Clinical trial NCT06189391: A Study to Evaluate MK-1045 (CN201) in Participants With Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma (MK-1045-001/CN201-101)
Official title: An Open-Label, Dose Escalation Phase 1a Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Preliminary Efficacy of MK-1045 (CN201) in Patients With Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE1
Conditions: Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma
Lead sponsor: MSD R&D (China) Co., Ltd.
Sponsor class: INDUSTRY
First posted: 2024-01-03
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: TREATMENT

Brief summary: Researchers are looking for new ways to treat people with relapsed or refractory B-Cell Non-Hodgkin Lymphoma (B-NHL). B-cells are a type of white blood cells that make antibodies and help fight infections. Non-Hodgkin Lymphoma is a type of cancer in the lymphatic system causing enlarged lymph nodes and/or organs in belly or chest. Relapsed means a disease or condition comes back after treatment Refractory means a disease does not respond to treatment or stops responding to a treatment.

MK-1045, the study medicine, is designed to treat relapsed or refractory B-NHL. MK-1045 is an immunotherapy, which is a treatment that helps the immune system fight cancer.

This is the first study in which MK-1045 will be given to people. The goal of this study is to learn about:

* The safety of MK-1045 and how well people tolerate it.
* The highest dose of MK-1484 that is well tolerated.
* How well MK-1045 works to treat relapsed or refractory B-NHL.


Eligibility criteria: Inclusion/Exclusion Criteria:

Inclusion Criteria

Inclusion Criteria include, but are not limited to:

* Has relapsed or refractory B-cell Non-Hodgkin's lymphoma (B-NHL) with disease history meeting the following World Health Organization (WHO) diagnostic subtypes of B-NHL that are CD19-positive in pathologic Immunohistochemistry test: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) (Grade I to III), marginal zone lymphoma, lymphoplasmacytic lymphoma, mantle cell lymphoma, small lymphocytic lymphoma, and transformed large B-cell lymphoma (During the dose-escalation phase, participants other than those treated with Chimeric antigen receptor T-cell (CAR-T) who cannot provide proof of pathologic immunohistochemistry CD19 positivity but have previous proof of CD20 positivity may be considered for enrollment after discussion with the sponsor)

  * Relapse is defined as the occurrence of progressive disease (PD) after complete response (CR) or partial response (PR) has been achieved after adequate treatment. Note: For DLBCL participants, relapse must occur after participants undergoing at least two lines of therapy; for other participants, they must undergo at least one line of therapy.
  * Refractory is defined as a situation that there is no standard of care available or that it is not applicable to use standard of care at this stage, including: Participants who are unresponsive to standard of care (e.g., monotherapy or combination therapy containing anti-CD20 monoclonal antibody) and whose best response to standard therapy is PD or stable disease (SD); Participants who are not eligible for autologous hematopoietic stem cell transplantation (ASCT) and have relapsed PD after receiving ASCT; Participants who have failed on chimeric antigen receptor T cell (CAR-T) immunotherapy, but the first dose of the study intervention must be at least 3 months after discontinuation of CAR-T therapy, and CD19 positive expression is still present in tumor tissue.
* Has at least one evaluable tumor lesion per the Lugano 2014 criteria, i.e., a lymph node lesion \> 15 mm in long diameter or an extranodal lesion \> 10 mm in long diameter according to computed tomography (CT) cross-sectional imaging or magnetic resonance imaging (MRI)
* Has an Eastern Cooperative Oncology Group (ECOG) performance score of ≤ 2 and an estimated survival time of more than 3 months
* Has essentially normal: bone marrow function; coagulation function; liver function; kidney function; lung function; and heart function

Exclusion Criteria

Exclusion Criteria include, but are not limited to:

* Has any other non-Hodgkin lymphoma (NHL) not listed in inclusion criteria
* Has been treated with anti-CD3/CD19 bispecific antibody (BsAb) prior to first dose of study intervention
* Has received chemotherapy, endocrine therapy, radiotherapy (palliative radiotherapy 2 weeks prior to the first administration of the investigational drug), or biologic therapy, and small molecule targeted agents within 2 weeks prior to the first administration of the investigational drug or within 5 half-lives of the drug, whichever is shorter
* Has received anti-CD20 antibody or anti-CD19 antibody within 4 weeks prior to first use of the investigational drug
* Has received anti-tumor immunotherapy or other unlisted clinical study intervention within 4 weeks prior to the first dose of study intervention, or within 5 half-lives of the drug, whichever is shorter
* Has undergone any major organ surgery (excluding aspiration biopsy) or significant trauma within 4 weeks prior to the first dose of study intervention or those requiring elective surgeries during the study
* Has received systemic corticosteroids (prednisone \>10 mg/day or equivalent) or other immunosuppressive agents within 14 days prior to the first dose of the study intervention, excluding the following agents: topical, ocular, intra-articular, intranasal, and inhaled corticosteroids, and short-term, prophylactic use of corticosteroids (e.g. to prevent radio contrast agent induced allergic reactions)
* Has used immunomodulatory agents, including but not limited to thymosin, interleukin-2 (IL-2), interferon (IFN) and anti-tumor Chinese patent drugs or Chinese herbal medicines within 14 days prior to the first dose of study intervention
* Has had a live attenuated vaccines within 4 weeks prior to the first dose of study intervention
* Has a central nervous system (CNS) infiltration
* Has previous or concomitant CNS diseases, including epilepsy, hemorrhagic/ischemic stroke, severe brain injury, dementia, Parkinson's disease, cerebellar disorder, organic cerebellar syndrome, or mental diseases
* Has prior or concomitant malignancies (except cured basal cell or squamous cell carcinoma of the skin, carcinoma in situ of the cervix, prostatic intraepithelial neoplasia, and other tumors that have been clinically cured for 5 years as assessed by the investigator)
* Has uncontrolled active infections currently requiring systemic anti-infective therapy within 3 days prior to first dose
* Has active hepatitis B and/or hepatitis C. Participants who are positive for antibodies to hepatitis C virus (HCV). Participants who are hepatitis B surface antigen (HBsAg) positive are not allowed to enroll in the dose-escalation period; however, those who were hepatitis B surface antigen (HBsAg)-positive but hepatitis B Virus deoxyribonucleic acid (HBV DNA)-negative and adherent to entecavir antiviral therapy and who agreed to regular monthly monitoring of HBV DNA are allowed to enroll in the dose-expansion period
* Has a history of immunodeficiency, including testing positive for human immunodeficiency virus (HIV) antibody
* Has a history of serious cardiovascular and cerebrovascular disease, including but not limited to: severe cardiac rhythm or conduction abnormalities; acute coronary syndrome, congestive heart failure, stroke, or other Grade 3 or higher cardiovascular and cerebrovascular events within 6 months prior to the first dose; ≥ Class II cardiac function as per New York Heart Association (NYHA) functional class or LVEF \< 50%; or clinically uncontrollable hypertension
* Has previous or current interstitial lung disease
* Has acute graft-versus-host disease (GVHD) or active chronic GVHD at present
* Has active or history of autoimmune diseases (e.g., systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, autoimmune thyroid disease, vasculitis, psoriasis, etc.) that may relapse, or participants who are at risks (e.g., organ transplant requiring immunosuppressive therapy). Participants with the following diseases are allowed to be further screened for enrollment: hypothyroidism managed with hormone replacement therapy only, and skin diseases not requiring systemic treatment (such as vitiligo, psoriasis, or alopecia).
* Has received immunotherapy with known Grade 3 or higher immune-related adverse events (irAEs)
* Has non-hematologic adverse reactions from prior anti-tumor therapy have not recovered to Grade ≤ 1 as assessed by National Cancer Institute NCI Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.0 (excluding toxicities such as alopecia that are assessed by the investigator to have no safety risk)

Primary outcomes:
measure: Number of Participants who Experience a Dose-limiting Toxicity (DLT)
timeFrame: Up to ~28 Days
measure: Number of Participants who Experience an Adverse Event (AE)
timeFrame: Up to ~15 months
measure: Number of Participants who Experience a Serious Adverse Events (SAE)
timeFrame: Up to ~15 months
measure: Number of Participants who Experience a Drug-related Adverse Event (DRAE)
timeFrame: Up to ~15 months
measure: Number of Participants who Experience an AE of Grade 3 or higher
timeFrame: Up to ~15 months
measure: Number of Participants who Experience an AE for Each Severity Grade from 1-5
timeFrame: Up to ~15 months
measure: Number of Participants who Experience a SAE or Serious Drug-related AE
timeFrame: Up to ~15 months
measure: Number of Participants who Experience a Dose Modification Due to an AE or DRAE
timeFrame: Up to ~15 months
measure: Number of Participants who Withdraw from the Study due to an AE or DRAE
timeFrame: Up to ~15 months
measure: Number of Participants who Died due to an AE or DRAE
timeFrame: Up to ~15 months
Secondary outcomes:
measure: Mean Change in Serum MK-1045 Concentration After Administration
timeFrame: Baseline and up to 12 months
measure: Area Under the Concentration-time Curve (AUC) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Area Under the Concentration-time Curve from Time 0 to 168 Hours Post Dose (AUC0-168) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 168 hours
measure: Area Under the Concentration-time Curve from Time 0 to Last Quantifiable Concentration Post Dose (AUC0-last) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 168 hours
measure: Maximum Concentration (Cmax) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Time to Maximum Concentration (Tmax) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Terminal Elimination Half-life (T1/2) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Clearance (CL) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Concentration at the End of Dosing Interval (Ctrough) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Area Under the Concentration-time Curve from Time 0 to the Dosing Interval (168 Hours) at Steady State (AUC0-tau) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 168 hours
measure: Accumulatio Ratio Based on Cmax (RAC-Cmax) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Accumulation Ratio Based on AUC0-tau (RAC_AUC0-tau) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Steady State Clearance (CLss) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Steady State Apparent Volume of Distribution (Vss) of MK-1045
timeFrame: Pre-dose and at designated time points post-dose up to 12 months
measure: Mean Number of B Cells in Peripheral Blood After Administration of MK-1045
timeFrame: Baseline and up to 12 months
measure: Mean Number of T cells in Peripheral Blood After Administration of MK-1045
timeFrame: Baseline and up to 12 months
measure: Mean Level of T Cell Activation After Administration with MK-1045
timeFrame: Baseline and up to 12 months
measure: Mean Level of T Cell Proliferation After Administration of MK-1045
timeFrame: Baseline and up to 12 months
measure: Mean Level of Cytokines in Peripheral Blood After Administration of MK-1045
timeFrame: Baseline up to 12 months
measure: Percentage of Participants who Develop Anti-drug Antibodies (ADA) to MK-1045
timeFrame: Baseline and up to 15 months
measure: Objective Response Rate (ORR)
timeFrame: Up to 15 months
measure: Duration of Response (DOR)
timeFrame: Up to ~15 months
measure: Complete Response Rate (CRR)
timeFrame: Up to ~15 months
measure: Duration of Complete Response (DCR)
timeFrame: Up to ~15 months
measure: Progression Free Survival (PFS)
timeFrame: Up to ~15 months
Other outcomes:
Locations:
city: Beijing
country: China
facility: Fifth Medical Center of PLA General Hospital ( Site 0005)
state: Beijing
city: Beijing
country: China
facility: Beijing Cancer hospital ( Site 0001)
state: Beijing
city: Xiameng
country: China
facility: The First Affiliated Hospital of Xiamen University ( Site 0011)
state: Fujian
city: Guangzhou
country: China
facility: Sun Yat-Sen University Cancer Center ( Site 0003)
state: Guangdong
city: Shijiazhuang
country: China
facility: The Fourth Hospital of Hebei Medical University. ( Site 0004)
state: Hebei
city: Zhengzhou
country: China
facility: Henan Cancer Hospital ( Site 0009)
state: Henan
city: Zhengzhou
country: China
facility: The First Affiliated Hospital of Zhengzhou University ( Site 0006)
state: Henan
city: Nanchang
country: China
facility: Jiangxi Cancer Hospital ( Site 0007)
state: Jiangxi
city: Jinan
country: China
facility: Shandong Cancer Hospital ( Site 0008)
state: Shandong
city: Shanghai
country: China
facility: Shanghai East Hospital ( Site 0002)
state: Shanghai
city: Tianjinc
country: China
facility: Tianjin Medical University Cancer Institute and Hospital ( Site 0010)
state: Tianjin
Study officials:
affiliation: Merck Sharp and Dohme LLC
name: Medical Director
role: STUDY_DIRECTOR
References: