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Study to Evaluate the Safety and Efficacy of Teropavimab and Zinlirvimab in Combination With Lenacapavir (GS-6207) in Virologically Suppressed Adults With HIV-1 Infection

Primary Purpose

HIV-1 Infection

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Oral Lenacapavir
Subcutaneous Lenacapavir
Teropavimab
Zinlirvimab
Sponsored by
Gilead Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV-1 Infection

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • On first-line antiretroviral therapy (ART) for ≥ 2 years prior to screening. A change in ART regimen ≥ 28 days prior to screening for reasons other than virologic failure (VF) (eg, tolerability, simplification, drug-drug interaction profile) is allowed
  • No documented historical resistance to the current ART regimen
  • Plasma HIV-1 RNA < 50 copies/mL at screening
  • Documented plasma HIV-1 RNA < 50 copies/mL for ≥ 18 months preceding the screening visit (or undetectable HIV-1 RNA level according to the local assay being used if the limit of detection is ≥ 50 copies/mL). Unconfirmed virologic elevations of ≥ 50 copies/mL (transient detectable viremia, or "blip") prior to screening are acceptable.
  • Proviral phenotypic sensitivity to both teropavimab and zinlirvimab at screening by the PhenoSense mAb Assay (Monogram Biosciences) for inclusion in the Primary Cohort; sensitivity at screening by the PhenoSense mAb Assay (Monogram Biosciences) to 1 mAb, either teropavimab or zinlirvimab, within 18 months prior to enrollment for inclusion in the optional Pilot Cohort

    -- In both cohorts, teropavimab sensitivity is defined as 90% inhibitory concentration (IC90) ≤ 2 μg/mL; zinlirvimab sensitivity is defined as IC90 ≤ 2 μg/mL;

  • CD4+ count nadir ≥ 350 cells/μL
  • Screening CD4+ count ≥ 500 cells/μL
  • Availability of a fully active alternative ART regimen, in the opinion of the investigator, in the event of discontinuation of the current ART regimen with development of resistance

Key Exclusion Criteria:

  • Comorbid condition requiring ongoing immunosuppression
  • Evidence of current hepatitis B virus (HBV) infection
  • Evidence of current hepatitis C virus (HCV) infection (prior infection cleared spontaneously or with treatment is acceptable)
  • History of opportunistic infection or illness indicative of Stage 3 HIV disease

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

Sites / Locations

  • Ruane Clinical Research Group Inc.
  • Mills Clinical Research
  • One Community Health
  • UCSD AntViral Research Center (AVRC)
  • Yale University; School of Medicine; AIDS Program
  • Midway Immunology and Research Center
  • University of Miami Miller School of Medicine Schiff Center for Liver Disease
  • Orlando Immunology Center
  • Triple O Research Institute, P.A
  • Mercer University, Department of Internal Medicine
  • Indiana CTSI Clinical Research Center
  • National Institutes of Health/Clinical Center
  • Be Well Medical Center
  • AXCES Research Group
  • Icahn School of Medicine at Mount Sinai-Clinical and Translational Research Center
  • NC TraCS Institute-CTRC; University of North Carolina at Chapel Hill
  • The Brody School of Medicine at East Carolina University, ECU Adult Specialty Care
  • Rosedale Health & Wellness
  • Perelman Center for Advanced Medicine at the Hospital of the University of Pennsylvania
  • St. Jude Children's Research Hospital
  • Central Texas Clinical Research
  • The Crofoot Research, INC.
  • Peter Shalit, M.D.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Primary Cohorts: Lenacapavir (LEN), Teropavimab, Zinlirvimab Dose C

Primary Cohorts: LEN, Teropavimab, Zinlirvimab Dose D

Optional Cohorts: Lenacapavir (LEN), Teropavimab, Zinlirvimab Dose C

Optional Cohorts: LEN, Teropavimab, Zinlirvimab Dose D

Arm Description

Participants will begin treatment by receiving LEN Dose A + LEN Dose B + teropavimab + zinlirvimab Dose C followed by LEN Dose A on the next day. The last treatment regimen will include LEN Dose B + teropavimab + zinlirvimab Dose C.

Participants will begin treatment by receiving LEN Dose A + LEN Dose B + teropavimab + zinlirvimab Dose D followed by LEN Dose A on the next day. The last treatment regimen will include LEN Dose B + teropavimab + zinlirvimab Dose D.

Optional cohort included participants from primary cohort who could not qualify for primary cohort at the study start. Participants in optional cohort will begin treatment by receiving LEN Dose A + LEN Dose B + teropavimab + zinlirvimab Dose C followed by LEN Dose A on the next day. The last treatment regimen will include LEN Dose B + teropavimab + zinlirvimab Dose C.

Optional cohort included participants screened for primary cohort but could not qualify for primary cohort at the study start. Participants in optional cohort will begin treatment by receiving LEN Dose A + LEN Dose B + teropavimab + zinlirvimab Dose D followed by LEN Dose A on the next day. The last treatment regimen will include LEN Dose B + teropavimab + zinlirvimab Dose D.

Outcomes

Primary Outcome Measures

Percentage of Participants Experiencing Treatment-Emergent Serious Adverse Events (SAEs)

Secondary Outcome Measures

Proportion of Participants With HIV-1 RNA < 50 Copies/mL at Week 26 as Determined by the US FDA-defined Snapshot Algorithm
Proportion of Participants With HIV-1 RNA ≥ 50 Copies/mL at Week 26 as Determined by the US FDA-defined Snapshot Algorithm
Proportion of Participants With Positive Anti-Teropavimab Antibodies
Proportion of Participants With Positive Anti-zinlirvimab Antibodies
Change from Baseline in CD4+ Cell Count at Week 26
Proportion of Participants Who Develop Treatment-Emergent Resistance to Lenacapvir (LEN), Teropavimab, and Zinlirvimab
Percentage of Participants Experiencing Treatment-Emergent Adverse Events (AEs)
Pharmacokinetic (PK) Parameter: AUC0-t of Teropavimab, and Zinlirvimab, and LEN
AUC0-t is defined as the concentration of drug over time from time zero to time "t".
PK Parameter: AUClast of Teropavimab, and Zinlirvimab, and LEN
AUClast is defined as the concentration of drug from time zero to the last observable concentration.
PK Parameter: T1/2 of Teropavimab, and Zinlirvimab, and LEN
T1/2 is defined as the estimate of the terminal elimination half-life of the drug.
PK Parameter: Cmax of Teropavimab, and Zinlirvimab, and LEN
Cmax is defined as the maximum observed concentration of drug.
PK Parameter: Tmax of Teropavimab, and Zinlirvimab, and LEN
Tmax is defined as the time (observed time point) of Cmax.
PK Parameter: Tlast of Teropavimab, and Zinlirvimab, and LEN
Tlast is defined as the time (observed time point) of Clast (the last observable concentration of drug).
PK Parameter: Ct of Teropavimab, and Zinlirvimab, and LEN
Ct is the concentration at a particular time (t).

Full Information

First Posted
March 19, 2021
Last Updated
June 13, 2023
Sponsor
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT04811040
Brief Title
Study to Evaluate the Safety and Efficacy of Teropavimab and Zinlirvimab in Combination With Lenacapavir (GS-6207) in Virologically Suppressed Adults With HIV-1 Infection
Official Title
A Phase 1b Randomized, Blinded, Proof-of-Concept Study to Evaluate the Safety and Efficacy of Broadly Neutralizing Antibodies (bNAbs) GS-5423 and GS-2872 in Combination With Capsid Inhibitor Lenacapavir (GS-6207) in Virologically Suppressed Adults With HIV-1 Infection
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 8, 2021 (Actual)
Primary Completion Date
April 18, 2023 (Actual)
Study Completion Date
October 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gilead Sciences

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 primary objective of this study is to evaluate the safety and tolerability of a combination of the broadly neutralizing antibodies (bNAbs) teropavimab (formerly GS-5423) and zinlirvimab (formerly GS-2872) in combination with the HIV capsid inhibitor lenacapavir (LEN).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV-1 Infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Masking Description
Clinical pharmacologist and sponsor are not masked to treatment assignment.
Allocation
Randomized
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Primary Cohorts: Lenacapavir (LEN), Teropavimab, Zinlirvimab Dose C
Arm Type
Experimental
Arm Description
Participants will begin treatment by receiving LEN Dose A + LEN Dose B + teropavimab + zinlirvimab Dose C followed by LEN Dose A on the next day. The last treatment regimen will include LEN Dose B + teropavimab + zinlirvimab Dose C.
Arm Title
Primary Cohorts: LEN, Teropavimab, Zinlirvimab Dose D
Arm Type
Experimental
Arm Description
Participants will begin treatment by receiving LEN Dose A + LEN Dose B + teropavimab + zinlirvimab Dose D followed by LEN Dose A on the next day. The last treatment regimen will include LEN Dose B + teropavimab + zinlirvimab Dose D.
Arm Title
Optional Cohorts: Lenacapavir (LEN), Teropavimab, Zinlirvimab Dose C
Arm Type
Experimental
Arm Description
Optional cohort included participants from primary cohort who could not qualify for primary cohort at the study start. Participants in optional cohort will begin treatment by receiving LEN Dose A + LEN Dose B + teropavimab + zinlirvimab Dose C followed by LEN Dose A on the next day. The last treatment regimen will include LEN Dose B + teropavimab + zinlirvimab Dose C.
Arm Title
Optional Cohorts: LEN, Teropavimab, Zinlirvimab Dose D
Arm Type
Experimental
Arm Description
Optional cohort included participants screened for primary cohort but could not qualify for primary cohort at the study start. Participants in optional cohort will begin treatment by receiving LEN Dose A + LEN Dose B + teropavimab + zinlirvimab Dose D followed by LEN Dose A on the next day. The last treatment regimen will include LEN Dose B + teropavimab + zinlirvimab Dose D.
Intervention Type
Drug
Intervention Name(s)
Oral Lenacapavir
Other Intervention Name(s)
GS-6207
Intervention Description
Tablets administered without regard to food
Intervention Type
Drug
Intervention Name(s)
Subcutaneous Lenacapavir
Other Intervention Name(s)
GS-6207
Intervention Description
Administered in the abdomen via subcutaneous injections
Intervention Type
Biological
Intervention Name(s)
Teropavimab
Other Intervention Name(s)
3BNC117-LS, GS-5423
Intervention Description
Administered intravenously
Intervention Type
Biological
Intervention Name(s)
Zinlirvimab
Other Intervention Name(s)
10-1074-LS, GS-2872
Intervention Description
Administered intravenously
Primary Outcome Measure Information:
Title
Percentage of Participants Experiencing Treatment-Emergent Serious Adverse Events (SAEs)
Time Frame
First dose date up to Week 26
Secondary Outcome Measure Information:
Title
Proportion of Participants With HIV-1 RNA < 50 Copies/mL at Week 26 as Determined by the US FDA-defined Snapshot Algorithm
Time Frame
Week 26
Title
Proportion of Participants With HIV-1 RNA ≥ 50 Copies/mL at Week 26 as Determined by the US FDA-defined Snapshot Algorithm
Time Frame
Week 26
Title
Proportion of Participants With Positive Anti-Teropavimab Antibodies
Time Frame
Week 26
Title
Proportion of Participants With Positive Anti-zinlirvimab Antibodies
Time Frame
Week 26
Title
Change from Baseline in CD4+ Cell Count at Week 26
Time Frame
Baseline; Week 26
Title
Proportion of Participants Who Develop Treatment-Emergent Resistance to Lenacapvir (LEN), Teropavimab, and Zinlirvimab
Time Frame
Day 1 up to Week 26
Title
Percentage of Participants Experiencing Treatment-Emergent Adverse Events (AEs)
Time Frame
First dose date up to Week 26
Title
Pharmacokinetic (PK) Parameter: AUC0-t of Teropavimab, and Zinlirvimab, and LEN
Description
AUC0-t is defined as the concentration of drug over time from time zero to time "t".
Time Frame
Day 1 up to Week 52
Title
PK Parameter: AUClast of Teropavimab, and Zinlirvimab, and LEN
Description
AUClast is defined as the concentration of drug from time zero to the last observable concentration.
Time Frame
Day 1 up to Week 52
Title
PK Parameter: T1/2 of Teropavimab, and Zinlirvimab, and LEN
Description
T1/2 is defined as the estimate of the terminal elimination half-life of the drug.
Time Frame
Day 1 up to Week 52
Title
PK Parameter: Cmax of Teropavimab, and Zinlirvimab, and LEN
Description
Cmax is defined as the maximum observed concentration of drug.
Time Frame
Day 1 up to Week 52
Title
PK Parameter: Tmax of Teropavimab, and Zinlirvimab, and LEN
Description
Tmax is defined as the time (observed time point) of Cmax.
Time Frame
Day 1 up to Week 52
Title
PK Parameter: Tlast of Teropavimab, and Zinlirvimab, and LEN
Description
Tlast is defined as the time (observed time point) of Clast (the last observable concentration of drug).
Time Frame
Day 1 up to Week 52
Title
PK Parameter: Ct of Teropavimab, and Zinlirvimab, and LEN
Description
Ct is the concentration at a particular time (t).
Time Frame
Day 1 up to Week 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: On first-line antiretroviral therapy (ART) for ≥ 2 years prior to screening. A change in ART regimen ≥ 28 days prior to screening for reasons other than virologic failure (VF) (eg, tolerability, simplification, drug-drug interaction profile) is allowed No documented historical resistance to the current ART regimen Plasma HIV-1 RNA < 50 copies/mL at screening Documented plasma HIV-1 RNA < 50 copies/mL for ≥ 18 months preceding the screening visit (or undetectable HIV-1 RNA level according to the local assay being used if the limit of detection is ≥ 50 copies/mL). Unconfirmed virologic elevations of ≥ 50 copies/mL (transient detectable viremia, or "blip") prior to screening are acceptable. Proviral phenotypic sensitivity to both teropavimab and zinlirvimab at screening by the PhenoSense mAb Assay (Monogram Biosciences) for inclusion in the Primary Cohort; sensitivity at screening by the PhenoSense mAb Assay (Monogram Biosciences) to 1 mAb, either teropavimab or zinlirvimab, within 18 months prior to enrollment for inclusion in the optional Pilot Cohort -- In both cohorts, teropavimab sensitivity is defined as 90% inhibitory concentration (IC90) ≤ 2 μg/mL; zinlirvimab sensitivity is defined as IC90 ≤ 2 μg/mL; CD4+ count nadir ≥ 350 cells/μL Screening CD4+ count ≥ 500 cells/μL Availability of a fully active alternative ART regimen, in the opinion of the investigator, in the event of discontinuation of the current ART regimen with development of resistance Key Exclusion Criteria: Comorbid condition requiring ongoing immunosuppression Evidence of current hepatitis B virus (HBV) infection Evidence of current hepatitis C virus (HCV) infection (prior infection cleared spontaneously or with treatment is acceptable) History of opportunistic infection or illness indicative of Stage 3 HIV disease Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilead Study Director
Organizational Affiliation
Gilead Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Ruane Clinical Research Group Inc.
City
Los Angeles
State/Province
California
ZIP/Postal Code
90036
Country
United States
Facility Name
Mills Clinical Research
City
Los Angeles
State/Province
California
ZIP/Postal Code
90069
Country
United States
Facility Name
One Community Health
City
Sacramento
State/Province
California
ZIP/Postal Code
95811
Country
United States
Facility Name
UCSD AntViral Research Center (AVRC)
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Yale University; School of Medicine; AIDS Program
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
Midway Immunology and Research Center
City
Fort Pierce
State/Province
Florida
ZIP/Postal Code
34982
Country
United States
Facility Name
University of Miami Miller School of Medicine Schiff Center for Liver Disease
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Orlando Immunology Center
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
Facility Name
Triple O Research Institute, P.A
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33407
Country
United States
Facility Name
Mercer University, Department of Internal Medicine
City
Macon
State/Province
Georgia
ZIP/Postal Code
31201
Country
United States
Facility Name
Indiana CTSI Clinical Research Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
National Institutes of Health/Clinical Center
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States
Facility Name
Be Well Medical Center
City
Berkley
State/Province
Michigan
ZIP/Postal Code
48072
Country
United States
Facility Name
AXCES Research Group
City
Santa Fe
State/Province
New Mexico
ZIP/Postal Code
87505
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai-Clinical and Translational Research Center
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
NC TraCS Institute-CTRC; University of North Carolina at Chapel Hill
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27514
Country
United States
Facility Name
The Brody School of Medicine at East Carolina University, ECU Adult Specialty Care
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Facility Name
Rosedale Health & Wellness
City
Huntersville
State/Province
North Carolina
ZIP/Postal Code
28078
Country
United States
Facility Name
Perelman Center for Advanced Medicine at the Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
St. Jude Children's Research Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States
Facility Name
Central Texas Clinical Research
City
Austin
State/Province
Texas
ZIP/Postal Code
78705
Country
United States
Facility Name
The Crofoot Research, INC.
City
Houston
State/Province
Texas
ZIP/Postal Code
77098
Country
United States
Facility Name
Peter Shalit, M.D.
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://www.gileadclinicaltrials.com/study/?id=GS-US-536-5816
Description
Gilead Clinical Trials Website

Learn more about this trial

Study to Evaluate the Safety and Efficacy of Teropavimab and Zinlirvimab in Combination With Lenacapavir (GS-6207) in Virologically Suppressed Adults With HIV-1 Infection

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