A Safety and Efficacy Study of CC-90011 in Combination With Nivolumab in Subjects With Advanced Cancers

Neoplasms Clinical Trial

Official title:

A Phase 2, Multicenter, Open-label, Multi-cohort Study to Assess Safety and Efficacy of CC-90011 in Combination With Nivolumab in Subjects With Advanced Cancers

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04350463
• Other study ID #: CC-90011-ST-002
• Secondary ID: U1111-1248-83522
• Status: Completed
• Phase: Phase 2
• Start date: July 14, 2020
• Est. completion date: December 19, 2023

Study information

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

Clinical Trial Summary

This is a Phase 2, multicenter, open-label, multi-cohort study to assess safety and efficacy of CC-90011 in combination with nivolumab in subjects with small cell lung cancer or squamous non-small cell lung cancer who have progressed after 1 or 2 lines of therapies.

The primary objectives of the study are to evaluate the overall response rate of subjects treated with CC-90011 in combination with nivolumab in three cohorts:

• Cohort A: SCLC in ICI naïve subjects

• Cohort B: SCLC in ICI progressor subjects

• Cohort C: sqNSCLC in ICI progressor subjects Overall response rate is defined as the proportion of subjects in the treated population who had complete response (CR) or partial response (PR) as assessed by Investigator review per RECIST v1.1.

In Cohort A, expected ORR for nivolumab monotherapy is 14% while target ORR is 30%. To achieve at least 80% power with one-sided type 1 error 0.1, 39 subjects will be enrolled according to a 2-stage group sequential design based on a binomial test. In stage 1, 12 subjects will be enrolled and treated with CC-90011 in combination with nivolumab. If there are 2 or more subjects responding, Cohort A will continue to enroll an additional 27 subjects. If 1 or less subjects respond in stage 1, Cohort A will stop for futility.

In Cohort B and C, expected ORR for nivolumab monotherapy is 5% while target ORR is 15%. To achieve at least 80% power with one-sided type 1 error 0.1, 48 subjects will be enrolled according to a 2-stage group sequential design based on a binomial test. In stage 1, 14 subjects will be enrolled and treated with CC-90011 in combination with nivolumab. If there are 1 or more subjects responding, Cohort B and C will continue to enroll an additional 34 subjects each. If 0 subjects respond in stage 1, Cohort B and C will stop for futility.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 92
• Est. completion date: December 19, 2023
• Est. primary completion date: December 19, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

Subjects must satisfy the following criteria to be enrolled in the study:

1. Subject is = 18 years of age at the time of signing the informed consent form (ICF).

2. Subject with histological or cytological confirmation of extensive stage Small Cell Lung Cancer (ES SCLC) or Stage IIIb or IV squamous Non-Small Cell Lung Cancer (sqNSCLC)

3. Subject has received 1 or 2 prior lines of therapies, defined as:

1. Cohort A (SCLC, Immune Checkpoint Inhibitor naïve):

• At least 1 prior treatment including a platinum-based chemotherapy doublet

• A minimum of 3 cycles of platinum-based chemotherapy in first line treatment, unless stopped at 2 cycles due to treatment-related toxicity

2. Cohort B (SCLC, ICI progressors):

• At least 1 prior first or second line treatment includes an ICI

• If treatment includes an ICI as maintenance therapy, at least 1 cycle of ICI in maintenance should have been completed

• At least 1 prior treatment including a platinum-based chemotherapy doublet

• A minimum of 3 cycles of platinum-based chemotherapy, with or without ICI, in first line treatment, unless stopped at 2 cycles due to treatment-related toxicity

• Subject must have progressed during ICI therapy, defined as unequivocal progression on or within 3 months of the last dose of ICI therapy (if no subsequent therapy)

3. Cohort C (sqNSCLC, ICI progressors):

• At least 1 prior first or second line treatment includes an ICI

• If treatment includes an ICI as maintenance therapy, at least 1 cycle of ICI in maintenance should have been completed

• At least 1 prior treatment including a platinum-based chemotherapy doublet

• A minimum of 3 cycles of platinum-based chemotherapy, with or without an ICI, in first line treatment, unless stopped at 2 cycles due to treatment-related toxicity

• Subject must have progressed during ICI therapy, defined as unequivocal progression on or within 3 months of the last dose of ICI therapy (if no subsequent therapy)

4. Subject has progressed at the last line of therapy.

5. Subject has a measurable disease defined by RECIST v1.1.

6. Subject agrees to provide a tumor biopsy from primary or metastatic site prior to first dose and at a pre-specified timepoint during treatment. Core biopsy is required however, in the event a core biopsy may not otherwise be feasible in the opinion of the treating physician, an endobronchial ultrasound-guided fine needle aspirate [EBUS-FNA]) biopsy, using the largest gauge needle, may be performed instead.

7. Subject has ECOG Performance Status of 0 to 1.

8. Subject must have the following laboratory values:

1. Absolute neutrophil count (ANC) = 1.5 x 109/L

2. Hemoglobin (Hgb) = 9 g/dL (one-time blood transfusion is allowed)

3. Platelet (Plt) Count = 150 x 109/L

4. White blood cells (WBC) = 2 x 109L

5. Serum AST/serum glutamic oxaloacetic transaminase (SGOT) or ALT/serum glutamic pyruvic transaminase (SGPT) = 3 x upper limit of normal (ULN) or = 5 x ULN if presence of liver metastases

6. Total serum bilirubin = 1.5 x ULN (= 3 x ULN, if Gilbert's syndrome or if indirect bilirubin concentrations are suggestive of extrahepatic source of the elevation)

7. Creatinine clearance (CrCl) = 60 mL/minute based on Cockcroft-Gault or modification of diet in renal disease (MDRD) or = 60 mL/min/1.73 m2

Exclusion Criteria:

The presence of any of the following will exclude a subject from enrollment:

1. Subject has not recovered to Grade 2 or lower clinically significant toxicities related to the prior therapy (alopecia excluded).

2. Subject has received prior LSD1 therapies.

3. Subject has a history of severe hypersensitivity reactions to other monoclonal antibodies

4. Subject with symptomatic and untreated or unstable central nervous system (CNS) metastases.

1. Subject has recently been treated with whole brain radiation or stereotactic radiosurgery for CNS metastases must have completed therapy at least 2 weeks prior to Cycle 1 Day 1 and has a follow-up brain computed tomography (CT) or magnetic resonance imaging (MRI) demonstrating either stable or improving metastases 2 or more weeks after completion of radiotherapy.

2. Subject must be asymptomatic and off steroids or on stable dose of steroids for at least 2 weeks (= 10 mg daily prednisone or equivalent) prior to first dose.

5. Subject has persistent diarrhea due to a malabsorptive syndrome (such as celiac sprue or inflammatory bowel disease) = NCI CTCAE Grade 2, despite medical management), or any other significant gastrointestinal (GI) disorder that could affect the absorption of the study treatments.

6. Subject with symptomatic or uncontrolled ulcers (gastric or duodenal), particularly those with a history of and/or risk of perforation and GI tract hemorrhages.

7. Subject with any hemorrhage/bleeding event > NCI CTCAE Grade 2 or haemoptysis > 1 teaspoon within 4 weeks prior to the first dose.

8. Subject has any of the following cardiovascular criteria:

1. Evidence of acute or ongoing cardiac ischemia

2. Current symptomatic pulmonary embolism

3. Unstable angina pectoris or myocardial infarction = 6 months prior to enrollment

4. Heart failure of New York Heart Association Classification III or IV = 6 months prior to enrollment

5. Persistent or clinically meaningful ventricular arrhythmias prior to enrollment

6. Cerebral vascular accident or transient ischemic attack = 6 months prior to enrollment

7. QT corrected based on Fridericia's equation (QTcF) = 450 milliseconds (msec) on Screening ECG, a baseline prolongation of QTcF interval = 450 msec (NCI CTCAE Grade = 2)

8. A history of additional risk factors for Torsades de pointes (TdP) (eg, heart failure, hypokalemia, family history of Long QT Syndrome)

9. Uncontrolled hypertension (blood pressure = 160/95 mm Hg)

9. Subject has known human immunodeficiency virus (HIV) infection.

10. Subject has known chronic active hepatitis B or C virus (HBV, HCV) infection.

1. Subject who is seropositive due to HBV vaccination is eligible.

2. Subject who has no active viral infection and is under adequate prophylaxis against HBV reactivation is eligible.

11. Subject has any other malignancy within 2 years prior to enrollment, with the exception of adequately treated in-situ bladder cancer, in-situ carcinoma of the cervix, uteri, nonmelanomatous skin cancer, ductal in situ breast carcinoma, thyroid cancer, or early stage prostate cancer (all treatment of which should have been completed 6 months prior to enrollment).

12. Subject has medical conditions requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone or equivalent) or other immunosuppressive medications within 14 days of enrollment.

1. A brief (= 7 days) course of corticosteroids for prophylaxis (eg, contrast dye allergy) or for treatment of nonautoimmune conditions (eg, delayed-type hypersensitivity reaction caused by contact allergen) is permitted.

2. Adrenal replacement steroid doses > 10 mg daily prednisone or equivalent are permitted in the absence of active autoimmune disease.

3. Topical, ocular, intra-articular, intranasal, and inhalational corticosteroids (with minimal systemic absorption) are permitted.

13. Subject has active autoimmune diseases or history of autoimmune diseases that may relapse. Subjects with the following diseases are allowed to be enrolled after further screening: type I diabetes, hypothyroidism managed with hormone replacement therapy only, skin diseases not requiring systemic treatment (such as vitiligo, psoriasis, or alopecia), or diseases not expected to recur in the absence of external triggering factors.

14. Subject is pregnant or nursing.

15. Subject has a history of persistent skin rash = NCI CTCAE Grade 2 related to prior ICI therapy.

16. Subject has organ transplant history, including allogeneic stem cell transplant.

17. Subject has interstitial lung disease history.

18. Subject has received a live/attenuated vaccine within 30 days of first dose.

19. Subject has previous SARS-CoV-2 infection either suspected or confirmed within 4 weeks prior to screening.

1. Acute symptoms must have resolved and based on Investigator assessment in consultation with the Medical Monitor, there are no sequelae that would place the subject at a higher risk of receiving investigational treatment.

Related Conditions & MeSH terms

• Neoplasms

Intervention

Drug:
• CC-90011
CC-90011
• Nivolumab
Nivolumab

Locations

Country	Name	City	State
France	Local Institution - 156	Lyon Cedex
France	Local Institution - 153	Marseille Cedex 5
France	Local Institution - 154	Rennes
France	Local Institution - 151	Saint-Herblain
France	Local Institution - 152	Villejuif CEDEX
Italy	Local Institution - 301	Aviano
Italy	Local Institution - 306	Meldola
Italy	Local Institution - 303	Milan
Italy	Local Institution - 305	Roma
Italy	Local Institution - 304	Verona
Poland	Local Institution - 451	Lodz
Poland	Local Institution - 452	Lodz
Poland	Local Institution - 454	Poznan
Poland	Local Institution - 453	Warsaw
Spain	Local Institution - 351	Badalona (Barcelona)
Spain	Local Institution - 355	Barcelona
Spain	Local Institution - 356	Barcelona
Spain	Local Institution - 361	La Coruna
Spain	Local Institution - 359	Las Palmas de Gran Canaria
Spain	Local Institution - 353	Madrid
Spain	Local Institution - 357	Madrid
Spain	Local Institution - 358	Madrid
Spain	Local Institution - 360	Majadahonda, Madrid
Spain	Local Institution - 352	Pamplona
Spain	Local Institution - 354	Valencia
Spain	Local Institution - 362	Valencia
United Kingdom	Local Institution - 254	London
United Kingdom	Local Institution - 251	Manchester
United Kingdom	Local Institution - 255	Sutton-Surrey
United States	Local Institution - 105	Canton	Ohio
United States	Local Institution - 104	Cleveland	Ohio
United States	Local Institution - 111	Fairfax	Virginia
United States	Local Institution - 107	Fort Sam Houston	Texas
United States	Local Institution - 110	Houston	Texas
United States	Local Institution - 102	Indianapolis	Indiana
United States	Local Institution - 106	New York	New York
United States	Local Institution - 109	Pittsburgh	Pennsylvania

Sponsors (1)

Lead Sponsor	Collaborator
Celgene

Countries where clinical trial is conducted

United States,  France,  Italy,  Poland,  Spain,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall response rate	The proportion of subjects in the treated population who had complete response (CR) or partial response (PR) as assessed by Investigator review per RECIST v1.1	Until 100-day safety follow-up of the last participant on treatment
Secondary	Adverse Events (AEs)	An AE is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a subject during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the subject's health, including laboratory test values, regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a preexisting condition) should be considered an AE. All adverse events will be collected and collated according to grade and frequency. This will include all events considered related or unrelated to study therapy.	Until 100-day safety follow-up of the last participant on treatment
Secondary	Duration of response	Every 6 weeks post C1D1 for the first 24 weeks and then every 8 weeks until disease progression, new anticancer therapy, death or withdrawal by subject.	Until 100-day safety follow-up of the last participant on treatment
Secondary	Progression-free survival	The time from the first dose of the study drug to the date of the first objectively documented tumor progression as assessed by Investigator review per RECIST v1.1 or death from any cause, whichever occurs first.	Until 100-day safety follow-up of the last participant on treatment
Secondary	Time to Response	The time from the first dose of the study drug to the date of the first confirmed documented response (CR or PR), as assessed by Investigator review per RECIST v1.1.	Until 100-day safety follow-up of the last participant on treatment
Secondary	Time to first subsequent therapy	The time from the first dose of the study drug to the date of the next cancer therapy or death.	Until 100-day safety follow-up of the last participant on treatment

External Links

•   BMS Clinical Trial Information
•   BMS Clinical Trial Patient Recruiting