The purpose of this study is to evaluate the safety and tolerability of IV administration of VX15/2503 in combination with a fixed dose of avelumab in patients with advanced non-small cell lung cancer. The dose escalation portion of the study will determine the maximum tolerated dose (MTD) of VX15/2503 administered in combination with avelumab.
This is a phase 1b/2 study, designed to evaluate the safety, tolerability, and efficacy of VX15/2503 in combination with avelumab in subjects diagnosed with advanced (stage IIIB/IV) NSCLC who have either progressed on first or second-line systemic anticancer therapy or who have declined treatment with first or second-line system anticancer therapy. The primary objective (Dose Escalation Phase) is to evaluate the safety and tolerability of ascending doses of VX15/2503 Q2W in combination with avelumab 10mg/kg Q2W. The second primary objective (Dose Expansion Phase) is to evaluate safety and tolerability of the recommended phase 2 dose of VX15/2503 administered in combination with 10 mg/kg avelumab Q2W. The secondary objectives include (Dose Expansion Phase), a preliminary estimate of efficacy using the following in accordance with Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, Objective Response (OR), Duration of Response (DoR) and Progression-Free Survival (PFS), as well as making a preliminary estimate of efficacy using the following in accordance with iRECIST, OR, DoR and PFS. Additional secondary objectives are to characterize the pharmacokinetics profile of VX15/2503 and avelumab administered Q2W in combination, evaluate the immunogenicity of VX15/2503 and avelumab administered Q2W and evaluate VX15/2503 and avelumab pharmacodynamics markers including but not limited to receptor occupancy. Exploratory objectives include identification of candidate biomarkers of activity and biomarkers that may predict response to treatment with combination therapy of VX15/2503 and avelumab. Enrollment will involve approximately 62 individuals who are 18 years of age or older with advanced non-small cell lung cancer. The study will be divided into two phases, dose escalation with up to 18 Immunotherapy naive subjects and dose expansion with up to 50 subjects (up to 22 subjects that are Immunotherapy naive and up to 28 subjects that have failed on Immunotherapy). Subjects that are enrolled in the dose escalation phase may continue into the dose expansion phase, as long as there is no evidence of disease progression. The subjects entering the dose expansion phase from dose escalation, may have their dose increased to the recommend phase 2 dose, once it is determined. Any subjects that have evidence of disease progression will be taken off of treatment and will have a post treatment safety follow-up visit 10 weeks after last treatment. Subjects that have discontinued study drug will also continue to be followed every 3 months for survival, or lost to follow-up. It is estimated that the study will take approximately 33 months between first subject enrolled and last subject visit.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
62
Dose escalation will begin at 5 mg/kg of VX15/2503 and will increase up to 20 mg/kg with a constant dose of avelumab at 10 mg/kg. A recommended phase II dose of VX15/2503 will be determined and then utilized in the expansion phase with 10 mg/kg of avelumab.
Highlands Oncology Group, PA
Fayetteville, Arkansas, United States
University of California Los Angeles (UCLA)
Los Angeles, California, United States
Mayo Clinic
Jacksonville, Florida, United States
Dose Escalation Phase: Number of subjects with dose-limiting toxicities (DLT)s at each dose level
DLTs will be described and graded according to the Common Terminology Criteria Adverse Events version 4.03 (CTCAE v4.03) and according to the specific MedRA terms from immune mediated AEs
Time frame: 21 Days for Each Escalation Phase
Dose Expansion Phase: Frequency and type of adverse events (AE)s
Safety assessments will be performed on a regular basis using physical examination, spontaneous AE reporting, scheduled and unscheduled laboratory assessments, and other diagnostic evaluations as indicated. Adverse events will be reported using the Common Terminology Criteria Adverse Events version 4.03 (CTCAE v4.03).
Time frame: 2 Years
Dose Expansion Phase: Objective Response (OR)
This is defined as complete response (CR) or partial response (PR) according to RECIST 1.1 from first dose until documented confirmed disease progression.
Time frame: 2 Years
Dose Expansion Phase: Duration of Response (DoR)
This is defined, for subjects with an objective response, as the time from first confirmed documented objective response (CR or PR) to the date of first confirmed documented objective progression of disease (PD) or death.
Time frame: 2 Years
Dose Expansion Phase: Progression Free Survival (PFS)
This is defined as the time from first dose to the date of the first confirmed documented objective progression of disease (PD) or death
Time frame: 2 Years
Dose Expansion Phase: Peak serum concentration (Cmax) of VX15/2503 and avelumab
PK Parameter
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Moffitt Cancer Center
Tampa, Florida, United States
Mayo Clinic
Rochester, Minnesota, United States
Washington University School of Medicine
St Louis, Missouri, United States
Northwell Health Cancer Institute
Lake Success, New York, United States
University of Rochester
Rochester, New York, United States
Gabrail Cancer Center
Canton, Ohio, United States
Providence Portland Medical Center
Portland, Oregon, United States
...and 1 more locations
Time frame: 2 Years
Dose Expansion Phase: Area under the serum concentration versus time curve (AUC) of VX15/2503 and avelumab
PK Parameter
Time frame: 2 Years
Dose Expansion Phase: Half-life of VX15/2503 and avelumab
PK Parameter
Time frame: 2 Years
Dose Expansion Phase: Immunogenicity of VX15/2503 and avelumab as measured by frequency and titer of human anti human antibodies
Anti Drug Antibodies (ADA)
Time frame: 2 Years
Dose Expansion Phase: Receptor occupancy of VX15/2503 and avelumab as measured by a flow cytometry based saturation assay
PD Parameter
Time frame: 2 Years
Dose Expansion Phase: Cellular SEMA4D levels as measured by flow cytometry
PD Parameter
Time frame: 2 Years
Dose Expansion Phase: Total soluble SEMA4D levels as measured by ELISA
PD Parameter
Time frame: 2 Years