This trial is being performed in two parts: Dose Escalation and Dose Expansion. The primary objective for the Dose Escalation part is to determine the safety and tolerability at different doses of DS-8273a administered in combination with nivolumab and to identify the dose combination for the Dose Expansion cohort in subjects with mismatch repair (MMR)-proficient advanced colorectal cancer. The primary objectives for the Dose Expansion part are: * To further evaluate the safety and tolerability of DS-8273a administered at the selected dose in combination with nivolumab in subjects with MMR-proficient advanced colorectal cancer * To evaluate preliminary anti-tumor activity of DS-8273a plus nivolumab administered at the selected dose in subjects with MMR-proficient advanced colorectal cancer
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
4
Nivolumab will be administered at 240 mg intravenously (IV) once every two weeks (Q2W) over 30 (± 5) minutes (on Days 1 and 15 of each cycle of 28 days). DS-8273a will be administered \[90 (± 15) minutes on Day 1 of Cycle 1, and 60 (± 15) minutes in subsequent infusions\] after the end of the nivolumab infusion in ascending doses up to 1200 mg IV Q2W. The regimen is adjusted based on injection site reactions or adverse events. Additional dose combinations may be considered based on the assessment of safety, primary pharmacodynamic (PDy) effects, and preliminary anti-tumor activities.
Georgetown University Medical Center
Washington D.C., District of Columbia, United States
South Texas Accelerated Research Therapeutics (START) Midwest
Grand Rapids, Michigan, United States
MD Anderson Cancer Center
Houston, Texas, United States
South Texas Accelerated Research Therapeutics, LLC (START)
San Antonio, Texas, United States
Dose Escalation Part: Number of Participants with Dose-Limiting Toxicities (DLT)
A DLT is defined as a study drug-related ≥ Grade 3 Adverse Event (AE) occurring during the first cycle (28 days) of treatment, with specific exceptions for hematologic events, elevations in hepatic function enzymes, and adverse events that are pre-identified as not being DLTs.
Time frame: During the first treatment cycle (28 days)
Dose Escalation and Dose Expansion Parts: Number of Participants with Clinically Significant Safety Parameters
Safety parameters will include adverse events that are serious (SAEs), treatment emergent (TEAEs), dose-limiting toxicities (DLTs), physical examination findings (including Eastern Cooperative Oncology Group \[ECOG\] Performance Status), vital sign measurements, clinical laboratory parameters (serum chemistry, hematology, and urinalysis), immune-related (ir) adverse events (irAEs), anti-drug antibody (ADA), and electrocardiogram (ECG) parameters.
Time frame: 2 years
Dose Escalation Part: Maximum Tolerated Dose (MTD)
The MTD is defined as the highest dose of DS-8273a in combination with the tested dose of nivolumab that results in a DLT in less than one-third of the subjects enrolled at that dose level of at least 6 evaluable subjects. However, AEs that meet the definition of DLT appearing at later cycles will also be considered for the determination of MTD and selection of the Dose Expansion dose. If the MTD is not reached at 1200 mg of DS-8273a IV Q2W, this highest tested dose may be selected as the maximum administered dose (MAD).
Time frame: 2 years
Dose Expansion Part: Overall Objective Response Rate (per Response Evaluation Criteria in Solid Tumors [RECIST] Version 1.1)
The overall objective response rate (ORR) is defined as the number of subjects whose Best Overall Response is either a Complete Response (CR) or Partial Response (PR), divided by the total number of treated subjects with at least one post-baseline tumor assessment.
Time frame: 2 years
Dose Expansion Part: Number of Participants in each Category of Best Overall Response (per Response Evaluation Criteria in Solid Tumors [RECIST] Version 1.1)
Categories: CR, PR, Stable Disease (SD), Progressive Disease (PD)
Time frame: 2 years
Dose Expansion Part: Disease Control Rate (DCR) for 6 Months
DCR for 6 months defined as the number of subjects with CR, PR, or SD for 6 months divided by the total number of treated subjects with at least 1 post-baseline tumor assessment
Time frame: 6 months
Dose Expansion Part: Number of Participants with Progression-Free Survival (PFS)
PFS is defined as survival without disease progression
Time frame: 2 years
Dose Expansion Part: Time to Progression (TTP)
Mean TTP within 2 years
Time frame: within 2 years
Dose Expansion Part: Duration of Response
Duration of response for those subjects with a Best Overall Response of CR or PR
Time frame: within 2 years
Dose Escalation Part: Number of Participants with Immune-related Response (per Criteria Modified from RECIST Version 1.1 [irRECIST])
Criteria include: * Immune-related (ir) Best Overall Response with response categories of irCR, irPR, irSD, irPD * Immune-related ORR (irORR) defined as the number of subjects whose Best Overall Response is either an irCR or irPR divided by the total number of treated subjects with at least 1 post-baseline tumor assessment * Duration of immune-related-response for those subjects with immune-related Best Overall Response of irCR or irPR * Immune-related DCR (irDCR) for 6 months defined as the number of subjects with irCR, irPR, or irSD for 6 months divided by the total number of treated subjects with at least 1 post-baseline tumor assessment * Immune-related PFS * Immune-related TTP
Time frame: 2 years
Plasma Concentrations of DS-8273a
The plasma concentrations of DS-8273a may be used to assess the exposure levels and for population pharmacokinetic (PK) analysis, if feasible, but no PK parameters will be calculated from the concentrations collected from this study due to sparse sampling time points.
Time frame: Before and at the end of the first 3 infusions (Cycle 1 Days 1 and 15, and Cycle 2 Day 1), a single time point on Cycle 1 Day 8, then every 16 weeks on the same days as ADA sample analysis, and at the last Visit (if not collected within prior 16 weeks)
Number of Participants with Primary Pharmacodynamic (PDy) Effects of the Combination Regimen on Myeloid-Derived Suppressor Cells (MDSCs) and their Subsets in Peripheral Blood
Subset Categories: Polymorphonuclear (PMN)-type and Monocytic-MDSCs (M-MDSCs)
Time frame: 2 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.