Clinical Trial: NCT02906670 - My Cancer Genome

NCT02906670

Description:

This is the first study to test Sym013 (Pan-HER) in humans. The primary purpose of this study is to see if Sym013 is safe and effective for patients with advanced epithelial malignancies without available therapeutic options.

Related Conditions:

Malignant Solid Tumor

Recruiting Status:

Active, not recruiting

Phase:

Phase 1/Phase 2

URL:

https://clinicaltrials.gov/show/NCT02906670

Trial Eligibility

Document

Title

Brief Title: Sym013 (Pan-HER) in Patients With Advanced Epithelial Malignancies
Official Title: An Open-label, Multicenter, Phase 1a/2a Trial Investigating the Safety, Tolerability and Antitumor Activity of Multiple Doses of Sym013, a mAb Mixture Targeting EGFR, HER2 and HER3, in Patients With Advanced Epithelial Malignancies

Clinical Trial IDs

ORG STUDY ID: Sym013-01
NCT ID: NCT02906670

Conditions

Oncology

Interventions

Drug	Synonyms	Arms
Sym013	Pan-HER	Phase 1a Dose Escalation

Purpose

Detailed Description

      This is an open-label, multicenter trial composed of 2 parts in which Sym013 will be
      evaluated when administered by intravenous infusion in patients with advanced epithelial
      malignancies without available therapeutic options.

      Part 1 is a Phase 1a dose-escalation designed to determine the recommended phase 2 dose
      (RP2D). Patients entered to Dose Level 1, 2, and 3 were treated every week (Q1W). As of April
      2017, the dosing schedule in this trial has been changed to every second week (Q2W). Patients
      entered to the trial prior to implementation of this amendment will continue to be treated
      Q1W.

      Once the RP2D is selected, an expansion cohort of patients with fluorodeoxyglucose (FDG)-avid
      tumors will undergo pre- and post-dosing fluorine-18 radiolabeled FDG (18F-FDG) positron
      emission tomography (PET) imaging to evaluate the effects on tumor metabolism of Sym013 when
      administered at this dose. Imaging to be paired with computed tomography (CT)/ magnetic
      resonance imaging (MRI) conducted for Disease Status Evaluation. Accrual to this cohort may
      occur concurrent with accrual to Part 2 of the study.

      Part 2 is a Phase 2a dose-expansion at the RP2D. Four tumor types to be evaluated in this
      part of the trial will be selected based upon findings from Part 1, additional preclinical
      data, and additional clinical data available at that time from other agents inhibiting these
      targets. Patients will be entered, depending upon their underlying malignancy, to 1 of 4
      corresponding expansion cohorts: Cohort A, Cohort B, Cohort C, or Cohort D.

Trial Arms

Name	Type	Description	Interventions
Phase 1a Dose Escalation	Experimental	Part 1 is a Phase 1a dose-escalation with Sym013 designed to determine the RP2D. Sym013 will be tested potentially in eight dose titration cohorts.	Sym013
PET Expansion Cohort	Experimental	An expansion cohort of patients with FDG-avid tumors will undergo pre- and post-dosing 18F-FDG PET imaging to evaluate the effects on tumor metabolism of Sym013 at the RP2D. Imaging to be paired with CT/MRI conducted for Disease Status Evaluation. Accrual to this cohort may occur concurrent with accrual to Part 2 of the study.	Sym013
Phase 2a Dose Expansion Cohort A	Experimental	Part 2 is a Phase 2a dose-expansion with Sym013 at the RP2D. One (1) of 4 tumor types to be evaluated in this arm of the trial will be selected based upon findings from Part 1, additional preclinical data, and additional clinical data available at that time from other agents inhibiting these targets.	Sym013
Phase 2a Dose Expansion Cohort B	Experimental	Part 2 is a Phase 2a dose-expansion with Sym013 at the RP2D. One (1) of 4 tumor types to be evaluated in this arm of the trial will be selected based upon findings from Part 1, additional preclinical data, and additional clinical data available at that time from other agents inhibiting these targets.	Sym013
Phase 2a Dose Expansion Cohort C	Experimental	Part 2 is a Phase 2a dose-expansion with Sym013 at the RP2D. One (1) of 4 tumor types to be evaluated in this arm of the trial will be selected based upon findings from Part 1, additional preclinical data, and additional clinical data available at that time from other agents inhibiting these targets.	Sym013
Phase 2a Dose Expansion Cohort D	Experimental	Part 2 is a Phase 2a dose-expansion with Sym013 at the RP2D. One (1) of 4 tumor types to be evaluated in this arm of the trial will be selected based upon findings from Part 1, additional preclinical data, and additional clinical data available at that time from other agents inhibiting these targets.	Sym013

Eligibility Criteria

        Inclusion Criteria:

        Main inclusion criteria all patients, Part 1 and Part 2:

          -  Male or female, at least 18 years of age at the time of informed consent

          -  Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1

          -  Life expectancy >3 months assessed during Screening

          -  Documented (histologically- or cytologically-proven) epithelial malignancy that is
             locally advanced or metastatic, having received all therapy known to confer clinical
             benefit

          -  PET Expansion Cohort: Epithelial malignancy, measurable according to RECIST v1.1 that
             has been confirmed by 18F-FDG-PET imaging to be FDG-avid within 28 days prior to C1/D1

        Additional inclusion criteria applicable to Part 2 ONLY:

          -  Epithelial malignancy (types to be specified in a protocol amendment), measurable
             according to RECIST v1.1 that has been confirmed by computed tomography (CT) or
             magnetic resonance imaging (MRI) within 4 weeks prior to C1/D1

          -  Willingness to undergo a pre-and post-dosing biopsy (total of 2 biopsies) from primary
             or metastatic tumor site(s) considered safe for biopsy

        Exclusion Criteria:

          -  Any antineoplastic agent (standard or investigational) within 4 weeks prior to C1/D1

          -  Part 2 ONLY: Radiotherapy against target lesions within 4 weeks prior to C1/D1, unless
             there is documented progression of the lesion following radiotherapy

          -  Immunosuppressive or systemic hormonal therapy (>10 mg daily prednisone equivalent)
             within 2 weeks prior to C1/D1 with exceptions

          -  Use of hematopoietic growth factors within 2 weeks prior to C1/D1

          -  Active second malignancy or history of another malignancy within the last 3 years,
             with allowed exceptions

          -  Central nervous system (CNS) malignancies; known, untreated CNS or leptomeningeal
             metastases, or spinal cord compression, any of the above not controlled by prior
             surgery or radiotherapy, or symptoms suggesting CNS involvement for which treatment is
             required

          -  Inadequate recovery from an acute toxicity associated with any prior antineoplastic
             therapy

          -  Major surgical procedure within 4 weeks prior to C1/D1 or inadequate recovery from any
             prior surgical procedure

          -  Non-healing wounds on any part of the body

          -  Active thrombosis, or a history of deep vein thrombosis or pulmonary embolism, within
             4 weeks prior to C1/D1, unless adequately treated and stable

          -  Active uncontrolled bleeding or a known bleeding diathesis

          -  Significant gastrointestinal abnormalities

          -  Significant cardiovascular disease or condition

          -  Abnormal hematologic, renal or hepatic function

Maximum Eligible Age:	N/A
Minimum Eligible Age:	18 Years
Eligible Gender:	All
Healthy Volunteers:	No

Primary Outcome Measures

Measure:	Part 1: Assess the safety and tolerability of Sym013 when administered Q1W and Q2W to patients with advanced epithelial malignancies without available therapeutic options
Time Frame:	18 months
Safety Issue:
Description:	Assess the occurrence of dose-limiting toxicities (DLTs) during Cycle 1 of Sym013 administration

Secondary Outcome Measures

Measure:	Part 1: Determine the RP2D of Sym013
Time Frame:	18 months
Safety Issue:
Description:	Determination based on evaluation of the patient data for DLTs from Part 1.

Measure:	Parts 1 and 2: Evaluate the immunogenicity of Sym013
Time Frame:	42 months
Safety Issue:
Description:	Serum sampling to assess the potential for anti-drug antibody (ADA) formation.

Measure:	Parts 1 and 2: Area under the concentration-time curve in a dosing interval (AUC)
Time Frame:	42 Months
Safety Issue:
Description:	Will be estimated using non-compartmental methods and actual time points.

Measure:	Parts 1 and 2: Maximum concentration (Cmax)
Time Frame:	42 Months
Safety Issue:
Description:	Will be derived from observed data.

Measure:	Parts 1 and 2: Time to reach maximum concentration (Tmax)
Time Frame:	42 months
Safety Issue:
Description:	Will be derived from observed data.

Measure:	Parts 1 and 2: Trough concentration (Ctrough)
Time Frame:	42 Months
Safety Issue:
Description:	Will be derived from observed data.

Measure:	Parts 1 and 2: Elimination half-life (T½)
Time Frame:	42 Months
Safety Issue:
Description:	Will be estimated using non-compartmental methods and actual time points.

Measure:	Parts 1 and 2: Clearance (CL)
Time Frame:	42 Months
Safety Issue:
Description:	Will be estimated using non-compartmental methods and actual time points.

Details

Phase:	Phase 1/Phase 2
Primary Purpose:	Interventional
Overall Status:	Recruiting
Lead Sponsor:	Symphogen A/S

Trial Keywords

Epithelial malignancies

Last Updated

February 21, 2018

Clinical Trials /

Sym013 (Pan-HER) in Patients With Advanced Epithelial Malignancies