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PRS-343 in HER2-Positive Solid Tumors

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ClinicalTrials.gov Identifier: NCT03330561
Recruitment Status : Recruiting
First Posted : November 6, 2017
Last Update Posted : August 10, 2018
Sponsor:
Information provided by (Responsible Party):
Pieris Pharmaceuticals, Inc.

Brief Summary:
A multi center, open-label, Phase 1 dose escalation study with expansion cohort is designed to determine the MTD, RP2D and dosing schedule of PRS-343 in patients with HER2+ advanced or metastatic solid tumors.

Condition or disease Intervention/treatment Phase
HER2-positive Breast Cancer HER2-positive Gastric Cancer HER2-positive Bladder Cancer HER2-positive Solid Tumor Drug: PRS-343 Phase 1

Detailed Description:

The study will evaluate PRS-343 administered by intravenous (IV) infusion every 3 weeks (Schedule 1) initially. If safety, PK, and PD data suggest a different dosing schedule should be evaluated, Schedule 2 or 3 (dosing every 2 weeks or every 4 weeks in a 28-day cycle, respectively) may be conducted. Separate MTDs may be determined for each schedule evaluated. Dose-limiting toxicities (DLTs) will be reported during the first cycle of each schedule (e.g., 21 days after the first dose in Cycle 1 for Schedule 1). Patients will be monitored for safety throughout the study. Dosing will continue until criteria for study drug discontinuation are met (disease progression or withdrawal from the study).

Patients with unknown HER2 status will be consented separately in a pre-screening visit in order to undergo HER2 testing prior to screening. All patients will be evaluated at screening (Day 28 to 1) and baseline (Day 1 predose).

Once the MTD has been established, an expansion cohort of up to 30 additional patients with locally advanced or metastatic HER2+ solid tumors considered likely to respond to a HER2 targeted CD137 agonist (e.g. gastric/gastroesophageal/esophageal, breast, bladder) may be enrolled. The expansion cohort will be enrolled at the MTD and/or at a lower dose level if safety/PD/PK/efficacy data support further evaluation of a lower dose level in order to determine the RP2D. The RP2D may be equivalent to or lower than the MTD.

An End-of-Treatment Visit will be performed at the time of treatment discontinuation. Patients will be evaluated 30 days after the End-of-Treatment Visit or prior to starting subsequent therapy, if sooner, at the Safety Follow-up Visit to assess any ongoing AEs as outlined in the protocol.

Patients will be assessed for tumor response/progression per RECIST v1.1


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 78 participants
Intervention Model: Single Group Assignment
Intervention Model Description: Drug PRS-343 Monotherapy
Masking: None (Open Label)
Masking Description: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1, Open-Label, Dose Escalation Study of PRS-343 in Patients With HER2-Positive Advanced or Metastatic Solid Tumors
Actual Study Start Date : September 28, 2017
Estimated Primary Completion Date : April 2020
Estimated Study Completion Date : September 2020

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: PRS-343 Drug: PRS-343
PRS-343
Other Name: HER2/41BB Bispecific




Primary Outcome Measures :
  1. Incidence and severity of AEs graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4 [ Time Frame: Up to 36 months ]

Secondary Outcome Measures :
  1. Peak Plasma Concentration (Cmax) [ Time Frame: Up to 36 months ]
  2. Area under the plasma concentration versus time curve (AUC) [ Time Frame: Up to 36 months ]
  3. Time to maximum dose concentration (Tmax) [ Time Frame: Up to 36 months ]
  4. Terminal half life (t1/2) [ Time Frame: Up to 36 months ]
  5. Tumor responses as defined by the Response Evaluation in Solid Tumors (RECIST) v.1.1 [ Time Frame: Up to 36 months ]
  6. Duration of response [ Time Frame: Up to 36 months ]
  7. Disease control rate [ Time Frame: Up to 36 months ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Signed written informed consent obtained prior to performing any study procedure, including pre-screening and screening procedures.
  2. Men and women ≥18 years.
  3. Dose escalation: Histologically or cytologically confirmed diagnosis of unresectable/locally advanced and/or metastatic HER2+ solid tumor malignancy and for which standard therapies are not available, are no longer effective, are not tolerated, or have been declined by the patient.

    Expansion cohort: Locally advanced or metastatic HER2+ solid tumors considered likely to respond to a HER2-targeted CD137 agonist (e.g. gastric/gastroesophageal/esophageal, breast, bladder).

  4. Dose escalation and expansion cohort: HER2+ tumors documented by clinical pathology report:

    1. Assessment of HER2 status in patients with breast cancer should follow the 2013 American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) criteria (37) as practicable.
    2. Assessment of HER2 status in patients with gastric and gastroesophageal junction adenocarcinoma should follow the criteria published by Ruschoff et al. (38) as practicable.
    3. Assessment of HER2 status in patients with non-breast/non-gastric cancers may follow local institutional criteria. These criteria should be made available to the Sponsor.
    4. All patients with breast and gastric/gastroesophageal junction cancers should have HER2 testing performed using a FDA approved test in a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory.
    5. Patients for whom the clinical pathology report includes only IHC as 3+ (does not reflex to ISH) may enroll without written report of ISH determined HER2 copy number, provided the investigational site confirms that archival tissue is available.
  5. Patients with breast cancer and gastric and gastroesophageal junction cancer must have received at least 1 prior HER2 targeted therapy for advanced/metastatic disease.
  6. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1.
  7. Estimated life expectancy of at least 3 months.
  8. Dose Escalation: Evaluable or measurable disease according to RECIST v1.1 Expansion Cohort (additional 30 patients) Measurable disease according to RECIST v1.1.
  9. Adequate organ function as defined below:

    1. Serum AST and ALT ≤ 3 X ULN
    2. Total serum bilirubin ≤ 1.5 X ULN
    3. Serum creatinine ≤ 1.5 X ULN OR calculated glomerular filtration rate (GFR) by Cockcroft-Gault formula ≥ 50 mL/min
    4. Hemoglobin ≥ 9 g/dL
    5. ANC ≥ 1500/mm3
    6. Platelet count ≥ 75,000/mm3
    7. Left ventricular ejection fraction (LVEF) determined by echocardiogram or multi-gated acquisition scan ≥ 50%
  10. Any prior cumulative doxorubicin dose must be ≤ 360 mg/m2; prior cumulative epirubicin dose must be ≤ 720 mg/m2.
  11. Women of childbearing potential must have a negative serum or urine pregnancy test within 96 hours prior to start of study drug.
  12. Women must not be breastfeeding.
  13. Women of childbearing potential must agree to follow instruction for method(s) of contraception for the duration of treatment with study drug PRS-343 plus 90 days post-treatment completion.
  14. Males who are sexually active with women of childbearing potential must agree to follow instructions for method(s) of contraception for the duration of treatment with study drug PRS 343 plus 90 days post-treatment completion.

Exclusion criteria:

  1. Known uncontrolled central nervous system (CNS) metastases and/or carcinomatous meningitis. Note: Patients with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least 4 weeks prior to the first dose of study treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are clinically stable off steroids for at least 7 days prior to study treatment. Carcinomatous meningitis precludes a patient from study participation regardless of clinical stability.
  2. History of acute coronary syndromes, including myocardial infarction, coronary artery bypass graft, unstable angina, coronary angioplasty or stenting within past 24 weeks.
  3. History of or current Class II, III or IV heart failure as defined by the New York Heart Association (NYHA) functional classification system (Appendix B).
  4. History of ejection fraction drop below the lower limit of normal with trastuzumab and/or pertuzumab.
  5. Medical, psychiatric, cognitive or other conditions that compromise the patient's ability to understand the patient information, to give informed consent, to comply with the study protocol or to complete the study.
  6. Any severe concurrent disease or condition (includes active infections, cardiac arrhythmia, interstitial lung disease) that in the judgment of the investigator would make study participation inappropriate for the patient.
  7. Previously known infection with human immunodeficiency virus (HIV); or hepatitis B or hepatitis C infection.
  8. History of infusion reactions to any component/excipient of PRS-343.
  9. Systemic steroid therapy (>10 mg daily prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment (Note: topical, inhaled, nasal and ophthalmic steroids are not prohibited).
  10. Autoimmune disease that has required systemic treatment in the past (i.e., with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is allowed.
  11. Has not recovered from the adverse effect of previous anticancer treatments to pre-treatment baseline or Grade 1 except for alopecia, anemia (hemoglobin must meet the study inclusion criteria) and peripheral neuropathy (which must have recovered to ≤ Grade 2).
  12. History of a second primary cancer with the exception of 1) curatively treated non-melanomatous skin cancer, 2) curatively treated cervical or breast carcinoma in situ, or 3) other malignancy with no known active disease present and no treatment administered during the last 2 years.
  13. Receipt of investigational treatment within 3 weeks of scheduled Cycle 1 Day 1 (C1D1) dosing.
  14. Receipt of cytotoxic chemotherapy within 3 weeks (6 weeks for nitrosoureas and mitomycin C) of scheduled C1D1 dosing.
  15. Receipt of radiation therapy within 3 weeks of scheduled C1D1 dosing, unless the radiation comprised a limited field to non-visceral structures (e.g., limb bone metastasis).
  16. Receipt of treatment with immunotherapy, biological therapies, targeted small molecules, hormonal therapies within 3 weeks of scheduled C1D1 dosing.
  17. Receipt of trastuzumab or ado-trastuzumab emtansine within 4 weeks of scheduled C1D1 dosing.
  18. Concurrent enrollment in another therapeutic clinical trial.
  19. Major surgery within 3 weeks of scheduled C1D1 dosing.

Information from the National Library of Medicine

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): NCT03330561


Contacts
Contact: Ingmar Bruns, MD PhD +1-857-246-8998 bruns@pieris.com
Contact: Kayti Aviano +1-857-246-8287 aviano@pieris.com

Locations
United States, California
University of California Los Angeles (UCLA) Recruiting
Santa Monica, California, United States, 90404
Contact: Monica Rocha    310-582-6324      
Principal Investigator: Sara Hurvitz, M.D.         
United States, District of Columbia
Georgetown University, Lombardi Comprehensive Cancer Center Recruiting
Washington, District of Columbia, United States, 20007
Contact: Laura Macke, MS, RN, OCN    202-687-2111    lab228@georgetown.edu   
Principal Investigator: Paula R Pohlman, M.D.         
United States, Maryland
Johns Hopkins University School of Medicine Recruiting
Baltimore, Maryland, United States, 21287
Contact: Corey Gray    410-502-5101    corey.gray@jhmi.edu   
Principal Investigator: Noah Hahn, M.D.         
United States, New York
Memorial Sloan Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: Brittanie Millange    646-888-4328    millangb@mskcc.org   
Contact: Carly Fein    646-888-4328    feinc@mskcc.org   
Principal Investigator: Geoffrey Y Ku, MD         
United States, Pennsylvania
University of Pittsburgh Medical Center (UPMC) Recruiting
Pittsburgh, Pennsylvania, United States, 15213
Contact: Courtney Shook    412-623-8349    shookc3@upmc.edu   
Principal Investigator: James Lee, M.D.         
United States, Tennessee
Sarah Cannon Research Institute Recruiting
Nashville, Tennessee, United States, 37203
Contact: Erin Fisher    615-525-4059    Erin.Fisher2@sarahcannon.com   
Principal Investigator: Johanna Bendell, M.D.         
United States, Texas
M.D. Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: Thao Nguyen, RN    713-745-5053    TNguyen32@mdanderson.org   
Contact: Rabia Khan, MD    713-563-4667    RKhan@mdanderson.org   
Principal Investigator: Sarina A Piha-Paul, M.D.         
START - South Texas Accelerated Research Therapeutics, LLC Recruiting
San Antonio, Texas, United States, 78229
Contact: Leslie Smetzer    210-593-5269    leslie.smetzer@startsa.com   
Principal Investigator: Amita Patnaik, M.D.         
NEXT Oncology Recruiting
San Antonio, Texas, United States, 78240
Contact: Kayla Dotson    210-595-5670    kdotson@nextsat.com   
Principal Investigator: Anthony Tolcher, M.D.         
Sponsors and Collaborators
Pieris Pharmaceuticals, Inc.
Investigators
Study Director: Ingmar Bruns, MD PhD Pieris Pharmaceuticals

Responsible Party: Pieris Pharmaceuticals, Inc.
ClinicalTrials.gov Identifier: NCT03330561     History of Changes
Other Study ID Numbers: PRS-343-PCS_04_16
First Posted: November 6, 2017    Key Record Dates
Last Update Posted: August 10, 2018
Last Verified: August 2018
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
Product Manufactured in and Exported from the U.S.: No

Keywords provided by Pieris Pharmaceuticals, Inc.:
HER2-positive breast cancer
HER2 -positive gastric cancer
HER2-positive bladder cancer
Pieris
PRS-343
Anticalin
Bi-specific
4-1BB
CD137
HER2

Additional relevant MeSH terms:
Stomach Neoplasms
Urinary Bladder Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Stomach Diseases
Urologic Neoplasms
Urogenital Neoplasms
Urinary Bladder Diseases
Urologic Diseases