Study Investigating the Association of NP137 With Atezolizumab-Bevacizumab Combination in First Line in Unresectable Hepatocellular Carcinoma (Liver-NET1)
Primary Purpose
Hepatocellular Carcinoma
Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
NP137
Atezolizumab
Bevacizumab
Sponsored by
About this trial
This is an interventional treatment trial for Hepatocellular Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Males or females ≥ 18 years of age
- Histologically confirmed (liver biopsy within 24 previous weeks) and documented unresectable hepatocellular carcinoma
- No prior systemic therapy for advanced HCC.
- Liver tumor burden < 50% of the liver (per Investigator judgment)
- Child-Pugh A (≤ 6) without any history of cirrhotic decompensation within the past 6 months
- Antiviral therapy required in hepatitis B virus patients (Hepatitis B antigen positive)
- Willing to have liver biopsy between C4 and C5
- Presence of a measurable tumor per RECIST v1.1 criteria
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1
- Life expectancy ≥ 12 weeks
- Absence of previous liver decompensation
- In case of cirrhosis, last esophageal varices detection by esogastroduodenal endoscopy have to be performed within last the 6 months before inclusion
Adequate hematologic function prior to the first dose of NP137, defined as:
- Absolute neutrophils count ≥ 1500 cells/µL
- Hemoglobin ≥ 9 g/dL with no transfusion within 4 weeks prior to first planned dose of NP137
- Platelet count > 50,000/µL with no transfusion within 2 weeks prior to first planned dose of NP137
Adequate renal function prior to first dose, defined as
- Serum creatinine < 1.5 ULN
- Creatinine clearance ≥ 30 mL/min/m2 (by Cockroft-Gault equation of 24-hour urine) if creatinine ≥ 1.5 X ULN
- Adequate hepatic function prior first dose, defined as AST/ALT ≤ 5 X ULN
- Women patients of childbearing potential* must have a negative serum pregnancy test at screening and baseline, and be willing to use a highly effective** contraception. The patient should be advised to continue the contraception for at least 6 months following the completion of dosing. Women with cessation for > 24 months of previously occurring menses, or women of any age who have had a hysterectomy, or have had both ovaries removed will be considered to be of non-childbearing potential.
- Male patients of reproductive potential must be willing to use one acceptable method of contraception, as judged by Investigator and Sponsor and/or to refrain from donating sperm from the time of screening through at least 6 months following the completion of dose administration.
- Amenable to computed tomography (CT) with 3 or 4 phase liver or magnetic resonance imaging (MRI) of abdomen and pelvis, and CT of chest, or MRI of whole body, for initial tumor size measurements and subsequent follow-up.
- Absence of other clinically relevant abnormalities for any screening laboratory test results as judged by the Investigator and Sponsor.
- Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
- Able to understand and provide written informed consent
- Patients covered by Health Insurance System
Exclusion Criteria:
- Any known history of encephalopathy
- Untreated or incompletely treated esophageal and/or gastric varices with bleeding or high-risk for bleeding
- Known esophageal varices with recent history of bleeding (within previous 6 months)
- Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
- Known fibrolamellar HCC, sarcomatoid HCC, or mixed cholangiocarcinoma and HCC
- Chronic treatment with immunosuppressive agents (like steroids) ≤ 6 weeks prior to first planned dose of treatment.
- Major surgical procedures, open biopsy or significant traumatic injury ≤ 4 weeks prior to first dose of treatment or anticipation of major surgical procedure during the course of the trial, minor surgical procedures ≤ 1 week of first planned dose
- Local therapy to liver within 28 days prior to initiation of study treatment or non-recovery from side effects of any such procedure
- Any clinically significant cardiovascular condition as judged by the Investigator
- Severe or uncontrolled renal condition
- Untreated chronic hepatitis B
- Co-infection of HBV and HCV
- Use of any prohibited concomitant medications within 14 days of the Baseline/Day 1 visit
- Contraindication to additionnal liver biopsy planned between C4 and C5
- Contraindication to iodinated contrast agent infusion
- Known current alcohol (> 20g/ Day in women and > 30g/ Day in men) or substance abuse
- History of leptomeningeal disease
- Active or history of autoimmune disease or immune deficiency
- History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography scan
- Known active tuberculosis
- History of malignancy other than HCC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death
- Pregnancy or breastfeeding, or intention of becoming pregnant during study treatment or within at least 6 months after the last dose of treatment
- Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
- Uncontrolled tumor-related pain
- Uncontrolled or symptomatic hypercalcemia
- Treatment with systemic immunostimulatory agents
- Inadequately controlled arterial hypertension
- Prior history of hypertensive crisis or hypertensive encephalopathy
- Evidence of bleeding diathesis or significant coagulopathy
- History of intestinal obstruction and/or clinical signs or symptoms of GI obstruction including sub-occlusive disease related to the underlying disease or requirement for routine parenteral hydration
- Serious, non-healing or dehiscing wound, active ulcer, or untreated bone fracture
- Metastatic disease that involves major airways or blood vessels, or centrally located mediastinal tumor masses
- Known clinically significant or life threatening organ or systemic disease such that in the opinion of the Investigator, the significance of the disease will compromise the patient's participation in the trial
- Known intolerance or hypersensitivity to the active ingredient or to one of the components of the study drug
- Subject in exclusion period for another study,
- Subject who cannot be contacted in an emergency
- Persons referred to in Articles L1121-5 to L1121-8 of the French code of public health (this corresponds to all persons protected: pregnant or parturient women, breastfeeding mothers, persons deprived of liberty by judicial or administrative decision, persons subject to a legal protection measure).
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Experimental
Arm Description
NP137+Atezolizumab-Bevacizumab
Outcomes
Primary Outcome Measures
Percentage Proportion of patients experiencing adverse events
Percentage Proportion of patients experiencing adverse events (AEs) of any grade and grade 3/4 AEs as defined by the National Cancer Institute - Common Terminology Criteria for Adverse Events (CTCAE v 5.0) throughout the study period.
Secondary Outcome Measures
Best overall objective response rate (ORR)
Best overall objective response rate (ORR) and ORR at 3 months, 6, 9, 12 months according to mRECIST and RECIST 1.1.
Full Information
NCT ID
NCT05546879
First Posted
September 15, 2022
Last Updated
September 23, 2022
Sponsor
University Hospital, Grenoble
Collaborators
NETRIS Pharma
1. Study Identification
Unique Protocol Identification Number
NCT05546879
Brief Title
Study Investigating the Association of NP137 With Atezolizumab-Bevacizumab Combination in First Line in Unresectable Hepatocellular Carcinoma
Acronym
Liver-NET1
Official Title
Study Investigating the Association of NP137 With Atezolizumab-Bevacizumab Combination in First Line in Unresectable Hepatocellular Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
September 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
November 2022 (Anticipated)
Primary Completion Date
November 2024 (Anticipated)
Study Completion Date
November 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Grenoble
Collaborators
NETRIS Pharma
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The study will assess the safety of the association of NP137 with the standard of care Atezolizumab-Bevacizumab in first line setting in patients with unresectable hepatocellular carcinoma.The study drug which is tested is the NP137 in association with Atezolizumab-Bevacizumab to allow a better tumor response as well as better survival outcomes with an acceptable safety.
Detailed Description
The study is a multicentric, prospective, single arm phase 1b trial. This study will enroll 43 to 52 patients and consists of 2 parts: Safety Lead-in Phase and Expansion Phase. Initially, 3 to 12 patients will be enrolled into a Safety Lead-in Phase based on a 3 + 3 design, with the possibility of dose de-escalation, to confirm the recommended dose of NP137 .The Expansion Phase will start after completion of Safety Lead-in Phase at the confirmed dose and will include 40 patients. Patients will be assigned to the experimental single arm (NP137+ Atezolizumab-Bevacizumab).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
Multicentric prospective single arm phase 1b trial
Masking
None (Open Label)
Allocation
N/A
Enrollment
52 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Experimental
Arm Type
Experimental
Arm Description
NP137+Atezolizumab-Bevacizumab
Intervention Type
Drug
Intervention Name(s)
NP137
Intervention Description
NP137 at 9 or 14 mg/kg IV will be administered every 21 days.
Intervention Type
Drug
Intervention Name(s)
Atezolizumab
Intervention Description
Atezolizumab will be administered by IV infusion at a fixed dose of 1200 mg on Day 1 of each 21-days cycle
Intervention Type
Drug
Intervention Name(s)
Bevacizumab
Intervention Description
Bevacizumab will be administered by IV infusion at a dose of 15 mg/kg on Day 1 of each 21-day cycle
Primary Outcome Measure Information:
Title
Percentage Proportion of patients experiencing adverse events
Description
Percentage Proportion of patients experiencing adverse events (AEs) of any grade and grade 3/4 AEs as defined by the National Cancer Institute - Common Terminology Criteria for Adverse Events (CTCAE v 5.0) throughout the study period.
Time Frame
At 36 months
Secondary Outcome Measure Information:
Title
Best overall objective response rate (ORR)
Description
Best overall objective response rate (ORR) and ORR at 3 months, 6, 9, 12 months according to mRECIST and RECIST 1.1.
Time Frame
At 3,6,9,12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Males or females ≥ 18 years of age
Histologically confirmed (liver biopsy within 24 previous weeks) and documented unresectable hepatocellular carcinoma
No prior systemic therapy for advanced HCC.
Liver tumor burden < 50% of the liver (per Investigator judgment)
Child-Pugh A (≤ 6) without any history of cirrhotic decompensation within the past 6 months
Antiviral therapy required in hepatitis B virus patients (Hepatitis B antigen positive)
Willing to have liver biopsy between C4 and C5
Presence of a measurable tumor per RECIST v1.1 criteria
Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1
Life expectancy ≥ 12 weeks
Absence of previous liver decompensation
In case of cirrhosis, last esophageal varices detection by esogastroduodenal endoscopy have to be performed within last the 6 months before inclusion
Adequate hematologic function prior to the first dose of NP137, defined as:
Absolute neutrophils count ≥ 1500 cells/µL
Hemoglobin ≥ 9 g/dL with no transfusion within 4 weeks prior to first planned dose of NP137
Platelet count > 50,000/µL with no transfusion within 2 weeks prior to first planned dose of NP137
Adequate renal function prior to first dose, defined as
Serum creatinine < 1.5 ULN
Creatinine clearance ≥ 30 mL/min/m2 (by Cockroft-Gault equation of 24-hour urine) if creatinine ≥ 1.5 X ULN
Adequate hepatic function prior first dose, defined as AST/ALT ≤ 5 X ULN
Women patients of childbearing potential* must have a negative serum pregnancy test at screening and baseline, and be willing to use a highly effective** contraception. The patient should be advised to continue the contraception for at least 6 months following the completion of dosing. Women with cessation for > 24 months of previously occurring menses, or women of any age who have had a hysterectomy, or have had both ovaries removed will be considered to be of non-childbearing potential.
Male patients of reproductive potential must be willing to use one acceptable method of contraception, as judged by Investigator and Sponsor and/or to refrain from donating sperm from the time of screening through at least 6 months following the completion of dose administration.
Amenable to computed tomography (CT) with 3 or 4 phase liver or magnetic resonance imaging (MRI) of abdomen and pelvis, and CT of chest, or MRI of whole body, for initial tumor size measurements and subsequent follow-up.
Absence of other clinically relevant abnormalities for any screening laboratory test results as judged by the Investigator and Sponsor.
Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
Able to understand and provide written informed consent
Patients covered by Health Insurance System
Exclusion Criteria:
Any known history of encephalopathy
Untreated or incompletely treated esophageal and/or gastric varices with bleeding or high-risk for bleeding
Known esophageal varices with recent history of bleeding (within previous 6 months)
Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
Known fibrolamellar HCC, sarcomatoid HCC, or mixed cholangiocarcinoma and HCC
Chronic treatment with immunosuppressive agents (like steroids) ≤ 6 weeks prior to first planned dose of treatment.
Major surgical procedures, open biopsy or significant traumatic injury ≤ 4 weeks prior to first dose of treatment or anticipation of major surgical procedure during the course of the trial, minor surgical procedures ≤ 1 week of first planned dose
Local therapy to liver within 28 days prior to initiation of study treatment or non-recovery from side effects of any such procedure
Any clinically significant cardiovascular condition as judged by the Investigator
Severe or uncontrolled renal condition
Untreated chronic hepatitis B
Co-infection of HBV and HCV
Use of any prohibited concomitant medications within 14 days of the Baseline/Day 1 visit
Contraindication to additionnal liver biopsy planned between C4 and C5
Contraindication to iodinated contrast agent infusion
Known current alcohol (> 20g/ Day in women and > 30g/ Day in men) or substance abuse
History of leptomeningeal disease
Active or history of autoimmune disease or immune deficiency
History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography scan
Known active tuberculosis
History of malignancy other than HCC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death
Pregnancy or breastfeeding, or intention of becoming pregnant during study treatment or within at least 6 months after the last dose of treatment
Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
Uncontrolled tumor-related pain
Uncontrolled or symptomatic hypercalcemia
Treatment with systemic immunostimulatory agents
Inadequately controlled arterial hypertension
Prior history of hypertensive crisis or hypertensive encephalopathy
Evidence of bleeding diathesis or significant coagulopathy
History of intestinal obstruction and/or clinical signs or symptoms of GI obstruction including sub-occlusive disease related to the underlying disease or requirement for routine parenteral hydration
Serious, non-healing or dehiscing wound, active ulcer, or untreated bone fracture
Metastatic disease that involves major airways or blood vessels, or centrally located mediastinal tumor masses
Known clinically significant or life threatening organ or systemic disease such that in the opinion of the Investigator, the significance of the disease will compromise the patient's participation in the trial
Known intolerance or hypersensitivity to the active ingredient or to one of the components of the study drug
Subject in exclusion period for another study,
Subject who cannot be contacted in an emergency
Persons referred to in Articles L1121-5 to L1121-8 of the French code of public health (this corresponds to all persons protected: pregnant or parturient women, breastfeeding mothers, persons deprived of liberty by judicial or administrative decision, persons subject to a legal protection measure).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Anna BOROWIK
Phone
0476769314
Email
aborowik@chu-grenoble.fr
First Name & Middle Initial & Last Name or Official Title & Degree
Irina GUIGARD
Phone
0476766150
Email
IGuigard@chu-grenoble.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gaël ROTH, MD PHD
Organizational Affiliation
University Hospital, Grenoble
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Study Investigating the Association of NP137 With Atezolizumab-Bevacizumab Combination in First Line in Unresectable Hepatocellular Carcinoma
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