Description:
In this four-part study, NKTR-214 will be administered in combination with nivolumab in Part
1, in combination with nivolumab with or without various chemotherapies in Part 2, and with
nivolumab and ipilimumab in Parts 3 & 4. In Part 1, the Recommended Phase 2 Dose (RP2D) of
NKTR-214 in combination with nivolumab will be determined. In Part 2, NKTR-214 with nivolumab
at the RP2D will be evaluated as first-line therapy and/or as second or third line therapy in
select patients with Melanoma, Renal Cell Carcinoma (RCC), Non-Small Cell Lung Cancer
(NSCLC), Urothelial Carcinoma (UC), metastatic Breast Cancer (mBC) and Colorectal Cancer
(CRC). In addition, in Part 2, the RP2D of NKTR-214 with nivolumab and various chemotherapies
and regimens in select cohorts of NSCLC patients will be determined. In Part 3, several
different regimens of the triplet combination of NKTR-214 plus nivolumab and ipilimumab will
be evaluated in select patients with RCC, NSCLC, Melanoma, and UC. In Part 4, the safety and
efficacy of the triplet combination will be evaluated further in select patients with RCC,
NSCLC, Melanoma and UC.
Title
- Brief Title: A Dose Escalation and Cohort Expansion Study of NKTR-214 in Combination With Nivolumab and Other Anti-Cancer Therapies in Patients With Select Advanced Solid Tumors
- Official Title: A Phase 1/2, Open-label, Multicenter Study of the Combination of NKTR-214 and Nivolumab or the Combination of NKTR-214, Nivolumab, and Other Anti-Cancer Therapies in Patients With Select Locally Advanced or Metastatic Solid Tumor Malignancies
Clinical Trial IDs
- ORG STUDY ID:
16-214-02
- NCT ID:
NCT02983045
Conditions
- Melanoma
- Renal Cell Carcinoma
- Non Small Cell Lung Cancer
- Urothelial Carcinoma
- Metastatic Breast Cancer
- Colorectal Cancer
Interventions
Drug | Synonyms | Arms |
---|
Combination of NKTR-214 + nivolumab | NKTR-214 + Opdivo® | Dose Escalation: Combination of NKTR-214 + nivolumab |
Combination of NKTR-214 + nivolumab | NKTR-214 + Opdivo®, Carboplatin (Paraplatin®), Cisplatin (Platinol®), Pemetrexed (Alimta®), Paclitaxel (Taxol®) | Dose Expansion: Combination of NKTR-214 + nivolumab |
Combination of NKTR-214 + nivolumab + ipilimumab | NKTR-214 + Opdivo® + Yervoy® | Experimental: Combination of NKTR-214 + nivolumab + ipi |
Combination of NKTR-214 + nivolumab + ipilimumab | NKTR-214 + Opdivo® + Yervoy® | Dose Expansion of the Part 3 RP2D |
Purpose
In this four-part study, NKTR-214 will be administered in combination with nivolumab in Part
1, in combination with nivolumab with or without various chemotherapies in Part 2, and with
nivolumab and ipilimumab in Parts 3 & 4. In Part 1, the Recommended Phase 2 Dose (RP2D) of
NKTR-214 in combination with nivolumab will be determined. In Part 2, NKTR-214 with nivolumab
at the RP2D will be evaluated as first-line therapy and/or as second or third line therapy in
select patients with Melanoma, Renal Cell Carcinoma (RCC), Non-Small Cell Lung Cancer
(NSCLC), Urothelial Carcinoma (UC), metastatic Breast Cancer (mBC) and Colorectal Cancer
(CRC). In addition, in Part 2, the RP2D of NKTR-214 with nivolumab and various chemotherapies
and regimens in select cohorts of NSCLC patients will be determined. In Part 3, several
different regimens of the triplet combination of NKTR-214 plus nivolumab and ipilimumab will
be evaluated in select patients with RCC, NSCLC, Melanoma, and UC. In Part 4, the safety and
efficacy of the triplet combination will be evaluated further in select patients with RCC,
NSCLC, Melanoma and UC.
Detailed Description
NKTR-214 (investigational agent) is an IL-2 pathway agonist designed to target CD122, a
protein which is found on certain immune cells (known as CD8+ T Cells and Natural Killer
Cells) to expand these cells to promote their anti-tumor effects. Nivolumab is a full human
monoclonal antibody that binds to PD-1 (programmed cell death protein 1) on immune cells and
promotes anti-tumor effects. NKTR-214, nivolumab and ipilimumab each target the immune system
differently and may act synergistically to promote anti-cancer effects.
The study is designed in four parts.
Part 1: Dose escalation of NKTR-214 in combination with nivolumab. Part 1 has been completed
and the recommended phase 2 dose (RP2D) has been identified, which is being studied further
in Parts 2, 3 and 4 of the study.
Part 2: Dose expansion of NKTR-214 in combination with nivolumab. Patients with the following
tumor types (Melanoma, RCC, NSCLC, UC, mBC and CRC) will be enrolled to receive the RP2D of
NKTR-214 in combination with nivolumab. In addition, NKTR-214 with nivolumab and other
anti-cancer therapies including cytotoxic chemotherapy will be evaluated in select patients
with NSCLC. Each cohort in Part 2 has a target enrollment of 12-36 patients and could include
up to a total of 650 patients who are either checkpoint-therapy naïve or anti-PD-1 or
anti-PD-L1 relapsed/refractory. One dedicated and separate cohort in Part 2 will evaluate
NKTR-214 with nivolumab in an additional 100 second-line NSCLC patients previously treated
with an anti-PD-1 or anti-PD-L1 in combination with doublet platinum-containing cytotoxic
chemotherapy in first-line.
Part 3: Schedule and safety finding of NKTR-214 in combination with nivolumab and ipilimumab.
During this part of the study, the RP2D triplet combination schedules will be determined in
the following tumor types: RCC, NSCLC, Melanoma, or UC.
Part 4: Dose expansion of triplet combinations of NKTR-214 in combination with nivolumab and
ipilimumab in select tumor types. Each cohort will enroll between 6-36 patients and could
include up to 106 patients. Enrollment into Part 4 will commence once the RP2D for the
triplet combination has been established in Part 3 for each respective tumor type.
All patients enrolled in the study will be closely monitored for safety, tolerability and
response per RECIST criteria. The primary efficacy endpoint of the combination will be
assessed using objective response rate (ORR). Exploratory immunological biomarkers in plasma
and tumor samples will evaluate immune activation.
Trial Arms
Name | Type | Description | Interventions |
---|
Dose Escalation: Combination of NKTR-214 + nivolumab | Experimental | NKTR-214 in escalating doses will be combined with one of the two proposed doses of nivolumab. The goal of this dose escalation Part 1 of the study is to find the RP2D. | - Combination of NKTR-214 + nivolumab
|
Dose Expansion: Combination of NKTR-214 + nivolumab | Experimental | Combination of NKTR-214+nivolumab in combination with cytotoxic chemotherapies for the following 2 cohorts of the Part 2:
NSCLC 1L nonsquamous plus platinum/pemetrexed NSCLC 1L squamous plus platinum/taxane | - Combination of NKTR-214 + nivolumab
|
Experimental: Combination of NKTR-214 + nivolumab + ipi | Experimental | NKTR-214 will be combined with nivolumab and ipilimumab. The goal of this dose schedule finding part of the study is to define the RP2D and administration schedule. | - Combination of NKTR-214 + nivolumab + ipilimumab
|
Dose Expansion of the Part 3 RP2D | Experimental | Experimental Combination of NKTR-214 + nivolumab + ipilimumab that may enroll between 12-26 patients per tumor type | - Combination of NKTR-214 + nivolumab + ipilimumab
|
Eligibility Criteria
INCLUSION CRITERIA - For Parts 1-4:
- Histologically confirmed diagnosis of a locally advanced (not amenable to curative
therapy such as surgical resection) or metastatic solid tumors
- Life expectancy > 12 weeks
- Patients must not have received prior interleukin-2 (IL-2) therapy
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Measurable disease per RECIST 1.1
- Patients with stable brain metastases under certain criteria
- Fresh and archival tumor tissue available Tumor specific inclusion criteria may apply.
EXCLUSION CRITERIA - For Parts 1-4:
- Use of an investigational agent or an investigational device within 28 days before
administration of first dose of NKTR--214
- Females who are pregnant or breastfeeding
- Participants who have an active autoimmune disease requiring systemic treatment within
the past 3 months or have a documented history of clinically severe autoimmune disease
that requires systemic steroids or immunosuppressive agents
- History of organ transplant that requires use of immune suppressive agents
- Active malignancy not related to the current diagnosed malignancy
- Evidence of clinically significant interstitial lung disease or active, noninfectious
pneumonitis
- Participants who have had < 28 days since the last chemotherapy, biological therapy,
or < 14 days from approved tyrosine kinase inhibitor (TKI) therapy, or systemic or
inhaled steroid therapy at doses greater than 10mg of prednisone Tumor specific
exclusion criteria may apply.
Other protocol defined inclusion/exclusion criteria may apply
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Efficacy of NKTR-214 in combination with nivolumab as assessed by the Objective Response Rate (ORR) based on immune-related RECIST (irRECIST) at the RP2D. |
Time Frame: | Through study completion, an expected average of 2 years |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Overall Survival (OS) |
Time Frame: | Within 3 years from study start |
Safety Issue: | |
Description: | Overall survival is defined as the time from date of first dose to the date of death |
Measure: | Progression-Free Survival (PFS) |
Time Frame: | Through study completion, an expected average of 2 years |
Safety Issue: | |
Description: | PFS is defined as the time from date of first dose to the date of the first objectively documented tumor progression or death due to any cause. |
Measure: | Clinical Benefit Rate (CBR) |
Time Frame: | Within 3 years from study start |
Safety Issue: | |
Description: | CBR will be assessed as the number of subjects with a BOR of Complete Response (CR), confirmed Partial Response (PR), or Stable Disease (SD) (where the duration of SD should be ≥ 84 days) divided by the total number of subjects in the Response Evaluable Population |
Measure: | Duration of Response (DOR) |
Time Frame: | Through study completion, an expected average of 2 years |
Safety Issue: | |
Description: | DOR is defined as time between the date of first radiographic images that documented objective response and the date of the first radiographic images that documented disease progression. |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Nektar Therapeutics |
Trial Keywords
- NKTR-214
- Bempegaldesleukin
- Nivolumab
- Ipilimumab
- Paclitaxel
- Carboplatin
- Cisplatin
- Pemetrexed
- Melanoma
- Renal Cell Carcinoma
- Non Small Cell Lung Cancer
- Urothelial Carcinoma
- Triple Negative Breast Cancer
- Colorectal Cancer
- Metastatic
- Advanced
- Immunotherapy
- Anti-PD-1
- anti-CTLA-4
Last Updated
August 26, 2021