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High-Risk Skin Cancers With Atezolizumab Plus NT-I7

Primary Purpose

Melanoma, Merkel Cell Carcinoma, Cutaneous Squamous Cell Carcinoma

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
NT-I7
atezolizumab
Sponsored by
NeoImmuneTech
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma

Eligibility Criteria

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

Key Inclusion Criteria:

  1. Patients must be ≥18 years of age on day of signing informed consent document.
  2. Eastern Cooperative Oncology Group (ECOG) performance status ≤2 (Karnofsky ≥60%).
  3. Patients must have adequate organ and marrow function.
  4. Patients positive for HIV can be considered.
  5. Arm I - cSCC: Patients must have biopsy-proven metastatic cSCC or locoregional cSCC that has recurred following standard locoregional therapy with surgery and/or radiation therapy; MCC: Patients must have biopsy-proven metastatic MCC or locoregional MCC in need of systemic therapy, including patients that have not had prior systemic therapy or have recurred following standard locoregional therapy with surgery and/or radiation therapy. Prior chemotherapy is allowed.
  6. Arm II - MCC: Patients must have biopsy-proven metastatic MCC or locoregional MCC that has recurred following anti-PD-1 or anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1; cSCC: Patients must have biopsy-proven metastatic cSCC or locoregional cSCC that has recurred following anti-PD-1 or anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1; Melanoma: Patients must have biopsy-proven metastatic melanoma or locoregional melanoma that has recurred following anti-PD-1, anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1.

Note: Prior therapy with ipilimumab is allowed (subject to a 6-week washout period) but not required.

Note: Progression following targeted therapies (e.g., BRAF inhibitor and/or MEK inhibitor) or other approved (e.g., talimogene laherparepvec [T-VEC]) or investigational therapies is allowed.

Key Exclusion Criteria:

  1. Pregnancy, lactation, or breastfeeding.
  2. Significant cardiovascular disease.
  3. Poorly controlled Type 2 diabetes mellitus.
  4. Major surgical procedure, other than for diagnosis, within 28 days prior to Cycle 1, Day 1, or anticipation of need for a major surgical procedure during the study.
  5. Patients who have had chemotherapy or radiotherapy within 2 weeks (4 weeks for nitrosoureas or systemic mitomycin C) prior to Cycle 1, Day 1.
  6. Patients who had prior treatment with immune CPIs, immunomodulatory monoclonal antibodies (mAbs), and/or mAb-derived therapies within 6 weeks before the initiation of study treatment, except for prior anti-PD-L1/anti-PD-1, which requires a 3-week washout period.
  7. Patients who have received treatment with any other investigational agent within 4 weeks prior to Cycle 1, Day 1.
  8. Patients who have received treatment and failed therapy with checkpoint inhibition plus a T-cell growth factor, e.g., IL-2 (NTKR-204), IL-15 (ALT-803) or IL-7 (CYT107).
  9. Patients with known primary central nervous system (CNS) malignancy, untreated CNS metastases, or active CNS metastases (progressing or requiring corticosteroids for symptomatic control) are excluded, with some exceptions.
  10. Patients who have leptomeningeal disease.
  11. Patients with autoimmune disease history.
  12. Patients who have received treatment with systemic immunosuppressive medications within 2 weeks prior to Cycle 1, Day 1.
  13. Patients who have a history of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or evidence of active pneumonitis on screening chest CT scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted.
  14. Patients with active hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] test at screening).
  15. Patients with active tuberculosis (TB).
  16. Patients who have severe infections within 4 weeks prior to Cycle 1, Day 1.
  17. Patients who have signs or symptoms of recent infection (not meeting the above criteria for severe infections) within 2 weeks before initiation of study treatment.
  18. Patients with prior allogeneic bone marrow transplantation or prior solid organ transplantation.
  19. Patients who have received a live, attenuated vaccine within 4 weeks prior to Cycle 1, Day 1 or anticipate that such a live attenuated vaccine be required during the study.

Sites / Locations

  • City of Hope
  • Northwestern University
  • Dana Farber
  • MGH
  • Washington University
  • Mt Sinai
  • Cleveland Clinic
  • Providence Portland Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Checkpoint Inhibitor-Naive cSCC, MCC Pts

Checkpoint Inhibitor-Relapsed/Refractory cSCC MCC Melanoma Pts

Arm Description

Anti-PD-1/PD-L1 naïve patients with cSCC and MCC

Anti-PD-1/PD-L1 relapsed/refractory patients with cSCC, MCC and melanoma

Outcomes

Primary Outcome Measures

Safety and Tolerability of NT-I7 in combination with atezolizumab to determine the maximum tolerated dose (MTD) and/or the recommended Phase 2 dose (RP2D) of NT-I7
Incidence, nature, and severity of adverse events graded according to NCI CTCAE v5.0 Incidence and nature of Dose-Limiting Toxicities (DLTs) Potential correlation with PK, pharmacodynamic, safety, and efficacy parameters

Secondary Outcome Measures

To evaluate immunogenicity of NT-I7 and atezolizumab
To determine and evaluate the incidence of anti-drug antibodies (ADA) to NT-I7 and atezolizumab during the study relative to the prevalence of ADA at baseline
Preliminary assessment of the Objective Response Rate (ORR) of NT-I7 in combination with atezolizumab
To preliminarily assess the Objective Response Rate (ORR) defined as percentage of patients who have at least one confirmed partial response (PR) or complete response (CR) according to RECIST v1.1, as determined by the investigator.
Preliminary assessment the Disease Control Rate (DCR) of NT-I7 in combination with atezolizumab
To preliminarily assess the Disease Control Rate (DCR) defined as proportion of patients with a best overall response of CR, PR or stable disease (SD).
Preliminary assessment the Duration of Objective Response (DOR) of NT-I7 in combination with atezolizumab
To preliminarily assess the Duration of Objective Response (DOR), defined as the time from the first occurrence of a documented objective response to the time of the first documented disease progression or death from any cause, whichever occurs first, per RECIST v1.1 as determined by the investigator.
Preliminary assessment the Progression Free Survival (PFS) of NT-I7 in combination with atezolizumab
To preliminarily assess the Progression Free Survival (PFS), defined as the time from the first study treatment (Cycle 1 Day 1) to the first occurrence of progression or death from any cause, whichever occurs first, per RECIST v1.1 as determined by the investigator.
Preliminary assessment the Overall Survival (OS) of NT-I7 in combination with atezolizumab
To preliminarily assess the Overall Survival (OS) defined as the time from first study treatment (Cycle 1 Day 1) to death from any cause.

Full Information

First Posted
March 26, 2019
Last Updated
February 14, 2023
Sponsor
NeoImmuneTech
Collaborators
Immune Oncology Network
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1. Study Identification

Unique Protocol Identification Number
NCT03901573
Brief Title
High-Risk Skin Cancers With Atezolizumab Plus NT-I7
Official Title
A Phase 1b/2a, Open Label Study to Evaluate Anti-tumor Efficacy and Safety of rhIL-7-hyFc (NT-I7) in Combination With Anti-PD-L1 (Atezolizumab) in Patients With Anti-PD-1/PD-L1 naïve or Relapsed/Refractory High-risk Skin Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 26, 2019 (Actual)
Primary Completion Date
February 2024 (Anticipated)
Study Completion Date
May 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NeoImmuneTech
Collaborators
Immune Oncology Network

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
The purpose of this study is to test whether the addition of NT-I7 to atezolizumab provides clinically meaningful outcomes for patients with anti-PD-1/PD-L1 naive or relapsed/refractory high-risk melanoma, Merkel Cell Carcinoma (MCC) and cutaneous Squamous Cell Carcinoma (cSCC)
Detailed Description
This is a Phase 1b/2a, open-label, multicenter study to evaluate the safety, tolerability and anti-tumor effect of NT-I7 (rhIL-7-hyFc) in combination with atezolizumab (MPDL3280A, anti-PD-L1) in patients with anti-PD-1/PD-L1 naïve or relapsed/refractory high-risk skin cancers including cutaneous Squamous Cell Carcinoma (cSCC), Merkel Cell Carcinoma (MCC) and melanoma. This study has been designed to evaluate the safety and tolerability, including the Maximum Tolerated Dose (MTD) or recommended Phase 2 dose (RP2D), of NT-I7 in combination with atezolizumab. There are two phases to this study: Phase 1b, a NT-I7 dose-escalation phase to determine the MTD or RP2D Phase 2a, a non-randomized parallel dose expansion phase to confirm the MTD or RP2D in both arms. Arm I: Anti-PD-1/PD-L1 (checkpoint inhibitors, CPI) naïve patients with cSCC and MCC Arm II: Anti-PD-1/PD-L1 relapsed/refractory patients with cSCC, MCC and melanoma Number of Patients A total of up to 84 patients will be enrolled; Up to 24 patients will be enrolled in the Phase 1b (up to 6 patients per dose level, using 3 + 3 design), and 60 patients will be enrolled in the Phase 2a (24 patients in Arm I, i.e., 12 patients for each indication, and 36 in Arm II, i.e., 12 patients for each indication).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma, Merkel Cell Carcinoma, Cutaneous Squamous Cell Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
84 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Checkpoint Inhibitor-Naive cSCC, MCC Pts
Arm Type
Experimental
Arm Description
Anti-PD-1/PD-L1 naïve patients with cSCC and MCC
Arm Title
Checkpoint Inhibitor-Relapsed/Refractory cSCC MCC Melanoma Pts
Arm Type
Experimental
Arm Description
Anti-PD-1/PD-L1 relapsed/refractory patients with cSCC, MCC and melanoma
Intervention Type
Drug
Intervention Name(s)
NT-I7
Other Intervention Name(s)
efineptakin alfa, rhIL-7-hyFc
Intervention Description
Dose Escalation (Phase 1b) - NT-I7 IM (intramuscular) on Day 1 of each Cycle until MTD or RP2D is achieved. Dose Expansion - NT-I7 IM (intramuscular) on Day 1 of each Cycle, at Maximum Tolerated Dose (MTD) or RP2D defined in escalation phase
Intervention Type
Drug
Intervention Name(s)
atezolizumab
Other Intervention Name(s)
Tecentriq
Intervention Description
Dose Escalation - atezolizumab IV (intravenous) on Day 1 of each Cycle Dose Expansion - atezolizumab IV (intravenous) on Day 1 of each Cycle
Primary Outcome Measure Information:
Title
Safety and Tolerability of NT-I7 in combination with atezolizumab to determine the maximum tolerated dose (MTD) and/or the recommended Phase 2 dose (RP2D) of NT-I7
Description
Incidence, nature, and severity of adverse events graded according to NCI CTCAE v5.0 Incidence and nature of Dose-Limiting Toxicities (DLTs) Potential correlation with PK, pharmacodynamic, safety, and efficacy parameters
Time Frame
Up to approximately 56 months
Secondary Outcome Measure Information:
Title
To evaluate immunogenicity of NT-I7 and atezolizumab
Description
To determine and evaluate the incidence of anti-drug antibodies (ADA) to NT-I7 and atezolizumab during the study relative to the prevalence of ADA at baseline
Time Frame
Up to approximately 56 months
Title
Preliminary assessment of the Objective Response Rate (ORR) of NT-I7 in combination with atezolizumab
Description
To preliminarily assess the Objective Response Rate (ORR) defined as percentage of patients who have at least one confirmed partial response (PR) or complete response (CR) according to RECIST v1.1, as determined by the investigator.
Time Frame
Up to approximately 56 months
Title
Preliminary assessment the Disease Control Rate (DCR) of NT-I7 in combination with atezolizumab
Description
To preliminarily assess the Disease Control Rate (DCR) defined as proportion of patients with a best overall response of CR, PR or stable disease (SD).
Time Frame
Up to approximately 56 months
Title
Preliminary assessment the Duration of Objective Response (DOR) of NT-I7 in combination with atezolizumab
Description
To preliminarily assess the Duration of Objective Response (DOR), defined as the time from the first occurrence of a documented objective response to the time of the first documented disease progression or death from any cause, whichever occurs first, per RECIST v1.1 as determined by the investigator.
Time Frame
Up to approximately 56 months
Title
Preliminary assessment the Progression Free Survival (PFS) of NT-I7 in combination with atezolizumab
Description
To preliminarily assess the Progression Free Survival (PFS), defined as the time from the first study treatment (Cycle 1 Day 1) to the first occurrence of progression or death from any cause, whichever occurs first, per RECIST v1.1 as determined by the investigator.
Time Frame
Up to approximately 56 months
Title
Preliminary assessment the Overall Survival (OS) of NT-I7 in combination with atezolizumab
Description
To preliminarily assess the Overall Survival (OS) defined as the time from first study treatment (Cycle 1 Day 1) to death from any cause.
Time Frame
Up to approximately 56 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Patients must be ≥18 years of age on day of signing informed consent document. Eastern Cooperative Oncology Group (ECOG) performance status ≤2 (Karnofsky ≥60%). Patients must have adequate organ and marrow function. Patients positive for HIV can be considered. Arm I - cSCC: Patients must have biopsy-proven metastatic cSCC or locoregional cSCC that has recurred following standard locoregional therapy with surgery and/or radiation therapy; MCC: Patients must have biopsy-proven metastatic MCC or locoregional MCC in need of systemic therapy, including patients that have not had prior systemic therapy or have recurred following standard locoregional therapy with surgery and/or radiation therapy. Prior chemotherapy is allowed. Arm II - MCC: Patients must have biopsy-proven metastatic MCC or locoregional MCC that has recurred following anti-PD-1 or anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1; cSCC: Patients must have biopsy-proven metastatic cSCC or locoregional cSCC that has recurred following anti-PD-1 or anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1; Melanoma: Patients must have biopsy-proven metastatic melanoma or locoregional melanoma that has recurred following anti-PD-1, anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1. Note: Prior therapy with ipilimumab is allowed (subject to a 6-week washout period) but not required. Note: Progression following targeted therapies (e.g., BRAF inhibitor and/or MEK inhibitor) or other approved (e.g., talimogene laherparepvec [T-VEC]) or investigational therapies is allowed. Key Exclusion Criteria: Pregnancy, lactation, or breastfeeding. Significant cardiovascular disease. Poorly controlled Type 2 diabetes mellitus. Major surgical procedure, other than for diagnosis, within 28 days prior to Cycle 1, Day 1, or anticipation of need for a major surgical procedure during the study. Patients who have had chemotherapy or radiotherapy within 2 weeks (4 weeks for nitrosoureas or systemic mitomycin C) prior to Cycle 1, Day 1. Patients who had prior treatment with immune CPIs, immunomodulatory monoclonal antibodies (mAbs), and/or mAb-derived therapies within 6 weeks before the initiation of study treatment, except for prior anti-PD-L1/anti-PD-1, which requires a 3-week washout period. Patients who have received treatment with any other investigational agent within 4 weeks prior to Cycle 1, Day 1. Patients who have received treatment and failed therapy with checkpoint inhibition plus a T-cell growth factor, e.g., IL-2 (NTKR-204), IL-15 (ALT-803) or IL-7 (CYT107). Patients with known primary central nervous system (CNS) malignancy, untreated CNS metastases, or active CNS metastases (progressing or requiring corticosteroids for symptomatic control) are excluded, with some exceptions. Patients who have leptomeningeal disease. Patients with autoimmune disease history. Patients who have received treatment with systemic immunosuppressive medications within 2 weeks prior to Cycle 1, Day 1. Patients who have a history of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or evidence of active pneumonitis on screening chest CT scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted. Patients with active hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] test at screening). Patients with active tuberculosis (TB). Patients who have severe infections within 4 weeks prior to Cycle 1, Day 1. Patients who have signs or symptoms of recent infection (not meeting the above criteria for severe infections) within 2 weeks before initiation of study treatment. Patients with prior allogeneic bone marrow transplantation or prior solid organ transplantation. Patients who have received a live, attenuated vaccine within 4 weeks prior to Cycle 1, Day 1 or anticipate that such a live attenuated vaccine be required during the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
NgocDiep Le, MD, PhD
Organizational Affiliation
NeoImmuneTech, Inc.
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Martin Cheever, MD
Organizational Affiliation
Fred Hutchinson Cancer Center
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Brian Gastman, MD
Organizational Affiliation
The Cleveland Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60208
Country
United States
Facility Name
Dana Farber
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
MGH
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Washington University
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Mt Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Providence Portland Medical Center
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

High-Risk Skin Cancers With Atezolizumab Plus NT-I7

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