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Study of Upifitamab Rilsodotin in Combination With Carboplatin in Participants With High-grade Serous Ovarian Cancer (UPGRADE)

Primary Purpose

Platinum-sensitive Ovarian Cancer (UPGRADE-A)

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
XMT-1536 (Upifitamab Rilsodotin)
Carboplatin
Sponsored by
Mersana Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Platinum-sensitive Ovarian Cancer (UPGRADE-A)

Eligibility Criteria

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

Inclusion Criteria:

Participant must be at least 18 years of age, and female; Participant must be able to understand the study procedures and agree to participate in the study by providing informed consent

  • Participants must have a histological diagnosis of metastatic or recurrent high-grade serous ovarian cancer, which includes fallopian tube, or primary peritoneal cancer.
  • Participant has received 1 to 3 prior lines of therapy for their ovarian cancer; a non-platinum-based chemotherapy regimen is permitted provided it is not the most recent line of therapy. Participant must have platinum-sensitive recurrent disease
  • Participant must have an ECOG performance status 0 or 1
  • Participant must have measurable disease as per RECIST v1.1
  • Tumor sample must be provided, either an archival tumor tissue block or slides or, if not available, a tumor tissue block or slides from a new tumor biopsy obtained through a low-risk, medically routine procedure.
  • Participants with toxicity from prior therapy or surgical procedures must have recovered to ≤ Grade 1. Participants with alopecia, stable immune-related toxicity such as hypothyroidism on hormone replacement, or adrenal insufficiency treated with ≤10 mg daily prednisone (or equivalent), after prior taxane therapy are exceptions to this criterion and may qualify for this study.
  • Participants must have cardiac left ventricular ejection fraction (LVEF) ≥50% or ≥ the institution's lower limit of normal as measured by either Echo or MUGA scan
  • Participants must have adequate organ function within 14 days prior to enrollment
  • A female participant is eligible to participate if she is not pregnant or breastfeeding, if she is not a woman of childbearing potential (WOCBP), or if she is a WOCBP potential and using a contraceptive method that is highly effective.

Exclusion Criteria:

  • Participant has known sensitivity to any of the study medications, or components thereof, or a history of drug or allergy that contraindicates their participation
  • Participant is unable or unlikely to comply with dosing schedule and study evaluations.
  • Participant has a prior hypersensitivity reaction to carboplatin requiring desensitization or discontinuation.
  • Participant has prior platelet or neutrophil toxicity to carboplatin-containing therapy requiring dose reduction to AUC <5 mg x mL/min in the most recent regimen containing carboplatin
  • Known history of CTCAE version 5.0 Grade 4 thrombocytopenia OR history of bleeding in association with any grade thrombocytopenia
  • Participant has had major surgery within 28 days of starting study treatment, systemic anticancer therapy within the lesser of 28 days or 5 half-lives of the prior therapy before starting study treatment (14 days or 5 half-lives for small molecule targeted therapy), or recent radiation therapy with unresolved toxicity or within a time window of potential toxicity
  • Participant has received prior treatment with mirvetuximab soravtansine or another ADC containing an auristatin or maytansinoid payload.
  • Participant has untreated CNS metastases (including new and progressive brain metastases), history of leptomeningeal metastasis, or carcinomatous meningitis.
  • Has a diagnosis of additional malignancy that required treatment within 2 years prior to screening, except for adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the breast or of the cervix
  • Participant is unwilling to be transfused with blood components.
  • Participant is receiving concurrent anti-cancer therapy (e.g. chemotherapy, radiation therapy, biologic therapy, immunotherapy, hormonal therapy, investigational therapy).

Sites / Locations

  • START Midwest

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Dose Escalation - Module A (UPGRADE-A)

Dose Expansion - Module A (UPGRADE-A)

Arm Description

XMT-1536 (Upifitabmab Rilsodotin) + carboplatin is administered in groups of patients who will receive doses of XMT-1536 that increase over time.

Once the MTD or RP2D is achieved in dose escalation, a new group of patients will receive XMT-1536 (Upifitamab Rilsodotin) at this fixed-dose + carboplatin.

Outcomes

Primary Outcome Measures

DES: Maximum tolerated dose (MTD) for Upifitamab Rilsodotin with carboplatin
Determine the MTD of Upifitamab rilsodotin in combination with carboplatin by evaluating adverse events in combination with carboplatin
EXP: Assess the feasibility of Upifitamab rilsodotin combination initiated at MTD or RP2D
Assess the feasibility of Upifitamab rilsodotin combination initiated at MTD or RP2D Assess the feasibility of Upifitamab rilsodotin combination initiated at MTD or RP2D, where the regimen will be considered feasible if at least 60% of participants complete at least four cycles of the carboplatin-upifitamab rilsodotin combination, allowing for standard treatment modifications, without discontinuing treatment earlier for reasons other than disease progression

Secondary Outcome Measures

DES and EXP: Safety and Tolerability, by observance of frequency and grade of adverse events based on CTCAE v5.0.
DES and EXP: Safety and Tolerability, by observance of frequency and grade of adverse events based on CTCAE v5.0.
DES and EXP: Time of maximum observed concentration of carboplatin
Determine the pharmacokinetics of carboplatin
DES and EXP: Maximum concentration of XMT-1536 (Upifitamab rilsodotin)
Determine the pharmacokinetics of XMT-1536 (Upifitamab rilsodotin)
DES and EXP: Maximum concentration of carboplatin
Determine the pharmacokinetics of carboplatin
DES and EXP: Area under the concentration curve of the last measurable concentration of XMT-1536 (upifitamab rilsodotin)
Determine the pharmacokinetics of XMT-1536 (Upifitamab rilsodotin)
DES and EXP: Area under the concentration curve of the last measurable concentration of carboplatin
Determine the pharmacokinetics of carboplatin
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin
ORR (by RECIST 1.1)
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin
DOR
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin
DCR
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin PFS (by RECIST 1.1)
PFS (by RECIST 1.1)
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin
OS
DES and EXP: Assess the correlation of tumor expression of NaPi2b and objective tumor response
Potential NaPi2b protein or RNA levels of NaPi2b transcript or other genes related to cancer measured in tumor samples Blood-based biomarkers, which may include serum cytokines, circulating immune cells, and circulating tumor cells

Full Information

First Posted
May 12, 2021
Last Updated
October 6, 2023
Sponsor
Mersana Therapeutics
Collaborators
IQVIA Biotech, PSI CRO
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1. Study Identification

Unique Protocol Identification Number
NCT04907968
Brief Title
Study of Upifitamab Rilsodotin in Combination With Carboplatin in Participants With High-grade Serous Ovarian Cancer
Acronym
UPGRADE
Official Title
Upifitamab Rilsodotin (Xmt-1536) An Open-Label, Multicenter, Dose Escalation And Expansion Study Of Upifitamab Rilsodotin In Combination With Carboplatin In Participants With High Grade Serous Ovarian Cancer (Upgrade-A)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Terminated
Why Stopped
Study Terminated by Sponsor
Study Start Date
June 11, 2021 (Actual)
Primary Completion Date
October 3, 2023 (Actual)
Study Completion Date
October 3, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mersana Therapeutics
Collaborators
IQVIA Biotech, PSI CRO

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
Phase 1 safety study of the antibody-drug conjugate (ADC) XMT-1536 (upifitamab rilsodotin) administered as an intravenous infusion once every four weeks in combination with Carboplatin in participants with high-grade serous ovarian cancer (HGSOC, including fallopian tube and primary peritoneal cancer). The trial consists of dose escalation (DES) and expansion (EXP) portion. In addition to safety assessments, the pharmacokinetics of the drug will be assessed along with ADC activity.
Detailed Description
This trial is an open-label, multi-center Phase 1 study of upifitamab rilsodotin administered as an intravenous infusion once every 28 days in combination with Carboplatinin patients with high-grade serous ovarian cancer (HGSOC, including fallopian tube and primary peritoneal cancer). The trial consists of dose escalation (DES) and expansion (EXP) portion. The primary objective of the dose escalation (DES) portion is to establish the maximum tolerated dose (MTD) for upifitamab rilsodotin in combination with Carboplatin. In the EXP portion of the trial, participants will initiate treatment at the MTD or recommended phase 2 dose (RP2D) determined in the DES for the combination.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Platinum-sensitive Ovarian Cancer (UPGRADE-A)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
31 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation - Module A (UPGRADE-A)
Arm Type
Experimental
Arm Description
XMT-1536 (Upifitabmab Rilsodotin) + carboplatin is administered in groups of patients who will receive doses of XMT-1536 that increase over time.
Arm Title
Dose Expansion - Module A (UPGRADE-A)
Arm Type
Experimental
Arm Description
Once the MTD or RP2D is achieved in dose escalation, a new group of patients will receive XMT-1536 (Upifitamab Rilsodotin) at this fixed-dose + carboplatin.
Intervention Type
Drug
Intervention Name(s)
XMT-1536 (Upifitamab Rilsodotin)
Other Intervention Name(s)
XMT-1536, UpRi
Intervention Description
Drug: XMT-1536 (Upifitamab Rilsodotin) XMT-1536 (Upifitamab Rilsodotin) will be administered on Day 1 of each 28-day cycle until disease progression, unacceptable toxicity, or either the patient or study physician determines it is in the best interest of the patient to discontinue participation in the study Other Names: XMT-1536 UpRi Drug: Carboplatin Carboplatin will be administered on Day 1 on each of the first six 28 day cycles.
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Description
Drug: XMT-1536 (Upifitamab Rilsodotin) XMT-1536 (Upifitamab Rilsodotin) will be administered on Day 1 of each 28-day cycle until disease progression, unacceptable toxicity, or either the patient or study physician determines it is in the best interest of the patient to discontinue participation in the study Other Names: XMT-1536 UpRi Drug: Carboplatin Carboplatin will be administered on Day 1 on each of the first six 28 day cycles.
Primary Outcome Measure Information:
Title
DES: Maximum tolerated dose (MTD) for Upifitamab Rilsodotin with carboplatin
Description
Determine the MTD of Upifitamab rilsodotin in combination with carboplatin by evaluating adverse events in combination with carboplatin
Time Frame
Up to 24 weeks, from the date of first dose until unacceptable side effects or a dose-limiting toxicity is met
Title
EXP: Assess the feasibility of Upifitamab rilsodotin combination initiated at MTD or RP2D
Description
Assess the feasibility of Upifitamab rilsodotin combination initiated at MTD or RP2D Assess the feasibility of Upifitamab rilsodotin combination initiated at MTD or RP2D, where the regimen will be considered feasible if at least 60% of participants complete at least four cycles of the carboplatin-upifitamab rilsodotin combination, allowing for standard treatment modifications, without discontinuing treatment earlier for reasons other than disease progression
Time Frame
First dose up until 30 days after study termination
Secondary Outcome Measure Information:
Title
DES and EXP: Safety and Tolerability, by observance of frequency and grade of adverse events based on CTCAE v5.0.
Description
DES and EXP: Safety and Tolerability, by observance of frequency and grade of adverse events based on CTCAE v5.0.
Time Frame
First dose up until 30 days after study termination
Title
DES and EXP: Time of maximum observed concentration of carboplatin
Description
Determine the pharmacokinetics of carboplatin
Time Frame
Daily for one week after first dose; weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent
Title
DES and EXP: Maximum concentration of XMT-1536 (Upifitamab rilsodotin)
Description
Determine the pharmacokinetics of XMT-1536 (Upifitamab rilsodotin)
Time Frame
weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
Title
DES and EXP: Maximum concentration of carboplatin
Description
Determine the pharmacokinetics of carboplatin
Time Frame
Weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
Title
DES and EXP: Area under the concentration curve of the last measurable concentration of XMT-1536 (upifitamab rilsodotin)
Description
Determine the pharmacokinetics of XMT-1536 (Upifitamab rilsodotin)
Time Frame
Weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
Title
DES and EXP: Area under the concentration curve of the last measurable concentration of carboplatin
Description
Determine the pharmacokinetics of carboplatin
Time Frame
Weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
Title
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin
Description
ORR (by RECIST 1.1)
Time Frame
Every 8 weeks for the first 12 months, then every 12 weeks on treatment
Title
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin
Description
DOR
Time Frame
Every 8 weeks for the first 12 months, then every 12 weeks on treatment
Title
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin
Description
DCR
Time Frame
Every 8 weeks for the first 12 months, then every 12 weeks on treatment
Title
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin PFS (by RECIST 1.1)
Description
PFS (by RECIST 1.1)
Time Frame
Every 8 weeks for the first 12 months, then every 12 weeks on treatment
Title
DES and EXP: Anti-neoplastic effects of XMT-1536 (Upifitamab rilsodotin) in combination with carboplatin
Description
OS
Time Frame
Every 90 days
Title
DES and EXP: Assess the correlation of tumor expression of NaPi2b and objective tumor response
Description
Potential NaPi2b protein or RNA levels of NaPi2b transcript or other genes related to cancer measured in tumor samples Blood-based biomarkers, which may include serum cytokines, circulating immune cells, and circulating tumor cells
Time Frame
Every 8 weeks for the first 12 months, every 12 weeks on treatment, every 90 days for OS

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participant must be at least 18 years of age, and female; Participant must be able to understand the study procedures and agree to participate in the study by providing informed consent Participants must have a histological diagnosis of metastatic or recurrent high-grade serous ovarian cancer, which includes fallopian tube, or primary peritoneal cancer. Participant has received 1 to 3 prior lines of therapy for their ovarian cancer; a non-platinum-based chemotherapy regimen is permitted provided it is not the most recent line of therapy. Participant must have platinum-sensitive recurrent disease Participant must have an ECOG performance status 0 or 1 Participant must have measurable disease as per RECIST v1.1 Tumor sample must be provided, either an archival tumor tissue block or slides or, if not available, a tumor tissue block or slides from a new tumor biopsy obtained through a low-risk, medically routine procedure. Participants with toxicity from prior therapy or surgical procedures must have recovered to ≤ Grade 1. Participants with alopecia, stable immune-related toxicity such as hypothyroidism on hormone replacement, or adrenal insufficiency treated with ≤10 mg daily prednisone (or equivalent), after prior taxane therapy are exceptions to this criterion and may qualify for this study. Participants must have cardiac left ventricular ejection fraction (LVEF) ≥50% or ≥ the institution's lower limit of normal as measured by either Echo or MUGA scan Participants must have adequate organ function within 14 days prior to enrollment A female participant is eligible to participate if she is not pregnant or breastfeeding, if she is not a woman of childbearing potential (WOCBP), or if she is a WOCBP potential and using a contraceptive method that is highly effective. Exclusion Criteria: Participant has known sensitivity to any of the study medications, or components thereof, or a history of drug or allergy that contraindicates their participation Participant is unable or unlikely to comply with dosing schedule and study evaluations. Participant has a prior hypersensitivity reaction to carboplatin requiring desensitization or discontinuation. Participant has prior platelet or neutrophil toxicity to carboplatin-containing therapy requiring dose reduction to AUC <5 mg x mL/min in the most recent regimen containing carboplatin Known history of CTCAE version 5.0 Grade 4 thrombocytopenia OR history of bleeding in association with any grade thrombocytopenia Participant has had major surgery within 28 days of starting study treatment, systemic anticancer therapy within the lesser of 28 days or 5 half-lives of the prior therapy before starting study treatment (14 days or 5 half-lives for small molecule targeted therapy), or recent radiation therapy with unresolved toxicity or within a time window of potential toxicity Participant has received prior treatment with mirvetuximab soravtansine or another ADC containing an auristatin or maytansinoid payload. Participant has untreated CNS metastases (including new and progressive brain metastases), history of leptomeningeal metastasis, or carcinomatous meningitis. Has a diagnosis of additional malignancy that required treatment within 2 years prior to screening, except for adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the breast or of the cervix Participant is unwilling to be transfused with blood components. Participant is receiving concurrent anti-cancer therapy (e.g. chemotherapy, radiation therapy, biologic therapy, immunotherapy, hormonal therapy, investigational therapy).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Brad Sumrow, MD
Organizational Affiliation
Mersana Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
START Midwest
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49546
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Study of Upifitamab Rilsodotin in Combination With Carboplatin in Participants With High-grade Serous Ovarian Cancer

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