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Sym024 Monotherapy and in Combination With Sym021 in Patients With Advanced Solid Tumor Malignancies

Primary Purpose

Metastatic Cancer, Solid Tumor

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Sym021
Sym024
Sponsored by
Symphogen A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Cancer focused on measuring Locally advanced/unresectable, Metastatic solid tumor, Anti-PD-1, PD-1, PD1, CD73, Squamous cell carcinoma of the head and neck (SCCHN), Non-small-cell lung carcinoma-adenocarcinoma histology subtype (NSCLC-Adeno), Pancreatic ductal adenocarcinoma (PDAC), Cholangiocarcinoma (CCA), Colorectal carcinoma (CRC), Gastric carcinoma (GC), Esophageal carcinoma (EsoCA), Mesothelioma (Meso), Sym021, Sym024, Head and neck squamous cell carcinoma (HNSCC), Cervical carcinoma (CC)

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female patients, ≥18 years.
  • Documented (histologically or cytologically proven), locally advanced or metastatic solid tumor malignancy (must be one of the following):

    1. Squamous cell carcinoma of the head and neck
    2. Non-small-cell lung carcinoma-adenocarcinoma histology subtype
    3. Pancreatic ductal adenocarcinoma
    4. Cholangiocarcinoma
    5. Colorectal carcinoma (microsatellite stable [MSS] and microsatellite instability-high [MSI-H] phenotypes)
    6. Gastric carcinoma (includes gastroesophageal carcinoma)
    7. Esophageal carcinoma (includes squamous cell and adenocarcinoma)
    8. Mesothelioma (pleural and peritoneal)
    9. Cervical carcinoma (CC) (includes adeno, squamous and mixed adeno-squamous carcinoma histology subtypes)
  • Malignancy that is not currently amenable to surgical intervention due to either medical contraindications or non-resectability of the tumor.
  • Measurable disease according to RECIST v1.1.
  • Refractory to or intolerant of existing therapy(ies) known to provide clinical benefit.
  • Agreeing to mandatory tumor tissue biopsies (2 total).
  • ECOG PS of 0 or 1.
  • Adequate organ function as indicated by the following laboratory values.
  • Adequate contraception required as appropriate.

Exclusion Criteria:

  • Central nervous system (CNS) malignancies.
  • Clinically significant cardiovascular disease or condition.
  • Active thrombosis, or a history of deep vein thrombosis or pulmonary embolism within 4 weeks prior to the first dose of study drug(s).
  • Active uncontrolled bleeding or a known bleeding diathesis.
  • Significant ocular disease or condition.
  • Significant pulmonary disease or condition.
  • Current or recent (within 6 months) significant gastrointestinal disease or condition.
  • Active, known or suspected autoimmune disease.
  • History of organ transplantation (i.e., stem cell or solid organ transplant).
  • Known history of human immunodeficiency virus (HIV) or known active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV).
  • Any other serious/active/uncontrolled infection.
  • History of significant toxicities associated with previous administration of immune checkpoint inhibitors.
  • Known or suspected hypersensitivity to any of the excipients of formulated study drug.
  • Unresolved >Grade 1 toxicity associated with any prior antineoplastic therapy.
  • Inadequate recovery from any prior surgical procedure, or patients having undergone any major surgical procedure within 4 weeks prior to the first dose of study drug(s).
  • Any other serious, life-threatening, or unstable preexisting medical condition (aside from the underlying malignancy).

Therapeutic Exclusions

  • Prior therapy with Sym024 or other inhibitors of CD73, CD39 or adenosine receptors ADORA2A, ADORA2B.
  • Part II and Part III, prior anti-PD-(L)1 therapy, except for indications where it is approved.
  • Any antineoplastic agent for the primary malignancy (standard or investigational) within 4 weeks or 5 elimination half-lives.
  • Any other investigational treatments within 2 weeks prior to the first dose of study drug(s).
  • Radiotherapy, with exceptions.
  • Live vaccines against infectious diseases 4 weeks prior to the first dose of study drug(s).
  • Immunosuppressive or systemic glucocorticoids therapy (>10 mg daily prednisone or equivalent) within 2 weeks prior to the first dose of study drug(s), with exceptions.
  • Prophylactic use of hematopoietic growth factors within 1 week prior to the first dose of study drug(s).

Sites / Locations

  • START Midwest
  • MD Anderson Cancer Center
  • NEXT Oncology
  • Princess Margaret Cancer Centre

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Sym024 Dose Level 1

Sym024 Dose Level 2

Sym024 Dose Level 3

Sym024 Dose Level 4

Sym024 Dose Level -1

Sym021+Sym024 Dose Level 2

Sym021+Sym024 Dose Level 3

Sym021+Sym024 Dose Level 4

Sym021+Sym024 Dose Level 5

Sym021+Sym024 Dose Level 1

Dose Expansion Sym021 (+Sym024)

Arm Description

Part I, Sym024 monotherapy dose level 1

Part I, Sym024 monotherapy dose level 2

Part I, Sym024 monotherapy dose level 3

Part I, Sym024 monotherapy dose level 4

Part I, Sym024 monotherapy dose level -1. Evaluate only if needed based on tolerability

Part II, Sym021 in combination with dose level 2 of Sym024

Part II, Sym021 in combination with dose level 3 of Sym024

Part II, Sym021 in combination with dose level 4 of Sym024

Part IIa, Sym024 monotherapy and in combination with Sym021

Part II, Sym021 in combination with dose level 1 of Sym024. Evaluate only if needed based on tolerability

Part III, dose expansion Sym024 and/or Sym021+Sym024

Outcomes

Primary Outcome Measures

Part I: To evaluate the incidence, severity and relationship of (S)AEs to establish the MTD/MAD of Sym024 monotherapy.
Assess the safety and tolerability of Sym024 monotherapy on a Q2W schedule (every two weeks). Assessment based on the occurrence of AEs meeting DLT criteria measured during Cycle 1
Part II: To evaluate the incidence, severity and relationship of (S)AEs to establish MTD/MAD of Sym024 in combination with Sym021.
Assess the safety and tolerability of the sequential escalating doses of Sym024 in combination with Sym021 on a Q2W schedule. Assessment based on the occurrence of AEs meeting DLT criteria measured during Cycle 1
Part III: To evaluate the incidence, severity and relationship of (S)AEs to further assess safety of Sym024 when administered alone or in combination with Sym021.
Assess the safety and tolerability of Sym024 and/or Sym021+Sym024 on a Q2W schedule. Assessment based on the occurrence of AEs

Secondary Outcome Measures

Evaluation of the immunogenicity of Sym024 as a single agent and in combination with Sym024
Serum sampling to assess the potential for anti-drug antibody (ADA) formation
Evaluation of objective response (OR) or stable disease (SD)
Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) and Immunotherapeutics Response Evaluation Criteria in Solid Tumors (iRECIST)
Time to progression (TTP) of disease
Based on time of enrollment to first evidence of progression on imaging studies, as assessed by RECIST v1.1 and iRECIST
Area under the concentration-time curve in a dosing interval (AUC)
Will be estimated using non-compartmental methods and actual timepoints
Maximum concentration (Cmax)
Will be derived from observed data
Time to reach maximum concentration (Tmax)
Will be derived from observed data
Trough concentration (Ctrough)
Will be derived from observed data
Terminal elimination half-life (T½)
Will be estimated using non-compartmental methods and actual timepoints
Clearance (CL)
Will be estimated using non-compartmental methods and actual timepoints

Full Information

First Posted
December 7, 2020
Last Updated
October 3, 2023
Sponsor
Symphogen A/S
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1. Study Identification

Unique Protocol Identification Number
NCT04672434
Brief Title
Sym024 Monotherapy and in Combination With Sym021 in Patients With Advanced Solid Tumor Malignancies
Official Title
A Phase 1, Open-Label, Multicenter Trial Investigating the Safety, Tolerability, and Preliminary Antineoplastic Activity of Sym024 (Anti-CD73) as Monotherapy and in Combination With Sym021 (Anti-PD-1) in Patients With Advanced Solid Tumor Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 19, 2020 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Symphogen A/S

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
The primary purpose of this study is to see if Sym024 is safe and tolerable as monotherapy and in combination with Sym021 in patients with solid tumor malignancies.
Detailed Description
Part 1 of this study will assess the safety and tolerability to establish the maximum tolerated dose (MTD) (or the maximum administered dose [MAD]) and/or the selected dose(s) of Sym024 in patients with solid tumor malignancies. Part 2 of this study will assess the safety and tolerability to establish the MTD (or the MAD) and/or the selected dose(s) of Sym024 when administered in combination with Sym021 in patients with solid tumor malignancies. Part 2a of this study will assess the safety and tolerability of Sym024 when first administered as a single agent during Cycle 1 (safety lead-in) followed by administration in combination with Sym021 during Cycle 2 and subsequent cycles. Part 3 of this study will assess the safety of Sym024 when administered alone or in combination with Sym021 in expanded cohorts of patients with solid tumor malignancies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Cancer, Solid Tumor
Keywords
Locally advanced/unresectable, Metastatic solid tumor, Anti-PD-1, PD-1, PD1, CD73, Squamous cell carcinoma of the head and neck (SCCHN), Non-small-cell lung carcinoma-adenocarcinoma histology subtype (NSCLC-Adeno), Pancreatic ductal adenocarcinoma (PDAC), Cholangiocarcinoma (CCA), Colorectal carcinoma (CRC), Gastric carcinoma (GC), Esophageal carcinoma (EsoCA), Mesothelioma (Meso), Sym021, Sym024, Head and neck squamous cell carcinoma (HNSCC), Cervical carcinoma (CC)

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Sym024 Dose Level 1
Arm Type
Experimental
Arm Description
Part I, Sym024 monotherapy dose level 1
Arm Title
Sym024 Dose Level 2
Arm Type
Experimental
Arm Description
Part I, Sym024 monotherapy dose level 2
Arm Title
Sym024 Dose Level 3
Arm Type
Experimental
Arm Description
Part I, Sym024 monotherapy dose level 3
Arm Title
Sym024 Dose Level 4
Arm Type
Experimental
Arm Description
Part I, Sym024 monotherapy dose level 4
Arm Title
Sym024 Dose Level -1
Arm Type
Experimental
Arm Description
Part I, Sym024 monotherapy dose level -1. Evaluate only if needed based on tolerability
Arm Title
Sym021+Sym024 Dose Level 2
Arm Type
Experimental
Arm Description
Part II, Sym021 in combination with dose level 2 of Sym024
Arm Title
Sym021+Sym024 Dose Level 3
Arm Type
Experimental
Arm Description
Part II, Sym021 in combination with dose level 3 of Sym024
Arm Title
Sym021+Sym024 Dose Level 4
Arm Type
Experimental
Arm Description
Part II, Sym021 in combination with dose level 4 of Sym024
Arm Title
Sym021+Sym024 Dose Level 5
Arm Type
Experimental
Arm Description
Part IIa, Sym024 monotherapy and in combination with Sym021
Arm Title
Sym021+Sym024 Dose Level 1
Arm Type
Experimental
Arm Description
Part II, Sym021 in combination with dose level 1 of Sym024. Evaluate only if needed based on tolerability
Arm Title
Dose Expansion Sym021 (+Sym024)
Arm Type
Experimental
Arm Description
Part III, dose expansion Sym024 and/or Sym021+Sym024
Intervention Type
Drug
Intervention Name(s)
Sym021
Other Intervention Name(s)
Anti-PD-1
Intervention Description
Sym021 is a humanized anti-PD-1 antibody.
Intervention Type
Drug
Intervention Name(s)
Sym024
Intervention Description
Sym024 is an anti-CD73 antibody.
Primary Outcome Measure Information:
Title
Part I: To evaluate the incidence, severity and relationship of (S)AEs to establish the MTD/MAD of Sym024 monotherapy.
Description
Assess the safety and tolerability of Sym024 monotherapy on a Q2W schedule (every two weeks). Assessment based on the occurrence of AEs meeting DLT criteria measured during Cycle 1
Time Frame
28 days
Title
Part II: To evaluate the incidence, severity and relationship of (S)AEs to establish MTD/MAD of Sym024 in combination with Sym021.
Description
Assess the safety and tolerability of the sequential escalating doses of Sym024 in combination with Sym021 on a Q2W schedule. Assessment based on the occurrence of AEs meeting DLT criteria measured during Cycle 1
Time Frame
28 days
Title
Part III: To evaluate the incidence, severity and relationship of (S)AEs to further assess safety of Sym024 when administered alone or in combination with Sym021.
Description
Assess the safety and tolerability of Sym024 and/or Sym021+Sym024 on a Q2W schedule. Assessment based on the occurrence of AEs
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Evaluation of the immunogenicity of Sym024 as a single agent and in combination with Sym024
Description
Serum sampling to assess the potential for anti-drug antibody (ADA) formation
Time Frame
24 months
Title
Evaluation of objective response (OR) or stable disease (SD)
Description
Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) and Immunotherapeutics Response Evaluation Criteria in Solid Tumors (iRECIST)
Time Frame
24 months
Title
Time to progression (TTP) of disease
Description
Based on time of enrollment to first evidence of progression on imaging studies, as assessed by RECIST v1.1 and iRECIST
Time Frame
24 months
Title
Area under the concentration-time curve in a dosing interval (AUC)
Description
Will be estimated using non-compartmental methods and actual timepoints
Time Frame
24 months
Title
Maximum concentration (Cmax)
Description
Will be derived from observed data
Time Frame
24 months
Title
Time to reach maximum concentration (Tmax)
Description
Will be derived from observed data
Time Frame
24 months
Title
Trough concentration (Ctrough)
Description
Will be derived from observed data
Time Frame
24 months
Title
Terminal elimination half-life (T½)
Description
Will be estimated using non-compartmental methods and actual timepoints
Time Frame
24 months
Title
Clearance (CL)
Description
Will be estimated using non-compartmental methods and actual timepoints
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients, ≥18 years. Documented (histologically or cytologically proven), locally advanced or metastatic solid tumor malignancy (must be one of the following): Squamous cell carcinoma of the head and neck Non-small-cell lung carcinoma-adenocarcinoma histology subtype Pancreatic ductal adenocarcinoma Cholangiocarcinoma Colorectal carcinoma (microsatellite stable [MSS] and microsatellite instability-high [MSI-H] phenotypes) Gastric carcinoma (includes gastroesophageal carcinoma) Esophageal carcinoma (includes squamous cell and adenocarcinoma) Mesothelioma (pleural and peritoneal) Cervical carcinoma (CC) (includes adeno, squamous and mixed adeno-squamous carcinoma histology subtypes) Malignancy that is not currently amenable to surgical intervention due to either medical contraindications or non-resectability of the tumor. Measurable disease according to RECIST v1.1. Refractory to or intolerant of existing therapy(ies) known to provide clinical benefit. Agreeing to mandatory tumor tissue biopsies (2 total). ECOG PS of 0 or 1. Adequate organ function as indicated by the following laboratory values. Adequate contraception required as appropriate. Exclusion Criteria: Central nervous system (CNS) malignancies. Clinically significant cardiovascular disease or condition. Active thrombosis, or a history of deep vein thrombosis or pulmonary embolism within 4 weeks prior to the first dose of study drug(s). Active uncontrolled bleeding or a known bleeding diathesis. Significant ocular disease or condition. Significant pulmonary disease or condition. Current or recent (within 6 months) significant gastrointestinal disease or condition. Active, known or suspected autoimmune disease. History of organ transplantation (i.e., stem cell or solid organ transplant). Known history of human immunodeficiency virus (HIV) or known active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV). Any other serious/active/uncontrolled infection. History of significant toxicities associated with previous administration of immune checkpoint inhibitors. Known or suspected hypersensitivity to any of the excipients of formulated study drug. Unresolved >Grade 1 toxicity associated with any prior antineoplastic therapy. Inadequate recovery from any prior surgical procedure, or patients having undergone any major surgical procedure within 4 weeks prior to the first dose of study drug(s). Any other serious, life-threatening, or unstable preexisting medical condition (aside from the underlying malignancy). Therapeutic Exclusions Prior therapy with Sym024 or other inhibitors of CD73, CD39 or adenosine receptors ADORA2A, ADORA2B. Part II and Part III, prior anti-PD-(L)1 therapy, except for indications where it is approved. Any antineoplastic agent for the primary malignancy (standard or investigational) within 4 weeks or 5 elimination half-lives. Any other investigational treatments within 2 weeks prior to the first dose of study drug(s). Radiotherapy, with exceptions. Live vaccines against infectious diseases 4 weeks prior to the first dose of study drug(s). Immunosuppressive or systemic glucocorticoids therapy (>10 mg daily prednisone or equivalent) within 2 weeks prior to the first dose of study drug(s), with exceptions. Prophylactic use of hematopoietic growth factors within 1 week prior to the first dose of study drug(s).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
N. Lakhani, MD PhD
Organizational Affiliation
START Midwest, USA
Official's Role
Principal Investigator
Facility Information:
Facility Name
START Midwest
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49545
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
NEXT Oncology
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1Z5
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Sym024 Monotherapy and in Combination With Sym021 in Patients With Advanced Solid Tumor Malignancies

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