A Study to Investigate the Safety and Tolerability of Intravenous QEQ278 in Patients With Advanced Solid Tumors

Study Overview
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Brief Summary
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To characterize safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary anti-tumor activity of QEQ278 in adult patients with advanced/metastatic non-small cell lung cancer, esophageal squamous cell carcinoma, renal cell carcinoma, and human papilloma virus associated head and neck squamous cell carcinoma.

Detailed Description
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This study is an open-label, phase I/Ib, multi-center study of QEQ278 as a single agent, consisting of a dose escalation part followed by a dose expansion part. In the dose escalation part of the study, patients with non-small cell lung cancer (NSCLC), esophageal squamous cell carcinoma (ESCC), renal cell carcinoma (RCC), or human papilloma virus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) will be treated with QEQ278 single agent until the maximum tolerated dose (MTD) is reached or a lower recommended dose (RD) is established. The study may enter the dose expansion, after an MTD(s) and/or RD(s) is declared in the dose escalation.

Official Title
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A Phase I/Ib, Open-label, Multi-center, Study of QEQ278 in Patients With Advanced Solid Tumors

Conditions
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Carcinoma, Non-Small-Cell Lung, Carcinoma, Renal Cell, Esophageal Squamous Cell Carcinoma, Squamous Cell Carcinoma of Head and Neck

Intervention / Treatment
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* Biological: QEQ278


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Signed informed consent must be obtained prior to participation in the study. Adult men and women ≥ 18 years of age. Histologically confirmed and documented advanced malignancies (locally advanced malignancies, non-curable by surgery or radiotherapy and metastatic disease). Disease must be measurable, including presence of at least one measurable lesion, as determined by RECIST v1.1. In the opinion of the treating investigator, patients must have received, but are not benefitting from standard therapies, be intolerant or ineligible to receive such therapy, or have no standard therapy option for the respective disease types (diseases listed below), as well as any other therapies deemed to be standard by local/institutional standard. Non-small cell lung cancer Esophageal squamous cell carcinoma Renal cell carcinoma HPV-associated head and neck squamous cell carcinoma Must have a site of disease amenable to biopsy and be a candidate for tumor biopsy according to the treating institution's guidelines. The patient must be willing to undergo a new tumor biopsy at screening and during treatment. Exclusion Criteria: Active previously documented or suspected autoimmune disease. Patients with vitiligo, type I diabetes, residual hypothyroidism only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur should not be excluded. Patients previously exposed to anti-PD-1/PD-L1 treatment who are adequately treated for skin rash or with replacement therapy for endocrinopathies should not be excluded. Patients with a history of or current interstitial lung disease or pneumonitis ≥ Grade 2. Patients who discontinued prior anti-PD-1 therapy due to an anti-PD-1-related toxicity Clinically significant cardiac disease or risk factors at screening Insufficient bone marrow function at screening: Infections: Known history of testing positive for Human Immunodeficiency Virus infection. Active Hepatitis B and / or Hepatitis C. Active, documented COVID-19 infection Known history of tuberculosis Any serious uncontrolled infection (acute or chronic). Systemic chronic steroid therapy (>10 mg/day prednisone or equivalent) or any immunosuppressive therapy, other than replacement-dose steroids in the setting of adrenal insufficiency, within 7 days of the first dose of study treatment. Topical, inhaled, and ophthalmic steroids are allowed. Other protocol-defined inclusion/exclusion criteria may apply.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Part 1: Dose escalation<br>Dose escalation with QEQ278 single agent | Biological: QEQ278<br>* Intravenous dosing of QEQ278<br>|
| Experimental: Part 2: Dose expansion<br>Dose expansion with QEQ278 single agent | Biological: QEQ278<br>* Intravenous dosing of QEQ278<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence and nature of Dose Limiting Toxicities (DLTs) during the DLT evaluation period for single agent QEQ278 | A DLT is defined as an adverse event or abnormal laboratory value assessed as unrelated to disease, disease progression, inter-current illness, or concomitant medications that occurs within the DLT evaluation period and meets the criteria defined in the study protocol. | 28 days | 
| Incidence and severity of adverse events (AEs) and serious adverse events (SAEs) | Incidence and severity of adverse events (AEs) and serious adverse events (SAEs), including changes in laboratory values, vital signs, and electrocardiograms (ECGs) qualifying and reported as AEs. | Up to 31 months | 
| Frequency of dose interruptions, reductions | Number of dose interruptions of QEQ278 and number of dose reductions of QEQ278 | Up to 30 months | 
| Dose intensity | Dose intensity of QEQ278 is defined as the ratio of actual cumulative dose received and actual duration of exposure. | Up to 30 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall response rate (ORR) per RECIST v1.1 | ORR is defined as the proportion of patients with a confirmed BOR of complete response (CR) or partial response (PR) by local investigator review as per RECIST v1.1. | Up to 30 months | 
| Disease control rate (DCR) per RECIST v1.1 | DCR is defined as the proportion of patients with a confirmed best overall response (BOR) of CR or PR or stable disease (SD) by local investigator review as per RECIST v1.1. | Up to 30 months | 
| Duration of Response (DOR) per RECIST v1.1 | DOR is defined as the time form the date of the first documented response (CR or PR) to the date of the first documented progression by local investigator review as per RECIST v1.1 or death due to underlying cancer. | Up to 30 months | 
| Progression-free survival (PFS) per RECIST v 1.1 | PFS is defined as the time from the date of start of treatment to the date of the first documented progression by local investigator review as per RECIST v1.1, or death due to any cause. | Up to 30 months | 
| Peak serum concentration (Cmax) of QEQ278 | The maximum (peak) serum drug concentration after single dose administration | During first 168 days of treatment | 
| Area under the concentration time curve (AUC) last of QEQ278 | The AUC from time zero to the last measurable concentration sampling time | During first 168 days of treatment | 
| Area under the concentration time curve (AUC) infinity of QEQ278 | The AUC from time zero to infinity | During first 168 days of treatment | 
| Time to reach peak serum concentration (Tmax) of QEQ278 | The time to reach maximum (peak) serum drug concentration after single dose administration | During first 168 days of treatment | 
| Elimination half-life (T1/2) of QEQ278 | The elimination half-life associated with the terminal slope of a semi logarithmic concentration-time curve | During first 168 days of treatment | 
| Total body clearance (CL) of QEQ278 | The total body clearance of drug from the serum | During first 168 days of treatment | 
| Volume of distribution (Vz) of QEQ278 | The apparent volume of distribution during terminal phase | During first 168 days of treatment | 
| Incidence of anti-drug antibody (ADA) | Immunogenicity of QEQ278 | Day 1 and 15 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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NKG2D, NKG2D-L, immunotherapy, ADCC, NK cells, NSCLC, ESCC, RCC, HPV-associated HNSCC, QEQ278