QUILT-3.090: NANT Squamous Cell Carcinoma (SCC) Vaccine: Subjects With SCC Who Have Progressed

Squamous Cell Carcinoma Clinical Trial

Official title:

QUILT-3.090: NANT Squamous Cell Carcinoma (SCC) Vaccine: Molecularly Informed Integrated Immunotherapy Combining (haNK) Cell Therapy With Adenoviral and Yeast-based Vaccines to Induce T-cell Responses in Subjects With SCC Who Have Progressed on or After Platinum-based Chemotherapy and Anti-programmed Cell Death Protein 1 (PD-1)/Programmed Death-ligand 1 (PD-L1) Therapy

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03387111
• Other study ID #: QUILT-3.090
• Status: Active, not recruiting
• Phase: Phase 1/Phase 2
• Start date: January 13, 2018
• Est. completion date: April 2021

Study information

• Verified date: August 2020
• Source: NantKwest, Inc.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a phase 1b/2 study to evaluate the safety and efficacy of metronomic combination therapy in subjects with SCC who have progressed on or after previous platinum-based chemotherapy and anti-PD-1/PD-L1 therapy. Phase 2 will be based on Simon's two-stage optimal design.

Description:

Treatment will be administered in 2 phases, an induction and a maintenance phase, as described below. Subjects will continue induction treatment for up to 1 year. Treatment in the study will be discontinued if the subject experiences progressive disease (PD) or unacceptable toxicity (not corrected with dose reduction), withdraws consent, or if the Investigator feels it is no longer in the subject's best interest to continue treatment. Those who have a complete response (CR) in the induction phase will enter the maintenance phase of the study. Subjects who experience ongoing stable disease (SD) or an ongoing partial response (PR) at 1 year may enter the maintenance phase at the Investigator's and Sponsor's discretion. Subjects may remain in the maintenance phase of the study for up to 1 year. The duration of the maintenance phase can exceed 1 year if the subject continues to benefit, per the Investigator's and Sponsor's discretion. Treatment will continue in the maintenance phase until the subject experiences PD or unacceptable toxicity (not corrected with dose reduction), withdraws consent, or if the Investigator feels it is no longer in the subject's best interest to continue treatment. The time on study treatment, including both the induction and maintenance phases, is up to 2 years. The duration of the study may exceed 2 years if the subject remains in the maintenance phase for more than 1 year, as described above.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 65
• Est. completion date: April 2021
• Est. primary completion date: January 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Age = 18 years.

2. Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.

3. Histologically-confirmed HNSCC or squamous NSCLC with progression on or after platinum-based chemotherapy and anti-PD-1/PD-L1 therapy.

4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.

5. Have at least 1 measurable lesion of = 1.0 cm.

6. Must have a recent formalin-fixed, paraffin-embedded (FFPE) tumor biopsy specimen following the conclusion of the most recent anticancer treatment. If an historic specimen is not available, the subject must be willing to undergo a biopsy during the screening period, if considered safe by the Investigator. If safety concerns preclude collection of a biopsy during the screening period, a tumor biopsy specimen collected prior to the conclusion of the most recent anticancer treatment may be used.

7. Must be willing to provide blood samples prior to the start of treatment on this study.

8. Must be willing to provide a tumor biopsy specimen 8 weeks after the start of treatment, if considered safe by the Investigator.

9. Ability to attend required study visits and return for adequate follow-up, as required by this protocol.

10. Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception for up to 1 year after completion of therapy, and non-sterile male subjects must agree to use a condom for up to 4 months after treatment. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, intrauterine devices (IUDs), and abstinence.

Exclusion Criteria:

1. Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.

2. Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, or autoimmune disease associated with lymphoma).

3. History of organ transplant requiring immunosuppression.

4. History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).

5. Inadequate organ function, evidenced by the following laboratory results:

1. Absolute neutrophil count < 1,000 cells//mm^3.

2. Uncorrectable grade 3 anemia (hemoglobin < 8 g/dL).

3. Platelet count < 75,000 cells/mm^3.

4. Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome).

5. Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases).

6. Alkaline phosphatase levels > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases).

7. Serum creatinine > 2.0 mg/dL or 177 µmol/L.

8. Serum anion gap > 16 mEq/L or arterial blood with pH < 7.3.

6. Uncontrolled hypertension (systolic > 160 mm Hg and/or diastolic > 110 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication. Subjects with uncontrolled hypertension should be medically managed on a stable regimen to control hypertension prior to study entry.

7. Serious myocardial dysfunction defined by ECHO as absolute left ventricular ejection fraction (LVEF) 10% below the institution's lower limit of predicted normal.

8. Dyspnea at rest due to complications of advanced malignancy or other disease requiring continuous oxygen therapy.

9. Positive results of screening test for human immunodeficiency virus (HIV).

10. Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.

11. Known hypersensitivity to any component of the study medication(s).

12. Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.

13. Concurrent or prior use of a strong cytochrome P450 (CYP)3A4 inhibitor (including ketoconazole, itraconazole, posaconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, and grapefruit products) or strong CYP3A4 inducers (including phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St John's Wort) within 14 days before study day 1.

14. Concurrent or prior use of a strong CYP2C8 inhibitor (gemfibrozil) or moderate CYP2C8 inducer (rifampin) within 14 days before study day 1.

15. Participation in an investigational drug study or history of receiving any investigational treatment within 30 days prior to screening for this study, except for testosterone-lowering therapy in men with prostate cancer.

16. Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.

17. Concurrent participation in any interventional clinical trial.

18. Pregnant and nursing women.

Related Conditions & MeSH terms

• Carcinoma
• Carcinoma, Squamous Cell
• Squamous Cell Carcinoma

Intervention

Drug:
• Aldoxorubicin HCl
Aldoxorubicin hydrochloride

Biological:
• ETBX-011
Ad5 [E1-, E2b-]-CEA
• ETBX-021
Ad5 [E1-, E2b-]-HER2
• ETBX-051
Ad5 [E1-, E2b-]-Brachyury vaccine
• ETBX-061
Ad5 [E1-, E2b-]-MUC1
• GI-4000
Vaccine derived from recombinant Saccharomyces cerevisiae yeast expressing mutant Ras proteins
• GI-6207
Vaccine derived from recombinant Saccharomyces cerevisiae yeast expressing mutant CEA proteins
• GI-6301
Vaccine derived from recombinant Saccharomyces cerevisiae yeast expressing mutant Brachyury yeast proteins
• haNK for infusion
NK-92 [CD16.158V, ER IL-2]

Drug:
• Avelumab
Recombinant human anti-PD-L1 IgG1 monoclonal antibody
• bevacizumab
Recombinant human anti-VEGF IgG1 monoclonal
• Capecitabine
5'-deoxy-5-fluoro-N-[(pentyloxy) carbonyl]-cytidine
• Cetuximab
Cetuximab is an epidermal growth factor receptor (EGFR) antagonist.
• Cisplatin
cis-diamminedichloroplatinum(II)
• Cyclophosphamide
2-[bis(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate
• Fluorouracil
5-fluoro-2,4 (1H,3H)-pyrimidinedione
• Leucovorin
L-Glutamic acid, N-[4-[[(2-amino-5-formyl-1,4,5,6,7,8-hexahydro-4-oxo-6-pteridinyl)methyl]amino]benzoyl]-, calcium salt
• nab-Paclitaxel
Benzenepropanoic acid, ß-(benzoylamino)-a-hydroxy-(2aR, 4S, 4aS, 6R, 9S, 11S, 12S, 12aR, 12bS)-6,12b-bis(acetyloxy)-12-(benzoyloxy)-2a, 3, 4, 4a, 5, 6, 9, 10, 11, 12, 12a, 12b-dodecahydro-4,11-dihydroxy-4a, 8, 13, 13-tetramethyl-5-oxo-7,11-methano-1H-cyclodeca[3,4]benz[1,2-b]oxet-9-y1ester,(aR,ßS)-(9CI) bound to albumin
• Necitumumab
Necitumumab is a recombinant human lgG1 monoclonal antibody.

Procedure:
• SBRT
Stereotactic Body Radiation Therapy

Biological:
• N-803
Recombinant human superagonist interleukin-15 (IL-15) complex [also known as IL-15N72D:IL-15RuSu/IgGI Fe complex1)

Locations

Country	Name	City	State
United States	Chan Soon-Shiong Institute for Medicine	El Segundo	California

Sponsors (1)

Lead Sponsor	Collaborator
NantKwest, Inc.

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs), graded using the NCI CTCAE Version 4.03.	Phase 1b primary endpoint	8 weeks
Primary	Objective response rate by RECIST	Phase 2 primary endpoint	1 year
Secondary	Objective response rate by RECIST	Phase 1b secondary endpoint	8 weeks
Secondary	Objective response rate by irRC	Phase 1b secondary endpoint	8 weeks
Secondary	Progression-free survival by RECIST during Phase 1b	Phase 1b secondary endpoint	8 weeks
Secondary	Progression-free survival by irRC during Phase 1b	Phase 1b secondary endpoint	8 weeks
Secondary	Overall survival	Phase 1b secondary endpoint	8 weeks
Secondary	Duration of response by RECIST and irRC	Phase 1b secondary endpoint	1 year
Secondary	Disease control rate (confirmed complete response, partial response, or stable disease lasting for at least 2 months) by RECIST and irRC.	Phase 1b secondary endpoint	1 year
Secondary	Patient-reported outcomes of pancreatic cancer symptoms	Phase 1b secondary endpoint	8 weeks
Secondary	Objective response rate by irRC	Phase 2 secondary endpoint	1 year
Secondary	Progression-free survival by RECIST during Phase 2	Phase 2 secondary endpoint	1 year
Secondary	Progression-free survival by irRC during Phase 2	Phase 2 secondary endpoint	1 year
Secondary	Overall survival	Phase 2 secondary endpoint	1 year
Secondary	Duration of response by RECIST and irRC	Phase 2 secondary endpoint	1 year
Secondary	Disease control rate (confirmed complete response, partial response, or stable disease lasting for at least 2 months) by RECIST and irRC.	Phase 2 secondary endpoint	1 year
Secondary	Patient-reported outcomes of pancreatic cancer symptoms	Phase 2 secondary endpoint	1 year
Secondary	Incidence of treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs), graded using the NCI CTCAE Version 4.03.	Phase 2 secondary endpoint	1 year