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Trial record 2 of 14 for:    NKTR-214

A Study to Evaluate Safety and Efficacy of Multiple Dosing With VB10.NEO and Bempegaldesleukin (NKTR-214) Immunotherapy in Patients With Locally Advanced or Metastatic Cancer (DIRECT-01)

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ClinicalTrials.gov Identifier: NCT03548467
Recruitment Status : Recruiting
First Posted : June 7, 2018
Last Update Posted : February 5, 2020
Sponsor:
Collaborator:
Nektar Therapeutics
Information provided by (Responsible Party):
Vaccibody AS

Brief Summary:
This open labelled first in human dose phase 1/2a study is designed to evaluate safety, feasibility and efficacy of multiple dosing with individualised VB10.NEO and bempegaldesleukin (NKTR-214) immunotherapy in patients with locally advanced or metastatic solid tumours.

Condition or disease Intervention/treatment Phase
Locally Advanced or Metastatic Solid Tumours Biological: VB10.NEO Drug: Bempegaldesleukin Phase 1 Phase 2

Detailed Description:

This open labelled first in human dose phase 1/2a study is designed to evaluate safety, feasibility and efficacy of multiple dosing with individualised VB10.NEO immunotherapy in patients with locally advanced or metastatic solid tumours including melanoma, non-small cell lung cancer (NSCLC), clear renal cell carcinoma, urothelial cancer or squamous cell carcinoma of the head and neck (SCCHN), who did not reach complete responses with immune checkpoint inhibitor (CPI) therapy as their standard of care (SOC) treatment.

Patients with melanoma, NSCLC, RCC and urothelial carcinoma must upon screening, have been receiving a CPI (anti-PD-1 or anti-PD-L1) for at least 12 weeks as the patient's standard of care. Patients with SCCHN can be screened as long as they have initiated treatment with CPI as SOC. The VB10.NEO vaccine will be added to continuing CPI treatment and shall not replace, omit, postpone or terminate the standard therapy. Patients who have been treated with CPI for at least 12 weeks, will be enrolled in case of some benefit to CPI treatment is expected, as defined by partial response, stable disease or disease progression (in case of a mixed response to CPI, provided at least one lesion shows measurable regression and patient, according to the investigator, would have a clinical benefit of continued immunotherapy).

The assumption is to combine the immuno-stimulating effect of CPIs with immune responses towards specific neo-antigens in the vaccine, which may possibly increase the anti-tumour effect to reach durable efficacy.

One arm of the study patients with SCCHN will have the option to be treated with bempegaldesleukin (NKTR-214) in combination with personalised VB10.NEO. This arm is open for enrollment from November 2019.

The study will be conducted in two parts. Part A will evaluate safety, feasibility and efficacy of individualised VB10.NEO and bempegaldesleukin (NKTR-214) immunotherapy in SCCHN patients. The expansion part B will explore efficacy and safety in further patients with selected types of cancer showing signs of efficacy during part A.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 65 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Intervention Model Description: Open Label
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open Labelled First Human Dose Phase 1/2a Study to Evaluate Safety, Feasibility, Efficacy of Multiple Dosing With Individualised VB10.NEO and Bempegaldesleukin (NKTR-214) Immunotherapy in Patients With Locally Advanced or Metastatic Melanoma, Non-small Cell Lung Cancer (NSCLC), Clear Renal Cell Carcinoma, Urothelial Cancer or Squamous Cell Carcinoma of Head and Neck, Who Did Not Reach Complete Responses With Current Standard of Care Immune Checkpoint Blockade
Actual Study Start Date : April 4, 2018
Estimated Primary Completion Date : January 2023
Estimated Study Completion Date : March 2023


Arm Intervention/treatment
Experimental: VB10.NEO intervention
Treatment with individualized VB10.NEO immunotherapy will commence as soon as the patient-specific VB10.NEO vaccine is available and if the patient-specific vaccine meets all pre-specified product release criteria after manufacturing to patients within the selected tumor types.
Biological: VB10.NEO
VB10.NEO is a vaccine and is supplied as a sterile, ready to use solution (14 vaccinations will be given).

Experimental: VB10.NEO in combination with bempegaldesleukin (NKTR-214)
Bempegaldesleukin (NKTR-214) will be given in combination with VB10.NEO in up to 10 patients with SCCHN. Treatment with individualized VB10.NEO immunotherapy will commence as soon as the patient-specific VB10.NEO vaccine is available and if the patient-specific vaccine meets all pre-specified product release criteria after manufacturing. Bempegaldesleukin (NKTR-214) will be given after at least 4 doses of VB10.NEO.
Biological: VB10.NEO
VB10.NEO is a vaccine and is supplied as a sterile, ready to use solution (14 vaccinations will be given).

Drug: Bempegaldesleukin
0.006 mg/kg bempegaldesleukin (NKTR-214) will be administered intravenously q4w for up to 11 doses starting from week 11 or at any dosing visit up to week 34 and for up to week 50 (up to 11 doses). The first 2 doses will be in a Q3W interval and following doses in Q4W intervals.
Other Name: NKTR-214




Primary Outcome Measures :
  1. Rate of Adverse Events including SAEs (Safety/tolerability) of VB10.NEO and the combination of VB10.NEO and bempegaldesleukin (NKTR-214) [ Time Frame: Up to 24 months ]
    Total number, severity (CTCAE grade) of adverse events (AEs), and if AE is leading to treatment discontinuation.


Secondary Outcome Measures :
  1. Immunogenicity by T-cell activity to each neoepitope of VB10.NEO and the combination of VB10.NEO and bempegaldesleukin (NKTR-214) [ Time Frame: Up to 24 months ]
    Descriptive analyses for each patient of the immune-response to each neoepiotope

  2. Objective Response Rate (ORR) [ Time Frame: Up to 24 months ]
    Description of tumor response by iRECIST at regular intervals

  3. Duration of Response (DOR) [ Time Frame: Up to 24 months ]
    Descriptive analysis of DOR by iRECIST at regular intervals

  4. Progression-free survival (PFS) [ Time Frame: Up to 24 months ]
    Descriptive analysis of PFS by iRECIST at regular intervals

  5. Survival at end of treatment (EoT) and end of study (EoS) [ Time Frame: At 14 months and 24 months ]
    Proportion of patients who are alive at EoT and EoS



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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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 for all arms

  • Have histologically confirmed locally advanced or metastatic melanoma, NSCLC, RCC, urothelial carcinoma or SCCHN.
  • Patients must have been on CPI (i.e., anti-PD-1 or anti PD-L1) for at least 12 weeks before screening and must be on CPI treatment as part of their cancer treatment as prescribed by the treating physician.

Inclusion criteria for SCCHN only

• Patients must be on CPI or must initiate treatment with CPI at screening as part of their cancer treatment.

All arms

  • Patients who have been on CPI for longer than 12 weeks at screening need to be per RECIST:

    • in partial response or;
    • stable disease or,
    • in progression, i.e., in case of a mixed response to CPI, provided at least one lesion shows measurable regression and who, according to the investigator, have a clinical benefit of continued immunotherapy.
  • Adequate tumour specimen must be available for exome sequencing.
  • Measurable disease per RECIST 1.1 criteria.
  • ECOG performance status ≤ 1.
  • Life expectancy at least 6 months in the best judgement of the investigator.
  • Willing and able to sign a written informed consent form.

Exclusion criteria

  • Ocular melanoma.
  • Brain metastases (unless controlled and stable for at least 6 weeks) or leptomeningeal spread of disease.
  • Positive serological test for hepatitis C virus or hepatitis B virus surface antigen (HBsAg) or human immunodeficiency virus (HIV).
  • Other concomitant or prior malignant disease, except for adequately treated basal cell carcinoma or other non-melanomatous skin cancer, low-grade urothelial cancer or other malignancies treated with curative intent within 2 or more years pre-study entry and in complete remission at study entry
  • Patients who have an active, known or suspected autoimmune disease. Patients having required systemic treatment within the past 3 months or have a documented history of clinically severe autoimmune disease that require systemic steroids or immunosuppressive agents (Exceptions include any patient on 10 mg or less of prednisolone or equivalent, patients with vitiligo, hypothyroidism stable on hormone replacement; type 1 diabetes, Grave's disease, Hashimoto's disease, alopecia areata, eczema).
  • Immunosuppression including the continued use (> 7 days) of high-dose (>10 mg of prednisolone or equivalents) systemic steroids or the use of immunosuppressive agents for any concurrent condition.

Other protocol defined inclusion exclusion criteria may apply


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): NCT03548467


Contacts
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Contact: Siri Torhaug, MD storhaug@vaccibody.com

Locations
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Germany
Charité Research Organisation, Campus Benjamin Franklin Recruiting
Berlin, Germany
Contact: Sebastian Ochsenreiter, MD, PhD         
Krankenhaus Nordwest gGmbH Recruiting
Frankfurt, Germany, 60488
Contact: Elke Jäger, PhD         
Martin-Luther-Universität Halle-Wittenberg, Universitätsklinikum Halle (Saale) Recruiting
Halle, Germany
Contact: Stephan Eisenmann, MD, PhD         
University Hospital Heidelberg, NCT, Im Neuenheimer Feld 460 Recruiting
Heidelberg, Germany, 69120
Contact: Jurgen Krauss, MD, PhD         
Universitätsmedizin Mannheim Recruiting
Mannheim, Germany, 68167
Contact: Jochen Utikal, Dr.         
Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie Recruiting
Munich, Germany, 81675
Contact: Angela Krackhardt, PhD         
Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinik Tübingen Not yet recruiting
Tübingen, Germany
Contact: Paul Stephan Mauz, MD, PhD         
Early Clinical Trials Unit (ECTU), Universitätsklinik Ulm Not yet recruiting
Ulm, Germany
Contact: Simon Laban, MD, PhD         
Zentrum für Innere Medizin, Universitätsklinikum Würzburg Recruiting
Würzburg, Germany
Contact: Anja Gesierich, MD, PhD         
Sponsors and Collaborators
Vaccibody AS
Nektar Therapeutics

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Responsible Party: Vaccibody AS
ClinicalTrials.gov Identifier: NCT03548467    
Other Study ID Numbers: VB N-01
First Posted: June 7, 2018    Key Record Dates
Last Update Posted: February 5, 2020
Last Verified: February 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Vaccibody AS:
melanoma
NSCLC
clear renal cell carcinoma
urothelial cancer or SCCHN