Clinical Trials /

Safety, Tolerability, and Immunogenicity of mRNA-4157 Alone in Participants With Resected Solid Tumors and in Combination With Pembrolizumab in Participants With Unresectable Solid Tumors

NCT03313778

Description:

The purpose of this study is to assess the safety, tolerability, and immunogenicity of mRNA-4157 alone in participants with resected solid tumors and in combination with pembrolizumab in participants with unresectable solid tumors.

Related Conditions:
  • Bladder Urothelial Carcinoma
  • Colorectal Carcinoma
  • Head and Neck Squamous Cell Carcinoma
  • Hypopharyngeal Squamous Cell Carcinoma
  • Laryngeal Squamous Cell Carcinoma
  • Malignant Solid Tumor
  • Melanoma
  • Non-Small Cell Lung Carcinoma
  • Oral Cavity Squamous Cell Carcinoma
  • Oropharyngeal Squamous Cell Carcinoma
  • Small Cell Lung Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Safety, Tolerability, and Immunogenicity of mRNA-4157 Alone in Participants With Resected Solid Tumors and in Combination With Pembrolizumab in Participants With Unresectable Solid Tumors
  • Official Title: A Phase 1, Open-Label, Multicenter Study to Assess the Safety, Tolerability, and Immunogenicity of mRNA-4157 Alone in Subjects With Resected Solid Tumors and in Combination With Pembrolizumab in Subjects With Unresectable Solid Tumors

Clinical Trial IDs

  • ORG STUDY ID: mRNA-4157-P101
  • NCT ID: NCT03313778

Conditions

  • Solid Tumors

Interventions

DrugSynonymsArms
mRNA-4157Part A: Dose Escalation
PembrolizumabPart B, C, and D: Dose Expansion

Purpose

The purpose of this study is to assess the safety, tolerability, and immunogenicity of mRNA-4157 alone in participants with resected solid tumors and in combination with pembrolizumab in participants with unresectable solid tumors.

Detailed Description

      This is a multi-part, dose-escalation study of mRNA-4157 monotherapy in participants with
      resected solid tumors (Part A) and of mRNA-4157 in combination with pembrolizumab in
      participants with both unresectable (locally advanced or metastatic) solid tumors (Parts B
      and C) and resected cutaneous melanoma (Part D). Parts A and B will include a dose escalation
      phase of the study to identify doses of mRNA-4157 for the expansion phase of the study. Doses
      of mRNA-4157 will be administered to participants in a dose escalation regimen. Participants
      in Parts B, C, and D dose expansion phase will receive mRNA-4157 at a recommended dose for
      expansion.
    

Trial Arms

NameTypeDescriptionInterventions
Part A: Dose EscalationExperimentalParticipants will receive a fixed applicable dose of mRNA-4157 administered via an intramuscular (IM) injection on Day 1 of each 21-day cycle for up to 9 cycles.
  • mRNA-4157
Part B: Dose EscalationExperimentalParticipants will receive a fixed applicable dose of mRNA-4157 administered via an IM injection on Day 1 of each 21-day cycle for up to 9 cycles and fixed-dose of pembrolizumab via IV infusion on Day 1 of each 21-day cycle until progression, unacceptable toxicity, or up to 35 cycles (approximately 2 years of treatment), whichever is sooner.
  • mRNA-4157
  • Pembrolizumab
Part A: Dose ExpansionExperimentalParticipants will receive mRNA-4157 via IM injection at an applicable dose, identified during the dose escalation phase of the study, on Day 1 of each 21-day cycle for up to 9 cycles.
  • mRNA-4157
Part B, C, and D: Dose ExpansionExperimentalParticipants will receive mRNA-4157 via IM injection at an applicable dose, identified during the dose escalation phase of the study, on Day 1 of each 21-day cycle for up to 9 cycles. Participants will also receive a fixed-dose of pembrolizumab via IV infusion on Day 1 of each 21-day cycle until progression, unacceptable toxicity, or up to 35 cycles (approximately 2 years of treatment), whichever is sooner.
  • mRNA-4157
  • Pembrolizumab

Eligibility Criteria

        Inclusion Criteria:

          -  Male or female, ≥18 years old with the ability to understand and provide signed and
             witnessed informed consent, and agree to comply with protocol requirements

          -  Part A: Participants must have one of the histologically-confirmed solid malignancies
             listed below, must be clinically disease-free at study entry (that is, participants in
             the adjuvant setting). Participants will be permitted to complete any standard of care
             adjuvant therapy prior to study entry, and those not eligible for any standard of care
             adjuvant treatment or who decline such treatment are permitted to consent to this
             study, as long as all treatment options have been transparently disclosed and
             documented in the participant's medical record.

          -  Part B: Participants must have one of the histologically- or cytologically-confirmed
             unresectable (locally advanced or metastatic) solid malignancies listed below, have
             measurable disease at study entry defined by Response Evaluation Criteria in Solid
             Tumors (RECIST) Version 1.1., and be considered suitable for treatment with
             pembrolizumab; in this study pembrolizumab will be considered an investigational study
             drug.

        Participants with any of the following solid malignancies:

        a. Non-small cell lung cancer (participants in Part B must either lack epidermal growth
        factor receptor (EGFR) sensitizing mutation or anaplastic lymphoma kinase (ALK)
        translocation per local test results or must have progressed on approved standard of care
        treatment for EGFR or ALK positive non-small cell lung cancer [NSCLC]) b. Small cell lung
        cancer c. Melanoma d. Bladder urothelial carcinoma e. Human papillomavirus-negative head
        and neck squamous cell carcinoma (HPV-ve HNSCC) f. Any solid malignancy known to be
        microsatellite instable (MSI) high/mismatch repair (MMR) deficient g. Any solid malignancy
        known to have a high tumor mutational load/burden

          -  Part C: Participants must have one of the histologically- or cytologically confirmed
             unresectable (locally advanced or metastatic) solid malignancies listed below, must
             not have received prior anti-programmed cell death protein 1 (PD-1)/programmed death
             -ligand 1 (PD-L1) therapy, and must have measurable disease at study entry defined by
             RECIST 1.1.

               1. Microsatellite stable (MSS)-CRC

               2. HPV-ve metastatic or recurrent HPV-ve HNSCC of the oral cavity, oropharynx,
                  hypopharynx, or larynx

               3. Bladder urothelial carcinoma

          -  Part D: Participants must have completed resected adjuvant melanoma and must be
             clinically disease-free at study entry. Participants will be permitted to complete any
             standard of care adjuvant therapy prior to study entry, and those not eligible for any
             standard of care adjuvant treatment or who decline such treatment are permitted to
             consent to this study, as long as all treatment options have been transparently
             disclosed and documented in the participant's medical record.

          -  Parts A and D: Participants must have a formalin-fixed paraffin embedded (FFPE) tumor
             sample available (for example, from their prior surgery) that is suitable for the next
             generation sequencing (NGS) required for this study.

          -  Parts B and C: Participants must have at least 1 lesion amenable to the mandatory
             fresh tumor biopsy at study entry and provide a biopsy suitable for the next
             generation sequencing (NGS) required for this study. An existing (archival) FFPE tumor
             sample may instead be used for NGS after discussing with medical monitor.

          -  Participants must have resolution of toxic effect(s) from prior therapy to Grade 1 or
             less. Participants with Grade ≤2 neuropathy or alopecia are an exception to this
             criterion. If a participant received major surgery or radiation therapy of >30 gray
             (Gy), they must have recovered from the toxicity and/or complications from the
             intervention to Grade 1 or less.

          -  Participant is willing to use an adequate method of contraception for the course of
             the study through 120 days after the last dose of study drug (male and female
             participants of childbearing potential).

          -  Participants with Performance Scale (PS) of 0 or 1 on the Eastern Cooperative Oncology
             Group (ECOG) PS

          -  Life expectancy >12 weeks at Screening

          -  Participants with adequate organ and marrow function

          -  Parts A and D: Participant must consent to required apheresis procedure and meet
             additional inclusion criteria per local institutional apheresis procedure.

        Exclusion Criteria:

          -  Treatment with any of the following:

               1. Any investigational agents, anti-cancer monoclonal antibody, anti-cancer
                  therapeutic vaccine, immunostimulant (for example, IL-2), or study drugs from a
                  previous clinical study within 4 weeks of the first dose of mRNA-4157 or
                  pembrolizumab (note only a 2 week wash out is required from prior pembrolizumab
                  treatment)

               2. Any chemotherapy, targeted small molecule therapy, or radiation therapy within 2
                  weeks of the first dose of mRNA-4157 or pembrolizumab

               3. Live-virus vaccination within 30 days of the first dose of mRNA-4157 or
                  pembrolizumab. Seasonal flu vaccines that do not contain live virus are
                  permitted.

               4. Any systemic steroid therapy or other form of immunosuppressive therapy within 7
                  days of the first dose of mRNA-4157 or pembrolizumab

               5. Transfusion of blood products (including platelets or red blood cells [RBCs]) or
                  administration of colony stimulating factors (including granulocyte colony
                  stimulating factor [G-CSF], granulocyte/macrophage colony stimulating factor
                  [GM-CSF], or recombinant erythropoietin) within 1 week of the NGS blood sample
                  during screening, and 4 weeks of the first dose of mRNA-4157 or pembrolizumab

          -  Prior PD-1/PD-L1 treatment is permitted for participants in Parts A, B, and D of this
             study, but only participants who have progressed on their prior PD-1/PD-L1 treatment
             without a partial or complete response, and without discontinuing for drug-related
             toxicity are eligible.

          -  Active central nervous system metastases and/or carcinomatous meningitis

          -  Active autoimmune disease that has required systemic treatment in past 2 years

          -  Has a history of (noninfectious) pneumonitis that required steroids or has current
             pneumonitis

          -  Has a diagnosis of immunodeficiency

          -  Any clinically-significant cardiac disease defined as New York Heart Association Class
             III or IV within the past 6 months of Screening, unless, in the opinion of the
             Investigator, the disease is well-controlled

          -  A history or current evidence of any condition, therapy, or laboratory abnormality
             that might confound the results of the study, interfere with participation for the
             full duration of the study, or is not in the best interest of the participant to
             participate, in the opinion of the treating Investigator

          -  Known psychiatric or substance abuse disorders that would interfere with cooperation
             with the requirements of the trial

          -  Previously identified hypersensitivity to components of the formulations used in this
             study

          -  Had a solid organ or allogeneic bone marrow transplant

          -  Participants with a history of interstitial lung disease

          -  An active infection requiring systemic therapy

          -  A known history of human immunodeficiency virus (HIV)

          -  Known active Hepatitis B or Hepatitis C

          -  Known additional malignancy that is progressing or requires active treatment,
             exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the
             skin that has undergone curative therapy, or in situ cervical cancer

          -  Participants participating in apheresis; mandatory in the Part A apheresis expansion
             phase cohort and Part D (optional for other study parts), must not meet any of the
             exclusion criteria on any day when apheresis is performed, either protocol specific
             apheresis criteria, or per local institutional apheresis protocol.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of Participants with Adverse Events
Time Frame:Part A: Baseline through 100 days after last mRNA-4157 dose; Parts B, C, and D: Baseline through 90 days after last pembrolizumab dose
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Percent Change from Baseline of Biomarker Levels in Tumors at Day 50
Time Frame:Baseline, Day 50
Safety Issue:
Description:
Measure:Antigen-Specific T-cell Responses in Peripheral Blood
Time Frame:Baseline through 100 days after last mRNA-4157 dose
Safety Issue:
Description:
Measure:Part C: Overall Response Rate (ORR): Number of Participants with Tumor Response (Partial or Complete)
Time Frame:Baseline through 30 days after the last dose of mRNA4157 and/or pembrolizumab
Safety Issue:
Description:
Measure:Part C: Duration of Response (DoR)
Time Frame:Baseline through 30 days after the last dose of pembrolizumab
Safety Issue:
Description:DoR is defined as time from first tumor response (partial or complete) until either radiological disease progression, clinical/symptomatic disease progression or death (whichever is sooner).
Measure:Part C: Progression Free Survival (PFS)
Time Frame:Baseline through 30 days after the last dose of pembrolizumab
Safety Issue:
Description:PFS is defined as time between the date of first dose of pembrolizumab and the date of either radiological disease progression, clinical/symptomatic disease progression or death (whichever is sooner).
Measure:Part C: Overall Survival (OS)
Time Frame:Baseline through 30 days after the last dose of pembrolizumab
Safety Issue:
Description:OS is defined as time between the date of the first dose of study drug and the date of death due to any cause.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:ModernaTX, Inc.

Trial Keywords

  • mRNA-4157
  • Personalized cancer vaccine
  • PCV
  • pembrolizumab
  • Moderna

Last Updated

August 26, 2021