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IKS014 in Advanced Solid Tumors That Express HER2

Primary Purpose

Breast Cancer, Gastric Cancer, Gastroesophageal-junction Cancer

Status
Recruiting
Phase
Phase 1
Locations
Australia
Study Type
Interventional
Intervention
IKS014
Sponsored by
Iksuda Therapeutics Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring HER2, IKS014, Low HER2, Advanced tumors, HER2+, HER2-positive, HER2 expression, GEJ

Eligibility Criteria

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

Key Inclusion Criteria: HER2 positive solid tumors with expression defined as IHC3+, IHC2+/ISH+, or low HER2 expression defined as IHC2+ (ISH-) or IHC1+ (ISH- /+ or untested). Participants with HR positive BC must have received prior treatment with a CDK4/6 inhibitor, in countries where this is standard therapy. Platelets ≥ 75,000 /mcL Hemoglobin ≥ 9.0 g/dL Absolute neutrophil count ≥ 1000/mcL No administration of granulocyte colony-stimulating factor (G-CSF) is allowed within 2 weeks prior to first study drug administration Creatinine clearance > 45/mL/min (using the Cockcroft-Gault equation) Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 3 x institutional upper limit of normal (ULN) ≤ 5 x ULN if liver metastases present Total bilirubin ≤ 1.5 x ULN if no liver metastases or < 3 x ULN with Gilbert's Syndrome or liver metastases at baseline Albumin > 2.5 g/dL Prothrombin time or international normalized ratio (INR) and either partial thromboplastin time (PTT) or activated (a) PTT ≤ 1.5 x ULN, ≤ 3 x institutional ULN if anticoagulated. Must have adequate treatment washout period before trial treatment, defined as: Major surgery (≥ 4 weeks) and radiation therapy (≥ 3 weeks; in case of palliative radiation ≥ 2 weeks) Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 (or equivalent Karnofsky PS) Part 2 Dose Expansion Cohorts May Include: Advanced or metastatic BC that is confirmed HER2-positive defined as IHC 3+ or IHC 2+ and evidence of HER2 amplification by ISH, as per ASCO-CAP and previously treated with at least two HER2 directed treatments. Advanced or metastatic BC that has low HER2 expression defined as IHC2+ (ISH-) or IHC1+ (ISH-/+ or untested) and previously treated with at least 1 prior line of therapy which may include chemotherapy and/or a HER2 directed ADC. Advanced or metastatic GC or GEJ cancer that is confirmed HER2-positive defined as IHC 3+ or IHC 2+ and evidence of HER2 amplification by ISH as per ASCO-CAP and previously treated with at least 1 prior line of therapy, which may include chemotherapy and/or a HER2 directed ADC. Advanced or metastatic GC or GEJ cancer that has low HER2 expression defined as IHC2+ (ISH-) or IHC1+ (ISH-/+ or untested) and has been previously treated with at least one prior line of therapy. Advanced or metastatic solid tumor that has any degree of HER2 expression (HER2 IHC3+, IHC2+, IHC1+ or ISH+) or a known activating HER2 mutation and has been treated with standard of care therapy relevant to the disease. Key Exclusion Criteria: History of (noninfectious) ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at Screening. Any clinically apparent ≥ Grade 2 pulmonary compromise resulting from intercurrent pulmonary illnesses including, but not limited to, any underlying pulmonary disorder (i.e., pulmonary emboli within three months of the trial enrollment, severe asthma, severe chronic obstructive pulmonary disease [COPD], restrictive lung disease, pleural effusion, etc.), and any autoimmune, connective tissue or inflammatory disorders with potential pulmonary involvement (e.g., rheumatoid arthritis, Sjogren's, sarcoidosis), or prior pneumonectomy. Current evidence of ≥ Grade 2 keratitis or other corneal abnormality. Evidence of a clinically significant (≥ Grade 2) abnormality on slit-lamp examination or other clinically significant ophthalmologic finding, as determined by an ophthalmologist. Evidence of clinically significant (≥ Grade 2) confluent superficial keratitis, a corneal epithelial defect, a corneal ulcer, or stromal opacity. Participant must not use contact lenses while participating in this study. Central nervous system metastatic disease unless treated with definitive local therapy (surgical resection, stereotactic radiotherapy, or whole brain radiotherapy) and participant is clinically, radiologically and neurologically stable for at least 4 weeks prior to the first dose of study drug not on steroid therapy or are on a stable or decreasing dose of steroids for at least 7 days prior to first dose of study drug. Prophylactic anticonvulsant medications are allowed. Active second malignancy or history of another malignancy within the last 2 years with the exception of: Treated, non-melanoma skin cancers Treated carcinoma in situ (CIS) (e.g., breast, cervix) Controlled, superficial carcinoma of the urinary bladder T1a or b carcinoma of the prostate treated according to local standard of care, with prostate specific antigen (PSA) within normal limits (WNL) for the institution Papillary thyroid carcinoma Stage I treated surgically for cure Clinically significant cardiovascular disease or condition Clinically significant liver disease Any other serious/active/uncontrolled infection, any infection requiring parenteral antibiotics, or unexplained fever > 38ºC within 2 weeks prior to first trial drug administration. Any other serious, life-threatening, or unstable preexisting medical condition (aside from the underlying malignancy), including significant organ system dysfunction, or clinically significant laboratory abnormality(ies), which, in the opinion of the Investigator, would either compromise the participant's safety or interfere with obtaining informed consent, compliance with trial procedures, or evaluation of the safety of the trial drug

Sites / Locations

  • Concord Repatriation General Hospital Medical Oncology Clinical Trials Unit
  • Westmead Hospital
  • Peninsula & South Eastern Haematology and Oncology Group (PSEHOG)Recruiting
  • Alfred Health
  • Linear Clinical ResearchRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Dose Escalation Cohort (Part 1)

Dose Expansion: HER2+ Breast Cancer Participants

Dose Expansion: HER2 Low Breast Cancer Participants

Dose Expansion: HER2+ Gastric Cancer or Gastro-esophageal Junction Participants

Dose Expansion: HER2 Low Gastric Cancer or Gastro-esophageal Junction Participants

Dose Expansion: HER2 Solid Tumor Cancer Participants

Arm Description

Each patient will receive repeat doses (by intravenous (IV) infusions) on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.

Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.

Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.

Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.

Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.

Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.

Outcomes

Primary Outcome Measures

Recommended Phase 2 Dose (Part 1)
Based on tolerability, preliminary anti-tumor activity, and pharmacokinetics
Objective Response Rate (Part 2)
Anti-tumor activity will be assessed by RECIST 1.1

Secondary Outcome Measures

Objective Response Rate (Part 1)
Anti-tumor activity will be assessed by RECIST 1.1
Plasma Concentrations of IKS014 (Part 1 and 2)
Pharmacokinetic parameters will be determined from observed concentrations of IKS014
Evaluation of the immunogenicity of IKS014 (Part 1 and 2)
Occurrence of ADA measured in serum at selected timepoints during the study

Full Information

First Posted
May 14, 2023
Last Updated
September 19, 2023
Sponsor
Iksuda Therapeutics Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05872295
Brief Title
IKS014 in Advanced Solid Tumors That Express HER2
Official Title
A Phase 1 Dose Escalation Trial to Determine the Safety, Tolerance, Maximum Tolerated Dose, and Preliminary Antineoplastic Activity of IKS014, a HER2-Targeting Antibody Drug Conjugate (ADC), in Participants With Advanced HER2+ Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 14, 2023 (Actual)
Primary Completion Date
September 2025 (Anticipated)
Study Completion Date
September 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Iksuda Therapeutics Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will evaluate the recommended dose for further clinical development, safety, tolerability, anti-tumor activity, immunogenicity, pharmacokinetics and pharmacodynamics of IKS014, a HER2 targeting antibody-drug conjugate, in patients with advanced solid tumors.
Detailed Description
The study will consist of 2 parts: dose-escalation (Part 1) and dose-expansion (Part 2). The dose-escalation part (Part 1) of the study is to evaluate the safety and tolerability of increasing dose levels of IKS014 to establish a recommended phase 2 dose (RP2D); and the dose-expansion part (Part 2) of the study is to further evaluate the safety, pharmacokinetics/pharmacodynamics, and efficacy of IKS014 at the RP2D.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Gastric Cancer, Gastroesophageal-junction Cancer
Keywords
HER2, IKS014, Low HER2, Advanced tumors, HER2+, HER2-positive, HER2 expression, GEJ

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation Cohort (Part 1)
Arm Type
Experimental
Arm Description
Each patient will receive repeat doses (by intravenous (IV) infusions) on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.
Arm Title
Dose Expansion: HER2+ Breast Cancer Participants
Arm Type
Experimental
Arm Description
Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.
Arm Title
Dose Expansion: HER2 Low Breast Cancer Participants
Arm Type
Experimental
Arm Description
Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.
Arm Title
Dose Expansion: HER2+ Gastric Cancer or Gastro-esophageal Junction Participants
Arm Type
Experimental
Arm Description
Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.
Arm Title
Dose Expansion: HER2 Low Gastric Cancer or Gastro-esophageal Junction Participants
Arm Type
Experimental
Arm Description
Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.
Arm Title
Dose Expansion: HER2 Solid Tumor Cancer Participants
Arm Type
Experimental
Arm Description
Each patient will receive IKS014 at the recommended dose defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met.
Intervention Type
Drug
Intervention Name(s)
IKS014
Intervention Description
IKS014 is a human monoclonal antibody (Ab) targeting HER2 linked to monomethyl auristatin F (MMAF) cytotoxic agent.
Primary Outcome Measure Information:
Title
Recommended Phase 2 Dose (Part 1)
Description
Based on tolerability, preliminary anti-tumor activity, and pharmacokinetics
Time Frame
Up to 24 months
Title
Objective Response Rate (Part 2)
Description
Anti-tumor activity will be assessed by RECIST 1.1
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
Objective Response Rate (Part 1)
Description
Anti-tumor activity will be assessed by RECIST 1.1
Time Frame
Up to 24 months
Title
Plasma Concentrations of IKS014 (Part 1 and 2)
Description
Pharmacokinetic parameters will be determined from observed concentrations of IKS014
Time Frame
Up to 48 months
Title
Evaluation of the immunogenicity of IKS014 (Part 1 and 2)
Description
Occurrence of ADA measured in serum at selected timepoints during the study
Time Frame
Up to 48 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: HER2 positive solid tumors with expression defined as IHC3+, IHC2+/ISH+, or low HER2 expression defined as IHC2+ (ISH-) or IHC1+ (ISH- /+ or untested). Participants with HR positive BC must have received prior treatment with a CDK4/6 inhibitor, in countries where this is standard therapy. Platelets ≥ 75,000 /mcL Hemoglobin ≥ 9.0 g/dL Absolute neutrophil count ≥ 1000/mcL No administration of granulocyte colony-stimulating factor (G-CSF) is allowed within 2 weeks prior to first study drug administration Creatinine clearance > 45/mL/min (using the Cockcroft-Gault equation) Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 3 x institutional upper limit of normal (ULN) ≤ 5 x ULN if liver metastases present Total bilirubin ≤ 1.5 x ULN if no liver metastases or < 3 x ULN with Gilbert's Syndrome or liver metastases at baseline Albumin > 2.5 g/dL Prothrombin time or international normalized ratio (INR) and either partial thromboplastin time (PTT) or activated (a) PTT ≤ 1.5 x ULN, ≤ 3 x institutional ULN if anticoagulated. Must have adequate treatment washout period before trial treatment, defined as: Major surgery (≥ 4 weeks) and radiation therapy (≥ 3 weeks; in case of palliative radiation ≥ 2 weeks) Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 (or equivalent Karnofsky PS) Part 2 Dose Expansion Cohorts May Include: Advanced or metastatic BC that is confirmed HER2-positive defined as IHC 3+ or IHC 2+ and evidence of HER2 amplification by ISH, as per ASCO-CAP and previously treated with at least two HER2 directed treatments. Advanced or metastatic BC that has low HER2 expression defined as IHC2+ (ISH-) or IHC1+ (ISH-/+ or untested) and previously treated with at least 1 prior line of therapy which may include chemotherapy and/or a HER2 directed ADC. Advanced or metastatic GC or GEJ cancer that is confirmed HER2-positive defined as IHC 3+ or IHC 2+ and evidence of HER2 amplification by ISH as per ASCO-CAP and previously treated with at least 1 prior line of therapy, which may include chemotherapy and/or a HER2 directed ADC. Advanced or metastatic GC or GEJ cancer that has low HER2 expression defined as IHC2+ (ISH-) or IHC1+ (ISH-/+ or untested) and has been previously treated with at least one prior line of therapy. Advanced or metastatic solid tumor that has any degree of HER2 expression (HER2 IHC3+, IHC2+, IHC1+ or ISH+) or a known activating HER2 mutation and has been treated with standard of care therapy relevant to the disease. Key Exclusion Criteria: History of (noninfectious) ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at Screening. Any clinically apparent ≥ Grade 2 pulmonary compromise resulting from intercurrent pulmonary illnesses including, but not limited to, any underlying pulmonary disorder (i.e., pulmonary emboli within three months of the trial enrollment, severe asthma, severe chronic obstructive pulmonary disease [COPD], restrictive lung disease, pleural effusion, etc.), and any autoimmune, connective tissue or inflammatory disorders with potential pulmonary involvement (e.g., rheumatoid arthritis, Sjogren's, sarcoidosis), or prior pneumonectomy. Current evidence of ≥ Grade 2 keratitis or other corneal abnormality. Evidence of a clinically significant (≥ Grade 2) abnormality on slit-lamp examination or other clinically significant ophthalmologic finding, as determined by an ophthalmologist. Evidence of clinically significant (≥ Grade 2) confluent superficial keratitis, a corneal epithelial defect, a corneal ulcer, or stromal opacity. Participant must not use contact lenses while participating in this study. Central nervous system metastatic disease unless treated with definitive local therapy (surgical resection, stereotactic radiotherapy, or whole brain radiotherapy) and participant is clinically, radiologically and neurologically stable for at least 4 weeks prior to the first dose of study drug not on steroid therapy or are on a stable or decreasing dose of steroids for at least 7 days prior to first dose of study drug. Prophylactic anticonvulsant medications are allowed. Active second malignancy or history of another malignancy within the last 2 years with the exception of: Treated, non-melanoma skin cancers Treated carcinoma in situ (CIS) (e.g., breast, cervix) Controlled, superficial carcinoma of the urinary bladder T1a or b carcinoma of the prostate treated according to local standard of care, with prostate specific antigen (PSA) within normal limits (WNL) for the institution Papillary thyroid carcinoma Stage I treated surgically for cure Clinically significant cardiovascular disease or condition Clinically significant liver disease Any other serious/active/uncontrolled infection, any infection requiring parenteral antibiotics, or unexplained fever > 38ºC within 2 weeks prior to first trial drug administration. Any other serious, life-threatening, or unstable preexisting medical condition (aside from the underlying malignancy), including significant organ system dysfunction, or clinically significant laboratory abnormality(ies), which, in the opinion of the Investigator, would either compromise the participant's safety or interfere with obtaining informed consent, compliance with trial procedures, or evaluation of the safety of the trial drug
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
David Browning
Phone
+1-615-975-7776
Email
david.browning@iksuda.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James O'Leary, MD
Organizational Affiliation
Iksuda Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
Concord Repatriation General Hospital Medical Oncology Clinical Trials Unit
City
Concord
State/Province
New South Wales
ZIP/Postal Code
2139
Country
Australia
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tam Bui, MD
Phone
(02) 9767 5988
First Name & Middle Initial & Last Name & Degree
Tam Bui, MD
Facility Name
Westmead Hospital
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Adnan Nagrial, MD
Phone
0403170371
First Name & Middle Initial & Last Name & Degree
Adnan Nagrial, MD
Facility Name
Peninsula & South Eastern Haematology and Oncology Group (PSEHOG)
City
Frankston
State/Province
Victoria
ZIP/Postal Code
3199
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vinod Ganju, MD
Phone
0397815244
First Name & Middle Initial & Last Name & Degree
Vinod Ganju, MD
Facility Name
Alfred Health
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3004
Country
Australia
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Malaka Ameratunga, MD
Phone
0390763129
First Name & Middle Initial & Last Name & Degree
Malaka Ameratunga, MD
Facility Name
Linear Clinical Research
City
Nedlands
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Peter Lau, MD
Phone
0438899188
First Name & Middle Initial & Last Name & Degree
Peter Lau, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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IKS014 in Advanced Solid Tumors That Express HER2

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