Clinical trial NCT02627274: A Study Evaluating Safety, Pharmacokinetics, and Therapeutic Activity of RO6874281 as a Single Agent (Part A) or in Combination With Trastuzumab or Cetuximab (Part B or C)
Official title: An Open-Label, Multicenter, Dose-Escalation, Phase Ia/Ib Study to Evaluate Safety, Pharmacokinetics, and Therapeutic Activity of RO6874281, an Immunocytokine Consisting of Interleukin 2 Variant (IL-2v) Targeting Fibroblast Activation Protein-α (FAP), as a Single Agent (Part A) or in Combination With Trastuzumab or Cetuximab (Part B or C)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Solid Tumor
Breast Cancer
Cancer of Head and Neck
Lead sponsor: Hoffmann-La Roche
Sponsor class: INDUSTRY
First posted: 2015-12-10
Enrollment: 134
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: TREATMENT

Brief summary: This first-in-human, open-label, multicenter, Phase Ia/Ib, adaptive, multiple ascending-dose study will evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary anti-tumor activity of RO6874281 as a single agent (Part A) or in combination with trastuzumab or cetuximab (Part B or C).


Eligibility criteria: Inclusion Criteria:

* Radiologically measurable and clinically evaluable disease
* Absence of rapid disease progression or threat to vital organs or critical anatomical sites requiring urgent alternative medical intervention
* Confirmed at least one tumor lesion with location accessible to safely biopsy per clinical judgment (special requirements apply for Part C; Participants with only one target lesion and no non-target lesions can enroll after documented agreement with the Medical Monitor).
* Life expectancy of greater than or equal to (\>=12) weeks
* Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1
* Participants with unilateral pleural effusion (other than non-small cell lung cancer \[NSCLC\] indication) should fulfill the following criteria for pulmonary and cardiac functions: Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification 0 - 1 level and New York Heart Association (NYHA) classification class 1 or better
* Forced expiratory volume 1 (FEV1) \>70% and forced vital capacity (FVC) \>70% of predicted value; participants with lung metastases should present with DLCO \>60% of predicted value
* Adequate cardiovascular, hematological, liver and renal function
* All acute toxic effects of any prior radiotherapy, chemotherapy, or surgical procedure must have resolved to grade less than or equal to (\<=) 1, except alopecia (any grade) and Grade 2 peripheral neuropathy
* Negative serum pregnancy test within 7 days prior to study treatment in premenopausal women and women less than (\<) 12 months after menopause
* For women who are not postmenopausal and have not undergone surgical sterilization: agreement to remain abstinent or use two adequate non-hormonal methods of contraception, including at least one method with a failure rate of \<1 percent (%) per year, during the treatment period and for a period of time after the last dose of study drug(s) as defined in the protocol
* For men: agreement to remain abstinent or use contraceptive measures and agreement to refrain from donating sperm during the treatment period and for at least for at least 2 months after the last dose of study treatment
* For Part A exclusively (RO6874281 monotherapy), confirmed advanced and/or metastatic solid tumor, with at least one tumor lesion of location accessible to biopsy per clinical judgment of the treating physician, and confirmed progression at baseline; for whom no standard therapy that would confer clinical benefit to the participant exists
* For Part B exclusively (RO6874281 in combination with trastuzumab), participants with metastatic or recurrent or locally advanced human epidermal growth factor receptor 2 (HER2)-positive breast cancer, as defined by the College of American Pathologists HER2 testing guidelines, who have progressed on at least two lines of HER2-directed therapies in the metastatic setting and the last therapy prior to going on study has to contain a HER2-directed antibody; baseline left ventricular ejection fraction (LVEF) of \>=50% (measured by echocardiography) predose on Cycle 1 Day 1
* For Part C exclusively (RO6874281 in combination with cetuximab), participants with recurrent, unresectable or metastatic squamous cell carcinoma of the head and neck. Participants can have had standard or experimental treatment, including but not limited to radiation therapy, chemotherapy, or immunotherapy
* Participants with Gilbert's syndrome will be eligible for the study

Exclusion Criteria:

* History of, active, or suspicion of autoimmune disease (exceptions apply)
* Adverse events from prior anti-cancer therapy that have not resolved to Grade 1, except for alopecia, vitiligo, or endocrinopathies managed with replacement therapy
* Symptomatic or untreated central nervous system (CNS) metastases
* History of treated asymptomatic CNS metastases with any of the following: Metastases to the brain stem, midbrain, pons, medulla, cerebellum, or within 10 millimeters (mm) of the optic nerves and chiasm; history of intracranial or spinal cord hemorrhage; lacking radiographic demonstration of improvement upon the completion of CNS-directed therapy and evidence of progression between completion of therapy and the baseline radiographic study; ongoing requirement for dexamethasone; stereotactic or whole brain radiation within 28 days before the start of study treatment; last CNS radiographic study less than 4 weeks since completion of radiotherapy and less than 2 weeks since the discontinuation of corticosteroids; CNS metastases treated by resection or brain biopsy performed within 28 days before the start of study treatment
* Participants with an active second malignancy
* Evidence of significant, uncontrolled concomitant diseases that could affect compliance with the protocol or interpretation of results, including diabetes mellitus, history of relevant pulmonary disorders, and known autoimmune diseases or other disease with ongoing fibrosis
* Participants (all indications) with confirmed bilateral pleural effusion and NSCLC participants with confirmed uni- or bilateral pleural effusion by X-ray are not eligible
* Significant cardiovascular/cerebrovascular disease within 6 months prior to Day 1 of study drug administration
* Active or uncontrolled infections
* Known human immunodeficiency virus (HIV) or known active hepatitis B virus or hepatitis C virus infection
* History of chronic liver disease or evidence of hepatic cirrhosis
* Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding that give reasonable suspicion of a disease or condition that would contraindicate the use of an investigational drug
* Major surgery or significant traumatic injury \<28 days prior to the first RO6874281 infusion (excluding biopsies) or anticipation of the need for major surgery during study treatment
* Dementia or altered mental status that would prohibit informed consent
* Pregnant or breastfeeding women
* Known hypersensitivity to any of the components of RO6874281
* Concurrent therapy with any other investigational drug
* Immune-related endocrinopathies
* Immunomodulating agents \<28 days prior to first dose of study drug
* Treatment with systemic immunosuppressive medications
* Severe dyspnea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy
* For Part B exclusively, known hypersensitivity to any of the components of trastuzumab
* For Part C exclusively, known hypersensitivity to any of the components of cetuximab
* For Parts A, B, and C, eligibility of participants who require blood transfusion before and after the start of the study treatment should be discussed by the Sponsor and investigator
* For Parts B and C, Participant eligibility for treatment with trastuzumab or cetuximab should be verified against trastuzumab or cetuximab labeling documents.

Primary outcomes:
measure: Percentage of Participants With Dose-Limiting Toxicities (DLTs)
timeFrame: Day 1 up to Day 21
measure: Maximum Tolerated Dose (MTD) of RO6874281
timeFrame: Day 1 up to Day 21
measure: Optimal Biological Dose (OBD) of RO6874281
timeFrame: Day 1 up to Day 21
measure: Recommended Dose for Further Development of RO6874281
timeFrame: Day 1 up to Day 21
measure: Systemic Clearance (CL) of RO6874281
timeFrame: Day 1 up to 24 months
measure: Volume of Distribution at Steady State (Vss) of RO6874281
timeFrame: Day 1 up to 24 months
measure: Area Under the Concentration-Time Curve (AUC) of RO6874281
timeFrame: Day 1 up to 24 months
measure: Maximum Observed Serum Concentration (Cmax) of RO6874281
timeFrame: Day 1 up to 24 months
Secondary outcomes:
measure: Number of T Cells in the Peripheral Blood
timeFrame: Day 1 up to 24 months
measure: Number of Natural Killer (NK) Cells in the Peripheral Blood
timeFrame: Day 1 up to 24 months
measure: Density of Cluster of Differentiation (CD)8+ Cells in Tumor Samples
timeFrame: Day 1 up to 24 months
measure: Density of CD3-/Perforin+ Cells in Tumor Samples
timeFrame: Day 1 up to 24 months
measure: Density of CD20 Cells in Tumor Samples
timeFrame: Day 1 up to 24 months
measure: Percentage of Participants With Overall Response According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
timeFrame: Day 1 up to 24 months
measure: Percentage of Participants With Disease Control According to RECIST v1.1
timeFrame: Day 1 up to 24 months
measure: Progression-Free Survival (PFS) According to RECIST v1.1
timeFrame: Day 1 up to 24 months
measure: Percentage of Participants With Overall Response According to Modified RECIST
timeFrame: Day 1 up to 24 months
measure: Percentage of Participants With Disease Control According to Modified RECIST
timeFrame: Day 1 up to 24 months
measure: PFS According to Modified RECIST
timeFrame: Day 1 up to 24 months
measure: Percentage of Participants With Overall Response According to iRECIST
timeFrame: Day 1 up to 24 months
measure: Percentage of Participants With Disease Control According to iRECIST
timeFrame: Day 1 up to 24 months
measure: PFS According to iRECIST
timeFrame: Day 1 up to 24 months
Other outcomes:
Locations:
city: Tucson
country: United States
facility: University of Arizona Cancer Center
state: Arizona
city: La Jolla
country: United States
facility: UCSD - Moores Cancer Center
state: California
city: Greeley
country: United States
facility: Banner MD Anderson Cancer Center
state: Colorado
city: Saint Louis
country: United States
facility: Washington University; Division of Oncology
state: Missouri
city: Columbus
country: United States
facility: The Ohio State University
state: Ohio
city: Edegem
country: Belgium
facility: UZ Antwerpen
city: Hamilton
country: Canada
facility: Juravinski Cancer Clinic; Department of Oncology
state: Ontario
city: Toronto
country: Canada
facility: Princess Margaret Cancer Center
state: Ontario
city: København Ø
country: Denmark
facility: Rigshospitalet; Onkologisk Klinik
city: Bordeaux
country: France
facility: Institut Bergonie; Oncologie
city: Dijon
country: France
facility: Centre Georges Francois Leclerc
city: Lyon
country: France
facility: Centre Leon Berard
city: Toulouse
country: France
facility: Institut Claudius Regaud; Departement Oncologie Medicale
city: VILLEJUIF Cedex
country: France
facility: Institut Gustave Roussy; Sitep
city: Meldola
country: Italy
facility: IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica
state: Emilia-Romagna
city: Milano
country: Italy
facility: Fondazione IRCCS Istituto Nazionale dei Tumori;S.S. Trattamento MedicoTumori dellaTesta e delCollo
state: Lombardia
city: Milano
country: Italy
facility: Istituto Europeo di Oncologia; Svil. Nuovi Farmaci per Terapie Innovative
state: Lombardia
city: Milano
country: Italy
facility: Azienda Socio Sanitaria Territoriale Niguarda (Ospedale Niguarda Ca' Granda); Oncologico -Onc.Falck
state: Lombardia
city: Pavia
country: Italy
facility: Ospedale Policlinico S. Matteo; Phase I Clinical Trial Unit and Experimental Therapy
state: Lombardia
city: Amsterdam
country: Netherlands
facility: Antoni Van Leeuwenhoek Ziekenhuis; Gastro-Enterologie
city: Rotterdam
country: Netherlands
facility: Erasmus MC
city: Pamplona
country: Spain
facility: Clinica Universitaria de Navarra
state: Navarra
city: Barcelona
country: Spain
facility: Hospital Univ Vall d'Hebron; Servicio de Oncologia
city: Leicester
country: United Kingdom
facility: Leicester Royal Infirmary
city: London
country: United Kingdom
facility: Guys and St Thomas NHS Foundation Trust, Guys Hospital
city: Manchester
country: United Kingdom
facility: Christie Hospital
Study officials:
affiliation: Hoffmann-La Roche
name: Clinical Trials
role: STUDY_DIRECTOR
References: