Clinical Trials /

First in Human Study of NG-350A (an Oncolytic Adenoviral Vector Which Expresses an Anti-CD40 Antibody)

NCT03852511

Description:

This study will evaluate the safety, tolerability and preliminary efficacy and also pharmacokinetics, immunogenicity and other pharmacodynamic effects to elucidate the mechanism of action of NG-350A, either alone or in combination with a check point inhibitor, in patients with advanced or metastatic epithelial tumours.

Related Conditions:
  • Adenocarcinoma of the Gastroesophageal Junction
  • Breast Carcinoma
  • Cervical Carcinoma
  • Endometrial Carcinoma
  • Esophageal Carcinoma
  • Gastric Carcinoma
  • Head and Neck Squamous Cell Carcinoma
  • Hepatocellular Carcinoma
  • Malignant Solid Tumor
  • Malignant Uterine Corpus Neoplasm
  • Non-Small Cell Lung Carcinoma
  • Skin Squamous Cell Carcinoma
  • Urothelial Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: First in Human Study of NG-350A (an Oncolytic Adenoviral Vector Which Expresses an Anti-CD40 Antibody)
  • Official Title: A Multicentre, Open Label, Non-randomised First in Human Study of NG-350A (Monotherapy), and NG-350A With a Check Point Inhibitor in Patients With Metastatic or Advanced Epithelial Tumours

Clinical Trial IDs

  • ORG STUDY ID: NG-350A-01
  • NCT ID: NCT03852511

Conditions

  • Metastatic Cancer
  • Epithelial Tumor

Interventions

DrugSynonymsArms
NG-350AIntravenous

Purpose

This study will evaluate the safety, tolerability and preliminary efficacy and also pharmacokinetics, immunogenicity and other pharmacodynamic effects to elucidate the mechanism of action of NG-350A, either alone or in combination with a check point inhibitor, in patients with advanced or metastatic epithelial tumours.

Detailed Description

      Phase Ia of this study is a dose escalation phase, investigating NG-350A administration by
      intravenous (IV) infusion, either alone or in combination with a check point inhibitor. Phase
      Ib of this study comprises of a Combination Dose Efficacy Expansion with NG-350A in
      combination with a check point inhibitor.
    

Trial Arms

NameTypeDescriptionInterventions
IntravenousExperimentalPatients will receive three single doses of NG-350A by IV infusion, followed by multiple cycles of check point inhibitor treatment.
  • NG-350A

Eligibility Criteria

        Inclusion Criteria:

          1. Provide written informed consent to participate

          2. Aged 18 years or over

          3. Have one of eleven histologically or cytologically confirmed metastatic or advanced
             carcinomas or adenocarcinomas that have progressed after at least one line of systemic
             therapy and are incurable by local therapy

             a. Tumour types eligible are: UC, SCCHN, MSI high/dMMR cancer, NSCLC,
             uterine/endometrial cancer, cervical cancer, oesophageal cancer, gastric cancer,
             cutaneous squamous cell carcinoma, HCC and TNBC

          4. Additional tumour type specific criteria:

               1. UC: carcinoma of the renal pelvis, ureter, bladder, or urethra that showed
                  predominantly transitional-cell features on histologic testing

               2. SCCHN with oropharyngeal cancer: known HPV p16 status

               3. MSI-high/dMMR cancer: MSI-high/dMMR status must be confirmed by an approved test

               4. NSCLC: either squamous or non-squamous histology

               5. Gastric cancer: gastric or gastroesophageal junction adenocarcinoma

          5. All patients enrolled in combination therapy cohorts with check point inhibitor (dose
             escalation and efficacy expansion phases) must have received prior treatment with a PD
             1/PD-L1 inhibitor therapy (prior PD-1/PD-L1 may have been given as monotherapy or
             combination therapy)

               1. In combination dose-escalation, patients may have received a PD 1/PD L1 inhibitor
                  as part of any prior line of therapy (additional criteria apply when this is the
                  most recent line of therapy - see below)

               2. In dose expansion cohorts, patients must have been treated with a PD 1/PD-L1
                  inhibitor as part of their most recent treatment

               3. For all patients who received PD-1/PD-L1 inhibitor therapy as part of their most
                  recent line of treatment (includes dose-escalation and all patients in
                  dose-expansion), this must have been for a minimum of 6 weeks and maximum of 6
                  months, with best response of SD or PD - Patients with PD following treatment
                  with a PD-1/PD-L1 inhibitor as their most recent therapy must have a <50%
                  increase in disease burden

          6. At least one measurable site of disease according to RECIST Version 1.1 criteria; this
             lesion must be either (i) outside a previously irradiated area or (ii) progressive if
             it is in a previously irradiated area

          7. Tumour accessible for biopsy, biopsy deemed safe for biopsy by the Investigator, and
             patient willing to consent to tumour biopsies

          8. Ability to comply with study procedures in the Investigator's opinion

          9. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1

         10. Predicted life expectancy of 6 months or more

         11. Adequate lung reserve

         12. Adequate renal function

         13. Adequate hepatic function

         14. Adequate bone marrow function

         15. Coagulation profile within the normal range (international normalized ratio ≤1.5)

         16. Meeting reproductive status requirements

        Exclusion Criteria:

          1. Prior or planned allogeneic or autologous bone marrow or organ transplantation

          2. Splenectomy

          3. Active infections requiring antibiotics, physician monitoring or systemic therapy
             within 1 week of the anticipated first dose of study drug, or recurrent fevers
             (>38.0˚C) associated with a clinical diagnosis of active infection

          4. Active viral disease or positive test for hepatitis B virus using hepatitis B surface
             antigen test or positive test for hepatitis C virus (HCV) using HCV ribonucleic acid
             (RNA) or HCV antibody test indicating acute or chronic infection. Positive test for
             HIV or AIDS

          5. Patients who have active autoimmune disease that has required systemic therapy in the
             past 2 years, are immunocompromised in the opinion of the Investigator, or are
             receiving systemic immunosuppressive treatment

             a. Patients with vitiligo, type I diabetes mellitus, asthma/atopy, residual
             hypothyroidism due to autoimmune disease (which only requires hormone replacement
             therapy), or conditions not expected to recur in the absence of an external trigger
             are permitted to enrol providing they comply with the other eligibility criteria
             relating to renal function. Use of inhaled corticosteroids, local steroid injection,
             or steroid eye drops is allowed

          6. Treatment with any live, live attenuated or COVID-19 vaccine in the 28 days before the
             first dose of NG 350A

             a. COVID-19 vaccines known not to be based on an adenoviral vector (e.g. mRNA
             vaccines) are not subject to the 28-day exclusion (see exclusion criterion 7)

          7. Treatment with any other vaccine (including known non-adenoviral COVID-19 vaccines) in
             the 7 days before first dose of NG-350A

          8. History of prior Grade 3-4 acute kidney injury or other clinically significant renal
             impairment

          9. History of clinically significant interstitial lung disease or non-infectious
             pneumonitis

         10. Lymphangitic carcinomatosis (clinically suspected or radiographic evidence)

         11. Infectious or inflammatory bowel disease in the 3 months before the first dose of
             study treatment

         12. Myocardial infarction, stroke or other significant cardiovascular or cerebrovascular
             event in the 12 months before the first dose of study treatment

         13. Pulmonary embolism, deep vein thrombosis, or other uncontrolled thromboembolic event
             in the 12 months before the first dose of study treatment, or current treatment with
             therapeutic or prophylactic anticoagulation therapy

         14. Grade 3 or 4 gastrointestinal bleeding (or risk factors for gastrointestinal bleeding)
             or haemoptysis in the 3 months before first dose of study treatment, or any history of
             bleeding requiring an investigative procedure (e.g. endoscopy), transfusion or
             hospitalisation in the 12 months before the first dose of study treatment

         15. Tumour location/extent considered by the Investigator to present a significant risk if
             tumour flare or necrosis were to occur (e.g. an initial increase in tumour size that
             may lead to intestinal, airway or ureter obstruction, or penetrating tumour
             infiltration of major blood vessels, or other hollow organs potentially at risk of
             perforation)

         16. Use of the following prior therapies/treatments:

               1. Treatment with any other anti CD40 antibody at any time

               2. Treatment with an investigational or licensed anti-cancer monoclonal antibody
                  (mAb), immune checkpoint inhibitor, immune stimulatory treatment or other
                  biological therapy in the 28 days prior to the first dose of study treatment.
                  Prior anti PD-1 / PD-L1 therapy is permitted without a 'washout' phase

               3. Treatment with an investigational or licensed chemotherapy, targeted small
                  molecule or other investigational drug in the 14 days or five half-lives
                  (whichever is shorter) before the first dose of study treatment

               4. Major surgery in the 28 days before the first dose of study treatment or
                  radiation therapy in the 14 days before the first dose of study treatment

             i. Bisphosphonate therapy or treatment with Receptor Activator of Nuclear factor
             Kappa-B (RANK)-ligand inhibitors for metastatic bone disease is permitted

         17. All toxicities attributed to prior anti-cancer therapy (including radiation therapy)
             other than alopecia must have resolved to Grade 1 or baseline before the first dose of
             study treatment. Patients with toxicities (other than renal toxicities) attributed to
             prior anti-cancer therapy that are not expected to resolve and result in long lasting
             sequelae, such as neuropathy after platinum-based therapy, are permitted to enrol

         18. Treatment with the antiviral agents ribavirin, adefovir, lamivudine or cidofovir
             within 7 days prior to the first dose of study treatment; or pegylated interferon
             (PEG-IFN) in the 14 days before the first dose of study treatment

         19. Known allergy/immune-related adverse reactions to NG-350A transgene or immune
             checkpoint inhibitor products or formulation; severe hypersensitivity to another
             monoclonal antibody

         20. Other prior malignancy active within the previous 3 years, except for local or organ
             confined early-stage cancer that has been definitively treated with curative intent,
             does not require ongoing treatment, has no evidence of residual disease and has a
             negligible risk of recurrence and is therefore unlikely to interfere with the primary
             and secondary endpoints of the study, including response rate and safety

         21. Symptomatic brain metastases or any leptomeningeal metastases that are symptomatic
             and/or require treatment. Patients with brain metastases are eligible if these have
             been treated (surgery, radiotherapy). Both surgery and or radiotherapy must have been
             completed at least 2 weeks before first dose of study treatment. There must also be no
             requirement for immunosuppressive doses of systemic corticosteroids (>10 mg/day
             prednisone equivalent) for at least 2 weeks before the first dose of study treatment

         22. Any serious or uncontrolled medical disorder that, in the opinion of the Investigator
             or the Medical Monitor, may increase the risk associated with study participation or
             study treatment administration, impair the ability of the patient to receive protocol
             therapy or interfere with the interpretation of study results
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Incidence of adverse events, serious adverse events, adverse events meeting protocol-defined DLT criteria, severe adverse events, adverse events leading to study treatment or study discontinuation, and adverse events resulting in death.
Time Frame:Throughout study to end of study treatment visit (Week 24 or +30 days after last study drug dose)
Safety Issue:
Description:Characterise the safety and tolerability of NG-350A, in combination with a check point inhibitor, by reviewing reported Adverse Events (AEs) and Serious Adverse Events (SAEs).

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:PsiOxus Therapeutics Ltd

Trial Keywords

  • metastatic; epithelial; virus; advanced

Last Updated

June 2, 2021