This study evaluated ADCT-502 in participants with Advanced Solid Tumors with HER2 Expression. Participants participated in a dose-escalation phase (Part 1) and were due to participate in the dose expansion phase (Part 2). In Part 2, patients were due to receive the dose level identified in Part 1, but the study was terminated prior to the beginning of Part 2.
Study ADCT-502-101 was the first clinical study with ADCT-502 in participants with Advanced Solid Tumors with HER2 Expression. ADCT-502 is an antibody drug conjugate (ADC) composed of an engineered version of the humanized monoclonal antibody trastuzumab, directed against the human HER2 receptor, conjugated to a pyrrolobenzodiazepine (PBD) dimer cytotoxin. ADCT-502 specifically binds to HER2, and once internalized, releases the PBD dimer to allow cross-linking of DNA and eventually trigger cell death. The study had 2 parts. In Part 1 (dose escalation) participants received an infusion of ADCT-502, at escalating doses. Part 1 continued until the maximum tolerated dose or the recommended dose(s) and schedule(s) for expansion were determined. In Part 2 (expansion), participants were due to be assigned to the recommended dose level of ADCT-502 identified in Part 1 by the Dose Escalation Steering Committee, but the study was terminated prior to the beginning of Part 2. For each participant, the study included a screening period (up to 28 days), a treatment period, and a follow-up period to assess disease progression and survival for up to 12 weeks after the last dose of study drug. The total study duration was dependent on overall participant tolerability to the study drug and response to treatment as participants were able to continue treatment until disease progression or unacceptable toxicity.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
21
Intravenous Infusion
Stanford Cancer Center
Palo Alto, California, United States
Roswell Park Cancer Institute
Buffalo, New York, United States
Memorial Sloan Kettering Memorial Hospital
New York, New York, United States
South Texas Accelerated Research Therapeutics, LLC
San Antonio, Texas, United States
Medical Oncology Clinic - Institut Jules Bordet
Brussels, Belgium
Number of Participants Who Experienced Dose-Limiting Toxicities
Time frame: Day 1 to 3 Weeks (one cycle)
Number of Participants Who Experienced a Dose-Limiting Toxicity With a CTCAE Grade of 3 or Above
The Common Terminology Criteria For Adverse Events (CTCAE) Version 4 will be used.
Time frame: Day 1 to 3 Weeks (one cycle)
Number of Participants Who Experience At Least One Treatment Emergent Adverse Event (TEAE)
An adverse event is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. A TEAE is defined as an adverse event with an onset that occurs after receiving study drug.
Time frame: Day 1 to end of trial, a maximum of 168 days (+ 30 days)
Number of Participants Who Experience At Least One Treatment Emergent Serious Adverse Event (SAE)
Time frame: Day 1 to end of trial, a maximum of 168 days (+ 30 days)
Number of Participants With Clinically Significant Clinical Laboratory Tests
Clinical significance was determined by the investigator.
Time frame: Day 1 to end of trial, a maximum of 168 days (+ 30 days)
Number of Participants With Clinically Significant Physical Examination Results
Clinical significance was determined by the investigator.
Time frame: Day 1 to end of trial, a maximum of 168 days (+ 30 days)
Number of Participants Who Experience a Clinically Significant Change in Eastern Cooperative Oncology Group (ECOG) Performance Status
Performance status was assessed using the ECOG performance status grades. These range between Grade 0 (fully active) and Grade 5 (dead). Clinical significance was determined by the investigator.
Time frame: Day 1 to end of trial, a maximum of 168 days (+ 30 days)
Number of Participants With Clinically Significant Vital Signs
Vital sign measurements include arterial blood pressure, heart rate, respiratory rate, and body temperature. Clinical significance was determined by the investigator.
Time frame: Day 1 to end of trial, a maximum of 168 days (+ 30 days)
Number of Participants Who Experience Clinically Significant Electrocardiogram (ECG) Results
Standard 12-lead ECG's will be used. Clinical significance was determined by the investigator.
Time frame: Day 1 to end of trial, a maximum of 168 days (+ 30 days)
Overall Response Rate (ORR)
ORR was defined as the number of participants with a best overall response of Complete Response (CR) or Partial Response (PR) at the time each participant discontinues ADCT-502. Analysis will be determined by the investigator per Response Evaluation In Solid Criteria (RECIST) version 1.1 criteria: partial response is when there is a decrease in sum of target disease ≥ 30%, and complete response is when all lesions have disappeared or all lesions have disappeared and all nodal disease is \< 10 mm each.
Time frame: Screening, day 1 of cycle 3 and cycle 5, then every 4 cycles, approximately every 12 weeks
Disease Control Rate (DCR)
DCR was defined as the number of participants with a best overall response of Complete Response (CR) or Partial Response (PR), or Stable Disease (SD). Analysis will be determined by the investigator per Response Evaluation In Solid Criteria (RECIST) version 1.1 criteria: stable disease is when the change is \> -30% and ≤ 20%, partial response is when there is a decrease in sum of target disease ≥ 30%, and complete response is when all lesions have disappeared or all lesions have disappeared and all nodal disease is \< 10 mm each.
Time frame: Screening, day 1 of cycle 3 and cycle 5, then every 4 cycles, approximately every 12 weeks
Duration of Response (DOR)
DOR was defined among responders (CR or PR) as the time from the earliest date of first response until the first date of either disease progression or death due to any cause.
Time frame: Screening, day 1 of cycle 3 and cycle 5, then every 4 cycles, approximately every 12 weeks
Progression-Free Survival (PFS)
PFS was defined among the efficacy population as the time from first dose of study drug until the first date of either disease progression or death due to any cause.
Time frame: Screening, day 1 of cycle 3 and cycle 5, then every 4 cycles, approximately every 12 weeks
Overall Survival (OS)
Median OS was defined as the time from the beginning of study drug treatment until death due to any cause.
Time frame: Screening, day 1 of cycle 3 and cycle 5, then every 4 cycles, approximately every 12 weeks
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Area Under the Plasma Concentration Versus Time Curve (AUC) of ADCT-502 (Total Antibody)
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Area Under the Plasma Concentration Time Curve (AUC) of Drug To-antibody Ratio [DAR] ≥0
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Area Under the Plasma Concentration Versus Time Curve (AUC) of PBD-conjugated Antibody (DAR ≥1)
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Area Under the Plasma Concentration Versus Time Curve (AUC) of Free Warhead SG3199
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Maximum Observed Plasma Concentration (Cmax) for ADCT-502 (Total Antibody)
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Maximum Observed Plasma Concentration (Cmax) for Drug To-antibody Ratio [DAR] ≥0
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Maximum Observed Plasma Concentration (Cmax) for PBD-conjugated Antibody (DAR ≥1)
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Maximum Observed Plasma Concentration (Cmax) for Free Warhead SG3199
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Time to Reach the Maximum Plasma Concentration (Tmax) for ADCT-502 (Total Antibody)
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Time to Reach the Maximum Plasma Concentration (Tmax) for Drug To-antibody Ratio [DAR] ≥0)
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Time to Reach the Maximum Plasma Concentration (Tmax) for PBD-conjugated Antibody (DAR ≥1)
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Time to Reach the Maximum Plasma Concentration (Tmax) for Free Warhead SG3199
Time frame: Before infusion, End of Infusion, and 1, 3, 6, 24, 48, 96, 168 and 336 hours post infusion for Cycle 1 & 2. Before infusion and end of infusion of Cycle 3 to disease progression, and 30 days and 12 weeks after last dose
Anti-drug Antibody (ADA) Titers to ADCT-502
Time frame: Blood sample collection before start of infusion in Cycles 1 and 2, and on Day 1 starting with Cycle 3 until disease progression, 30 days and 12 weeks after last dose