Description:
Primary Objectives:
Dose escalation (Part 1)
Part 1A (SAR439459 monotherapy)
- To determine the maximum tolerated dose (MTD) and/or maximum administered dose (MAD) of
SAR439459 when administered intravenously as monotherapy in adult patients with advanced
solid tumors.
Part 1B (SAR439459 and cemiplimab combination therapy)
- To determine the MTD and/or MAD of SAR439459 administered intravenously in combination
with cemiplimab administered intravenously in adult patients with advanced solid tumors.
Dose expansion (Part 2)
Part 2A (SAR439459 monotherapy)
- To determine optimal dose of SAR439459 administered intravenously in adult patients with
advanced melanoma who have failed a prior therapy based on anti-PD-1 (programmed cell
death-1) or anti-PD-L1.
Part 2B (SAR439459 and cemiplimab combination therapy)
- To determine the objective response rate (ORR) of SAR439459 in combination with
cemiplimab in adult patients with selected advanced solid tumors by evaluation of
antitumor response according to Response Evaluation Criteria in Solid Tumors 1.1 (RECIST
1.1).
Secondary Objectives:
- Pharmacokinetic (PK) profile SAR439459 monotherapy and combined with cemiplimab, PK
profile of cemiplimab combined with SAR439459.
- Immunogenicity of SAR439459 monotherapy and combined with cemiplimab.
Dose escalation (Part 1)
- Overall safety/tolerability profile of SAR439459 monotherapy and combined with
cemiplimab.
- Preliminary recommended phase 2 dose (pRP2D) of SAR439459 as monotherapy or combined
with cemiplimab.
Dose expansion (Part 2)
- Progression free survival (PFS), time to progression (TTP), ORR, and safety of SAR439459
as monotherapy and PFS, TTP, duration of response (DOR), disease control rate (DCR) and
safety in combination with cemiplimab.
- To confirm the optimal dose of SAR439459 administered in combination with cemiplimab.
Title
- Brief Title: A First-in-human Study of the Safety, Pharmacokinetics, Pharmacodynamics and Anti-tumor Activity of SAR439459 Monotherapy and Combination of SAR439459 and Cemiplimab in Patients With Advanced Solid Tumors
- Official Title: A Phase 1/1b First-in-human Dose Escalation and Expansion Study for the Evaluation of Safety, Pharmacokinetics, Pharmacodynamics, and Anti-tumor Activity of SAR439459 Administered Intravenously as Monotherapy and in Combination With Cemiplimab in Adult Patients With Advanced Solid Tumors
Clinical Trial IDs
- ORG STUDY ID:
TCD14678
- SECONDARY ID:
2018-001113-32
- NCT ID:
NCT03192345
Conditions
Interventions
Drug | Synonyms | Arms |
---|
SAR439459 | | Dose Escalation SAR439459 + cemiplimab combination |
Cemiplimab REGN2810 | | Dose Escalation SAR439459 + cemiplimab combination |
Purpose
Primary Objectives:
Dose escalation (Part 1)
Part 1A (SAR439459 monotherapy)
- To determine the maximum tolerated dose (MTD) and/or maximum administered dose (MAD) of
SAR439459 when administered intravenously as monotherapy in adult patients with advanced
solid tumors.
Part 1B (SAR439459 and cemiplimab combination therapy)
- To determine the MTD and/or MAD of SAR439459 administered intravenously in combination
with cemiplimab administered intravenously in adult patients with advanced solid tumors.
Dose expansion (Part 2)
Part 2A (SAR439459 monotherapy)
- To determine optimal dose of SAR439459 administered intravenously in adult patients with
advanced melanoma who have failed a prior therapy based on anti-PD-1 (programmed cell
death-1) or anti-PD-L1.
Part 2B (SAR439459 and cemiplimab combination therapy)
- To determine the objective response rate (ORR) of SAR439459 in combination with
cemiplimab in adult patients with selected advanced solid tumors by evaluation of
antitumor response according to Response Evaluation Criteria in Solid Tumors 1.1 (RECIST
1.1).
Secondary Objectives:
- Pharmacokinetic (PK) profile SAR439459 monotherapy and combined with cemiplimab, PK
profile of cemiplimab combined with SAR439459.
- Immunogenicity of SAR439459 monotherapy and combined with cemiplimab.
Dose escalation (Part 1)
- Overall safety/tolerability profile of SAR439459 monotherapy and combined with
cemiplimab.
- Preliminary recommended phase 2 dose (pRP2D) of SAR439459 as monotherapy or combined
with cemiplimab.
Dose expansion (Part 2)
- Progression free survival (PFS), time to progression (TTP), ORR, and safety of SAR439459
as monotherapy and PFS, TTP, duration of response (DOR), disease control rate (DCR) and
safety in combination with cemiplimab.
- To confirm the optimal dose of SAR439459 administered in combination with cemiplimab.
Detailed Description
The duration of the study for an individual patient will start from the signature of the main
informed consent and include a screening period of up to 4 weeks (28 days), a treatment
period of at least 1 or 2 cycles (21 or 14 days per cycle, respectively), an end-of-treatment
visit at least 30 days following the last administration of study drug (or until the patient
receives another anticancer therapy, whichever is earlier), and a follow-up visit 3 months
after treatment discontinuation and every 3 months following, until disease progression, or
initiation of another antitumor treatment, or death, whichever is earlier. For the urothelial
cancer cohort in Part 2B, follow-up visits will occur every 3 months until death or the
cutoff date for the overall survival analysis (approximately 12 months after last patient
first dose), whichever comes first.
Patients who have no disease progression, and continue to benefit from the study drug(s),
will be allowed to continue treatment beyond the common study end-date at their assigned dose
unless the study is terminated by the Sponsor. The expected enrollment period is
approximately 42 months.
Trial Arms
Name | Type | Description | Interventions |
---|
Dose Escalation SAR439459 monotherapy | Experimental | SAR439459 administered intravenously every 2 weeks in a 14-day cycle with escalating doses | |
Dose Expansion SAR439459 monotherapy | Experimental | SAR439459 administered intravenously every 3 weeks in a 21-day cycle with the previously determined recommended doses as the patients will be randomized to 2 different doses | |
Dose Escalation SAR439459 + cemiplimab combination | Experimental | SAR439459 + cemiplimab combination administered intravenously every 2 weeks in a 14-day cycle or every 3 weeks in a 21-day cycle with escalating SAR439459 doses and cemiplimab | - SAR439459
- Cemiplimab REGN2810
|
Dose Expansion SAR439459 + cemiplimab combination | Experimental | SAR439459 + cemiplimab combination administered intravenously every 3 weeks in a 21-day cycle with previously determined SAR439459 doses and cemiplimab | - SAR439459
- Cemiplimab REGN2810
|
Eligibility Criteria
Inclusion criteria:
Dose escalation (Part 1A and Part 1B)
- Patients with histologically confirmed, advanced unresectable or metastatic solid
tumor whom in the opinion of the Investigator does not have a suitable alternative
therapy.
Dose expansion (Part 2A)
- Patients with histologically confirmed, advanced unresectable or metastatic melanoma
whom in the opinion of the Investigator does not have a suitable alternative therapy.
- Patients must have failed after any prior therapy based on anti-PD-1 or anti-PD-L1 as
defined by disease progression within 26 weeks of initiating anti-PD-1 or anti-PD-L1
based therapy without any evidence of a response (primary resistance to anti-PD-1 or
anti-PD-L1).
- Patients must have a site of disease amenable to biopsy and be a candidate for tumor
biopsy. Patients must be able and willing to provide mandatory tumor biopsies prior to
and during study treatment.
Dose expansion (Part 2B)
- Patients with disease location amenable to mandatory tumor biopsy at baseline with
histologically confirmed advanced unresectable or metastatic melanoma, colorectal
adenocarcinoma, urothelial cancer, hepatocellular carcinoma (HCC), or non-small cell
lung cancer (NSCLC).
- Melanoma patients must have failed one prior therapy based on anti-PD-1 or anti-PD-L1.
- Patients with colorectal cancer must have progressed after last line of therapy.
- Patients with urothelial cancer must have disease progression during or following
platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant
treatment with platinum-containing chemotherapy. Patients must not have received >2
lines of therapy for advanced disease. Patients must not have received prior treatment
with anti-PD-1 or anti-PD-L1.
- Patients with HCC must have failed after 1 prior therapy based on anti-PD-1 or
anti-PD-L1.
- Patients with NSCLC must have failed during or after 1 prior therapy based on
anti-PD-1 or anti-PD-L1.
- Patients with histologically confirmed, advanced unresectable or metastatic melanoma,
or colorectal cancer or NSCLC whom in the opinion of the Investigator do not have a
suitable alternative therapy.
Dose expansion parts 2A and 2B
- At least 1 measurable lesion by RECIST v1.1.
All cohorts
- Patient understands and has signed Informed Consent form and is willing and able to
comply with the requirements of the trial.
Exclusion criteria:
- Age <18 years or < the country's legal age of majority if the legal age is more than
18 years.
- Eastern Cooperative Oncology Group (ECOG) performance status >1.
- Concurrent treatment with any other anticancer therapy (including radiotherapy or
investigational agents) or participation in another clinical study.
- Washout period of less than 3 weeks to prior anticancer therapy.
- Women of reproductive potential and male subjects with female partners of childbearing
potential who are not willing to avoid pregnancy by using highly effective
contraceptive.
- Pregnant or breast-feeding women.
- Unwillingness and inability to comply with scheduled visits, drug administration plan,
laboratory tests, other study procedures, and study restrictions.
- Significant and uncontrolled concomitant illness, including any psychiatric condition.
- Active infections, including unexplained fever (temperature >38.1ºC), or antibiotic
therapy within 1 week prior to enrollment.
- Any prior organ transplant including allogeneic bone marrow transplant.
- History within the last 5 years of an invasive malignancy other than the one treated
in this study, with the exception of resected/ablated basal or squamous-cell carcinoma
of the skin or carcinoma in situ of the cervix, or other local tumors considered cured
by local treatment.
- History of known human immunodeficiency virus (HIV), HIV serology at screening will be
conducted only for patients in German study sites.
- Known uncontrolled hepatitis B virus (HBV) infection.
- Known untreated current hepatitis C virus (HCV) infection.
- Any major surgery within the last 28 days.
- Patients with primary central nervous system (CNS) tumors and/or CNS metastases of
non-CNS primary tumors.
- History of congestive heart failure, myocardial infarction with reduced ejection
fraction, symptomatic coronary artery disease, documented uncontrolled hypertension,
major clinically significant Electrocardiography (ECG) and echocardiogram
abnormalities, significant ventricular arrhythmias, significant valvular heart disease
(including valve replacement), vascular malformation, aneurysm, significant pulmonary
conditions such as idiopathic pulmonary hypertension, uncontrolled chronic lung
disease.
- History of severe, acute or chronic renal diseases.
- Any of the following within 6 months prior to study enrollment: pulmonary embolism,
deep vein thrombosis, active uncontrolled bleeding, infectious or inflammatory bowel
disease, diverticulitis, intestinal obstruction or perforation and gastrointestinal
hemorrhage.
- Inadequate hematological, renal or liver function.
- Non-resolution of any prior treatment related toxicity to Grade <2.
- Prior treatment with any anti-transforming growth factor β (anti-TGFβ) inhibitors.
- Known allergies to any component of SAR439459 and/or cemiplimab.
- Patients with uveal melanoma and patients with prior or ongoing uveitis.
- Patients who received prior immunotherapy who developed toxicity leading to a
permanent discontinuation of immunotherapy.
- Ongoing or recent (within 5 years) evidence of significant autoimmune disease that
required treatment with systemic immunosuppressive treatments.
- Immunosuppressive corticosteroid doses (>10 mg prednisone daily or equivalent) within
4 weeks prior to the first dose of SAR439459 and/or cemiplimab (occasional use of
inhaled, intraocular, nasal or topical steroids for symptomatic relief allowed).
- History of interstitial lung disease or active non-infectious pneumonitis that
required immune-suppressive doses of glucocorticoids to assist with management.
- Patients with underlying cancer predisposition syndromes.
- Receipt of a live vaccine within 30 days of planned start of study medication.
- Therapeutic doses of anticoagulants or antiplatelet agents within 7 days prior the
first dose of SAR439459.
- Prothrombin time (PT) or international normalized ratio (INR) > 1.5 × upper limit of
normal (ULN).
- Patients accommodated in an institution because of regulatory or legal order;
prisoners or patients who are legally institutionalized.
The above information is not intended to contain all considerations relevant to a patient's
potential participation in a clinical trial.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence of Dose Limiting Toxicities (DLTs) |
Time Frame: | Through the end of 1 or 2 cycles, total duration up to 6 weeks (for Part 1A each cycle is 2 weeks; for Part 1B each cycle is 2 or 3 weeks) |
Safety Issue: | |
Description: | Incidence of DLTs at Cycle 1 and/or 2 in Parts 1A and 1B. |
Secondary Outcome Measures
Measure: | Overall safety profile |
Time Frame: | Continuous throughout study assessment (up to approximately 1 year) |
Safety Issue: | |
Description: | The overall safety profile of SAR439459 administered in monotherapy (Part 1A and Part 2A) or in combination with cemiplimab (Part 1B and Part 2B). |
Measure: | Progression free survival (PFS) |
Time Frame: | Continuous throughout study assessment (up to approximately 1 year) |
Safety Issue: | |
Description: | The time from first investigational medicinal product (IMP) administration until objective tumor progression or death (Part 2A and Part 2B). |
Measure: | Time to progression (TTP) |
Time Frame: | Continuous throughout study assessment (up to approximately 1 year) |
Safety Issue: | |
Description: | The time from first IMP administration until objective tumor progression (Part 2A and 2B). |
Measure: | Objective Response Rate (ORR) Part 2A |
Time Frame: | Continuous throughout study assessment (up to approximately 1 year) |
Safety Issue: | |
Description: | Efficacy as documented by ORR will be assessed by evaluation of antitumor response information according to RECIST 1.1 (Part 2A). |
Measure: | Duration of response Part 2B |
Time Frame: | Continuous throughout study assessment (up to approximately 1 year) |
Safety Issue: | |
Description: | Time from initial response to the first documented tumor progression. |
Measure: | Disease Control Rate Part 2B |
Time Frame: | Continuous throughout study assessment (up to approximately 1 year) |
Safety Issue: | |
Description: | Sum of complete response, partial response and stable disease rates |
Measure: | Immunogenicity evaluation |
Time Frame: | Up to approximately 1 year |
Safety Issue: | |
Description: | Blood samples will be assessed for human anti-SAR439459 antibodies (all cohorts) and for human anti-cemiplimab antibodies (Parts 1B and 2B). |
Measure: | Cmax for SAR439459 and for cemiplimab |
Time Frame: | Cycle 1, Day 1 to Day 15 or to Day 22 |
Safety Issue: | |
Description: | Maximum plasma concentration observed. |
Measure: | AUC for SAR439459 |
Time Frame: | Cycle 1, Day 1 to Day 15 or to Day 22 |
Safety Issue: | |
Description: | Area under the serum concentration versus time curve extrapolated to infinity. |
Measure: | AUC0-tau for SAR439459 and for cemiplimab |
Time Frame: | Cycle 1, Day 1 to Day 15 or to Day 22 |
Safety Issue: | |
Description: | Area under the plasma concentration versus time curve calculated using the trapezoidal method from time zero to 14 or 21 days post-dose. |
Measure: | t1/2z for SAR439459 |
Time Frame: | Cycle 1, Day 1 to Day 15 or to Day 22 |
Safety Issue: | |
Description: | Terminal half-life associated with the terminal slope (λz). |
Measure: | CL for SAR439459 |
Time Frame: | Cycle 1, Day 1 to Day 15 or to Day 22 |
Safety Issue: | |
Description: | Total body clearance of a drug from plasma calculated using the following equation from AUC: CL= Dose/AUC on cycle 1. |
Measure: | Vss for SAR439459 |
Time Frame: | Cycle 1, Day 1 to Day 15 or to Day 22 |
Safety Issue: | |
Description: | Estimate of Volume of distribution at the steady state after single intravenous dose. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Sanofi |
Last Updated
February 9, 2021