A Study of XMT-2056 in Advanced/Recurrent Solid Tumors That Express HER2

HER2-positive Breast Cancer Clinical Trial

Official title:

A Phase 1, First-in-Human, Dose Escalation and Expansion, Multicenter Study of XMT-2056 in Participants With Advanced/Recurrent Solid Tumors That Express HER2

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05514717
• Other study ID #: MER-XMT-2056-1
• Status: Recruiting
• Phase: Phase 1
• Start date: January 24, 2023
• Est. completion date: April 2027

Study information

• Verified date: April 2024
• Source: Mersana Therapeutics
• Contact: Janice Kim
• Phone: 617-715-8214
• Email: medicalinformation[@]mersana.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A Study of XMT-2056 in advanced/recurrent solid tumors that express HER2.

Description:

The first-in-human (FIH) study of XMT-2056 is a Phase 1, open-label study of XMT-2056 in previously treated patients with advanced/recurrent solid tumors expressing HER2. The XMT-2056 monotherapy trial will consist of dose escalation (DES) and expansion (EXP) parts.

DES will be the dose-finding portion of the study to assess the safety and tolerability of XMT-2056 and determine the maximum tolerated dose (MTD) and/or Recommended Phase 2 Dose (RP2D). The RP2D will be determined based on the totality of the clinical data, including safety and preliminary anti-tumor effect, PK, and relevant biomarker data.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 162
• Est. completion date: April 2027
• Est. primary completion date: April 2027
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Participant has recurrent or metastatic solid tumors with HER2 expression and has disease progression after treatment, is intolerant to treatment, or is contraindicated with available anti-cancer therapies known to confer benefit, based on investigator's judgement. Note: Participants must have HER2 positivity per the results of their most recent tumor tissue testing, defined as IHC 3+ or IHC 2+ in combination with in situ hybridization (ISH)+. Participants with ERBB2-activating mutations or ERBB2 gene amplification in the absence of HER2 positivity are considered ineligible.

• Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.

• Participant must have measurable disease as defined by RECIST version 1.1.

• Participant has fresh tumor biopsy tissue available for submission to central laboratory. If obtaining fresh tumor tissue is medically contraindicated, archival tumor tissue can be submitted following written approval of the request by the study Medical Monitor. Samples must be obtained after the participant's most recent HER2-targeting therapy unless determined to be medically contraindicated after discussion with the medical monitor.

Exclusion Criteria:

• • Participant is receiving immunosuppressive doses of systemic medications, (doses >10 mg/day prednisone or equivalent) that cannot be discontinued for at least 2 weeks before the first dose and during study drug treatment administration. Note: physiologic hormone replacement therapy is an exception.

• Participant has received prior treatment targeting STING pathway.

• Diagnosis of additional malignancy that required active treatment (including surgery, systemic therapy, and radiation) within the last 2 years, expect for adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the breast or the cervix. Participants with an additional malignancy that has a low risk for recurrence may be eligible after discussion with the study Medical Monitor.

• Participants have untreated CNS metastases (including new and progressive brain metastases), history of leptomeningeal metastasis, or carcinomatous meningitis.

1. Participants are eligible if CNS metastases are adequately treated and participants are neurologically stable for at least 2 weeks prior to enrollment.

2. In addition, participants must be either off corticosteroids, or on a stable/decreasing dose of = 10 mg prednisone daily (or equivalent).

Related Conditions & MeSH terms

• Breast Neoplasms
• HER2-positive Breast Cancer
• HER2-positive Gastric Cancer

Intervention

Drug:
• XMT-2056
XMT-2056 will be administered through a vein in your arm or port catheter (intravenously)

Locations

Country	Name	City	State
United States	Massachusetts General Hospital	Boston	Massachusetts
United States	The University of Texas MD Anderson Cancer Center	Houston	Texas
United States	Tennessee Oncology, PLLC	Nashville	Tennessee
United States	Memorial Sloan Kettering Cancer Center	New York	New York
United States	Stanford University Medical Center	Stanford	California

Sponsors (1)

Lead Sponsor	Collaborator
Mersana Therapeutics

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Frequency of dose-limiting toxicities (DLTs) associated with XMT-2056 during the first cycle of treatment (Dose Escalation)	Determine the maximum tolerated dose (MTD) of XMT-2056	15 months
Primary	Incidence of adverse events (Dose Escalation and Dose Expansion)	Assess the safety and tolerability of XMT-2056 by determining the number of patients with adverse events from date of first dose to 30 days post last dose.	3 years
Primary	Objective Response Rate (ORR) (Dose Expansion)	The percentage of patients with a best overall response of confirmed complete or partial response as assessed by the investigator per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1	3 years
Secondary	Objective Response Rate (ORR) (Dose Escalation)	The percentage of patients with a best overall response of confirmed complete or partial response as assessed by the investigator per Resist Evaluation Criteria in Solid Tumors (RECIST) version 1.1	3 years
Secondary	Duration of response (DOR) (Dose Escalation and Dose Expansion)	The time from when response criteria are first met until disease progression or death in participants who achieve a confirmed complete or partial response.	3 years
Secondary	Disease control rate (DCR) (Dose Escalation and Dose Expansion)	The percentage of patients who achieve a complete response, partial response or stable disease as the result of study treatment	3 years
Secondary	Time of maximum observed plasma concentration of XMT-2056 (Tmax) (Dose Escalation and Dose Expansion)	Assess the pharmacokinetics of XMT-2056	3 years
Secondary	Maximum observed plasma concentration of XMT-2056 (Cmax) (Dose Escalation and Dose Expansion)	Assess the pharmacokinetics of XMT-2056	3 years
Secondary	Area under the concentration-time curve of XMT-2056 (AUC) (Dose Escalation and Dose Expansion)	Assess the pharmacokinetics of XMT-2056	3 years
Secondary	Systemic clearance of XMT-2056 (Dose Escalation and Dose Expansion)	Assess the pharmacokinetics of XmT-2056 by measuring the rate at which the drug is eliminated from the body	3 years
Secondary	Apparent terminal elimination of half-life of XMT-2056 (Dose Escalation and Dose Expansion)	Assess the pharmacokinetics of XMT-2056	3 years
Secondary	Volume of Distribution (Dose Escalation and Dose Expansion)	Assess the pharmacokinetics of XMT-2056	3 years
Secondary	Trough concentration of XMT-2056 (Ctrough) (Dose Escalation and Dose Expansion)	Assess the pharmacokinetics of XMT-2056 by measuring the lowest concentration of drug before dosing	3 years
Secondary	Serum samples for analysis of XMT-2056 antidrug and neutralizing antibodies (ADA/nAb) (Dose Escalation and Dose Expansion)	Assess the development of antidrug antibodies (ADA) and neutralizing antibodies (nAB) to XMT-2056	3 years