Safety and Efficacy of KY1044 and Atezolizumab in Advanced Cancer

Sponsor
Kymab Limited (Industry)
Overall Status
Recruiting
CT.gov ID
NCT03829501
Collaborator
Sanofi (Industry)
412
12
4
51.1
34.3
0.7

Study Details

Study Description

Brief Summary

A Phase 1/2, open label, multi-center study to evaluate the safety, efficacy and tolerability of KY1044 as single agent and in combination with anti-PD-L1 (atezolizumab) in adult patients with selected advanced malignancies, who are ineligible for or there are no available therapies known to confer a clinical benefit for their disease, or they have exhausted all such available options in each indication and therefore will be patients for whom a clinical trial is appropriate.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
412 participants
Allocation:
Non-Randomized
Intervention Model:
Sequential Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase 1/2, Open-label, Multi-center Study of the Safety and Efficacy of KY1044 as Single Agent and in Combination With Anti-PD-L1 (Atezolizumab) in Adult Patients With Selected Advanced Malignancies
Actual Study Start Date :
Jan 28, 2019
Anticipated Primary Completion Date :
May 1, 2023
Anticipated Study Completion Date :
May 1, 2023

Arms and Interventions

Arm Intervention/Treatment
Experimental: KY1044 monotherapy phase 1

KY1044 monotherapy dose escalation

Drug: KY1044
A human anti-ICOS monoclonal antibody

Experimental: KY1044 and atezolizumab phase 1

KY1044 and atezolizumab combination dose escalation

Drug: KY1044 and atezolizumab
A human anti-ICOS monoclonal antibody in combination with anti-PD-L1 monoclonal antibody (atezolizumab)

Experimental: KY1044 monotherapy phase 2

KY1044 monotherapy

Drug: KY1044
A human anti-ICOS monoclonal antibody

Experimental: KY1044 and atezolizumab phase 2

KY1044 and atezolizumab combination

Drug: KY1044 and atezolizumab
A human anti-ICOS monoclonal antibody in combination with anti-PD-L1 monoclonal antibody (atezolizumab)

Outcome Measures

Primary Outcome Measures

  1. Safety: Incidence and severity of adverse events (AEs) and serious adverse events (SAEs) (Phase 1) [Up to 48 months]

  2. Tolerability: Number of dose interruptions, reductions and dose intensity (Phase 1) [Up to 48 months]

  3. Overall response rate (ORR) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (Phase 2) [Up to 48 months]

  4. Incidence of Dose Limiting Toxicities (DLTs) with KY1044 as single agent (Phase 1) [Within first 21 days of treatment]

  5. Incidence of DLTs with KY1044 in combination with atezolizumab (Phase 1) [Within first 21 days of treatment]

Secondary Outcome Measures

  1. Best overall response (BOR) per RECIST 1.1 [Up to 48 months]

  2. Progression Free Survival (PFS) per RECIST 1.1 [Up to a PFS event, approximately every 3 months]

  3. Duration of Response (DOR) per RECIST 1.1 [Up to a PFS event, approximately every 3 months]

  4. ORR per Immune-Related Response Evaluation Criteria in Solid Tumors (iRECIST) (Phase 1 and Phase 2) [Up to 48 months]

  5. PFS per iRECIST (Phase 1 and Phase 2) [Up to 48 months]

  6. ORR per RECIST 1.1 (Phase 1) [Up to 48 months]

  7. Survival rate [At 12 and 24 months]

  8. Safety: Incidence and severity of AEs and SAEs (Phase 2) [Up to 48 months]

  9. Number of dose interruptions, reductions and dose intensity (Phase 2) [Up to 48 months]

  10. Maximum Concentration (Cmax) of KY1044 and of atezolizumab if in combination [Up to 48 months]

  11. Half-life (t1/2) of of KY1044 and of atezolizumab if in combination [Up to 48 months]

  12. Number of participants with anti-KY1044 and anti-atezolizumab antibodies [Up to 48 months]

  13. Number of participants with presence of tumor-infiltrating lymphocytes (TILs) as determined by expression of ICOS (Inducible T cell Costimulator), FOXP3 (Forkhead box P3) and CD8 cells [Up to 48 months]

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Age ≥18 years (≥20 years in Taiwan)

  • Histologically documented advanced/metastatic malignancies

  • Phase 1 and Phase 2 participants with advanced/metastatic malignancies who have measurable disease (non-measurable disease is allowed only in Phase 1) as determined by RECIST 1.1 will be eligible if, according to the National Comprehensive Cancer Network (NCCN) guidelines, there are no available therapies known to confer a clinical benefit for their disease, or they have exhausted all such available options.

Additionally, the following specific tumor indications will be enrolled:
  1. Phase 1: Participants with advanced/metastatic malignancies, and preferred indications (non-small cell lung cancer (NSCLC), head and neck squamous cell carcinoma (HNSCC), hepatocellular carcinoma (HCC), melanoma, cervical, esophageal, gastric, renal, pancreatic, and triple negative breast cancer)

  2. Phase 2 KY1044 single agent: Participants with advanced/metastatic malignancies in indications in which signs of anti-tumor activity (Complete Response (CR), Partial Response (PR) or durable stable disease (SD) with tumor shrinkage that does not qualify for PR) were seen during the dose escalation of KY1044 as single agent

  3. Phase 2 KY1044 in combination with atezolizumab: Participants with advanced/metastatic malignancies in the selected indications below, and/or indications which have shown promising activity in Phase 1:

  • NSCLC (anti-PD-(L)1 therapy naïve and pre-treated between 1 and 2 prior lines of systemic therapy for advanced disease)

  • Gastric (anti-PD-(L)1 therapy naïve and pre-treated)

  • Recurrent and/or metastatic HNSCC (anti-PD-(L)1 therapy naïve and pre-treated between 1 and 2 prior lines of systemic therapy for advanced disease)

  • Esophageal (anti-PD-(L)1 therapy naïve and pre-treated)

  • Cervical (anti-PD-(L)1 therapy naïve and pre-treated)

  • Indications, in which signs of anti-tumor activity has been observed in Phase 1 with KY1044 in combination with atezolizumab

  • Prior therapy with anti-PD-(L)1 inhibitors is allowed provided any toxicity attributed to prior anti-PD-(L)1-directed therapy did not lead to discontinuation of therapy

  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1

  • Life expectancy longer than 12 weeks

  • Must have a site of disease amenable to biopsy, and be a candidate for tumor biopsy according to the treating institution's guidelines. Participants must be willing to undergo a new tumor biopsy at screening, and during therapy on the study

Exclusion Criteria:
  • Presence of symptomatic central nervous system (CNS) metastases, or CNS metastases that require local CNS-directed therapy, or increasing doses of corticosteroids within the prior 2 weeks of first dose of study treatment

  • History of severe hypersensitivity reactions to other monoclonal antibodies and/or their excipients

  • Known presence of neutralizing anti-atezolizumab antibodies (for patients previously treated with atezolizumab)

  • Having out of range laboratory values: creatinine, bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), absolute neutrophil count (ANC), platelet count, hemoglobin

  • Impaired cardiac function or clinically significant cardiac disease, including any of the following:

  1. Clinically significant and/or uncontrolled heart disease such as congestive heart failure requiring treatment (New York Heart Association [NYHA] Grade ≥2), uncontrolled hypertension or clinically significant arrhythmia

  2. QTcF >470 msec on screening (electrocardiogram) ECG using Fridericia's formula (QTcF) or congenital long QT syndrome

  3. Acute myocardial infarction or unstable angina pectoris

  • Known human immunodeficiency virus (HIV), active hepatitis B virus (HBV) or active hepatitis C virus (HCV) infection

  • Malignant disease, other than that being treated in this study

  • Any medical condition that would, in the Investigator's judgment, prevent participation in the clinical study due to safety concerns, compliance with clinical study procedures or interpretation of study results

  • Active autoimmune disease or a documented history of autoimmune disease

  • Participants previously exposed to anti-PD-(L)1 treatment who are not adequately treated for skin rash or had no replacement therapy for endocrinopathies should be excluded

  • Participants with a history of drug-induced pneumonitis or current pneumonitis

  • Systemic steroid therapy or any immunosuppressive therapy. Topical, inhaled, nasal, and ophthalmic steroids are not prohibited

  • Use of live attenuated vaccines against infectious diseases within 4 weeks of the first dose of study treatment. SARS-CoV-2 vaccines authorized for use by the competent local regulatory health authorities for active immunization to prevent COVID 19 are allowed (unless the vaccine is live or live attenuated) and must be given in accordance with the prevailing immunization guidelines.

  • Anti-CTLA4, anti-PD-(L)1 treatment within 4 weeks of the first dose of study treatment

  • Pre-treatment with anti-CTLA4 antibodies in combination with any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathway

  • Presence of Common Terminology Criteria for Adverse Events version 5 (CTCAE v5) ≥Grade 2 toxicity (except alopecia, peripheral neuropathy and ototoxicity, which are excluded if CTCAE v5 ≥Grade 3) due to prior cancer therapy

  • Radiotherapy within 2 weeks of the first dose of study treatment, except for palliative radiotherapy to a limited field, such as for the treatment of bone pain or a focally painful tumor mass. To allow evaluation for response to treatment, participants enrolled in the Phase 2 part must have remaining measurable disease that has not been irradiated

  • Pregnant or lactating women

Contacts and Locations

Locations

Site City State Country Postal Code
1 Kymab investigational site 1102 New Haven Connecticut United States 06510
2 Kymab investigational site 1104 Sarasota Florida United States 34232
3 Kymab investigational site 1103 Nashville Tennessee United States 37203
4 Kymab investigator site 1101 Houston Texas United States 77030
5 Kymab investigational site 3901 Milano Italy
6 Kymab investigational site 3903 Milano Italy
7 Kymab investigational site 3902 Napoli Italy
8 Kymab investigational site 8801 Taipei Taiwan
9 Kymab investigational site 4405 London United Kingdom
10 Kymab investigational site 4402 Manchester United Kingdom
11 Kymab investigational site 4404 Oxford United Kingdom
12 Kymab investigational site 4401 Sutton United Kingdom

Sponsors and Collaborators

  • Kymab Limited
  • Sanofi

Investigators

  • Study Director: Clinical Sciences & Operations, Sanofi

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Kymab Limited
ClinicalTrials.gov Identifier:
NCT03829501
Other Study ID Numbers:
  • KY1044-CT01
  • Sanofi Study ID
First Posted:
Feb 4, 2019
Last Update Posted:
May 20, 2022
Last Verified:
May 1, 2022
Individual Participant Data (IPD) Sharing Statement:
Yes
Plan to Share IPD:
Yes
Studies a U.S. FDA-regulated Drug Product:
Yes
Studies a U.S. FDA-regulated Device Product:
No
Additional relevant MeSH terms:

Study Results

No Results Posted as of May 20, 2022