Description:
This study is a Phase Ib/II, multi-center, open-label study of IMCgp100 as a single agent and
in combination with durvalumab (MEDI4736) and/or tremelimumab in metastatic cutaneous
melanoma. The purpose of this study is to characterize the safety, tolerability,
pharmacokinetics (PK), pharmacodynamics, and to evaluate the anti-tumor activity of IMCgp100
in combination with durvalumab (MEDI4736, programmed death-ligand 1 [PD-L1] inhibitor),
tremelimumab (CLTA-4 inhibitor), and the combination of durvalumab with tremelimumab compared
to single-agent IMCgp100 alone. The study will enroll patients who have metastatic melanoma
that is refractory to treatment with an anti-PD-1 inhibitor in the metastatic setting. This
study will also evaluate the safety, tolerability, and anti-tumor activity of IMCgp100
monotherapy in patients with advanced non-uveal melanoma who progressed on prior PD-1
inhibitors approved for the treatment of advanced melanoma; patients with BRAF mutations must
be refractory to approved BRAF-based therapy.
Recent biologic evidence indicates that optimal responses to programmed cell death-1 (PD-1)
directed therapy require the presence of CD8+ T cells in the tumor microenvironment and thus
therapies such as IMCgp100 that recruit these effector cells to the tumor may overcome
pre-existing resistance to checkpoint blockade. This emerging biology of checkpoint inhibitor
resistance suggests the combination of IMCgp100 with checkpoint inhibition may have enhanced
activity in patients with pre-existing resistance.
Title
- Brief Title: Phase 1b/2 Study of the Combination of IMCgp100 With Durvalumab and/or Tremelimumab in Cutaneous Melanoma
- Official Title: A Phase Ib/II Open-label, Multi-center Study of the Safety and Efficacy of IMCgp100 in Combination With Durvalumab (MEDI4736) or Tremelimumab or the Combination of Durvalumab and Tremelimumab Compared to IMCgp100 Alone in Patients With Advanced Melanoma
Clinical Trial IDs
- ORG STUDY ID:
IMCgp100-201
- NCT ID:
NCT02535078
Conditions
Interventions
Drug | Synonyms | Arms |
---|
IMCgp100 | | Arm 1 |
durvalumab | MEDI4736 | Arm 1 |
tremelimumab | | Arm 2 |
Purpose
This study is a Phase Ib/II, multi-center, open-label study of IMCgp100 as a single agent and
in combination with durvalumab (MEDI4736) and/or tremelimumab in metastatic cutaneous
melanoma. The purpose of this study is to characterize the safety, tolerability,
pharmacokinetics (PK), pharmacodynamics, and to evaluate the anti-tumor activity of IMCgp100
in combination with durvalumab (MEDI4736, programmed death-ligand 1 [PD-L1] inhibitor),
tremelimumab (CLTA-4 inhibitor), and the combination of durvalumab with tremelimumab compared
to single-agent IMCgp100 alone. The study will enroll patients who have metastatic melanoma
that is refractory to treatment with an anti-PD-1 inhibitor in the metastatic setting. This
study will also evaluate the safety, tolerability, and anti-tumor activity of IMCgp100
monotherapy in patients with advanced non-uveal melanoma who progressed on prior PD-1
inhibitors approved for the treatment of advanced melanoma; patients with BRAF mutations must
be refractory to approved BRAF-based therapy.
Recent biologic evidence indicates that optimal responses to programmed cell death-1 (PD-1)
directed therapy require the presence of CD8+ T cells in the tumor microenvironment and thus
therapies such as IMCgp100 that recruit these effector cells to the tumor may overcome
pre-existing resistance to checkpoint blockade. This emerging biology of checkpoint inhibitor
resistance suggests the combination of IMCgp100 with checkpoint inhibition may have enhanced
activity in patients with pre-existing resistance.
Trial Arms
Name | Type | Description | Interventions |
---|
Arm 1 | Experimental | IMCgp100 with durvalumab (MEDI4736) | |
Arm 2 | Experimental | IMCgp100 with tremelimumab | |
Arm 3 | Experimental | IMCgp100 with durvalumab (MEDI4736) and tremelimumab | - IMCgp100
- durvalumab
- tremelimumab
|
Arm 4 | Experimental | IMCgp100 (single agent) | |
Eligibility Criteria
Inclusion Criteria:
1. Age ≥ 18 years
2. Written informed consent must be obtained from all patients prior to any study
procedures
3. Patients with advanced non-uveal melanoma defined as unresectable stage III or
metastatic stage IV disease. Patients with acral or mucosal melanoma are acceptable.
4. Phase 1b Arm 4 and Phase II: Patients with disease progression following initiation of
treatment with an approved PD-1 inhibitor. No prior cytotoxic therapy in the advanced
setting is permitted. Patients with BRAF mutations must be refractory to approved
BRAF-based therapy. CTLA-4-inhibition therapy is acceptable as a prior line of therapy
or in combination with anti-PD-1 therapy.
5. HLA-A*0201 positive by Central Assay
6. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
7. Phase II cohorts only: patients must have measurable disease according to RECIST v.1.1
criteria. Patients enrolled in Ph Ib cohorts must have evaluable disease
8. Ongoing treatment with systemic steroids or other immunosuppressive therapies.
Exclusion Criteria:
1. Presence of untreated or symptomatic central nervous system metastases, or central
nervous system metastases.
2. History of severe hypersensitivity reactions to other mAbs
3. History of treatment-related interstitial lung disease/pneumonitis
4. Impaired baseline organ function as evaluated by out-of-range laboratory values.
5. Clinically significant cardiac disease or impaired cardiac function.
6. Active autoimmune disease or a documented history of autoimmune disease.
7. Active infection requiring systemic antibiotic therapy. Patients requiring systemic
antibiotics for infection must have completed therapy before Screening is initiated
8. Known history of human immunodeficiency virus (HIV) infection. Testing for HIV status
is not necessary unless clinically indicated or if required by local regulation
9. Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, currently
requiring medical intervention, per institutional protocol. Testing for HBV or HCV
status is not necessary unless clinically indicated or the patient has a history of
HBV or HCV infection requiring treatment with currently an unknown status. History of
treated hepatitis is not exclusionary
10. Malignant disease, other than that being treated in this study. Pregnant or breast
feeding.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Phase 1b Number of dose-limiting toxicities |
Time Frame: | 12 months |
Safety Issue: | |
Description: | The number of dose-limiting toxicities (DLT) observed during the DLT observation period. DLT observation period for the Arms 1 to 3 Phase Ib cohorts will be the first 2 cycles of treatment (C1D1 until C2D28). The DLT observation period for Arm 4 Phase Ib will be from C1D22 to C2D14. A DLT is defined as an adverse event or abnormal laboratory value that occurs during the relevant DLT period which is assessed as having a suspected relationship to study drug, and unrelated to disease, disease progression, inter-current illness, or concomitant medications, occurs during the DLT Observation Period or is Grade 3 or higher per NCI CTCAE version 4.03, or as specified in the protocol. |
Secondary Outcome Measures
Measure: | Phase 2b Objective Response Rate |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Objective Response Rate (RECIST v1.1) Objective response rate, defined as the proportion of patients with a best response of CR or PR based on investigator assessment, as defined in RECIST v1.1. |
Measure: | Overall survival |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Time from the date of first dose until death due to any cause. |
Measure: | Safety: AEs and SAEs |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Safety incidence and severity of AEs and SAEs including changes in laboratory. parameters, vital signs, and electrocardiograms (ECG). |
Measure: | Tolerability |
Time Frame: | 2 years |
Safety Issue: | |
Description: | The number of dose interruptions, reductions, and dose intensity of all administered study medications. |
Measure: | Serum Pharmacokinetics |
Time Frame: | 2 years |
Safety Issue: | |
Description: | AUClast : Area under the curve (AUC) from time zero to the last measurable concentration sampling time (tlast) (mass x time x volume-1) |
Measure: | Serum Pharmacokinetics |
Time Frame: | 2 years |
Safety Issue: | |
Description: | AUCinf : The AUC from time zero to infinity (mass x time x volume-1) |
Measure: | Serum Pharmacokinetics |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Cmax : Maximum Plasma Concentration |
Measure: | Serum Pharmacokinetics |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Tmax: The time to reach maximum (peak) plasma, blood, serum, or other body fluid drug concentration after single dose administration (time) |
Measure: | Serum Pharmacokinetics |
Time Frame: | 2 years |
Safety Issue: | |
Description: | t1/2 : Elimination half-life associated with the terminal slope (λz) of a semi logarithmic concentration-time curve (time) |
Measure: | Correlation of PD-L1 and gp100 |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Measure: | Progression Free Survival |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Correlation of gp100 and PD-L1 expression by immunohistochemistry evaluated in pre-treatment biopsies with anti-tumor activity. |
Measure: | Duration of Response |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Time from the date of first documented response until date of documented progression or death in the absence of disease progression. The median duration of response and corresponding 90% confidence interval will be presented. |
Measure: | Overall Survival |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Time from the date of first dose until death due to any cause. OS will be presented including all patients treated at the MTD or RP2D. |
Measure: | Time to Response |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Time from initiation of therapy to the time that an OR per RECISTv1.1 is achieved. |
Measure: | Disease Control Rate |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Proportion of patients with either a best response of PR or CR or with SD over 24 weeks after first dose in the study. The DCR and associated 90% confidence interval will be presented by treatment arm. |
Measure: | Formation of Anti-drug Antibodies |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Incidence of anti-IMCgp100, anti-durvalumab, and anti-tremelimumab antibody formation following multiple infusions of IMCgp100 alone and in combination with durvalumab and/or tremelimumab. |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Immunocore Ltd |
Trial Keywords
- IMCgp100
- gp100
- metastatic cutaneous melanoma
- checkpoint inhibitor
- PD-1
- PD-L1
- CTLA-4
- durvalumab
- tremelimumab
- Tebentafusp
- Bispecific T cell receptor fusion protein
- ImmTAC
- Immune mobilizing monoclonal T cell receptor against cancer
- Immunotherapy
- mucosal melanoma
- acral melanoma
Last Updated
March 24, 2021