First in Human Study of IMGN151 in Recurrent Endometrial Cancer and Recurrent, High-grade Serous Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancers

Endometrial Cancer Clinical Trial

Official title:

A Phase 1, First-in-Human, Open-Label, Dose-Escalation and Expansion Study of IMGN151 (Anti-FRα Antibody-drug Conjugate) in Adult Patients With Recurrent Endometrial Cancer and Recurrent, High-Grade Serous Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancers

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05527184
• Other study ID #: IMGN151-1001
• Status: Recruiting
• Phase: Phase 1
• Start date: January 11, 2023
• Est. completion date: December 30, 2025

Study information

• Verified date: February 2024
• Source: ImmunoGen, Inc.
• Contact: ImmunoGen, Inc.
• Phone: 781-895-0600
• Email: medicalinformation[@]immunogen.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

IMGN151-1001 is a Phase 1, first in human, open-label dose-escalation and expansion study in adult patients with recurrent endometrial cancer, recurrent, high-grade serous epithelial ovarian, primary peritoneal, or fallopian tube cancers.

Description:

This Phase 1 study is designed to characterize the safety, tolerability, PK, immunogenicity, and preliminary antitumor activity of IMGN151 in patients with recurrent endometrial cancer, or recurrent, high-grade serous epithelial ovarian cancer, primary peritoneal, or fallopian tube cancers. All patients will be, in the opinion of the investigator, appropriate for nonplatinum single-agent therapy for their next line of therapy.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 227
• Est. completion date: December 30, 2025
• Est. primary completion date: June 30, 2024
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Patients = 18 years of age

2. Patients must have an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1.

3. Dose-Escalation Phase: Patients must have a confirmed diagnosis of recurrent endometrial cancer or high-grade serous epithelial ovarian cancer (EOC), primary peritoneal, or fallopian tube cancer.

4. Expansion Phase: Patients must have a confirmed diagnosis of recurrent endometrial cancer or platinum-resistant, high-grade serous epithelial ovarian cancer (PROC), primary peritoneal, or fallopian tube cancer.

Note: Progression should be calculated from the date of the last administered dose of platinum therapy to the date of the radiographic imaging showing progression.

5. Prior anticancer therapy

1. For Expansion Phase: Patients must have recurrent endometrial cancer or patients with PROC must have received 1-4 prior systemic lines of therapy.

2. Neoadjuvant ± adjuvant therapies are considered 1 line of therapy.

3. Maintenance therapy (eg, bevacizumab or poly [ADP-ribose] polymerase [PARP] inhibitors) will be considered part of the preceding line of therapy (ie, not counted independently).

4. Therapy changed due to toxicity in the absence of progression will be considered part of the same line (ie, not counted independently).

5. Hormonal therapy will be counted as a separate line of therapy unless it was given as maintenance.

6. Evaluable lesions

1. Dose-Escalation Phase: Patients may have radiologically evaluable or nonevaluable disease.

2. Expansion Phase: Patients must have at least 1 lesion that meets the definition of measurable disease by RECIST v1.1 (radiologically measured by the investigator).

7. Patients must be willing to provide an archival tumor tissue block or slides or to undergo a procedure to obtain a new biopsy using a low-risk, medically routine procedure for retrospective IHC confirmation of FRa status.

8. Patients must have completed prior therapy within the specified times below:

1. Systemic antineoplastic therapy within 5 half-lives or 4 weeks (whichever is shorter) before the first dose of IMGN151

2. Focal radiation completed at least 2 weeks before the first dose of IMGN151

9. Patients must have stabilized or recovered (Grade 1 or baseline) from all prior therapy-related toxicities (except alopecia).

10. Patients must have completed any major surgery at least 4 weeks before the first dose of IMGN151 and have recovered or stabilized from the side effects of prior surgery before the first dose of IMGN151.

11. Patients must have adequate hematologic, liver, and kidney functions defined as follows:

1. Absolute neutrophil count (ANC) = 1.5 ×10 9/L (1500/µL) without granulocyte colony-stimulating factor (G-CSF) in the prior 10 days or long-acting white blood cell growth factors in the prior 20 days

2. Platelet count = 100 × 10 9/L (100,000/µL) without platelet transfusion in the prior 10 days

3. Hemoglobin = 9.0 g/dL without packed red blood cell transfusion in the prior 21 days

4. Estimated glomerular filtration rate (eGFR) = 60 mL/min/1.73 m2 or an estimated creatinine clearance of = 60 mL/min

5. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) = 3.0 × upper limit of normal (ULN)

6. Serum bilirubin = 1.5 × ULN (patients with documented diagnosis of Gilbert syndrome are eligible if total bilirubin < 3.0 × ULN)

7. Serum albumin = 2 g/dL

12. Patients must be willing and able to sign the informed consent form (ICF) and to adhere to the protocol requirements.

13. Females of childbearing potential (FOCBP) must agree to use highly effective contraceptive method(s) while on IMGN151 and for at least 3 months after the last dose.

14. FOCBP must have a negative serum pregnancy test at Screening and a negative serum or urine pregnancy test within 72 hours before the first dose of IMGN151.

Exclusion Criteria:

1. Patients with endometrioid, clear cell, mucinous, or sarcomatous histology, mixed tumors containing any of the above histologies, or low-grade/borderline ovarian tumor

2. Patients with prior wide-field radiotherapy affecting at least 20% of the bone marrow

3. Patients with > Grade 1 peripheral neuropathy per CTCAE v5.0

4. Patients with active or chronic corneal disorders, history of corneal transplantation, or active ocular conditions requiring ongoing treatment/monitoring, such as uncontrolled glaucoma, wet age-related macular degeneration requiring intravitreal injections, active diabetic retinopathy with macular edema, macular degeneration, presence of papilledema, and/or monocular vision

5. Patients with serious concurrent illness or clinically relevant active infection, including, but not limited to the following:

1. Active hepatitis B or C infection (whether or not on active antiviral therapy)

2. HIV infection in patients with CD4+ T-cell (CD4+) counts < 350 cells/µL

3. Active cytomegalovirus infection

4. Active COVID-19/SARS-CoV-2 infection. Although SARS-CoV-2 testing is not mandatory for study entry, testing should follow local clinical practice guidelines and standards

5. Any other concurrent infectious disease requiring IV antibiotics within 2 weeks before the first dose of IMGN151 Note: Testing at Screening is not required for the above infections unless clinically indicated.

6. Patients with a history of multiple sclerosis or other demyelinating disease and/or Lambert-Eaton syndrome (paraneoplastic syndrome)

7. Patients with clinically significant cardiac disease including, but not limited to, any of the following:

1. Myocardial infarction = 6 months before the first dose

2. Unstable angina pectoris

3. Uncontrolled congestive heart failure (New York Heart Association > class II)

4. Uncontrolled = Grade 3 hypertension (per CTCAE v5.0)

5. Uncontrolled cardiac arrhythmias

6. QTc interval > 470 ms

8. Patients with a history of hemorrhagic or ischemic stroke within 6 months before enrollment

9. Patients with a history of cirrhotic liver disease (Child-Pugh Class B or C)

10. Patients with evidence of pneumonitis on baseline imaging or patients with a previous clinical diagnosis of noninfectious interstitial lung disease (ILD), including noninfectious pneumonitis

11. Patients requiring use of folate-containing supplements (eg, folate deficiency)

12. Patients with prior hypersensitivity to monoclonal antibodies (mAb)

13. Females who are pregnant or breastfeeding

14. For Expansion Phase: Patients who received a prior FRa-targeting agent

15. Patients with untreated or symptomatic central nervous system metastases

16. Patients with a history of other malignancy within 3 years before enrollment Note:

Patients with tumors with a negligible risk for metastasis or death (eg, adequately controlled basal-cell carcinoma or squamous-cell carcinoma of the skin, or carcinoma in situ of the cervix or breast) are eligible.

17. Prior known hypersensitivity reactions to study drugs and/or any of their excipients

Related Conditions & MeSH terms

• Endometrial Cancer
• Endometrial Neoplasms
• Fallopian Tube Cancer
• Fallopian Tube Neoplasms
• Primary Peritoneal Carcinoma

Intervention

Drug:
• IMGN151
IMGN151 is an antibody-drug conjugate (ADC).

Locations

Country	Name	City	State
United States	University of Colorado Anschutz Cancer Pavilion	Aurora	Colorado
United States	MD Anderson Cancer Center	Houston	Texas
United States	UCLA	Los Angeles	California
United States	Tennessee Oncology Nashville	Nashville	Tennessee
United States	OU Health Stephenson Cancer Center	Oklahoma City	Oklahoma
United States	Florida Cancer Specialists	Sarasota	Florida

Sponsors (1)

Lead Sponsor	Collaborator
ImmunoGen, Inc.

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Determine Progression Free Survival (Escalation)	PFS (defined as the time from first dose of IMGN151 until investigator-assessed radiological PD or death, whichever occurs first)	Up to 1 year
Primary	Characterize Safety (Escalation)	Incidence of adverse events (AE), serious adverse events (SAEs), and DLTs	Up to 1 year
Primary	Define Recommended Phase 2 Dose (Escalation)	Definition of RP2D	Up to 1 year
Primary	Determine Objective Response Rate (Expansion)	ORR (which includes best response of CR or PR as assessed by the investigator)	Up to 3 years
Secondary	During dose escalation and expansion to characterize study drug concentration	Study drug concentration	There are 9 blood draw collection time points at Cycles 1 and 3, 3 blood draw time points at Cycles 2,4,5 and 6, and collection at every 3 cycles after cycle 6 until end of study (approximately up to 2 years). Each cycle is 21 days.
Secondary	During dose escalation and expansion to measure the concentration of anti-drug antibody	Anti-drug antibody	There are 2 collection time points at Cycles 1 and 3, 1 collection time point at Cycles 2, 4, 5 and 6, and and collection at every 3 cycles after cycle 6 until end of study (approximately up to 2 years). Each cycle is 21 days.
Secondary	During dose expansion describe the duration of response and progression-free survival	Time to disease progression	From screening to end of study (approximately up to 2 years) for each patient
Secondary	During dose escalation to describe the objective response rate and duration of response	Time to disease progression	From screening to end of study (approximately up to 2 years) for each patient
Secondary	During dose expansion measure incidence and severity of Treatment Emergent Adverse Events by CTCAE v5.0	Number of treatment emergent adverse events as assessed by CTCAE v5.0	From screening to end of study (approximately up to 2 years) for each patient