Description:
This is a Phase II, prospective, non-randomized, open-label trial involving cancer patients
with known inflamed tumor types. Patients with previously treated advanced/metastatic
non-small cell lung cancer or renal cell cancer will be recruited in near equal distribution.
All patients must have documented response or prolonged stable disease to previous
immunotherapy. At present, we plan to enrol 55 patients, to be treated with durvalumab and
oleclumab. The regimen will consist of durvalumab 1500 mg given by vein every 4 weeks and
oleclumab 3000 mg given by vein every 2 weeks x 4 doses then IV every 4 weeks till disease
progression, withdrawal of subject consent, or another reason for discontinuation. Estimated
total duration from time to first subjects consent to last subject's last visit is
approximately 36 months.
Title
- Brief Title: A Phase 2 Study of Durvalumab (MEDI4736) and Oleclumab (MEDI9447) in Multi-Cancer Populations With Correlation to Clinical, Molecular and Immunologic Parameters With DNA MethylaTION
- Official Title: A Phase 2 Study of Durvalumab (MEDI4736) and Oleclumab (MEDI9447) in Multi-Cancer Populations With Correlation to Clinical, Molecular and Immunologic Parameters With DNA MethylaTION (DOMINATION)
Clinical Trial IDs
- ORG STUDY ID:
DOMINATION
- SECONDARY ID:
19-6281
- NCT ID:
NCT04262375
Conditions
- Non Small Cell Lung Cancer
- Renal Cell Carcinoma
Interventions
Drug | Synonyms | Arms |
---|
Durvalumab | IMFINZI | Durvalumab and Oleclumab |
Oleclumab | | Durvalumab and Oleclumab |
Purpose
This is a Phase II, prospective, non-randomized, open-label trial involving cancer patients
with known inflamed tumor types. Patients with previously treated advanced/metastatic
non-small cell lung cancer or renal cell cancer will be recruited in near equal distribution.
All patients must have documented response or prolonged stable disease to previous
immunotherapy. At present, we plan to enrol 55 patients, to be treated with durvalumab and
oleclumab. The regimen will consist of durvalumab 1500 mg given by vein every 4 weeks and
oleclumab 3000 mg given by vein every 2 weeks x 4 doses then IV every 4 weeks till disease
progression, withdrawal of subject consent, or another reason for discontinuation. Estimated
total duration from time to first subjects consent to last subject's last visit is
approximately 36 months.
Detailed Description
Study Hypotheses:
1. Circulating free methylated DNA immunoprecipitation and high-throughput sequencing
(cfMeDIP-seq) can yield cancer type-agnostic predictive biomarker(s) of response and/or
toxicity in subjects receiving this combination.
2. The combination of oleclumab (anti-cluster of differentiation [CD]73 monoclonal
antibody) with durvalumab (anti programmed cell death ligand 1 [PD-L1]) will demonstrate
adequate safety, tolerability, and antitumor activity in subjects with metastatic
non-small-cell lung cancer (NSCLC) and renal cell cancer (RCC) previously treated with
checkpoint inhibitors.
Trial Arms
Name | Type | Description | Interventions |
---|
Durvalumab and Oleclumab | Experimental | A single dose level for oleclumab and durvalumab will be used, comprising of Oleclumab 3000 mg IV Q2W for 4 doses, then Q4W AND Durvalumab 1500 mg IV Q4W | |
Eligibility Criteria
Inclusion Criteria:
1. Age ≥ 18 years at the time of screening or age of consent according to law
2. Life expectancy of at least 12 weeks
3. Written informed consent and any locally required authorization obtained from the
subject prior to performing any protocol-related procedures, including screening
evaluations
4. ECOG 0 or 1
5. Weight ≥35kg
6. Subjects diagnosed with histologically or cytologically confirmed non small cell lung
(NSCLC) or renal cell carcinoma (RCC)
7. Subjects must have at least 1 measurable lesion according to RECIST version 1.1.
8. Archival tumor formalin-fixed, paraffin-embedded (FFPE) specimens for correlative
biomarker studies are required (1 H&E and 15 unstained slides). Subjects with
insufficient archived tumor samples are still eligible, pending discussion with the
principal investigator on a case by case basis
9. Adequate organ and marrow function
10. Females of childbearing potential who are sexually active with a nonsterilized male
partner must use at least one highly effective method of contraception from screening
to 90 days after the final dose of study treatment
11. Nonsterilized male subjects who are sexually active with a female partner of
childbearing potential must use a male condom with spermicide from screening to 90
days after receipt of the final dose of study treatment
Exclusion Criteria:
1. Receipt of any conventional or investigational anticancer therapy within 21 days or
palliative radiotherapy within 14 days prior to the scheduled first dose of study
treatment
2. Prior receipt of any agents targeting CD73, including patients treated with adenosine
receptor antagonists, CD39 or CD73 inhibitors
3. Prior receipt of any innate immune agonists
4. Patients with NSCLC with known activating EGFR mutations or ALK translocations
5. Concurrent enrollment in another therapeutic clinical study. Enrollment in
observational studies will be allowed
6. Any toxicity (excluding alopecia) from prior standard therapy that has not been
completely resolved to baseline at the time of consent
7. Subjects with a history of Grade 3 or greater thromboembolic events in the prior 12
months or thromboembolic event of any grade with ongoing symptoms
8. Subjects with prior history of myocardial infarction, transient ischemic attack,
congestive heart failure ≥ Class 3 based on New York Heart Association Functional
Classification or stroke within the past 3 months prior to the scheduled first dose of
study treatment
9. Active or prior documented autoimmune disorders within the past 3 years prior to the
scheduled first dose of study treatment
10. HIV, Hep A, B, or C
11. History of primary immunodeficiency, solid organ transplantation, or active
tuberculosis
12. Known allergy or hypersensitivity to investigational product formulations
13. History of more than one event of infusion related reactions (IRR) requiring permanent
discontinuation of IV drug treatment
14. Active grade 3 or greater edema
15. History of Grade 3 or greater thromboembolic events in the prior 12 months or
thromboembolic event of any grade with ongoing symptoms
16. Uncontrolled intercurrent
17. Any history of untreated leptomeningeal disease or cord compression
18. Untreated CNS metastatic disease
19. Current or prior use of immunosuppressive medication within 14 days prior to the
scheduled first dose of study treatment
20. Receipt of live, attenuated vaccine within 30 days prior to the scheduled first dose
of study treatment
21. Major surgery within 28 days prior to scheduled first dose of study treatment or still
recovering from prior surgery
22. Females who are pregnant, lactating, or intend to become pregnant during their
participation in the study
23. Subjects who are involuntarily incarcerated or are unable to willingly provide consent
or are unable to comply with the protocol procedures
24. Any condition that would interfere with the evaluation of the study regimen or
interpretation of patient safety or study results
25. Any condition that would interfere with safe administration or evaluation of the
investigational products or interpretation of subject safety or study results
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Association between cfMeDIP and Response (defined as either complete response, partial response, or stable disease ≥ 4 cycles, as per RECIST 1.1. Association between cfMeDIP and Toxicity (defined as ≥ Grade 2 immune- adverse event (AE) as per CTCAE 5.0). |
Time Frame: | 3 years |
Safety Issue: | |
Description: | To identify cfMeDIP-seq-based predictive signature(s) that are correlated with specific outcome to durvalumab and oleclumab such as response/resistance or occurrence of toxicity in non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC) |
Secondary Outcome Measures
Measure: | Incidence of treatment-emergent adverse events (AEs) |
Time Frame: | 3 years |
Safety Issue: | |
Description: | To assess the safety and tolerability of durvalumab and oleclumab in specific disease states in NSCLC and RCC |
Measure: | Overall survival (OS) or progression-free survival (PFS) |
Time Frame: | 3 years |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Withdrawn |
Lead Sponsor: | University Health Network, Toronto |
Last Updated
November 17, 2020