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GEN1047 for Solid Tumors - First in Human (FIH) Trial

Primary Purpose

Breast Cancer, Breast Neoplasms, Endometrial Cancer, Endometrial Neoplasm, Ovarian Cancer, Ovarian Neoplasms

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
GEN1047 is a bispecific antibody that induces T-cell mediated cytotoxicity of B7H4-positive cells.
Sponsored by
Genmab
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer, Breast Neoplasms

Eligibility Criteria

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

Key Inclusion Criteria:

Dose escalation part:

• Participants must have histologically or cytologically confirmed solid tumor(s) in any of the following selected indications for which there is no further available standard therapy likely to confer clinical benefit (or participant is not a candidate or has previously refused such earlier available therapy), and for whom, in the opinion of the investigator, experimental therapy with GEN1047 may be beneficial (breast cancer, uterine cancer, ovarian cancer, NSCLC-SCC).

Expansion part:

• Participant must have an advanced or metastatic, pathologically confirmed diagnosis of one of the following tumors for which there is no further available standard therapy likely to confer clinical benefit (or participant is not a candidate or has previously refused such available therapy), and for whom, in the opinion of the investigator, experimental therapy with GEN1047 may be beneficial (breast cancer, uterine cancer, ovarian cancer, NSCLC-SCC). For all indications: Participants may have received up to 4 prior systemic treatment regimens for advanced/metastatic disease (maintenance treatment is considered being part of 1 treatment line).

Both, dose escalation and expansion part:

  • Participant must sign and ICF, prior to any screening procedures
  • Participants with ovarian cancer:

    • Must have documented progressive disease.
    • CA-125 positivity according to the Gynecologic Cancer Intergroup Guideline (GCIG) with a pretreatment sample that is at least twice the upper limit of the reference range.
  • Either recurrence after, or progression on or lack of response to established standard of care (SOC) anticancer therapies; or are deemed intolerant to or ineligible for, standard curative therapy in the recurrent setting.
  • At least 1 measurable lesion per RECIST v1.1. The measurable lesion(s) must be outside the field of radiation therapy (RT) if there was prior treatment with RT.
  • Eastern Cooperative Oncology Group performance status (ECOG-PS) score of 0 to 1
  • Should provide a tumor tissue sample during the Screening period and prior to C1D1.
  • Must have acceptable laboratory parameters as specified in the protocol.
  • Provide all pre-trial CT scans since failure of last prior therapy (eg, documenting radiographic progression), if available.

Key Exclusion Criteria (dose escalation and expansion part):

  • Exclusions related to cardiovascular disease

    • Symptomatic congestive heart failure (grade III or IV as classified by the New York Heart Association), unstable angina pectoris or cardiac arrhythmia.
    • History of myocardial infarction within 6 months prior to planned start of GEN1047.
    • Uncontrolled hypertension defined as systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg, despite optimal medical management. Prolonged QTc interval >480 milliseconds using Fridericia's QT correction formula.
    • Any other cardiac disease(s) not listed that, in the opinion of the investigator, is/are clinically significant and/or unacceptable.
  • Exclusions related to the central nervous system

    • Participant has any history of intracerebral arteriovenous malformation, cerebral aneurysm, new (within the last 6 months) or symptomatic brain metastases, spinal cord compression (from disease), or stroke. (Transient ischemic attack >1 month prior to Screening is allowed.)
    • Participants with known unstable CNS metastases and any active or history of carcinomatous meningitis will be excluded. Participants with previously treated brain metastases may participate provided they are radiologically stable (ie, without evidence of progression) for at least 28 days by repeat imaging prior to C1D1. Participants should be clinically stable and should not be undergoing steroid taper or have received stereotactic radiation or whole-brain radiation within 14 days prior to C1D1. Chronic steroid therapy is acceptable provided that the dose is stable for the last 14 days prior to C1D1 (≤10 mg prednisone daily or equivalent, corresponding to a maximum administration exposure of ≤140 mg within 14 days).
    • A participant with new or progressive brain metastases. Spinal cord metastasis is acceptable. However, participants with spinal cord compression should be excluded.
  • Participant has been exposed to any of the following prior therapies within the specified timeframes:

    • Radiotherapy: Radiotherapy within 14 days prior to first GEN1047 administration. Palliative radiotherapy will be allowed.
    • The use of RANK-L inhibitors and bisphosphonates (if on stable dose for at least 4 weeks) is permitted while participating in this trial. However, the initiation of growth factors and bisphosphonates is not allowed during the first 4 weeks of GEN1047 administration, unless agreed upon by the investigator and sponsor medical monitor.
    • Treatment with any investigational or non-investigational anticancer agent (including investigational vaccines) or used an invasive investigational medical device within 28 days or 5 half-lives, whichever is shorter, before the planned first dose of GEN1047 or is currently enrolled in an interventional trial.
    • Prophylaxis with live, attenuated vaccines within 28 days prior to first dose of GEN1047; or prophylaxis with the first and/or subsequent injection(s) of SARS-CoV-2 nucleic acid vaccine within 28 days prior to first dose of GEN1047.
    • Chronic systemic immunosuppressive corticosteroid doses, ie, prednisone >10 mg daily (or equivalent) or a cumulative dose >140 mg prednisone within 14 days (or equivalent) before the first GEN1047 administration. Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is permitted.
    • Has received granulocyte colony-stimulating factor (G-CSF) or granulocyte/macrophage colony stimulating factor support within 2 weeks prior to the first GEN1047 administration or being chronically transfusion dependent.
    • Any prior therapy with an antibody targeting CD3 or other T cell activating surface marker.
  • Toxicities from previous anticancer therapies that have not resolved to baseline levels or to ≤ grade 1, except for alopecia, anorexia, vitiligo, fatigue, hyperthyroidism, hypothyroidism, and peripheral neuropathy. Anorexia, hyperthyroidism, hypothyroidism, and peripheral neuropathy must have recovered to ≤ grade 2.
  • Has ongoing or active infection requiring IV treatment with anti-infective therapy that has been administered <2 weeks prior to first dose.
  • Has a history of non-infectious pneumonitis that has required steroids, or currently has any grade of pneumonitis.
  • Has a serious, non-healing wound, or skin ulcer (of any grade).
  • Has a history of organ allograft (except for corneal transplant)
  • Autologous or allogeneic bone marrow transplant, or stem cell rescue within 3 months prior to the first GEN1047 administration.
  • Chimeric antigen receptor (CAR)-T cell therapy within 30 days prior to first GEN1047 administration.
  • Has a known past or current malignancy other than inclusion diagnosis, except for:

    • Cervical carcinoma of Stage 1B or less.
    • Non-invasive basal cell or squamous cell skin carcinoma.
    • Non-invasive, superficial bladder cancer.
    • Prostate cancer with a current PSA level <0.1 ng/mL.
    • Any curable cancer with a complete response of >2 years duration.
  • A history of ≥ grade 3 allergic reactions to antibody therapy or has known allergies, hypersensitivity, or intolerance to GEN1047 or its excipients.
  • A history of ≥ grade 3 cytokine release syndrome or ≥ grade 3 immune effector cell-associated neurotoxicity syndrome to antibody therapy, CAR-T cell therapy, or other immune effector cell therapy

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Sites / Locations

  • Yale University - Yale Cancer CenterRecruiting
  • Sarah Cannon Research InstituteRecruiting
  • Rigshospitalet (Copenhagen University Hospital)Recruiting
  • Institut CurieRecruiting
  • Institut Gustave RoussyRecruiting
  • Hospital Universitari Vall d'HebronRecruiting
  • START Madrid-CIOCCRecruiting
  • Clinica Universidad de NavarraRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

GEN1047

Arm Description

Outcomes

Primary Outcome Measures

Escalation: Number of Participants with Dose Limiting Toxicities
To determine the maximum tolerated dose (MTD) and/or maximum administered dose (MAD) and recommended phase 2 dose (RP2D) or doses, to be studied in expansion part. DLT will be graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) criteria version 5.0.
Escalation: Number of Participants with Treatment Emergent Adverse Events (TEAEs)
An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. TEAE is defined as an AE occurring or worsening between the first dose of study drug and 30 days after the last dose received.
Expansion: Objective Response Rate (ORR)
ORR is defined as percentage of participants with best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) based on RECIST v1.1.

Secondary Outcome Measures

Escalation and Expansion: Clearance
Escalation and Expansion: Volume of Distribution (Vd)
Escalation and Expansion: Area Under the Concentration-time Curve from Time 0 to Time of Last Dose (AUClast)
Escalation and Expansion: Maximum (Peak) Plasma Concentration (Cmax)
Escalation and Expansion: Time to Reach Cmax (Tmax)
Escalation and Expansion: Plasma Trough (Pre-dose) Concentrations (Cthrough)
Escalation and Expansion: Elimination half-life (t 1/2)
Escalation and Expansion: Number of Participants with Anti-Drug Antibody (ADA)
Escalation: ORR
ORR is defined as percentage of participants with BOR of confirmed CR or confirmed PR based on RECIST v1.1.
Escalation and Expansion: Duration of Response (DOR)
DOR is defined as the time from the first documented response to the first documented progression or death due to any cause.
Escalation and Expansion: Time to response (TTR)
Time to response (TTR) is defined as the time from the date of Cycle 1 Day 1 (C1D1) to the first documented response of either confirmed CR or confirmed PR.
Escalation and Expansion: Disease control rate (DCR)
The disease control rate (DCR) is defined as the percentage of participants with BOR of confirmed CR, confirmed PR, or SD according to RECIST v1.1
Expansion: Progression Free Survival (PFS)
PFS is defined as the time from the date of C1D1 to the date of the first documented progression or death due to any cause, whichever occurs earlier according to RECIST v1.1.
Expansion: Overall Survival (OS)
OS is defined as the time from date of C1D1 to date of death due to any cause.
Expansion: Number of Participants with TEAEs
An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. TEAE is defined as an AE occurring or worsening between the first dose of study drug and 30 days after the last dose received.

Full Information

First Posted
November 8, 2021
Last Updated
August 7, 2023
Sponsor
Genmab
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1. Study Identification

Unique Protocol Identification Number
NCT05180474
Brief Title
GEN1047 for Solid Tumors - First in Human (FIH) Trial
Official Title
First-in-human, Open-label, Dose-escalation Trial With Expansion Cohorts to Evaluate Safety of GEN1047 in Subjects With Malignant Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 13, 2021 (Actual)
Primary Completion Date
January 31, 2025 (Anticipated)
Study Completion Date
August 12, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genmab

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
The drug investigated in the study is an antibody, GEN1047. Since this is the first study of GEN1047 in humans, the main purpose is to evaluate safety. Besides safety, the study will determine the recommended GEN1047 dose to be tested in a larger group of participants and assess preliminary clinical activity of GEN1047. GEN1047 will be studied in a broad group of cancer participants, having different kinds of solid tumors. All participants will get GEN1047. The study consists of two parts: Part 1 tests increasing doses of GEN1047 ("escalation"), followed by Part 2 ("expansion") which tests the recommended GEN1047 dose from Part 1.
Detailed Description
The trial is an open-label, multi-center safety trial of GEN1047. The trial consists of two parts: a dose escalation part ("escalation" - phase 1) and an expansion part ("expansion" - phase 2a). The goal of the dose escalation part is to find out if GEN1047 is safe in participants with specific solid tumors and to find the best dose(s). In the expansion part of the trial up to two doses of GEN1047 will be tested.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Breast Neoplasms, Endometrial Cancer, Endometrial Neoplasm, Ovarian Cancer, Ovarian Neoplasms, Squamous Non Small Cell Lung Cancer (NSCLC-SCC)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
500 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GEN1047
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
GEN1047 is a bispecific antibody that induces T-cell mediated cytotoxicity of B7H4-positive cells.
Intervention Description
GEN1047 will be administered as an intravenous infusion. The dose-levels will be determined by the starting dose and the escalation steps taken in the trial.
Primary Outcome Measure Information:
Title
Escalation: Number of Participants with Dose Limiting Toxicities
Description
To determine the maximum tolerated dose (MTD) and/or maximum administered dose (MAD) and recommended phase 2 dose (RP2D) or doses, to be studied in expansion part. DLT will be graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) criteria version 5.0.
Time Frame
From the first Cycle (Cycle length=21 days) in each cohort
Title
Escalation: Number of Participants with Treatment Emergent Adverse Events (TEAEs)
Description
An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. TEAE is defined as an AE occurring or worsening between the first dose of study drug and 30 days after the last dose received.
Time Frame
From first dose date up to end of the safety follow up period, 30 days after last dose
Title
Expansion: Objective Response Rate (ORR)
Description
ORR is defined as percentage of participants with best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) based on RECIST v1.1.
Time Frame
Up to 5 years
Secondary Outcome Measure Information:
Title
Escalation and Expansion: Clearance
Time Frame
Predose and postdose at multiple timepoints of each Cycle (Cycle length=21 days)
Title
Escalation and Expansion: Volume of Distribution (Vd)
Time Frame
Predose and postdose at multiple timepoints of each Cycle (Cycle length=21 days)
Title
Escalation and Expansion: Area Under the Concentration-time Curve from Time 0 to Time of Last Dose (AUClast)
Time Frame
Predose and postdose at multiple timepoints of each Cycle (Cycle length=21 days)
Title
Escalation and Expansion: Maximum (Peak) Plasma Concentration (Cmax)
Time Frame
Predose and postdose at multiple timepoints of each Cycle (Cycle length=21 days)
Title
Escalation and Expansion: Time to Reach Cmax (Tmax)
Time Frame
Predose and postdose at multiple timepoints of each Cycle (Cycle length=21 days)
Title
Escalation and Expansion: Plasma Trough (Pre-dose) Concentrations (Cthrough)
Time Frame
Predose and postdose at multiple timepoints of each Cycle (Cycle length=21 days)
Title
Escalation and Expansion: Elimination half-life (t 1/2)
Time Frame
Predose and postdose at multiple timepoints of each Cycle (Cycle length=21 days)
Title
Escalation and Expansion: Number of Participants with Anti-Drug Antibody (ADA)
Time Frame
Up to 5 years
Title
Escalation: ORR
Description
ORR is defined as percentage of participants with BOR of confirmed CR or confirmed PR based on RECIST v1.1.
Time Frame
Up to 5 years
Title
Escalation and Expansion: Duration of Response (DOR)
Description
DOR is defined as the time from the first documented response to the first documented progression or death due to any cause.
Time Frame
Up to 5 years
Title
Escalation and Expansion: Time to response (TTR)
Description
Time to response (TTR) is defined as the time from the date of Cycle 1 Day 1 (C1D1) to the first documented response of either confirmed CR or confirmed PR.
Time Frame
Up to 5 years
Title
Escalation and Expansion: Disease control rate (DCR)
Description
The disease control rate (DCR) is defined as the percentage of participants with BOR of confirmed CR, confirmed PR, or SD according to RECIST v1.1
Time Frame
Up to 5 years
Title
Expansion: Progression Free Survival (PFS)
Description
PFS is defined as the time from the date of C1D1 to the date of the first documented progression or death due to any cause, whichever occurs earlier according to RECIST v1.1.
Time Frame
Up to 5 years
Title
Expansion: Overall Survival (OS)
Description
OS is defined as the time from date of C1D1 to date of death due to any cause.
Time Frame
Up to 5 years
Title
Expansion: Number of Participants with TEAEs
Description
An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. TEAE is defined as an AE occurring or worsening between the first dose of study drug and 30 days after the last dose received.
Time Frame
From first dose date up to end of the safety follow up period, 30 days after last dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Criteria - Escalation Part: Participant must have histologically or cytologically confirmed solid tumor(s) in any of the following selected indications for which there is no further available standard therapy likely to confer clinical benefit (or participant is not a candidate or has previously refused such earlier available therapy), and for whom, in the opinion of the investigator, experimental therapy with GEN1047 may be beneficial (breast cancer, endometrial cancer, ovarian cancer, squamous non-small-cell lung cancer [NSCLC-SCC]). Participants with ovarian cancer must have documented progressive disease (PD) on or after last prior treatment and within 60 days of screening. Must be at least 18 years of age (or the legal age of consent in the jurisdiction in which the trial is taking place) on the day of signing informed consent. Must have either recurrence after, or progression on or lack of response to available relevant standard of care (SoC) anticancer therapies; or are deemed intolerant to or ineligible for, standard curative therapy in the recurrent setting. Must have at least 1 measurable lesion per RECIST v1.1. The measurable lesion(s) must be outside the field of radiation therapy (RT) if there was prior treatment with RT. Must have an Eastern Cooperative Oncology Group performance status (ECOGPS) score of 0 to 1 at Screening and on C1D1 pretreatment. Should provide a tumor tissue sample during the Screening period and prior to C1D1. Provide all tumor-assessing pre-trial CT scans since failure of last prior therapy. Criteria - Expansion Part: Participants must have documented PD according to RECIST v1.1 on or after last prior treatment with latest scan performed a maximum of 28 days prior to the first dose. Participant must have advanced (unresectable) or metastatic, histologically confirmed diagnosis (breast cancer, endometrial cancer, ovarian cancer. Must be a female and at least 18 years of age (or the legal age of consent in the jurisdiction in which the trial is taking place) at the time of consent. Must have at least 1 measurable lesion per RECIST v1.1 as assessed by local investigator. Must have an ECOG- PS score of 0 to 1 at Screening and on Cycle 1 Day 1 (C1D1) pretreatment. Should provide a tumor tissue sample during the Screening period and prior to C1D1. Provide all tumor-assessing pre-trial CT scans since failure of last prior therapy. Key Exclusion Criteria: Significant cardiovascular impairment within 6 months of the first dose of trial drug. Participant with new or progressive brain metastases or spinal cord compression. Participant has a history of bowel obstruction related to underlying disease. Participant has been exposed to any prior therapy with a compound targeting CD3 and/or B7H4 or cell based therapies. Current pneumonitis (any grade) including any radiological change of ongoing pneumonitis at baseline or history of non-infectious drug-, immune-, or radiation-related pneumonitis that required steroid.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Genmab Trial Information
Phone
+4570202728
Email
clinicaltrials@genmab.com
Facility Information:
Facility Name
Yale University - Yale Cancer Center
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520-8028
Country
United States
Individual Site Status
Recruiting
Facility Name
Sarah Cannon Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Individual Site Status
Recruiting
Facility Name
Rigshospitalet (Copenhagen University Hospital)
City
Copenhagen
ZIP/Postal Code
2100
Country
Denmark
Individual Site Status
Recruiting
Facility Name
Institut Curie
City
Paris
ZIP/Postal Code
75248
Country
France
Individual Site Status
Recruiting
Facility Name
Institut Gustave Roussy
City
Villejuif
ZIP/Postal Code
75005
Country
France
Individual Site Status
Recruiting
Facility Name
Hospital Universitari Vall d'Hebron
City
Barcelona
ZIP/Postal Code
8035
Country
Spain
Individual Site Status
Recruiting
Facility Name
START Madrid-CIOCC
City
Madrid
ZIP/Postal Code
28050
Country
Spain
Individual Site Status
Recruiting
Facility Name
Clinica Universidad de Navarra
City
Pamplona
ZIP/Postal Code
31008
Country
Spain
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

GEN1047 for Solid Tumors - First in Human (FIH) Trial

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