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WTX-330 in Patients With Advanced or Metastatic Solid Tumors or Non-Hodgkin Lymphoma

Primary Purpose

Advanced or Metastatic Solid Tumors, Non-Hodgkin Lymphoma

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
WTX-330
Sponsored by
Werewolf Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced or Metastatic Solid Tumors focused on measuring WTX-330, Cancer, Immunotherapy, Interleukin-12, IL-12, Checkpoint inhibitor resistance

Eligibility Criteria

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

Inclusion Criteria: Age ≥ 18 years. Dose Escalation: A diagnosis of a relapsed/refractory advanced or metastatic solid tumor for which the patient has progressed on or is intolerant of standard therapy, or for whom no standard therapy with proven benefit exists. Dose Expansion: A diagnosis of a relapsed/refractory advanced or metastatic malignancy for which the patient has progressed on or is intolerant of standard therapy, or for whom no standard therapy with proven benefit exists. For Arm A, patients must have a tumor type for which a CPI is indicated/approved and demonstrate primary or secondary resistance to a standard of care anti-PD(L)1-based treatment regimen. For Arm B, patients must have a solid tumor type for which a CPI is not indicated/approved or non-Hodgkin lymphoma. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1. At least one measurable lesion per RECIST 1.1 or an evaluable lesion per Lugano classification (for lymphoma). Agrees to undergo a pre-treatment and on-treatment biopsy of a primary or metastatic solid tumor or lymphoma lesion. HIV-infected patients must be on antiretroviral therapy and have well-controlled disease. Adequate organ and bone marrow function. Willingness of men and women of reproductive potential to use highly effective birth control for the duration of treatment and for 4 months following the last dose of study drug. Additional criteria may apply. Exclusion Criteria: A history of another active malignancy (i.e., a second cancer) within the previous 2 years, except for localized cancers that are not related to the current cancer being treated, are considered cured, and, in the opinion of the Investigator, present a low risk of recurrence. These exceptions include but are not limited to basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the prostate, cervix, or breast. Received prior treatment with IL-12, including by intratumoral injection. Patients with primary CNS malignancies. Presence of CNS metastases that are symptomatic and/or require local CNS directed therapy (such as XRT or surgery) or increasing doses of corticosteroids within 2 weeks prior to the first dose of study drug. Patients with treated brain metastases should be neurologically stable and receiving ≤ 10 mg per day of prednisone or equivalent prior to study entry. Significant cardiovascular disease. Significant electrocardiogram (ECG) abnormalities Active autoimmune disease requiring systemic treatment in the past 2 years. Diagnosis of immunodeficiency, on immunosuppressive therapy, or receiving chronic systemic or enteric steroid therapy (dose > 10 mg/day of prednisone or equivalent). Prior receipt of an allogeneic stem cell transplant or allogeneic CAR-T cell therapy. Major surgery (excluding placement of vascular access) within 2 weeks prior to the first dose of study drug. Investigational agent or anticancer therapy (including chemotherapy, biologic therapy, immunotherapy, anticancer Chinese medicine, or anticancer herbal remedy) within 5 half-lives or 4 weeks (whichever is shorter) prior to the first dose of study drug. Radiotherapy within 2 weeks of the start of study treatment. A 1-week washout is permitted for palliative radiation (≤ 2 weeks of radiotherapy) to non-CNS disease. Any unresolved toxicities from prior therapy greater than NCI-CTCAE version 5.0 Grade 1 at the time of starting study drug with the exception of alopecia and Grade 2 platinum therapy-related neuropathy. Use of sensitive substrates of major CYP450 isozymes. Any illness, medical condition, organ system dysfunction, or social situation (including mental illness or substance abuse), that may interfere with a patient's ability to sign the ICF, adversely affect the patient's ability to cooperate and participate in the study, or compromise interpretation of study results. Received a live vaccine within 30 days of the first dose of study drug. Active, uncontrolled systemic bacterial, viral, or fungal infection. HIV-infected participants with a history of Kaposi sarcoma and/or Multicentric Castleman Disease. Active infection with hepatitis B as determined by hepatitis B surface antigen and hepatitis B core antibody, or hepatitis B virus deoxyribonucleic acid (DNA) by quantitative polymerase chain reaction (qPCR) testing. Active infection with hepatitis C as determined by hepatitis C virus (HCV) antibody or HCV RNA by qPCR testing. Pregnant or lactating. History of hypersensitivity to any of the study drug components. Additional criteria may apply

Sites / Locations

  • HonorHealthRecruiting
  • Northwestern UniversityRecruiting
  • Indiana UniversityRecruiting
  • Mass General HospitalRecruiting
  • Providence Cancer Institute Franz ClinicRecruiting
  • University of Pittsburgh Medical CenterRecruiting
  • NEXT OncologyRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

WTX-330 dose escalation

WTX-330 dose expansion in patients for whom CPI therapy is indicated (Arm A)

WTX-330 dose expansion in patients for whom CPI therapy is not indicated (Arm B)

Arm Description

Patients with relapsed/refractory advanced or metastatic solid tumors

WTX-330 dose expansion in patients with tumor types for which a CPI is indicated/approved who demonstrate primary or secondary resistance to an anti-PD(L)1-based regimen

WTX-330 dose expansion in patients with tumor types for which a CPI is not indicated/ approved

Outcomes

Primary Outcome Measures

Incidence of Dose Limiting Toxicities (DLTs)
Incidence of treatment emergent adverse events
Incidence of changes in clinical laboratory abnormalities
Investigator-assessed objective response rate (ORR) by RECIST 1.1 and immune ORR by iRECIST (for solid tumors) or response by Lugano criteria (for lymphomas)

Secondary Outcome Measures

Plasma concentrations of WTX-330 and free IL-12
Changes in circulating immune cell populations
Changes in soluble cytokines including IL-2, IL-4, IL-6, IL-10, IFN-γ and IP-10
Changes in tumor immune cell profile by immunohistochemistry (IHC)
Investigator-assessed ORR by RECIST 1.1 and immune ORR by iRECIST (for solid tumors) or response by Lugano criteria (for lymphomas) in patients who have progressed on CPIs or who have tumor indications for which CPIs are not approved
Antidrug antibody (ADA) occurrence
Duration of response
Progression free survival
Overall survival
Identification of potential biomarkers of target engagement and immune pathway activation in tumor biopsies

Full Information

First Posted
December 9, 2022
Last Updated
July 10, 2023
Sponsor
Werewolf Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05678998
Brief Title
WTX-330 in Patients With Advanced or Metastatic Solid Tumors or Non-Hodgkin Lymphoma
Official Title
A Phase 1 (First-In-Human [FIH]), Multi-Site, Dose Escalation and Expansion Study of WTX-330 in Adult Patients With Advanced or Metastatic Solid Tumors or Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 6, 2022 (Actual)
Primary Completion Date
November 2023 (Anticipated)
Study Completion Date
November 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Werewolf Therapeutics, Inc.

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
A first-in-human, Phase 1, open-label, multicenter study of WTX-330 administered as a monotherapy to patients with advanced or metastatic solid tumors or non-Hodgkin lymphoma.
Detailed Description
This is a first-in-human, Phase 1, open-label, multicenter study to evaluate the safety, tolerability and preliminary efficacy of WTX-330, a conditionally-activated IL-12 prodrug, when administered as a monotherapy to patients with advanced or metastatic solid tumors or non-Hodgkin lymphoma. Dose escalation will be conducted in patients with advanced and/or metastatic solid tumors who are refractory to all standard of care therapies. Dose expansion will be conducted in two arms: Arm A will enroll patients with indications for which a checkpoint inhibitor (CPI) is indicated/approved who demonstrate primary or secondary resistance to an anti-PD(L)1 treatment regimen, and Arm B will enroll patients with tumor types for which CPI therapy is not indicated/approved.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced or Metastatic Solid Tumors, Non-Hodgkin Lymphoma
Keywords
WTX-330, Cancer, Immunotherapy, Interleukin-12, IL-12, Checkpoint inhibitor resistance

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
WTX-330 dose escalation
Arm Type
Experimental
Arm Description
Patients with relapsed/refractory advanced or metastatic solid tumors
Arm Title
WTX-330 dose expansion in patients for whom CPI therapy is indicated (Arm A)
Arm Type
Experimental
Arm Description
WTX-330 dose expansion in patients with tumor types for which a CPI is indicated/approved who demonstrate primary or secondary resistance to an anti-PD(L)1-based regimen
Arm Title
WTX-330 dose expansion in patients for whom CPI therapy is not indicated (Arm B)
Arm Type
Experimental
Arm Description
WTX-330 dose expansion in patients with tumor types for which a CPI is not indicated/ approved
Intervention Type
Drug
Intervention Name(s)
WTX-330
Intervention Description
Investigation Product
Primary Outcome Measure Information:
Title
Incidence of Dose Limiting Toxicities (DLTs)
Time Frame
4 weeks
Title
Incidence of treatment emergent adverse events
Time Frame
24 months
Title
Incidence of changes in clinical laboratory abnormalities
Time Frame
24 months
Title
Investigator-assessed objective response rate (ORR) by RECIST 1.1 and immune ORR by iRECIST (for solid tumors) or response by Lugano criteria (for lymphomas)
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Plasma concentrations of WTX-330 and free IL-12
Time Frame
24 months
Title
Changes in circulating immune cell populations
Time Frame
24 months
Title
Changes in soluble cytokines including IL-2, IL-4, IL-6, IL-10, IFN-γ and IP-10
Time Frame
24 months
Title
Changes in tumor immune cell profile by immunohistochemistry (IHC)
Time Frame
24 months
Title
Investigator-assessed ORR by RECIST 1.1 and immune ORR by iRECIST (for solid tumors) or response by Lugano criteria (for lymphomas) in patients who have progressed on CPIs or who have tumor indications for which CPIs are not approved
Time Frame
24 months
Title
Antidrug antibody (ADA) occurrence
Time Frame
24 months
Title
Duration of response
Time Frame
24 months
Title
Progression free survival
Time Frame
24 months
Title
Overall survival
Time Frame
36 months
Title
Identification of potential biomarkers of target engagement and immune pathway activation in tumor biopsies
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years. Dose Escalation: A diagnosis of a relapsed/refractory advanced or metastatic solid tumor for which the patient has progressed on or is intolerant of standard therapy, or for whom no standard therapy with proven benefit exists. Dose Expansion: A diagnosis of a relapsed/refractory advanced or metastatic malignancy for which the patient has progressed on or is intolerant of standard therapy, or for whom no standard therapy with proven benefit exists. For Arm A, patients must have a tumor type for which a CPI is indicated/approved and demonstrate primary or secondary resistance to a standard of care anti-PD(L)1-based treatment regimen. For Arm B, patients must have a solid tumor type for which a CPI is not indicated/approved or non-Hodgkin lymphoma. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1. At least one measurable lesion per RECIST 1.1 or an evaluable lesion per Lugano classification (for lymphoma). Agrees to undergo a pre-treatment and on-treatment biopsy of a primary or metastatic solid tumor or lymphoma lesion. HIV-infected patients must be on antiretroviral therapy and have well-controlled disease. Adequate organ and bone marrow function. Willingness of men and women of reproductive potential to use highly effective birth control for the duration of treatment and for 4 months following the last dose of study drug. Additional criteria may apply. Exclusion Criteria: A history of another active malignancy (i.e., a second cancer) within the previous 2 years, except for localized cancers that are not related to the current cancer being treated, are considered cured, and, in the opinion of the Investigator, present a low risk of recurrence. These exceptions include but are not limited to basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the prostate, cervix, or breast. Received prior treatment with IL-12, including by intratumoral injection. Patients with primary CNS malignancies. Presence of CNS metastases that are symptomatic and/or require local CNS directed therapy (such as XRT or surgery) or increasing doses of corticosteroids within 2 weeks prior to the first dose of study drug. Patients with treated brain metastases should be neurologically stable and receiving ≤ 10 mg per day of prednisone or equivalent prior to study entry. Significant cardiovascular disease. Significant electrocardiogram (ECG) abnormalities Active autoimmune disease requiring systemic treatment in the past 2 years. Diagnosis of immunodeficiency, on immunosuppressive therapy, or receiving chronic systemic or enteric steroid therapy (dose > 10 mg/day of prednisone or equivalent). Prior receipt of an allogeneic stem cell transplant or allogeneic CAR-T cell therapy. Major surgery (excluding placement of vascular access) within 2 weeks prior to the first dose of study drug. Investigational agent or anticancer therapy (including chemotherapy, biologic therapy, immunotherapy, anticancer Chinese medicine, or anticancer herbal remedy) within 5 half-lives or 4 weeks (whichever is shorter) prior to the first dose of study drug. Radiotherapy within 2 weeks of the start of study treatment. A 1-week washout is permitted for palliative radiation (≤ 2 weeks of radiotherapy) to non-CNS disease. Any unresolved toxicities from prior therapy greater than NCI-CTCAE version 5.0 Grade 1 at the time of starting study drug with the exception of alopecia and Grade 2 platinum therapy-related neuropathy. Use of sensitive substrates of major CYP450 isozymes. Any illness, medical condition, organ system dysfunction, or social situation (including mental illness or substance abuse), that may interfere with a patient's ability to sign the ICF, adversely affect the patient's ability to cooperate and participate in the study, or compromise interpretation of study results. Received a live vaccine within 30 days of the first dose of study drug. Active, uncontrolled systemic bacterial, viral, or fungal infection. HIV-infected participants with a history of Kaposi sarcoma and/or Multicentric Castleman Disease. Active infection with hepatitis B as determined by hepatitis B surface antigen and hepatitis B core antibody, or hepatitis B virus deoxyribonucleic acid (DNA) by quantitative polymerase chain reaction (qPCR) testing. Active infection with hepatitis C as determined by hepatitis C virus (HCV) antibody or HCV RNA by qPCR testing. Pregnant or lactating. History of hypersensitivity to any of the study drug components. Additional criteria may apply
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Study Director
Phone
617-952-0555
Email
clinicaltrials@werewolftx.com
Facility Information:
Facility Name
HonorHealth
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
Clinical Trials Nurse Navigation
Phone
480-323-1339
Email
clinicaltrials@honorhealth.com
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Study Coordinator
Phone
312-695-1301
Email
cancertrials@northwestern.edu
Facility Name
Indiana University
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anne Younger
Phone
317-274-0951
Email
anefoste@iu.edu
Facility Name
Mass General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aparna Parikh
Phone
617-724-4000
Email
aparna.parikh@mgh.harvard.edu
Facility Name
Providence Cancer Institute Franz Clinic
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Patrick Rethwisch
Phone
503-215-6450
Email
patrick.rethwisch@providence.org
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Julie Urban
Phone
412-623-7396
Email
IDDCReferrals@upmc.edu
Facility Name
NEXT Oncology
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cynthia Deleon
Phone
210-580-9521
Email
cdeleon@nextoncology.com

12. IPD Sharing Statement

Learn more about this trial

WTX-330 in Patients With Advanced or Metastatic Solid Tumors or Non-Hodgkin Lymphoma

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