Description:
The primary goal of this Phase 1 study is to characterize the safety and tolerability of
MGD013 and establish the maximum tolerated dose (MTD) of MGD013. Pharmacokinetics (PK),
immunogenicity, pharmacodynamics (PD), and the anti-tumor activity of MGD013 will also be
assessed.
Title
- Brief Title: A Study of MGD013 in Patients With Unresectable or Metastatic Neoplasms
- Official Title: A Phase 1, First-in-Human, Open-Label, Dose Escalation Study of MGD013, A Bispecific DART® Protein Binding PD-1 and LAG-3 in Patients With Unresectable or Metastatic Neoplasms
Clinical Trial IDs
- ORG STUDY ID:
CP-MGD013-01
- NCT ID:
NCT03219268
Conditions
- Advanced Solid Tumors
- Hematologic Neoplasms
- Ovarian Cancer
- HER2-positive Breast Cancer
- Non Small Cell Lung Cancer
- Small-cell Lung Cancer
- Squamous Cell Carcinoma of Head and Neck
- Cholangiocarcinoma
- Cervical Cancer
- TNBC - Triple-Negative Breast Cancer
Interventions
Drug | Synonyms | Arms |
---|
MGD013 | tebotelimab | MGD013 |
MGD013 in combination with margetuximab | tebotelimab in combination with MGAH22 | MGD013 plus margetuximab |
Purpose
The primary goal of this Phase 1 study is to characterize the safety and tolerability of
MGD013 and establish the maximum tolerated dose (MTD) of MGD013. Pharmacokinetics (PK),
immunogenicity, pharmacodynamics (PD), and the anti-tumor activity of MGD013 will also be
assessed.
Detailed Description
This is a Phase 1, open-label, dose escalation and cohort expansion study designed to
characterize the safety, tolerability, PK, PD, immunogenicity, and preliminary antitumor
activity of MGD013 administered by IV infusion every 2 weeks. The study consists of a Dose
Escalation Phase to determine the MTD or maximum administered dose (MAD) of MGD013 if no MTD
is defined, followed by a Cohort Expansion Phase to further define the safety and initial
antitumor activity of MGD013 with the dose established in the Dose Escalation Phase.
In the Dose Escalation Phase, MGD013 will be evaluated in sequential escalating flat doses in
successive cohorts of 1 to 6 patients each. Upon completion of the Dose Escalation Phase, a
Cohort Expansion Phase will be initiated at the MTD/MAD.
Patients with unresectable, locally advanced or metastatic solid tumors of any histology will
be enrolled in the Dose Escalation Phase. The Cohort Expansion Phase will be limited to
selected cohorts of patients with unresectable, locally advanced or metastatic solid tumors
or hematologic malignancies for whom there is no available therapy likely to confer clinical
benefit. Two additional cohorts will enroll patients with gastric/gastroesophageal cancer or
epithelial ovarian cancer, with MGD013 given every 3 weeks.
A separate cohort will evaluate the combination of MGD013 with margetuximab (anti-HER2
monoclonal antibody) in approximately 99 patients, in subgroups with HER2-positive gastric or
gastroesophageal cancer, HER2-positive breast cancer, and any other HER2-positive cancer.
Trial Arms
Name | Type | Description | Interventions |
---|
MGD013 | Experimental | MGD013 administered IV once every 2 weeks for up to 96 weeks | |
MGD013 plus margetuximab | Experimental | MGD013 administered in combination with margetuximab IV once every 3 weeks for up to 32 3-week cycles | - MGD013
- MGD013 in combination with margetuximab
|
Eligibility Criteria
Inclusion Criteria:
- Histologically proven, locally advanced unresectable or metastatic solid tumors (or
hematologic malignancies, Cohort Expansion only) for whom no approved therapy with
demonstrated clinical benefit is available or standard treatment was declined.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Life expectancy ≥ 12 weeks
- Measurable disease
- Tissue specimen available for retrospective analysis of PD-1, PD-L1, LAG-3, and MHC-II
expression
- Acceptable laboratory parameters
HER2+ Cohort:
- Locally advanced or metastatic HER2+ locally advanced or metastatic solid tumors,
regardless of organ of origin.
i. The cancer must have progressed following standard therapy, or has progressed during or
after HER2-directed therapy if approved and available for patients with HER2+ breast,
gastric, or gastroesophageal junction cancer.
ii. History of HER2 positivity defined as 3+ by IHC or 2+ by IHC in combination with in
situ hybridization (ISH) positivity most recent tumor biopsy.
- All patients in the HER2+ cohort must be willing to provide consent for a baseline and
on-treatment tumor biopsy during the screening period and within 14 days prior to
Cycle 3 Day 1. Exceptions may be made based on a medical contraindication at the
discretion of the Sponsor's Medical Monitor. This requirement will be discontinued
after an adequate number of samples are collected, as determined by the Sponsor.
Exclusion Criteria:
- Symptomatic central nervous system (CNS) metastases or primary CNS lymphoma
- History of allogeneic bone marrow, stem-cell, or solid organ transplant
- History of known or suspected autoimmune disease with the specific exceptions of
vitiligo, resolved childhood atopic dermatitis, psoriasis not requiring systemic
treatment (within the past 2 years), and patients with a history of Grave's disease
that are now euthyroid clinically and by laboratory testing.
- Treatment with any systemic chemotherapy within 3 weeks prior to the initiation of
study drug; treatment with biologics or investigational therapy within the 4 weeks
prior to the initiation of study drug.
- Major surgery within 4 weeks prior to the initiation of study drug.
- Prior treatment with combination of monoclonal antibodies against PD-1 and LAG-3
(Cohort Expansion only).
- Treatment with radiation therapy within 2 weeks prior to the initiation of study drug.
- Clinically significant cardiovascular disease.
- QTcF prolongation > 480 milliseconds
- HER2+ cohort: left ventricular ejection fraction less than 50%
- Clinically significant pulmonary compromise, including a requirement for supplemental
oxygen use to maintain adequate oxygenation.
- Active pneumonitis or history of non-infectious pneumonitis.
- Clinically significant gastrointestinal disorders.
- Evidence of active viral, bacterial, or systemic fungal infection requiring parenteral
treatment within 7 days prior to the initiation of study drug.
- Known history of positive testing for human immunodeficiency virus or history of
acquired immune deficiency syndrome.
- Known history of hepatitis B (except in hepatocellular carcinoma) or hepatitis C
infection or known positive test for hepatitis B surface antigen, hepatitis B core
antigen, or hepatitis C polymerase chain reaction (PCR)
- Vaccination with any live virus vaccine within 4 weeks prior to the initiation of
study drug administration. Inactivated annual influenza vaccination is allowed
- Dementia or altered mental status that would preclude understanding and rendering of
informed consent
- Confirmed or presumed COVID-19/SARS-CoV-2 infection. While SARS-CoV-2 testing is not
mandatory for study entry, testing should follow local clinical practice
guidelines/standards. Patients with a positive test result for SARS-CoV-2 infection,
known asymptomatic infection, or presumed infection are excluded. Patients may be
considered eligible after a resolved SARS-CoV-2 infection once he or she remains
afebrile for at least 72 hours and after other SARS-CoV-2-related symptoms have fully
recovered to baseline for a minimum of 72 hours.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence of Treatment-Emergent Adverse Events as assessed by CTCAE v4.03 (MGD013 monotherapy) |
Time Frame: | 24 months |
Safety Issue: | |
Description: | Safety
Safety is based on evaluation of adverse events (AEs) and serious adverse events (SAEs) from the time of study drug administration through the End of Study visit. |
Secondary Outcome Measures
Measure: | Area Under the Plasma Concentration versus Time Curve (AUC) of MGD013 and MGD013 plus margetuximab |
Time Frame: | 24 months |
Safety Issue: | |
Description: | AUC |
Measure: | Maximum Plasma Concentration (Cmax) of MGD013 and MGD013 plus margetuximab |
Time Frame: | 24 months |
Safety Issue: | |
Description: | Cmax |
Measure: | Time to reach maximum (peak) plasma concentration (Tmax) of MGD013 and MGD013 plus margetuximab |
Time Frame: | 24 months |
Safety Issue: | |
Description: | Tmax |
Measure: | Trough plasma concentration (Ctrough) of MGD013 and MGD013 plus margetuximab |
Time Frame: | 24 months |
Safety Issue: | |
Description: | Ctrough |
Measure: | Total body clearance of the drug from plasma (CL) of MGD013 and MGD013 plus margetuximab |
Time Frame: | 24 months |
Safety Issue: | |
Description: | CL |
Measure: | Apparent volume of distribution at steady state (Vss) of MGD013 and MGD013 plus margetuximab |
Time Frame: | 24 months |
Safety Issue: | |
Description: | Vss |
Measure: | Terminal half-life (t1/2) of MGD013 and MGD013 plus margetuximab |
Time Frame: | 24 months |
Safety Issue: | |
Description: | t1/2 |
Measure: | Percent of patients with anti-drug antibody |
Time Frame: | 24 months |
Safety Issue: | |
Description: | immunogenicity |
Measure: | Incidence of Treatment-Emergent Adverse Events as assessed by CTCAE v4.03 (MGD013 plus margetuximab) |
Time Frame: | 24 months |
Safety Issue: | |
Description: | Safety |
Measure: | Efficacy: Preliminary anti-tumor activity of MGD013 and MGD013 plus margetuximab |
Time Frame: | 36 months |
Safety Issue: | |
Description: | Preliminary anti-tumor activity of MGD013 and MGD013 plus margetuximab |
Measure: | Overall survival |
Time Frame: | Up to 2 years after end of treatment visit |
Safety Issue: | |
Description: | Time from start of treatment to death |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | MacroGenics |
Last Updated
August 9, 2021