A Dose Escalation and Cohort Expansion Study of NKTR-214 in Combination With Nivolumab and Other Anti-Cancer Therapies in Patients With Select Advanced Solid Tumors (PIVOT-02)
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| ClinicalTrials.gov Identifier: NCT02983045 |
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Recruitment Status :
Active, not recruiting
First Posted : December 6, 2016
Last Update Posted : August 26, 2021
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| Condition or disease | Intervention/treatment | Phase |
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| Melanoma Renal Cell Carcinoma Non Small Cell Lung Cancer Urothelial Carcinoma Metastatic Breast Cancer Colorectal Cancer | Drug: Combination of NKTR-214 + nivolumab Drug: Combination of NKTR-214 + nivolumab + ipilimumab | Phase 1 Phase 2 |
NKTR-214 (investigational agent) is an IL-2 pathway agonist designed to target CD122, a protein which is found on certain immune cells (known as CD8+ T Cells and Natural Killer Cells) to expand these cells to promote their anti-tumor effects. Nivolumab is a full human monoclonal antibody that binds to PD-1 (programmed cell death protein 1) on immune cells and promotes anti-tumor effects. NKTR-214, nivolumab and ipilimumab each target the immune system differently and may act synergistically to promote anti-cancer effects.
The study is designed in four parts.
Part 1: Dose escalation of NKTR-214 in combination with nivolumab. Part 1 has been completed and the recommended phase 2 dose (RP2D) has been identified, which is being studied further in Parts 2, 3 and 4 of the study.
Part 2: Dose expansion of NKTR-214 in combination with nivolumab. Patients with the following tumor types (Melanoma, RCC, NSCLC, UC, mBC and CRC) will be enrolled to receive the RP2D of NKTR-214 in combination with nivolumab. In addition, NKTR-214 with nivolumab and other anti-cancer therapies including cytotoxic chemotherapy will be evaluated in select patients with NSCLC. Each cohort in Part 2 has a target enrollment of 12-36 patients and could include up to a total of 650 patients who are either checkpoint-therapy naïve or anti-PD-1 or anti-PD-L1 relapsed/refractory. One dedicated and separate cohort in Part 2 will evaluate NKTR-214 with nivolumab in an additional 100 second-line NSCLC patients previously treated with an anti-PD-1 or anti-PD-L1 in combination with doublet platinum-containing cytotoxic chemotherapy in first-line.
Part 3: Schedule and safety finding of NKTR-214 in combination with nivolumab and ipilimumab. During this part of the study, the RP2D triplet combination schedules will be determined in the following tumor types: RCC, NSCLC, Melanoma, or UC.
Part 4: Dose expansion of triplet combinations of NKTR-214 in combination with nivolumab and ipilimumab in select tumor types. Each cohort will enroll between 6-36 patients and could include up to 106 patients. Enrollment into Part 4 will commence once the RP2D for the triplet combination has been established in Part 3 for each respective tumor type.
All patients enrolled in the study will be closely monitored for safety, tolerability and response per RECIST criteria. The primary efficacy endpoint of the combination will be assessed using objective response rate (ORR). Exploratory immunological biomarkers in plasma and tumor samples will evaluate immune activation.
| Study Type : | Interventional (Clinical Trial) |
| Estimated Enrollment : | 557 participants |
| Allocation: | Non-Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | None (Open Label) |
| Primary Purpose: | Treatment |
| Official Title: | A Phase 1/2, Open-label, Multicenter Study of the Combination of NKTR-214 and Nivolumab or the Combination of NKTR-214, Nivolumab, and Other Anti-Cancer Therapies in Patients With Select Locally Advanced or Metastatic Solid Tumor Malignancies |
| Actual Study Start Date : | December 19, 2016 |
| Estimated Primary Completion Date : | November 2021 |
| Estimated Study Completion Date : | December 2021 |
| Arm | Intervention/treatment |
|---|---|
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Experimental: Dose Escalation: Combination of NKTR-214 + nivolumab
NKTR-214 in escalating doses will be combined with one of the two proposed doses of nivolumab. The goal of this dose escalation Part 1 of the study is to find the RP2D.
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Drug: Combination of NKTR-214 + nivolumab
Patients with select tumor types will receive NKTR-214 doses administered either q3w or q2w, in combination with 240 mg nivolumab q2w or in combination with 360 mg of nivolumab q3w.
Other Name: NKTR-214 + Opdivo® |
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Experimental: Dose Expansion: Combination of NKTR-214 + nivolumab
Combination of NKTR-214+nivolumab in combination with cytotoxic chemotherapies for the following 2 cohorts of the Part 2: NSCLC 1L nonsquamous plus platinum/pemetrexed NSCLC 1L squamous plus platinum/taxane |
Drug: Combination of NKTR-214 + nivolumab
Select patient cohorts with select tumor types will be dosed with NKTR-214 + nivolumab at the RP2D + other anti-cancer therapies per institution standard.
Other Names:
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Experimental: Experimental: Combination of NKTR-214 + nivolumab + ipi
NKTR-214 will be combined with nivolumab and ipilimumab. The goal of this dose schedule finding part of the study is to define the RP2D and administration schedule.
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Drug: Combination of NKTR-214 + nivolumab + ipilimumab
Combination of NKTR-214 at 0.006 mg/kg q3w in combination with nivolumab and ipilimumab in up to three different dosing schedules to identify dose and schedules that will proceed into Part 4.
Other Name: NKTR-214 + Opdivo® + Yervoy® |
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Experimental: Dose Expansion of the Part 3 RP2D
Experimental Combination of NKTR-214 + nivolumab + ipilimumab that may enroll between 12-26 patients per tumor type
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Drug: Combination of NKTR-214 + nivolumab + ipilimumab
Combination of NKTR-214 + nivolumab + ipilimumab will be administered at the RP2D dose/schedule in patient cohorts with select tumor types.
Other Name: NKTR-214 + Opdivo® + Yervoy® |
- Efficacy of NKTR-214 in combination with nivolumab as assessed by the Objective Response Rate (ORR) based on immune-related RECIST (irRECIST) at the RP2D. [ Time Frame: Through study completion, an expected average of 2 years ]
- Efficacy of NKTR-214 in combination with nivolumab and ipilimumab as assessed by the Objective Response Rate (ORR) based on immune-related RECIST (irRECIST) at the RP2D. [ Time Frame: Through study completion, an expected average of 2 years ]
- Overall Survival (OS) [ Time Frame: Within 3 years from study start ]Overall survival is defined as the time from date of first dose to the date of death
- Progression-Free Survival (PFS) [ Time Frame: Through study completion, an expected average of 2 years ]PFS is defined as the time from date of first dose to the date of the first objectively documented tumor progression or death due to any cause.
- Clinical Benefit Rate (CBR) [ Time Frame: Within 3 years from study start ]CBR will be assessed as the number of subjects with a BOR of Complete Response (CR), confirmed Partial Response (PR), or Stable Disease (SD) (where the duration of SD should be ≥ 84 days) divided by the total number of subjects in the Response Evaluable Population
- Duration of Response (DOR) [ Time Frame: Through study completion, an expected average of 2 years ]DOR is defined as time between the date of first radiographic images that documented objective response and the date of the first radiographic images that documented disease progression.
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
INCLUSION CRITERIA - For Parts 1-4:
- Histologically confirmed diagnosis of a locally advanced (not amenable to curative therapy such as surgical resection) or metastatic solid tumors
- Life expectancy > 12 weeks
- Patients must not have received prior interleukin-2 (IL-2) therapy
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Measurable disease per RECIST 1.1
- Patients with stable brain metastases under certain criteria
- Fresh and archival tumor tissue available Tumor specific inclusion criteria may apply.
EXCLUSION CRITERIA - For Parts 1-4:
- Use of an investigational agent or an investigational device within 28 days before administration of first dose of NKTR--214
- Females who are pregnant or breastfeeding
- Participants who have an active autoimmune disease requiring systemic treatment within the past 3 months or have a documented history of clinically severe autoimmune disease that requires systemic steroids or immunosuppressive agents
- History of organ transplant that requires use of immune suppressive agents
- Active malignancy not related to the current diagnosed malignancy
- Evidence of clinically significant interstitial lung disease or active, noninfectious pneumonitis
- Participants who have had < 28 days since the last chemotherapy, biological therapy, or < 14 days from approved tyrosine kinase inhibitor (TKI) therapy, or systemic or inhaled steroid therapy at doses greater than 10mg of prednisone Tumor specific exclusion criteria may apply.
Other protocol defined inclusion/exclusion criteria may apply
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02983045
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| Study Director: | Study Director | Nektar Therapeutics |
| Responsible Party: | Nektar Therapeutics |
| ClinicalTrials.gov Identifier: | NCT02983045 |
| Other Study ID Numbers: |
16-214-02 |
| First Posted: | December 6, 2016 Key Record Dates |
| Last Update Posted: | August 26, 2021 |
| Last Verified: | August 2021 |
| Individual Participant Data (IPD) Sharing Statement: | |
| Plan to Share IPD: | Undecided |
| Studies a U.S. FDA-regulated Drug Product: | Yes |
| Studies a U.S. FDA-regulated Device Product: | No |
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NKTR-214 Bempegaldesleukin Nivolumab Ipilimumab Paclitaxel Carboplatin Cisplatin Pemetrexed Melanoma Renal Cell Carcinoma |
Non Small Cell Lung Cancer Urothelial Carcinoma Triple Negative Breast Cancer Colorectal Cancer Metastatic Advanced Immunotherapy Anti-PD-1 anti-CTLA-4 |
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Carcinoma Carcinoma, Non-Small-Cell Lung Colorectal Neoplasms Melanoma Carcinoma, Renal Cell Carcinoma, Transitional Cell Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms by Site Lung Neoplasms Respiratory Tract Neoplasms Thoracic Neoplasms Lung Diseases Respiratory Tract Diseases |
Carcinoma, Bronchogenic Bronchial Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms, Nerve Tissue Nevi and Melanomas |