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Ivosidenib, Nivolumab, and Ipilimumab Combination in Previously Treated Subjects With Nonresectable or Metastatic IDH1 Mutant Cholangiocarcinoma

Primary Purpose

IDH1-mutant Cholangiocarcinoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Ivosidenib
Recommended Combination Dose (RCD) of ivosidenib
Nivolumab
Ipilimumab
Sponsored by
Servier Bio-Innovation LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for IDH1-mutant Cholangiocarcinoma

Eligibility Criteria

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

Inclusion Criteria: Male of female participant age ≥ 18 years old Have documented IDH1 gene-mutated disease based on local testing procedure (R132C/L/G/H/S mutations variants tested) Eastern Cooperative Oncology Group performance status (ECOG PS) score of 0 or 1 Has a histopathological diagnosis consistent with nonresectable or metastatic cholangiocarcinoma and are not eligible for curative resection, transplantation, or ablative therapies Participants must have at least one measurable lesion as defined by RECIST Version 1.1. Subjects who have received prior local therapy (including but not limited to embolization, chemoembolization, radiofrequency ablation, or radiation therapy) are eligible provided measurable disease falls outside of the treatment field or if within the field but has shown ≥ 20% growth in size post-treatment assessment. Exclusion Criteria: Received prior treatment with an IDH inhibitor or prior treatment with an immune checkpoint inhibitor other than anti-PD1/L1 Have active autoimmune disease or any condition requiring systemic treatment with either corticosteroids (> 10 mg daily of prednisone equivalents) or other immunosuppressive medications within 14 days of study treatment Participants who have not recovered from toxicity of previous anticancer therapy, including Grade ≥ 1 non-hematologic toxicity, according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0, prior to the first IMP administration. Residual Grade ≤ 2 toxicity from chemotherapy (e.g., alopecia, neuropathy) may be allowed. Have known symptomatic brain metastases requiring steroids. Subjects with previously diagnosed brain metastases are eligible if they have completed their treatment and have recovered from the acute effects of radiation therapy or surgery prior to study entry, have discontinued corticosteroid treatment for these metastases for at least 4 weeks, and have radiographically stable disease for at least 3 months prior to study entry. Note: Up to 10 mg per day of prednisone equivalent will be allowed.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    Safety Lead-In Phase - ivosidenib

    Experimental Phase - Cohort 1

    Experimental Phase - Cohort 2

    Arm Description

    First phase of the study.

    Second phase of the study. Cohort 1 will include the anti-PD1/L1-naïve subpopulation.

    Second phase of the study. Cohort 2 will include the anti-PD1/L1 previously treated subpopulation.

    Outcomes

    Primary Outcome Measures

    Safety Phase: Number of dose limiting toxicities (DLTs) associated with study drug regimen, during the first 2 cycles of treatment
    Occurring during the safety lead-in phase
    Safety Phase: To determine the recommended combination dose (RDC) of ivosidenib in combination of immunotherapy
    Occurring during the safety lead-in phase
    Expansion Phase: To assess the Objective Response (confirmed complete response [CR] or confirmed partial response [PR]) of antitumor activity using RECIST v1.1)
    To assess the Objective Response (confirmed complete response [CR] or confirmed partial response [PR]) of antitumor activity using RECIST v1.1)
    Safety Phase: Number of Adverse Events (AEs)
    Occurring during the safety lead-in phase
    Safety Phase: Number of Adverse Events of Special Interests (AESIs)
    Occurring during the safety lead-in phase
    Safety Phase: Number of Serious Adverse Events (SAEs)
    Occurring during the safety lead-in phase

    Secondary Outcome Measures

    Safety Phase: area under the concentration-vs-time curve (AUC) from 0 to time of last measurable concentration (AUC0-t)
    Occurring during the safety lead-in phase
    Safety Phase: Plasma 2-hydroxyglutarate (2-HG) concentration
    Occurring during the safety lead-in phase
    Expansion Phase: Number of Adverse Events (AEs)
    Occurring during the expansion phase
    Expansion Phase: Duration of response (DOR)
    Occurring during the expansion phase
    Expansion Phase: progression-free survival (PFS)
    Occurring during the expansion phase
    Expansion Phase: disease control (DC) (complete response-CR, partial response-PR, or stable disease-SD)
    Occurring during the expansion phase
    Expansion Phase: time to response (TTR) according to RECIST v1.1
    Occurring during the expansion phase
    Expansion Phase: Overall survival (OS)
    Occurring during the expansion phase
    Expansion Phase : area under the concentration-vs-time curve (AUC) from 0 to time of last measurable concentration (AUC0-t)
    Occurring during the expansion phase
    Expansion Phase: Plasma 2-hydroxygluturate (2-HG) concentration
    Occurring during the expansion phase
    Safety Phase: AUC over 1 dosing interval at steady state (AUCtau,ss)
    Occurring during the safety lead-in phase
    Safety Phase: time to maximum concentration (Tmax)
    Occurring during the safety lead-in phase
    Safety Phase: maximum concentration (Cmax)
    Occurring during the safety lead-in phase
    Safety Phase: trough concentration (Ctrough)
    Occurring during the safety lead-in phase
    Safety Phase: apparent volume of distribution (Vd/F)
    Occurring during the safety lead-in phase
    Safety Phase: apparent clearance (CL/F)
    Occurring during the safety lead-in phase
    Expansion Phase: Number of Adverse Events of Special Interests (AESIs)
    Occurring during the expansion phase
    Expansion Phase: Number of Serious Adverse Events (SAEs)
    Occurring during the expansion phase
    Expansion Phase: AUC over 1 dosing interval at steady state (AUCtau,ss)
    Occurring during the expansion phase
    Expansion Phase: time to maximum concentration (Tmax)
    Occurring during the expansion phase
    Expansion Phase: maximum concentration (Cmax)
    Occurring during the expansion phase
    Expansion Phase: trough concentration (Ctrough)
    Occurring during the expansion phase
    Expansion Phase: apparent volume of distribution (Vd/F)
    Occurring during the expansion phase
    Expansion Phase: apparent clearance (CL/F)
    Occurring during the expansion phase

    Full Information

    First Posted
    April 21, 2023
    Last Updated
    October 20, 2023
    Sponsor
    Servier Bio-Innovation LLC
    Collaborators
    Institut de Recherches Internationales Servier
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05921760
    Brief Title
    Ivosidenib, Nivolumab, and Ipilimumab Combination in Previously Treated Subjects With Nonresectable or Metastatic IDH1 Mutant Cholangiocarcinoma
    Official Title
    A Phase 1/2, Safety Lead-in and Dose Expansion, Openlabel, Multicenter Trial Investigating the Safety, Tolerability, and Preliminary Activity of Ivosidenib in Combination With Nivolumab and Ipilimumab in Previously Treated Subjects With Nonresectable or Metastatic Cholangiocarcinoma With an IDH1 Mutation
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 23, 2023 (Anticipated)
    Primary Completion Date
    March 2026 (Anticipated)
    Study Completion Date
    March 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Servier Bio-Innovation LLC
    Collaborators
    Institut de Recherches Internationales Servier

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    This is a Phase 1/2 study evaluating the safety, tolerability, and activity of ivosidenib in combination with immunotherapy in participants with nonresectable or metastatic cholangiocarcinoma. The study includes two phases: the safety lead-in phase to determine the recommended combination dose (RCD) of ivosidenib in combination with immunotherapy and the dose expansion phase to assess the efficacy of ivosidenib in combination with immunotherapy. Study treatment will be administered until participant experiences unacceptable toxicity, disease progression, or other discontinuation criteria are met.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    IDH1-mutant Cholangiocarcinoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    92 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Safety Lead-In Phase - ivosidenib
    Arm Type
    Experimental
    Arm Description
    First phase of the study.
    Arm Title
    Experimental Phase - Cohort 1
    Arm Type
    Experimental
    Arm Description
    Second phase of the study. Cohort 1 will include the anti-PD1/L1-naïve subpopulation.
    Arm Title
    Experimental Phase - Cohort 2
    Arm Type
    Experimental
    Arm Description
    Second phase of the study. Cohort 2 will include the anti-PD1/L1 previously treated subpopulation.
    Intervention Type
    Drug
    Intervention Name(s)
    Ivosidenib
    Intervention Description
    ivosidenib taken once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Recommended Combination Dose (RCD) of ivosidenib
    Intervention Description
    The RCD of ivosidenib taken once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Nivolumab
    Intervention Description
    Nivolumab taken by intravenous infusion
    Intervention Type
    Drug
    Intervention Name(s)
    Ipilimumab
    Intervention Description
    Ipilimumab taken by intravenous infusion
    Primary Outcome Measure Information:
    Title
    Safety Phase: Number of dose limiting toxicities (DLTs) associated with study drug regimen, during the first 2 cycles of treatment
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Through the end of Cycle 2, day 42 (Cycle 1 and 2 are each 21 days)
    Title
    Safety Phase: To determine the recommended combination dose (RDC) of ivosidenib in combination of immunotherapy
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Through the end of Cycle 2, day 42 (Cycle 1 and 2 are each 21 days)
    Title
    Expansion Phase: To assess the Objective Response (confirmed complete response [CR] or confirmed partial response [PR]) of antitumor activity using RECIST v1.1)
    Description
    To assess the Objective Response (confirmed complete response [CR] or confirmed partial response [PR]) of antitumor activity using RECIST v1.1)
    Time Frame
    up to 3 years
    Title
    Safety Phase: Number of Adverse Events (AEs)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Safety Phase: Number of Adverse Events of Special Interests (AESIs)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Safety Phase: Number of Serious Adverse Events (SAEs)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Secondary Outcome Measure Information:
    Title
    Safety Phase: area under the concentration-vs-time curve (AUC) from 0 to time of last measurable concentration (AUC0-t)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Safety Phase: Plasma 2-hydroxyglutarate (2-HG) concentration
    Description
    Occurring during the safety lead-in phase
    Time Frame
    up to 3 years
    Title
    Expansion Phase: Number of Adverse Events (AEs)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: Duration of response (DOR)
    Description
    Occurring during the expansion phase
    Time Frame
    up to 3 years
    Title
    Expansion Phase: progression-free survival (PFS)
    Description
    Occurring during the expansion phase
    Time Frame
    up to 3 years
    Title
    Expansion Phase: disease control (DC) (complete response-CR, partial response-PR, or stable disease-SD)
    Description
    Occurring during the expansion phase
    Time Frame
    up to 3 years
    Title
    Expansion Phase: time to response (TTR) according to RECIST v1.1
    Description
    Occurring during the expansion phase
    Time Frame
    up to 3 years
    Title
    Expansion Phase: Overall survival (OS)
    Description
    Occurring during the expansion phase
    Time Frame
    up to 3 years
    Title
    Expansion Phase : area under the concentration-vs-time curve (AUC) from 0 to time of last measurable concentration (AUC0-t)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: Plasma 2-hydroxygluturate (2-HG) concentration
    Description
    Occurring during the expansion phase
    Time Frame
    up to 3 years
    Title
    Safety Phase: AUC over 1 dosing interval at steady state (AUCtau,ss)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Safety Phase: time to maximum concentration (Tmax)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Safety Phase: maximum concentration (Cmax)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Safety Phase: trough concentration (Ctrough)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Safety Phase: apparent volume of distribution (Vd/F)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Safety Phase: apparent clearance (CL/F)
    Description
    Occurring during the safety lead-in phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: Number of Adverse Events of Special Interests (AESIs)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: Number of Serious Adverse Events (SAEs)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: AUC over 1 dosing interval at steady state (AUCtau,ss)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: time to maximum concentration (Tmax)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: maximum concentration (Cmax)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: trough concentration (Ctrough)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: apparent volume of distribution (Vd/F)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years
    Title
    Expansion Phase: apparent clearance (CL/F)
    Description
    Occurring during the expansion phase
    Time Frame
    Up to 3 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male of female participant age ≥ 18 years old Have documented IDH1 gene-mutated disease based on local testing procedure (R132C/L/G/H/S mutations variants tested) Eastern Cooperative Oncology Group performance status (ECOG PS) score of 0 or 1 Has a histopathological diagnosis consistent with nonresectable or metastatic cholangiocarcinoma and are not eligible for curative resection, transplantation, or ablative therapies Participants must have at least one measurable lesion as defined by RECIST Version 1.1. Subjects who have received prior local therapy (including but not limited to embolization, chemoembolization, radiofrequency ablation, or radiation therapy) are eligible provided measurable disease falls outside of the treatment field or if within the field but has shown ≥ 20% growth in size post-treatment assessment. Exclusion Criteria: Received prior treatment with an IDH inhibitor or prior treatment with an immune checkpoint inhibitor other than anti-PD1/L1 Have active autoimmune disease or any condition requiring systemic treatment with either corticosteroids (> 10 mg daily of prednisone equivalents) or other immunosuppressive medications within 14 days of study treatment Participants who have not recovered from toxicity of previous anticancer therapy, including Grade ≥ 1 non-hematologic toxicity, according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0, prior to the first IMP administration. Residual Grade ≤ 2 toxicity from chemotherapy (e.g., alopecia, neuropathy) may be allowed. Have known symptomatic brain metastases requiring steroids. Subjects with previously diagnosed brain metastases are eligible if they have completed their treatment and have recovered from the acute effects of radiation therapy or surgery prior to study entry, have discontinued corticosteroid treatment for these metastases for at least 4 weeks, and have radiographically stable disease for at least 3 months prior to study entry. Note: Up to 10 mg per day of prednisone equivalent will be allowed.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Institut de Recherches Internationales Servier
    Phone
    +33 1 55 72 60-00
    Email
    scientificinformation@servier.com

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Qualified scientific and medical researchers can request access to anonymized patient-level and study-level clinical trial data. Access can be requested for all interventional clinical studies: used for Marketing Authorization (MA) of medicines and new indications approved after 1 January 2014 in the European Economic Area (EEA) or the United States (US). where Servier is the Marketing Authorization Holder (MAH). The date of the first MA of the new medicine (or the new indication) in one of the EEA Member States will be considered for this scope. In addition, access can be requested for all interventional clinical studies in patients: sponsored by Servier with a first patient enrolled as of 1 January 2004 onwards for New Chemical Entity or New Biological Entity (new pharmaceutical form excluded) for which development has been terminated before any Marketing authorization (MA) approval.
    IPD Sharing Time Frame
    After Marketing Authorization in EEA or US if the study is used for the approval.
    IPD Sharing Access Criteria
    Researchers should register on Servier Data Portal and fill in the research proposal form. This form in four parts should be fully documented. The Research Proposal Form will not be reviewed until all mandatory fields are completed.
    IPD Sharing URL
    http://clinicaltrials.servier.com/

    Learn more about this trial

    Ivosidenib, Nivolumab, and Ipilimumab Combination in Previously Treated Subjects With Nonresectable or Metastatic IDH1 Mutant Cholangiocarcinoma

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