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RBS2418 Evaluation in Subjects With Unresectable or Metastatic Tumors

Primary Purpose

Advanced Cancer

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
RBS2418
Sponsored by
Riboscience, LLC.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Cancer focused on measuring Metastatic tumors, Recurrent tumors, Unresectable tumors

Eligibility Criteria

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

Inclusion Criteria:

  1. Be willing and able to provide written informed consent for the study. The subject may also provide consent for Future biomedical research (FBR). However, the subject may participate in the main study without participating in FBR.
  2. 18 years of age on day of signing informed consent.
  3. Male and female subjects with advanced unresectable, recurrent or metastatic tumors who have received standard of care (SOC) therapy for their advanced/metastatic tumors and have no other SOC therapy available. Additionally, subjects must have received, have been intolerant to, have been ineligible for, or have declined all treatment known to confer significant clinical benefit.
  4. Have histologically or cytologically confirmed cancer diagnosis based on pathology report.
  5. Have a predicted life expectancy of greater or equal to 3 months.
  6. Have measurable disease based on RECIST 1.1.
  7. Have a performance status of 0, 1 or 2 using the ECOG Performance Scale within 14 days of first dose of study drug.
  8. Willing to submit a pre-treatment (archival or fresh-tissue if no archival is available) and on-treatment tissue sample for intra-tumoral ENPP1 assessment. Subjects in whom the treating physician deems such biopsy is clinically contraindicated will be evaluated on a case-by-case basis for enrollment pending Sponsor consultation.
  9. Have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of study drug female subjects of childbearing potential who are not surgically sterilized or postmenopausal). If the urine test is positive, or cannot be confirmed as negative, a serum pregnancy test will be required.
  10. Demonstrate adequate organ function: hematological, renal, hepatic, coagulation parameters and obtained within 14 days prior to the first study treatment

Exclusion Criteria:

  1. Any approved anti-cancer therapy including chemotherapy, targeted small molecule therapy or radiation therapy within 2 weeks prior to trial Day 1; or if subject has not recovered (i.e., Less than or equal to Grade 1 or returned to baseline level) from adverse events due to a previously administered agent; the following exceptions are allowed:

    • Palliative radiotherapy for bone metastases or soft tissue lesions should be completed > 7 days prior to baseline imaging
    • Hormone-replacement therapy or oral contraceptives
    • Subjects with Grade 2 neuropathy or Grade 2 alopecia
  2. Subjects with evidence of rapid progression on prior therapy resulting in rapid clinical deterioration should be excluded from participation in the trial.
  3. Currently participating and receiving trial therapy or has participated in a trial of an investigational agent and/or has used an investigational device within 28 days prior to Day 1.
  4. Uncontrolled tumor-related pain
  5. Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
  6. Malignancies other than indications open for enrollment within 3 years prior to Day 1, with the exception of those with negligible risk of metastasis or death treated with expected curative outcome, undergoing active surveillance or treatment-naïve for indolent tumors
  7. Treatment with systemic immunomodulating agents (including but not limited to Interferons (IFNs), Interleukin-2 (IL-2), anti-PD-1/PD-L1 inhibitors, ipilimumab) within 4 weeks or five half-lives of the drug, whichever is shorter, prior to first dose.
  8. History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins.
  9. Known hypersensitivity allergy or contraindication to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the PD-1/PD-L1 inhibitor formulation.
  10. Active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
  11. History or any evidence of interstitial lung disease
  12. Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment.
  13. Active HIV requiring therapy and Uncontrolled HIV*. HIV antibody testing recommended per investigator's clinical suspicion.
  14. Severe infections within 4 weeks prior to enrollment, including, but not limited to, hospitalization for complications of infection, bacteremia, or the presence of any active infection requiring systemic therapy.
  15. Received therapeutic oral or IV antibiotics within 2 weeks prior to Day 1
  16. Received a live, attenuated vaccine within 28 days prior to enrollment/cohort assignment or anticipation that such a live attenuated vaccine will be required during the trial

Sites / Locations

  • Honor Health Research InstituteRecruiting
  • Stanford Cancer InstituteRecruiting
  • UCLA Hematology/Oncology - Santa MonicaRecruiting
  • Christiana Care Health ServicesRecruiting
  • American Oncology Partners of Maryland, PARecruiting
  • Ichan School of Medicine at Mount SinaiRecruiting
  • Carolina BioOncology InstituteRecruiting
  • Tranquil Research
  • NEXT ViriginaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Treatment Group A-1

Treatment Group A-2

Treatment Group B

Arm Description

For Treatment Group A-1, a cohort of three (3) subjects will be dosed at the starting dose of 100 mg twice a day (BID) of RBS2418. Subsequent subjects will then be enrolled in serial, three (3) subject cohorts, with 100% dose increments (doubling the dose) until 800 mg BID

For Treatment Group A-2, a cohort of three (3) subjects will be dosed at the starting dose of 100 mg twice a day (BID) of RBS2418 in combination with pembrolizumab 200 mg IV (administered on Day 1 and every 3 weeks). Subsequent subjects will then be enrolled in serial, three (3) subject cohorts, with 100% dose increments (doubling the dose) until 800 mg BID

After dose escalation phase is completed in both monotherapy and combination therapy setting (A-1 and A-2), an expansion treatment group will be enrolled, and subjects (n=20- 40) will be treated with a fixed dose of RBS2418 to be selected by the Sponsor in consultation with the SRC and after reviewing the totality of the dose escalation data both as monotherapy and combination therapy.

Outcomes

Primary Outcome Measures

Treatment emergent dose limiting toxicities (DLT)
When more than 1 DLT occurs in ≤ 6 patients in a dosing cohort, MTD has been exceeded and no more patients are to be treated at that dose level
Peak plasma concentration (Cmax) of RBS2418
maximum plasma concentration of RBS2418
Area under the plasma concentration versus time curve (AUC)
area under the curve for RBS2418
Optimal Biologically Active Dose
Plasma concentration of RBS2418 that corresponds to EC90
Half-life (t1/2)
half-life of RBS2418
Number of participants with treatment emergent Adverse events
Adverse events, as graded by NCI CTCAE v5.0 including adverse events of special interest (AESI) classified by system organ class, preferred term, severity and relationship to drug

Secondary Outcome Measures

Overall response rate (ORR) by RECIST
Beginning with screening, all imaging assessments will be evaluated using RECIST 1.1. On- study imaging assessments will be performed Q9W. RECIST 1.1 will be used by the site for treatment decisions until the first radiographic evidence of PD.

Full Information

First Posted
February 9, 2022
Last Updated
December 22, 2022
Sponsor
Riboscience, LLC.
Collaborators
Oncobay Clinical, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT05270213
Brief Title
RBS2418 Evaluation in Subjects With Unresectable or Metastatic Tumors
Official Title
A First-In-Human, Phase 1 a/b Dose Escalation and Expansion Study to Evaluate RBS2418 as Monotherapy and in Combination With Pembrolizumab in Subjects With Advanced Unresectable, Recurrent or Metastatic Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
April 19, 2022 (Actual)
Primary Completion Date
January 2023 (Anticipated)
Study Completion Date
January 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Riboscience, LLC.
Collaborators
Oncobay Clinical, Inc

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
RBS2418 (investigational product) is a specific immune modulator, working through ectonucleotide pyrophosphatase/phosphodiesterase I (ENPP1), designed to lead to anti-tumor immunity by increasing endogenous 2'-3'-cyclic guanosine monophosphate-adenosine monophosphate (cGAMP) and adenosine triphosphate (ATP levels) and reducing adenosine production in the tumors. RBS2418 has the potential to be an important therapeutic option for subjects both as monotherapy and in combination with checkpoint blockade. This study is an open-label, multi-site Phase 1a/1b study of RBS2418, a selective ENPP1 inhibitor, in combination with pembrolizumab or as a monotherapy in subjects with advanced unresectable, recurrent or metastatic tumors.
Detailed Description
In this Phase 1a/b study, subjects must have received standard of care (SOC) therapy for their advanced/metastatic tumors and subjects must have received, have been intolerant to, have been ineligible for, or have declined all treatment known to confer significant clinical benefit. Subjects must also have at least 1 measurable lesion per Response Evaluation Criteria in Solid Tumors (RECIST1.1), an Eastern Cooperative Oncology Group (ECOG) performance score of 0, 1 or 2 and predicted life expectancy of greater than 3 months. An imaging scan is required at baseline, up to 28 days prior to treatment initiation. Subjects are required to provide an adequate tumor tissue sample (archival or fresh-tissue if no archival is available). Approximately 24 - 64 subjects will be enrolled and will receive therapy as part of their respective treatment groups (ascending doses of RBS2418 of 100 mg, 200 mg, 400 mg and 800 mg BID as monotherapy or in combination with pembrolizumab 200 mg IV q3w). The study consists of two (2) phases. The first part of the study (Part A) is the dose escalation phase of the study and is planned to enroll up to 8 cohorts in total (3-6 subjects per cohort) to receive RBS2418 as monotherapy or in combination with pembrolizumab to identify the fixed dose to be evaluated further in the expansion phase of the study (Part B) (~20-40 subjects). A "3+3" design will be used to establish dose limiting toxicities (DLT), the maximum tolerated dose and the dose level of RBS2418 corresponding to an optimal biologically active dose to aid in the selection of the fixed expansion cohort dose. In all treatment arms, treatment will continue until progressive disease (PD), unacceptable adverse events (AEs), intercurrent illness that prevents further administration of treatment, investigator's decision to withdraw the subject, subject withdrawal of consent, pregnancy of the subject, noncompliance with study dosing or procedure requirements, subject receiving approximately 2 years of RBS2418 monotherapy or in combination with pembrolizumab, or administrative reasons requiring cessation of treatment. After the last dose of study drug, each subject will be followed for 30 days for AE monitoring. Serious adverse events (SAEs) will be collected for 90 days after the end of treatment or for 30 days after the end of treatment, if the subject initiates new anticancer therapy, whichever is earlier

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Cancer
Keywords
Metastatic tumors, Recurrent tumors, Unresectable tumors

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
A "3+3" design will be used to establish dose limiting toxicities (DLT), the maximum tolerated dose (MTD, if applicable) and the dose level of RBS2418 as monotherapy and in combination with pembrolizumab corresponding to an optimal biologically active dose to aid in the selection of the fixed expansion cohort dose. There will be three treatment groups for this study: Treatment Group A-1: RBS2418 Dose Escalation (Monotherapy) Treatment Group A-2: RBS2418 Dose Escalation plus Pembrolizumab (Combination Therapy) Treatment Group B: RBS2418 as Monotherapy or RBS2418 plus Pembrolizumab Expansion Phase
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
64 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Group A-1
Arm Type
Experimental
Arm Description
For Treatment Group A-1, a cohort of three (3) subjects will be dosed at the starting dose of 100 mg twice a day (BID) of RBS2418. Subsequent subjects will then be enrolled in serial, three (3) subject cohorts, with 100% dose increments (doubling the dose) until 800 mg BID
Arm Title
Treatment Group A-2
Arm Type
Experimental
Arm Description
For Treatment Group A-2, a cohort of three (3) subjects will be dosed at the starting dose of 100 mg twice a day (BID) of RBS2418 in combination with pembrolizumab 200 mg IV (administered on Day 1 and every 3 weeks). Subsequent subjects will then be enrolled in serial, three (3) subject cohorts, with 100% dose increments (doubling the dose) until 800 mg BID
Arm Title
Treatment Group B
Arm Type
Experimental
Arm Description
After dose escalation phase is completed in both monotherapy and combination therapy setting (A-1 and A-2), an expansion treatment group will be enrolled, and subjects (n=20- 40) will be treated with a fixed dose of RBS2418 to be selected by the Sponsor in consultation with the SRC and after reviewing the totality of the dose escalation data both as monotherapy and combination therapy.
Intervention Type
Drug
Intervention Name(s)
RBS2418
Intervention Description
RBS2418 is a potent and selective small molecule inhibitor of ectonucleotide pyrophosphatase/phosphodiesterase I (ENPP1). RBS2418 as monotherapy potentially can have an activating effect on the anti-tumor innate immune response and lead to anti-tumor responses in adult subjects with advanced or metastatic tumors.
Primary Outcome Measure Information:
Title
Treatment emergent dose limiting toxicities (DLT)
Description
When more than 1 DLT occurs in ≤ 6 patients in a dosing cohort, MTD has been exceeded and no more patients are to be treated at that dose level
Time Frame
From 1- 21 days of the first cycle (each cycle is 21 days)
Title
Peak plasma concentration (Cmax) of RBS2418
Description
maximum plasma concentration of RBS2418
Time Frame
Day 0 - 5
Title
Area under the plasma concentration versus time curve (AUC)
Description
area under the curve for RBS2418
Time Frame
Day 0 - 5
Title
Optimal Biologically Active Dose
Description
Plasma concentration of RBS2418 that corresponds to EC90
Time Frame
Day 0 - 5
Title
Half-life (t1/2)
Description
half-life of RBS2418
Time Frame
Day 0 - 5
Title
Number of participants with treatment emergent Adverse events
Description
Adverse events, as graded by NCI CTCAE v5.0 including adverse events of special interest (AESI) classified by system organ class, preferred term, severity and relationship to drug
Time Frame
30 days from last dose
Secondary Outcome Measure Information:
Title
Overall response rate (ORR) by RECIST
Description
Beginning with screening, all imaging assessments will be evaluated using RECIST 1.1. On- study imaging assessments will be performed Q9W. RECIST 1.1 will be used by the site for treatment decisions until the first radiographic evidence of PD.
Time Frame
nine weeks from first dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be willing and able to provide written informed consent for the study. The subject may also provide consent for Future biomedical research (FBR). However, the subject may participate in the main study without participating in FBR. 18 years of age on day of signing informed consent. Male and female subjects with advanced unresectable, recurrent or metastatic tumors who have received standard of care (SOC) therapy for their advanced/metastatic tumors and have no other SOC therapy available. Additionally, subjects must have received, have been intolerant to, have been ineligible for, or have declined all treatment known to confer significant clinical benefit. Have histologically or cytologically confirmed cancer diagnosis based on pathology report. Have a predicted life expectancy of greater or equal to 3 months. Have measurable disease based on RECIST 1.1. Have a performance status of 0, 1 or 2 using the ECOG Performance Scale within 14 days of first dose of study drug. Willing to submit a pre-treatment (archival or fresh-tissue if no archival is available) and on-treatment tissue sample for intra-tumoral ENPP1 assessment. Subjects in whom the treating physician deems such biopsy is clinically contraindicated will be evaluated on a case-by-case basis for enrollment pending Sponsor consultation. Have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of study drug female subjects of childbearing potential who are not surgically sterilized or postmenopausal). If the urine test is positive, or cannot be confirmed as negative, a serum pregnancy test will be required. Demonstrate adequate organ function: hematological, renal, hepatic, coagulation parameters and obtained within 14 days prior to the first study treatment Exclusion Criteria: Any approved anti-cancer therapy including chemotherapy, targeted small molecule therapy or radiation therapy within 2 weeks prior to trial Day 1; or if subject has not recovered (i.e., Less than or equal to Grade 1 or returned to baseline level) from adverse events due to a previously administered agent; the following exceptions are allowed: Palliative radiotherapy for bone metastases or soft tissue lesions should be completed > 7 days prior to baseline imaging Hormone-replacement therapy or oral contraceptives Subjects with Grade 2 neuropathy or Grade 2 alopecia Subjects with evidence of rapid progression on prior therapy resulting in rapid clinical deterioration should be excluded from participation in the trial. Currently participating and receiving trial therapy or has participated in a trial of an investigational agent and/or has used an investigational device within 28 days prior to Day 1. Uncontrolled tumor-related pain Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures Malignancies other than indications open for enrollment within 3 years prior to Day 1, with the exception of those with negligible risk of metastasis or death treated with expected curative outcome, undergoing active surveillance or treatment-naïve for indolent tumors Treatment with systemic immunomodulating agents (including but not limited to Interferons (IFNs), Interleukin-2 (IL-2), anti-PD-1/PD-L1 inhibitors, ipilimumab) within 4 weeks or five half-lives of the drug, whichever is shorter, prior to first dose. History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins. Known hypersensitivity allergy or contraindication to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the PD-1/PD-L1 inhibitor formulation. Active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). History or any evidence of interstitial lung disease Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment. Active HIV requiring therapy and Uncontrolled HIV*. HIV antibody testing recommended per investigator's clinical suspicion. Severe infections within 4 weeks prior to enrollment, including, but not limited to, hospitalization for complications of infection, bacteremia, or the presence of any active infection requiring systemic therapy. Received therapeutic oral or IV antibiotics within 2 weeks prior to Day 1 Received a live, attenuated vaccine within 28 days prior to enrollment/cohort assignment or anticipation that such a live attenuated vaccine will be required during the trial
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Leslie O'Toole, BSN
Phone
4123523504
Email
leslie.otoole@riboscience.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ildiko Csiki, MD PHD
Phone
2155312470
Email
ildiko.csiki@riboscience.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ildiko Csiki, MD PHD
Organizational Affiliation
Riboscience, LLC.
Official's Role
Study Director
Facility Information:
Facility Name
Honor Health Research Institute
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mei Yu
First Name & Middle Initial & Last Name & Degree
Michael Gordon
Facility Name
Stanford Cancer Institute
City
Palo Alto
State/Province
California
ZIP/Postal Code
94305
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Moonkyung Kim
First Name & Middle Initial & Last Name & Degree
Christopher Chen
Facility Name
UCLA Hematology/Oncology - Santa Monica
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vik Mardirosian
First Name & Middle Initial & Last Name & Degree
Zev Wainberg
Facility Name
Christiana Care Health Services
City
Newark
State/Province
Delaware
ZIP/Postal Code
19713
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Denise DeMaio
First Name & Middle Initial & Last Name & Degree
Jamal Misleh
Facility Name
American Oncology Partners of Maryland, PA
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20817
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jenelle Larkin
First Name & Middle Initial & Last Name & Degree
Ralph Boccia
Facility Name
Ichan School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zichen Li
First Name & Middle Initial & Last Name & Degree
Thomas Marron
Facility Name
Carolina BioOncology Institute
City
Huntersville
State/Province
North Carolina
ZIP/Postal Code
28078
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Caleb Suddreth
First Name & Middle Initial & Last Name & Degree
John Powderly
Facility Name
Tranquil Research
City
Webster
State/Province
Texas
ZIP/Postal Code
77598
Country
United States
Individual Site Status
Completed
Facility Name
NEXT Virigina
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Amanda Betancourt
Phone
210-580-9520
First Name & Middle Initial & Last Name & Degree
Alexander Spira
First Name & Middle Initial & Last Name & Degree
Kristine Freeman

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

RBS2418 Evaluation in Subjects With Unresectable or Metastatic Tumors

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