GSK3359609 Plus Tremelimumab for the Treatment of Advanced Solid Tumors

Neoplasms Clinical Trial

Official title:

A Phase I/II, Open-label, Two Part Study of GSK3359609 in Combination With Tremelimumab in Participants With Selected, Advanced Solid Tumors

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03693612
• Other study ID #: 207871
• Status: Completed
• Phase: Phase 1/Phase 2
• Start date: November 26, 2018
• Est. completion date: September 16, 2021

Study information

• Verified date: July 2022
• Source: GlaxoSmithKline
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate if the combination of GSK3359609 and tremelimumab is safe and tolerable (Part 1) and provides significant survival benefit to subjects with relapsed/refractory (R/R) Head and Neck Squamous Cell Carcinomas (HNSCC) to warrant further clinical investigation (Part 2). Part 1 (dose escalation) will enroll subjects with advanced, selected solid tumors. Subjects will receive escalating doses of GSK3359609 and tremelimumab in combination in Part 1. Part 2 is randomized expansion and will enroll subjects with R/R HNSCC who have disease progression after receiving at least 1 platinum-based chemotherapy and at least 1 anti-programmed death receptor protein-1 (PD-1)/anti-programmed death-ligand 1 (PD-L1) therapy, whether in combination or separately. In Part 2, subjects will be randomized in a ratio of 2:1 to receive either GSK3359609 in combination with tremelimumab at the recommended Phase 2 dose or investigators choice of a single-agent standard of care (SOC) therapy including paclitaxel, docetaxel or cetuximab. The total duration of subjects in the study will be approximately 4 years.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 26
• Est. completion date: September 16, 2021
• Est. primary completion date: June 25, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Capable of giving signed informed consent/assent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and protocol.

• Male or female, aged 18 years or older.

• Body weight >=30 kilograms (kg).

• Histological or cytological documentation of an invasive malignancy that was diagnosed as locally advanced/metastatic or relapsed/refractory and is of one of the following tumor types: a) Part 1: cutaneous melanoma; HNSCC (oral cavity, larynx, oropharynx, hypopharynx, nasal cavity/paranasal sinuses); non-small cell lung cancer (squamous and non-squamous); urothelial carcinoma of the upper and lower urinary tract; clear cell renal carcinoma; castrate resistant prostate adenocarcinoma. b) Part 2: HNSCC (oral cavity, larynx, pharynx, paranasal sinuses).

• Part 1 only: Disease that has progressed after standard therapy for the specific tumor type, or for which standard therapy has proven to be ineffective, intolerable, or is considered inappropriate, or if no further standard therapy exists, or where standard therapy is refused. May be anti-PD-1/anti-PD-L1 experienced or naïve.

• Part 2 only: Disease that has progressed after receiving platinum-based chemotherapy (unless medically contraindicated or discontinued due to toxicity) and anti-PD-1/anti-PD-L1 therapy (in combination or as separate lines of therapy in either sequence).

• Measurable disease per RECIST version 1.1 guidelines. Palpable lesions that are not measurable by radiographic or photographic evaluations may not be utilized as the only measurable lesion. Any measurable lesion biopsied at Screening cannot be followed as a target/index lesion unless agreed upon by GlaxoSmithKline (GSK).

• Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 0 or 1.

• Adequate organ function.

• A female subject is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions apply: a) Not a woman of childbearing potential (WOCBP); or, b) A WOCBP who agrees to follow the contraceptive while receiving study intervention and for at least 180 days after the last dose of study intervention.

• A male subject must agree to use a highly effective contraception while receiving study intervention and for at least 180 days after the last dose of study intervention and refrain from donating sperm during this period.

• Agree to collection of tumor tissue: a) Part 1 and Part 2: Archival tumor tissue collected any time from the initial diagnosis of invasive malignancy; a fresh tumor biopsy will be required if archival specimen is unavailable prior to first dose. b) Part 1 pharmacokinetic/pharmacodynamic cohort(s): Archival tissue as noted in point (a) above. Paired tumor biopsies: tumor tissue collected any time after completion of dosing of the last therapy and prior to first dose and an on-treatment biopsy. c) Part 2: A minimum of 15 subjects from each arm will be required to provide paired tumor biopsies (in addition to the archival tissues as noted in point (a) above): tumor tissue collected any time after completion of dosing of the last therapy and prior to first dose and an on-treatment biopsy.

Exclusion Criteria:

• Received prior treatment with the following therapies; calculation is based on date of last therapy to date of first dose of study intervention or SOC: a) Cytotoxic T-Lymphocyte-Associated Protein 4 (CTLA-4 [including tremelimumab] or Inducible T Cell Co-Stimulator (ICOS)-directed therapies at any time; b) >=4 lines of prior anticancer treatment: In subjects that relapse or progress within 1 year from the beginning of adjuvant or concurrent therapy, the adjuvant/concurrent therapy is considered first line therapy; c) Systemic anticancer therapy or investigational therapy within 30 days, or 5 half-lives, whichever is shorter; at least 14 days must have elapsed between the date of the last prior therapy to the date of first dose of study intervention or SOC.

• Prior radiation therapy: permissible if at least one non-irradiated measurable lesion is available for assessment per RECIST v1.1 or if a solitary measurable lesion was irradiated, objective progression is documented. At least 14 days must have elapsed between the date of the last dosage of radiation and the first dose of study intervention/SOC.

• Invasive malignancy or history of invasive malignancy other than disease under study within the last two years, except: a) Any other invasive malignancy for which the subject was definitively treated, has been disease-free for <=2 years and in the opinion of the Investigator and Medical Monitor will not affect the evaluation of the effects of the study intervention or SOC on the currently targeted malignancy, may be included in this clinical study; Curatively treated non-melanoma skin cancer or successfully treated in-situ carcinoma.

• Toxicity from previous anticancer treatment that includes: a) >=Grade 3 toxicity considered related to prior immunotherapy and that led to treatment discontinuation; b) Toxicity related to prior treatment that has not resolved to <=Grade 1 (except alopecia, vitiligo, hearing loss, endocrinopathy managed with replacement therapy, and peripheral neuropathy which must be <=Grade 2).

• Central nervous system (CNS) metastases, with the following exception: Subjects with previously treated CNS metastases who are clinically stable and had no requirement for steroids during at least 14 days prior to first dose of study intervention or SOC.

• Major surgery <=28 days of first dose of study intervention or SOC.

• Autoimmune disease (current or history) or syndrome that required systemic treatment within the past 2 years. Replacement therapies which include physiological doses of corticosteroids for treatment of endocrinopathies (i.e., adrenal insufficiency) are not considered systemic treatments.

• Recent history (within 24 weeks) of gastrointestinal obstruction that required surgery, acute diverticulitis, inflammatory bowel disease, or intra-abdominal abscess.

• Receiving systemic steroids (>=10 milligrams [mg] oral prednisone or equivalent) or other immunosuppressive agents within 7 days prior to first dose of study intervention or SOC.

• Prior allogeneic/autologous bone marrow or solid organ transplantation.

• Received live-virus vaccine within 30 days from start of study intervention or SOC.

• Current or history of idiopathic pulmonary fibrosis, pneumonitis (for past, subject is excluded if steroids were required), interstitial lung disease or organizing pneumonia.

• Recent history (within 24 weeks) of uncontrolled, symptomatic ascites, pleural or pericardial effusions.

• History or evidence of cardiac abnormalities within the 24 weeks prior to enrollment which include: a) Serious uncontrolled cardiac arrhythmia or clinically significant electrocardiogram abnormalities including second degree (Type II) or third degree atrioventricular block. b) Cardiomyopathy, myocardial infarction, acute coronary syndromes (including unstable angina pectoris), coronary angioplasty, stenting, or bypass grafting. c) Symptomatic pericarditis.

• Current unstable liver or biliary disease per Investigator assessment defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis.

• Active infection requiring systemic therapy.

• Known human immunodeficiency virus infection; positive test for hepatitis B active infection (presence of hepatitis B surface antigen) or hepatitis C active infection.

• History of severe hypersensitivity to monoclonal antibodies, the Standard of Care agents, including any ingredient used in the formulation, based on which treatment the subject is to receive.

• Any serious and/or unstable pre-existing medical (aside from malignancy), psychiatric disorder, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures, in the opinion of the Investigator.

• For subjects receiving SOC: Requires therapy with a medication that may alter the PK of the SOC agent (e.g., strong inducers or inhibitors of cytochrome P (CYP)3A4 for subjects receiving docetaxel or paclitaxel) during the study treatment period. Please refer to the package insert for the agent the subject is to receive.

• For subjects receiving SOC: Any contraindication, per the package insert and/or Institutional guidelines, to the treatment the subject is to receive.

Related Conditions & MeSH terms

• Neoplasms

Intervention

Drug:
• feladilimab
feladilimab is humanized anti-ICOS agonist immunoglobulin G (IgG) 4 monoclonal antibody (mAb), which will be administered as an intravenous (IV) infusion once every 3 weeks.
• Tremelimumab
Tremelimumab is humanized anti-CTLA-4 IgG2 mAb, which will be administered as an IV infusion once every 3 weeks for 6 doses, thereafter once every 12 weeks .
• Docetaxel
Docetaxel is a microtubule stabilizer which will be administered as an IV infusion once every 3 weeks at a dose of 75 milligrams per meter square (mg/m^2).
• Paclitaxel
Paclitaxel is a microtubule stabilizer which will be administered as an IV infusion once weekly at a dose of 80 mg/m^2.
• Cetuximab
Cetuximab is a recombinant, human/mouse chimeric anti-estimated glomerular filtration rate (EGFR) mAb. Cetuximab will be administered at a loading dose of 400 mg/m^2 followed by 250 mg/m^2 once weekly.

Locations

Country	Name	City	State
Australia	GSK Investigational Site	Melbourne	Victoria
Canada	GSK Investigational Site	Ottawa	Ontario
Canada	GSK Investigational Site	Toronto	Ontario
United States	GSK Investigational Site	Boston	Massachusetts
United States	GSK Investigational Site	New York	New York
United States	GSK Investigational Site	New York	New York
United States	GSK Investigational Site	Pittsburgh	Pennsylvania
United States	GSK Investigational Site	San Antonio	Texas

Sponsors (2)

Lead Sponsor	Collaborator
GlaxoSmithKline	MedImmune LLC

Countries where clinical trial is conducted

United States,  Australia,  Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of Participants With Dose Limiting Toxicities (DLTs)-Part 1	A DLT is considered by the investigator to be clinically relevant, attributed event within first 28 days of intervention meeting the following criteria of toxicity, Hematologic: Febrile neutropenia, Grade 4 neutropenia of greater than (>) 7 days in duration or requiring Granulocyte- Colony stimulating factor (G-CSF), Grade 4 anemia and Grade 3 thrombocytopenia with bleeding or Grade 4 thrombocytopenia; Non-hematologic: Grade 4 toxicity, Grade 3 pneumonitis, any greater than or equal to (=) Grade 2 pneumonitis that does not resolve to less than or equal to (= ) Grade 1 within 3 days of the initiation of maximal supportive care, Grade 3 toxicity that does not resolve to Grade 1 or baseline within 3 days despite optimal supportive care and any Grade 2 ocular toxicity requiring systemic steroids, or any = Grade 3 ocular toxicity.	Up to 28 days
Primary	Number of Participants With DLTs According to Severity-Part 1	The severity of all toxicities were graded using the National Cancer Institute- Common Toxicity Criteria for Adverse Events (NCI-CTCAE) version 5.0. Grade 1: Mild reaction; infusion interruption not indicated; intervention not indicated; Grade 2: Requires therapy or infusion interruption but responds promptly to symptomatic treatment or prophylactic medications indicated for =24 hours; Grade 3: Prolonged (i.e., not rapidly responsive to symptomatic medication and/or brief interruption of infusion) or recurrence of symptoms following initial improvement; hospitalization indicated for other clinical sequelae; Grade 4: Life-threatening; pressor or ventilatory support indicated; Grade 5: Death related to AE.	Up to 28 days
Primary	Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) and Adverse Events of Special Interest (AESI)-Part 1	An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. An SAE is defined as any untoward medical occurrence that, at any dose: results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent disability/incapacity; is a congenital anomaly/birth defect and important medical events may jeopardize the subject or may require medical or surgical intervention/SOC to prevent one of the other outcomes mentioned before. AESIs are defined as events of potential immunologic etiology, including immune related AEs.	Up to 4 years
Primary	Number of Participant With AE/SAE/DLTs Leading to Dose Modifications/Delays/Withdrawals-Part 1	The number of participants with AE/SAE/DLTs leading to dose modifications/delays/withdrawals were summarized.	Up to 4 years
Primary	Number of Participants With AEs, SAEs, AESIs According to Severity - Part 1	The severity of all toxicities were graded using the National Cancer Institute- Common Toxicity Criteria for Adverse Events (NCI-CTCAE) version 5.0. Grade 1: Mild reaction; infusion interruption not indicated; intervention not indicated; Grade 2: Requires therapy or infusion interruption but responds promptly to symptomatic treatment or prophylactic medications indicated for =24 hours; Grade 3: Prolonged (i.e., not rapidly responsive to symptomatic medication and/or brief interruption of infusion) or recurrence of symptoms following initial improvement; hospitalization indicated for other clinical sequelae; Grade 4: Life-threatening; pressor or ventilatory support indicated; Grade 5: Death related to AE.	Up to 4 years
Primary	Number of Participants With Severe- AEs/SAEs/DLTs Leading to Dose Modifications/Delays/Withdrawals-Part 1	The number of participants with severe- AE/SAE/DLTs leading to dose modifications/delays/withdrawals were summarized.	Up to 4 years
Primary	Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP)-Part 1	SBP and DBP were measured after 5 minutes of rest for the participant.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Temperature-Part 1	Temperature was measured after 5 minutes of rest for the participant.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Pulse Rate-Part 1	Pulse rate was measured after 5 minutes of rest for the participant.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Respiratory Rate-Part 1	Respiratory rate was measured after 5 minutes of rest for the participant.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Oxygen Saturation-Part 1	Oxygen saturation was measured using pulse oximeter after 5 minutes of rest for the participant.	Baseline (Day 1) and Week 4
Primary	Number of Participants With Electrocardiogram (ECG) Findings	Single 12-lead ECG was obtained using an automated ECG machine. ECG findings were categorized as: normal, abnormal - clinically significant (CS), or abnormal - not clinically significant (NCS), as determined by the investigator.	Baseline (Pre dose, Day 1) and up to 4 Years
Primary	Change From Baseline in Neutrophil, Lymphocyte, Monocyte, Eosinophil, Basophil and Platelet Count-Part 1	Blood samples were collected to assess change from Baseline in neutrophil, lymphocyte, monocyte, eosinophil, basophil and platelet counts.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Hemoglobin Level-Part 1	Blood samples were collected to assess change from baseline in hemoglobin level.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Hematocrit Level-Part 1	Blood samples were collected to assess change from baseline in hematocrit level.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Erythrocytes Count-Part 1	Blood samples were collected to assess change from baseline in Erythrocytes count.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Albumin and Total Protein Levels-Part 1	Blood samples were collected to assess change from Baseline in albumin and total protein levels.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Creatinine and Bilirubin Levels-Part 1	Blood samples were collected to assess change from baseline in creatinine and bilirubin levels.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), Lactate Dehydrogenase (LDH) Levels-Part 1	Blood samples were collected to assess change from baseline in ALT, AST ALP, LDH levels.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Amylase and Lipase Levels-Part 1	Blood samples were collected to assess change from baseline in amylase and lipase levels.	Baseline (Day 1) and week 4
Primary	Change From Baseline in Urea, Glucose, Potassium, Sodium and Calcium Levels-Part 1	Blood samples were collected to assess change in levels of urea, glucose, potassium, sodium and calcium from baseline.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Specific Gravity of Urine-Part 1	Urine samples were collected to assess change from baseline in specific gravity of urine.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Potential of Hydrogen (pH) of Urine-Part 1	Urine samples were collected to assess change from baseline in pH of urine.	Baseline (Day 1) and Week 4
Primary	Number of Participants With Abnormal Urinalysis Parameters-Part 1	The dipstick test gives positive or negative results for protein, ketones, occult blood and glucose in urine. Positive test results were considered as abnormal. Number of participants with positive test results have been summarized.	Week 4
Primary	Change From Baseline in Thyroid Stimulating Hormone (TSH) or Thyrotropin-Part 1	Blood samples were collected to assess change from Baseline in TSH.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Free Triiodothyronine (T3)-Part 1	Blood samples were collected to assess change from Baseline in free T3.	Baseline (Day 1) and Week 4
Primary	Change From Baseline in Free Thyroxine (T4)-Part 1	Blood samples were collected to assess change from baseline in free T4.	Baseline (Day 1) and Week 4
Primary	Overall Survival-Part 2	For participants in Part 2, overall survival is defined as time from the date of randomization to the date of death due to any cause.	Up to 4 years
Secondary	Overall Response Rate-Part 1	Overall response rate is defined as percentage of participants with confirmed complete response (Disappearance of all target lesions. Any pathological lymph nodes [whether target or non-target] must have reduction in short axis to <10 millimeter [mm]) or partial response (At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters) at any time as per response evaluation criteria in solid tumors (RECIST) version 1.1.	Up to 4 years
Secondary	Overall Response Rate-Part 2	Overall response rate is defined as percentage of participants with confirmed complete response (Disappearance of all target lesions. Any pathological lymph nodes [whether target or non-target] must have reduction in short axis to <10 mm) or partial response (At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters) at any time as per RECIST version 1.1.	Up to 4 years
Secondary	Disease Control Rate-Part 1	Disease control rate is defined as percentage of subjects with confirmed complete response (Disappearance of all target lesions. Any pathological lymph nodes [whether target or non-target] must have reduction in short axis to <10 mm) or partial response (At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters) or at least 18 weeks of stable disease (Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD) as per RECIST version 1.1.	Up to 4 years
Secondary	Disease Control Rate-Part 2	Disease control rate is defined as percentage of subjects with confirmed complete response (Disappearance of all target lesions. Any pathological lymph nodes [whether target or non-target] must have reduction in short axis to <10 mm) or partial response (At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters) or at least 18 weeks of stable disease (Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD) as per RECIST version 1.1.	Up to 4 years
Secondary	Progression Free Survival-Part 2	For Part 2, progression free survival duration is defined as the time from the date of randomization to first documented evidence of disease progression (At least a 20% increase in the sum of diameters of target lesions and In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm) or death (regardless of cause of death), whichever comes first as per RECIST version 1.1.	Up to 4 years
Secondary	Time to Response-Part 2	Time to response is defined as the time from the first dose to the first documented evidence of complete response (Disappearance of all target lesions. Any pathological lymph nodes [whether target or non-target] must have reduction in short axis to <10 mm) or partial response (At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters) for participants with a confirmed CR or PR as per RECIST version 1.1.	Up to 4 years
Secondary	Duration of Response-Part 2	Duration of response is defined as time from the first documented evidence of response until the first documented sign of disease progression or death among participants who achieve a response (CR [Disappearance of all target lesions. Any pathological lymph nodes {whether target or non-target} must have reduction in short axis to <10 mm or PR [At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters] as per RECIST version 1.1).	Up to 4 years
Secondary	Maximum Observed Plasma Concentration (Cmax) of Feladilimab-Part 1	Blood samples were collected at indicated time points for pharmacokinetic assessment.	Pre-dose, end of infusion and 4 hours post dose at Day 1
Secondary	Cmax of Tremelimumab-Part 1	Blood samples were collected at indicated time points for pharmacokinetic assessment.	Pre-dose, end of infusion and 4 hours post dose at Day 1
Secondary	Cmax of Feladilimab-Part 2	Blood samples were planned to be collected at indicated time points for pharmacokinetic assessment.	Pre-dose at Weeks 1, 2, 4, 7, 10, 13, 16, 19, 25, then every 12 weeks for 2 years; end of infusion at Weeks 1, 19 and 25; and 4 hours post-infusion at Week 1
Secondary	Cmax of Tremelimumab-Part 2	Blood samples were planned to be collected at indicated time points for pharmacokinetic assessment.	Pre-dose at Weeks 1, 2, 4, 7, 10, 13, 16, 19, 25, then every 12 weeks for 2 years; end of infusion at Weeks 1, 19 and 25; and 4 hours post-infusion at Week 1
Secondary	Minimum Observed Plasma Concentration (Cmin) of Feladilimab-Part 1	Blood samples were collected at indicated time points for pharmacokinetic assessment.	Pre-dose, end of infusion and 4 hours post dose at Day 1
Secondary	Cmin of Tremelimumab-Part 1	Blood samples were collected at indicated time points for pharmacokinetic assessment.	Pre-dose, end of infusion and 4 hours post dose at Day 1
Secondary	Cmin of Feladilimab-Part 2	Blood samples were planned to be collected at indicated time points for pharmacokinetic assessment.	Pre-dose at Weeks 1, 2, 4, 7, 10, 13, 16, then every 12 weeks for 2 years; end of infusion; and 4 hours post-infusion at Week 1
Secondary	Cmin of Tremelimumab-Part 2	Blood samples were planned to be collected at indicated time points for pharmacokinetic assessment.	Pre-dose at Weeks 1, 2, 4, 7, 10, 13, 16, then every 12 weeks for 2 years; end of infusion; and 4 hours post-infusion at Week 1
Secondary	Area Under the Plasma Concentration-time Curve (AUC[0-t]) of Feladilimab-Part 1	Blood samples were collected at indicated time points for pharmacokinetic assessment.	Pre-dose, end of infusion and 4 hours post dose at Day 1
Secondary	AUC(0-t) of Tremelimumab-Part 1	Blood samples were collected at indicated time points for pharmacokinetic assessment.	Pre-dose, end of infusion and 4 hours post dose at Day 1
Secondary	AUC(0-t) of Feladilimab-Part 2	Blood samples were planned to be collected at indicated time points for pharmacokinetic assessment.	Pre-dose at Weeks 1, 2, 4, 7, 10, 13, 16, 19, 25, then every 12 weeks for 2 years; end of infusion at Weeks 1, 19 and 25, and 4 hours post-infusion at Week 1
Secondary	AUC(0-t) of Tremelimumab-Part 2	Blood samples were planned to be collected at indicated time points for pharmacokinetic assessment	Pre-dose at Weeks 1, 2, 4, 7, 10, 13, 16, then every 12 weeks for 2 years; end of infusion; and 4 hours post-infusion at Week 1
Secondary	Number of Participants With Anti-drug Antibodies Against Feladilimab-Part 1	Serum samples were collected and tested for the presence of antibodies to feladilimab.	Pre-dose at Week 4, 7, 10 and 13
Secondary	Number of Participants With Anti-drug Antibodies Against Tremelimumab-Part 1	Serum samples were collected and tested for the presence of antibodies to tremelimumab.	Pre-dose at Week 1, 4, 7, 10 and 13
Secondary	Number of Participants With Anti-drug Antibodies Against Feladilimab-Part 2	Serum samples will be collected and tested for the presence of antibodies to feladilimab.	Up to 2.5 years
Secondary	Change From Baseline in Free T4-Part 2	Blood samples will be collected to assess change from baseline in free T4.	Baseline and up to 2 years
Secondary	Number of Participants With Anti-drug Antibodies Against Tremelimumab-Part 2	Serum samples will be collected and tested for the presence of antibodies to tremelimumab.	Up to 2.5 years
Secondary	Number of Participants With AEs, SAEs and AESI-Part 2	An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. An SAE is defined as any untoward medical occurrence that, at any dose: results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent disability/incapacity; is a congenital anomaly/birth defect and important medical events may jeopardize the subject or may require medical or surgical intervention/SOC to prevent one of the other outcomes mentioned before. AESIs are defined as events of potential immunologic etiology, including immune related AEs.	Up to 4 years
Secondary	Number of Participants With AEs, SAEs, AESIs Based on Severity-Part 2	The severity of all toxicities were graded using the National Cancer Institute- Common Toxicity Criteria for Adverse Events (NCI-CTCAE) version 5.0. Grade 1: Mild reaction; infusion interruption not indicated; intervention not indicated; Grade 2: Requires therapy or infusion interruption but responds promptly to symptomatic treatment or prophylactic medications indicated for =24 hours; Grade 3: Prolonged (i.e., not rapidly responsive to symptomatic medication and/or brief interruption of infusion) or recurrence of symptoms following initial improvement; hospitalization indicated for other clinical sequelae; Grade 4: Life-threatening; pressor or ventilatory support indicated; Grade 5: Death related to AE	Up to 4 years
Secondary	Number of Participants With Severe- AEs/SAEs/DLTs Leading to Dose Modifications/Delays/Withdrawals-Part 2	The number of participants with severe- AE/SAE/DLTs leading to dose modifications/delays/withdrawals were planned to be summarized.	Up to 4 years
Secondary	Change From Baseline in SBP and DBP-Part 2	SBP and DBP will be measured after 5 minutes of rest for the participant.	Baseline and up to 2 years
Secondary	Change From Baseline in Temperature-Part 2	Temperature will be measured after 5 minutes of rest for the participant.	Baseline and up to 2 years
Secondary	Change From Baseline in Pulse Rate-Part 2	Pulse rate will be measured after 5 minutes of rest for the participant.	Baseline and up to 2 years
Secondary	Change From Baseline in Respiratory Rate-Part 2	Respiratory rate will be measured after 5 minutes of rest for the participant.	Baseline and up to 2 years
Secondary	Change From Baseline in Oxygen Saturation-Part 2	Oxygen saturation will be measured using pulse oximetry after 5 minutes of rest for the participant.	Baseline and up to 2 years
Secondary	Change From Baseline in ECG Measurement-Part 2	Single 12-lead ECG will be obtained using an automated ECG machine.	Baseline (Pre-dose) up to 2 years
Secondary	Change From Baseline in Neutrophil, Lymphocyte, Monocyte, Eosinophil, Basophil and Platelet Count-Part 2	Blood samples will be collected to assess change from baseline in neutrophil, lymphocyte, monocyte, eosinophil, basophil and platelet count.	Baseline and up to 2 years
Secondary	Change From Baseline in Hemoglobin Level-Part 2	Blood samples will be collected to assess change from baseline in hemoglobin level.	Baseline and up to 2 years
Secondary	Change From Baseline in Hematocrit Level-Part 2	Blood samples will be collected to assess change from baseline in hematocrit level.	Baseline and up to 2 years
Secondary	Change From Baseline in Erythrocytes Count-Part 2	Blood samples will be collected to assess change from Baseline in erythrocytes count.	Baseline and up to 2 years
Secondary	Change From Baseline in Albumin and Total Protein Levels-Part 2	Blood samples will be collected to assess change from baseline in albumin and total protein levels.	Baseline and up to 2 years
Secondary	Change From Baseline in Creatinine and Bilirubin Levels-Part 2	Blood samples will be collected to assess change from baseline in creatinine and bilirubin levels.	Baseline and up to 2 years
Secondary	Change From Baseline in ALT, AST, ALP, LDH Levels-Part 2	Blood samples will be collected to assess change from baseline in ALT, AST ALP, LDH, amylase and lipase levels.	Baseline and up to 2 years
Secondary	Change From Baseline in Amylase and Lipase Levels-Part 2	Blood samples were collected to assess change from baseline in amylase and lipase levels.	Baseline and up to 2 years
Secondary	Change From Baseline in Urea, Glucose, Potassium, Sodium and Calcium Levels -Part 2	Blood samples will be collected to assess change in levels of urea, glucose, potassium, sodium and calcium from baseline.	Baseline and up to 2 years
Secondary	Change From Baseline in Specific Gravity of Urine-Part 2	Urine samples will be collected to assess change from Baseline in specific gravity of urine.	Baseline and up to 2 years
Secondary	Change From Baseline in pH of Urine-Part 2	Urine samples will be collected to assess change from baseline in pH of urine.	Baseline and up to 2 years
Secondary	Number of Participants With Abnormal Urinalysis Parameters-Part 2	The dipstick test gives positive or negative results for protein, ketones, occult blood and glucose. Positive test results were considered as abnormal. Number of participants with positive test results were planned to be summarized.	Up to 2 years
Secondary	Change From Baseline in TSH-Part 2	Blood samples will be collected to assess change from Baseline in TSH.	Baseline and up to 2 years
Secondary	Change From Baseline in Free T3-Part 2	Blood samples will be collected to assess change from baseline in free T3.	Baseline and up to 2 years