Clinical trial NCT06885034: A Study to Test the Safety and Effectiveness of GSK5764227, Alone or With Other Treatments, in Participants With Advanced Gastrointestinal Cancers That Cannot be Surgically Removed
Official title: A Phase1b/2, Multicenter, Randomized, Open-label Study to Evaluate the Efficacy and Safety of GSK5764227 Alone and in Combination in Participants With Previously Treated Advanced Unresectable or Metastatic Gastrointestinal Solid Tumors
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: PHASE1
PHASE2
Conditions: Gastrointestinal Neoplasms
Keywords: GSK5764227
Solid Tumors
Lead sponsor: GlaxoSmithKline
Sponsor class: INDUSTRY
First posted: 2025-03-19
Enrollment: 120
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study will check how well a new medicine, GSK5764227, works, how safe it is and how the body handles it in participants all around the world with advanced inoperable or metastatic gastrointestinal cancer who have previously received treatment.


Eligibility criteria: Inclusion criteria:

Participants are eligible to be included in the study only if all of the following criteria apply:

* Is at least 18 or the legal age of consent in the jurisdiction in which the study is taking place years of age at the time of signing the informed consent form (ICF).
* Has histologically confirmed unresectable/metastatic adenocarcinoma of the colon or rectum (histology defined by World Health Organization (WHO) classification).
* Must have received at least 1 and no more than 2 lines of systemic treatment for advanced colorectal cancer (CRC), with documented progression on most recent prior line of therapy.
* Has at least 1 target lesion per RECIST 1.1, as determined by the investigator.
* Must provide tumor tissue from a newly obtained fresh biopsy or an archival tumor tissue.
* Is willing to use adequate contraception.
* Is capable of giving signed informed consent, including compliance with the requirements and restrictions listed in the ICF and in the protocol.
* Has an ECOG performance status of 0 or 1.
* Has adequate organ function.

Exclusion criteria:

Participants are excluded from the study if any of the following criteria apply:

* Has a malignancy (except disease under study) that has progressed or required active treatment within the past 24 months except for basal cell or squamous cell carcinomas of the skin or in-situ carcinomas \[e.g., breast, cervix, bladder\] that have been resected with no evidence of disease.
* Has had any major surgery within 28 days prior to randomization.
* Has any history of prior allogenic or autologous bone marrow transplant or other solid organ transplant.
* Has known sensitivity to study intervention components or excipients or other allergy that, in the opinion of the investigator or medical monitor, contraindicates participation in the study.
* Has severe, uncontrolled or active cardiovascular disorders.
* Has serious or poorly controlled hypertension.
* Has clinically significant bleeding symptoms or significant bleeding tendency within 1 month prior to the first dose.
* Has serious infection within 4 weeks prior to the first dose.
* Known active infectious diseases requiring systemic treatment or known Human immunodeficiency virus (HIV).
* Has serious arteriovenous thromboembolic events (such as deep vein thrombosis, pulmonary embolism, etc.) within 3 months prior to the first dose.
* Has untreated brain or Central nervous system (CNS) metastases or brain/CNS metastases that have progressed.
* Has current active pneumonitis or any history of pneumonitis requiring steroids or immunomodulatory treatment within 90 days of planned \[randomization\] or any history of drug-induced pneumonitis.
* Has a history of autoimmune disease that has required systemic treatments in the 2 years prior to screening.
* Has any active renal condition (e.g., infection, requirement for dialysis, or any other significant renal condition that could affect the participant's safety).
* Has ongoing adverse reaction(s) from prior therapy that has(have) not recovered to Grade 1 or to the baseline status preceding prior therapy.
* Has any serious and/or unstable medical or psychiatric disorder or other condition(s) (including laboratory assessment abnormalities) that could interfere with the participant's safety, obtainment of informed consent, or compliance to the study procedures.
* Has cirrhosis or current unstable liver or biliary disease per investigator assessment defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal/gastric varices, or persistent jaundice.
* Has documented presence of Hepatitis B surface antigen (HBsAg) at screening or within 3 months prior to the first dose of study intervention.
* Has a positive Hepatitis C virus (HCV)antibody test result at screening or within 3 months prior to the first dose of study intervention.
* Has a positive HCV RNA test result at screening or within 3 months prior to the first dose of study intervention.
* Has received immunosuppressive agents within 30 days prior to first dose of study intervention (or requires long-term \[30 days or longer\]).
* Has received any prior therapy with an Antibody-drug conjugate (ADC) with a Topoisomerase-1 (TOPO1)-inhibitor payload.
* Has received any live vaccine within 30 days of randomization.
* Is currently enrolled or has participated in any other clinical study involving an investigational study intervention or any other type of interventional medical research and/or has received treatment with any anticancer or investigational agent within 4 weeks prior to randomization.
* Is pregnant or breastfeeding.
* Is unable to adhere to the protocol defined SoA, including requirements for the Follow-up Period of the study.

Primary outcomes:
measure: Confirmed Objective Response Rate (ORR)
timeFrame: Up to approximately 17 months
Secondary outcomes:
measure: Unconfirmed ORR
timeFrame: Up to approximately 32 months
measure: Duration of Response (DoR)
timeFrame: Up to approximately 32 months
measure: Progression Free Survival (PFS)
timeFrame: Up to approximately 32 months
measure: Number of participants with AEs, serious adverse events (SAEs) and adverse events of special interest (AESIs) by severity
timeFrame: Up to approximately 32 months
measure: Number of participants with AEs leading to dose modifications, discontinuation of study interventions or death
timeFrame: Up to approximately 32 months
measure: Changes from baseline in vital signs: Temperature (degree Celsius)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline vital signs: Respiratory rate (breaths per minute)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline vital signs: Pulse rate (beats per minute)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline vital signs: Blood pressure [millimetres of mercury (mmHg)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline in hematology parameters: [White blood cell count (WBCs per microliter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline in hematology parameters: [Haemoglobin (Hgb) (grams per deciliter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline in hematology parameters:[Haematocrit (Proportion of red blood cells in blood)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from Baseline haematology parameter: [Red Blood Cell Count (RBC) (million cells per microliter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline haematology parameters: Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils (giga cells per liter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from Baseline haematology parameter: Platelet count (cells per microliter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline Clinical chemistry parameters: Total Protein, Albumin (Grams per deciliter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline Clinical Chemistry parameters: AST/SGOT, ALT/ SGPT, ALP and CPK (International Units per liter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline Clinical Chemistry parameters: Total Bilirubin and Direct Bilirubin, Glucose, Calcium, Potassium, Sodium, Magnesium, Urea Nitrogen or urea, and Creatinine (milligrams per deciliter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline Clinical Chemistry parameters: Lactate dehydrogenase, Amylase and Lipase (units per liter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline Clinical Chemistry parameters: Chloride (millimoles per liter)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline Clinical Chemistry parameters: Creatinine clearance (milliliters per minute)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline cardiac function: Electrocardiogram (ECG) (milliseconds)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Changes from baseline Eastern Cooperative Oncology Group performance status (ECOG-PS)
timeFrame: Baseline (Day 1) and up to approximately 32 months
measure: Maximum observed concentration (Cmax) of GSK5764227 (conjugated antibody) and GSK5757810A (small molecule toxin)
timeFrame: Up to approximately 32 months
measure: Time to reach Cmax (Tmax) of GSK5764227 (conjugated antibody) and GSK5757810A (small molecule toxin)
timeFrame: Up to approximately 32 months
measure: Area under the concentration-time curve (AUC) of GSK5764227 (conjugated antibody) and GSK5757810A (small molecule toxin)
timeFrame: Up to approximately 32 months
measure: Number of participants with Antidrug antibody (ADA) or Neutralizing Antibody (NAb)
timeFrame: Up to approximately 32 months
measure: Titers of ADA against GSK5764227
timeFrame: Up to approximately 32 months
measure: Number of participants with symptomatic AEs, by severity, as measured by Patient Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)
timeFrame: Up to approximately 32 months
measure: Level of bother of AEs as measured by Functional Assessment of Cancer Therapy - Item GP5 (FACT-GP5)
timeFrame: Up to approximately 32 months
Other outcomes:
Locations:
Study officials:
References: