Clinical trial NCT05435339: A Study to Evaluate Safety, Tolerability, and Preliminary Effect of the GEN1053 Antibody on Malignant Solid Tumors as Monotherapy
Official title: First-in-Human, Open-label, Dose-Escalation Trial With an Expansion Cohort to Evaluate the Safety of GEN1053 as Monotherapy in Subjects With Malignant Solid Tumors
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE1
PHASE2
Conditions: Solid Tumor, Adult
Keywords: Monoclonal antibody
Lead sponsor: Genmab
Sponsor class: INDUSTRY
Collaborators: name: BioNTech SE
First posted: 2022-06-28
Enrollment: 31
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Sequential assignment
Primary purpose: TREATMENT

Brief summary: The drug that will be investigated in the study is GEN1053. GEN1053 is an antibody designed to (re)activate and increase antitumor immunity.

Since this is the first study of GEN1053 in humans, the main purpose is to evaluate safety. Besides safety, the study will determine the recommended GEN1053 dose to be tested in a larger group of participants and assess preliminary clinical activity of GEN1053.

GEN1053 will be studied in a broad group of cancer patients, having different kinds of solid tumors. All participants will get GEN1053. The study consists of two parts: Part 1 tests increasing doses of GEN1053 ("escalation"), followed by Part 2 which tests the recommended phase 2 dose GEN1053 dose from Part 1 ("expansion").

Detailed description: The trial is a First in Human open-label, multicenter, multinational safety trial in participants with non-central nervous system (non-CNS) metastatic or advanced malignant solid tumors for whom there is no available standard therapy likely to confer clinical benefit, evaluating the safety, tolerability, preliminary antitumor activity, pharmacokinetics (PK), pharmacodynamics (PD), and immunogenicity of GEN1053.

The trial will be conducted as follows:

* The Dose Escalation part (Part 1) will explore the safety of escalating doses of GEN1053 as monotherapy (phase 1)
* The Expansion part (Part 2) is planned to provide additional safety and initial antitumor activity information of the Recommended Phase 2 dose (RP2D) for GEN1053 monotherapy in selected tumor indications, as well as more detailed data related to the mode of action (MoA).

Eligibility criteria: Key Inclusion Criteria:

For both the Dose Escalation and Expansion parts:

* Be ≥18 years of age.
* Have measurable disease according to RECIST 1.1
* Provide all pre-baseline scans since failure of last prior therapy (ie radiographic PD), if available
* Have Eastern Cooperative Oncology Group performance status ≤1.
* Have organ and bone marrow function as follows:

Bone marrow / hematological function:

* Absolute neutrophil count (ANC) ≥1.5×10\^9/L
* Hemoglobin ≥9.0 g/dL
* Platelet count ≥150×10\^9/L

Liver function:

* Total bilirubin ≤ upper limit of normal (ULN)
* Alanine aminotransferase ≤1.5×ULN
* Aspartate aminotransferase ≤1.5×ULN
* Albumin ≥30 g/L

Coagulation status:

* Prothrombin time (PT)/International normalized ratio ≤1.5
* Activated partial thromboplastin time (aPTT) ≤1.5×ULN
* Renal function: Glomerular filtration rate ≥45 mL/min/1.73 m², according to the abbreviated Modification of Diet in Renal Disease equation

For Monotherapy Dose Escalation (phase 1) only:

* Subjects with histologically or cytologically confirmed non-CNS solid tumors that are metastatic or advanced.
* Subjects who have progressed on standard of care therapy or for whom there is no available standard therapy likely to provide clinical benefit, or who are not candidates for or refuse such available therapy, and for whom, in the opinion of the investigator, experimental therapy with GEN1053 may be beneficial.
* Fresh biopsies mandatory for all patients in Monotherapy Dose Escalation

For the Expansion part Only:

•Subjects with histologically or cytologically confirmed diagnosis of recurrent, unresectable or metastatic HNSCC, who have progressed on standard of care therapy or do not have any further available standard therapy or are not candidates for or refuse standard therapy (if subjects had access), and for whom experimental therapy with GEN1053 may be beneficial in the opinion of the investigator.

Key Exclusion Criteria (all parts):

* Has uncontrolled intercurrent illness, including but not limited to:

  * Ongoing or active infection requiring IV treatment with anti-infective therapy administered less than 2 weeks prior to first dose.
  * Symptomatic congestive heart failure (Grade III or IV as classified by the New York Heart Association), unstable angina pectoris or cardiac arrhythmia.
  * Uncontrolled hypertension defined as systolic blood pressure ≥160 mm Hg and/or diastolic blood pressure ≥100 mm Hg, despite optimal medical management.
  * Prolonged QTc interval at baseline of ≥470 milliseconds using Fridericia's QT correction formula.
  * Ongoing or recent (within 1 year) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk for irAEs.
  * History of grade 3 or higher irAEs that led to treatment discontinuation of a CPI.
  * History of chronic liver disease or evidence of hepatic cirrhosis.
  * Evidence of interstitial lung disease.
  * Ongoing pneumonitis or history of non-infectious pneumonitis that has required steroids.
  * Known platelet function defects
* Prior therapy:

  * Radiotherapy within 14 days prior to first GEN1053 administration. Palliative radiotherapy will be allowed.
  * Treatment with an anti-cancer agent (within 28 days or after at least 5 half-lives of the drug, whichever is shorter), prior to GEN1053 administration.
  * Subject with a condition requiring systemic treatment with either corticosteroids (\>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of first treatment. Inhaled or topical steroids, and adrenal or pituitary replacement steroid \> 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease.

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply

Primary outcomes:
measure: Number of Participants With Dose Limiting Toxicities (DLTs)
timeFrame: Day 1 up to Day 21
measure: Number of Participants With At Least One Treatment-emergent Adverse Event (TEAE)
timeFrame: Up to approximately 1.5 years
Secondary outcomes:
measure: Clearance (CL) of GEN1053
timeFrame: Cycle 1 and Cycle 3 (cycles were 3 weeks)
measure: Volume of Distribution (Vz) of GEN1053
timeFrame: Cycle 1 and Cycle 3 (cycles were 3 weeks)
measure: Maximum (Peak) Concentration (Cmax) of GEN1053
timeFrame: Cycle 1 and Cycle 3 (cycles were 3 weeks)
measure: Time to Maximum (Peak) Concentration (Tmax) of GEN1053
timeFrame: Cycle 1 and Cycle 3 (cycles were 3 weeks)
measure: Predose Trough Concentration (Ctrough) of GEN1053
timeFrame: Cycle 1 and Cycle 3 (cycles were 3 weeks)
measure: Elimination Half-life (t1/2) of GEN1053
timeFrame: Cycle 1 and Cycle 3 (cycles were 3 weeks)
measure: Area Under the Concentration-time Curve (AUC) From Time Zero to Last Quantifiable Measurement (AUClast) of GEN1053
timeFrame: Cycle 1 and Cycle 3 (cycles were 3 weeks)
measure: AUC From Time Zero Over the Dosing Interval (AUCtau) of GEN1053
timeFrame: Cycle 1 and Cycle 3 (cycles were 3 weeks)
measure: Number of Participants With Anti-drug Antibodies (ADAs) to GEN1053
timeFrame: Cycle 1 Day 1 through end of safety follow up (60 days after last dose [cycles were 3 weeks]), up to approximately 1.5 years
measure: Objective Response Rate (ORR)
timeFrame: Up to approximately 1.5 years
measure: Disease Control Rate (DCR)
timeFrame: Up to approximately 1.5 years
measure: Duration of Response (DOR)
timeFrame: Up to approximately 1.5 years
Other outcomes:
Locations:
city: New Haven
country: United States
facility: Yale University
state: Connecticut
city: Nashville
country: United States
facility: Sarah Cannon Research Institute
state: Tennessee
city: Pamplona
country: Spain
facility: Clinica Universidad de Navarra
state: Navarra
city: Barcelona
country: Spain
facility: Hospital Universitari Vall d'Hebron
city: Madrid
country: Spain
facility: Centro Integral Oncologico Clara Campal
Study officials:
References: