Description:
This clinical trial is evaluating a drug called BT5528 alone and in combination with
nivolumab in participants with advanced solid tumors that are identified as positive for
EphA2 expression. The main goals of this study are to:
- Find the recommended dose of BT5528 that can be given safely to participants alone and
in combination with nivolumab
- Learn more about the side effects of BT5528
- Learn more about BT5528 therapy alone and in combination with nivolumab.
Title
- Brief Title: Study BT5528-100 in Patients With Advanced Solid Tumors Associated With EphA2 Expression
- Official Title: Phase I/II Study of the Safety, Pharmacokinetics, and Preliminary Clinical Activity of BT5528 in Patients With Advanced Malignancies Associated With EphA2 Expression
Clinical Trial IDs
- ORG STUDY ID:
BT5528-100
- NCT ID:
NCT04180371
Conditions
- Advanced Solid Tumor Identified as Positive for EphA2 Tumor Expression by Central Laboratory (Phase 1)
- Non Small Cell Lung Cancer Identified as Positive for EphA2 Tumor Expression by Central Laboratory (Phase 2)
Interventions
Drug | Synonyms | Arms |
---|
BT5528 | | Phase I - Dose escalation (BT5528) |
Nivolumab | Opdivo | Phase I - Dose escalation combination (BT5528 & nivolumab) |
Purpose
This clinical trial is evaluating a drug called BT5528 alone and in combination with
nivolumab in participants with advanced solid tumors that are identified as positive for
EphA2 expression. The main goals of this study are to:
- Find the recommended dose of BT5528 that can be given safely to participants alone and
in combination with nivolumab
- Learn more about the side effects of BT5528
- Learn more about BT5528 therapy alone and in combination with nivolumab.
Detailed Description
BT5528 consists of a bicyclic peptide (Bicycle®) which binds to EphA2, and is covalently
attached to a spacer and a protease cleavable peptide linker attached to MMAE.
The Phase I/II multi-center, open-label trial will evaluate BT5528 administered once-weekly
as a single agent and in combination with nivolumab. The Phase I portion is a dose escalation
primarily designed to assess the safety and tolerability of BT5528 and to determine a
recommended Phase II dose (RP2D). Following selection of a recommended Phase II dose (RP2D),
a dose expansion portion will be initiated with the primary objective of evaluating the
clinical activity of BT5528.
Trial Arms
Name | Type | Description | Interventions |
---|
Phase I - Dose escalation (BT5528) | Experimental | Cohorts of participants will receive increasing doses of BT5528. It is expected that up to 48 participants will participate in this dose escalation arm. | |
Phase I - Dose escalation combination (BT5528 & nivolumab) | Experimental | Cohorts of participants will receive increasing doses of BT5528 and a standard dose of nivolumab. It is expected that up to 24 participants will participate in this dose escalation combination arm. | |
Phase II - Dose expansion 1 (BT5528) | Experimental | A cohort of participants will receive the selected dose of BT5528 as a monotherapy. It is expected that up to 40 patients with non-small cell lung cancer (NSCLC) with EGFR mutation and confirmed EphA2 tumor expression will participate in this dose expansion arm. | |
Phase II - Dose expansion combination (BT5528 & nivolumab) | Experimental | A cohort of participants will receive the selected dose of BT5528 in combination with a standard dose of nivolumab. It is expected that up to 14 participants with non-small cell lung cancer without EGFR mutation and confirmed EphA2 tumor expression will participate in this dose expansion arm. | |
Phase II - Dose expansion 2 (BT5528) | Experimental | A cohort of participants will receive the selected dose of BT5528 as a monotherapy. It is expected that up to 40 patients with NSCLC without EGFR mutation and confirmed EphA2 tumor expression will participate in this dose expansion arm. | |
Eligibility Criteria
General Inclusion:
- Written informed consent, according to local guidelines, signed and dated by the
patient or by a legal guardian prior to the performance of any study-specific
procedures, sampling or analyses
- Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1
- Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
- Acceptable renal, hepatic, hematologic and coagulation functions
- Negative pregnancy test for women of childbearing potential
- Male participants with female partners of childbearing potential and female
participants of childbearing potential are required to follow highly effective
contraception
- Availability of archived tumor samples or willingness to provide fresh tumor biopsy
during screening for EphA2 assessment
Additional inclusion criteria for Phase I (dose escalation phase, with BT5528 alone or in
combination with nivolumab):
- Metastatic recurrent histologically confirmed malignant solid tumors confirmed to have
EphA2 tumor expression. Confirmation of EphA2 expression prior to enrollment is not
required for participants with ovarian cancer and specific other individual tumor
types.
- Exhausted all appropriate treatment options per local guidelines
Additional inclusion criteria for Phase II (dose expansion phase, with BT5528 alone or in
combination with nivolumab):
- Participants with metastatic recurrent disease histologically confirmed to be
adenocarcinoma subtype of NSCLC (adeno-NSCLC) or other tumor subtypes are eligible and
must have exhausted all appropriate treatment options per local guidelines including
progression on or after platinum-based chemotherapy and appropriate therapies for
driver mutations (if applicable).
- Confirmed EphA2 tumor expression prior to enrollment, unless waived for specific tumor
types
Exclusion criteria (all participants):
- Chemotherapy treatments within 14 days prior to first dose of study treatment, other
anticancer treatments, treatment within 28 days or 5 half-lives, whichever is the
shorter
- Experimental treatments within 4 weeks of first dose of BT5528
- Current treatment with strong inhibitors or inducers of CYP3A4 or strong inhibitors of
P-gp
- Uncontrolled, symptomatic brain metastases
- Any condition, therapy or laboratory abnormality that might confound the results of
the study, interfere with the patient's participation, or is not in the best interest
of the patient to participate in the opinion of the investigator including but not
limited to specific cardiovascular criteria
- Thromboembolic events and/or bleeding disorders 3 months (e.g., deep vein thrombosis
[DVT] or pulmonary embolism [PE]) prior to first dose
Additional Exclusion Criteria (BT5528 in combination with nivolumab):
- Prior organ transplant (including allogeneic)
- Diagnosis of clinically relevant immunodeficiency
- Active systemic infection requiring therapy
- More than 10 mg daily prednisone equivalent or other strong immunosuppressant
- History of autoimmune disease except alopecia or vitiligo
- History of interstitial lung disease
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Phase I: Number of participants receiving BT5528 alone and in combination with nivolumab with treatment-emergent adverse events |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until 30 days post last dose |
Safety Issue: | |
Description: | Safety reported as incidence of treatment-emergent adverse events |
Secondary Outcome Measures
Measure: | Phase I: Objective response rate by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months |
Safety Issue: | |
Description: | Objective Response Rate (ORR) |
Measure: | Phase I: Duration of response by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months |
Safety Issue: | |
Description: | Duration of Response (DOR) |
Measure: | Phase I: Clinical benefit rate by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months |
Safety Issue: | |
Description: | Clinical benefit rate |
Measure: | Phase I: Time to tumor progression by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months |
Safety Issue: | |
Description: | Time to progression (TTP) |
Measure: | Phase I: Progression free survival time by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months |
Safety Issue: | |
Description: | Progression free survival (PFS) |
Measure: | Phase I: Progression free survival at 6 months by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months) |
Safety Issue: | |
Description: | Progression free survival (PFS) |
Measure: | Phase I: Overall survival time at 12 months in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until death or loss of follow-up or withdrawal of consent (assessed every 3 months up to 12 months |
Safety Issue: | |
Description: | Overall survival (OS) |
Measure: | Phase II: Determination of the number of participants with non-small cell lung cancer or other identified tumor subtypes positive for EphA2 tumor expression receiving BT5528 alone and in combination with nivolumab with treatment-emergent adverse events |
Time Frame: | From Cycle 1 Day 1 (each cycle is 28 days) until 30 days post last dose |
Safety Issue: | |
Description: | |
Measure: | All phases: Determine the plasma concentrations of BT5528 in plasma from all participants taking BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1,and end of each cycle (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or withdrawal of consent(assessed up to 12 months |
Safety Issue: | |
Description: | |
Measure: | All phases: Determine the plasma concentrations of MMAE in plasma from all participants taking BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1,and end of each cycle (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or withdrawal of consent(assessed up to 12 months |
Safety Issue: | |
Description: | |
Measure: | All phases: Number of participants positive for anti-drug antibodies (ADA) from all participants receiving BT5528 alone and in combination with nivolumab |
Time Frame: | From Cycle 1,and end of each cycle (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or withdrawal of consent(assessed up to 12 months |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Bicycle Tx Limited |
Trial Keywords
Last Updated
August 23, 2021