Phase 3 Study of Adagloxad Simolenin (OBI-822)/OBI-821 Treatment for Breast Cancer Patients

Overview

Sponsor-declared trial summary

Key facts

Sponsor

Obi Pharma Inc.

Participant type

Patients

Age range

18-64 years, 65+ years

Gender

Male and Female

Therapeutic area

Diseases [C] - Neoplasms [C04]

Trial duration

16 May 2022 → 28 Nov 2025

Decision date (initial)

2024-08-09

Transition trial

Yes

Low-intervention

No

Rare-disease indication

No

Vulnerable population

Yes

Funding sources

OBI Pharma, Inc.

External identifiers

EU CT number

2023-508755-39-00

EudraCT number

2018-001438-16

WHO UTN

U1111-1302-6117

ClinicalTrials.gov

NCT03562637

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Safety, Efficacy

To determine the effect of adagloxad simolenin (OBI-822)/OBI-821 treatment on improving invasive disease-free survival (IDFS) in the study population.

Secondary objectives 2

1. To determine the impact of adagloxad simolenin (OBI-822)/OBI-821 treatment in the study population, on: a. Overall survival (OS) b. Quality of Life (QoL) c. Breast cancer-free interval (BCFI) d. Distant disease-free survival (DDFS).
2. To determine safety and tolerability of adagloxad simolenin (OBI-822)/OBI-821 in the study population.

Conditions and MedDRA coding

Triple Negative Breast Cancer

Study design 4 periods

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 15

1. 1. Male or female patient ≥18 years.
2. 2. Documented radiographic and histopathologic confirmed primary localized invasive breast cancer.
3. 3. Histologically documented TNBC (estrogen receptor-negative [ER-] / progesterone receptor-negative [PR-] / human epidermal growth factor 2-negatove [HER2-]) defined as ER-negative and PR-negative (≤5% positive cells stain by IHC for both ER and PR), and negative HER2/neustatus, confirmed on tumor sample. HER2/neu-negative will be defined as one of the following criteria: - IHC 0 or 1+ - Single-probe average HER2 gene copy number of <6 signals/nucleus - (ISH concordance with FISH HER2/neu chromosome 17 (CEP17) non-amplified ratio of <2.
4. 4. Globo H IHC H-score ≥15 from the residual primary site/or lymphnode (if primary site is not available) tumor obtained at the time ofdefinitive surgery or initial diagnosis (only if surgical tumor sample is not available). Globo H expression will be determined during prescreening by a central laboratory. Instructions for submission of slides/tumor tissue blocks are provided in the protocol and study Lab Manual.
5. 5. No evidence of metastatic disease in chest, abdomen, and pelvis by CT or other adequate imaging during the Screening Phase. Imaging within 3 months prior to randomization is acceptable as baseline scan. Bone scans and imaging of the brain at screening is optional, and should be symptom directed.
6. 6. High-risk patients with no evidence of disease after completing standard treatment and meeting ONE of the following criteria: - Neoadjuvant chemotherapy followed by definitive surgery: Residual invasive disease following neoadjuvant chemotherapy defined as: A contiguous focus of residual invasive cancer in the surgical breast specimen measuring ≥1 cm in diameter and/or with residual invasive cancer in at least one axillary node (micrometastases or macrometastases), as determined by local pathology review. - Definitive surgery followed by adjuvant chemotherapy: Pathological Prognostic Stage IIB, Stage IIIA, IIIB, or Stage IIIC disease according to the 8th edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual.
7. 7. Must have completed at least 4 cycles of a standard taxane and anthracycline-based multi-agent chemotherapy regimen (or a taxaneonly regimen if the patient is ineligible for anthracycline treatment) either in the neoadjuvant or adjuvant setting (e.g., National Comprehensive Cancer Network recommended regimens).
8. 8. Randomization must occur (a) within 16 weeks after definitive surgery and radiation therapy (if radiation therapy administered) in patients who received neoadjuvant multiagent chemotherapy or, (b) for patients receiving adjuvant multiagent chemotherapy (not including capecitabine, immune checkpoint inhibitor), within 16 weeks after the completion of the adjuvant multiagent chemotherapy and radiation therapy (if radiation therapy administered). Note: patients may be randomized and initiate study treatment concurrent with adjuvant SOC therapy (observation, capecitabine; immune checkpoint inhibitor ± capecitabine).
9. 9. All treatment-related toxicities resolved to Grade <1 on National Cancer Institute-Common Terminology Criteria for Adverse Events (version 5.0) criteria (except hair loss and ≤Grade 2 neuropathy, which are acceptable).
10. 10. Eastern Cooperative Oncology Group (ECOG) performance status ≤1.
11. 11. Females must be either of non-childbearing potential, i.e., surgically sterilized (have documented sterilization, bilateral oophorectomy /salpingectomy at least 3 months before the start of the trial and/or hysterectomy), or one year postmenopausal; or if of childbearing potential must have a negative pregnancy test (urine or serum) at screening.
12. 12. Males and females of childbearing potential and their partners must be willing to use effective contraception during the entire study Treatment Phase and for at least 4 weeks (28 days) after the last dose of study treatment.
13. 13. Adequate hematological, hepatic and renal function as defined below: - Absolute neutrophil count (ANC) ≥1,500/μL - Platelets ≥75,000/μL - Hemoglobin ≥8.5 g/dL - Serum creatinine ≤1.5 × upper limit of normal (ULN) or calculated Creatinine clearance ≥55 mL/min for patients with creatinine levels >1.5 ×institutional ULN (glomerular filtration rate can also be used in place of creatinine or creatinine clearance may be calculated per institutional standard) - Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤3 × ULN - Alkaline phosphatase (ALP) ≤2.5 × ULN - Serum total bilirubin ≤1.5 × ULN (unless Gilbert's disease is documented).
14. 14. Consent to participate with a signed and dated Institutional Review Board /Independent Ethics Committee -approved patient informed consent for the study prior to beginning any specific study procedures.
15. 15. Ability to understand and willingness to complete all protocol required procedures.

Exclusion criteria 16

1. 1. Local recurrence of or previous history of any ipsilateral or contralateral invasive breast cancer within 10 years prior to randomization [for synchronous tumors see Exclusion Criteria #3].
2. 2. Definitive clinical or radiologic evidence of metastatic disease.
3. 3. Synchronous bilateral breast cancer, unless both tumors are confirmed as TNBC.
4. 4. Have received any anti-cancer vaccines.
5. 5. Concomitant treatment with anticancer therapy other than adjuvant SOC therapy (capecitabine; immune checkpoint inhibitor), or other investigational therapy, if expected during the study.
6. 6. A history of other malignancies (except appropriately treated melanoma in situ, non-melanoma skin carcinoma, carcinoma in situ of the uterine cervix, follicular or papillary thyroid cancer or other nonbreast malignancies with a similar outcome to those mentioned above) within 5 years prior to randomization.
7. 7. Have any active autoimmune disease or disorder that requires Systemic immunosuppressive/immunomodulatory therapy. NOTE: Autoimmune diseases that are confined to the skin (e.g., psoriasis) that can be treated with topical steroids alone are allowed during the study.
8. 8. Oral/parenteral corticosteroid treatment (>5 mg/day of prednisone /equivalent), within 2 weeks prior to randomization or anytime during the study. NOTE: inhaled steroids for treatment of asthma; and topical steroids are allowed.
9. 9. Any known uncontrolled concurrent illness that would limit compliance with study requirements, including but not limited to ongoing or active infections, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, psychiatric disorders, or substance abuse.
10. 10. Any known hypersensitivity to active/inactive ingredients in the study drug formulation or known severe allergy or anaphylaxis to fusion proteins.
11. 11. Prior receipt of a glycoconjugate vaccine for cancer immunotherapy.
12. 12. Known history or positive for human immunodeficiency virus (HIV) positive, unless on effective anti-retroviral therapy with undetectable viral load within 6 months of therapy (note: HIV testing is not required for study entry).
13. 13. Known active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection prior to randomization. Patients who have completed curative therapy and have undetectable viral load for HCV are eligible. For patients with evidence of chronic HBV infection, the HBV viral load must be undetectable on suppressive therapy. (note: HBV/HCV testing is not required for study entry).
14. 14. Any condition, including significant diseases and/or laboratory abnormalities that would place the patient at unacceptable risk for study participation.
15. 15. Currently pregnant or breastfeeding women.
16. 16. Currently participating in or has participated in a breast cancer therapeutic clinical trial within 4 weeks (28 days) prior to randomization.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

1. IDFS (Invasive Disease Free Survival), defined by STEEP, as time from randomization to the date of first invasive disease recurrence (local, regional or distant), date of second primary invasive cancer (breast or not), or date of death from any cause, whichever occurs first.

Secondary endpoints 5

1. 1. OS status.
2. 2. Change from baseline in health-related quality of life (HRQOL) using the global health status/QoL scale from EORTC QLQ-C30 and EQ-5D-5L questionnaires.
3. 3. Breast cancer-free interval (BCFI).
4. 4. Distant disease-free survival (DDFS).
5. 5. Incidence of AEs and SAEs, incidence of abnormal laboratory values, and change from baseline in safety parameters.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Comparator 2

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Obi Pharma Inc.

Sponsor organisation

Obi Pharma Inc.

Address

6 F. No. 508 Sec. 7, Zhongxiao E. Rd, Nangang Dist. Zhongxiao E. Rd Nangang Dist.

City

Taipei

Postcode

115011

Country

Taiwan

Scientific contact point

Organisation

Obi Pharma Inc.

Contact name

Elena Chen, MD, Director, Product Development, Medical Officer

Public contact point

Organisation

Obi Pharma Inc.

Contact name

Elena Chen, MD, Director, Product Development, Medical Officer

Third parties 9

Locations

1 EU/EEA country · 6 investigational sites

By country

Investigational sites

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Summary of results Art. 37(4) CTR

Layperson summary Annex V

Documents 9 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

Application history

3 submissions — initial application plus substantial / non-substantial modifications