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Study of ALE.C04 in Patients With Head and Neck Cancer

Primary Purpose

Head and Neck Cancer, Head and Neck Squamous Cell Carcinoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
ALE.C04
Pembrolizumab
Sponsored by
Alentis Therapeutics AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Cancer focused on measuring Immunotherapy, Anti-Claudin1, ALE.C04, Phase I/II

Eligibility Criteria

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

Inclusion Criteria: Be willing and able to provide written informed consents Be 18 years of age on day of signing informed consent. Have histologically or cytologically confirmed Recurrent or Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC) that is considered incurable by local therapies. Have provided tissue for claudin-1 (CLDN1), programmed death ligand-1 (PD-L1) and biomarker analysis in a central Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory. Have measurable disease based on RECIST 1.1 as determined by the site. Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale. Have results from testing of human papillomavirus (HPV) status for oropharyngeal cancer Exclusion Criteria: Has progressive disease (PD) within 6 months of completion of curatively intended systemic treatment for locoregionally advanced HNSCC (Phase II randomized combination part only). Has had radiation therapy (or other non-systemic therapy) within 2 weeks prior to randomization or patient has not fully recovered (i.e., ≤Grade 1 or at baseline) from adverse events due to a previously administered treatment. Palliative radiotherapy to a limited field is allowed. Severe immune-related adverse events leading to discontinuation of prior immune-oncology agent only for Phase I dose escalation monotherapy and combination and Phase II monotherapy. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Dermatological conditions requiring active pharmacological treatment including psoriasis, atopic dermatitis, excessively dry skin or recurrent conjunctivitis, scleroderma, vitiligo, or any other active autoimmune dermatological disorder. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the clinical study, interfere with the patient's participation for the full duration of the clinical study, or is not in the best interest of the patient to participate, in the opinion of the treating investigator. Has received prior therapy with an anti-programmed death (PD)-1, anti-PD-L1 or anti-PD-L2 (Phase II randomized combination part only).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Active Comparator

    Experimental

    Arm Label

    Phase 1 Dose Escalation

    Phase 1 Recommended Dose for Expansion

    Phase 2 Randomized Combination part

    Phase 2 Randomized Monotherapy part

    Arm Description

    ALE.C04 single agent: Three planned doses of ALE.C04 and ALE.C04 in combination with pembrolizumab. Once a certain dose level of ALE.C04 is considered safe and well tolerated, the first cohort of patients receiving ALE.C04 at a lower dose level combined with pembrolizumab will be initiated

    One dose of ALE.C04 will be considered (dose identified from Phase 1 Dose Escalation part) Two ALE.C04 dose levels (higher or lower) will be considered for the combination with pembrolizumab

    ALE.C04 at RP2D combined to pembrolizumab compared to pembrolizumab monotherapy

    ALE.C04 monotherapy (DL1 Q3W) ALE.C04 monotherapy (DL2 Q3W)

    Outcomes

    Primary Outcome Measures

    Incidence of Dose Limiting Toxicity (DLT)
    Phase I dose escalation
    Incidence and severity of adverse events (AEs), serious adverse events (SAEs)
    Descriptive statistics will be used to summarize results
    Confirmed Objective Response Rate (ORR) by investigators assessment according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
    Proportion of patients with confirmed Complete Response (CR) or Partial Response (PR) according to RECIST 1.1 for Phase II
    Confirmed Progression Free Survival (PFS) by Blinded Independent Central Review (BICR) assessment according to RECIST1.1
    Time from start of study treatment to first documentation of objective progressive disease (PD) as per RECIST1.1 or to death due to any causes whichever come first during phase II

    Secondary Outcome Measures

    Confirmed ORR by investigators assessment according to RECIST1.1
    Proportion of patients with confirmed CR or PR according to RECIST1.1
    Confirmed immune Objective Response Rate (iORR) by investigators assessment according to immune RECIST
    Proportion of patients with confirmed immune CR or immune PR according to immune RECIST
    Disease Control Rate (DCR) as per investigator assessment according to RECIST1.1
    Proportion of patients with CR, PR or Stable Disease (SD) according to RECIST1.1
    Immune Disease Control Rate (iDCR) as per investigator assessment according to immune RECIST
    Proportion of patients with immune CR, immune PR or immune SD according to immune RECIST
    Duration Of Response (DOR)
    The time from first documentation of objective response to the first documentation of PD per RECIST 1.1 or to death due to any cause, whichever comes first.
    Immune Duration Of Response (iDOR)
    The time from first documentation of objective response to the first documentation of immune PD per immune RECIST or to death due to any cause, whichever comes first.
    Progression Free Survival (PFS) evaluated by investigators
    The time from start of study treatment to first documentation of objective PD per RECIST1.1 following study therapy, or to death due to any cause, whichever comes first.
    Immune Progression Free Survival (iPFS) evaluated by investigators
    The time from start of study treatment to first documentation of objective immune PD per immune RECIST following study therapy, or to death due to any cause, whichever comes first.
    Overall Survival (OS)
    The time from start of study treatment to date of death due to any cause.
    Maximum serum concentration (Cmax) pharmacokinetics (PK) of ALE.C04
    Maximum serum concentration (Cmax) will be derived by non-compartmental analysis and summarized by dose cohort
    Minimum serum concentration (Cmin) pharmacokinetics (PK) of ALE.C04
    Minimum serum concentration will be derived by non-compartmental analysis and summarized by dose cohort
    Area under the concentration-time curve (AUC) pharmacokinetics (PK) of ALE.C04
    Area under the concentration-time curve will be derived by non-compartmental analysis and summarized by dose cohort
    Maximum serum concentration (Cmax) Pharmacokinetics (PK) of pembrolizumab
    Maximun Serum concentration (Cmax) by time point will be reported
    Minimum serum concentration (Cmin) Pharmacokinetics (PK) of pembrolizumab
    Minimum serum concentration (Cmin) by time point will be reported
    Area under the concentration-time curve (AUC) Pharmacokinetics (PK) of pembrolizumab
    Area under the concentration-time curve (AUC) by time point will be reported
    Immunogenicity of ALE.C04
    To assess the presence of serum anti-drug antibodies (ADA) against ALE.C04
    Change from baseline in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30
    The C30 has 30 items in total. Among those items, 28 items are symptoms scales with score range from 1 to 4. A high score represents a high level of symptomatology. The 2 other items are global health status with score range of 1 to 7. A high score represents high quality of life.
    Change from baseline in European Organisation for Research and Treatment of Cancer Quality of Life Question Head and Neck module 43 (HN43)
    The HN43 has 43 items of symptoms scale with score range of 1 to 4. A high score represents a high level of symptomatology.

    Full Information

    First Posted
    September 7, 2023
    Last Updated
    September 19, 2023
    Sponsor
    Alentis Therapeutics AG
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06054477
    Brief Title
    Study of ALE.C04 in Patients With Head and Neck Cancer
    Official Title
    A Phase I/II, Open-Label, Multi-Center Study of ALE.C04 as a Single Agent and in Combination With Pembrolizumab in Adult Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    September 30, 2023 (Anticipated)
    Primary Completion Date
    February 2028 (Anticipated)
    Study Completion Date
    February 2028 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Alentis Therapeutics AG

    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
    The purpose of this study is to evaluate the safety profile of ALE.C04 monotherapy and in combination with pembrolizumab, to characterize pharmacokinetics profile of ALE.C04, recommended Phase II dose (RP2D) for ALE.C04 in combination with pembrolizumab and as monotherapy and to assess anti-tumor activity of ALE.C04 monotherapy and in combination with pembrolizumab in patients with Head and Neck Cancer.
    Detailed Description
    The study comprises a phase I and a phase II. The phase I dose escalation part for both ALE.C04 monotherapy and in combination with pembrolizumab and a recommended dose for expansion (RDE) part for both ALE.C04 monotherapy and in combination with pembrolizumab. The phase II comprises a 1:1 randomized 2 arms assessing 2 dose levels of ALE.C04 as monotherapy and a 1:1 randomized 2 arms assessing ALE.C04 and pembrolizumab given in combination versus pembrolizumab monotherapy

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Head and Neck Cancer, Head and Neck Squamous Cell Carcinoma
    Keywords
    Immunotherapy, Anti-Claudin1, ALE.C04, Phase I/II

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    Phase 1 will consist of i) a dose escalation of ALE.C04 monotherapy evaluating approximately 3 dose levels of ALE.C04, ii) a dose escalation of ALE.C04 and pembrolizumab combination evaluating approximately 2 dose levels of ALE.C04 and iii) one Recommended Dose for Expansion (RDE) evaluating one dose level of ALE.C04 monotherapy aiming to detect anti-tumor activity of ALE.C04 single agent and iv) a randomized two RDEs evaluating two dose level of ALE.C04 combined with pembrolizumab to establish Recommended Phase 2 Dose (RP2D). Phase 2 will consist of i) ALE.C04 randomized part evaluating two dose levels of the single agent to establish RP2D and ii) A randomized part comparing ALE.C04 (at the RP2D dose determined in the phase 1) combined to pembrolizumab with pembrolizumab alone.
    Masking
    None (Open Label)
    Masking Description
    Open Label
    Allocation
    Randomized
    Enrollment
    220 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Phase 1 Dose Escalation
    Arm Type
    Experimental
    Arm Description
    ALE.C04 single agent: Three planned doses of ALE.C04 and ALE.C04 in combination with pembrolizumab. Once a certain dose level of ALE.C04 is considered safe and well tolerated, the first cohort of patients receiving ALE.C04 at a lower dose level combined with pembrolizumab will be initiated
    Arm Title
    Phase 1 Recommended Dose for Expansion
    Arm Type
    Experimental
    Arm Description
    One dose of ALE.C04 will be considered (dose identified from Phase 1 Dose Escalation part) Two ALE.C04 dose levels (higher or lower) will be considered for the combination with pembrolizumab
    Arm Title
    Phase 2 Randomized Combination part
    Arm Type
    Active Comparator
    Arm Description
    ALE.C04 at RP2D combined to pembrolizumab compared to pembrolizumab monotherapy
    Arm Title
    Phase 2 Randomized Monotherapy part
    Arm Type
    Experimental
    Arm Description
    ALE.C04 monotherapy (DL1 Q3W) ALE.C04 monotherapy (DL2 Q3W)
    Intervention Type
    Drug
    Intervention Name(s)
    ALE.C04
    Intervention Description
    Q3W
    Intervention Type
    Drug
    Intervention Name(s)
    Pembrolizumab
    Other Intervention Name(s)
    Keytruda
    Intervention Description
    200mg Q3W
    Primary Outcome Measure Information:
    Title
    Incidence of Dose Limiting Toxicity (DLT)
    Description
    Phase I dose escalation
    Time Frame
    21 days
    Title
    Incidence and severity of adverse events (AEs), serious adverse events (SAEs)
    Description
    Descriptive statistics will be used to summarize results
    Time Frame
    Up to 30 days after last dose - Approximately 4.5 years
    Title
    Confirmed Objective Response Rate (ORR) by investigators assessment according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
    Description
    Proportion of patients with confirmed Complete Response (CR) or Partial Response (PR) according to RECIST 1.1 for Phase II
    Time Frame
    Up to 4.5 year
    Title
    Confirmed Progression Free Survival (PFS) by Blinded Independent Central Review (BICR) assessment according to RECIST1.1
    Description
    Time from start of study treatment to first documentation of objective progressive disease (PD) as per RECIST1.1 or to death due to any causes whichever come first during phase II
    Time Frame
    Up to 4.5 year
    Secondary Outcome Measure Information:
    Title
    Confirmed ORR by investigators assessment according to RECIST1.1
    Description
    Proportion of patients with confirmed CR or PR according to RECIST1.1
    Time Frame
    up to 4.5 year
    Title
    Confirmed immune Objective Response Rate (iORR) by investigators assessment according to immune RECIST
    Description
    Proportion of patients with confirmed immune CR or immune PR according to immune RECIST
    Time Frame
    up to 4.5 year
    Title
    Disease Control Rate (DCR) as per investigator assessment according to RECIST1.1
    Description
    Proportion of patients with CR, PR or Stable Disease (SD) according to RECIST1.1
    Time Frame
    up to 4.5 years
    Title
    Immune Disease Control Rate (iDCR) as per investigator assessment according to immune RECIST
    Description
    Proportion of patients with immune CR, immune PR or immune SD according to immune RECIST
    Time Frame
    up to 4.5 years
    Title
    Duration Of Response (DOR)
    Description
    The time from first documentation of objective response to the first documentation of PD per RECIST 1.1 or to death due to any cause, whichever comes first.
    Time Frame
    up to 4.5 years
    Title
    Immune Duration Of Response (iDOR)
    Description
    The time from first documentation of objective response to the first documentation of immune PD per immune RECIST or to death due to any cause, whichever comes first.
    Time Frame
    up to 4.5 years
    Title
    Progression Free Survival (PFS) evaluated by investigators
    Description
    The time from start of study treatment to first documentation of objective PD per RECIST1.1 following study therapy, or to death due to any cause, whichever comes first.
    Time Frame
    up to 4.5 years
    Title
    Immune Progression Free Survival (iPFS) evaluated by investigators
    Description
    The time from start of study treatment to first documentation of objective immune PD per immune RECIST following study therapy, or to death due to any cause, whichever comes first.
    Time Frame
    up to 4.5 years
    Title
    Overall Survival (OS)
    Description
    The time from start of study treatment to date of death due to any cause.
    Time Frame
    up to 4.5 years
    Title
    Maximum serum concentration (Cmax) pharmacokinetics (PK) of ALE.C04
    Description
    Maximum serum concentration (Cmax) will be derived by non-compartmental analysis and summarized by dose cohort
    Time Frame
    up to 4.5 years
    Title
    Minimum serum concentration (Cmin) pharmacokinetics (PK) of ALE.C04
    Description
    Minimum serum concentration will be derived by non-compartmental analysis and summarized by dose cohort
    Time Frame
    up to 4.5 years
    Title
    Area under the concentration-time curve (AUC) pharmacokinetics (PK) of ALE.C04
    Description
    Area under the concentration-time curve will be derived by non-compartmental analysis and summarized by dose cohort
    Time Frame
    up to 4.5 years
    Title
    Maximum serum concentration (Cmax) Pharmacokinetics (PK) of pembrolizumab
    Description
    Maximun Serum concentration (Cmax) by time point will be reported
    Time Frame
    up to 4.5 years
    Title
    Minimum serum concentration (Cmin) Pharmacokinetics (PK) of pembrolizumab
    Description
    Minimum serum concentration (Cmin) by time point will be reported
    Time Frame
    up to 4.5 years
    Title
    Area under the concentration-time curve (AUC) Pharmacokinetics (PK) of pembrolizumab
    Description
    Area under the concentration-time curve (AUC) by time point will be reported
    Time Frame
    up to 4.5 years
    Title
    Immunogenicity of ALE.C04
    Description
    To assess the presence of serum anti-drug antibodies (ADA) against ALE.C04
    Time Frame
    up to 4.5 years
    Title
    Change from baseline in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30
    Description
    The C30 has 30 items in total. Among those items, 28 items are symptoms scales with score range from 1 to 4. A high score represents a high level of symptomatology. The 2 other items are global health status with score range of 1 to 7. A high score represents high quality of life.
    Time Frame
    Phase II combination part only - Up to 4.5 year
    Title
    Change from baseline in European Organisation for Research and Treatment of Cancer Quality of Life Question Head and Neck module 43 (HN43)
    Description
    The HN43 has 43 items of symptoms scale with score range of 1 to 4. A high score represents a high level of symptomatology.
    Time Frame
    Phase II combination part only - Up to 4.5 year

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Be willing and able to provide written informed consents Be 18 years of age on day of signing informed consent. Have histologically or cytologically confirmed Recurrent or Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC) that is considered incurable by local therapies. Have provided tissue for claudin-1 (CLDN1), programmed death ligand-1 (PD-L1) and biomarker analysis in a central Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory. Have measurable disease based on RECIST 1.1 as determined by the site. Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale. Have results from testing of human papillomavirus (HPV) status for oropharyngeal cancer Exclusion Criteria: Has progressive disease (PD) within 6 months of completion of curatively intended systemic treatment for locoregionally advanced HNSCC (Phase II randomized combination part only). Has had radiation therapy (or other non-systemic therapy) within 2 weeks prior to randomization or patient has not fully recovered (i.e., ≤Grade 1 or at baseline) from adverse events due to a previously administered treatment. Palliative radiotherapy to a limited field is allowed. Severe immune-related adverse events leading to discontinuation of prior immune-oncology agent only for Phase I dose escalation monotherapy and combination and Phase II monotherapy. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Dermatological conditions requiring active pharmacological treatment including psoriasis, atopic dermatitis, excessively dry skin or recurrent conjunctivitis, scleroderma, vitiligo, or any other active autoimmune dermatological disorder. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the clinical study, interfere with the patient's participation for the full duration of the clinical study, or is not in the best interest of the patient to participate, in the opinion of the treating investigator. Has received prior therapy with an anti-programmed death (PD)-1, anti-PD-L1 or anti-PD-L2 (Phase II randomized combination part only).
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Luigi Manenti, MD
    Phone
    41782304288
    Email
    ale.c04.01@alentis.ch

    12. IPD Sharing Statement

    Learn more about this trial

    Study of ALE.C04 in Patients With Head and Neck Cancer

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