A Dose-escalation Study of ARX788, IV Administered in Subjects With Advanced Cancers With HER2 Expression

NCT02512237 | Terminated Phase 1 DMC

• 2 other identifiers: ZMC-ARX788-101Universal Trial Number (UTN)
• Study Type: interventional
• Target: 9
• Locations: 2 countries
• Sites: 7

Brief Summary

This is a 2-part, Phase 1 FIH study with Phase 1a designed to determine the maximum tolerated dose (MTD)/recommended Phase 2 dose (RP2D) in subjects with metastatic cancers with a human epidermal growth factor receptor 2 (HER2) test result that is in situ hybridization (ISH) positive (+) or immunohistochemistry (IHC) 3+ or 2+, and Phase 1b designed to assess anticancer activity and safety in three expansion cohorts: two different advanced breast cancer expansion cohorts (namely, for tumors that test as HER2 ISH positive or IHC3+ and for tumors that test as HER2 ISH negative with IHC 2+), and one advanced gastric cancer expansion cohort (for tumors that test as HER2 ISH positive or IHC3+).

Conditions

Breast Neoplasms; Stomach Neoplasms

Keywords

HER2; breast cancer; ADC; antibody drug conjugate; elevated HER2 expression

Outcome Measures

Primary Outcomes (1)

• Maximum tolerated dose of ARX788

  Determine highest dose level at which less than 2 of 6 subjects experience a dose limiting toxicity.

  12 months

Secondary Outcomes (5)

• Number of subjects with Adverse Events

  30 months

• Area under the plasma concentration versus time curve (AUC) of ARX788 after infusion

  30 months

• Half-life of ARX788 after infusion

  30 months

• Number of participants with tumor response to ARX788 administration

  18 months

• Number of subjects developed anti-ARX788 antibody

  30 months

Study Arms (4)

Phase 1a: Dose-Escalation

EXPERIMENTAL

Six cohorts with escalated dose levels of ARX788 at 0.33 mg/kg, 0.66 mg/kg, 1.3 mg/kg, 2.2 mg/kg, 2.9 mg/kg and 3.8 mg/kg will be administered every 3 weeks via intravenous infusion to determine the MTD.

Drug: ARX788

Phase 1b: Dose-evaluation 1

EXPERIMENTAL

Breast cancer subjects with high HER2 expression, categorized as ISH positive or IHC3+, will be administered with ARX788 at MTD every 3 weeks via intravenous infusion.

Drug: ARX788

Phase 1b: Dose-evaluation 2

EXPERIMENTAL

Breast cancer subjects with mid/low HER2 expression, categorized as ISH negative AND IHC2+, will be administered with ARX788 at MTD every 3 weeks via intravenous infusion.

Drug: ARX788

Phase 1b: Dose-evaluation 3

EXPERIMENTAL

Gastric cancer subjects with high HER2 expression, categorized as ISH positive or IHC3+, will be administered with ARX788 at MTD every 3 weeks via intravenous infusion.

Drug: ARX788

Interventions

ARX788 DRUG

ARX788, an antibody drug conjugate

Phase 1a: Dose-Escalation; Phase 1b: Dose-evaluation 1; Phase 1b: Dose-evaluation 2; Phase 1b: Dose-evaluation 3

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Life expectancy \>12 weeks.
• BMI is between 18 to 32 kg/m2
• Subjects whose advanced cancer has failed treatment or whose cancer has progressed following available standard therapy or for whom such therapy is not acceptable to the subject. Subjects whose tumor tissue local laboratory results are HER2 ISH positive or IHC3+ must have been previously treated with a HER2 targeting therapy (e.g. trastuzumab, in the country or region where such therapies are available and part of standard of care), or have failed SOC therapy. Subjects who have been previously treated with a HER2 targeting therapy such as trastuzumab or ado-trastuzumab emtansine are eligible.
• Disease measurability: Phase 1a: measureable or non-measureable disease; Phase 1b: disease must be measureable (per RECIST v1.1) (subjects with non-measureable disease are not eligible for Phase 1b).
• Histopathologic evidence of breast cancer based upon pathologist's report.
• Tumor tissue local laboratory HER2 testing results (clinical pathology report) based on FDA or other regulatory agency approved, validated or commercially available IHC or ISH HER2 assay. Pre-screening for HER2 is allowed only for subjects with breast and gastric cancer, where applicable. Subjects with other types of cancer must have previously tested for HER2 status by HER2 IHC or ISH assay. 1) Phase 1a: ISH positive or IHC 2+ or 3+. 2) Phase 1b: Cohort 1: advanced breast cancer, ISH positive or IHC 3+; Cohort 2: advanced breast cancer, ISH negative with IHC 2+; and Cohort 3: advanced gastric cancer, ISH positive or IHC 3+.
• Local pathology laboratory determination of HER2 status will be accepted, provided that the local laboratory is an accredited site for HER2 testing. In Phase 1b, if the local laboratory was not accredited at the time of testing, an adequate tumor tissue sample is required for central pathology laboratory HER2 testing. The tissue sample may be provided as 10 pre-cut unstained slides or a tumor block.
• Eastern Cooperative Oncology Group Performance Status of 0 to 1.
• Acute toxicities from any prior therapy, surgery, or radiotherapy must have resolved to Grade 0 or 1 as per the NCI-CTCAE v 4.03.
• The last dose of prior anticancer therapy must have been administered at least 28 days prior to the first dose of the IMP.
• Adequate bone marrow function defined by absolute neutrophil count of ≥1.5×109/L, platelet count of ≥100.0×109/L, and hemoglobin of ≥9.0 g/dL.
• Adequate hepatic function defined by serum total bilirubin ≤1.5 × upper limit of normal (ULN), aspartate aminotransferase/alanine aminotransferase ≤2.5 × ULN (or ≤5 × ULN in subjects with liver metastases).
• Adequate renal function assessed by serum creatinine within reference lab normal limits and creatinine clearance (by Chronic Kidney Disease Epidemiology \[CKD-EPI\] Collaboration equation) ≥60 mL/min.
• Adequate cardiac function as assessed by cardiac troponin I within normal range; left ventricular ejection fraction ≥ 50% or institutional lower limit of normal; cumulative anthracycline dose \<360 mg/m2 doxorubicin or equivalent.
• Willing and able to understand and sign an informed consent inform and to comply with all aspects of the protocol.

You may not qualify if:

• History of allergic reactions to any component of the ARX788.
• \. History of seizure disorder.
• History of unstable central nervous system (CNS) metastases or seizure disorder related to the malignancy; however, those subjects who were treated for prior CNS metastases and who are asymptomatic may participate in the study as long as they are not receiving treatment with steroids.
• History of congestive heart failure, unstable angina pectoris, unstable atrial fibrillation, or cardiac arrhythmia.
• Grade 2 to 4 peripheral neuropathy (NCI CTCAE v 4.03).
• Non-manageable electrolyte imbalances including hypokalemia, hypocalcemia, or hypomagnesemia (Grade 2 or greater based on NCI CTCAE v 4.03).
• Any uncontrollable intercurrent illness, infection, or other conditions that could limit study compliance or interfere with assessments.
• Exposure to any other investigational or commercial anticancer agents or therapies administered with the intention to treat malignancy within 28 days before the first dose of the IMP.
• Significant surgical intervention within 21 days of the first dose of the IMP or with ongoing post-operative complications if more than 21 days.
• Radiotherapy administrated less than 21 days prior to the first dose of the IMP, or localized palliative radiotherapy administered less than 7 days prior to the first dose of the IMP, or radiotherapy induced toxicity of Grade 2 or greater based on NCI CTCAE v 4.03.
• Pregnancy or breast feeding.
• Legal incapacity/limited legal capacity for providing informed consent.

Sponsors & Collaborators

• Zhejiang Medicine Co., Ltd.: lead
• Ambrx, Inc.: collaborator

Study Sites (7)

Mater Adult Hospital

South Brisbane, Queensland, 4101, Australia

Location

Princess Alexandra Hospital

Woolloongabba, Queensland, 4102, Australia

Location

Monash Medical Centre

Clayton, Victoria, 3168, Australia

Location

Epworth Healthcare

Richmond, Victoria, 3121, Australia

Location

Auckland City Hospital

Grafton, Auckland, 1023, New Zealand

Location

Wellington Hospital

Newtown, Wellington Region, 6022, New Zealand

Location

Christchurch Hospital

Christchurch, 8140, New Zealand

Location

MeSH Terms

Conditions

Breast Neoplasms; Stomach Neoplasms

Interventions

ARX788

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 22, 2015
• First Posted: July 30, 2015
• Study Start: March 1, 2016
• Primary Completion: January 1, 2017
• Study Completion: January 1, 2017
• Last Updated: June 5, 2020

Record last verified: 2020-06

Data Sharing

• IPD Sharing: Will not share

Locations

AU (4); NZ (3)