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A Study of NTX-1088, a Monoclonal Antibody Targeting the Poliovirus Receptor (PVR, CD155), as Monotherapy and Combined With Pembrolizumab

Primary Purpose

Cancer, Tumor, Solid, Advanced Solid Tumor

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
NTX-1088
Pembrolizumab
Sponsored by
Nectin Therapeutics Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer focused on measuring PVR, IO, Immune Oncology

Eligibility Criteria

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

Inclusion Criteria:

  1. Histologic or cytologic evidence of an advanced (locally advanced or metastatic) malignant solid cancer known to express PVR, or if the patient's cancer has been documented to express PVR.
  2. Must have disease that is resistant to or relapsed following available standard systemic therapy, or for which there is no standard systemic therapy or reasonable therapy in the physician's judgment likely to result in clinical benefit, or if such therapy has been refused by the patient.
  3. Tumor tissue or paraffin block, ideally from the patient's most recent biopsy within 1 year of study treatment. A fresh tumor biopsy will be obtained if archival samples are not available or from tumor sampled more than 1 year prior to enrollment. Patient must be amenable to on treatment biopsy.
  4. Disease that is measurable by Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1.
  5. A least 18 years old.
  6. An Eastern Cooperative Oncology Group (ECOG) performance status of ≤1.
  7. Adequate baseline hematopoietic, kidney and liver function.
  8. A left ventricular ejection fraction (LVEF) ≥ 45%.
  9. Female participants are eligible to participate if not pregnant, not breastfeeding, and must agree to follow contraceptive guidance during the treatment period and for at least 120 days after the last dose of study treatment.
  10. Male subjects must agree to follow contraceptive guidance during the study period and for at least 120 days after the last dose of study treatment.
  11. Patient must give informed written consent for the study.
  12. Patient must adhere to the study visit schedule and other protocol requirements.
  13. Patient has sufficient venous access for protocol defined plasma/blood sampling.

Exclusion Criteria:

  1. The patient was discontinued from prior treatment with an immuno-oncology therapeutic due to a Grade 3 or higher immune-related adverse event.
  2. Received radiotherapy within 2 weeks of treatment.
  3. Received radiation therapy to the lung that is greater than 30 Gray within 6 months of the first dose of study medication.
  4. The patient is concurrently receiving treatment with anticancer therapies (cytotoxic chemotherapy, monoclonal antibodies, and/or small molecule tyrosine kinase inhibitors).
  5. Received an allogeneic tissue/solid organ transplant.
  6. Received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention.
  7. Received prior treatment with NTX-1088 or another investigational agent targeting PVR.
  8. The participant must have recovered adequately from any major surgery and/or any complications from the surgery prior to starting study intervention.
  9. Currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study treatment.
  10. The patient must have recovered from all AEs due to previous therapies to Grade ≤1 or baseline.
  11. The patient has an active autoimmune disease that required systemic treatment in the past.
  12. Presence of an uncontrolled endocrine disorder.
  13. Presence of clinically significant cardiovascular disease.
  14. History of (non-infectious) pneumonitis or interstitial pulmonary disease that required steroids or has current pneumonitis or interstitial pulmonary disease.
  15. Presence of uncontrolled, clinically significant pulmonary disease.
  16. A previous severe hypersensitivity reaction (Grade ≥3) to pembrolizumab and/or any of its excipients.
  17. A diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study drug. Inhaled or topical steroids are permitted in the absence of active autoimmune disease.
  18. An uncontrolled intercurrent illness that would limit compliance with study requirements.
  19. History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study or interfere with participation in the study.
  20. A positive status for human immunodeficiency virus (HIV).
  21. A known history of Hepatitis B (defined as HBsAg reactive) or known active Hepatitis C virus (defined as HCV RNA detected) infection.
  22. Oxygen dependent.
  23. The patient has any medical condition which, in the opinion of the Investigator, places the patient at an unacceptably high risk for toxicities.
  24. Additional active malignancy that is progressing or has required active treatment within the past 3 years.
  25. Known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable.
  26. Patient is pregnant or breast feeding.

Sites / Locations

  • City of HopeRecruiting
  • Ochsner Clinic FoundationRecruiting
  • The University of Texas MD Anderson Cancer CenterRecruiting
  • Hadassah Medical CenterRecruiting
  • Sheba Medical CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Part 1 - Dose Escalation Phase (Monotherapy)

Part 1 - Dose Escalation Phase (Combination Therapy)

Part 2 - Dose Expansion (Monotherapy)

Part 2 - Dose Expansion (Combination Therapy)

Arm Description

NTX-1088 administered as a 60-minute IV infusion at escalating doses as a monotherapy. NTX-1088 will be administered on Day 1 of a 21-day cycle.

NTX-1088 administered as a 60-minute IV infusion in escalating doses in combination with pembrolizumab. NTX-1088 will be administered on Day 1 of a 21-day cycle. Pembrolizumab will be administered as a 30-minute IV infusion, within 2 hours prior to NTX-1088 administration, at a dose of 200 mg on Day 1 of every 21-day cycle.

NTX-1088 administered at the RP2D as a 60-minute IV infusion as a monotherapy.

NTX-1088 administered at the RP2D as a 60-minute IV infusion in combination with pembrolizumab at the standard labeled dose.

Outcomes

Primary Outcome Measures

Dose-limiting Toxicity (DLT)
The incidence of DLTs during the DLT assessment period.
Dose-Finding
Determination of the MTD or maximum tested dose, and the RP2D.
Frequency and Severity of Adverse Events (AE)
The incidences and percentages of patients experiencing AEs summarized by NCI CTCAE version 5.0 grade and by causality.

Secondary Outcome Measures

Pharmacokinetics of NTX-1088
Maximum Plasma Concentration (Cmax)
Pharmacokinetics of NTX-1088
Area Under the Curve (AUC)
Objective Response Rate (ORR)
ORR according to RECIST v1.1.
Duration of Response (DoR)
Time from the date measurement criteria are first met for PR or CR to the date measurement criteria are first met for progressive disease.
Progression Free Survival (PFS)
Time from the date of initiation of study therapy to the date measurement criteria are first met for progressive disease or death from any cause, whichever occurs first.
Overall Survival (OS)
Time from the date of initiation of study therapy to the date of death from any cause.

Full Information

First Posted
May 12, 2022
Last Updated
September 30, 2023
Sponsor
Nectin Therapeutics Ltd
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT05378425
Brief Title
A Study of NTX-1088, a Monoclonal Antibody Targeting the Poliovirus Receptor (PVR, CD155), as Monotherapy and Combined With Pembrolizumab
Official Title
A Phase 1, First-in-Human Study of NTX-1088, a Monoclonal Antibody Targeting the Poliovirus Receptor (PVR, CD155), as Monotherapy and Combined With Pembrolizumab, in Patients With Advanced Solid Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 1, 2022 (Actual)
Primary Completion Date
June 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nectin Therapeutics Ltd
Collaborators
Merck Sharp & Dohme LLC

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
This is a Phase 1,open-label, multi-center, first-in-human, 2-part (Part 1: dose escalation and Part 2: expansion) study, evaluating multiple doses and schedules of intravenously (IV) administered NTX-1088, with or without pembrolizumab, in patients with advanced solid malignancies (i.e., locally advanced or metastatic).
Detailed Description
This is a Phase 1, open-label, multi-center study whose principal Part 1 stage objective is to determine the recommended Phase 2 dose (RP2D) of the anti-PVR monoclonal antibody (mAb) as a single agent and combined with the anti-PD-1 mAb pembrolizumab in patients with advanced solid malignancies. In the Part 2 stage, the antitumor activity of NTX-1088 alone or combined with pembrolizumab will be evaluated in patients with malignancies known to express PVR.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer, Tumor, Solid, Advanced Solid Tumor, Metastatic Cancer, Locally Advanced Solid Tumor
Keywords
PVR, IO, Immune Oncology

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Part 1 - Dose Escalation Phase (Monotherapy)
Arm Type
Experimental
Arm Description
NTX-1088 administered as a 60-minute IV infusion at escalating doses as a monotherapy. NTX-1088 will be administered on Day 1 of a 21-day cycle.
Arm Title
Part 1 - Dose Escalation Phase (Combination Therapy)
Arm Type
Experimental
Arm Description
NTX-1088 administered as a 60-minute IV infusion in escalating doses in combination with pembrolizumab. NTX-1088 will be administered on Day 1 of a 21-day cycle. Pembrolizumab will be administered as a 30-minute IV infusion, within 2 hours prior to NTX-1088 administration, at a dose of 200 mg on Day 1 of every 21-day cycle.
Arm Title
Part 2 - Dose Expansion (Monotherapy)
Arm Type
Experimental
Arm Description
NTX-1088 administered at the RP2D as a 60-minute IV infusion as a monotherapy.
Arm Title
Part 2 - Dose Expansion (Combination Therapy)
Arm Type
Experimental
Arm Description
NTX-1088 administered at the RP2D as a 60-minute IV infusion in combination with pembrolizumab at the standard labeled dose.
Intervention Type
Drug
Intervention Name(s)
NTX-1088
Intervention Description
IgG4 mAb targeting the poliovirus receptor (PVR, CD155).
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Intervention Description
IgG4 mAb with high specificity of binding to the PD-1 receptor, thus inhibiting its interaction with programmed cell death ligand 1 (PD-L1) and programmed cell death ligand 2 (PD-L2).
Primary Outcome Measure Information:
Title
Dose-limiting Toxicity (DLT)
Description
The incidence of DLTs during the DLT assessment period.
Time Frame
First 21 days of treatment.
Title
Dose-Finding
Description
Determination of the MTD or maximum tested dose, and the RP2D.
Time Frame
Screening to 30 days from last dose.
Title
Frequency and Severity of Adverse Events (AE)
Description
The incidences and percentages of patients experiencing AEs summarized by NCI CTCAE version 5.0 grade and by causality.
Time Frame
Screening to 30 days from last dose.
Secondary Outcome Measure Information:
Title
Pharmacokinetics of NTX-1088
Description
Maximum Plasma Concentration (Cmax)
Time Frame
Day 1 of dosing through 21 days post last dose.
Title
Pharmacokinetics of NTX-1088
Description
Area Under the Curve (AUC)
Time Frame
Day 1 of dosing through 21 days post last dose.
Title
Objective Response Rate (ORR)
Description
ORR according to RECIST v1.1.
Time Frame
Day 1 of dosing through 90 days after the last dose.
Title
Duration of Response (DoR)
Description
Time from the date measurement criteria are first met for PR or CR to the date measurement criteria are first met for progressive disease.
Time Frame
Day 1 of dosing through 90 days after the last dose.
Title
Progression Free Survival (PFS)
Description
Time from the date of initiation of study therapy to the date measurement criteria are first met for progressive disease or death from any cause, whichever occurs first.
Time Frame
Day 1 of dosing through 90 days after the last dose.
Title
Overall Survival (OS)
Description
Time from the date of initiation of study therapy to the date of death from any cause.
Time Frame
Day 1 of dosing through 90 days after the last dose.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologic or cytologic evidence of an advanced (locally advanced or metastatic) malignant solid cancer known to express PVR, or if the patient's cancer has been documented to express PVR. Must have disease that is resistant to or relapsed following available standard systemic therapy, or for which there is no standard systemic therapy or reasonable therapy in the physician's judgment likely to result in clinical benefit, or if such therapy has been refused by the patient. Tumor tissue or paraffin block, ideally from the patient's most recent biopsy within 1 year of study treatment. A fresh tumor biopsy will be obtained if archival samples are not available or from tumor sampled more than 1 year prior to enrollment. Patient must be amenable to on treatment biopsy. Disease that is measurable by Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1. A least 18 years old. An Eastern Cooperative Oncology Group (ECOG) performance status of ≤1. Adequate baseline hematopoietic, kidney and liver function. A left ventricular ejection fraction (LVEF) ≥ 45%. Female participants are eligible to participate if not pregnant, not breastfeeding, and must agree to follow contraceptive guidance during the treatment period and for at least 120 days after the last dose of study treatment. Male subjects must agree to follow contraceptive guidance during the study period and for at least 120 days after the last dose of study treatment. Patient must give informed written consent for the study. Patient must adhere to the study visit schedule and other protocol requirements. Patient has sufficient venous access for protocol defined plasma/blood sampling. Exclusion Criteria: The patient was discontinued from prior treatment with an immuno-oncology therapeutic due to a Grade 3 or higher immune-related adverse event. Received radiotherapy within 2 weeks of treatment. Received radiation therapy to the lung that is greater than 30 Gray within 6 months of the first dose of study medication. The patient is concurrently receiving treatment with anticancer therapies (cytotoxic chemotherapy, monoclonal antibodies, and/or small molecule tyrosine kinase inhibitors). Received an allogeneic tissue/solid organ transplant. Received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention. Received prior treatment with NTX-1088 or another investigational agent targeting PVR. The participant must have recovered adequately from any major surgery and/or any complications from the surgery prior to starting study intervention. Currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study treatment. The patient must have recovered from all AEs due to previous therapies to Grade ≤1 or baseline. The patient has an active autoimmune disease that required systemic treatment in the past. Presence of an uncontrolled endocrine disorder. Presence of clinically significant cardiovascular disease. History of (non-infectious) pneumonitis or interstitial pulmonary disease that required steroids or has current pneumonitis or interstitial pulmonary disease. Presence of uncontrolled, clinically significant pulmonary disease. A previous severe hypersensitivity reaction (Grade ≥3) to pembrolizumab and/or any of its excipients. A diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study drug. Inhaled or topical steroids are permitted in the absence of active autoimmune disease. An uncontrolled intercurrent illness that would limit compliance with study requirements. History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study or interfere with participation in the study. A positive status for human immunodeficiency virus (HIV). A known history of Hepatitis B (defined as HBsAg reactive) or known active Hepatitis C virus (defined as HCV RNA detected) infection. Oxygen dependent. The patient has any medical condition which, in the opinion of the Investigator, places the patient at an unacceptably high risk for toxicities. Additional active malignancy that is progressing or has required active treatment within the past 3 years. Known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable. Patient is pregnant or breast feeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Keren Paz, PhD
Phone
201-218-1774
Email
keren@nectintx.com
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Miguel Villalona-Calero, MD
Facility Name
Ochsner Clinic Foundation
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70121
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marc Matrana, MD
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sarina A Piha-Paul, MD
First Name & Middle Initial & Last Name & Degree
Sarina A Piha-Paul, MD
Facility Name
Hadassah Medical Center
City
Jerusalem
ZIP/Postal Code
9574425
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jonathan Cohen, MD/PhD
Facility Name
Sheba Medical Center
City
Ramat Gan
ZIP/Postal Code
5262131
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shirly Grynberg, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of NTX-1088, a Monoclonal Antibody Targeting the Poliovirus Receptor (PVR, CD155), as Monotherapy and Combined With Pembrolizumab

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