Clinical Trials /

A Study of TAK-981 Given With Pembrolizumab in Participants With Select Advanced or Metastatic Solid Tumors

NCT04381650

Description:

TAK-981 is being tested in combination with pembrolizumab to treat participants who have select advanced or metastatic solid tumors. The study aims are to evaluate the safety, tolerability, and preliminary efficacy of TAK-981 in combination with pembrolizumab. Participants will be on this combination treatment for 21-day cycles. They will continue with this treatment for up to 24 months or until participants meet any discontinuation criteria.

Related Conditions:
  • Cervical Adenocarcinoma
  • Cervical Adenosquamous Carcinoma
  • Cervical Squamous Cell Carcinoma
  • Colorectal Carcinoma
  • Cutaneous Melanoma
  • Laryngeal Squamous Cell Carcinoma
  • Non-Squamous Non-Small Cell Lung Carcinoma
  • Oral Cavity Squamous Cell Carcinoma
  • Pharyngeal Squamous Cell Carcinoma
  • Small Cell Lung Carcinoma
  • Squamous Cell Lung Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Study of TAK-981 Given With Pembrolizumab in Participants With Select Advanced or Metastatic Solid Tumors
  • Official Title: A Phase 1b/2 Study of TAK-981 Plus Pembrolizumab to Evaluate the Safety, Tolerability, and Antitumor Activity of the Combination in Patients With Select Advanced or Metastatic Solid Tumors

Clinical Trial IDs

  • ORG STUDY ID: TAK-981-1502
  • SECONDARY ID: 2020-004325-23
  • NCT ID: NCT04381650

Conditions

  • Advanced or Metastatic Solid Tumors

Interventions

DrugSynonymsArms
TAK-981Dose Escalation: TAK-981 + Pembrolizumab (fixed dose)
PembrolizumabDose Escalation: TAK-981 + Pembrolizumab (fixed dose)

Purpose

TAK-981 is being tested in combination with pembrolizumab to treat participants who have select advanced or metastatic solid tumors. The study aims are to evaluate the safety, tolerability, and preliminary efficacy of TAK-981 in combination with pembrolizumab. Participants will be on this combination treatment for 21-day cycles. They will continue with this treatment for up to 24 months or until participants meet any discontinuation criteria.

Detailed Description

      The drug being tested in this study is called TAK-981. TAK-981 is being tested to treat
      people who have select advanced or metastatic solid tumors. The study will include a dose
      escalation phase and a dose expansion phase.

      The study will enroll approximately 242 patients, approximately 32 participants in the dose
      escalation phase 1 and approximately 76 to 210 participants in each of the 8 cohorts of dose
      expansion phase. Participants will receive escalating doses of TAK-981 and fixed dose of
      pembrolizumab until RP2D is determined:

      • Dose Escalation: TAK-981 + Pembrolizumab (fixed dose)

      Once RP2D is determined, participants of select advanced or metastatic solid tumors will
      receive TAK-981 in below defined cohorts in the expansion phase:

        -  Dose Expansion Phase: Cohort A: Non-squamous NSCLC

        -  Dose Expansion Phase: Cohort B: Cervical Cancer

        -  Dose Expansion Phase: Cohort C: MSS-CRC

        -  Dose Expansion Phase: Cohort D: Cutaneous Melanoma

        -  Dose Expansion Phase: Cohort E: Squamous NSCLC

        -  Dose Expansion Phase: Cohort F: Small Cell Lung Cancer

        -  Dose Expansion Phase: Cohort G: HNSCC

        -  Dose Expansion Phase: Cohort H: MSI-H/dMMR CRC

      This multi-center trial will be conducted worldwide. The overall time to participate in this
      study is 48 months. Participants will make multiple visits to the clinic, and
      progression-free survival follow-up for maximum up to 12 months after last dose of study
      drug.
    

Trial Arms

NameTypeDescriptionInterventions
Dose Escalation: TAK-981 + Pembrolizumab (fixed dose)ExperimentalEscalating doses of TAK-981 with starting dose of 40 mg, intravenous (IV) infusion, on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle and pembrolizumab 200 mg, IV infusion, as a fixed dose every 3 weeks in 21-day Treatment Cycle until RP2D is determined (for a maximum of 24 months).
  • TAK-981
  • Pembrolizumab
Dose Expansion Phase: Cohort A: Non-squamous NSCLCExperimentalTAK-981 at RP2D as IV infusion in participants with non-squamous non-small cell lung cancer (NSCLC) on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle up to disease progression or 24-months and pembrolizumab 200 mg IV infusion as a fixed dose every 3 weeks in 21-day Treatment Cycle for a maximum of 24 months.
  • TAK-981
  • Pembrolizumab
Dose Expansion Phase: Cohort B: Cervical CancerExperimentalTAK-981 at RP2D as IV infusion in participants with cervical cancer on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle up to disease progression or 24-months and pembrolizumab 200 mg IV infusion as a fixed dose every 3 weeks in 21-day Treatment Cycle for a maximum of 24 months.
  • TAK-981
  • Pembrolizumab
Dose Expansion Phase: Cohort C: MSS-CRCExperimentalTAK-981 at RP2D as IV infusion in participants with microsatellite stable colorectal cancer (MSS-CRC) on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle up to disease progression or 24-months and pembrolizumab 200 mg IV infusion as a fixed dose every 3 weeks in 21-day Treatment Cycle for a maximum of 24 months.
  • TAK-981
  • Pembrolizumab
Dose Expansion Phase: Cohort D: Cutaneous MelanomaExperimentalTAK-981 at RP2D as IV infusion in participants with Cutaneous melanoma on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle up to disease progression or 24-months and pembrolizumab 200 mg IV infusion as a fixed dose every 3 weeks in 21-day Treatment Cycle for a maximum of 24 months.
  • TAK-981
  • Pembrolizumab
Dose Expansion Phase: Cohort E: Squamous NSCLCExperimentalTAK-981 at RP2D as IV infusion in participants with Squamous non-small cell lung cancer (NSCLC) on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle up to disease progression or 24-months and pembrolizumab 200 mg IV infusion as a fixed dose every 3 weeks in 21-day Treatment Cycle for a maximum of 24 months.
  • TAK-981
  • Pembrolizumab
Dose Expansion Phase: Cohort F: Small Cell Lung CancerExperimentalTAK-981 at RP2D as IV infusion in participants with Small cell lung cancer on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle up to disease progression or 24-months and pembrolizumab 200 mg IV infusion as a fixed dose every 3 weeks in 21-day Treatment Cycle for a maximum of 24 months.
  • TAK-981
  • Pembrolizumab
Dose Expansion Phase: Cohort G: HNSCCExperimentalTAK-981 at RP2D as IV infusion in participants with head and neck squamous cell carcinoma (HNSCC) on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle up to disease progression or 24-months and pembrolizumab 200 mg IV infusion as a fixed dose every 3 weeks in 21-day Treatment Cycle for a maximum of 24 months.
  • TAK-981
  • Pembrolizumab
Dose Expansion Phase: Cohort H: MSI-H/dMMR CRCExperimentalTAK-981 at RP2D as IV infusion in participants with microsatellite instability, high levels/ mismatch-repair-deficient colorectal cancer ( MSI-H/dMMR CRC) on Days 1, 4, 8 and 11 or Days 1 and 8 or Days 1, 8 and 15 in each 21-day Treatment Cycle up to disease progression or 24-months and pembrolizumab 200 mg IV infusion as a fixed dose every 3 weeks in 21-day Treatment Cycle for a maximum of 24 months.
  • TAK-981
  • Pembrolizumab

Eligibility Criteria

        Inclusion Criteria:

          1. Has a histologically or cytologically documented, advanced (metastatic and/or
             unresectable) cancer as listed below that is incurable: Note: Prior neoadjuvant or
             adjuvant therapy included in initial treatment may not be considered first- or
             later-line standard of care treatment unless such treatments were completed less than
             12 months prior to the current tumor recurrence.

             A. Non-squamous NSCLC for which prior standard first-line treatment containing an
             anti-programmed cell death protein 1/programmed cell death protein 1 ligand
             (PD-1/PD-L1) checkpoint inhibitor (CPI) alone or in combination has failed and that
             has progressed to no more than 1 prior systemic therapy. In Phase 2, participants with
             non-squamous NSCLC must have not received more than 1 prior systemic therapy and must
             not have presented with disease progression during the first 5 months of treatment
             with first-line CPI/anti-PD-(1/L1)-containing therapy.

             Note: In Phase 1, participants with non-squamous NSCLC and known driver
             mutations/genomic aberrations (eg, EGFR, B-Raf proto-oncogene mutation V600E [BRAF
             V600E], and ROS proto-oncogene 1 [ROS1] sensitizing mutations, neurotrophic receptor
             tyrosine kinase [NRTK] gene fusions, and anaplastic lymphoma kinase [ALK]
             rearrangements) must have also shown progressive disease after treatment with a
             commercially available targeted therapy. In Phase 2, participants with driver
             mutations are not eligible.

             B. CPI-naive cervical cancer (squamous cell carcinoma, adenosquamous carcinoma or
             adenocarcinoma of the cervix) participants for whom prior standard first-line
             treatment has failed and who have received no more than 1 prior systemic line of
             therapy for recurrent or Stage IVB cervical cancer. Note: The following cervical
             tumors are not eligible: minimal deviation/adenoma malignum, gastric-type
             adenocarcinoma, clear-cell carcinoma, and mesonephric carcinoma. Histologic
             confirmation of the original primary tumor is required via pathology report. Note:
             First-line treatment must have consisted of platinum-containing doublet. Chemotherapy
             administered concurrently with primary radiation (e.g., weekly cisplatin) is not
             counted as a systemic chemotherapy regimen.

             C. CPI-naïve microsatellite stable-colorectal cancer (MSS-CRC) participants for whom
             prior standard first-line treatment has failed and who have progressed on no more than
             3 chemotherapy regimens.

             Note: Participants must have received prior treatment with fluoropyrimidine-,
             oxaliplatin-, and irinotecan-containing regimens if indicated.

             D. Unresectable Stage III or Stage IV cutaneous melanoma that has not received prior
             therapy with a CPI in the metastatic setting.

             E. Squamous NSCLC for which prior standard first-line treatment containing an
             anti-PD-(1/L1) checkpoint inhibitor alone or in combination has failed. Participant
             must have not received more than 1 prior systemic therapy and must not have presented
             with disease progression during the first 5 months of treatment with first-line
             CPI/anti-PD-(1/L1)-containing therapy.

             F. SCLC that has progressed during or after first-line platinum-based chemotherapy
             regimen or equivalent if platinum-based therapy is contraindicated.

             G. HNSCC (oral cavity, pharynx, larynx) not amenable to local therapy with curative
             intent that has progressed:

               -  Within 6 months of the last dose of platinum therapy in the adjuvant (ie, with
                  radiation after surgery) or primary (ie, with radiation) settings, or

               -  On or after 1 prior systemic immune CPI/anti-PD-(1/L1)-containing therapy in the
                  metastatic setting. HNSCC participant must have not received more than 1 prior
                  systemic therapy and must not have presented with disease progression during the
                  first 5 months of treatment with first-line CPI/anti-PD-(1/L1)-containing
                  therapy. H. Treatment-naïve MSI-H/dMMR CRC.

          2. Has at least 1 radiologically measurable lesion based on RECIST, Version 1.1. Tumor
             lesions situated in a previously irradiated area are considered measurable if
             progression has been demonstrated in such lesions.

          3. Has a performance status of 0 or 1 on the Eastern Cooperative Group Oncolgy (ECOG)
             Performance Scale.

          4. Has left ventricular ejection fraction (LVEF) ≥40%; as measured by echocardiogram
             (ECHO) or multiple-gated acquisition (MUGA) scan.

          5. Has recovered to Grade 1 or baseline from all toxicity associated with previous
             therapy or have the toxicity established as sequela. Note: Has a neuropathy ≤Grade 2,
             any grade alopecia, or autoimmune endocrinopathies with stable replacement therapy are
             permitted.

          6. Demonstrate adequate organ function as described below:

        A. Platelet count ≥75.0 × 10^9/L. B. Absolute neutrophil count (ANC) ≥1.0 × 10^9/L. C.
        Hemoglobin ≥85 g/L (red blood cell [RBC] transfusion allowed ≥14 days before assessment).

        D. Estimated creatinine clearance using the Cockcroft-Gault formula ≥45 mL/minute for
        participants with serum creatinine concentrations above the upper limit of normal (ULN).

        E. Aspartate aminotransferase (AST, GOT) and alanine aminotransferase (ALT, GPT) ≤3.0 ×
        ULN; bilirubin ≤1.5 × ULN. Participants with Gilbert's syndrome may have a bilirubin level
        >1.5 × ULN, per discussion between the investigator and the medical monitor.

        Exclusion Criteria:

          1. Received extended field radiotherapy ≤4 weeks before the start of treatment (≤7 days
             for limited field radiation for palliation outside the chest or brain).

          2. History of uncontrolled brain metastasis (evidence of progression by imaging over a
             period of 4 weeks and/or neurologic symptoms that have not returned to baseline).
             Participant with treated brain metastases are allowed provided they are radiologically
             stable, without evidence of progression for at least 4 weeks by repeat imaging,
             clinically stable, and without requirement of steroid treatment for at least 14 days
             prior to first dose of study treatment. Note: For asymptomatic participants, screening
             brain imaging is not required.

          3. Second malignancy within the previous 3 years, except treated basal cell or localized
             squamous skin carcinomas, localized prostate cancer, cervical carcinoma in situ,
             resected colorectal adenomatous polyps, breast cancer in situ, or other malignancy for
             which the participant is not on active anticancer therapy.

          4. Major surgery ≤14 days from the first dose of study drug and not recovered fully from
             any complications from surgery.

          5. History of immune-related adverse events (AEs) related to treatment with immune CPIs
             that required treatment discontinuation.

          6. Receiving or requires the continued use of medications that are known to be strong or
             moderate inhibitors and inducers of cytochrome P-450 (CYP) 3A4/5. To participate in
             this study, such participant should discontinue use of such agents for at least 2
             weeks (1 week for CYP3A4/5 and Pgp inhibitors) before receiving a dose of TAK-981.

          7. Had received any live vaccine (e.g., varicella, pneumococcus) within 4 weeks of
             initiation of study treatment.

          8. Baseline prolongation of the QT interval corrected using Fridericia's formula (QTcF)
             (eg, repeated demonstration of QTcF interval >480 ms, history of congenital long QT
             syndrome, or torsades de pointes).

          9. Has a history of autoimmune disease requiring systemic immunosuppressive therapy with
             daily doses of prednisone >10 mg/day or equivalent doses, or any other form of
             immunosuppressive therapy. Hormone therapy (e.g., thyroxine, insulin, or physiologic
             corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not
             considered an excluded form of systemic treatment of an autoimmune disease.

         10. Has a history of noninfectious pneumonitis that required steroids or a history of
             interstitial lung disease.

         11. Has an evidence of active, non-infectious pneumonitis.

         12. Has a history of allogeneic tissue or solid organ transplant.

         13. Has an active infection requiring systemic therapy.

         14. Has a known history of HIV infection or any other relevant congenital or acquired
             immunodeficiency.

         15. Has a known hepatitis B virus surface antigen seropositive or detectable hepatitis C
             infection viral load. Note: Participants who have positive hepatitis B core antibody
             or hepatitis B surface antigen antibody can be enrolled but must have an undetectable
             hepatitis B viral load.

        16. History of any of the following ≤6 months before first dose: congestive heart failure
        New York Heart Association Grade III or IV, unstable angina, myocardial infarction,
        unstable symptomatic ischemic heart disease, uncontrolled hypertension despite appropriate
        medical therapy, ongoing symptomatic cardiac arrhythmias >Grade 2, pulmonary embolism or
        symptomatic cerebrovascular events, or any other serious cardiac condition (eg, pericardial
        effusion or restrictive cardiomyopathy). Chronic atrial fibrillation on stable
        anticoagulant therapy is allowed.

        17. Psychiatric illness/social circumstances that would limit compliance with study
        requirements and substantially increase the risk of AEs or has compromised ability to
        provide written informed consent.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Phase 1: Number of Participants With One or More Treatment Emergent Adverse Events (TEAEs)
Time Frame:Up to 48 months
Safety Issue:
Description:An AE is any untoward medical occurrence in a participant administered a medicinal investigational drug. The untoward medical occurrence does not necessarily have to have a causal relationship with treatment. A TEAE is defined as an AE that occurs after administration of first dose of study drug and through 30 days after last dose of study drug or until start of subsequent antineoplastic therapy. AEs will be evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), v5.0 except cytokine release syndrome (CRS), will be graded according to American society for transplantation and cellular therapy (ASCST) Consensus Grading for CRS.

Secondary Outcome Measures

Measure:Phase 1: Cmax: Maximum Observed Plasma Concentration for TAK-981
Time Frame:Cycle 1 (each cycle is 21 days) Days 1, 4, 8 and 11, pre-dose and at multiple timepoints (Up to 24 hours) post-dose; Cycle 2, Days 1 and 8, at multiple time points post-dose.
Safety Issue:
Description:
Measure:Phase 1: Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for TAK-981
Time Frame:Cycle 1 (each cycle is 21 days) Days 1, 4, 8 and 11, pre-dose and at multiple timepoints (Up to 24 hours) post-dose; Cycle 2, Days 1 and 8, at multiple time points post-dose.
Safety Issue:
Description:
Measure:Phase 1: AUCt: Area Under the Plasma Concentration-time Curve from Time 0 to Time t Over the Dosing Interval for TAK-981
Time Frame:Cycle 1 (each cycle is 21 days) Days 1, 4, 8 and 11, pre-dose and at multiple timepoints (Up to 24 hours) post-dose; Cycle 2, Days 1 and 8, at multiple time points post-dose.
Safety Issue:
Description:
Measure:Phase 1: AUC∞: Area Under the Plasma Concentration-time Curve from Time 0 to Infinity for TAK-981
Time Frame:Cycle 1 (each cycle is 21 days) Days 1, 4, 8 and 11, pre-dose and at multiple timepoints (Up to 24 hours) post-dose; Cycle 2, Days 1 and 8, at multiple time points post-dose.
Safety Issue:
Description:
Measure:Phase 1: t1/2z: Terminal Disposition Phase Half-life for TAK-981
Time Frame:Cycle 1 (each cycle is 21 days) Days 1, 4, 8 and 11, pre-dose and at multiple timepoints (Up to 24 hours) post-dose; Cycle 2, Days 1 and 8, at multiple time points post-dose.
Safety Issue:
Description:
Measure:Phase 1: CL: Total Clearance After Intravenous Administration for TAK-981
Time Frame:Cycle 1 (each cycle is 21 days) Days 1, 4, 8 and 11, pre-dose and at multiple timepoints (Up to 24 hours) post-dose; Cycle 2, Days 1 and 8, at multiple time points post-dose.
Safety Issue:
Description:
Measure:Phase 1: Vss: Volume of Distribution at Steady State After Intravenous Administration for TAK-981
Time Frame:Cycle 1 (each cycle is 21 days) Days 1, 4, 8 and 11, pre-dose and at multiple timepoints (Up to 24 hours) post-dose; Cycle 2, Days 1 and 8, at multiple time points post-dose.
Safety Issue:
Description:
Measure:Phases 1 and 2: ORR as Defined by the Investigator According to iRECIST Modification
Time Frame:Up to 48 months
Safety Issue:
Description:
Measure:Phases 1 and 2: Disease Control Rate (DCR)
Time Frame:Up to 48 months
Safety Issue:
Description:DCR is defined as the percentage of participants who achieve stable disease (SD) or better (CR+PR+SD determined by the investigator) during the study.
Measure:Phases 1 and 2: Durable Response Rate (DRR)
Time Frame:Up to 48 months
Safety Issue:
Description:DRR is defined as the rate of objective responses (CR + PR) maintained for at least 6 months initiating at any time within 12 months of commencing therapy.
Measure:Phases 1 and 2: Duration of Response (DOR)
Time Frame:Up to 48 months
Safety Issue:
Description:DOR is defined as a time from the time of first documentation of tumor response to the first recorded occurrence of disease progression (PD) or death from any cause (whichever occurs first), through end of study (up to approximately 48 months).
Measure:Phases 1 and 2: Progression-free Survival (PFS)
Time Frame:Up to 48 months
Safety Issue:
Description:PFS is defined as time from the date of the first dose administration to the date of first documentation of PD or death due to any cause whichever occurs first, through the end of the study (up to approximately 48 months).
Measure:Phases 1 and 2: Time to Response (TTR)
Time Frame:Up to 48 months
Safety Issue:
Description:TTR is defined as time from the date of the first dose administration to the date of first documented PR or better (up to approximately 48 months).
Measure:Phases 1 and 2: Time to Progression (TTP)
Time Frame:Up to 48 months
Safety Issue:
Description:TTP is defined as the from the date of the first dose administration to the date of the first documentation of PD as defined by standard disease criteria.
Measure:Phase 2: Overall Survival (OS)
Time Frame:Up to 48 months
Safety Issue:
Description:OS is defined as the time from the date of the first dose administration to the date of death. Participants without documentation of death at the time of analysis will be censored at the date last known to be alive.
Measure:Phase 1: Percentage of Participants at Each Dose Level Demonstrating Adduct Formation in Blood
Time Frame:Up to 48 months
Safety Issue:
Description:TAK-981-SUMO adduct formation in blood will be evaluated.
Measure:Phase 1: Percent Change in Small Ubiquitin-like Modifier (SUMO) 2/3 Signal With Pre and Post-dose in Blood
Time Frame:Up to 48 months
Safety Issue:
Description:SUMO pathway inhibition in blood will be evaluated.
Measure:Phase 2: Percentage of Participants With One or More Treatment Emergent Adverse Events (TEAEs)
Time Frame:Up to 48 months
Safety Issue:
Description:
Measure:Phase 2: Number of Participants With Grade 3 or Higher Treatment Emergent Adverse Events (TEAEs)
Time Frame:Up to 48 months
Safety Issue:
Description:
Measure:Phase 2: Number of Participants with One or More TEAEs Leading to Dose Modifications and Treatment Discontinuation
Time Frame:Up to 48 months
Safety Issue:
Description:

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Takeda

Trial Keywords

  • Drug therapy

Last Updated

July 19, 2021