Clinical Trials /

MGD019 DART® Protein in Unresectable/Metastatic Cancer

NCT03761017

Description:

The purpose of this study is to evaluate the safety and tolerability, pharmacokinetics (PK) pharmacodynamics and preliminary antitumor activity of MGD019.

Related Conditions:
  • Colorectal Carcinoma
  • Malignant Solid Tumor
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: MGD019 DART® Protein in Unresectable/Metastatic Cancer
  • Official Title: A Phase 1, First-in-Human, Open-Label, Dose Escalation and Cohort Expansion Study of MGD019, a Bispecific DART® Protein Binding PD-1 and CTLA-4 in Patients With Unresectable or Metastatic Neoplasms

Clinical Trial IDs

  • ORG STUDY ID: CP-MGD019-01
  • NCT ID: NCT03761017

Conditions

  • Squamous Cell Non Small Cell Lung Cancer
  • Prostate Cancer Metastatic
  • Cutaneous Melanoma
  • Colorectal Cancer
  • Advanced Cancer
  • Solid Tumor, Adult

Interventions

DrugSynonymsArms
MGD019MGD019

Purpose

The purpose of this study is to evaluate the safety and tolerability, pharmacokinetics (PK) pharmacodynamics and preliminary antitumor activity of MGD019.

Detailed Description

      This Phase 1, open-label study will characterize safety, dose-limiting toxicities (DLTs), and
      maximum tolerated/administered dose (MTD/MAD) of MGD019. Dose escalation will occur in a
      3+3+3 design in patients with advanced solid tumors of any histology. Once the MTD/MAD is
      determined, a Cohort Expansion Phase will be enrolled to further characterize safety and
      initial anti-tumor activity in patients with specific tumor types anticipated to be sensitive
      to dual checkpoint blockade.
    

Trial Arms

NameTypeDescriptionInterventions
MGD019ExperimentalBispecific DART protein binding PD-1 and CTLA-4
  • MGD019

Eligibility Criteria

        Inclusion Criteria:

          -  Dose escalation: Patients with histologically proven, unresectable, locally advanced
             or metastatic solid tumors for whom no approved therapy with demonstrated clinical
             benefit is available or patients who are intolerant to standard therapy.

          -  Cohort Expansion Phase:

          -  Checkpoint inhibitor-naïve squamous cell NSCLC, including:

               1. Patients that have progressed during or following treatment with platinum-based
                  chemotherapy for advanced disease. Patients harboring an activating epidermal
                  growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK)
                  rearrangement must have progressed following at least one available EGFR or ALK
                  targeted therapy. ROS1 rearrangement or BRAF mutation must have progressed
                  following at least 1 available EGFR (including osimertinib for EGFR T790M-mutated
                  NSCLC), ALK, ROS1 or BRAF targeted therapy, respectively

               2. Patients that have progressed during or following treatment with platinum-based
                  chemotherapy for advanced disease and patients with previously untreated squamous
                  cell NSCLC without activating mutations for whom checkpoint inhibitor therapy is
                  not approved or available.

          -  Advanced non-microsatellite instability-high colorectal cancer (CRC) with recurrence,
             progression, or intolerance to standard therapy consisting of at least 2 prior
             standard regimens. CRC harboring an activating EGFR mutation must have progressed
             during or following at least one available EGFR targeted therapy. Patients who are
             inappropriate candidates for or have refused treatment with these regimens are also
             eligible. Patients should have received no more than 4 prior lines of systemic
             therapy.

          -  Checkpoint inhibitor-naïve mCRPC that has progressed during or following no more than
             2 prior lines of an androgen receptor antagonist or androgen synthesis inhibitor
             (e.g., enzalutamide or abiraterone, respectively), if approved and available, with a
             PSA value of at least 2 ng/mL and meeting at least one of the following:

          -  Progression in measurable disease (RECIST v1.1).

          -  Appearance of 2 or more new bone lesions according to Prostate Cancer Working Group 2
             (PCWG-2).

          -  Rising PSA defined as at least two sequential rises in PSA.

          -  Eligible patients may have received prior chemotherapy (i.e. docetaxel), and patients
             with known homologous recombination (HRR) pathway gene alterations must have received
             the applicable approved therapy (e.g. olaparib).

          -  Cutaneous melanoma that has progressed during or following systemic treatment for
             unresectable, locally advanced, or metastatic disease. Patients will have received
             PD-(L)1 and/or CTLA-4 pathway inhibitors where available and indicated.

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

          -  Life expectancy ≥ 12 weeks.

          -  Measurable disease as per RECIST 1.1 for the purpose of response assessment must
             either (a) not reside in a field that has been subjected to prior radiotherapy or (b)
             have demonstrated clear evidence of radiographic progression since the completion of
             prior radiotherapy and prior to study enrollment.

          -  All patients must have an identified formalin-fixed, paraffin embedded (FFPE) tumor
             specimen (up to 20 slides or a block) for immunohistochemical evaluation of
             pharmacodynamic markers of interest. Patients may undergo a fresh tumor biopsy during
             the screening period if a tumor sample is not available. Patients in the mCRPC
             expansion cohort with bone only disease not amenable to fresh biopsy may be eligible
             in consultation with the Sponsor.

          -  Acceptable laboratory parameters and adequate organ reserve.

        Exclusion Criteria:

          -  In patients who have previously received an immune checkpoint inhibitor (e.g.,
             anti-PD-L1, anti-PD-1, anti-CTLA-4), toxicities related to the checkpoint inhibitor
             must have resolved to ≤ Grade 1 or baseline. Patients with well controlled immune
             endocrinopathies secondary to prior checkpoint therapy are eligible.

          -  Patients with symptomatic CNS metastases. Patients with history of prior CNS
             metastasis must have been treated, must be asymptomatic, and must not have concurrent
             treatment for the CNS disease, progression of CNS metastases on magnetic resonance
             imaging (MRI) or computed tomography (CT) for at least 14 days after last day of prior
             therapy for the CNS metastases, or concurrent leptomeningeal disease or cord
             compression.

          -  Patients who sustained the following Grade 3 immune checkpoint inhibitor related AEs
             are ineligible: Ocular AE, changes in liver function tests that met the criteria for
             Hy's law (> 3 × ULN of either ALT or AST with concurrent > 2 × ULN of total bilirubin
             and without alternate etiology), neurologic toxicity, colitis, renal toxicity,
             pneumonitis.

          -  Patients who have received prior therapy with a combination of monoclonal antibodies
             against PD-1/PD-L1 and CTLA-4 will be excluded in the Cohort Expansion (this does not
             apply to the melanoma expansion cohort).

          -  Patients with any history of known or suspected autoimmune disease with certain
             exceptions

          -  History of prior allogeneic bone marrow, stem-cell, or solid organ transplantation.

          -  History of trauma or major surgical procedure within 4 weeks prior to initiation of
             study drug administration.

          -  Systemic antineoplastic therapy, or investigational therapy (for all tumor types) or
             androgen receptor antagonist/androgen synthesis inhibitor for mCRPC (e.g.,
             enzalutamide or abiraterone, respectively) within the 4 weeks prior to initiation of
             study drug administration.

          -  Treatment with radiation therapy within 2 weeks prior to initiation of study drug
             administration.

          -  Radioligand (e.g., radium-223) within 6 months prior to initiation of study drug
             administration for mCRPC in the Cohort Expansion Phase.

          -  Serum testosterone > 50 ng/dl or > 1.7 nmol/L for mCRPC in the Cohort Expansion Phase.

          -  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
Time Frame:30 days after last dose
Safety Issue:
Description: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:Cmax
Time Frame:up to 108 weeks
Safety Issue:
Description:Maximum Plasma Concentration of MGD019
Measure:Tmax
Time Frame:up to 108 weeks
Safety Issue:
Description:Time to reach maximum (peak) plasma concentration of MGD019
Measure:AUC
Time Frame:up to 108 weeks
Safety Issue:
Description:Area Under the Plasma Concentration versus Time Curve of MGD019
Measure:Ctrough
Time Frame:up to 108 weeks
Safety Issue:
Description:Trough plasma concentration of MGD019
Measure:CL
Time Frame:up to 108 weeks
Safety Issue:
Description:Total body clearance of the drug from plasma of MGD019
Measure:Vss
Time Frame:up to 108 weeks
Safety Issue:
Description:Apparent volume of distribution at steady state of MGD019
Measure:t1/2
Time Frame:up to 108 weeks
Safety Issue:
Description:Terminal half life of MGD019
Measure:Percent of patients with anti-drug antibodies against MGD019
Time Frame:up to 108 weeks
Safety Issue:
Description:Immunogenicity
Measure:Preliminary anti-tumor activity of MGD019
Time Frame:Every 12 - 24 weeks while patient is on treatment
Safety Issue:
Description:Efficacy assessed using conventional Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1)
Measure:Radiographic progression-free survival (PFS) in metastatic castration-resistant prostate cancer (mCRPC)
Time Frame:up to 2 years post last treatment
Safety Issue:
Description:Time from first dose to first occurrence of radiographic progression, or death
Measure:Prostate specific antigen (PSA) response rate in mCRPC
Time Frame:up to 2 years post last treatment
Safety Issue:
Description:Percent of patients with 50% or more decline in PSA and confirmed 3 weeks later
Measure:Best PSA percent change in mCRPC
Time Frame:up to 2 years post last treatment
Safety Issue:
Description:Best percent change in PSA from baseline
Measure:Duration of PSA response
Time Frame:up to 2 years post last treatment
Safety Issue:
Description:Time from PSA response to time of PSA progression

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:MacroGenics

Trial Keywords

  • Checkpoint blockade

Last Updated

August 27, 2021