Clinical trial NCT03352531: Study of the Safety, Pharmacokinetics, and Antitumor Activity of AK105 in Subjects With Advanced Solid Tumors
Official title: A Phase 1A/1B Multicenter, Open-label, Dose-escalation, and Dose-expansion Study to Evaluate the Safety, Pharmacokinetics, and Antitumor Activity of AK105 in Subjects With Advanced Solid Tumors
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Advanced Cancer
Keywords: Anti-PD-1 monoclonal antibody
immunotherapy
immuno-oncology
advanced solid tumors
Lead sponsor: Akeso
Sponsor class: INDUSTRY
First posted: 2017-11-24
Enrollment: 99
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This study is to characterize the safety, tolerability, pharmacokinetics (PK), immunogenicity, pharmacodynamics (PD) and anti-tumor activity of AK105 as a single agent in adult subjects with advanced solid tumor malignancies. The study consists of a dose escalation phase (Phase 1a) to determine the maximum tolerated dose (MTD), or recommended Phase 2 dose (RP2D) for AK105 as a single agent, and a dose expansion phase (Phase 1b) in subjects with specific tumor types which will characterize treatment of AK105 as a single agent at the MTD or RP2D.


Eligibility criteria: Inclusion Criteria:

* Written and signed informed consent and any locally required authorization obtained from the subject/legal representative.
* In dose-escalation cohorts (Phase 1a), histologically or cytologically documented advanced or metastatic solid tumor that is refractory/relapsed to standard therapies, or for which no effective standard therapy is available, or the subject refuses standard therapy.
* In the dose-expansion cohorts (Phase 1b), histologically or cytologically confirmed selected advanced solid tumors.
* Subject must have at least one measurable lesion according to RECIST Version1.1.
* Eastern Cooperative Oncology Group (ECOG) Performance Score of 0 or 1.
* Available archived tumor tissue sample to allow for correlative biomarker studies. In the setting where archival material is unavailable or unsuitable for use, the subject must consent and undergo fresh tumor biopsy.
* Adequate organ function.

Exclusion Criteria:

* History of severe hypersensitivity reactions to other mAbs.
* For dose-escalation phase (Phase 1a), prior exposure to any anti-PD-1, anti-PD-L1, anti-CTL4 antibody. For dose-expansion phase (Phase 1b), prior exposure to any anti-PD-1, anti-PD-L1, anti-CTL4 antibody or any other antibody or drug targeting T-cell costimulation or checkpoint pathways such as ICOS, or agonists such as CD40, CD137, GITR, OX40 etc.
* Receipt of any immunotherapy, any conventional or investigational systemic anticancer therapy within 4 weeks prior to the first dose of AK105.
* Prior treatment with systemic immune modulating agents (other than agents specified above) that was within 28 days prior to enrollment, or within 90 days prior to enrollment if there was an immune related adverse event, or associated with toxicity that resulted in discontinuation of the immune modulating agent.
* Any concurrent chemotherapy, immunotherapy, biologic or hormonal therapy for cancer treatment. Concurrent use of hormones for non-cancer related conditions is acceptable.
* Subjects with a condition requiring systemic treatment with either corticosteroid (\> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration.
* Active or prior documented autoimmune disease within the past 2 years.
* Active or prior documented inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
* History of primary immunodeficiency.
* History of organ transplant or hematopoietic stem cell that requires use of immunosuppressives.
* Known allergy or reaction to any component of the AK105 formulation.
* History of interstitial lung disease or non-infectious pneumonitis except for those induced by radiation therapies.
* Any condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product or interpretation of subject safety or study results.
* Known history of tuberculosis.
* Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS).
* Known active hepatitis B or C infections, or any positive test at screening for hepatitis B or C virus indicating acute or chronic infection except for subjects with HCC. Subjects with past or resolved HBV infection are eligible. Subjects positive for HCV antibody are eligible only if qualitative HCV RNA tests is negative.
* An active infection requiring systemic therapy with the exception of antiviral therapy for hepatitis as specified by the protocol.
* Receipt of live or attenuated vaccination within 30 days prior to the first dose of AK105.
* Active or prior documented esophageal or gastric variceal bleeding
* Clinically apparent ascites on physical examination. Ascites that requires active ongoing paracentesis (within 6 weeks prior to the first scheduled dose) to control symptoms. Note: ascites detectable on imaging studies only are allowed.
* Portal vein invasion at the main portal (Vp4), inferior vena cava, or cardiac involvement of HCC based on imaging.
* Clinically diagnosed hepatic encephalopathy characterized by asterixis.

Primary outcomes:
measure: Number of participants with adverse events (AEs)
timeFrame: From the time of informed consent signed through 90 days after the last dose of AK105
measure: Number of participants with a Dose Limiting Toxicity (DLT)
timeFrame: During the first 4 weeks
Secondary outcomes:
measure: Objective response rate (ORR)
timeFrame: Up to 2 years
measure: Disease control rate (DCR)
timeFrame: Up to 2 years
measure: Progression-free survival (PFS)
timeFrame: Up to 2 years
measure: Overall survival (OS)
timeFrame: Up to 2 years
measure: Area under the curve (AUC) of AK105
timeFrame: From first dose of AK105 through 30 days after last dose of AK105
measure: Maximum observed concentration (Cmax) of AK105
timeFrame: From first dose of AK105 through 30 days after last dose of AK105
measure: Minimum observed concentration (Cmin) of AK105 at steady state
timeFrame: From first dose of AK105 through 30 days after last dose of AK105
measure: Number of subjects who develop detectable anti-drug antibodies (ADAs)
timeFrame: From first dose of AK105 through to 90 days after last dose of AK105
Other outcomes:
Locations:
city: Darlinghurst
country: Australia
facility: St Vincent's Hospital, Sydney (The Kinghorn Cancer Centre)
state: New South Wales
city: East Albury
country: Australia
facility: Border Medical Oncology
state: New South Wales
city: Liverpool
country: Australia
facility: Liverpool Hospital
state: New South Wales
city: South Brisbane
country: Australia
facility: ICON Cancer Foundation
state: Queensland
city: Adelaide
country: Australia
facility: Ashford Cancer Centre Research
state: South Australia
Study officials:
References:
citation: Huang Z, Pang X, Zhong T, Qu T, Chen N, Ma S, He X, Xia D, Wang M, Xia M, Li B. Penpulimab, an Fc-Engineered IgG1 Anti-PD-1 Antibody, With Improved Efficacy and Low Incidence of Immune-Related Adverse Events. Front Immunol. 2022 Jun 27;13:924542. doi: 10.3389/fimmu.2022.924542. eCollection 2022.
citation: Zheng Y, Mislang ARA, Coward J, Cosman R, Cooper A, Underhill C, Zhu J, Xiong J, Jiang O, Wang H, Xie Y, Zhou Y, Jin X, Li B, Wang ZM, Kwek KY, Xia D, Xia Y, Xu N. Penpulimab, an anti-PD1 IgG1 antibody in the treatment of advanced or metastatic upper gastrointestinal cancers. Cancer Immunol Immunother. 2022 Oct;71(10):2371-2379. doi: 10.1007/s00262-022-03160-1. Epub 2022 Feb 15.