Clinical Trials /

Intrahepatic Delivery of SD-101 by Pressure-Enabled Regional Immuno-oncology (PERIO), With Checkpoint Blockade in Adults With Metastatic Uveal Melanoma

NCT04935229

Description:

This study is an open-label, phase 1/1b study of the pressure-enabled hepatic artery infusion of SD-101, a TLR 9 agonist, alone or in combination with intravenous checkpoint blockade in adults with metastatic uveal melanoma.

Related Conditions:
  • Uveal Neoplasm
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Intrahepatic Delivery of SD-101 by Pressure-Enabled Regional Immuno-oncology (PERIO), With Checkpoint Blockade in Adults With Metastatic Uveal Melanoma
  • Official Title: A Phase 1/1b, Open-Label Study of the Pressure-Enabled Hepatic Artery Infusion of SD-101, a TLR9 Agonist, Alone or in Combination With Intravenous Checkpoint Blockade in Adults With Metastatic Uveal Melanoma

Clinical Trial IDs

  • ORG STUDY ID: TS-PERIO-01
  • NCT ID: NCT04935229

Conditions

  • Metastatic Uveal Melanoma in the Liver

Interventions

DrugSynonymsArms
SD-101SD-101
NivolumabOpdivoSD-101
IpilimumabYervoySD-101

Purpose

This study is an open-label, phase 1/1b study of the pressure-enabled hepatic artery infusion of SD-101, a TLR 9 agonist, alone or in combination with intravenous checkpoint blockade in adults with metastatic uveal melanoma.

Detailed Description

      In the Sentinel Cohort, patients will receive 2 SD-101 infusions (2 weeks apart) with
      assessments for toxicity prior to escalating from the first dose level (0.5 mg) to the second
      dose level (2 mg). In the absence of dose-limiting toxicities (DLTs), each patient will be
      eligible to transition into Cohort A.

      In Cohorts A-C and Phase 1b, patients will receive 2 cycles of SD-101. Each cycle consists of
      3 consecutive weekly infusions. Escalating doses of SD-101 will be administered alone (Cohort
      A), together with nivolumab (Cohort B), and together with combined ipilimumab and nivolumab
      (Cohort C). Cohorts B and C will begin one dose level below the MTD or optimal dose from
      Cohort A to optimize safety when adding CPI to SD-101.

      Following determination of the recommended MTD or optimal dose of SD-101 for PEDD/HAI and
      which checkpoint inhibitor (CPI) regimen(s) are tolerated, the study will progress to Phase
      1b. Patients in Phase 1b will receive the SD-101 dose selected from Phase 1 in the presence
      of systemic single- or double-agent checkpoint blockade. The choice of single- or
      double-agent CPI therapy together with SD-101 for Phase 1b will consider safety data in
      addition to response rates from Cohorts B and C in Phase 1.
    

Trial Arms

NameTypeDescriptionInterventions
SD-101Experimental3 weekly doses of SD-101 given via hepatic artery infusion over 2 cycles
  • SD-101
  • Nivolumab
  • Ipilimumab

Eligibility Criteria

        Inclusion Criteria:

          1. Male or female, age ≥18 years of age at screening

          2. Able to understand the study and provide written informed consent prior to any study
             procedures

          3. Has histologically or cytologically confirmed metastatic UM with liver-only or liver
             dominant disease. Liver-dominant disease will be defined as:

               1. Phase 1, Cohort A - Intrahepatic metastases representing the largest fraction of
                  disease relative to other organs, with permissible extrahepatic sites being the
                  lungs, skin or subcutaneous tissues, and bone.

               2. Phase 1, Cohorts B and C and Phase 1b - Intrahepatic metastases representing the
                  largest fraction of disease relative to other organs, or if progression of LM
                  represent a significant threat to the patient's life.

          4. Has not received prior cytotoxic chemotherapy, targeted therapy, or external radiation
             therapy within 14 days prior to enrollment

          5. Phase 1 only: Has not received therapy with prior immunological checkpoint blockade
             within 30 days before the first dose of study intervention and has no ongoing
             immune-mediated AEs Grade 2 or higher Phase 1b only: Has not ever received therapy
             with prior immunological checkpoint blockade

          6. Has not ever received prior embolic HAI therapy with permanent embolic material.

             Note: Prior surgical resection or radiofrequency ablation of oligometastatic liver
             disease is allowed on both the Phase 1 and Phase 1b portions of this study. Liver
             lesions that received ablative therapies should not be considered target lesions
             unless they have clearly progressed since the therapy.

          7. Has no prior history of or other concurrent malignancy unless the malignancy is
             clinically insignificant, no ongoing treatment is required, and the patient is
             clinically stable

          8. Has measurable disease in the liver according to RECIST v.1.1 criteria

          9. Has an ECOG PS of 0-1 at screening

         10. Has a life expectancy of >3 months at screening as estimated by the investigator

         11. Has a QTc interval ≤480 msec

         12. All associated clinically significant (in the judgment of the investigator)
             drug-related toxicity from previous cancer therapy must be resolved (to Grade ≤1 or
             the patient's pretreatment level) prior to study treatment administration (Grade 2
             alopecia and endocrinopathies controlled on replacement therapy are allowed).

         13. Has adequate organ function at screening as evidence by:

               -  Platelet count >100,000/μL

               -  Hemoglobin ≥8.0 g/dL

               -  White blood cell count (WBC) >2,000/μL

               -  Serum creatinine ≤2.0 mg/dL unless the measured creatinine clearance is ≥30
                  mL/min calculated by Cockcroft-Gault formula.

               -  Total and direct bilirubin ≤2.0 × the upper limit of normal (ULN) and alkaline
                  phosphatase ≤5 × ULN. For patients with documented Gilbert's disease, total
                  bilirubin up to 3.0 mg/dL is allowed.

               -  ALT and AST ≤5 × ULN

               -  Prothrombin time/International Normalized Ratio (INR) or activated partial
                  thromboplastin time (aPTT) test results at screening ≤1.5 × ULN (this applies
                  only to patients who do not receive therapeutic anticoagulation; patients
                  receiving therapeutic anticoagulation should be on a stable dose for at least 4
                  weeks prior to the first dose of study intervention) Note: Laboratory tests with
                  exclusionary results judged by the investigator as not compatible with the
                  patient's clinical status may be repeated once for eligibility purposes.

         14. Females of childbearing potential must be nonpregnant and nonlactating, or
             post-menopausal, and have a negative serum human chorionic gonadotropin (hCG)
             pregnancy test result at screening and prior to the first dose of study intervention.

               -  Females of childbearing potential must agree to abstain from sexual activity with
                  nonsterilized male partners, or if sexually active with a nonsterilized male
                  partner must agree to use highly effective methods of contraception from
                  screening, throughout the study and agree to continue using such precautions for
                  100 days after the final dose of study intervention.

               -  Nonsterilized males who are sexually active with a female of childbearing
                  potential must agree to use effective methods of contraception and avoid sperm
                  donation from Day 1 throughout the study and for 30 days after the final dose of
                  study intervention.

        Exclusion Criteria:

          1. Has received chemotherapy or an investigational agent within 14 days (or 5 half-lives,
             whichever is shorter) before screening

          2. Has active, untreated brain metastasis

          3. Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection.

          4. Has portal vein thrombosis, or severe portal hypertension as defined by a history of
             variceal hemorrhage or active ascites accumulation

          5. Has more than 2/3 parenchymal replacement by tumor of both liver lobes

          6. Phase 1 only:

               1. Has Child-Pugh Class B or C cirrhosis, or

               2. Has experienced a Grade 3 or higher immune-related AE from prior CPI therapy, or

               3. Is unable to be temporarily removed from chronic anticoagulation therapy, or

               4. Has a history of bleeding disorders

          7. Has active coronavirus disease 2019 (COVID 19), other severe infection, including a
             liver infection, within 2 weeks before the first dose of study drug, or uncontrolled
             human immunodeficiency virus (HIV) infection at screening

          8. Has had bacterial pneumonia within 8 weeks of first dose of study drug

          9. Has active, known, or suspected autoimmune disease or immune-mediated disease. Type I
             diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders
             (such as vitiligo, psoriasis or alopecia) not requiring systemic treatment or
             conditions not expected to recur in the absences of an external trigger are not
             exclusionary.

         10. Is receiving systemic steroid therapy >10 mg of prednisone daily or equivalent or any
             other immunosuppressive medication at any dose level. Local steroid therapies (e.g.,
             otic, ophthalmic, intra-articular or inhaled medications) are acceptable.

         11. Has significant concurrent or intercurrent illness, psychiatric disorder, or alcohol
             or chemical dependence that would, in the opinion of the Investigator and/or Medical
             Monitor, compromise their safety or compliance or interfere with interpretation of the
             study

         12. Lactating women are excluded from study participation

         13. Has previously received SD 101

         14. Medical history of significant hypersensitivity, severe and unresolved immune-mediated
             reactions, severe infusion-related reactions, or allergic reaction to TLR9 agonists or
             CPI agents in the judgment of the investigator

         15. Patients who were enrolled in the Phase 1 portion of the study will not be eligible
             for enrollment in Phase 1b
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Phase 1: To Determine the Safety of SD-101 Alone, in Combination with Nivolumab, and in Combination with Both Nivolumab and Ipilimumab
Time Frame:12 months
Safety Issue:
Description:As a measure of safety, adverse events will be graded according to CTCAE v5.0.

Secondary Outcome Measures

Measure:Phase 1: Determination of Single vs. Dual-agent CPI in Phase 1b using CTCAE v5.0
Time Frame:6 months
Safety Issue:
Description:The choice of single- or dual-agent CPI therapy together with SD-101 for Phase 1b will consider AEs/SAEs per CTCAE v5.0.
Measure:Phase 1: Determination of Single vs. Dual-agent CPI in Phase 1b using RECIST v1.1
Time Frame:6 months
Safety Issue:
Description:The choice of single- or dual-agent CPI therapy together with SD-101 for Phase 1b will consider response rates per RECIST v1.1 from Cohorts B and C in Phase 1.
Measure:Phase 1b: To Assess Treatment-Emergent Adverse Events of the Chosen MTD or Optimal Dose of SD-101 in Combination with CPI
Time Frame:6 months
Safety Issue:
Description:As a measure of safety, adverse events will be graded according to CTCAE v5.0.
Measure:Phase 1b: Assess Preliminary Efficacy in Terms of iRECIST for Immune Based Therapeutics
Time Frame:12 months
Safety Issue:
Description:As a measure of activity, iRECIST will be utilized to determine ORR.
Measure:Phase 1b: Assess Preliminary Efficacy in Terms of modified RECIST (mRECIST) for Immune Based Therapeutics
Time Frame:12 months
Safety Issue:
Description:As a measure of activity, mRECIST will be utilized to determine ORR.
Measure:Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
Time Frame:12 months
Safety Issue:
Description:As a measure of activity, RECIST 1.1 will be utilized to determine hepatic-specific response rate (HRR).
Measure:Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
Time Frame:12 months
Safety Issue:
Description:As a measure of activity, RECIST 1.1 will be utilized to determine duration of response (DOR).
Measure:Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
Time Frame:12 months
Safety Issue:
Description:As a measure of activity, RECIST 1.1 will be utilized to determine overall progression-free survival (PFS).
Measure:Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
Time Frame:12 months
Safety Issue:
Description:As a measure of activity, RECIST 1.1 will be utilized to determine clinical benefit (complete response [CR] + partial response [PR] + stable disease [SD]).

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:TriSalus Life Sciences, Inc.

Trial Keywords

  • Uveal Melanoma
  • Liver Metastases
  • TLR9
  • SD-101

Last Updated

August 9, 2021