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Safety, Tolerability, and Anti-Tumor Activity of AFM24 in Combination With SNK01 in Subjects With Advanced/Metastatic EGFR-Expressing Cancers

Primary Purpose

Squamous Cell Carcinoma of Head and Neck, Carcinoma, Non-Small-Cell Lung, Colorectal Neoplasms

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AFM24
SNK01
Sponsored by
NKGen Biotech, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Squamous Cell Carcinoma of Head and Neck focused on measuring EGFR Positive, EGFR, EGFR+, AFM24, SNK01, Solid tumor, Lung cancer, Refractory, Metastatic, NSCLC, SCCHN, NK cells, Natural killer cell, IgG1, antibody, CD16A, ADCC, ADCP

Eligibility Criteria

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

Key Inclusion Criteria:

  1. Capable of giving signed informed consent
  2. Males and females age ≥ 18 years
  3. Phase 1/Dose Escalation : any histologically confirmed advanced or metastatic EGFR-positive malignancy for which all standard of care treatment options have been received and are no longer effective or are considered inappropriate at the discretion of the investigator.
  4. Phase 2a/Expansion : histologically confirmed advanced or metastatic EGFR positive malignancy of mCRC (EXP-1 cohort), SCCHN (EXP-2 cohort) or NSCLC (EXP-3 cohort).
  5. Additional Criteria for Phase 2a/Expansion: subjects must have a disease history specific to their disease as listed below:

    1. EXP-1: mCRC. Metastatic colorectal cancer (mCRC) MSI low/DNA mismatch repair proficient. Subjects must have received ≥ 1 lines of previous combination therapy and must have been exposed to oxaliplatin, irinotecan, a fluoropyrimidine, a VEGF targeting agent and, if considered appropriate by the treating physician, an EGFR targeted antibody.
    2. EXP-2: SCCHN. Subjects with advanced or metastatic SCCHN whose disease has progressed after having received ≥ 1 prior lines of therapy for advanced disease, which must have included platinum-based therapy, fluoropyrimidine, and an anti PD 1/PD-L1 antibody.
    3. EXP-3: NSCLC. Subjects with advanced or metastatic EGFR-expressing NSCLC (EGFR WT) whose disease has progressed after having received ≥ 1 prior lines of therapy for advanced disease. Subjects must have received at least a platinum-based doublet in combination with anti-PD1/PD-L1 antibody or must have received a platinum-based doublet followed by an anti-PD1/PD-L1 antibody.
  6. One or more measurable tumors lesions per RECIST v1.1
  7. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  8. Adequate bone marrow, hepatic and renal function.

Key Exclusion Criteria:

  1. Superior vena cava syndrome contra-indicating hydration
  2. Untreated or symptomatic central nervous system (CNS) metastases
  3. No resolution of specific toxicities related to any prior anti-cancer therapy to Grade ≤ 1 according to the NCI-CTCAE v.5.0 (except peripheral or motor neuropathy, lymphopenia and alopecia)
  4. Treatment with systemic anticancer therapy or an investigational device within 4 weeks (6 weeks if therapy was mitomycin C and/or nitrosoureas), or within 5 half-lives of the agent (if half-life is known and it is shorter) before the first dose of study treatment.
  5. Radiation therapy within 2 weeks before first dose of any study treatment or unresolved (NCI CTCAE v5.0 Grade > 1) toxicity from previous radiotherapy
  6. Clinically significant cardiovascular disease
  7. Major surgery within 4 weeks prior to any study treatment administration
  8. Any pulmonary, thyroid, renal, hepatic severe/uncontrolled concurrent medical disease that in the opinion of the Investigator could cause unacceptable safety risks or compromise compliance with the protocol
  9. Active uncontrolled viral, fungal, or bacterial infection requiring systematic therapy within 14 days prior to first dose of study treatment.
  10. Known history of testing positive for human immunodeficiency virus (HIV), and/or positive test for Hepatitis B virus surface antigen (HBsAg) and/or positive Hep C antibody result with detectable hepatitis C virus (HCV) ribonucleic acid (RNA) indicating acute or chronic infection.
  11. Autoimmune disease requiring therapy; immunodeficiency, or any disease process requiring systemic immunosuppressive therapy
  12. A serious nonmalignant disease that could compromise protocol objectives in the opinion of the Investigator and/or the Sponsor
  13. Any other condition that, in the opinion of the Investigator, would prohibit the subject from participating in the study

Sites / Locations

  • USC/Norris Comprehensive Cancer Center
  • Sarcoma Oncology Center
  • University of Chicago

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Phase 1, Dose Escalation

Phase 2a, Expansion Cohort 1 - Metastatic colorectal cancer (EXP-1: mCRC)

Phase 2a, Expansion Cohort 2 - Head and Neck Squamous Cell Carcinoma (EXP-2: SCCHN)

Phase 2a, Expansion Cohort 3 - Non-small cell lung cancer (EXP-3: NSCLC)

Arm Description

It is estimated that approximately 3-6 subjects will be enrolled per cohort in three dose cohorts for a total of 12-18 participants. SNK01 (fixed dose) will be administered weekly by IV infusion.

SNK01 (fixed dose) will be administered weekly by IV infusion.

SNK01 (fixed dose) will be administered weekly by IV infusion.

SNK01 (fixed dose) will be administered weekly by IV infusion.

Outcomes

Primary Outcome Measures

Phase 1/Dose Escalation
Determine the maximum tolerated dose (MTD) of AFM24 in combination with SNK01. To be assessed by the incidence and severity of dose-limiting toxicity (DLT) within the DLT observation period.
Phase 1/Dose Escalation
Determine the recommended phase 2 dose (RP2D) of AFM24 in combination with SNK01. To be assessed by the incidence and severity of dose-limiting toxicity (DLT) within the DLT observation period.
Phase 2a/Expansion
Determine objective response rate (ORR) of AFM24 in combination with SNK01. Determine ORR using Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1

Secondary Outcome Measures

Phase 1/Dose Escalation
Assess safety and tolerability of AFM24 in combination with SNK01. Determine frequency and severity of treatment-emergent AEs (TEAEs) per National Cancer Institute's Common Toxicity Criteria for Adverse Events (NCI CTCAE v 5.0).
Phase 1/Dose Escalation
Determine preliminary efficacy of AFM24 in combination with SNK01. Determine ORR using RECIST v1.1 evaluated by local assessment.
Phase 1/Dose Escalation
Maximum observed plasma concentration (Cmax) of AFM24
Phase 1/Dose Escalation
Time to maximum plasma concentration (Tmax) of AFM24
Phase 1/Dose Escalation
Minimum plasma concentration (Cmin) of AFM24
Phase 1/Dose Escalation
Area under plasma concentration-time curve for dosing interval (AUCtau) of AFM24
Phase 1/Dose Escalation
Immunogenicity of AFM24 when AFM24 is given in combination with SNK01 Frequency of subjects developing AFM24 anti drug antibodies (ADAs) through completion of the Phase 1/dose escalation portion
Phase 2a/Expansion
Safety and tolerability of AFM24 in combination with SNK01 Frequency of TEAEs graded according to NCI CTCAE v 5.0
Phase 2a/Expansion
To assess progression-free survival (PFS) according to RECIST v1.1 by local assessment Assess the number of subjects with PFS defined as duration of time from start of combination treatment to date of progression.
Phase 2a/Expansion
To assess overall survival (OS).
Phase 2a/Expansion
To assess duration of response (DOR) according to RECIST v1.1 by local assessment.
Phase 2a/Expansion
To assess clinical benefit rate (CBR) according to RECIST v1.1 by local assessment.
Phase 2a/Expansion
Maximum observed plasma concentration (Cmax) of AFM24.
Phase 2a/Expansion
Time to maximum plasma concentration (Tmax) of AFM24.
Phase 2a/Expansion
Minimum plasma concentration (Cmin) of AFM24.
Phase 2a/Expansion
Area under plasma concentration-time curve for dosing interval (AUCtau) of AFM24.
Phase 2a/Expansion
Immunogenicity of AFM24 when AFM24 is given in combination with SNK01 Frequency of subjects developing AFM24 ADAs and frequency of subjects developing neutralizing ADAs.

Full Information

First Posted
October 18, 2021
Last Updated
July 27, 2023
Sponsor
NKGen Biotech, Inc.
Collaborators
Affimed GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT05099549
Brief Title
Safety, Tolerability, and Anti-Tumor Activity of AFM24 in Combination With SNK01 in Subjects With Advanced/Metastatic EGFR-Expressing Cancers
Official Title
A Phase 1/2a, Open-Label, Multi-Center Study Evaluating the Safety, Tolerability, and Anti-Tumor Activity of AFM24 in Combination With Ex Vivo Expanded Autologous Natural Killer Cells (SNK01) in Subjects With Advanced/Metastatic EGFR-Expressing Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 3, 2021 (Actual)
Primary Completion Date
November 2025 (Anticipated)
Study Completion Date
November 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NKGen Biotech, Inc.
Collaborators
Affimed GmbH

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
This is an open-label, multi-center study to evaluate the safety, tolerability, and anti-tumor activity of SNK01 in combination with AFM24 in subjects with advanced or metastatic EGFR-expressing cancers.
Detailed Description
The study will be conducted in two phases. The Phase 1/dose escalation phase will gather preliminary safety and tolerability data for escalating doses of AFM24 in combination with SNK01 at a fixed dose in order to determine the MTD/RP2D for the combination dose regimen to be used in the Phase 2a/expansion. The Phase 2a/expansion portion of the study will gather additional safety, tolerability, efficacy, and anti-tumor activity information for the combination of AFM24 with SNK01 in subjects with three types of advanced or metastatic EGFR-expressing cancers.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Squamous Cell Carcinoma of Head and Neck, Carcinoma, Non-Small-Cell Lung, Colorectal Neoplasms, Advanced Solid Tumor, Refractory Tumor, Metastatic Tumor
Keywords
EGFR Positive, EGFR, EGFR+, AFM24, SNK01, Solid tumor, Lung cancer, Refractory, Metastatic, NSCLC, SCCHN, NK cells, Natural killer cell, IgG1, antibody, CD16A, ADCC, ADCP

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
Subjects will be enrolled sequentially in cohorts of 3 to 6 subjects into Phase 1/dose escalation. The dose escalation will follow the standard oncology Phase 1 3 + 3 dose escalation design. A minimum of 3 cohorts will be utilized and dose increases will be determined by the Safety Review Committee. Once RP2D is determined in Phase 1/dose escalation, the Phase 2a/expansion phase will begin enrolling up to 121 subjects.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
121 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Phase 1, Dose Escalation
Arm Type
Experimental
Arm Description
It is estimated that approximately 3-6 subjects will be enrolled per cohort in three dose cohorts for a total of 12-18 participants. SNK01 (fixed dose) will be administered weekly by IV infusion.
Arm Title
Phase 2a, Expansion Cohort 1 - Metastatic colorectal cancer (EXP-1: mCRC)
Arm Type
Experimental
Arm Description
SNK01 (fixed dose) will be administered weekly by IV infusion.
Arm Title
Phase 2a, Expansion Cohort 2 - Head and Neck Squamous Cell Carcinoma (EXP-2: SCCHN)
Arm Type
Experimental
Arm Description
SNK01 (fixed dose) will be administered weekly by IV infusion.
Arm Title
Phase 2a, Expansion Cohort 3 - Non-small cell lung cancer (EXP-3: NSCLC)
Arm Type
Experimental
Arm Description
SNK01 (fixed dose) will be administered weekly by IV infusion.
Intervention Type
Drug
Intervention Name(s)
AFM24
Intervention Description
Tetravalent, bispecific EGFR- and CD16A-binding innate cell engager.
Intervention Type
Biological
Intervention Name(s)
SNK01
Intervention Description
Patient-specific ex-vivo expanded autologous natural killer cells.
Primary Outcome Measure Information:
Title
Phase 1/Dose Escalation
Description
Determine the maximum tolerated dose (MTD) of AFM24 in combination with SNK01. To be assessed by the incidence and severity of dose-limiting toxicity (DLT) within the DLT observation period.
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 1/Dose Escalation
Description
Determine the recommended phase 2 dose (RP2D) of AFM24 in combination with SNK01. To be assessed by the incidence and severity of dose-limiting toxicity (DLT) within the DLT observation period.
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 2a/Expansion
Description
Determine objective response rate (ORR) of AFM24 in combination with SNK01. Determine ORR using Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
Phase 1/Dose Escalation
Description
Assess safety and tolerability of AFM24 in combination with SNK01. Determine frequency and severity of treatment-emergent AEs (TEAEs) per National Cancer Institute's Common Toxicity Criteria for Adverse Events (NCI CTCAE v 5.0).
Time Frame
Up to 24 months
Title
Phase 1/Dose Escalation
Description
Determine preliminary efficacy of AFM24 in combination with SNK01. Determine ORR using RECIST v1.1 evaluated by local assessment.
Time Frame
Up to 24 months
Title
Phase 1/Dose Escalation
Description
Maximum observed plasma concentration (Cmax) of AFM24
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 1/Dose Escalation
Description
Time to maximum plasma concentration (Tmax) of AFM24
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 1/Dose Escalation
Description
Minimum plasma concentration (Cmin) of AFM24
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 1/Dose Escalation
Description
Area under plasma concentration-time curve for dosing interval (AUCtau) of AFM24
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 1/Dose Escalation
Description
Immunogenicity of AFM24 when AFM24 is given in combination with SNK01 Frequency of subjects developing AFM24 anti drug antibodies (ADAs) through completion of the Phase 1/dose escalation portion
Time Frame
Up to 24 months
Title
Phase 2a/Expansion
Description
Safety and tolerability of AFM24 in combination with SNK01 Frequency of TEAEs graded according to NCI CTCAE v 5.0
Time Frame
Up to 24 months
Title
Phase 2a/Expansion
Description
To assess progression-free survival (PFS) according to RECIST v1.1 by local assessment Assess the number of subjects with PFS defined as duration of time from start of combination treatment to date of progression.
Time Frame
Up to 24 months
Title
Phase 2a/Expansion
Description
To assess overall survival (OS).
Time Frame
Up to 24 months
Title
Phase 2a/Expansion
Description
To assess duration of response (DOR) according to RECIST v1.1 by local assessment.
Time Frame
Up to 24 months
Title
Phase 2a/Expansion
Description
To assess clinical benefit rate (CBR) according to RECIST v1.1 by local assessment.
Time Frame
Up to 24 months
Title
Phase 2a/Expansion
Description
Maximum observed plasma concentration (Cmax) of AFM24.
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 2a/Expansion
Description
Time to maximum plasma concentration (Tmax) of AFM24.
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 2a/Expansion
Description
Minimum plasma concentration (Cmin) of AFM24.
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 2a/Expansion
Description
Area under plasma concentration-time curve for dosing interval (AUCtau) of AFM24.
Time Frame
28 days starting on cycle 1 day 1
Title
Phase 2a/Expansion
Description
Immunogenicity of AFM24 when AFM24 is given in combination with SNK01 Frequency of subjects developing AFM24 ADAs and frequency of subjects developing neutralizing ADAs.
Time Frame
Up to 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Capable of giving signed informed consent Males and females age ≥ 18 years Phase 1/Dose Escalation : any histologically confirmed advanced or metastatic EGFR-positive malignancy for which all standard of care treatment options have been received and are no longer effective or are considered inappropriate at the discretion of the investigator. Phase 2a/Expansion : histologically confirmed advanced or metastatic EGFR positive malignancy of mCRC (EXP-1 cohort), SCCHN (EXP-2 cohort) or NSCLC (EXP-3 cohort). Additional Criteria for Phase 2a/Expansion: subjects must have a disease history specific to their disease as listed below: EXP-1: mCRC. Metastatic colorectal cancer (mCRC) MSI low/DNA mismatch repair proficient. Subjects must have received ≥ 1 lines of previous combination therapy and must have been exposed to oxaliplatin, irinotecan, a fluoropyrimidine, a VEGF targeting agent and, if considered appropriate by the treating physician, an EGFR targeted antibody. EXP-2: SCCHN. Subjects with advanced or metastatic SCCHN whose disease has progressed after having received ≥ 1 prior lines of therapy for advanced disease, which must have included platinum-based therapy, fluoropyrimidine, and an anti PD 1/PD-L1 antibody. EXP-3: NSCLC. Subjects with advanced or metastatic EGFR-expressing NSCLC (EGFR WT) whose disease has progressed after having received ≥ 1 prior lines of therapy for advanced disease. Subjects must have received at least a platinum-based doublet in combination with anti-PD1/PD-L1 antibody or must have received a platinum-based doublet followed by an anti-PD1/PD-L1 antibody. One or more measurable tumors lesions per RECIST v1.1 Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Adequate bone marrow, hepatic and renal function. Key Exclusion Criteria: Superior vena cava syndrome contra-indicating hydration Untreated or symptomatic central nervous system (CNS) metastases No resolution of specific toxicities related to any prior anti-cancer therapy to Grade ≤ 1 according to the NCI-CTCAE v.5.0 (except peripheral or motor neuropathy, lymphopenia and alopecia) Treatment with systemic anticancer therapy or an investigational device within 4 weeks (6 weeks if therapy was mitomycin C and/or nitrosoureas), or within 5 half-lives of the agent (if half-life is known and it is shorter) before the first dose of study treatment. Radiation therapy within 2 weeks before first dose of any study treatment or unresolved (NCI CTCAE v5.0 Grade > 1) toxicity from previous radiotherapy Clinically significant cardiovascular disease Major surgery within 4 weeks prior to any study treatment administration Any pulmonary, thyroid, renal, hepatic severe/uncontrolled concurrent medical disease that in the opinion of the Investigator could cause unacceptable safety risks or compromise compliance with the protocol Active uncontrolled viral, fungal, or bacterial infection requiring systematic therapy within 14 days prior to first dose of study treatment. Known history of testing positive for human immunodeficiency virus (HIV), and/or positive test for Hepatitis B virus surface antigen (HBsAg) and/or positive Hep C antibody result with detectable hepatitis C virus (HCV) ribonucleic acid (RNA) indicating acute or chronic infection. Autoimmune disease requiring therapy; immunodeficiency, or any disease process requiring systemic immunosuppressive therapy A serious nonmalignant disease that could compromise protocol objectives in the opinion of the Investigator and/or the Sponsor Any other condition that, in the opinion of the Investigator, would prohibit the subject from participating in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Chang, MPH
Organizational Affiliation
NKGen Biotech, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
USC/Norris Comprehensive Cancer Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Sarcoma Oncology Center
City
Santa Monica
State/Province
California
ZIP/Postal Code
90403
Country
United States
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Safety, Tolerability, and Anti-Tumor Activity of AFM24 in Combination With SNK01 in Subjects With Advanced/Metastatic EGFR-Expressing Cancers

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