High-Risk Skin Cancers With Atezolizumab Plus NT-I7

Melanoma Clinical Trial

Official title:

A Phase 1b/2a, Open Label Study to Evaluate Anti-tumor Efficacy and Safety of rhIL-7-hyFc (NT-I7) in Combination With Anti-PD-L1 (Atezolizumab) in Patients With Anti-PD-1/PD-L1 naïve or Relapsed/Refractory High-risk Skin Cancers

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT03901573
• Other study ID #: NIT-106
• Secondary ID: ION-02
• Status: Terminated
• Phase: Phase 1/Phase 2
• Start date: December 26, 2019
• Est. completion date: August 15, 2023

Study information

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

Clinical Trial Summary

The purpose of this study is to test whether the addition of NT-I7 to atezolizumab provides clinically meaningful outcomes for patients with anti-PD-1/PD-L1 naive or relapsed/refractory high-risk melanoma, Merkel Cell Carcinoma (MCC) and cutaneous Squamous Cell Carcinoma (cSCC)

Description:

This is a Phase 1b/2a, open-label, multicenter study to evaluate the safety, tolerability and anti-tumor effect of NT-I7 (rhIL-7-hyFc) in combination with atezolizumab (MPDL3280A, anti-PD-L1) in patients with anti-PD-1/PD-L1 naïve or relapsed/refractory high-risk skin cancers including cutaneous Squamous Cell Carcinoma (cSCC), Merkel Cell Carcinoma (MCC) and melanoma.

This study has been designed to evaluate the safety and tolerability, including the Maximum Tolerated Dose (MTD) or recommended Phase 2 dose (RP2D), of NT-I7 in combination with atezolizumab.

There are two phases to this study:

• Phase 1b, a NT-I7 dose-escalation phase to determine the MTD or RP2D

• Phase 2a, a non-randomized parallel dose expansion phase to confirm the MTD or RP2D in both arms.

Arm I: Anti-PD-1/PD-L1 (checkpoint inhibitors, CPI) naïve patients with cSCC and MCC

Arm II: Anti-PD-1/PD-L1 relapsed/refractory patients with cSCC, MCC and melanoma

Number of Patients A total of up to 84 patients will be enrolled; Up to 24 patients will be enrolled in the Phase 1b (up to 6 patients per dose level, using 3 + 3 design), and 60 patients will be enrolled in the Phase 2a (24 patients in Arm I, i.e., 12 patients for each indication, and 36 in Arm II, i.e., 12 patients for each indication).

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 31
• Est. completion date: August 15, 2023
• Est. primary completion date: August 15, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Key Inclusion Criteria:

1. Patients must be =18 years of age on day of signing informed consent document.

2. Eastern Cooperative Oncology Group (ECOG) performance status =2 (Karnofsky =60%).

3. Patients must have adequate organ and marrow function.

4. Patients positive for HIV can be considered.

5. Arm I - cSCC: Patients must have biopsy-proven metastatic cSCC or locoregional cSCC that has recurred following standard locoregional therapy with surgery and/or radiation therapy; MCC: Patients must have biopsy-proven metastatic MCC or locoregional MCC in need of systemic therapy, including patients that have not had prior systemic therapy or have recurred following standard locoregional therapy with surgery and/or radiation therapy. Prior chemotherapy is allowed.

6. Arm II - MCC: Patients must have biopsy-proven metastatic MCC or locoregional MCC that has recurred following anti-PD-1 or anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1; cSCC: Patients must have biopsy-proven metastatic cSCC or locoregional cSCC that has recurred following anti-PD-1 or anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1; Melanoma: Patients must have biopsy-proven metastatic melanoma or locoregional melanoma that has recurred following anti-PD-1, anti-PD-L1, or has SD following anti-PD-1 or anti-PD-L1, defined as 12 weeks of SD per RECIST 1.1.

Note: Prior therapy with ipilimumab is allowed (subject to a 6-week washout period) but not required.

Note: Progression following targeted therapies (e.g., BRAF inhibitor and/or MEK inhibitor) or other approved (e.g., talimogene laherparepvec [T-VEC]) or investigational therapies is allowed.

Key Exclusion Criteria:

1. Pregnancy, lactation, or breastfeeding.

2. Significant cardiovascular disease.

3. Poorly controlled Type 2 diabetes mellitus.

4. Major surgical procedure, other than for diagnosis, within 28 days prior to Cycle 1, Day 1, or anticipation of need for a major surgical procedure during the study.

5. Patients who have had chemotherapy or radiotherapy within 2 weeks (4 weeks for nitrosoureas or systemic mitomycin C) prior to Cycle 1, Day 1.

6. Patients who had prior treatment with immune CPIs, immunomodulatory monoclonal antibodies (mAbs), and/or mAb-derived therapies within 6 weeks before the initiation of study treatment, except for prior anti-PD-L1/anti-PD-1, which requires a 3-week washout period.

7. Patients who have received treatment with any other investigational agent within 4 weeks prior to Cycle 1, Day 1.

8. Patients who have received treatment and failed therapy with checkpoint inhibition plus a T-cell growth factor, e.g., IL-2 (NTKR-204), IL-15 (ALT-803) or IL-7 (CYT107).

9. Patients with known primary central nervous system (CNS) malignancy, untreated CNS metastases, or active CNS metastases (progressing or requiring corticosteroids for symptomatic control) are excluded, with some exceptions.

10. Patients who have leptomeningeal disease.

11. Patients with autoimmune disease history.

12. Patients who have received treatment with systemic immunosuppressive medications within 2 weeks prior to Cycle 1, Day 1.

13. Patients who have a history of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or evidence of active pneumonitis on screening chest CT scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted.

14. Patients with active hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] test at screening).

15. Patients with active tuberculosis (TB).

16. Patients who have severe infections within 4 weeks prior to Cycle 1, Day 1.

17. Patients who have signs or symptoms of recent infection (not meeting the above criteria for severe infections) within 2 weeks before initiation of study treatment.

18. Patients with prior allogeneic bone marrow transplantation or prior solid organ transplantation.

19. Patients who have received a live, attenuated vaccine within 4 weeks prior to Cycle 1, Day 1 or anticipate that such a live attenuated vaccine be required during the study.

Related Conditions & MeSH terms

• Carcinoma
• Carcinoma, Merkel Cell
• Cutaneous Squamous Cell Carcinoma
• Melanoma
• Merkel Cell Carcinoma
• Skin Neoplasms

Intervention

Drug:
• NT-I7
Dose Escalation (Phase 1b) - NT-I7 IM (intramuscular) on Day 1 of each Cycle until MTD or RP2D is achieved. Dose Expansion - NT-I7 IM (intramuscular) on Day 1 of each Cycle, at Maximum Tolerated Dose (MTD) or RP2D defined in escalation phase
• atezolizumab
Dose Escalation - atezolizumab IV (intravenous) on Day 1 of each Cycle Dose Expansion - atezolizumab IV (intravenous) on Day 1 of each Cycle

Locations

Country	Name	City	State
United States	Dana Farber	Boston	Massachusetts
United States	MGH	Boston	Massachusetts
United States	Northwestern University	Chicago	Illinois
United States	Cleveland Clinic	Cleveland	Ohio
United States	City of Hope	Duarte	California
United States	Mt Sinai	New York	New York
United States	Providence Portland Medical Center	Portland	Oregon
United States	Washington University	Saint Louis	Missouri

Sponsors (2)

Lead Sponsor	Collaborator
NeoImmuneTech	Immune Oncology Network

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Safety and Tolerability of NT-I7 in combination with atezolizumab to determine the maximum tolerated dose (MTD) and/or the recommended Phase 2 dose (RP2D) of NT-I7	Incidence, nature, and severity of adverse events graded according to NCI CTCAE v5.0; Incidence and nature of Dose-Limiting Toxicities (DLTs); Potential correlation with PK, pharmacodynamic, safety, and efficacy parameters	Up to approximately 56 months
Secondary	To evaluate immunogenicity of NT-I7 and atezolizumab	To determine and evaluate the incidence of anti-drug antibodies (ADA) to NT-I7 and atezolizumab during the study relative to the prevalence of ADA at baseline	Up to approximately 56 months
Secondary	Preliminary assessment of the Objective Response Rate (ORR) of NT-I7 in combination with atezolizumab	To preliminarily assess the Objective Response Rate (ORR) defined as percentage of patients who have at least one confirmed partial response (PR) or complete response (CR) according to RECIST v1.1, as determined by the investigator.	Up to approximately 56 months
Secondary	Preliminary assessment the Disease Control Rate (DCR) of NT-I7 in combination with atezolizumab	To preliminarily assess the Disease Control Rate (DCR) defined as proportion of patients with a best overall response of CR, PR or stable disease (SD).	Up to approximately 56 months
Secondary	Preliminary assessment the Duration of Objective Response (DOR) of NT-I7 in combination with atezolizumab	To preliminarily assess the Duration of Objective Response (DOR), defined as the time from the first occurrence of a documented objective response to the time of the first documented disease progression or death from any cause, whichever occurs first, per RECIST v1.1 as determined by the investigator.	Up to approximately 56 months
Secondary	Preliminary assessment the Progression Free Survival (PFS) of NT-I7 in combination with atezolizumab	To preliminarily assess the Progression Free Survival (PFS), defined as the time from the first study treatment (Cycle 1 Day 1) to the first occurrence of progression or death from any cause, whichever occurs first, per RECIST v1.1 as determined by the investigator.	Up to approximately 56 months
Secondary	Preliminary assessment the Overall Survival (OS) of NT-I7 in combination with atezolizumab	To preliminarily assess the Overall Survival (OS) defined as the time from first study treatment (Cycle 1 Day 1) to death from any cause.	Up to approximately 56 months