Description:
Basket trial concept to independently and simultaneously assess the effects of the association of atezolizumab + BDB001 + radiotherapy in multiple solid tumors.
Basket trial concept to independently and simultaneously assess the effects of the association of atezolizumab + BDB001 + radiotherapy in multiple solid tumors.
Recruiting
Phase 2
| Drug | Synonyms | Arms |
|---|---|---|
| Association atezolizumab + BDB001 + RT | Population 1: Pancreatic cancer | |
| Association atezolizumab + BDB001+ RT | Population 2: Virus-associated tumors | |
| Association atezolizumab + BDB001+ RT | Population 3: anti-PD-1/L1 refractory non-small lung cancer | |
| Association atezolizumab + BDB001 + RT | Population 4: Soft-tissue sarcoma | |
| Association atezolizumab + BDB001 + RT | Population 5: anti-PD-1/L1 refractory bladder cancer | |
| Association atezolizumab + BDB001 + RT | Population 6: Triple negative breast cancer |
6 independent, multicenter, prospective, single-arm phase II trials, based on 2-stage Simon's
optimal design, will be conducted in parallel to assess the efficacy of atezolimab + BDB001+
radiotherapy, separately, in distinct populations of solid tumors:
- Population 1: pancreatic cancer
- Population 2: virus-associated tumors
- Population 3: anti-PD-1/L1 refractory non-small lung cancer
- Population 4: soft-tissue sarcoma
- Population 5: anti-PD-1/L1 refractory bladder cancer
- Population 6: anti-PD-1/L1 refractory triple negative breast cancer
| Name | Type | Description | Interventions |
|---|---|---|---|
| Population 1: Pancreatic cancer | Experimental | Participants with pancreatic cancer will be treated with Atezolizumab combined with BDB001 and radiotherapy. |
|
| Population 2: Virus-associated tumors | Experimental | Participants with virus-associated tumors will be treated with Atezolizumab combined with BDB001 and radiotherapy. |
|
| Population 3: anti-PD-1/L1 refractory non-small lung cancer | Experimental | Participants with anti-PD-1/L1 refractory non-small lung cancer will be treated with Atezolizumab combined with BDB001 and radiotherapy. |
|
| Population 4: Soft-tissue sarcoma | Experimental | Participants with soft-tissue sarcoma will be treated with Atezolizumab combined with BDB001 and radiotherapy. |
|
| Population 5: anti-PD-1/L1 refractory bladder cancer | Experimental | Participants with anti-PD-1/L1 refractory bladder cancer will be treated with Atezolizumab combined with BDB001 and radiotherapy. |
|
| Population 6: Triple negative breast cancer | Experimental | Participants with anti-PD-1/L1 refractory triple negative breast cancer will be treated with Atezolizumab combined with BDB001 and radiotherapy. |
|
Inclusion criteria:
1. histologically confirmed pancreatic cancer, virus-associated tumors [including
papillomaviruses-related cancers (cervical, head and neck, and nasal), Epstein-Barr
virus (nasopharyngeal carcinoma) and Kaposi's sarcoma-associated herpes virus),
non-small cell lung cancer, soft-tissue sarcomas, bladder cancer, triple negative
breast cancer. For population 4, diagnosis must be confirmed by the RRePS Network as
recommended by the French NCI,
2. Metastatic disease,
3. Age ≥ 18 years,
4. ECOG ≤ 1,
5. At least two lesions: one lesion that can be treated by radiotherapy and one site of
disease that must be uni-dimensionally ≥ 10 mm considered as measurable according to
RECIST v1.1. This lesion will not be treated by radiotherapy, however, note that
lesion(s) that will be treated by radiotherapy will also be considered as measurable.
Note that the largest size of the metastases to be irradiated will be 3cm,
6. Life expectancy > 6 months,
7. At least one tumor site that can be biopsied for research purpose. Tumor lesion in
close proximity to vascular structures such as large vessels, aneurysm or pulmonary
arteriovenous malformation will not be considered for biopsy,
8. Availability of archived paraffin-embedded tumor tissue for research purpose,
9. Participant must have advanced disease and must not be a candidate for other approved
therapeutic regimen known to provide significant clinical benefit based on
investigator judgement,
10. Participants who received prior anti-PD-1/L1 therapy must fulfill the following
requirements
- Have achieved a complete response, partial response or stable disease and
subsequently had disease progression while still on anti-PD-1/L1 therapy
- Have received at least two doses of an approved anti-PD-1/L1 therapy (by any
regulatory authority)
- Have demonstrated disease progression as defined by RECIST v1.1 within 18 weeks
from the last dose of the anti- PD-1/L1 therapy.
11. Adequate hematological, renal, metabolic and hepatic functions
12. No prior or concurrent malignant disease needing an active treatment,
13. At least three weeks since last chemotherapy, immunotherapy or any other
pharmacological treatment and/or radiotherapy,
14. Recovery to grade ≤ 1 from any adverse event (AE) derived from previous treatment,
excluding alopecia of any grade and non-painful peripheral neuropathy grade ≤ 2,
15. Women of childbearing potential must have a negative serum pregnancy test within 7
days prior to inclusion.
16. Both women and men must agree to use an effective method of contraception throughout
the treatment period and for five months after discontinuation of treatment.
17. Voluntary signed and dated written informed consents prior to any specific study
procedure,
18. Participants with a social security in compliance with the French law.
Exclusion criteria:
1. Previous treatment with a TLR agonist
2. Evidence of progressive or symptomatic central nervous system (CNS) or leptomeningeal
metastases,
3. Women who are pregnant or breast feeding,
4. Participation in a study involving a medical or therapeutic intervention in the last
30 days,
5. Known hypersensitivity to CHO cell products or to any involved study drug or of its
formulation components,
6. History of severe allergic anaphylactic reactions to chimeric, human or humanized
antibodies, or fusion proteins,
7. Treatment with systemic immunosuppressive medications including, but not limited to,
cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-TNF agents within
2 weeks prior to inclusion.
8. Major surgical procedure, open biopsy or significant traumatic injury within 28 days
before inclusion,
9. Any of the following cardiac criteria: congestive heart failure ≥ New York Heart
Association (NYHA) class 2, unstable angina, new-onset angina, myocardial infarction
less than 6 months before inclusion, uncontrolled cardiac arrhythmias, known left
ventricular ejection fraction (LVEF) <50%
10. Individuals deprived of liberty or placed under legal guardianship,
11. Prior organ transplantation, including allogeneic stem cell transplantation,
12. Known clinically significant liver disease, including active viral, alcoholic, or
other hepatitis, cirrhosis, fatty liver and inherited liver disease,
13. History of intra-abdominal inflammatory process within the last 12 months such as, but
not limited to, diverticulitis, peptic ulcer disease or colitis.
14. History of autoimmune disease including, but not limited to systemic lupus
erythematosus (SLE), Sjögren's syndrome, glomerulonephritis, multiple sclerosis,
rheumatoid arthritis, vasculitis, systemic immune activation, inflammatory bowel
disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener's
granulomatosis, Guillain-Barré syndrome, Bell's palsy.
15. History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced
pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening
chest CT scan.
16. Poorly controlled Type II diabetes mellitus defined as a screening fasting plasma
glucose ≥160 mg/dL (or 8.8 mmol/L).
17. Severe infections within 2 weeks prior to inclusion, including but not limited to
SARS-Cov-2 infection, hospitalization for complications of infection, bacteremia, or
severe pneumonia.
18. Received therapeutic oral or IV antibiotics within 2 weeks prior to inclusion.
19. Participant has spinal cord compression not definitively treated with surgery and/or
radiation or previously diagnosed and treated spinal cord compression without evidence
that disease is clinically stable at least 14 days prior to inclusion.
20. Administration of a live, attenuated vaccine within 4 weeks before the start of study
medication .
21. Has known active hepatitis B or hepatitis C,known history of Human Immunodeficiency or
known acquired immunodeficiency syndrome, known history of tuberculosis
22. Patients with current retinal disorder confirmed by retinal examination (external
ocular examination, routine slit lamp biomicroscopy of anterior ocular structures and
evaluation of the anterior and posterior chamber,
23. Patients who wear contact lenses unable to replace them with glasses.
| Maximum Eligible Age: | N/A |
| Minimum Eligible Age: | 18 Years |
| Eligible Gender: | All |
| Healthy Volunteers: | No |
| Measure: | Assessment of the antitumor activity of atezolizumab combined with BDB001 and radiotherapy in patients with pancreatic cancer. |
| Time Frame: | Within 6 months of treatment onset |
| Safety Issue: | |
| Description: | Antitumor activity will be assessed in terms of disease control rate within 24 weeks of treatment onset and is defined as the proportion of patients with complete response (CR), partial response (PR) or stable disease (SD) observed within 24 weeks of treatment onset (while treated with the investigational product), based on RECIST 1.1 criteria. |
| Measure: | 6-month Progression-free rate (PFR) in patients with pancreatic cancer. |
| Time Frame: | 6 months |
| Safety Issue: | |
| Description: | Progression-free rate is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST 1.1 criteria. |
| Measure: | 6-month Progression-free rate (PFR) in patients with virus-associated tumor. |
| Time Frame: | 6 months |
| Safety Issue: | |
| Description: | Progression-free rate is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST 1.1 criteria. |
| Measure: | 6-month Progression-free rate (PFR) in patients with non-small cell lung cancer. |
| Time Frame: | 6 months |
| Safety Issue: | |
| Description: | Progression-free rate is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST 1.1 criteria. |
| Measure: | 6-month Progression-free rate (PFR) in patients with bladder cancer. |
| Time Frame: | 6 months |
| Safety Issue: | |
| Description: | Progression-free rate is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST 1.1 criteria. |
| Measure: | 6-month Progression-free rate (PFR) in patients with triple negative breast cancer. |
| Time Frame: | 6 months |
| Safety Issue: | |
| Description: | Progression-free rate is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST 1.1 criteria. |
| Measure: | 6-month objective response rate (ORR) independently for each population. |
| Time Frame: | 6 months |
| Safety Issue: | |
| Description: | Objective response is defined as the proportion of patients with complete response (CR) or partial response (PR) observed at 6 months, based on RECIST 1.1 criteria. |
| Measure: | Objective response rate (ORR) within 24 weeks of treatment onset, independently for each population. |
| Time Frame: | Within 6 months |
| Safety Issue: | |
| Description: | Objective response is defined as the proportion of patients with complete response (CR) or partial response (PR) observed within 24 wekks after treatment onset, based on RECIST 1.1 criteria. |
| Measure: | Best overall response, independently for each population. |
| Time Frame: | Throughout the treatment period, an expected average of 6 months |
| Safety Issue: | |
| Description: | Best overall response is defined as the best response across all time points (RECIST 1.1). The best overall response is determined once all the data for the patient is known (RECIST 1.1). |
| Measure: | 1-year progression-free survival, independently for each population. |
| Time Frame: | 1 year |
| Safety Issue: | |
| Description: | Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST 1.1) or death (from any cause), whichever occurs first. |
| Measure: | 2-year progression-free survival, independently for each population. |
| Time Frame: | 2 years |
| Safety Issue: | |
| Description: | Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST 1.1) or death (from any cause), whichever occurs first. |
| Measure: | 1-year overall survival, independently for each population. |
| Time Frame: | 1 year |
| Safety Issue: | |
| Description: | Overall survival is defined as the delay between the start date of treatment and the date of death (of any cause). |
| Measure: | 2-year overall survival, independently for each population. |
| Time Frame: | 2 years |
| Safety Issue: | |
| Description: | Overall survival is defined as the delay between the start date of treatment and the date of death (of any cause). |
| Measure: | Safety profile, independently for each population: Common Terminology Criteria for Adverse Events version 5 |
| Time Frame: | Throughout the treatment period, an expected average of 6 months |
| Safety Issue: | |
| Description: | Toxicity graded using the Common Terminology Criteria for Adverse Events version 5. |
| Measure: | Tumor immune cells levels |
| Time Frame: | before treatment onset and cycle 3 day 1 (each cycle is 21 days) |
| Safety Issue: | |
| Description: | Levels of immune cells in tumor will be measured by immunohistochemistry. |
| Measure: | Blood cytokines levels |
| Time Frame: | baseline, cycle 1 day 1, cycle 2 day 1, cycle 3 day 1 and progression (each cycle is 21 days) |
| Safety Issue: | |
| Description: | Levels of cytokines in blood will be measured by ELISA. |
| Measure: | Blood lymphocytes levels |
| Time Frame: | baseline, cycle 1 day 1, cycle 2 day 1, cycle 3 day 1 and progression (each cycle is 21 days) |
| Safety Issue: | |
| Description: | Levels of lymphocytes in blood will be measured by flow cytometry. |
| Measure: | Blood kynurenine levels |
| Time Frame: | baseline, cycle 1 day 1, cycle 2 day 1, cycle 3 day 1 and progression (each cycle is 21 days) |
| Safety Issue: | |
| Description: | Levels of kynurenine in blood will be measured by ELISA. |
| Phase: | Phase 2 |
| Primary Purpose: | Interventional |
| Overall Status: | Recruiting |
| Lead Sponsor: | Institut Bergonié |
May 5, 2021