DAREON™-5: A Study to Test Whether Different Doses of BI 764532 Help People With Small Cell Lung Cancer or Other Neuroendocrine Cancers

Small Cell Lung Carcinoma Clinical Trial

Official title:

DAREON™-5: An Open-label, Multi-center Phase II Dose Selection Trial of Intravenous BI 764532, a DLL3-targeting T Cell Engager, in Patients With Relapsed/Refractory Extensive-stage Small Cell Lung Cancer and in Patients With Other Relapsed/Refractory Neuroendocrine Carcinomas

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05882058
• Other study ID #: 1438-0005
• Secondary ID: 2023-504247-13-0
• Status: Recruiting
• Phase: Phase 2
• Start date: September 25, 2023
• Est. completion date: July 3, 2025

Study information

• Verified date: May 2024
• Source: Boehringer Ingelheim
• Contact: Boehringer Ingelheim
• Phone: 1-800-243-0127
• Email: clintriage.rdg[@]boehringer-ingelheim.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is open to adults with small cell lung cancer and other neuroendocrine tumours. The study is in people with advanced cancer for whom previous treatment was not successful or no standard treatment exists. The purpose of this study is to find a suitable dose of BI 764532 that people with advanced cancer can tolerate when taken alone. 2 different doses of BI 764532 are tested in this study. Another purpose is to check whether BI 764532 can make tumours shrink. BI 764532 is an antibody-like molecule (DLL3/CD3 bispecific) that may help the immune system fight cancer. Participants are put into 2 groups randomly, which means by chance. One group gets dose 1 of BI 764532 and the other group gets dose 2 of BI 764532. Participants get BI 764532 infusions into a vein when starting treatment. If there is benefit for the participants and if they can tolerate it, the treatment is given up to the maximum duration of the study. During this time, participants visit the study site regularly. The total number of visits depends on how they respond to and tolerate the treatment. The first study visits include an over-night stay to monitor participants' safety. Doctors record any unwanted effects and regularly check the general health of the participants.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 120
• Est. completion date: July 3, 2025
• Est. primary completion date: September 25, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion criteria:

1. Male or female participants =18 years old and at least at the legal age of consent in countries where it is greater than 18 years at the time of signature of the informed consent form (ICF).

2. Signed and dated written informed consent in accordance with International Council for Harmonisation-Good Clinical Practice (ICH-GCP) and local legislation prior to admission to the trial.

3. Histologically or cytologically confirmed, cancer of the following histologies:

• Small cell lung cancer (SCLC)
• Extra-pulmonary neuroendocrine carcinoma (epNEC) (except Merkel cell carcinoma (MCC), Medullary thyroid cancer (MTC) and Neuroendocrine prostate cancer (NEPC))
• Large cell neuroendocrine carcinoma (LCNEC) of the lung Patients with tumours with mixed histologies for any above type are eligible only if the neuroendocrine carcinoma/small tumour cells component is predominant and represents at least 50% of the overall tumour tissue. Patients must have progressed or recurred after standard of care therapy
• SCLC: after at least two prior lines of therapy, including at least one platinum-based regimen; in countries where standard of care in first line therapy includes PD-L1 inhibitor treatment patients should have received the combination of platinum-based regimen plus PD-L1 inhibitor unless they have been unable to receive checkpoint inhibitor treatment.
• epNEC/LCNEC: after at least one platinum-based regimen

4. Eastern Cooperative Oncology Group (ECOG) score of 0 or 1.

5. Measurable lesions as defined per Response Evaluation Criteria In Solid Tumours (RECIST) v 1.1 within 21 days prior to the first dose of BI 764532.

6. Availability of archival tumour tissue sample.

7. Adequate organ function as defined in the protocol.

8. All toxicities related to previous anti-cancer therapies have resolved = Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 prior to trial treatment administration (except for alopecia, peripheral neuropathy, fatigue and endocrinopathies controlled by replacement therapy which must be = CTCAE Grade 2 and amenorrhea/menstrual disorders which can be any grade).

9. Women of childbearing potential (WOCBP)and men able to father a child must be ready and able to use highly effective methods of birth control per ICH M3 (R2) that result in a low failure rate of less than 1% per year when used consistently and correctly. A list of contraception methods meeting these criteria and instructions on the duration of their use is provided in the participant information

Exclusion criteria:

1. Untreated or symptomatic brain metastases. Participants with treated, stable brain

metastases are eligible provided they meet the following criteria:

• Radiotherapy or surgery for brain metastases was completed at least 2 weeks prior to the first administration of BI 764532.
• Patient is off steroids for at least 7 days (physiologic doses of steroids are permitted), and the patient is off anti-epileptic drugs for at least 7 days or on stable doses of anti-epileptic drugs for malignant central nervous system (CNS) disease.

2. Presence of leptomeningeal disease.

3. Active/previous history of interstitial lung disease or non-infectious pneumonitis (any grade).

4. Participants who experienced severe, life-threatening immune-mediated adverse events or infusion-related reactions including those that lead to permanent discontinuation while on treatment with immuno-oncology agents.

5. Prior anti-cancer therapy:

• Patients who have been treated with any other anti-cancer drug within 4 weeks or within 5 half-life periods (whichever is shorter) prior to first administration of BI 764532.
• Patients who have been treated with extensive field radiotherapy including whole brain irradiation within 2 weeks prior to first administration of BI 764532.

6. Previous treatment with Delta-like ligand 3 (DLL3)-targeting T cell engagers or cell therapies.

7. Diagnosis of immunodeficiency or systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of BI 764532. Physiological replacement of steroids is allowed.

8. Unresolved toxicity from prior anti-tumour therapy, defined as per protocol. Further exclusion criteria apply.

Related Conditions & MeSH terms

• Carcinoma
• Neuroendocrine Neoplasms
• Neuroendocrine Tumors
• Small Cell Lung Carcinoma

Intervention

Drug:
• BI 764532, formulation 1
BI 764532, formulation 1
• BI 764532, formulation 2
BI 764532, formulation 2

Locations

Country	Name	City	State
Belgium	UNIV UZ Gent	Gent
Belgium	UZ Leuven	Leuven
Bulgaria	MHAT UniHospital	Panagyurishte
Bulgaria	MHAT Heart and brain	Pleven
China	West China Hospital	Chengdu
China	Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine	Hangzhou
China	960 Hospital of the Chinese People's Liberation Army	Jinan
China	Qilu Hospital, Shangdong University	Jinan
China	The Second Affiliated Hospital to Nanchang University	Nanchang
China	Shanghai Chest Hospital	Shanghai
France	HOP Intercommunal	Créteil
France	HOP Cochin	Paris
France	HOP Civil	Strasbourg
Germany	Evangelische Lungenklinik Berlin	Berlin
Germany	Universitätsklinikum Carl Gustav Carus Dresden	Dresden
Germany	Universitätsklinikum Erlangen	Erlangen
Germany	Asklepios Fachkliniken München-Gauting	Gauting
Germany	LungenClinic Grosshansdorf GmbH	Großhansdorf
Germany	Universitätsmedizin der Johannes Gutenberg-Universität Mainz	Mainz
Japan	Aichi Cancer Center Hospital	Aichi, Nagoya
Japan	National Cancer Center Hospital East	Chiba, Kashiwa
Japan	Sendai Kousei Hospital	Miyagi, Sendai
Japan	Osaka International Cancer Institute	Osaka, Osaka
Japan	Kindai University Hospital	Osaka, OsakaSayama
Japan	National Cancer Center Hospital	Tokyo, Chuo-ku
Japan	Japanese Foundation for Cancer Research	Tokyo, Koto-ku
Korea, Republic of	Asan Medical Center	Seoul
Korea, Republic of	Samsung Medical Center	Seoul
Korea, Republic of	Severance Hospital	Seoul
Portugal	Hospital CUF Tejo	Lisboa
Portugal	Hospital CUF Porto	Porto
Spain	Hospital del Mar	Barcelona
Spain	Hospital Vall d'Hebron	Barcelona
Spain	Hospital Universitario 12 de Octubre	Madrid
Spain	Hospital Virgen de la Victoria	Malaga
Spain	Hospital Clínico de Valencia	Valencia
Taiwan	NCKUH	Tainan
Taiwan	Taipei Veterans General Hospital	Taipei
Taiwan	Chang Gung Memorial Hospital(Linkou)	Taoyuan County
United Kingdom	Leicester Royal Infirmary	Leicester
United Kingdom	University College Hospital	London
United Kingdom	Freeman Hospital	Newcastle Upon Tyne
United States	Dana-Farber Cancer Institute	Boston	Massachusetts
United States	Montefiore Medical Center	Bronx	New York
United States	Indiana University	Indianapolis	Indiana
United States	Mayo Clinic Cancer Center	Jacksonville	Florida
United States	University of Kentucky Medical Center	Lexington	Kentucky
United States	Valkyrie Clinical Trials	Los Angeles	California
United States	University of Miami	Miami	Florida
United States	Infirmary Cancer Care	Mobile	Alabama
United States	Laura & Isaac Perlmutter Cancer Center at NYU Langone Health	New York	New York
United States	Mayo Clinic-Arizona	Phoenix	Arizona
United States	Mayo Clinic, Rochester	Rochester	Minnesota
United States	University of California San Francisco	San Francisco	California

Sponsors (1)

Lead Sponsor	Collaborator
Boehringer Ingelheim

Countries where clinical trial is conducted

United States,  Belgium,  Bulgaria,  China,  France,  Germany,  Japan,  Korea, Republic of,  Portugal,  Spain,  Taiwan,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Objective response (OR), defined as a best overall response of confirmed complete response (CR) or confirmed partial response (PR)	according to RECIST v 1.1 by investigator assessment from the date of treatment start until the earliest date of disease progression, death, or last evaluable tumour assessment before start of subsequent anti-cancer therapy, loss to follow-up, or withdrawal of consent.	up to 23 months
Primary	Occurrence of treatment-emergent adverse events (TEAEs) during the on-treatment period		up to 23 months
Secondary	Duration of objective response (DOR) based on investigator assessment	DOR is defined as the time from first documented confirmed OR until the earliest date of disease progression or death among patients with confirmed OR.	up to 23 months
Secondary	Progression-free survival (PFS) based on investigator assessment	PFS is defined as the time from treatment start until the earliest date of tumour progression according RECIST v 1.1 or death from any cause, whichever occurs first.	up to 23 months
Secondary	Disease control (DC), defined as best overall response of CR or PR or stable disease (SD) based on investigator assessment	where best overall response is defined according to RECIST v 1.1, from first treatment administration until the earliest of disease progression, death, or last evaluable tumour assessment before start of subsequent anti-cancer therapy, loss to follow-up or withdrawal of consent	up to 23 months
Secondary	Overall survival (OS), defined as the time from treatment start until death from any cause		up to 23 months
Secondary	Change from baseline in EORTC QLQ-C30 physical functioning domain score	European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) The QLQ-C30 is comprised of 30 questions. It incorporates both multi-item scales and single-item measures. These include one global health status/Quality of Life (QoL) scale, five functional scales, three symptom scales and six single items to assess dyspnea, insomnia, appetite loss, constipation, diarrhoea and financial difficulties.; All scales and single-item measures range in score from 0 to 100. A high score for a functional scale represents a high/healthy level of functioning. A high score for the global health status/QoL represents a high QoL. A high score for a symptom scale/item represents a high level of symptomatology/problems.	at baseline, at month 23
Secondary	Change from baseline in EORTC QLQ-C30 role functioning domain score		at baseline, at month 23
Secondary	Occurrence of treatment-emergent AEs leading to study drug discontinuation during the on-treatment period		up to 23 months

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