A Study of MGD020 Alone or Combined With MGD014 in Persons With HIV-1 on Antiretroviral Therapy

Human Immunodeficiency Virus I Infection Clinical Trial

Official title:

A Phase 1 Study of MGD020 as a Single Agent or in Combination With MGD014 in Persons With HIV-1 on Antiretroviral Therapy

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT05261191
• Other study ID #: CP-MGD020-01
• Secondary ID: 272201500032C-P0
• Status: Active, not recruiting
• Phase: Phase 1
• Start date: September 26, 2022
• Est. completion date: May 2024

Study information

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

Clinical Trial Summary

Study CP-MGD020-01 is a phase 1, open-label, dose-escalation, and multi-dose expansion study of MGD020 as a single agent or in combination with MGD014 in persons with HIV-1 (PWH) on antiretroviral therapy (ART). The study is designed to evaluate the safety, tolerability, pharmacokinetics (PK), immunogenicity, and pharmacodynamics (PD) of the study drugs. The study consists of 3 parts (Part 1A, Part 1B, and Part 2). The participant's standard of care ART regimen is continued throughout the study period. MGD020 is a bispecific DART® molecule that binds CD3 and gp41 subunit of HIV-1 envelope. MGD014 is a bispecific DART® molecule that binds CD3 and gp120 subunit of HIV-1 envelope. These DART molecules redirect CD3+ T lymphocytes to kill HIV-1-infected CD4+ T cells. Part 1A evaluates groups of participants given a single dose of MGD020. A 2-week safety period is observed prior to escalation to the next dose level. Dose escalation continues until either the maximum tolerated dose (MTD) or maximum administered dose (MAD) is determined. Part 1B begins after the end of Part 1A. Part 1B evaluates groups of participants given a single dose of the MGD020 MTD or MAD from Part 1A and a fixed dose of of MGD014. The first group will be treated with a single dose of MGD020, at a dose determined to be one dose lower than the single-agent MTD/MAD from Part 1A, and a single 300 mcg/kg dose of MGD014. Dose escalation proceeds until either the MTD or MAD is determined. Part 2 begins after the end of Part 1B. Part 2 is a multi-dose expansion group. Each participant will receive the MTD or MAD of MGD020 from Part 1B and a fixed dose of MGD014 from Part 1B, administered every 2 weeks (Q2W) for 3 combination doses over 4 weeks. Up to 6 participants may be enrolled in Part 2.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 54
• Est. completion date: May 2024
• Est. primary completion date: May 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

• Aged = 18 years and = 70 years of age and able to provide informed consent
• HIV-1 infection documented by rapid HIV test or HIV enzyme or chemiluminescence immunoassay and confirmed by a different second test.
• Plasma HIV-1 RNA viral load
• < 50 copies/mL at 2 time points within 24 months prior to screening (1 time point within 12 months prior to screening), and
• < 50 copies/mL at screening, and
• Not = 50 copies/mL on 2 consecutive time points within 24 months nor > 1000 copies/mL at any time within 6 months prior to screening
• On continuous antiretroviral therapy (ART) for at least 24 months prior to screening and must continue ART throughout the study.
• CD4 cell count > 350 cells/mm3 at screening
• Acceptable laboratory values related to bone marrow, kidney and liver function.
• Individuals of childbearing potential must agree to use highly effective forms of contraception throughout the study through 6 months after the last dose of MGD014.

Exclusion Criteria:

• History of any HIV-1 vaccine or HIV-1 immunotherapy, except MGD014 or MGD020, within 6 months prior to screening.
• History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the patient's participation for the full duration of the trial, or is not in the best interest of the patient.
• Active viral, bacterial, or systemic fungal infection requiring intravenous antibiotic, antiviral, or antifungal treatment within 7 days prior to the initiation of study drug.
• Active coronavirus disease 19 (COVID-19)/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
• Participation in another investigational clinical research study within 60 days prior to screening.
• History of virologic failure on an ART regimen containing FDA-approved HIV-1 entry inhibitors (maraviroc, enfuvirtide, and/or ibalizumab). Virologic failure is defined as a confirmed plasma HIV-1 RNA = 150 copies/mL following assessment of drug adherence, repeat HIV-1 RNA testing with continued treatment, and/or resistance testing

Related Conditions & MeSH terms

• Acquired Immunodeficiency Syndrome
• HIV Infections
• Human Immunodeficiency Virus I Infection
• Human Immunodeficiency Virus Type 1
• Immunodeficiency Virus Type 1, Human
• Immunologic Deficiency Syndromes

Intervention

Biological:
• MGD020
MGD020 is a bispecific DART molecule that binds CD3 and gp41 subunit of HIV-1 envelope.
• MGD014
MGD014 is a bispecific DART molecule that binds CD3 and gp120 subunit of HIV-1 envelope.

Locations

Country	Name	City	State
United States	UNC Hospital - Chapel Hill	Chapel Hill	North Carolina
United States	Case Western Reserve University Hospital	Cleveland	Ohio
United States	Icahn School of Medicine at Mt. Sinai	New York	New York

Sponsors (4)

Lead Sponsor	Collaborator
MacroGenics	Department of Health and Human Services, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number and types of adverse events (AEs), including serious adverse events (SAEs), and AEs leading to treatment discontinuation in participants receiving MGD020 alone in Part 1A	Observation of side effects determines the highest safe dose for further study	Throughout the study, up to 43 days
Primary	Number and types of adverse events (AEs), including serious adverse events (SAEs), and AEs leading to treatment discontinuation in participants receiving MGD020 and MGD014 in Part 1B.	Observation of side effects determines the highest safe dose for further study	Throughout the study, up to 43 days
Primary	Number and types of adverse events (AEs), including serious adverse events (SAEs), and AEs leading to treatment discontinuation in participants receiving MGD020 and MGD014 in Part 2.	Observation of side effects determines the highest safe dose for further study	Throughout the study, up to 81 days.
Secondary	Maximum concentration of MGD020	The highest concentration of MGD020 at the end of the infusion	Study Day 1, 2, 3, 8, 15, 29, and 43 for Parts 1A and 1B. Study Day 1, 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Maximum concentration of MDG014	The highest concentration of MGD014 at the end of the infusion	Study Day 1, 2, 3, 8, 15, 29, and 43 for Part 1B. Study Day 1, 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Time to maximal concentration of MGD020	The amount of time required to get maximum concentration of MGD020	Study Day 1, 2, 3, 8, 15, 29, and 43 for Parts 1A and 1B. Study Day 1, 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Time to maximal concentration of MGD014	The amount of time required to get maximum concentration of MGD014	Study Day 1, 2, 3, 8, 15, 29, and 43 for Part 1B. Study Day 1, 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Area under the concentration-time curve (AUC) of MGD020	Total body exposure to MGD020	Study Day 1, 2, 3, 8, 15, 29, and 43 for Parts 1A and 1B. Study Day 1, 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	AUC of MGD014	Total body exposure to MGD014	Study Day 1, 2, 3, 8, 15, 29, and 43 for Part 1B. Study Day 1, 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Trough concentration of MGD020	The amount of MGD020 left after dosing	Study Day 2, 3, 8, 15, 29, and 43 for Parts 1A and 1B. Study Day 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Trough concentration of MGD014	The amount of MGD014 left after dosing	Study Day 2, 3, 8, 15, 29, and 43 for Part 1B. Study Day 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Half-life of MGD020	The amount of time needed for the body to clear half of the dose of MGD020	Study Day 2, 3, 8, 15, 29, and 43 for Parts 1A and 1B. Study Day 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Half-life of MGD014	The amount of time needed for the body to clear half of the dose of MGD014	Study Day 2, 3, 8, 15, 29, and 43 for Part 1B. Study Day 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Volume of Distribution at steady state of MGD020	This parameter measures how much of the drug remains in the bloodstream or is distributed to body tissues.	Study Day 2, 3, 8, 15, 29, and 43 for Parts 1A and 1B. Study Day 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Volume of Distribution at steady state of MGD014	This parameter measures how much of the drug remains in the bloodstream or is distributed to body tissues.	Study Day 2, 3, 8, 15, 29, and 43 for Part 1B. Study Day 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Clearance of MGD020	Total body clearance of the drug from plasma of MGD020	Study Day 2, 3, 8, 15, 29, and 43 for Parts 1A and 1B. Study Day 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Clearance of MGD014	Total body clearance of the drug from plasma of MGD014	Study Day 2, 3, 8, 15, 29, and 43 for Parts 1A and 1B. Study Day 2, 3, 8, 15, 29, 43, 50, 64, and 78 for Part 2
Secondary	Change from baseline in serum cytokine levels of IFN-?, IL-2, IL-5, IL-6, IL-10, and TNF-a		Day 1, 2, and 8 Part 1B. Day 1, 2, 8, 15, and 29 in Part 2.
Secondary	Anti-drug antibody formation to MGD020	Number of patients who develop antibodies against MDG020	Day 1, 15, 29 and 43 in Part 1A and 1B. Day 1, 15, 29, and 78 in Part 2.
Secondary	Anti-drug antibody formation to MGD014	Number of patients who develop antibodies against MDG014	Day 1, 15, 29 and 43 in Part 1A and 1B. Day 1, 15, 29, and 78 in Part 2.