Clinical Trials /

Dupilumab_Metastatic NSCLC

NCT05013450

Description:

This is an Phase Ib/2 study, single arm, single cohort study to determine the safety and tolerability of Dupilumab with PD-(L)1 blockade for patients with relapsed/refractory metastatic NSCLC. For Phase 2, to determine the effect of adding IL-4Ra blockade to PD-(L)1 blocking agents in patients with relapsed/refractory NSCLC, who have progressed on prior PD-(L)1 agents

Related Conditions:
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Not yet recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Dupilumab_Metastatic NSCLC
  • Official Title: A Phase 1b/2 Trial of Dupilumab Given in Conjunction With PD-1 or PD-L1 Blockade in the Treatment of Relapsed/Refractory Metastatic NSCLC

Clinical Trial IDs

  • ORG STUDY ID: STUDY-21-00907
  • NCT ID: NCT05013450

Conditions

  • Metastatic Non-small Cell Lung Cancer

Interventions

DrugSynonymsArms
DupilumabDupilumab + anti-PD-1/PD-L1 (SOC)
PD-1/PD-L1 blockadeDupilumab + anti-PD-1/PD-L1 (SOC)

Purpose

This is an Phase Ib/2 study, single arm, single cohort study to determine the safety and tolerability of Dupilumab with PD-(L)1 blockade for patients with relapsed/refractory metastatic NSCLC. For Phase 2, to determine the effect of adding IL-4Ra blockade to PD-(L)1 blocking agents in patients with relapsed/refractory NSCLC, who have progressed on prior PD-(L)1 agents

Trial Arms

NameTypeDescriptionInterventions
Dupilumab + anti-PD-1/PD-L1 (SOC)ExperimentalPatients will continue SOC immunotherapy with PD-1/PD-L1 blockade following progression of disease, and three q3w cycles of dupilumab will be administered
  • Dupilumab
  • PD-1/PD-L1 blockade

Eligibility Criteria

        Inclusion Criteria:

          -  Patients must have a pathologically confirmed diagnosis of NSCLC

          -  Patients must have progressed (clinically or radiographically) on or following prior
             therapy with a PD-1 or PD-L1 targeted antibody

          -  Patients may have only 0 or 1 intervening lines of therapy from the prior PD-(L)1
             blocking therapy

          -  Patient must be willing and able to provide blood samples (12 green-top tubes, roughly
             100mL) at the time points indicated in the Study Calendar.

          -  Patient must be willing and able to have core needle biopsies, or forceps biopsies if
             clinically feasible by (Goal 3-6 biopsies, final number to be determined by the
             interventionalist performing the procedure as safe) of tumor prior to initiation of
             dupilumab and at the on-treatment time point.

          -  Age ≥ 18 years.

          -  ECOG 0-2. The exception will be patients carrying long term disability (such as
             cerebral palsy) where the disability is not acute nor progressive, and unlikely to
             significantly affect their response to therapy.

          -  Women of child-bearing potential and men must agree to use adequate contraception
             prior to study entry, for the duration of study participation, and for 3 months
             following completion of therapy. Should a woman become pregnant or suspect she is
             pregnant while participating in this study, she should inform her treating physician
             immediately. A female of child-bearing potential is any woman (regardless of sexual
             orientation, having undergone a tubal ligation, or remaining celibate by choice) who
             meets the following criteria:

          -  Has not undergone a hysterectomy or bilateral oophorectomy; or

          -  Has not been naturally postmenopausal for at least 12 consecutive months

          -  Ability to understand and the willingness to sign a written informed consent.

        Exclusion Criteria:

          -  Patients who have had chemotherapy or radiotherapy within 14 days from start of
             therapy. Washout for palliative radiotherapy is 14 days.

          -  Patients may not be receiving any other investigational agents.

          -  Uncontrolled intercurrent illness including, but not limited to, ongoing or active
             infection requiring antibiotics (exception is a brief (≤10days) course of antibiotics
             to be completed before initiation of treatment), symptomatic congestive heart failure,
             unstable angina pectoris, or psychiatric illness/social situations that would limit
             compliance with study requirements.

          -  Patients must not be pregnant or nursing due to the potential for congenital
             abnormalities and the potential of this regimen to harm nursing infants.

          -  Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any
             other form of immunosuppressive therapy within 7 days prior to the first dose of trial
             treatment. Patients on chronic steroids (more than 4 weeks at stable dose) equivalent
             to ≤ 10mg prednisone will not be excluded.

          -  Has active autoimmune disease that has required systemic treatment in the past 1 year
             (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 acceptable.

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

          -  HIV positive with detectable viral load, or anyone not on stable anti-viral (HAART)
             regimen, or with <350 CD4+ T cells/microliter in the peripheral blood.

          -  Has known active Hepatitis B (e.g., HBV detected by PCR or active Hepatitis C (e.g.,
             HCV RNA [qualitative] is detected). Patients with hepatitis B (HepBsAg+) who have
             controlled infection (serum hepatitis B virus DNA PCR that is below the limit of
             detection AND receiving anti-viral therapy for hepatitis B) are permitted. Patients
             with controlled infections must undergo periodic monitoring of HBV DNA. Patients must
             remain on anti-viral therapy for at least 6 months beyond the last dose of
             investigational study drug.

          -  History of allogeneic hematopoietic cell transplantation or solid organ
             transplantation.

          -  Receipt of a live vaccine within 30 days of planned start of study medication

          -  Documented allergic or hypersensitivity response to any protein therapeutics (e.g.,
             recombinant proteins, vaccines, intravenous immune globulins, monoclonal antibodies,
             receptor traps)Principle investigator believes that for one or multiple reasons the
             patient will be unable to comply with all study visits, or if they believe the trial
             is not clinically in the best interest of the patient.

          -  History of irAE in response to prior immunotherapy that has not improved to a Grade 0
             or 1; this does not include endocrinopathies which can be treated with hormone
             replacement therapy.

          -  History of interstitial lung disease (e.g., idiopathic pulmonary fibrosis, organizing
             pneumonia) or active, noninfectious pneumonitis attributed to prior use of cancer
             immunotherapy that required immune-suppressive doses of glucocorticoids to assist with
             management. A history of radiation pneumonitis in the radiation field is permitted.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Dose Limiting Toxicity (DLTs)
Time Frame:9 weeks
Safety Issue:
Description:Phase 1: Dose Limiting Toxicity (DLTs) as defined based on the NCI Common Toxicity Criteria for Adverse Events (CTCAE), version 5.0.

Secondary Outcome Measures

Measure:Best overall response (BORR)
Time Frame:2 years
Safety Issue:
Description:Best overall response (BORR) will be a combined percent of the patients experiencing a partial response (PR) or a complete response (CR) at any point within the first year from the initiation of therapy, or until the documented progression of disease or start of a new anti-cancer therapy. Best overall response (BORR) will be a combined percent of the patients experiencing a partial response (PR) or a complete response (CR) at any point within the first year from the initiation of therapy, or until the documented progression of disease or start of a new anti-cancer therapy.
Measure:Progression-free survival (PFS)
Time Frame:2 years
Safety Issue:
Description:Progression-free survival (PFS) is defined as the time in days from the first administration of dupilumab until documented progression of disease on imaging or death Defined as the time in days from the first administration of dupilumab until documented progression of disease on imaging or death
Measure:Overall Survival (OS)
Time Frame:2 years
Safety Issue:
Description:Overall survival (OS) is defined as the time in days from the first administration of dupilumab until documented death from any cause.
Measure:Duration of response (DOR)
Time Frame:2 years
Safety Issue:
Description:Duration of response (DOR) is defined as the time from which a patient achieves either a PR or a CR until subsequent progression of disease is documented radiographically or clinically. Defined as the time from which a patient achieves either a PR or a CR until subsequent progression of disease is documented radiographically or clinically.

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Not yet recruiting
Lead Sponsor:Thomas Marron

Last Updated

August 19, 2021