IKS03 in Patients With Advanced B Cell Non-Hodgkin Lymphomas
Study Details
Study Description
Brief Summary
This first-in-human study will evaluate the recommended dose for further clinical development, safety, tolerability, antineoplastic activity, immunogenicity, pharmacokinetics and pharmacodynamics of IKS03, a CD19 targeting antibody-drug conjugate, in patients with advanced B cell non-Hodgkin lymphoma (NHL).
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1 |
Detailed Description
The study will consist of 2 parts: dose-escalation (Part 1) and dose-expansion (Part 2). The dose-escalation part (Part 1) of the study is to evaluate the safety and tolerability of increasing dose levels of IKS03 to establish a recommended dose for expansion (RDE); and the dose-expansion part (Part 2) of the study is to further evaluate the safety, pharmacokinetics/pharmacodynamics, and efficacy of IKS03 at the RDE.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Dose Escalation Cohort (Part 1) Each patient will receive repeat doses (by intravenous (IV) infusions) on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met. |
Drug: IKS03
IKS03 is a human monoclonal antibody (Ab) targeting CD19 linked to a pyrrolobenzodiazepine (PBD) pro-drug as the cytotoxic agent.
|
Experimental: Dose Expansion: Diffuse-Large B-Cell Lymphoma Participants Each patient will receive IKS03 at the recommended dose for expansion (RDE) defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met. |
Drug: IKS03
IKS03 is a human monoclonal antibody (Ab) targeting CD19 linked to a pyrrolobenzodiazepine (PBD) pro-drug as the cytotoxic agent.
|
Experimental: Dose Expansion: Follicular Cell Lymphoma Participants Each patient will receive IKS03 at the recommended dose for expansion (RDE) defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met. |
Drug: IKS03
IKS03 is a human monoclonal antibody (Ab) targeting CD19 linked to a pyrrolobenzodiazepine (PBD) pro-drug as the cytotoxic agent.
|
Experimental: Dose Expansion: Mantle Cell Lymphoma Participants Each patient will receive IKS03 at the recommended dose for expansion (RDE) defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met. |
Drug: IKS03
IKS03 is a human monoclonal antibody (Ab) targeting CD19 linked to a pyrrolobenzodiazepine (PBD) pro-drug as the cytotoxic agent.
|
Experimental: Dose Expansion: Other B cell lymphoma (B-NHL not otherwise specified [NOS]) Each patient will receive IKS03 at the recommended dose for expansion (RDE) defined in Part 1 on Day 1 of each 21-day cycle. Participants may continue on study until disease progression, unacceptable toxicity, or other withdrawal criteria is met. |
Drug: IKS03
IKS03 is a human monoclonal antibody (Ab) targeting CD19 linked to a pyrrolobenzodiazepine (PBD) pro-drug as the cytotoxic agent.
|
Outcome Measures
Primary Outcome Measures
- Recommended Dose for Expansion (Part 1) [Up to 20 months]
RDE will be determined using dose limiting toxicities (DLTs) and all other available study data
- Antineoplastic effect of IKS03 (Part 2) [up to 42 months]
Antineoplastic effects will be assessed by Criteria for Response Assessment: The Lugano Classification (Cheson 2014)
Secondary Outcome Measures
- Evaluation of the immunogenicity of IKS03 (Part 1 and 2) [Up to 42 months]
Occurrence of ADA measured in serum at selected timepoints during the study
- Plasma Concentrations of IKS03 (Part 1 and 2) [Up to 42 months]
Pharmacokinetic profile will be characterized by concentrations of IKS03
- Determine recommended Phase 2 dose (RP2D) (Part 2) [Up to 42 months]
Based on evidence of antitumor activity, acceptable tolerability, evidence of achieving target plasma concentration
Eligibility Criteria
Criteria
Inclusion Criteria:
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Males or females, ≥ 18 years of age
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Part 1: documented B cell NHL (any subtype except Burkitt lymphoma, Waldenström macroglobulinemia, chronic lymphocytic leukemia); previously confirmed CD19-positive if feasible
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Part 2: documented B cell NHL (subtypes to be determined); confirmed CD19-positive; possible expansion cohorts may include:
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Diffuse large B cell lymphoma (including germinal center B cell type, activated B cell type)
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Follicular lymphoma (including duodenal-type follicular lymphoma)
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Mantle cell lymphoma
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B cell lymphomas not specified
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If B cell NHL subtype likely to have bone marrow involvement must be willing to undergo bone marrow biopsy in the event of an on-study complete response to confirm response
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NHL that is relapsed, refractory to, or intolerant of existing therapy(ies) with known curative potential, or for which no standard therapy is available; must have received at least 2 prior lines of systemic therapy
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Must be in need of systemic treatment and not require immediate cytoreductive therapy
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Part 1: measurable or non-measurable disease
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Part 2: measurable disease according to The Revised Criteria/Lugano Classification
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Part 1: screening tumor biopsy requested, but optional; Part 2: patient must agree to screening tumor biopsy
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ECOG performance status 0 or 1; anticipated life expectancy ≥ 10 weeks
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Women of childbearing potential and fertile men agreeing to use a highly effective method of contraception; women beginning 2 weeks prior to the first dose, men beginning prior to the first dose, and both continuing until 6 months after the last dose of study drug; male patients must also agree to refrain from sperm donation during this period.
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Ability to understand and give written informed consent
Exclusion Criteria:
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Women who are pregnant or intending to become pregnant before, during, or within 6 months after the last dose of study drug; women who are breastfeeding.
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Central nervous system (CNS) lymphoma, leptomeningeal infiltration, or spinal cord compression not controlled by prior surgery or radiotherapy; symptoms suggesting CNS involvement
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Part 2: History of another malignancy within 2 years, with the exception of:
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Treated, non-melanoma skin cancers
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Treated carcinoma in situ (e.g., breast, cervix)
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Controlled, superficial carcinoma of the urinary bladder
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T1a or b prostate carcinoma treated according to standard of care, with PSA within normal limits
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Any of the following hematologic abnormalities at baseline (transfusion allowed > 5 days previous):
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Hemoglobin < 8.0 g/dL
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Absolute neutrophil count < 1,000 per mm3
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Platelet count < 75,000 per mm3
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Any of the following laboratory abnormalities at baseline:
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Total bilirubin > 1.5 × upper limit of normal (ULN); > 3 × ULN if with Gilbert's Syndrome
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AST or ALT > 3 × ULN; > 5 × ULN if due to hepatic involvement by tumor
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Estimated GFR ≤ 60 mL/min/1.73 m2
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Albuminuria defined as urine albumin to creatinine ratio < 30 mg/g or < 3 mg/mmol) by spot urine albumin
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Any of the following coagulation parameter abnormalities at baseline unless on a stable dose of anticoagulant therapy for a prior thrombotic event:
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PT or INR > 1.5 × ULN; > 3× ULN if anticoagulated)
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PTT > 1.5 × ULN; > 3× ULN if anticoagulated
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Patients with:
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Active thrombosis, or a history of deep vein thrombosis or pulmonary embolism, within 4 weeks unless adequately treated and stable
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Active uncontrolled bleeding or a known bleeding diathesis
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Significant cardiovascular disease or condition, including:
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Congestive heart failure or angina pectoris requiring therapy
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Ventricular arrhythmia requiring therapy or other uncontrolled arrhythmia
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Severe conduction disturbance (e.g., 3rd degree heart block)
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QTc interval ≥ 480 milliseconds
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Left ventricular ejection fraction below the lower limit of normal or < 50% by MUGA scan or echocardiogram
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Class III or IV cardiovascular disease according to the New York Heart Association Functional Classification
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History of acute coronary syndromes (e.g., MI, unstable angina), coronary angioplasty, stenting, or bypass within 6 months
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Significant liver disease, including:
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Non-infectious hepatitis
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Hepatic cirrhosis (Child-Pugh Class C)
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Significant pulmonary disease or condition, including:
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Significant symptomatic COPD, as assessed by the Investigator
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History or any current evidence on imaging studies of interstitial lung disease, pulmonary fibrosis
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History of pulmonary inflammatory disease, pneumonitis, ARDS
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History of pneumonia within 6 months
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Significant corneal disease or condition, including history of or current evidence of keratitis
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Known HIV infection or AIDS
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Active hepatitis B virus or hepatitis C virus infection
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Any other serious/active/uncontrolled infection, any infection requiring parenteral antibiotics, or unexplained fever > 38ºC within 2 weeks
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Unresolved Grade > 1 AE associated with any prior antineoplastic therapy (except persistent Grade 2 alopecia, peripheral neuropathy, decreased hemoglobin, neutropenia, lymphopenia, hypomagnesemia, and/or endocrine end-organ failure being adequately managed by HRT)
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Known or suspected hypersensitivity to any of the excipients of formulated study drug
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Inadequate recovery from a surgical procedure, or a major surgical procedure within 4 weeks
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Any other serious, life-threatening, or unstable preexisting medical condition, including significant organ system dysfunction, or clinically significant laboratory abnormality(ies)
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A psychiatric disorder or altered mental status that would preclude understanding of the informed consent process
Drugs and Other Treatments to be Excluded:
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Receipt of:
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Any CD19-targeted therapy within 3 months
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Any tumor vaccine within 6 weeks (must have progressed if previously received)
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Prior autologous/allogeneic CAR-T therapy if known to be CD19-negative after
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Any other antineoplastic agent for the primary malignancy without delayed toxicity within 4 weeks or 5 plasma half-lives, whichever is shortest (except nitrosoureas and mitomycin C within 6 weeks)
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Any other investigational treatments within 4 weeks
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Drugs known to impair renal function, including:
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NSAIDS within 3 days
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Aminoglycoside antibiotics, amphotericin B, etc. within 1 week
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Bisphosphonates within 1 month
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Autologous hematopoietic stem cell transplantation (HSCT) within 3 months
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Allogeneic HSCT within 6 months, or:
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If receiving immunosuppression
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If with active evidence of GVHD
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Radiotherapy:
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To target lesions within 4 weeks unless progression of the lesion has been documented
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To non-target lesions within 1 week
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Live/live-attenuated vaccines against infectious diseases within 4 weeks
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Immunosuppressive or systemic glucocorticoid therapy (> 10 mg prednisone daily or equivalent) within 2 weeks
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Prophylactic use of hematopoietic growth factors within 1 week
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Iksuda Therapeutics Ltd.
Investigators
- Study Director: Paul I Nadler, MD, Iksuda Therapeutics
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IKS03-01