A Phase I/Ib Study of NIZ985 Alone and in Combination With Spartalizumab

  • STATUS
    Recruiting
  • participants needed
    68
  • sponsor
    Novartis Pharmaceuticals
Updated on 19 February 2024

Summary

The purpose of this phase I/Ib study is to determine the safety profile of NIZ985 (new formulation), and if it can be safely combined with Spartalizumab and to determine the appropriate dose and schedule for further study. Moreover, the study will characterize the pharmacokinetic profiles of NIZ985 as a single agent and in combination with Spartalizumab and identify preliminary anti-tumor activity.

Description

This is a phase I/Ib, open-label, global, multi-center study of subcutaneously administered NIZ985 alone and in combination with Spartalizumab in subjects with advanced solid tumors and lymphoma who have progressed after obtaining a previous response to anti-PD-1/ Check Point Inhibitor (CPI) therapy.

The study consists of two parts, dose escalation and dose expansion. Two separate arms will be examined during the escalation portion: 1) evaluation of NIZ985 as a single agent. Spartalizumab may be added at the time of the first disease re-evaluation and 2) administration of NIZ985 and Spartalizumab as a combination starting from Cycle 1Day 1.

Details
Condition In Escalation: All Patients With Solid Tumors and Lymphoma, In Expansion: Melanoma
Age 18-100 years
Treatment NIZ985 and Spartalizumab
Clinical Study IdentifierNCT04261439
SponsorNovartis Pharmaceuticals
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

\. Signed informed consent must be obtained prior to participation in the study
For Japan only: written consent is necessary both from the patient and his/her
legal representative if he/she is under the age of 20 years
\. Male or female patients 18 years of age 3. Histologically confirmed and
documented advanced solid tumors and lymphoma (includes locally advanced
malignancies that are not curable by surgery or radiotherapy, and those with
metastatic disease) with documented progression following standard therapy
and for whom, in the opinion of the Investigator, no standard therapy is
available, tolerated or appropriate. Disease must be measurable as determined
by RECIST 1.1 (refer to Appendix 1) or Cheson et al (2014)
Escalation: Patients previously treated with CPI (anti PD-1/PD-L1 and/or anti CTLA-4) who have previously responded and progressed. Previous response is an initial radiographic CR/PR (a confirmatory scan is not required) or SD lasting 6 months if the most recent regimen included CPI
Expansion: Patients with cutaneous melanoma previously treated with CPI (anti PD 1/ PD-L1 and/or anti CTLA-4) who have previously responded and progressed. Previous response is radiographic CR/PR (a confirmatory scan is not required) or SD lasting 6 months if the most recent regimen included CPI. 4\. Patients must be willing and able to comply with the protocol for the duration of the study including undergoing treatment, scheduled visits, and examinations including follow up. 5\. Patients must have a site of disease amenable to biopsy and be a candidate for tumor biopsy according to the treating institution's guidelines. Patient must be willing to undergo a new tumor biopsy at screening and during therapy on the study. At screening, submission of a recent archival biopsy sample is permitted if the following 3 conditions are met
Biopsy was collected 3 months before screening
No immunotherapy was given to the patient since collection of the biopsy
Biopsy sample is present at site prior to the first dose of study treatment. 6. ECOG performance status 1 and in the opinion of the investigator, likely to complete at least 28 days of treatment

Exclusion Criteria

Patients that have received any prior IL-15 treatment
History of severe hypersensitivity reactions to any ingredient of study drug(s) and other mAbs and/or their excipients
Patients with primary CNS tumors are excluded. Presence of symptomatic CNS metastases, or CNS metastases that require local CNS-directed therapy (such as radiotherapy or surgery), or increasing doses of corticosteroids 2 weeks prior to study entry. Patients with treated symptomatic brain metastases should be neurologically stable (for 4 weeks post-treatment and prior to study entry) and at a dose of 10 mg per day prednisone or equivalent for at least 2 weeks before administration of any study treatment
Systemic chronic steroid therapy (> 10mg/day prednisone or equivalent) or any immunosuppressive therapy, other than replacement-dose steroids in the setting of adrenal insufficiency, within 7 days of the first dose of study treatment. Topical, inhaled, nasal and ophthalmic steroids are allowed
Malignant disease, other than that being treated in this study, that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer or other tumors that will not affect life expectancy
Patients having out of range lab values during screening and before the first dose of study treatment. Out of range lab values are defined as
Absolute neutrophil count (ANC) <1.0 x 109/L
Platelets <75 x 109/L
Hemoglobin (Hgb) < 9 g/dL
Serum creatinine > 1.5 x ULN or creatinine clearance < 40mL/min using Cockcroft-Gault formula
Total bilirubin > 1.5 x ULN, (except for patients with Gilbert's syndrome > 3.0 x ULN or direct bilirubin > 1.5 x ULN)
Aspartate transaminase (AST) > 3 x ULN
Alanine transaminase (ALT) > 3x ULN
Serum electrolytes grade 2 despite adequate supplementation
Impaired cardiovascular function or clinically significant cardiovascular disease, including any of the following
Clinically significant and/or uncontrolled heart disease such as congestive heart failure requiring treatment (NYHA Grade 2), uncontrolled hypertension or clinically significant arrhythmia
QTcF >470 msec on screening ECG or congenital long QT syndrome
Acute myocardial infarction or unstable angina < 3 months prior to study entry
Infection(s)
HIV infection
Active HBV or HCV infection (per institutional guidelines). Patients with chronic HBV or HCV disease that is controlled under antiviral therapy are allowed in expansion but not in escalation
Infection requiring systemic antibiotic therapy. Patients requiring systemic antibiotics for infection must have completed treatment before screening is initiated
Active, known or suspected autoimmune disease. Patients with vitiligo, type I diabetes, residual hypothyroidism only requiring hormone replacement, psoriasis not requiring systemic treatment or conditions not expected to recur may be considered. Patients previously exposed to CPI treatment who were adequately treated for skin rash or with replacement therapy for endocrinopathies should not be excluded
History of or current interstitial lung disease or pneumonitis grade 2
Radiotherapy within 2 weeks of the first dose of study drug, except for palliative radiotherapy to a limited field. To allow evaluation for response to treatment, patients enrolled in the expansion must have remaining measurable disease that has not been irradiated
Treatment with cytotoxic or targeted antineoplastics within 3 weeks of initiation of study treatment. For cytotoxic agents that have major delayed toxicities, a washout period of one cycle is indicated (examples are nitrosoureas and mitomycin C which typically require a 6 week washout). Prior antibodies or immunotherapies require a 4 week washout. Ongoing bisphosphonate therapy and growth hormone-releasing hormone (GHRH) agonist therapy is allowed. Supportive therapy with denosumab is allowed. For patients with lymphoma, the following washout criteria may be used
Systemic antineoplastic therapy (including cytotoxic chemotherapy, alfa-
interferon, kinase inhibitors or other targeted small molecules, and toxin
immunoconjugates) or any experimental therapy within 14 days or 5 half-lives
whichever is shorter, before the first dose of study treatment
\. Presence of Grade 2 toxicity according to National Cancer Institute (NCI)
Common Terminology Criteria for Adverse Events (CTCAE v5.0), from prior cancer
therapy with the exception of neuropathy (inclusion of patients with
neuropathy of Grade 2 or less is permitted), ototoxicity, and alopecia
\. Two weeks since major surgery treatment (mediastinoscopy, insertion of a
central venous access device and insertion of a feeding tube are not
considered major surgery)
\. Use of any live vaccines against infectious diseases within 4 weeks of
initiation of study treatment
\. Use of hematopoietic growth factors or transfusion support 2 weeks prior
to start of study treatment. If growth factors were initiated more than 2
weeks prior to the first dose of study treatment and the patient is on a
stable dose, they can be maintained
\. Any medical condition that would, in the investigator's judgement
prevent the patient's participation in the clinical study due to safety
concerns, compliance with clinical study procedures, or interpretation of
study results
\. Pregnant or nursing (lactating) women
\. Women of child-bearing potential, defined as all women physiologically
capable of becoming pregnant, unless they are using highly effective methods
of contraception while taking study medication and for 150 days after stopping
medication. Highly effective methods of contraception methods include
Total abstinence (when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g. calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception
Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy), total hysterectomy, or tubal ligation at least six weeks before taking investigational drug(s). In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment
Male sterilization (at least 6 months prior to screening). For female subjects on the study, the vasectomized male partner should be the sole partner for that subject
Use of oral (estrogen and progesterone), injected, or implanted hormonal methods of contraception or placement of an intrauterine device (IUD) or intrauterine system (IUS), or other forms of hormonal contraception that have comparable efficacy (failure rate <1%), for example, hormone vaginal ring or transdermal hormone contraception
In case of use of oral contraception women should have been stable on the same pill for a minimum of 3 months before taking study treatment
NOTE: Women are considered post-menopausal and not of child bearing potential
if they have had over 12 months of natural (spontaneous) amenorrhea with an
appropriate clinical profile (e.g. age appropriate [generally age from 40 to
years], history of vasomotor symptoms [e.g. hot flush]) in the absence of
other medical justification or have had surgical bilateral oophorectomy (with
or without hysterectomy), total hysterectomy or tubal ligation at least six
weeks ago. In the case of oophorectomy alone, only when the reproductive
status of the woman has been confirmed by follow up hormone level assessment
is she considered not of child bearing potential
\. A condom is required for all sexually active male participants to prevent
them from fathering a child AND to prevent delivery of study treatment via
seminal fluid to their partner. Sexually active males receiving NIZ985 as a
single agent or in combination with Spartalizumab must use a condom during
intercourse for 30 days after their last dose of NIZ985. In addition, male
participants must not donate sperm for 30 days after the last dose of NIZ985
Patients should not father a child during this post treatment period. A condom
is required to be used also by vasectomized men as well as during intercourse
with a male partner in order to prevent delivery of the drug via semen
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