Study of OB-002 in Patients With Refractory Metastatic Cancer

Metastatic Breast Cancer Clinical Trial

Official title:

A Phase 1b, Open-label, Non-randomized Trial for the Assessment of Safety, Tolerability, and Pharmacokinetics of OB-002 as a Monotherapy in Patients With Refractory Metastatic Colorectal, Pancreatic, Gastric, Breast, or Urothelial Cancer

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05940844
• Other study ID #: OB-002-101
• Status: Not yet recruiting
• Phase: Phase 1
• Start date: January 2024
• Est. completion date: August 2025

Study information

• Verified date: July 2023
• Source: Orion Biotechnology Polska Sp. z o.o.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is an open-label, non-randomized trial with OB-002 monotherapy dose escalation followed by a dose expansion in patients with metastatic colorectal, pancreatic, gastric, breast, or urothelial cancer who have progressed on two or more treatment regimens.

Description:

The dose escalation will use a conventional 3+3 approach, at a minimum of four planned dose levels (0.25, 0.5, 1.0, and 1.5 mg/kg), to establish a maximum tolerated dose (MTD). Additional dose levels may be investigated if PK, pharmacodynamic (PD), safety, and efficacy data indicate higher dose levels may be appropriate. The first patient - sentinel patient - at each dose level will be observed for three days before additional patients can be dosed within the same dose level. The patients will be dosed once weekly (Days 1, 8, 15, and 22) over a 4-week treatment cycle with a 28-day dose-limiting toxicity (DLT) observation period. After a full cohort has completed Day 28 assessments there will be a pause for safety evaluation conducted by the Safety Monitoring Committee (SMC). Once safety data have been reviewed, the SMC will make their recommendations to Orion who will decide whether to proceed to dosing the next dose cohort. Screening may continue during the SMC pause. Once all patients in the highest planned cohort (1.5 mg/kg OB 002) have completed Day 28 assessments, safety, PK, receptor occupancy (RO), and tolerability data will be reviewed to determine which dose level should be expanded or whether an additional dose level is needed. The expanded cohort will enrol 6 patients at the identified dose level. Patients may remain on treatment until disease progression with a follow-up (FU) period of up to 12 months. All adverse events (AEs) and non-invasive tumor assessments will be documented throughout the FU period to characterize the objective response rate (ORR) and, progression-free survival (PFS). Patients that do not complete the DLT observation period for non-DLT reasons will be replaced

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 36
• Est. completion date: August 2025
• Est. primary completion date: April 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Written informed consent.

2. Patients at least 18 years of age on the day of providing consent.

3. Patients with accessible metastatic lesions for repetitive biopsy retrieval.

4. Patients with histologically or cytologically confirmed metastatic colorectal, pancreatic, gastric, breast, or urothelial tumors who have progressed or were intolerant after two or more regimens and for whom no standard of care or curative therapy options are available.

5. Patients with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 within 7 days of the start of treatment

6. Patients with evaluable and measurable lesions as per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1

7. Patients with adequate organ function at the time of enrollment as defined below:

1. Neutrophil count =1500/mm3

2. Platelet count =7.5 × 105/mm3

3. Hemoglobin >9.0g/dL (transfusion >2 weeks before testing permitted)

4. Aspartate transaminase (AST), alanine transaminase (ALT) =2.5 × the upper limit of normal (ULN) (=5-times in patients with liver metastasis)

5. Total bilirubin =1.5 × ULN

6. Creatinine clearance >60 mL (determined by Cockcroft-Gault Equation)

7. International normalized ratio (INR) =1.5 × ULN and partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT)

8. In women with the potential for pregnancy (including patients with amenorrhea due to medical reasons, such as chemical menopause), after consenting to the study, the patient must agree to use contraception from enrollment and for at least 12 weeks after taking the final dose of the investigational drug. Women with the potential for pregnancy include those who have begun menstruation, who have not undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy, and who have not gone through menopause. Menopause is defined as the consecutive absence of menstrual periods for =12 months. Total abstinence is an acceptable mode of contraception.

9. In the case of men, the patient must agree after consenting to the study to use contraception from enrollment and for at least 13 weeks after taking the final dose of the investigational drug (a period of 90 days [the spermatogenesis cycle] is added to 5-times the elimination half-time of I/O agent. Total abstinence is an acceptable mode of contraception.

Exclusion criteria:

1. Unwilling to undergo biopsy retrieval during screening (unless an archival sample taken within 3 months before screening is available) and after the fourth infusion of OB-002

2. Patients who have undergone systemic chemotherapy, radiotherapy, surgery, or hormone therapy <28 days before enrollment, also see exclusion criterion #8. Note: Patients must have recovered from all AEs due to previous therapies to =Grade 1 or baseline. Patients with =Grade 2 neuropathy may be eligible. If patients received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting study treatment.

3. Patients with a history of CCR5 antagonist therapy (e.g., vicriviroc, maraviroc).

4. Patients with uncontrolled hypertension (systolic blood pressure =150 mmHg or diastolic blood pressure =90 mmHg) with treatment

5. QTc interval greater than 450 msec (males) or 470 msec (females)

6. Patients with acute coronary syndrome (including myocardial infarction and unstable angina), and with a history of coronary angioplasty or stent placement performed within 6 months before enrollment

7. Patients with a large amount of pleural effusion or ascites requiring more than weekly drainage

8. Patients with a history of (non-infectious) pneumonitis that required steroids or have current pneumonitis.

9. Patients with a =Grade 3 active infection according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0

10. Patients with symptomatic brain metastasis (1-week washout is permitted for palliative radiation (=2 weeks of radiotherapy) to non-central nervous system [CNS] disease)

11. Patients with partial or complete gastrointestinal obstruction

12. Patients with interstitial lung disease requiring treatment with systemic steroids or other agents

13. Patients who test positive for either anti-human immunodeficiency virus type 1 (HIV-1) antibodies, hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus (HCV) antibodies with a positive HCV RNA viral load test

14. Patients with concurrent autoimmune disease, or a history of chronic or recurrent autoimmune disease

15. Patients who require systemic corticosteroids equivalent to =10 mg prednisone (excluding temporary usage for tests, prophylactic administration for allergic reactions, or to alleviate swelling associated with radiotherapy) or immunosuppressants, or who have received such a therapy <14 days before enrollment in the present study

16. Patients with a history or findings of =Grade 3 congestive heart failure according to the New York Heart Association functional classification

17. Patients with a seizure disorder who require pharmacotherapy

18. Persistent proteinuria >3.5 g/24 hours measured by urine protein-creatinine ratio from a random urine sample (=Grade 3, NCI CTCAE v5.0)

19. Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation

20. Major surgical procedure or significant traumatic injury within 28 days before the start of study medication

21. Non-healing wound, non-healing ulcer, or non-healing bone fracture

22. Patients with evidence or history of any bleeding diathesis, irrespective of severity

23. Any hemorrhage or bleeding event =Grade 3 (NCI CTCAE v 5.0) within 4 weeks prior to the start of the study medication

24. Women who are pregnant or breastfeeding, or with the potential for pregnancy unwilling to undergo contraception

25. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of the study drug

Related Conditions & MeSH terms

• Metastatic Breast Cancer
• Metastatic Cancer
• Metastatic Colorectal Cancer
• Metastatic Gastric Cancer
• Metastatic Pancreatic Cancer
• Metastatic Urothelial Carcinoma
• Neoplasm Metastasis

Intervention

Drug:
• OB-002
The patients will be dosed once weekly (Days 1, 8, 15 and 22) over a 4-week treatment cycle with a 28 day dose-limiting toxicity (DLT) observation period.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Orion Biotechnology Polska Sp. z o.o.

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Exploratory: immunogenicity of OB-002	A number of patients developing antidrug antibodies (ADA) and the titers developed in these participants.	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Other	Exploratory: evaluation of receptor occupancy (RO) of OB-002 in blood	Percent of CCR5 receptors occupied by OB-002 in blood	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)
Other	Exploratory: evaluation of receptor occupancy (RO) of OB-002 in tumor	Percent of CCR5 receptors occupied by OB-002 in tumor biopsies	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)
Other	Exploratory: preliminary efficacy of OB-002 as monotherapy based on best overall response	Objective response rate (ORR): defined as the proportion of patients having best overall response (BOR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 by the investigator.	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months, assessed up to 12 months
Other	Exploratory: preliminary efficacy of OB-002 as monotherapy based on complete response	Objective response rate (ORR): defined as the proportion of patients having complete response (CR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 by the investigator.	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months, assessed up to 12 months
Other	Exploratory: preliminary efficacy of OB-002 as monotherapy based on partial response	Objective response rate (ORR): defined as the proportion of patients having a partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 by the investigator.	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months, assessed up to 12 months
Other	Exploratory: preliminary efficacy of OB-002 as monotherapy based on Progression-free survival	Progression-free survival (PFS): defined as the time from randomization until objective tumor progression or death, whichever comes first by RECIST v1.1	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months, assessed up to 12 months
Other	Exploratory: evaluation of OB-002 on blood biomarkers (immune cells)	Systemic monitoring of circulating immune cells	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Other	Exploratory: evaluation of OB-002 on blood biomarkers (cytokines)	Systemic monitoring of secreted cytokines.	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Other	Exploratory: evaluation of OB-002 on blood biomarkers (chemokines)	Systemic monitoring of secreted chemokines.	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Other	Exploratory: evaluation of OB-002 on tumor biomarkers (tumor-associated immune cells in TMI)	Examination of tumor-associated immune cells in tumor microenvironment	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Other	Exploratory: evaluation of OB-002 on blood biomarkers (TCR)	Genomic analyses on whole blood/peripheral blood mononuclear cells (PBMC) for T-cell repertoire (TCR) analyses	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Other	Exploratory: evaluation of OB-002 on blood biomarkers (ctDNA)	Plasma circulating tumor DNA (ctDNA) analysis	From first infusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Primary	Safety: adverse events	Number of patients experiencing adverse events (AEs), serious AEs (SAEs) abnormalities in clinical laboratory tests, vital signs, electrocardiograms (ECGs), and physical exams	From date of screening until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Primary	Safety: Maximum Tolerated Dose	MTD will be defined on the basis of dose-limiting toxicities (DLTs)	From date of first infusion with 28 days observation period (+/-3 days)
Secondary	(PK) Pharmacokinetics Cmax	To evaluate the multiple-dose pharmacokinetic (PK) profile of OB-002 with maximum observed concentration (Cmax) profile of OB-002 in patients with refractory metastatic colorectal, pancreatic, breast, or urothelial cancer.	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)
Secondary	(PK) Pharmacokinetics Tmax	To evaluate the multiple-dose pharmacokinetic (PK) profile of OB-002 with time to maximum serum concentration (Tmax) in patients with refractory metastatic colorectal, pancreatic, breast, or urothelial cancer.	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)
Secondary	(PK) Pharmacokinetics AUC0-t	To evaluate the multiple-dose pharmacokinetic (PK) profile of OB-002 with area under the curve from time 0 to last sampling time (AUC0-t) in patients with refractory metastatic colorectal, pancreatic, breast, or urothelial cancer.	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)
Secondary	(PK) Pharmacokinetics AUC0 8	To evaluate the multiple-dose pharmacokinetic (PK) profile of OB-002 with area under the curve from time 0 to infinity (AUC0 8) in patients with refractory metastatic colorectal, pancreatic, breast, or urothelial cancer.	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)
Secondary	(PK) Pharmacokinetics t1/2	To evaluate the multiple-dose pharmacokinetic (PK) profile of OB-002 with terminal half-life (t1/2) in patients with refractory metastatic colorectal, pancreatic, breast, or urothelial cancer.	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)
Secondary	(PK) Pharmacokinetics Vd	To evaluate the multiple-dose pharmacokinetic (PK) profile of OB-002 with the volume of distribution (Vd) in patients with refractory metastatic colorectal, pancreatic, breast, or urothelial cancer.	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)
Secondary	(PK) Pharmacokinetics CL	To evaluate the multiple-dose pharmacokinetic (PK) profile of OB-002 with clearance (CL) in patients with refractory metastatic colorectal, pancreatic, breast, or urothelial cancer.	samples are collected from first to fourth infusion (period of 28 days +/- 2 days)