BI-1607 in Combination With Trastuzumab in Subjects With HER2-positive Advanced Solid Tumors

HER2-positive Breast Cancer Clinical Trial

— CONTRAST  

Official title:

Phase 1/2a Open-label Clinical Trial of BI-1607, an Fc-Engineered Monoclonal Antibody to CD32b (FcγRIIB), in Combination With Trastuzumab in Subjects With HER2-positive Advanced Solid Tumors

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT05555251
• Other study ID #: 21-BI-1607-01
• Status: Active, not recruiting
• Phase: Phase 1/Phase 2
• Start date: July 28, 2022
• Est. completion date: April 2024

Study information

• Verified date: February 2024
• Source: BioInvent International AB
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

HER2+ breast and gastric cancer patients' survival is significantly improved by trastuzumab alone or in combination with chemotherapy. However, many patients remain uncured and develop resistance to trastuzumab resulting in relapse or progression of the disease. BI-1607, a human immunoglobulin G1 (IgG1) monoclonal antibody (mAb) targets CD32b (Fc Gamma Receptor IIB), it is intended to enhance the efficacy and overcome resistance to existing cancer treatments such as trastuzumab.

This is a Phase 1/2a, first-in-human, open-label, multicenter, dose-escalation, consecutive-cohort study of BI-1607 in combination with trastuzumab in subjects with HER2+ advanced solid tumors whose tumor has progressed after standard therapy.

Description:

This is a Phase 1/2a, first-in-human, open-label, multicenter, dose-escalation, consecutive-cohort study of BI-1607 in combination with trastuzumab in subjects with HER2+ advanced solid tumors whose tumor has progressed after standard therapy.

The Phase 1 part of the trial is a dose escalation study of BI-1607 combined with trastuzumab in HER2+ advanced or metastatic solid tumors, the aim is to assess safety and tolerability and to determine the recommended phase II dose of BI-1607 in combination with trastuzumab.

The selected dose of BI-1607 will be studied in a subsequent Phase 2a part of the trial along with trastuzumab in 2 open-label, expansion cohorts of 15 evaluable subjects each. The first cohort will enroll subjects with locally advanced or metastatic HER2+ breast cancer, and the second will recruit subjects with HER2+ metastatic gastric or gastroesophageal junction adenocarcinoma. The aim of the phase 2a is to collect additional safety data to further support the recommended dose, and to detect early signs of clinical activity.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 18
• Est. completion date: April 2024
• Est. primary completion date: February 7, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Main Inclusion Criteria:

• Is willing and able to provide written informed consent for the trial.

• Is =18 years of age on day of signing informed consent.

• Has received standard of care or is intolerant to standard of care antineoplastic therapy. Subjects who are intolerant to trastuzumab cannot be enrolled in the study.

• Has at least 1 measurable disease lesion as defined by RECIST v1.1 criteria.

• Has a locally confirmed HER2+ tumor.

• Must have progressive disease after the last line of treatment. In addition, subjects must have received the following previous lines of treatment:

1. Prior lines of treatment including trastuzumab and chemotherapy.

2. At least one prior line of treatment with an antibody-drug conjugate (ADC) (eg, trastuzumab-emtansine [TDM-1, or trastuzumab-deruxtecan]).

Main Exclusion Criteria:

• Needs doses of prednisolone >10 mg daily (or equipotent doses of other corticosteroids) while on the trial other than as premedication.

• Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.

• Has cardiac or renal amyloid light-chain amyloidosis.

• Has had clinically significant lung disease requiring systemic corticosteroid treatment within the last 6 months of enrollment.

• Has an active, known, or suspected autoimmune disease.

• Is at high medical risk because of nonmalignant systemic disease including severe active infections on treatment with antibiotics, antifungals, or antivirals.

• Has presence of chronic graft versus host disease.

• Has had an allogenic tissue/solid organ transplant.

• Has uncontrolled or significant cardiovascular disease.

• Has a known additional malignancy of another type, except for adequately treated cone-biopsied carcinoma in situ (eg, breast carcinoma, cervical cancer in situ), adequately controlled superficial bladder cancer, and basal or squamous cell carcinoma of the skin.

• Has a diagnosis of primary or acquired immunodeficiency disorder or is taking any other form of immunosuppressive therapy.

Related Conditions & MeSH terms

• Adenocarcinoma
• Breast Neoplasms
• HER2-positive Breast Cancer
• HER2-positive Gastric Cancer
• HER2-positive Metastatic Breast Cancer
• Metastatic Gastric Adenocarcinoma
• Metastatic Gastroesophageal Junction Adenocarcinoma

Intervention

Drug:
• BI-1607
administered at different doses in Phase I by intravenous infusions every 3 weeks.
• BI-1607
administered at the recommended dose in Phase 2a by intravenous infusions every 3 weeks.
• Trastuzumab
administered at 8mg/kg for the first infusion and at 6mg/kg in subsequent infusions by intravenous infusions every 3 weeks.

Locations

Country	Name	City	State
Germany	Evang. Kliniken Essen-Mitte	Essen
Germany	Krankenhaus Nordwest	Frankfurt
Spain	Hospital Vall d'Hebron	Barcelona
Spain	Complejo hospitalario Ruber Juan Bravo	Madrid
United Kingdom	Churchill Hospital	Oxford
United Kingdom	Southampton General Hospital	Southampton

Sponsors (1)

Lead Sponsor	Collaborator
BioInvent International AB

Countries where clinical trial is conducted

Germany,  Spain,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Exploratory: investigate expression levels of Fc receptors, and other immunological markers on immune cells infiltrating the tumor	Expression levels of Fc receptors (eg, CD32b) and other markers of immunological activity using immunohistochemistry (IHC) and/or nucleotide-based assays using tissue samples	1 day
Other	Exploratory: investigate the genetic background of subjects with respect to FcgammaR isoforms and explore a potential correlation of the genetic background with clinical responses	Determination of Fcgamma receptor isoforms using nucleotide-based assays on genetic material extracted from whole blood	1 day
Other	Exploratory: explore any exposure-response and/or exposure-safety relationship between BI-1607 serum concentrations and clinical outcome	Correlation of BI-1607 PK and antitumor activity measures, as well as to safety measures of interest	1 day
Primary	Assessment of the safety and tolerability profile of BI-1607 in combination with trastuzumab	Adverse events (AEs) and serious adverse events (SAEs) (graded according to the National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] v5.0) and their causality in relation to BI-1607 or to the combination with trastuzumab	End of treatment visit or 30 days after last dose of study drug.
Primary	Identify Dose limiting toxicities, determine the maximum tolerate dose of BI-1607 and propose a recommended Phase 2 dose (RP2D) for evaluation of BI-1607 in combination with trastuzumab.	Occurrence of DLTs	22 days
Secondary	Assessment of the pharmacokinetic (PK) profile of BI-1607 when administered every 3 weeks in combination with trastuzumab	The PK parameters will include area under the serum concentration-time curve, maximum concentration, time to maximum concentration, and terminal half-life	90 days after the last dose of BI-1607
Secondary	Assessment of the immunogenicity of BI-1607 when administered in combination with trastuzumab	Antidrug antibody response to BI-1607 in blood serum	90 days after the last dose of BI-1607
Secondary	Assessment of the CD32b receptor occupancy (RO) of BI-1607 on B cells when administered in combination with trastuzumab	RO on circulating B lymphocytes	30 days after the last dose of BI-1607
Secondary	Assessment of the possible antitumor activity of BI-1607 in combination with trastuzumab	Best tumor response, objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, progression-free survival (PFS), time to response, duration of response (DOR) and OS	1 year after the last treatment