Phase 1/2a Open-Label, Dose-Escalation, Multicenter, First-in-Human, Consecutive-Cohort, Clinical Trial of BI-1808, a Monoclonal Antibody to Tumor Necrosis Factor Receptor 2 (TNFR2), as a Single Agent and in Combination with Pembrolizumab in Subjects with Advanced Malignancies

Overview

Sponsor-declared trial summary

Key facts

Sponsor

BioInvent International AB

Participant type

Patients

Age range

18-64 years, 65+ years

Gender

Male and Female

Therapeutic area

Diseases [C] - Neoplasms [C04]

Trial duration

9 Apr 2020 → ongoing

Decision date (initial)

2024-04-19

Transition trial

Yes

Low-intervention

No

Rare-disease indication

No

Vulnerable population

Yes

Funding sources

BioInvent International AB

External identifiers

EU CT number

2023-509847-29-00

EudraCT number

2020-002090-10

ClinicalTrials.gov

NCT04752826

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Safety

Phase 1: To assess the safety and tolerability profile of increasing doses of BI1808, as a single agent (Phase 1, Part A), and in combination with pembrolizumab (BI-1808 with pembrolizumab [Phase 1, Part B]) in subjects with advanced malignancies.
Phase 1: To identify dose-limiting toxicities (DLTs), determine the maximum tolerated dose (MTD) and select a signal- seeking Phase 2 dose of BI-1808, given via intravenous (IV) infusion, as a single agent (Phase 1, Part A), and in combination with pembrolizumab (Phase 1, Part B) in subjects with advanced malignancies.
Phase 2a: To assess the safety and tolerability profile of BI-1808, as a single agent (Phase 2a, Part A), in combination with pembrolizumab (Phase 2a, Part B), and in combination with pembrolizumab and paclitaxel (Phase 2a, Part C), in subjects with advanced malignancies.

Secondary objectives 1

1. To assess the PK profile of BI-1808 when administered every 3 weeks as a single agent (Phase 1, Part A and phase 2a part A), in combination with pembrolizumab (Phase 1, Part B and Phase 2a, part B), and in combination with pembrolizumab and paclitaxel (Phase 2a, Part C) in subjects with advanced malignancies. To assess the immunogenicity of BI-1808 in subjects with advanced malignancies (Phase 1, Parts A and B, and Phase 2a, Parts A, B and C). To evaluate the (RO) (PD) of BI -1808 as a single agent and in combination with pembrolizumab or pembrolizumab and paclitaxel on T-cells expressing TNFR2 in subjects with advanced malignancies (Phase 1, Parts A and B, and Phase 2a, Parts A, B and C).

Conditions and MedDRA coding

Advanced solid tumors

Study design 5 periods

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 9

1. 1. Is willing and able to provide written informed consent for the trial.
2. 2. Is ≥18 years of age on the day of signing informed consent.
3. 3. Has a histologically confirmed advanced malignancy. Subjects with TCL [MF or SS] who satisfy the Phase 2a, Cohort 3-specific eligibility criteria may be enrolled into the Phase 1 part of the study.
4. 4. Has received standard of care or is intolerant of, refuses, or is not eligible for standard antineoplastic therapy.
5. 5. Has at least 1 measurable disease lesion as defined by RECIST v 1.1 (not applicable for subjects with TCL).
6. 6. Is willing to safely undergo tissue biopsies of involved tissue, if required. However, if the Investigator considers that a baseline tumor tissue biopsy is not safe and technically feasible, then the subject will not be required to undergo the biopsy. Note: for subjects with CTCL, skin punch biopsies are required, as specified in Cohort-specific inclusion criterion 2g, unless agreed otherwise with Sponsor a. The Screening biopsy, if required, must be performed prior to the first dose of BI-1808 (on non-previously irradiated lesions only), and at least 4 weeks following the last dose of tumor-directed therapy. The biopsy at Screening can be replaced with a formalin-fixed archival tumor tissue sample collected from a previous standard of care biopsy, provided that the biopsy was performed after the subject’s last tumor-directed therapy and prior to study entry. Subjects who do not have an archival tissue sample at Screening may still be enrolled in the study.
7. 7. Has a life expectancy of ≥12 weeks.
8. 8. Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1.
9. 9. Has adequate organ function as confirmed by laboratory values.

Exclusion criteria 20

1. 1. Needs doses of prednisolone >10 mg daily (or equipotent doses of other corticosteroids) while on the trial other than as premedication(except for subjects with TCL). During the Screening period, doses of up to 20 mg/day may be given but the dose must be reduced to 10 mg/day within 7 days prior to the first dose of study drug(except for subjects with TCL). Steroids are allowed as premedication in subjects with allergies to contrast scans.
2. 11. Is a female subject and has the ability to become pregnant (or already pregnant or lactating/breastfeeding). However, those female subjects who have a negative serum or urine pregnancy test up to 72 hours prior to their first dose of study treatment and agree to use a highly effective method of birth control for 4 weeks before entering the trial, during the trial, and for 12 months after their last dose of study treatment (BI-1808, pembrolizumab or paclitaxel), are considered eligible.
3. 12. Is a male subject with partner(s) of childbearing potential (unless he agrees to use a barrier method of contraception [condom plus spermicide gel] with the female partner(s) who are using one highly effective method of contraception during the trial and for 12 months after completing treatment). Men with pregnant or lactating partners should be advised to use barrier method contraception (condom plus spermicidal gel) to prevent exposure to the fetus or neonate.
4. 13. Has had major surgery from which the subject has not yet recovered.
5. 14. Is at high medical risk because of nonmalignant systemic disease including severe active infections on treatment with antibiotics, antifungals, or antivirals.
6. 15. Has presence of chronic graft versus host disease.
7. 16. Has had an allogenic tissue/solid organ transplant.
8. 17. Has known human immunodeficiency (HIV) and/or history of hepatitis B or C infections, or has a positive test for HIV antibody, hepatitis B antigen/hepatitis B virus DNA or hepatitis C antibody or RNA.
9. 18. Has a history of active tuberculosis (Bacillus tuberculosis).
10. 19. Has received a live vaccine within 30 days before the first dose of study treatment. COVID-19 vaccines based on viral RNA or protein fragments are allowed. COVID 19 vaccines based on live replicating viral or bacterial vectors (eg, adenoviruses, adeno-associated viruses, vesicular stomatitis virus, vaccinia viruses, or measles virus) are not allowed.
11. 20. Has uncontrolled or significant cardiovascular disease as per protocol.
12. 2. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated CNS metastases may participate provided they are radiologically stable (without evidence of progression for at least 4 weeks by repeat imaging [note that the repeat imaging should be performed during study Screening]); have no newly onset or worsening symptomatology of brain metastases; and have not required steroids for at least 14 days before study treatment.
13. 3. Has symptomatic ascites or pleural effusion, requires surgical intervention of additional medication.
14. 5. Has cardiac or renal amyloid light-chain amyloidosis.
15. 6. Has received the following: a. Chemotherapy or small molecule products within 4 weeks of first dose of BI 1808. b. Radiotherapy within 2 weeks of first dose of BI-1808. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) for non-CNS disease. Subjects who have previously had radiation pneumonitis are not allowed. c. Immunotherapy within 4 weeks prior to the first dose of BI-1808.
16. 7. Has not recovered from AEs to at least Grade 1 by NCI CTCAE (version 5.0) due to prior anticancer therapies. Exceptions to this are alopecia or certain Grade 1 toxicities, which in the opinion of the Investigator should not exclude the subject. Subjects with ≤Grade 2 neuropathy may be eligible, after discussion with the Medical Monitor.
17. 8. Has had Grade ≥3 autoimmune manifestations of previous immune checkpoint inhibitor treatments (eg, anti-PD-1, anti-PD-L1, or anti-CTLA4).Exceptions are adverse events with short duration, managed and resolved with adequate medical intervention, or where the subject could be rechallenged with immune checkpoint inhibitor treatment without further events. Exceptions must be agreed between the Investigator and Sponsor.
18. 9. Has a history of (noninfectious) pneumonitis that required steroids or has current pneumonitis.
19. 10. Has an active, known, or suspected autoimmune disease. However, subjects with Type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, mild psoriasis, or alopecia not requiring systemic treatment), or conditions not expected to recur in the absence of an external trigger will be permitted to participate.
20. 4. Has known or suspected hypersensitivity to BI-1808 (all subjects) or pembrolizumab (subjects in Phase 1, Part B and Phase 2a, Part B and C, or paclitaxel (subjects in Phase 2a, Part C) or any of their excipients. Previous isolated infusion-related reactions are not to be considered a reason for exclusion unless Grade 4 in intensity.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 2

1. Phase 1:Adverse events (AEs) and serious adverse events (SAEs) (graded according to National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] version 5.0) or newer when applicable, clinically significant laboratory parameters and physical findings and their causality to BI1808, or BI 1808 in combination with pembrolizumab. Occurrence of dose-limiting toxicities (DLTs) of BI-1808 and in combination with pembrolizumab.
2. Phase 2a: AEs and SAEs (graded according to CTCAE version 5.0 or newer when applicable, clinically significant laboratory parameters and physical findings and their causality to BI1808, or BI 1808 in combination with pembrolizumab or pembrolizumab and paclitaxel.

Secondary endpoints 1

1. Standard PK parameters for BI-1808 (including, but not limited to approximations of area under the serum concentration-time curve [AUC], maximum concentration [Cmax], and terminal half life [t½]). Antidrug antibodies (ADA) response to BI 1808. TNFR2 receptor occupancy on CD14+ and/or CD16+ cells.

Investigational products

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

Test 4

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

BioInvent International AB

Sponsor organisation

BioInvent International AB

Address

Ideongatan 1 A, Lunds Allhelgonafors. Lunds Allhelgonafors.

City

Lund

Postcode

223 62

Country

Sweden

Scientific contact point

Organisation

BioInvent International AB

Contact name

Ingunn Munch Lindvig

Public contact point

Organisation

BioInvent International AB

Contact name

Ingunn Munch Lindvig

Third parties 11

Locations

4 EU/EEA countries · 11 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

Documents 33 files

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

Application history

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