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Bintrafusp Alfa in Previously Treated Patients With R/M Non-keratinizing NPC

Primary Purpose

Nasopharyngeal Carcinoma, Recurrent Carcinoma, Metastatic Cancer

Status
Active
Phase
Phase 2
Locations
Hong Kong
Study Type
Interventional
Intervention
Bintrafusp Alfa
Sponsored by
The University of Hong Kong
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nasopharyngeal Carcinoma focused on measuring Recurrent, Metastatic, non-keratinizing, Nasopharyngeal Carcinoma

Eligibility Criteria

18 Years - 79 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically or cytologically confirmed non-keratinizing differentiated (World Health Organization WHO Type II) or undifferentiated (WHO Type III) nasopharyngeal carcinoma (NPC) that has recurred at regional or / and distant sites
  • Measurable disease according to the RECIST criteria (version 1.1) for the evaluation of measurable disease
  • Received one or more lines of chemotherapy, which must include prior treatment with a platinum agent either for the treatment of metastatic or recurrent disease
  • Experienced progression of disease within 6 months following completion of a platinum-based combination therapy as part of (neo)-adjuvant therapy
  • Male or female subjects with age: 18-79 years old
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
  • No prior immunotherapy
  • Written informed consent obtained for clinical trial participation and providing archival tumor tissue, if available
  • Females of childbearing potential or non-sterilized male who are sexually active must use a highly effective method of contraception
  • Females of childbearing potential must have negative serum or urine pregnancy test
  • Have life expectancy ≥ 3 months
  • Adequate organ function as defined as: Absolute neutrophil count ≥ 1.5 x 10^9/L, Platelet count ≥ 100 x 10^9/L, Hemoglobin >= 8.0 g/dL, Serum alanine aminotransferase ([ALT]; serum glutamate-pyruvate transferase [SGPT]), or serum aspartate aminotransferase [AST] where available at the center) < 2.5 x upper limit of normal (ULN), OR < 5 x ULN in the presence of liver metastases
  • Serum total bilirubin < 2 x ULN
  • Serum creatinine < 1.5 x ULN

Exclusion Criteria:

  • Prior invasive malignancy within 2 years except for non-invasive malignancies such as cervical carcinoma in situ, in situ prostate cancer, non-melanomatous carcinoma of the skin, lobular or ductal carcinoma in situ of the breast that has been surgically cured
  • Isolated local recurrence or persistent disease
  • Has disease that is suitable for local therapy administrated with curative intent
  • Severe, active co-morbidity
  • Currently participating in and receiving clinical trial treatment or has participated in a trial of an investigational agent and received study treatment or used an investigational device within 4 weeks of the first dose of treatment
  • Has prior chemotherapy, targeted therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (≤ grade 1 or at baseline) from adverse events due to previous administered agent
  • Untreated active central nervous system (CNS) metastatic disease, lepto-meningeal disease, or cord compression
  • Clinically significant (active) cardiovascular disease: cerebral vascular accident/stroke (<6 months prior to enrollment), myocardial infarction (<6 months prior to enrollment), unstable angina, congestive heart failure (≥New York Heart Association Classification Class II), or serious cardiac arrhythmia requiring medication.
  • Prior treatment with any other anti-programmed cell death protein-1 (anti-PD-1), or PD Ligand-1 (PD-L1) or PD Ligand-2 (PD-L2) agent or an antibody targeting other immuno-regulatory receptors or mechanisms
  • Irritable bowel syndrome or other serious gastrointestinal chronic conditions associated with diarrhea within the past 3 years prior to the start of treatment
  • Known history of testing positive for HIV or known acquired immunodeficiency syndrome.
  • On chronic systemic steroid or any other forms of immunosuppressive medication within 14 days prior to the treatment. Except: Intra-nasal, inhaled, topical steroids, or local steroid injection (e.g., intraarticular injection); Systemic corticosteroids at physiologic doses ≤10 mg/day of prednisone or equivalent; Steroids as premedication for hypersensitivity reactions due to bintrafusp alfa
  • Active or prior documented autoimmune or inflammatory disorders in the past 2 years, except diabetes type I, vitiligo, psoriasis, or hypo- or hyperthyroid diseases not requiring immunosuppressive treatment
  • Known active hepatitis B or known hepatitis C is detected; subjects who have been treated and now have an undetectable viral load are eligible
  • History of primary immunodeficiency or solid organ transplantation
  • Receipt of live, attenuated vaccine within 28 days prior to the study treatment
  • Active infection requiring systemic therapy
  • Severe hypersensitivity reaction to treatment with another monoclonal antibody (mAb)
  • Females who are pregnant, lactating, or intend to become pregnant during their participation in the study
  • Psychiatric disorders and substance (drug/alcohol) abuse

Sites / Locations

  • Queen Mary Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bintrafusp Alfa

Arm Description

Single group assignment of bintrafusp alfa in previously treated patients with recurrent and metastatic (R/M) nonkeratinizing nasopharyngeal carcinoma (NPC)

Outcomes

Primary Outcome Measures

Evaluation of Objective Tumour Response
To evaluate the objective tumor response (ORR) to bintrafusp alfa in previously treated R/M NPC patients per response evaluation criteria of solid tumor (RECIST) version 1.1

Secondary Outcome Measures

Progression-Free survival assessment
To assess the progression-free survival (PFS) per RECIST version 1.1
Time-to-progression (TTP) assessment
To assess the time-to-progression (TTP) per RECIST version 1.1
Median Survival
To assess the median survival
Toxicity and Tolerability measurement
To measure the toxicities and tolerability in previously treated R/M NPC patients receiving bintrafusp alfa with the most updated version of CTCAE criteria
Objective Response Rate (ORR)
To evaluate ORR, PFS and TTP per immune-related RECIST (irRECIST)
Survival rate assessment
To measure the survival rate in 12 months and 24 months
Duration of Response (DOR) evaluation
To evaluate the duration of response (DOR) in previously treated R/M NPC patients receiving bintrafusp alfa
Investigate the relationship between the response to bintrafusp alfa and plasma Epstein-Barr virus (EBV) deoxyribonucleic acid (DNA) level
EBV-DNA will be determined using real-time quantitative polymerase chain reaction and the clearance (half-life) during the first 4 weeks of bintrafusp alfa will be measured. The half-life will be correlated with patients ORR, PFS, and OS
Disease Control Rate (DCR)
Defined as the percentage of patients with a CR, PR, or SD ≥ 6 months per RECIST 1.1
Time to Response (TTR)
Defined as the duration to first documented tumor response
Quality of Life (QoL)
To evaluate via the patient-reported EORTC-QLQ-C30 and H&N-35 questionnaires

Full Information

First Posted
April 14, 2020
Last Updated
October 24, 2022
Sponsor
The University of Hong Kong
Collaborators
Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany
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1. Study Identification

Unique Protocol Identification Number
NCT04396886
Brief Title
Bintrafusp Alfa in Previously Treated Patients With R/M Non-keratinizing NPC
Official Title
Phase II Prospective Study of Bintrafusp Alfa in Previously Treated Patients With Recurrent and Metastatic (R/M) Non-keratinizing Nasopharyngeal Carcinoma (NPC)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 27, 2020 (Actual)
Primary Completion Date
September 30, 2022 (Actual)
Study Completion Date
December 31, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The University of Hong Kong
Collaborators
Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This would be a phase II prospective single arm mono-institutional study conducted in Queen Mary Hospital (Hong Kong) assessing the efficacy and safety of bintrafusp alfa in previously treated patients with recurrent and metastatic (R/M) non-keratinizing nasopharyngeal carcinoma (NPC).
Detailed Description
All the patients must be registered with the Investigator(s) prior to initiation of treatment. The registration desk will confirm all eligibility criteria and obtain essential information (including patient number). Patients shall receive Bintrafusp alfa treatment through intravenous therapy every two weeks up until disease progression, unacceptable toxicity or for a maximum of 2 years. Survival Follow-up till 2 years will also be performed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasopharyngeal Carcinoma, Recurrent Carcinoma, Metastatic Cancer, Non-keratinizing Carinoma
Keywords
Recurrent, Metastatic, non-keratinizing, Nasopharyngeal Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
38 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bintrafusp Alfa
Arm Type
Experimental
Arm Description
Single group assignment of bintrafusp alfa in previously treated patients with recurrent and metastatic (R/M) nonkeratinizing nasopharyngeal carcinoma (NPC)
Intervention Type
Drug
Intervention Name(s)
Bintrafusp Alfa
Intervention Description
Bintrafusp alfa will be administered intravenously every 2 weeks
Primary Outcome Measure Information:
Title
Evaluation of Objective Tumour Response
Description
To evaluate the objective tumor response (ORR) to bintrafusp alfa in previously treated R/M NPC patients per response evaluation criteria of solid tumor (RECIST) version 1.1
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Secondary Outcome Measure Information:
Title
Progression-Free survival assessment
Description
To assess the progression-free survival (PFS) per RECIST version 1.1
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Title
Time-to-progression (TTP) assessment
Description
To assess the time-to-progression (TTP) per RECIST version 1.1
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Title
Median Survival
Description
To assess the median survival
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Title
Toxicity and Tolerability measurement
Description
To measure the toxicities and tolerability in previously treated R/M NPC patients receiving bintrafusp alfa with the most updated version of CTCAE criteria
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Title
Objective Response Rate (ORR)
Description
To evaluate ORR, PFS and TTP per immune-related RECIST (irRECIST)
Time Frame
From the date of screening to radiographically documented progression according to irRECIST, assessed up to 2 years
Title
Survival rate assessment
Description
To measure the survival rate in 12 months and 24 months
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Title
Duration of Response (DOR) evaluation
Description
To evaluate the duration of response (DOR) in previously treated R/M NPC patients receiving bintrafusp alfa
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Title
Investigate the relationship between the response to bintrafusp alfa and plasma Epstein-Barr virus (EBV) deoxyribonucleic acid (DNA) level
Description
EBV-DNA will be determined using real-time quantitative polymerase chain reaction and the clearance (half-life) during the first 4 weeks of bintrafusp alfa will be measured. The half-life will be correlated with patients ORR, PFS, and OS
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Title
Disease Control Rate (DCR)
Description
Defined as the percentage of patients with a CR, PR, or SD ≥ 6 months per RECIST 1.1
Time Frame
From the date of screening to radiographically documented progression according to RECIST 1.1, assessed up to 2 years
Title
Time to Response (TTR)
Description
Defined as the duration to first documented tumor response
Time Frame
From the date of screening to first radiographically documented tumor response according to RECIST 1.1, assessed up to 2 years
Title
Quality of Life (QoL)
Description
To evaluate via the patient-reported EORTC-QLQ-C30 and H&N-35 questionnaires
Time Frame
Every 12 weeks from the date of screening in the first year of study enrolment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed non-keratinizing differentiated (World Health Organization WHO Type II) or undifferentiated (WHO Type III) nasopharyngeal carcinoma (NPC) that has recurred at regional or / and distant sites Measurable disease according to the RECIST criteria (version 1.1) for the evaluation of measurable disease Received one or more lines of chemotherapy, which must include prior treatment with a platinum agent either for the treatment of metastatic or recurrent disease Experienced progression of disease within 6 months following completion of a platinum-based combination therapy as part of (neo)-adjuvant therapy Male or female subjects with age: 18-79 years old Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 No prior immunotherapy Written informed consent obtained for clinical trial participation and providing archival tumor tissue, if available Females of childbearing potential or non-sterilized male who are sexually active must use a highly effective method of contraception Females of childbearing potential must have negative serum or urine pregnancy test Have life expectancy ≥ 3 months Adequate organ function as defined as: Absolute neutrophil count ≥ 1.5 x 10^9/L, Platelet count ≥ 100 x 10^9/L, Hemoglobin >= 8.0 g/dL, Serum alanine aminotransferase ([ALT]; serum glutamate-pyruvate transferase [SGPT]), or serum aspartate aminotransferase [AST] where available at the center) < 2.5 x upper limit of normal (ULN), OR < 5 x ULN in the presence of liver metastases Serum total bilirubin < 2 x ULN Serum creatinine < 1.5 x ULN Exclusion Criteria: Prior invasive malignancy within 2 years except for non-invasive malignancies such as cervical carcinoma in situ, in situ prostate cancer, non-melanomatous carcinoma of the skin, lobular or ductal carcinoma in situ of the breast that has been surgically cured Isolated local recurrence or persistent disease Has disease that is suitable for local therapy administrated with curative intent Severe, active co-morbidity Currently participating in and receiving clinical trial treatment or has participated in a trial of an investigational agent and received study treatment or used an investigational device within 4 weeks of the first dose of treatment Has prior chemotherapy, targeted therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (≤ grade 1 or at baseline) from adverse events due to previous administered agent Untreated active central nervous system (CNS) metastatic disease, lepto-meningeal disease, or cord compression Clinically significant (active) cardiovascular disease: cerebral vascular accident/stroke (<6 months prior to enrollment), myocardial infarction (<6 months prior to enrollment), unstable angina, congestive heart failure (≥New York Heart Association Classification Class II), or serious cardiac arrhythmia requiring medication. Prior treatment with any other anti-programmed cell death protein-1 (anti-PD-1), or PD Ligand-1 (PD-L1) or PD Ligand-2 (PD-L2) agent or an antibody targeting other immuno-regulatory receptors or mechanisms Irritable bowel syndrome or other serious gastrointestinal chronic conditions associated with diarrhea within the past 3 years prior to the start of treatment Known history of testing positive for HIV or known acquired immunodeficiency syndrome. On chronic systemic steroid or any other forms of immunosuppressive medication within 14 days prior to the treatment. Except: Intra-nasal, inhaled, topical steroids, or local steroid injection (e.g., intraarticular injection); Systemic corticosteroids at physiologic doses ≤10 mg/day of prednisone or equivalent; Steroids as premedication for hypersensitivity reactions due to bintrafusp alfa Active or prior documented autoimmune or inflammatory disorders in the past 2 years, except diabetes type I, vitiligo, psoriasis, or hypo- or hyperthyroid diseases not requiring immunosuppressive treatment Known active hepatitis B or known hepatitis C is detected; subjects who have been treated and now have an undetectable viral load are eligible History of primary immunodeficiency or solid organ transplantation Receipt of live, attenuated vaccine within 28 days prior to the study treatment Active infection requiring systemic therapy Severe hypersensitivity reaction to treatment with another monoclonal antibody (mAb) Females who are pregnant, lactating, or intend to become pregnant during their participation in the study Psychiatric disorders and substance (drug/alcohol) abuse
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chi Leung Chiang, FRCR
Organizational Affiliation
The University of Hong Kong
Official's Role
Principal Investigator
Facility Information:
Facility Name
Queen Mary Hospital
City
Hong Kong
Country
Hong Kong

12. IPD Sharing Statement

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Bintrafusp Alfa in Previously Treated Patients With R/M Non-keratinizing NPC

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