A Phase I/Ib Study of NZV930 Alone and in Combination With PDR001 and /or NIR178 in Patients With Advanced Malignancies.

Study Overview
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Brief Summary
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The purpose of this study was to assess the safety, tolerability, and preliminary anti-tumor activity of experimental medication NZV930 alone and when combined with PDR001 and/or NIR178, in patients with advanced cancers

Official Title
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A Phase I/Ib, Open-label, Multi-center, Study of NZV930 as a Single Agent and in Combination With PDR001 and/or NIR178 in Patients With Advanced Malignancies.

Conditions
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Non-small Cell Lung Cancer (NSCLC), Triple Negative Breast Cancer (TNBC), Pancreatic Ductal Adenocarcinoma (PDAC), Colorectal Cancer Microsatellite Stable (MSS), Ovarian Cancer, Renal Cell Carcinoma (RCC), Metastatic Castration Resistant Prostate Cancer (mCRPC)

Intervention / Treatment
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* Other: NZV930
* Other: PDR001
* Drug: NIR178


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult men & women ≥ 18 years of age Histologically confirmed advanced malignancies with documented progression following standard therapy, or for whom, in the opinion of the investigator, no appropriate standard therapy exists. 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. ECOG performance status 0-2 and in the opinion of the investigator, likely to complete at least 56 days of treatment. Exclusion Criteria: Symptomatic or uncontrolled Brain metastases requiring concurrent treatment, inclusive of but not limited to surgery, radiation and/or corticosteroids. Patients with treated symptomatic brain metastases should be neurologically stable for 4 weeks post-treatment prior to study entry and at doses of <10 mg per day prednisolone or equivalent for at least 2 weeks before administration of any study treatment. Patients who required discontinuation of treatment due to treatment-related toxicities with prior immunotherapy. Patients previously treated with anti-CD73 treatment and/or adenosine receptor A2a (A2aR) inhibitors. Active, previously documented, or suspected autoimmune disease within the past 2 years. 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. Additionally, 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. History of or current drug-induced interstitial lung disease or pneumonitis grade ≥ 2. Impaired cardiovascular function or clinically significant cardiovascular disease, including any of the following: Clinically significant and/or uncontrolled heart disease such as congestive heart failure requiring treatment (NYHA Grade ≥ 2), uncontrolled hypertension or clinically significant arrhythmia Patients with corrected QT using the Fridericia's correction (QTcF) > 470 msec for females or >450 msec for males, on screening ECG or congenital long QT syndrome Acute myocardial infarction or unstable angina < 3 months prior to study entry History of stroke or transient ischemic event requiring medical therapy Symptomatic claudication Infection: HIV infection, Active HBV or HCV infection (per institutional guidelines). Patients with chronic HBV or HCV disease that is controlled under antiviral therapy are allowed in the expansion but not in the escalation, Known history of tuberculosis Infection requiring systemic antibiotic therapy. Patients requiring systemic antibiotics for infection must have completed treatment before screening is initiated. Systemic anti-cancer therapy within 2 weeks of the first dose of study treatment. For cytotoxic agents that have major delayed toxicity, e.g. mitomycin C and nitrosoureas, 6 weeks is indicated as washout period. For patients receiving anticancer immunotherapies, 4 weeks is indicated as the washout period. 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, nasal, 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: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: NZV930 Monotherapy<br>Single Agent NZV930 | Other: NZV930<br>* NZV930, Specified dose on specified days, intravenous (IV)<br>* Other names: Biological;|
| Experimental: NZV930 with PDR001 Doublet Therapy<br>Combination of NZV930 with PDR001 | Other: NZV930<br>* NZV930, Specified dose on specified days, intravenous (IV)<br>* Other names: Biological;Other: PDR001<br>* PDR001, Specified dose on specified days, intravenous (IV)<br>* Other names: Biological;|
| Experimental: NZV930 with NIR178 Doublet Therapy<br>Combination of NZV930 with NIR178 | Other: NZV930<br>* NZV930, Specified dose on specified days, intravenous (IV)<br>* Other names: Biological;Drug: NIR178<br>* NIR178 Specified dose on specified days, Orally<br>|
| Experimental: NZV930 with NIR178 & PDR001 Triplet Therapy<br>Combination of NZV930 with NIR178 and PDR001 | Other: NZV930<br>* NZV930, Specified dose on specified days, intravenous (IV)<br>* Other names: Biological;Other: PDR001<br>* PDR001, Specified dose on specified days, intravenous (IV)<br>* Other names: Biological;Drug: NIR178<br>* NIR178 Specified dose on specified days, Orally<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with adverse events as a measure of safety and tolerability of the NZV930 in combination with PDR001 and/or NIR178 | Incidence and severity of AEs and SAEs, incl. changes in laboratory parameters, vital signs, and ECGs Dose limiting toxicity in cycle 1 (28 days) for single agent NZV930 and NZV930 in combination with PDR001 and/or NIR178 during dose escalation phase only Tolerability: dose interruptions Tolerability: dose reductions Tolerability: dose intensity | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall response rate (ORR) | Defined as the proportion of patients with best overall response of CR or PR | 3 years | 
| Clinical Benefit Rate (CBR) | Defined as the proportion of patients with best overall response of CR, PR or SD >= 16 weeks | 3 years | 
| Progression Free Survival (PFS) | Defined as the time from the date of start of treatment to the date of the event defined as first documented progression or death due to any cause | 3 years | 
| Serum concentration vs. time profiles of NZV930 (free drug) and PDR001. | Serum concentration vs. time profiles of NZV930 (free drug) and PDR001. | 3 years | 
| Plasma concentration vs. time profiles for NIR178 and derived PK parameters | Concentration time profile of NIR178 and its metabolites | 3 years | 
| To assess the immunogenicity of NZV930 and PDR001 | Presence and titer of anti-drug antibodies, anti-NZV930 and anti-PDR001 in (patients receiving combination with PDR001). | 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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NZV930, PDR001, NIR178, Immune checkpoint inhibitor, immunotherapy, CD73, PD-1, PD-L1, A2aR, Adenosine