Clinical Trials /

Efficacy of Spartalizumab Across Multiple Cancer-types in Patients With PD1-high mRNA Expressing Tumors

NCT04802876

Description:

This is an open-label, single arm, non-randomized, multicenter phase II study to evaluate the efficacy of spartalizumab in monotherapy in metastatic patients with Programmed Death-1 (PD1)-high-expressing tumors.

Related Conditions:
  • Malignant Solid Tumor
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Efficacy of Spartalizumab Across Multiple Cancer-types in Patients With PD1-high mRNA Expressing Tumors
  • Official Title: Efficacy of Spartalizumab Across Multiple Cancer-types in Patients With PD1-high mRNA Expressing Tumors Defined by a Single and Pre-specified Cutoff

Clinical Trial IDs

  • ORG STUDY ID: ACROPOLI (SOLTI-1904)
  • NCT ID: NCT04802876

Conditions

  • MSI-H Colorectal Cancer
  • Melanoma
  • Anal Carcinoma
  • Mesothelioma
  • Triple Negative Breast Cancer
  • Lung Adenocarcinoma
  • Cholangiocarcinoma
  • Cervical Carcinoma
  • Kidney Clear Cell Carcinoma
  • Stomach Adenocarcinoma
  • Esophageal Adenocarcinoma
  • Uterine Endometrial Carcinoma
  • Head and Neck Squamous Cell Carcinoma
  • Sarcoma
  • Lung Squamous Cell Carcinoma
  • Bladder Carcinoma
  • Thyroid Carcinoma
  • Hepatocellular Carcinoma
  • Uveal Melanoma
  • HER2-positive Breast Cancer
  • Pancreatic Adenocarcinoma
  • Squamous Esophageal Carcinoma
  • Ovarian Serous Cystadenocarcinoma
  • Uterine Carcinosarcoma
  • Small Cell Lung Cancer
  • Hormone Receptor Positive / HER2-negative Breast Cancer
  • Lung Adenocarcinoma EGFR-mutated/ ALK Traslocation
  • Colorectal Adenocarcinoma
  • Prostate Adenocarcinoma
  • Carcinoma of Unknown Primary
  • Other Histology

Interventions

DrugSynonymsArms
SpartalizumabPDR001Spartalizumab (PDR001)

Purpose

This is an open-label, single arm, non-randomized, multicenter phase II study to evaluate the efficacy of spartalizumab in monotherapy in metastatic patients with Programmed Death-1 (PD1)-high-expressing tumors.

Detailed Description

      A molecular pre-screening will be performed to know PD1 messenger RNA (mRNA) expression
      levels on a tumor sample using the nCounter-based technology. This will be centrally
      performed at Hospital Clinic of Barcelona. If the tumor is PD1-high (Cohort 1), as defined by
      the pre-specified cutoff, patients (a total of 111) will receive spartalizumab 400 mg every
      four weeks. A cohort of 30 patients with PD1-low advanced solid tumors where the efficacy of
      PD1 inhibitors has been previously established (i.e. with a FDA or EMA monotherapy indication
      approved) will also be recruited (cohort 2).

      One of the aims of the study is to show the value of the biomarker independently of the tumor
      histology. Thus, a wide variety of cancer-types (30 different types) will be represented.
    

Trial Arms

NameTypeDescriptionInterventions
Spartalizumab (PDR001)Experimental400mg/intravenous every 28 days
  • Spartalizumab

Eligibility Criteria

        Inclusion Criteria:

          1. Male/female participants who are at least 18 years of age on the day of signing
             informed consent with histologically confirmed diagnosis of PD1 mRNA high-expression
             (cohort 1) or PD1 mRNA low-expression (cohort 2) determined on the tumor sample will
             be enrolled in this study. Enrollment of patients > 75 years of age is allowed after
             consultation and approval of the study medical monitor.

          2. Life expectancy > 3 months as per investigator opinion.

          3. The participant (or legally acceptable representative if applicable) provides written
             specific informed consent for the remaining screening tests and study procedures
             before inclusion in the trial.

          4. Have measurable disease based on RECIST 1.1. Lesions situated in a previously
             irradiated area are considered measurable if progression has been demonstrated in such
             lesions.

          5. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
             Evaluation of ECOG is to be performed within 10 days prior to the date of allocation.

          6. Have adequate organ function. Specimens must be collected within 10 days prior to the
             start of study treatment.

          7. Patients could have received any number of previous treatments other than immune
             checkpoint inhibitors.

          8. Treatment-related toxicities (except alopecia) must ≤ Grade 1 at the time of
             allocation according to CTCAE version 5.0.

        Exclusion Criteria:

          1. A Women of childbearing potential who has a positive urine pregnancy test within 72
             hours prior to allocation. If the urine test is positive or cannot be confirmed as
             negative, a serum pregnancy test will be required.

             Note: in the event that 72 hours have elapsed between the screening pregnancy test and
             the first dose of study treatment, another pregnancy test (urine or serum) must be
             performed and must be negative in order for subject to start receiving study
             medication.

          2. Has received prior therapy with an anti-PD1, anti-PDL1, or anti-PDL2 agent or with an
             agent directed to another stimulatory or co-inhibitory T-cell receptor.

          3. Has received prior systemic anti-cancer therapy, including investigational agents
             within 2 weeks. Medical Monitor could consider shorter interval for kinase inhibitors
             or other short half-life drugs prior to allocation.

             Note: Participants must have recovered from all AEs due to previous therapies to
             ≤Grade 1 or baseline according to CTCAE version 5.0 (except alopecia). Participants
             with ≤Grade 2 neuropathy may be eligible.

             Note: If participant received major surgery, they must have recovered adequately from
             the toxicity and/or complications from the intervention prior to starting study
             treatment.

          4. Has received prior radiotherapy within 2 weeks of start of study treatment.
             Participants must have recovered from all radiation-related toxicities, not require
             corticosteroids and not have had radiation pneumonitis. A 1-week washout is permitted
             for palliative radiation (≤2 weeks of radiotherapy) to non-CNS disease.

          5. Use of any live vaccines against infectious diseases within 4 weeks of initiation of
             study treatment.

          6. Is currently participating in or has participated in a study of an investigational
             agent or has used an investigational device within 2 weeks prior to the first dose of
             study treatment.

             Note: Participants who have entered the follow-up phase of an investigational study
             may participate as long as it has been 2 weeks after the last dose of the previous
             investigational agent.

          7. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
             (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of
             immunosuppressive therapy within 7 days prior to the first dose of study drug.

          8. Has a known additional malignancy that is progressing or has required active treatment
             within the past 3 years.

             Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of
             the skin or carcinoma in situ (e.g. breast carcinoma, cervical cancer in situ) that
             have undergone potentially curative therapy are not excluded.

          9. Patients with thymoma are not eligible. Patients with active CNS metastases and/or
             carcinomatous meningitis are not eligible. Subjects with up to three cerebral
             metastases are eligible, if all lesions are stable and have been definitively treated
             with stereotactic radiation therapy, surgery or gamma knife therapy with no evidence
             of disease progression for at least 4 weeks by repeat imaging (note that the repeat
             imaging should be performed during study screening), clinically stable and without
             requirement of steroid treatment for at least 14 days prior to first dose of study
             treatment.

         10. Has severe hypersensitivity (≥Grade 3) to Spartalizumab and/or any of its excipients.

         11. History of severe hypersensitivity reactions to other monoclonal antibodies, which in
             the opinion of the investigator may pose an increased risk of serious infusion
             reaction.

         12. Has active autoimmune disease that has required systemic treatment in the past 2 years
             (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive
             drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid
             replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a
             form of systemic treatment.

         13. Has a history of (non-infectious) pneumonitis that required steroids or has current
             pneumonitis.

         14. Has an active infection requiring systemic therapy.

         15. Has a known history of Human Immunodeficiency Virus (HIV).

         16. Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg]
             reactive) or known active Hepatitis C virus (defined as HCV RNA is detected)
             infection.

         17. Has a known history of active TBC (Bacillus Tuberculosis).

         18. Has a history or current evidence of any condition, therapy, or laboratory abnormality
             that might confound the results of the study, interfere with the subject's
             participation for the full duration of the study, or is not in the best interest of
             the subject to participate, in the opinion of the treating investigator.

         19. Has known psychiatric or substance abuse disorders that would interfere with
             cooperation with the requirements of the trial.

         20. Is pregnant or breastfeeding or expecting to conceive or father children within the
             projected duration of the study, starting with the screening visit through 150 days
             after the last dose of trial treatment.

         21. Women of child-bearing potential, defined as all women physiologically capable of
             becoming pregnant, unless they are using highly effective methods of contraception
             during dosing and for 150-days after stopping treatment with spartalizumab. Highly
             effective contraception methods include:

               1. Total abstinence (when this is in line with the preferred and usual lifestyle of
                  the subject). Periodic abstinence (e.g., calendar, ovulation, symptothermal,
                  post-ovulation methods) and withdrawal are not acceptable methods of
                  contraception.

               2. Female sterilization (have had surgical bilateral oophorectomy with or without
                  hysterectomy), total hysterectomy, or tubal ligation at least six weeks before
                  taking study treatment. In case of oophorectomy alone, only when the reproductive
                  status of the woman has been confirmed by follow up hormone level assessment.

               3. Male sterilization (at least 6 months prior to screening). The vasectomized male
                  partner should be the sole partner for that subject.

               4. Placement of a non-hormonal intrauterine device (IUD) or intrauterine system
                  (IUS) with a documented failure rate of less than 1% per year.

             Notes:

               -  Double-barrier contraception: condom and occlusive cap (diaphragm or
                  cervical/vault caps) with a vaginal spermicidal agent
                  (foam/gel/cream/suppository) are not considered highly effective methods of
                  contraception.

               -  Women are considered post-menopausal and not of child bearing potential if they
                  have had 12 months of natural (spontaneous) amenorrhea with an appropriate
                  clinical profile (i.e. age appropriate, history of vasomotor symptoms) or have
                  had surgical bilateral oophorectomy (with or without hysterectomy), total
                  hysterectomy, or tubal ligation at least six weeks ago. In the case of
                  oophorectomy alone, only when the reproductive status of the woman has been
                  confirmed by follow up hormone level assessment is she considered not of child
                  bearing potential.

         22. Sexually active males, unless they use a condom during intercourse while on treatment
             and for 150 days after stopping treatment with spartalizumab should not father a child
             in this period. A condom is required to be used by vasectomized men as well during
             intercourse in order to prevent delivery of the drug via semen.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall Response rate (ORR)
Time Frame:Until objective tumor response, on average 10 months
Safety Issue:
Description:Proportion of patients with best overall response of complete response (CR) or partial response (PR), as per local investigator´s assessment and according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria.

Secondary Outcome Measures

Measure:Clinical Benefit Rate (CBR) in patients with high mRNA PD1 expressing tumors (Cohort 1)
Time Frame:Until objective tumor response, on average 10 months
Safety Issue:
Description:Proportion of patients with a best overall response of CR, PR or an overall lesion response of Stable Disease (SD) or Non-PR/Non-progression disease (PD) lasting ≥ 24 weeks, based on local investigator´s assessment according to RECIST v1.1.
Measure:Progression free survival (PFS) in patients with high mRNA PD1 expressing tumors (Cohort 1)
Time Frame:From date of allocation to disease progression or death from any cause,whichever came first, assessed up to approximately 36 months
Safety Issue:
Description:Time from allocation to the first occurrence of disease progression, as determined locally by the investigator using RECIST v.1.1, or death from any cause, whichever occurs first.
Measure:Duration of response (DoR) in patients with high mRNA PD1 expressing tumors (Cohort 1)
Time Frame:From date of allocation to disease progression or death from any cause,whichever came first, assessed up to approximately 36 months
Safety Issue:
Description:Time from the first occurrence of a documented objective response to disease progression, as determined locally by the investigator through use of RECIST v.1.1, or death from any cause, whichever occurs first
Measure:Time to response (TtR) in patients with high mRNA PD1 expressing tumors (Cohort 1)
Time Frame:Until objective tumor response, on average 10 months
Safety Issue:
Description:Time from allocation to the first objective tumor response (tumor shrinkage of ≥30%) observed for patients who achieved a CR or PR.
Measure:Overall survival (OS) in patients with high mRNA PD1 expressing tumors (Cohort 1)
Time Frame:From date of allocation to death assessed up to approximately 36 months
Safety Issue:
Description:Time from allocation to death from any cause
Measure:PFS compared to PFS on prior line of therapy (pre-PFS) in patients with high mRNA PD1 expressing tumors (Cohort 1)
Time Frame:From date of allocation to disease progression or death from any cause,whichever came first, assessed up to approximately 36 months
Safety Issue:
Description:PFS on study treatment compared to PFS on prior line of therapy (pre-PFS).
Measure:ORR in patients with low mRNA PD1-expressing tumors (Cohort 2)
Time Frame:Until objective tumor response, on average 10 months
Safety Issue:
Description:Proportion of patients with best overall response of complete response (CR) or partial response (PR), as per local investigator´s assessment and according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria.
Measure:CBR in patients with low mRNA PD1 expressing tumors (Cohort 2)
Time Frame:Until objective tumor response, on average 10 months
Safety Issue:
Description:Proportion of patients with a best overall response of CR, PR or an overall lesion response of Stable Disease (SD) or Non-PR/Non-progression disease (PD) lasting ≥ 24 weeks, based on local investigator´s assessment according to RECIST v1.1.
Measure:PFS in patients with low mRNA PD1 expressing tumors (Cohort 2)
Time Frame:From date of allocation to disease progression or death from any cause,whichever came first, assessed up to approximately 36 months
Safety Issue:
Description:Time from allocation to the first occurrence of disease progression, as determined locally by the investigator using RECIST v.1.1, or death from any cause, whichever occurs first.
Measure:DoR in patients with low mRNA PD1 expressing tumors (Cohort 2)
Time Frame:From date of allocation to disease progression or death from any cause,whichever came first, assessed up to approximately 36 months
Safety Issue:
Description:Time from the first occurrence of a documented objective response to disease progression, as determined locally by the investigator through use of RECIST v.1.1, or death from any cause, whichever occurs first
Measure:TtR in patients with low mRNA PD1 expressing tumors (Cohort 2)
Time Frame:Until objective tumor response, on average 10 months
Safety Issue:
Description:Time from allocation to the first objective tumor response (tumor shrinkage of ≥30%) observed for patients who achieved a CR or PR.
Measure:OS in patients with low mRNA PD1 expressing tumors (Cohort 2)
Time Frame:From date of allocation to death assessed up to approximately 36 months
Safety Issue:
Description:Time from allocation to death from any cause
Measure:PFS compared to PFS on prior line of therapy (pre-PFS) in patients with low mRNA PD1 expressing tumors (Cohort 2)
Time Frame:From date of allocation to disease progression or death from any cause,whichever came first, assessed up to approximately 36 months
Safety Issue:
Description:PFS on study treatment compared to PFS on prior line of therapy (pre-PFS).
Measure:Incidence, seriousness, treatment-related and intensity of Treatment Emergent Adverse Events
Time Frame:During the whole treatment period (from baseline until patients' final treatment which is defined as the end of the Treatment Phase of the study, an average of 10 months
Safety Issue:
Description:Incidence, seriousness, treatment-related and intensity of Treatment Emergent Adverse Events (TEAEs) assessed by the NCI Common Terminology for Classification of Adverse Events (CTCAE) version 5, including dose reductions, delays and treatment discontinuations.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:SOLTI Breast Cancer Research Group

Trial Keywords

  • PD1
  • Immunotherapy

Last Updated

August 16, 2021