3BNC117-LS and 10-1074-LS Plus N-803 (bNAb+N-803)

Human Immunodeficiency Virus Clinical Trial

Official title:

An Open Label, Single Arm Study of the Safety and Antiretroviral Activity of Two Long-acting Broadly Neutralizing Antibodies Plus an IL-15 Superagonist in ART-treated Adults Living With HIV During Analytical Treatment Interruption

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05245292
• Other study ID #: MCA-1031 (ES38918)
• Secondary ID: 1U01AI145921
• Status: Recruiting
• Phase: Phase 1
• Start date: December 7, 2022
• Est. completion date: December 31, 2025

Study information

• Verified date: June 2024
• Source: Rockefeller University
• Contact: Recruitment Specialist
• Phone: 800-782-2737
• Email: rucares[@]rockefeller.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The proposed study is a phase 1, open label, single arm study to evaluate the safety and antiretroviral activity of the combination of two long-acting broadly neutralizing antibodies, 3BNC117-LS dosed once at 30 mg/kg and 10-1074-LS dosed once at 10 mg/kg, both intravenously (IV) at week 0, plus an IL-15 superagonist complex, N-803, dosed at 6 mcg/kg, subcutaneously (SC) at week 1 and then every 3 weeks for a total of 8 doses, in ART-treated adults living with HIV during analytical treatment interruption.

Description:

The proposed study is a phase 1, open label study of the safety and antiretroviral activity of the 3BNC117-LS plus 10-1074-LS broadly neutralizing antibody (bNAb) combination plus N-803, an IL-15 superagonist complex, in ART-treated individuals living with HIV during interruption of ART.

Thirty-six eligible participants will be enrolled sequentially and will be assigned to Group A or Group B after Monogram PhenoSense Assay results become available: Group A - participants with 3BNC117 and 10-1074 IC90 less or equal to 1 mcg/mL and MPI greater or equal to 98% by the Monogram PhenoSense assay using PBMCs; Group B - all other participants, including participants from whom the PhenoSense Assay (PBMC) does not yield a result.

Participants will discontinue ART on day 2 (2 days after the first antibody infusions) and will be followed for up to 72 weeks while off ART and for 12 weeks after ART is resumed.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 36
• Est. completion date: December 31, 2025
• Est. primary completion date: December 31, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

1. Male and females, age 18 to 70.

2. Confirmed HIV-1 infection.

3. On antiretroviral therapy with plasma HIV-1 RNA levels of < 50 copies/ml and no reported interruption of ART for 7 consecutive days or longer for at least 48 weeks, and < 20 copies/ml at screening.

NOTE: At least two Viral Load (VL) measurements within 48 weeks prior to the Step 0 screening visit must be available for review. A single plasma HIV-1 RNA > 50 copies/mL but < 200 copies/mL that is followed by an HIV-1 RNA <50 copies/mL is permitted.

4. Current CD4+ T cell counts > 450 cells/mcL, CD4+ T cell % = 15%, and CD4+ T cell count nadir of = 200 cells/mcL.

5. If on an NNRTI-based regimen, willing to switch to an integrase inhibitor-based regimen for at least 4 weeks prior to discontinuing ART.

6. For participants who can become pregnant (i.e., participants who have not been post-menopausal for at least 24 consecutive months, who have had menses within the preceding 24 months, or who have not undergone surgical sterilization, specifically hysterectomy and/or bilateral oophorectomy), negative pregnancy test at screening (Step 0) and within 48 hours prior to day 0 (Step 1 entry).

7. Participants who can become pregnant must agree to use two methods of contraception, one of which must be from the highly effective methods for contraception listed below. Barrier methods of contraception are permitted for the second method of contraception. Contraception must be used from 10 days prior to the first of the investigational products (IP), while receiving the IPs, for 12 months after the last IP dose and until ART is reinitiated and viral suppression is achieved.

8. Participants who can impregnate a partner and who are engaging in sexual activity that could lead to pregnancy must agree to use condoms from 10 days prior to the first dose of the investigational products (IP), while receiving the IPs, and for 12 months after the last IP dose to avoid impregnating a partner who can get pregnant.

9. Willingness to use barrier protection (male or female) during sexual activity during analytical treatment interruption (ATI) and until viral re-suppression for those who re-start ART.

Exclusion Criteria:

1. History of AIDS-defining illness within 3 years prior to enrollment.

2. History of systemic corticosteroids (e.g. an equivalent dose of prednisone of > 20 mg daily for > 14 days), immunosuppressive anti-cancer, interleukins, systemic interferons, systemic chemotherapy or other medications considered significant by the trial physician within the last 6 months.

3. Any clinically significant acute or chronic medical condition (e.g. such as autoimmune diseases, cirrhosis), other than HIV infection, that in the opinion of the investigator would preclude participation.

4. History of or current clinical atherosclerotic cardiovascular disease (ASCVD), as defined by 2013 ACC/AHA guidelines.

5. QTcF interval = 440 ms at screening.

6. Any history of an HIV-associated malignancy, including Kaposi's sarcoma, or any type of lymphoma or virus-associated cancers.

7. History of Progressive Multifocal Leukoencephalopathy (PML).

8. Active or recent non-HIV-associated malignancy requiring systemic chemotherapy or surgery in the preceding 36 months or for whom such therapies are expected in the subsequent 12 months;

9. Hepatitis B or C infection as indicated by the presence of Hepatitis B surface antigen (HBsAg) or hepatitis C virus RNA (HCV-RNA) in blood.

10. Participants with known hypersensitivity to any constituent of the investigational products.

11. Pregnancy or lactation.

12. ART initiated during acute infection (defined as p24, HIV NAAT, or HIV RNA PCR positive, and negative or indeterminate HIV antibody testing).

13. Receipt of cabotegravir-LA IM or rilpivirine-LA IM within 24 months prior to Step 1 study entry.

14. Known resistance to all drugs within two or more ARV drug classes.

15. Laboratory abnormalities in the parameters listed below:

• Absolute neutrophil count < 1,000 cells/microlitre;

• Hemoglobin < 10 gm/dL;

• Platelet count < 100,000 cells/microlitre;

• ALT > 1.5 x ULN;

• AST > 1.5 x ULN;

• Total bilirubin > 1.5 x ULN;

• eGFR < 60 mL/min/1.73m2;

16. Any history of receipt of therapeutic HIV vaccine or HIV monoclonal antibody therapy.

17. Participation in any clinical study of an investigational product within 12 weeks prior to study entry (day 0) or expected participation in such a study during this study.

Related Conditions & MeSH terms

• Acquired Immunodeficiency Syndrome
• HIV Infections
• Human Immunodeficiency Virus

Intervention

Drug:
• 3BNC117-LS
Intravenous infusion of 3BNC117-LS at 30 mg/kg
• 10-1074-LS
Intravenous infusion of 10-1074-LS at 10 mg/kg
• N803
Subcutaneous injections of N803 at 6 mcg/kg

Locations

Country	Name	City	State
United States	The Rockefeller University	New York	New York
United States	Weill Cornell Medicine, Cornell Clinical Trials Unit	New York	New York
United States	Perelman School of Medicine University of Pennsylvania	Philadelphia	Pennsylvania

Sponsors (4)

Lead Sponsor	Collaborator
Rockefeller University	National Institute of Allergy and Infectious Diseases (NIAID), University of Pennsylvania, Weill Medical College of Cornell University

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Plasma rebound virus sensitivity	The relationship between plasma rebound virus sensitivity to 3BNC117-LS and 10-1074-LS and serum levels of 3BNC117-LS and 10-1074-LS at the time of viral rebound.	48 weeks
Other	HIV-1 specific T cell immune response changes	Changes in HIV-1 specific T cell immune responses in peripheral blood, measured by assays such as polyfunctional intracellular cytokine staining (ICS) and viral inhibition assay before, during and after immunotherapy with 3BNC117-LS and 10-1074-LS in combination with N-803.	72 weeks
Other	Latent HIV-1 reservoir composition	Composition of the latent HIV-1 reservoir before and after immunotherapy with 3BNC117-LS and 10-1074-LS in combination with N-803 evaluated by Q4PCR or other appropriate assays that may become available.	72 weeks
Other	Neutralization sensitivity	Neutralization sensitivity by TZM/bl assay (IC50, IC80 and IC90) of representative viruses during ART and antibody suppression, and of plasma rebound viruses to 3BNC117 and 10-1074.	72 weeks
Primary	Treatment-related Grade 3 adverse events and serious adverse events	The number of participants with treatment-related solicited and unsolicited grade 3 and serious adverse events (including confirmed laboratory abnormalities), or premature study treatment discontinuation due to an adverse event (regardless of grade).	72 weeks
Primary	Any serious adverse events	The number of participants with serious adverse events, regardless of relationship to 3BNC117-LS, 10-1074-LS and N-803.	72 weeks
Primary	Dosing completion	The proportion of participants who complete dosing with 3BNC117-LS, 10-1074-LS and N-803.	24 weeks
Primary	Viral rebound before or at week 24 post withdrawing ART	The number of participants experiencing viral rebound, defined as confirmed HIV-1 RNA >200 copies/mL at or prior to week 24 of ART discontinuation.	24 weeks
Primary	ART not restarted by weeks 60 and 72	The proportion of participants who do not meet ART restart criteria by weeks 60 and 72.	72 weeks
Primary	ART not restarted when bNABs below threshold	The proportion of participants who do not meet ART restart criteria for 12 or more weeks after bNAbs are below a threshold of 10 mcg/ml.	72 weeks
Secondary	Treatment-related Grade 2 adverse events	The number of participants with treatment-related solicited and unsolicited grade 2 adverse events.	72 weeks
Secondary	Viral rebound through Step 2	The number of participants experiencing viral rebound, defined as confirmed HIV-1 RNA >200 copies/mL, through Step 2 of the study.	72 weeks
Secondary	Time from ART withdrawal to re-initiating ART	Time from ART withdrawal to virologic or immunologic criteria (i.e. viral load, CD4 cell count, or development of severe acute retroviral syndrome) to reinitiate ART.	72 weeks
Secondary	Viral rebound determined by Monogram assay	Time to viral rebound (confirmed HIV-1 RNA >200 copies/mL) across different 3BNC117-LS and 10-1074-LS IC90s cut points determined by the Monogram PhenoSense assay.	72 weeks
Secondary	Size of latent HIV-1 reservoir	Size of the latent HIV-1 reservoir, measured by IPDA and/or other appropriate assay, before, during (Step 1) and after dosing with 3BNC117-LS, 10-1074-LS and N-803 (Step 2), and after antibody concentrations have declined below a therapeutic threshold.	72 weeks
Secondary	Changes in HIV-1 specific T Cell immune responses	Changes in HIV-1 specific T cell immune responses in peripheral blood, measured by ELISPOT, before, during (Step 1) and after dosing with 3BNC117-LS, 10-1074-LS and N-803 (Step 2), and after antibody concentrations have declined below a therapeutic threshold.	72 weeks
Secondary	Half-life of 3BNC117-LS and 10-1074-LS	Half-life of 3BNC117-LS and 10-1074-LS, when administered in combination with N-803 to individuals with HIV during ART interruption.	72 weeks
Secondary	Anti-drug antibodies (ADA)	The proportion of individuals with treatment-induced ADA against each bNAb or N-803 and magnitude of the response.	72 weeks