Solid Tumors, Colon Cancer, MSS, Mismatch-repair proficient, Microsatellite stable

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥18 years.
  • Ability to understand and willingness to sign a written informed consent document.
  • Phase I: Must have received all curative treatment options and at least 2 lines of systemic therapy.
  • Phase II: Must have received at least 2 lines of systemic therapy including a fluropyrimidine, oxaliplatin, and irinotecan-containing regimen. KRAS/NRAS/BRAF wildtype patients must have received or refused anti-EGR.
  • Must have received all curative treatment options and at least 2 lines of systemic and standard therapy.
  • Must have measurable disease based on RECIST 1.1
  • Must have biopsiable disease.
  • ECOG performance status 0 or 1
  • Life expectancy of greater than 3 months.
  • Patients must have adequate organ and marrow function defined by study-specified laboratory tests within 21 days of initial study drug.
  • Men must use acceptable form of birth control while on study.
  • Woman of childbearing potential must have a negative pregnancy test and follow contraceptive guidelines as defined per protocol.

Exclusion Criteria:

  • Prior treatment with immunotherapy agents (including, anti-PD-1, anti-PD-L1, anti- PD-L2, anti-CTLA4, etc.).
  • Prior therapy with a PI3K inhibitor
  • Chemotherapy, target small molecule therapy, investigational therapy, or surgery within 4 weeks prior to first dose of treatment.
  • Has received prior radiotherapy within 2 weeks prior to the start of treatment.
  • Patient who is receiving or have received any other investigational agents within 4 weeks prior to the first dose of treatment.
  • Has received a live vaccine 30 days prior to the first dose of study drug.
  • Has known additional malignancy that is progressing or requires active treatment..
  • Has known central nervous system (CNS) metastases and/or carcinomatous meningitis.
  • Has symptomatic ascites or has required a paracentesis in the last 12 weeks.
  • Hypersensitivity reaction to study drug.
  • Patients diagnosed of immunodeficiency or are on any immunosuppressive agents within 7 days prior to first dose of study drug.
  • Has active autoimmune disease that has required systemic treatment in the past 12 months, or a documented history of clinically severe autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents.
  • Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis.
  • Has an active infection requiring systemic therapy.
  • Infection with HIV or hepatitis B or C.
  • CMV PCR (cytomegalovirus polymerase chain reaction) positive.
  • Known history or concurrent interstitial lung disease.
  • Type I diabetes or Type II diabetes requiring treatment with a sulfonylurea, meglitinide, or insulin at screening.
  • Uncontrolled cardiovascular disease.
  • Patient with uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Use of anti-arrhythmic therapy (beta blockers or digoxin are permitted).
  • Use of CYP3A4 inhibitors and inducers within 2 weeks of starting study drug and throughout treatment.
  • Any arterial or venous thrombotic or embolic events within 3 months of start of study drug.
  • Non-healing wound, ulcer, or fracture.
  • Patients with evidence or history of bleeding condition.
  • Had a blood or platelet transfusion within 7 days of Cycle 1 Day 1 treatment.
  • Seizure disorder requiring anti-seizure medication.
  • Conditions, including alcohol or drug dependence, intercurrent illness, or lack of sufficient peripheral venous access, that would affect the patient's ability to comply with study visits and procedures.
  • Are pregnant or breastfeeding.
  • Unwilling or unable to follow the study schedule for any reason.

Sites / Locations

  • Sidney Kimmel Comprehensive Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Phase I - Copanlisib and Nivolumab (De-Escalation)

Phase II /Arm A-P13K mutation/Copanlisib and Nivolumab

Phase II/Arm B -P13K wild type /Copanlisib and Nivolumab

Arm Description

Outcomes

Primary Outcome Measures

Number of Participants Experiencing a Dose Limiting Toxicity
Number of participants experiencing a Dose Limiting Toxicity (DLT) in each dose level. DLT is defined as any of the following study drug-related toxicities occurring during the first cycle of study drug on study: Grade 4 anemia Grade ≥ 3 neutropenia lasting ≥ 14 days Grade ≥ 3 febrile neutropenia Grade 4 thrombocytopenia, or Grade 3 thrombocytopenia with clinically significant bleeding Treatment-related ≥ grade 4 AEs, except transient hyperglycemia Grade ≥ 3 Pneumonitis or recurrent Grade 2 pneumonitis Grade ≥ 3 Nephritis Grade ≥ 3 elevated AST or ALT Grade ≥ 2 eye pain or reduction of visual acuity that does not respond to topical therapy, improve to ≤ grade 1 within 2 weeks of topical therapy, or requires systemic therapy Any other Grade ≥ 3 toxicities (with certain exceptions for transient AEs or asymptomatic labs)
6-month Objective Response Rate (ORR) of Patients Treated With Copanlisib and Nivolumab
The proportion of subjects with partial response (PR) or complete response (CR) as defined by Response Evaluation Criteria in Solid Tumors (RECIST 1.1). Per RECIST 1.1, complete response is defined as disappearance of all target lesions, and partial response is defined as at least a 30% decrease in the sum of diameters of target lesions. Lesions are assessed by CT or MRI.

Secondary Outcome Measures

Disease Control Rate (DCR) Status at 6 Months.
Percentage of participants achieving stable disease (SD) or better (SD + PR + CR). Per RECIST 1.1, complete response is defined as disappearance of all target lesions, partial response is defined as at least a 30% decrease in the sum of diameters of target lesions, stable disease occurs when there is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (at least 20% increase). Lesions are assessed by CT or MRI.
Duration of Response (DOR)
Number of months from the first documentation of a response to date of disease progression.
Progression Free Survival (PFS)
Number of months from treatment to disease progression (PD)
Overall Survival (OS)
Number of months from the date of first treatment until death or end of follow-up.
Number of Participants Experiencing Study Drug-related Toxicities
Number of participants experiencing study drug-related adverse events Grade 3 or higher as defined by CTCAE v5.0.

Full Information

First Posted
October 15, 2018
Last Updated
September 1, 2023
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Bayer, Bristol-Myers Squibb
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1. Study Identification

Unique Protocol Identification Number
NCT03711058
Brief Title
Study of PI3Kinase Inhibition (Copanlisib) and Anti-PD-1 Antibody Nivolumab in Relapsed/Refractory Solid Tumors With Expansions in Mismatch-repair Proficient (MSS) Colorectal Cancer
Official Title
A Phase I/II Study of PI3Kinase Inhibition (Copanlisib) and Anti-PD-1 Antibody Nivolumab in Relapsed/Refractory Solid Tumors With Expansions in Mismatch-repair Proficient (MSS) Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 17, 2019 (Actual)
Primary Completion Date
June 14, 2022 (Actual)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Bayer, Bristol-Myers Squibb

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
A phase I/II study of PI3Kinase inhibition (copanlisib) and anti-PD-1 antibody nivolumab in relapsed/refractory solid tumors with expansions in mismatch-repair proficient (MSS) colorectal cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Unresectable or Metastatic Microsatellite Stable (MSS) Solid Tumor Along With Microsatellite Stable (MSS) Colon Cancer, Colon Cancer
Keywords
Immunotherapy, Nivolumab, Copanlisib, Unresectable, Metastatic, PD-1, P13K, Antibody, Solid Tumors, Colon Cancer, MSS, Mismatch-repair proficient, Microsatellite stable

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
48 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Phase I - Copanlisib and Nivolumab (De-Escalation)
Arm Type
Experimental
Arm Title
Phase II /Arm A-P13K mutation/Copanlisib and Nivolumab
Arm Type
Experimental
Arm Title
Phase II/Arm B -P13K wild type /Copanlisib and Nivolumab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Copanlisib
Other Intervention Name(s)
Bay 80-6946
Intervention Description
Copanlisib will be administered as a 60 minute IV infusion (-5min/+10min) at a dose of 45 mg - 60 mg IV. Copanlisib will be administered once a week (days 1, 8, and 15 or Day 1 and Day 15 of each 28 day cycle). Drug: 45 or 60 mg IV
Intervention Type
Drug
Intervention Name(s)
Nivolumab
Other Intervention Name(s)
OPDIVO, Bay 80-6946
Intervention Description
Nivolumab 480 mg will be administered as a 30 minute IV infusion (-5min/+10min) on Day 1 of each 28 day cycle. Drug: 480 mg IV
Primary Outcome Measure Information:
Title
Number of Participants Experiencing a Dose Limiting Toxicity
Description
Number of participants experiencing a Dose Limiting Toxicity (DLT) in each dose level. DLT is defined as any of the following study drug-related toxicities occurring during the first cycle of study drug on study: Grade 4 anemia Grade ≥ 3 neutropenia lasting ≥ 14 days Grade ≥ 3 febrile neutropenia Grade 4 thrombocytopenia, or Grade 3 thrombocytopenia with clinically significant bleeding Treatment-related ≥ grade 4 AEs, except transient hyperglycemia Grade ≥ 3 Pneumonitis or recurrent Grade 2 pneumonitis Grade ≥ 3 Nephritis Grade ≥ 3 elevated AST or ALT Grade ≥ 2 eye pain or reduction of visual acuity that does not respond to topical therapy, improve to ≤ grade 1 within 2 weeks of topical therapy, or requires systemic therapy Any other Grade ≥ 3 toxicities (with certain exceptions for transient AEs or asymptomatic labs)
Time Frame
28 days
Title
6-month Objective Response Rate (ORR) of Patients Treated With Copanlisib and Nivolumab
Description
The proportion of subjects with partial response (PR) or complete response (CR) as defined by Response Evaluation Criteria in Solid Tumors (RECIST 1.1). Per RECIST 1.1, complete response is defined as disappearance of all target lesions, and partial response is defined as at least a 30% decrease in the sum of diameters of target lesions. Lesions are assessed by CT or MRI.
Time Frame
6-months
Secondary Outcome Measure Information:
Title
Disease Control Rate (DCR) Status at 6 Months.
Description
Percentage of participants achieving stable disease (SD) or better (SD + PR + CR). Per RECIST 1.1, complete response is defined as disappearance of all target lesions, partial response is defined as at least a 30% decrease in the sum of diameters of target lesions, stable disease occurs when there is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (at least 20% increase). Lesions are assessed by CT or MRI.
Time Frame
6-months
Title
Duration of Response (DOR)
Description
Number of months from the first documentation of a response to date of disease progression.
Time Frame
2 years
Title
Progression Free Survival (PFS)
Description
Number of months from treatment to disease progression (PD)
Time Frame
2 years
Title
Overall Survival (OS)
Description
Number of months from the date of first treatment until death or end of follow-up.
Time Frame
2 years
Title
Number of Participants Experiencing Study Drug-related Toxicities
Description
Number of participants experiencing study drug-related adverse events Grade 3 or higher as defined by CTCAE v5.0.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years. Ability to understand and willingness to sign a written informed consent document. Phase I: Must have received all curative treatment options and at least 2 lines of systemic therapy. Phase II: Must have received at least 2 lines of systemic therapy including a fluoropyrimidine, oxaliplatin, and irinotecan-containing regimen. KRAS/NRAS/BRAF wildtype patients must have received or refused anti-EGR. Must have received all curative treatment options and at least 2 lines of systemic and standard therapy. Must have measurable disease based on RECIST 1.1 Must have biopsiable disease. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 Life expectancy of greater than 3 months. Patients must have adequate organ and marrow function defined by study-specified laboratory tests within 21 days of initial study drug. Men must use acceptable form of birth control while on study. Woman of childbearing potential must have a negative pregnancy test and follow contraceptive guidelines as defined per protocol. Exclusion Criteria: Prior treatment with immunotherapy agents (including, anti-PD-1, anti-PD-L1, anti- PD-L2, anti-CTLA4, etc.). Prior therapy with a PI3K inhibitor Chemotherapy, target small molecule therapy, investigational therapy, or surgery within 4 weeks prior to first dose of treatment. Has received prior radiotherapy within 2 weeks prior to the start of treatment. Patient who is receiving or have received any other investigational agents within 4 weeks prior to the first dose of treatment. Has received a live vaccine 30 days prior to the first dose of study drug. Has known additional malignancy that is progressing or requires active treatment.. Has known central nervous system (CNS) metastases and/or carcinomatous meningitis. Has symptomatic ascites or has required a paracentesis in the last 12 weeks. Hypersensitivity reaction to study drug. Patients diagnosed of immunodeficiency or are on any immunosuppressive agents within 7 days prior to first dose of study drug. Has active autoimmune disease that has required systemic treatment in the past 12 months, or a documented history of clinically severe autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents. Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis. Has an active infection requiring systemic therapy. Infection with HIV or hepatitis B or C. Cytomegalovirus polymerase chain reaction (CMV PCR) positive. Known history or concurrent interstitial lung disease. Type I diabetes or Type II diabetes requiring treatment with a sulfonylurea, meglitinide, or insulin at screening. Uncontrolled cardiovascular disease. Patient with uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Use of anti-arrhythmic therapy (beta blockers or digoxin are permitted). Use of CYP3A4 inhibitors and inducers within 2 weeks of starting study drug and throughout treatment. Any arterial or venous thrombotic or embolic events within 3 months of start of study drug. Non-healing wound, ulcer, or fracture. Patients with evidence or history of bleeding condition. Had a blood or platelet transfusion within 7 days of Cycle 1 Day 1 treatment. Seizure disorder requiring anti-seizure medication. Conditions, including alcohol or drug dependence, intercurrent illness, or lack of sufficient peripheral venous access, that would affect the patient's ability to comply with study visits and procedures. Are pregnant or breastfeeding. Unwilling or unable to follow the study schedule for any reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nilofer Azad, MD
Organizational Affiliation
Johns Hopkins Medical Institution
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sidney Kimmel Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
31619463
Citation
Morschhauser F, Machiels JP, Salles G, Rottey S, Rule SAJ, Cunningham D, Peyrade F, Fruchart C, Arkenau HT, Genvresse I, Liu L, Kochert K, Shen K, Kneip C, Pena CE, Grevel J, Zhang J, Cisternas G, Reschke S, Granvil C, Awada A. On-Target Pharmacodynamic Activity of the PI3K Inhibitor Copanlisib in Paired Biopsies from Patients with Malignant Lymphoma and Advanced Solid Tumors. Mol Cancer Ther. 2020 Feb;19(2):468-478. doi: 10.1158/1535-7163.MCT-19-0466. Epub 2019 Oct 16.
Results Reference
derived

Learn more about this trial

Study of PI3Kinase Inhibition (Copanlisib) and Anti-PD-1 Antibody Nivolumab in Relapsed/Refractory Solid Tumors With Expansions in Mismatch-repair Proficient (MSS) Colorectal Cancer

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