The primary purpose of this study is to evaluate the tolerability and safety profile of ASP8374 when administered as a single agent and in combination with pembrolizumab in participants with locally advanced (unresectable) or metastatic solid tumor malignancies. Also primary purpose is to characterize the pharmacokinetic profile of ASP8374 when administered as a single agent and in combination with pembrolizumab. Last primary purpose of this study is to determine the recommended Phase 2 dose (RP2D) of ASP8374 when administered as a single agent and in combination with pembrolizumab. The secondary purpose of this study is to evaluate the anti-tumor effect (objective response rate \[ORR\], duration of response \[DOR\], persistence of response after discontinuation, and disease control rate \[DCR\]) of ASP8374 when administered as a single agent and in combination with pembrolizumab. NTP: Neutropenia NHAE:Non-haematological AE GBS: Guillain-Barré syndrome"" IRR: Infusion-related reaction AST: Aspartate aminotransferase ALT: Alanine aminotransferase MS/MG: Myasthenia Syndrome/Myasthenia Gravis TRT: Treatment-related Toxicity TCP: Thrombocytopenia
This is a multi-center, multiple-dose, dose-escalation and expansion study of ASP8374 as a single agent and in combination with pembrolizumab. After discontinuation of study drug treatment (initial treatment and re-treatment), all participants will complete an end of treatment visit along with 30-day and 90-day safety follow-up visits from the last dose of ASP8374. Participants will be enrolled in respectively escalation cohorts or expansion cohorts. The 90-day safety follow-up visit is optional for participants who discontinue due to progressive disease or initiate new anticancer treatment after the last dose of study drug. Escalation cohorts: Approximately 60 participants may be enrolled in the escalation cohorts (approximately 30 participants for monotherapy and 30 participants for combination therapy). Expansion cohorts: The total number of subjects in the expansion cohorts will depend on the observed pharmacokinetic and antitumor activity. It is estimated that approximately 240 participants may be enrolled in the monotherapy and combination therapy expansion cohorts. As the number of participants in the escalation cohorts and the expansion cohorts will depend on the observed Dose Limiting Toxicity (DLT), pharmacokinetics and antitumor activity, approximately 300 participants are expected to be enrolled.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
169
intravenous
intravenous
Honor Health Research Institute
Scottsdale, Arizona, United States
Cedars-Sinai Medical Center
Los Angeles, California, United States
University of California Los Angeles
Los Angeles, California, United States
University of California, Davis
Sacramento, California, United States
University of California, San Francisco
San Francisco, California, United States
Number of Participants with Dose Limiting Toxicities (DLTs)
DLT was defined as any of the following AE that cannot clearly attribute to a cause other than study drug: Grade (Gr) 4 NTP or Gr ≥ 3 febrile NTP Gr 4 TCP; or Gr 3 TCP accompanied by bleeding that required any transfusion Gr 4 anemia or Gr 3 anemia requiring transfusion Gr ≥ 3 NHAE Gr ≥ 2 pneumonitis Gr ≥ 2 encephalopathy, meningitis, or motor or sensory neuropathy AST or ALT \> 5x upper limit of normal (ULN; Gr ≥ 3) without liver metastases AST or ALT \> 8 x ULN in participants with liver metastases AST or ALT \> 3 x ULN \& total bilirubin \> 2 x ULN (in participant with Gilbert syndrome: AST or ALT \> 3x ULN \& direct bilirubin \> 1.5 x ULN) Total bilirubin \> 3x ULN (Gr ≥ 3) GBS or MS/MG IRR that required the infusion to be discontinued Prolonged delay (\> 2 weeks) in initiating cycle 2 due to TRT Any TRT that caused the participant to discontinue treatment during cycle 1 Missing \>25% of ASP8374 or pembrolizumab doses as a result of drug-related AE(s) during the 1st cycle Gr 5 toxicity
Time frame: Up to 21 Days (For ASP8374 0.5 mg: Up to 7 days)
Number of Participants with Treatment Emergent Adverse Events (TEAEs)
An AE was defined as any untoward medical occurrence in a participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An AE could therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product. An AE is considered "serious" if, it results in any of the following outcomes: results in death; is life-threatening; results in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions; results in congenital anomaly, or birth defect; requires inpatient hospitalization; or leads to prolongation of hospitalization; other medically important events. TEAE was defined as an AE observed after starting administration of the study drug.
Time frame: From first dose up to 90 days after last dose (maximum duration: 938 days)
Number of Participants with Infusion Related Reactions
Number of participants with infusion related reactions are reported.
Time frame: From first dose up to 90 days after last dose (maximum duration: 938 days)
Number of Participants with Immune- Related Treatment Emergent Adverse Events (IrTEAEs)
AEs associated with pembrolizumab exposure may represent an immune-related response. Immune-related AEs observed with currently approved check point inhibitor CPIs include rash, oral mucositis, dry mouth, colitis/diarrhea, hepatitis, pneumonitis, and endocrinopathies (hypophysitis, hypothyroidism, hyperthyroidism, adrenal insufficiency and Type 1 diabetes mellitus). Other less frequent irAEs associated with CPIs include: nephritis; pancreatitis; myositis; arthritis; neurologic toxicities (Guillain-Barre syndrome, myasthenia gravis, posterior reversible encephalopathy syndrome, aseptic meningitis, enteric neuropathy, transverse myelitis, and autoimmune encephalitis), cardiotoxicity (myocarditis and conduction abnormalities); hematologic toxicity (red cell aplasia, neutropenia, thrombo-cytopenia, acquired hemophilia A, and cryoglobulinemia); and eye inflammation (episcleritis, conjunctivitis, uveitis or orbital inflammation).
Time frame: From first dose up to 90 days after last dose (maximum duration: 938 days)
Number of Participants with Eastern Cooperative Oncology Group (ECOG) Performance status
The ECOG was used to assess performance status. Number of participants in each of the ECOG PS grade were reported. 0 = Fully active, able to carry on all predisease performance without restriction; 1. Restricted in physically strenuous activity, but ambulatory and able to carry out work of a light or sedentary nature; 2. Ambulatory and capable of all self-care, but unable to carry out any work activities. Up and about more than 50% of waking hours; 3. Capable of only limited self-care, confined to bed or chair more than 50% of waking hours; 4. Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair.
Time frame: End of treatment ASP8374 (Up to 427 days)
Pharmakokinetics (PK) of ASP8374 (Cycle 1): Area Under the Concentration-Time Curve From Time Zero to Last Measurable Concentration (AUClast) (Monotherapy Dose Escalation Cohort)
Area under the concentration-time curve from the time zero to the last measurable concentration was derived from the plasma samples.
Time frame: Cycles 1: predose, end of dosing (within 20 minutes), 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
Pharmakokinetics (PK) of ASP8374 (Cycle 7): Area Under the Concentration-Time Curve From Time Zero to Last Measurable Concentration (AUClast) (Monotherapy Dose Escalation Cohort)
Area under the concentration-time curve from the time zero to the last measurable concentration was derived from the plasma samples.
Time frame: Cycles 7: predose, end of dosing (within 20 minutes), 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 1): Area Under the Concentration-Time Curve From the Time of Dosing Extrapolated to Time Infinity (AUCinf) (Monotherapy Dose Escalation Cohort)
Area under the concentration-time curve from the time of dosing extrapolated to time infinity was derived from the plasma samples.
Time frame: Cycle 1: predose. end of dosing, 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 1): Percentage of AUCinf due to extrapolation from the last measurable concentration to time infinity [AUCinf(%extrap)] (Monotherapy Dose Escalation Cohort)
Percentage of AUCinf due to extrapolation from the last measurable concentration to time infinity was derived from the plasma samples.
Time frame: Cycle 1: predose. end of dosing, 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 7): Area Under the Concentration-Time Curve From the Time of Dosing to the Start of the Next Dosing Interval at Multiple Dose Conditions (AUCtau) (Monotherapy Dose Escalation Cohort)
AUCtau: Area under the concentration-time curve from the time of dosing to the start of the next dosing interval was derived from plasma samples.
Time frame: Cycle 7: predose. end of dosing, 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle= 21 days)
PK of ASP8374 (Cycle 1): Maximum Plasma concentration (Cmax) (Monotherapy Dose Escalation Cohort)
Maximum plasma concentration of ASP8374 was derived from the plasma samples.
Time frame: Cycles 1: predose, end of dosing (within 20 minutes), 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 7): Cmax (Monotherapy Dose Escalation Cohort)
Maximum plasma concentration of ASP8374 was derived from the plasma samples.
Time frame: Cycles 7: predose, end of dosing (within 20 minutes), 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 7): Trough concentration (Ctrough) (Monotherapy Dose Escalation Cohort)
Trough Concentration was derived from the PK samples.
Time frame: Cycle 7: predose
PK of ASP8374 (Cycle 1): Time of Maximum Concentration (Tmax) (Monotherapy Dose Escalation Cohort)
Time of maximum plasma concentration of ASP8374 was derived from the plasma samples.
Time frame: Cycles 1: predose, end of dosing (within 20 minutes), 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 7): Tmax (Monotherapy Dose Escalation Cohort)
Time of maximum plasma concentration of ASP8374 was derived from the plasma samples.
Time frame: Cycles 7: predose, end of dosing (within 20 minutes), 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 1): Terminal Elimination Half-life (T1/2) of ASP8374 (Monotherapy Dose Escalation Cohort)
Terminal half life of ASP8374 was derived from the plasma samples.
Time frame: Cycle 1: predose. end of dosing, 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 1): Time of Last Measurable Concentration (tlast) (Monotherapy Dose Escalation Cohort)
Time of last measurable concentration was derived from the plasma samples.
Time frame: Cycles 1: predose, end of dosing (within 20 minutes), 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 7): tlast (Monotherapy Dose Escalation Cohort)
Time of last measurable concentration was derived from the plasma samples.
Time frame: Cycles 7: predose, end of dosing (within 20 minutes), 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 1): Total Systemic Observed Clearance After Intravenous Dosing (CLobs) of ASP8374 (Monotherapy Dose Escalation Cohort)
Total systemic observed clearance after intravenous dosing was derived from the plasma samples
Time frame: Cycles 1: predose, end of dosing (within 20 minutes), 4hr, 24hrt, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 1): Volume of Distribution During the Terminal Elimination Phase (Vz) after Intravenous Dosing (Monotherapy Dose Escalation Cohort)
Volume of distribution after intravenous dosing during the terminal elimination phase was derived from plasma samples.
Time frame: Cycle 1: predose. end of dosing, 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle = 21 days)
PK of ASP8374 (Cycle 7): Apparent Volume of Distribution at Steady State (Vss) after Intravenous Dosing of ASP8374 (Monotherapy Dose Escalation Cohort)
Volume of distribution at steady state after intravenous dosing was derived from plasma samples.
Time frame: Cycle 7: predose. end of dosing, 4hr, 24hr, 48hr, 168hr, 336hr postdose (each cycle= 21 days)
Best Overall Response (BOR) as per RECIST as per Response Evaluation Criteria in Solid Tumors v1.1 (RECIST v1.1)
The BOR rate was defined as the percentage of participants whose best response was Complete Response (CR) or Partial Response (PR) as defined by RECIST v1.1 criteria. CR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. PR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.
Time frame: From start of study until radiographical progression or date of censoring (maximum duration: 938 days)
BOR as per immune Response Evaluation Criteria in Solid Tumors (iRECIST)
The BOR rate was defined as the percentage of participants whose best response was immune complete response (iCR) or immune partial response (iPR) as defined by RECIST v1.1 criteria. immune complete response (iCR) or immune partial response (iPR). iCR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. iPR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.
Time frame: From start of study until radiographical progression or date of censoring (maximum duration: 938 days)
Objective Response Rate (ORR) as per RECIST v1.1
ORR as per RECIST v1.1 was defined as the percentage of participants for each dose level whose best overall response was rated as confirmed CR or PR. CR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. PR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.
Time frame: From start of study until radiographical progression or date of censoring (maximum duration: 938 days)
ORR as per iRECIST
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Mount Sinai Comprehensive Cancer Center
Miami Beach, Florida, United States
University of Iowa Hospitals and Clinics
Iowa City, Iowa, United States
University of Kansas Cancer Center
Fairway, Kansas, United States
Karmanos Cancer Institute
Detroit, Michigan, United States
Henry Ford Health System
Detroit, Michigan, United States
...and 44 more locations
ORR as per iRECIST was defined as the percentage of participants for each dose level whose best overall response was rated as confirmed iCR or iPR. iCR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. iPR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.
Time frame: From start of study until radiographical progression or date of censoring (maximum duration: 938 days)
Duration of Response as per RECIST v1.1
DOR as per RECIST v1.1 was defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date of radiographical progression or date of censoring. CR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. PR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.
Time frame: From the date of the first response CR/PR to the date of radiographical progression or date of censoring (maximum 938 days)
DOR as per iRECIST
DOR as per iRECIST was defined as the time from the date of the first response iCR/iPR (whichever is first recorded) to the date of radiographical progression or date of censoring. iCR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. iPR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.
Time frame: From the date of the first response iCR/iPR to the date of radiographical progression or date of censoring (maximum 938 days)
Persistence of Response After Discontinuation as per RECIST v1.1
Persistence of response as per RECIST v1.1 was defined as the time from the date of treatment discontinuation to the date of radiographical progression or date of censoring. Persistence of response was derived for participants who at the time of treatment discontinuation had a confirmed response of CR or PR based on RECIST 1.1. CR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. PR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.
Time frame: From date of treatment discontinuation to the date of radiographical progression or date of censoring (maximum duration: 938 days)
Persistence of Response After Discontinuation as per iRECIST
Persistence of response as per iRECIST was defined as the time from the date of treatment discontinuation to the date of radiographical progression or date of censoring. Persistence of response was derived for participants who at the time of treatment discontinuation had a confirmed response of iCR or iPR. iCR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. iPR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.
Time frame: From date of treatment discontinuation to the date of radiographical progression or date of censoring (maximum duration: 938 days)
Disease Control Rate (DCR) as per RECIST v1.1
DCR as per RECIST v1.1 was defined as the percentage of participants for each dose level whose best overall response is rated as confirmed CR, PR or Stable Disease (SD). CR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. PR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters. SD was defined as neither sufficient decrease to qualify for PR nor sufficient increase to qualify for progressive disease taking as reference the smallest sum of diameters.
Time frame: From start of study until radiographical progression or date of censoring (maximum duration: 938 days)
Disease Control Rate (DCR) as per iRECIST
DCR as per iRECIST was defined as the perccentage of participants for each dose level whose best overall response is rated as confirmed iCR, iPR or immune Stable Disease (iSD). iCR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. iPR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters. iSD was defined as neither sufficient decrease to qualify for PR nor sufficient increase to qualify for progressive disease taking as reference the smallest sum of diameters.
Time frame: From start of study until radiographical progression or date of censoring (maximum duration: 938 days)
Time to Response as per RECIST v1.1
Time to response was defined as the time from first dose date until the first response CR/PR (whichever is first recorded). CR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. PR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters. Time to response was calculated for objective responders only. Confirmation response is required.
Time frame: From first dose date until the first response CR/PR (maximum duration: 938 days)
Time to Response as per iRECIST
Time to response was defined as the time from first dose date until the first response iCR/iPR (whichever is first recorded). iCR was defined as disappearance of all target and nontarget lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm from baseline measurement. iPR was defined as at least a 30% decrease in the sum of diameters (longest for nonnodal lesions, short axis for nodal lesions) of target lesions taking as reference to the baseline sum of diameters.Time to response was calculated for objective responders only. Confirmation response is required.
Time frame: From first dose date until the first response iCR/iPR (maximum duration: 938 days)