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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT03837899
Other study ID # D419EC00001
Secondary ID 2018-003118-42
Status Active, not recruiting
Phase Phase 1/Phase 2
First received
Last updated
Start date March 7, 2019
Est. completion date December 30, 2024

Study information

Verified date May 2024
Source AstraZeneca
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of the study is to determine the recommended dose of durvalumab and tremelimumab (immunotherapy drugs) in pediatric patients with advanced solid and hematological cancers and expand in a second phase to test the efficacy of these drugs once this dose is determined.


Description:

This is a first time in pediatrics study primarily designed to evaluate the safety and tolerability of durvalumab and durvalumab in combination with tremelimumab at increasing doses in pediatric patients with advanced solid malignancies and hematological malignancies (including lymphomas) and for whom no standard of care treatments exist. Although treatment efficacy is not a primary objective of this study given its early phase nature, the patients screened for this study have no curative options and this study offers the potential of some benefit. The study will also characterize the PK of durvalumab and durvalumab in combination with tremelimumab in children and adolescents and explore potential biological activity and immunogenicity by assessing pharmacodynamics, anti drug antibody (ADA) levels, and anti-tumor activity. The results from this trial will form the basis for decisions for potential future pediatric studies


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 56
Est. completion date December 30, 2024
Est. primary completion date February 28, 2023
Accepts healthy volunteers No
Gender All
Age group 0 Years to 18 Years
Eligibility Inclusion Criteria: - Max Age =17 years - Solid Tumors (except primary central nervous system malignant tumors): Patients must have a histopathologic confirmation of malignancy. Patients must have progressed or are refractory to standard therapies, and for whom no standard of care treatments exist - Non-Hodgkin's Lymphoma, limited to primary mediastinal B-cell lymphoma and anaplastic large cell lymphoma. Patients must have progressed or are refractory to standard therapies, and for whom no standard of care treatments exist. - Provision of diagnostic tumor sample mandated if available - Evaluable disease - No prior exposure to immune-mediated therapy - Adequate organ and marrow function - Life expectancy of at least 3 months Exclusion Criteria: - History of allogeneic organ transplantation (exceptions may be allowed for NHL after discussion with Sponsor). History of autologous bone marrow transplant may be allowed (after discussion with Sponsor). - Active or prior documented autoimmune or inflammatory disorders (exceptions) - Uncontrolled intercurrent illness - History of primary immunodeficiency - Active infection including tuberculosis, hepatitis B, C or HIV - Any unresolved toxicity NCI CTCAE version 5.0 Grade =2 from previous anticancer therapy (exceptions)

Study Design


Intervention

Drug:
Durvalumab / Tremelimumab Combination Therapy
Starting dose: durvalumab: 20mg/kg tremelimumab: 1mg/kg at cycles 2 to 5 only co-administered with durvalumab. The Recommended Phase 2 dose will be used for the dose expansion phase.

Locations

Country Name City State
France Research Site Lille Cedex
France Research Site Marseille
France Research Site Paris Cedex 05
Germany Research Site Köln
Italy Research Site Genova
Italy Research Site Milano
Italy Research Site Rome
Italy Research Site Torino
Netherlands Research Site Utrecht
Spain Research Site Barcelona
Spain Research Site Madrid
United Kingdom Research Site Leeds
United Kingdom Research Site London
United Kingdom Research Site Sutton
United States Research Site Baltimore Maryland
United States Research Site Boston Massachusetts
United States Research Site Charleston South Carolina
United States Research Site New Hyde Park New York
United States Research Site Oklahoma City Oklahoma

Sponsors (1)

Lead Sponsor Collaborator
AstraZeneca

Countries where clinical trial is conducted

United States,  France,  Germany,  Italy,  Netherlands,  Spain,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Dose-Finding Phase: Maximum Serum Concentration (Cmax) of Durvalumab Serum samples were collected from the participants at the defined timepoints. Cmax was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 6, 8, 10 and 12
Primary Dose-Finding Phase: Minimum Serum Concentration (Cmin) of Durvalumab Serum samples were collected from the participants at the defined timepoints. Cmin was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 6, 8, 10 and 12
Primary Dose-Finding Phase: Area Under the Serum Concentration-Time Curve (AUC) From Zero to 14 (AUC 0-14) of Durvalumab Serum samples were collected from the participants at the defined timepoints. AUC (0-14) was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1 and Cycle 1 Day 8
Primary Dose-Finding Phase: AUC From Zero to 28 (AUC 0-28) of Durvalumab Serum samples were collected from the participants at the defined timepoints. AUC (0-28) was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, and Cycle 1 Day 15
Primary Dose-Finding Phase: Time to Cmax (Tmax) of Durvalumab Serum samples were collected from the participants at the defined timepoints. Tmax was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 6, 8, 10 and 12
Primary Dose-Finding Phase: Apparent Terminal Elimination Half-life Associated With the Terminal Slope of the Semi-logarithmic Concentration Time Curve (t½?z) of Durvalumab Serum samples were collected from the participants at the defined timepoints. T½?z was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 6, 8, 10 and 12
Primary Dose-Finding Phase: Dose-Normalized AUC (0-14) (AUC [0-14]/D) of Durvalumab Serum samples were collected from the participants at the defined timepoints. AUC(0-14)/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1 and Cycle 1 Day 8
Primary Dose-Finding Phase: Dose-Normalized AUC (0-28) (AUC [0-28]/D) of Durvalumab Serum samples were collected from the participants at the defined timepoints. AUC(0-28)/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, and Cycle 1 Day 15
Primary Dose-Finding Phase: Dose-Normalized Cmax (Cmax/D) of Durvalumab Serum samples were collected from the participants at the defined timepoints. Cmax/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 6, 8, 10 and 12
Primary Dose-Finding Phase: Cmax of Tremelimumab Serum samples were collected from the participants at the defined timepoints. Cmax was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 2 Day 8, Cycle 2 Day 15, pre-infusion and post-infusion in Cycle 3, 4, and 5
Primary Dose-Finding Phase: Cmin of Tremelimumab Serum samples were collected from the participants at the defined timepoints. Cmin was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 2 Day 8, Cycle 2 Day 15, pre-infusion and post-infusion in Cycle 3, 4, and 5
Primary Dose-Finding Phase: (AUC 0-14) of Tremelimumab Serum samples were collected from the participants at the defined timepoints. AUC (0-14) was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1, and Cycle 2 Day 8
Primary Dose-Finding Phase: (AUC 0-28) of Tremelimumab Serum samples were collected from the participants at the defined timepoints. AUC (0-28) was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 2 Day 8, and Cycle 2 Day 15
Primary Dose-Finding Phase: Tmax of Tremelimumab Serum samples were collected from the participants at the defined timepoints. Tmax was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 2 Day 8, Cycle 2 Day 15, pre-infusion and post-infusion in Cycle 3, 4, and 5
Primary Dose-Finding Phase: T½?z of Tremelimumab Serum samples were collected from the participants at the defined timepoints. T½?z was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 2 Day 8, Cycle 2 Day 15, pre-infusion and post-infusion in Cycle 3, 4, and 5
Primary Dose-Finding Phase: AUC (0-14)/D of Tremelimumab Serum samples were collected from the participants at the defined timepoints. AUC(0-14)/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1 and Cycle 2 Day 8
Primary Dose-Finding Phase: AUC (0-28)/D of Tremelimumab Serum samples were collected from the participants at the defined timepoints. AUC(0-28)/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 2 Day 8, and Cycle 2 Day 15
Primary Dose-Finding Phase: Cmax/D of Tremelimumab Serum samples were collected from the participants at the defined timepoints. Cmax/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 2 Day 8, Cycle 2 Day 15, pre-infusion and post-infusion in Cycle 3, 4, and 5
Primary Dose-Finding Phase: Number of Participants With Adverse Events (AE), Serious AE (SAE), AE Leading to Discontinuation of Durvalumab and Tremelimumab, AE of Special Interest (AESI) or AE of Possible Interest (AEPI) Related to Durvalumab and Tremelimumab An AE was defined as any untoward medical occurrence in a participant temporally associated with the use of study treatment, whether or not considered related to the study treatment. SAEs were any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. Some AEs and higher-level terms were considered AESI or AEPIs and this list of categories were provided by the patient safety team. From Day 1 up to 15 months
Primary Dose-Expansion Phase Only: Objective Response Rate (ORR) ORR as per RECIST 1.1 was defined as the percentage of participants with at least 1 investigator-assessed visit response of complete response (CR) or partial response (PR) that was subsequently confirmed on another scan not less than 4 weeks after visit observed response. CR was defined as disappearance of all target lesions (TLs), any pathological lymph nodes selected as TLs with reduction in short axis to < 10 millimeter (mm). PR was defined as at least a 30% decrease in the sum of diameters of TLs, with reference to baseline sum of diameters as long as criteria for PD are not met. From first dose of study treatment until death or up to approximately 4 years (clinical DCO of 20 Apr 2023)
Primary Dose-Expansion Phase Only: Duration of Response (DOR) Duration of response was the time from the first documentation of CR/PR (which was subsequently confirmed) until the date of documented progression, or death which coincides with the progression free survival (PFS) endpoint. For participants who did not progress following a response, the DOR was censored during the PFS censoring time. It was calculated using Kaplan-Meier technique. From first dose of study treatment until death or up to approximately 4 years (clinical DCO of 20 Apr 2023)
Primary Dose-Expansion Phase Only: Best Objective Response (BOR) BOR was calculated based on the overall visit responses from each RECIST 1.1 assessment. Categorization of BOR for solid tumors were based on RECIST 1.1 using the following response categories: CR, PR, stable disease (SD), progression of disease (PD), and not evaluable (NE). CR: disappearance of all TLs. Any pathological lymph nodes selected as TLs had a reduction in short axis to <10 mm. PR: 30% decrease in the sum of diameters of TLs. SD: Neither sufficient decrease in sum of diameters to qualify for PR nor sufficient increased to qualify for PD. PD: >= 20 % increase in the sum of diameters to TLs and an increase of >= 5 mm. NE: Only relevant if any of the TLs were not assessed or NE or had a lesion intervention at visit. Non-CR/Non-PD: Persistence of 1+ non-target lesion (s). Non-CR/non-PD was relevant to participants who did not have measurable disease at baseline. From first dose of study treatment until death or up to approximately 4 years (clinical DCO of 20 Apr 2023)
Primary Dose-Expansion Phase Only: Disease Control Rate (DCR) DCR was defined as the percentage of participants who achieved a BOR of unconfirmed CR or PR, respectively, or who had SD. CR was defined as disappearance of all TLs, any pathological lymph nodes selected as TLs with reduction in short axis to < 10 mm. PR was defined as at least a 30% decrease in the sum of diameters of TLs, with reference to baseline sum of diameters as long as criteria for PD are not met. SD: Neither sufficient decrease in sum of diameters to qualify for PR nor sufficient increased to qualify for PD. At 16 and 24 Weeks
Primary Dose-Expansion Phase Only: PFS PFS as per RECIST 1.1 was defined as the time from the date of first dose of study treatment until the date of objective disease progression or death by any cause in the absence of progression, regardless of whether the participant withdrew from study therapy or received another anti-cancer therapy prior to progression (date of PFS event or censoring - date of first dose + 1). Confidence interval was calculated using Kaplan-Meier technique. From first dose of study treatment until death or up to approximately 4 years (clinical DCO of 20 Apr 2023)
Primary Dose-Expansion Phase Only: Overall Survival (OS) OS was defined as the time from the date of first dose of study treatment until death due to any cause regardless of whether the patient withdraws from study treatment or received another anti-cancer therapy (i.e date of death or censoring - date of first dose + 1). From first dose of study treatment until death or up to approximately 4 years (clinical DCO of 20 Apr 2023)
Primary Dose-Expansion Phase Only: Survival Rate at 12 Months and 24 Months Survival rates were defined as the Kaplan-Meier estimate of OS at 12 and 24 months. At 12 and 24 Weeks
Secondary Dose-Expansion Phase: Cmax of Durvalumab Serum samples were collected from the participants at the defined timepoints. Cmax was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 8, and 12
Secondary Dose-Expansion Phase: Cmin of Durvalumab Serum samples were collected from the participants at the defined timepoints. Cmin was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 8, and 12
Secondary Dose-Expansion Phase: AUC (0-14) of Durvalumab Serum samples were collected from the participants at the defined timepoints. AUC (0-14) was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1 and Cycle 1 Day 8
Secondary Dose-Expansion Phase: AUC (0-28) of Durvalumab Serum samples were collected from the participants at the defined timepoints. AUC (0-28) was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, and Cycle 1 Day 15
Secondary Dose-Expansion Phase: Tmax of Durvalumab Serum samples were collected from the participants at the defined timepoints. Tmax was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 8, and 12
Secondary Dose-Expansion Phase: T½?z of Durvalumab Serum samples were collected from the participants at the defined timepoints. T½?z was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 8, and 12
Secondary Dose-Expansion Phase: AUC (0-14)/D of Durvalumab Serum samples were collected from the participants at the defined timepoints. AUC (0-14)/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1 and Cycle 1 Day 8
Secondary Dose-Expansion Phase: AUC (0-28)/D of Durvalumab Serum samples were collected from the participants at the defined timepoints. AUC (0-28)/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, and Cycle 1 Day 15
Secondary Dose-Expansion Phase: Cmax/D of Durvalumab Serum samples were collected from the participants at the defined timepoints. Cmax/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, pre-infusion and post-infusion in Cycle 3, 4, 8, and 12
Secondary Dose-Expansion Phase: Cmax of Tremelimumab Serum samples were collected from the participants at the defined timepoints. Cmax was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 3 Day 1 pre-infusion and post-infusion on Cycle 4
Secondary Dose-Expansion Phase: Cmin of Tremelimumab Serum samples were collected from the participants at the defined timepoints. Cmin was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 3 Day 1 pre-infusion and post-infusion on Cycle 4
Secondary Dose-Expansion Phase: AUC (0-14) of Tremelimumab Serum samples were collected from the participants at the defined timepoints. AUC (0-14) was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1 and Cycle 1 Day 8
Secondary Dose-Expansion Phase: AUC (0-28) of Tremelimumab Serum samples were collected from the participants at the defined timepoints. AUC (0-28) was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, and Cycle 1 Day 15
Secondary Dose-Expansion Phase: Tmax of Tremelimumab Serum samples were collected from the participants at the defined timepoints. Tmax was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 3 Day 1 pre-infusion and post-infusion on Cycle 4
Secondary Dose-Expansion Phase: T½?z of Tremelimumab Serum samples were collected from the participants at the defined timepoints. T½?z was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 3 Day 1 pre-infusion and post-infusion on Cycle 4
Secondary Dose-Expansion Phase: AUC (0-14)/D of Tremelimumab Serum samples were collected from the participants at the defined timepoints. AUC (0-14)/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1 and Cycle 1 Day 8
Secondary Dose-Expansion Phase: AUC (0-28)/D of Tremelimumab Serum samples were collected from the participants at the defined timepoints. AUC (0-28)/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, and Cycle 1 Day 15
Secondary Dose-Expansion Phase: Cmax/D of Tremelimumab Serum samples were collected from the participants at the defined timepoints. Cmax/D was determined using standard non-compartmental methods. Pre-infusion and post-infusion on Cycle 1 Day 1, Cycle 1 Day 8, Cycle 1 Day 15, pre-infusion and post-infusion on Cycle 2 Day 1, Cycle 3 Day 1 pre-infusion and post-infusion on Cycle 4
Secondary Dose-Finding Phase: Percentage of Participants Who Developed Detectable Anti-Drug Antibodies (ADAs) ADA prevalence was defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. Persistently positive was defined as having at least 2 post-baseline ADA positive measurements with at least 16 weeks (112 days) between the first and last positive measurements, or an ADA positive result at the last available assessment. Transiently positive was defined as having at least 1 post-baseline ADA positive measurement and not fulfilling the conditions for persistently positive. Pre-infusion on Cycle 1 Day 1 and Cycle 3 Day 1 (durvalumab and tremelimumab), pre-infusion on Cycle 2 Day 1, Cycle 5 Day 1 and Cycle 8 Day 1 for tremelimumab
Secondary Dose-Expansion Phase: Percentage of Participants Who Developed Detectable ADAs ADA prevalence was defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. Persistently positive was defined as having at least 2 post-baseline ADA positive measurements with at least 16 weeks (112 days) between the first and last positive measurements, or an ADA positive result at the last available assessment. The category includes participants meeting these criteria who are ADA positive at baseline. Transiently positive was defined as having at least 1 post-baseline ADA positive measurement and not fulfilling the conditions for persistently positive. The category includes participants meeting these criteria who are ADA positive at baseline. Pre-infusion on Cycle 1 Day 1 and Cycle 3 Day 1 (durvalumab and tremelimumab) and random sample on Cycle 7 Day 1 for tremelimumab
Secondary Number of Participants With Individual Antibody Titer Measurement Blood samples were planned to be collected for vaccine antibody titer measurements before and after planned routine immunization. Pre-infusion on Cycle 1 Day 1 and Cycle 4 Day 1 for durvalumab, pre-infusion on Cycle 1 Day 1, pre-infusion on Cycle 3, 4, and 8 Day 1 for tremelimumab (dose-expansion)
Secondary Median Percent Change From Baseline of Cluster of Differentiation 4+ (CD4+), CD8+, B Cells, Natural Killer (NK) Cells, and T-cell Activation With Ki67 Blood samples were collected at indicated timepoints for flow cytometry assessment. Cycle (C) and Day (D). Data collected for the flow cytometry analysis from the participants enrolled in both the dose finding and dose expansion phase were analyzed in the context of the dosing regimen received, to determine any potential differences in the immune response based on the durvalumab dose. Pre-dose Cycle 1 Day 8, pre-dose Cycle 2 Day 1, Cycle 2 Day 8, pre-dose Cycle 3 Day 1 (Dose-finding); Pre-dose Cycle 1 Day 1, Cycle 1 Day 8, pre-dose Cycle 2 Day 1 (Dose-expansion)
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