First-in-human, Phase 1b/2 safety study of the antibody-drug conjugate (ADC) XMT-1536 (upifitamab rilsodotin) administered as an intravenous infusion once every four weeks. Patients with tumor types likely to express NaPi2b were enrolled in dose escalation. Patients with platinum-resistant ovarian cancer and non-small cell lung cancer (adenocarcinoma subtype) were enrolled in the expansion segment of this study. Patients with platinum-resistant, high-grade serous ovarian cancer were enrolled in the UPLIFT segment of this study. In addition to safety assessments, the pharmacokinetics of the drug were assessed along with ADC activity. A QTc sub-study was added for the UPLIFT cohort for a sub-set of sites.
This is a multi-center study of XMT-1536 (upifitamab rilsodotin) in patients with tumors likely to express NaPi2b, focusing on patients with platinum-resistant ovarian cancer and non-small cell lung cancer, adenocarcinoma subtype. XMT-1536 (upifitamab rilsodotin) was administered as an intravenous infusion once every four weeks. The study consisted of three segments: dose escalation (DES), dose expansion (EXP), and the pivotal cohort (UPLIFT). The DES segment studied small groups of patients who received increased doses. A Safety Review Committee was established to review the data from each dose level before moving to the next higher dose. The dose escalation cohort has ended and is no longer enrolling patients. Enrollment into the EXP segment consisted of 2 parallel cohorts of patients to confirm the dose that has been identified in DES and estimate the objective response rate in each patient population. The EXP and UPLIFT cohorts are no longer enrolling patients. All adverse events were graded according to the National Cancer Institute (NCI) Common Terminology Criteria version (CTCAE v5.0). Throughout the study, pharmacokinetics were measured using proprietary assays developed by Mersana. Anti-cancer activity were measured via RECIST.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
523
XMT-1536 will be administered once every 28 days until disease progression, unacceptable toxicity, or either the patient or study physician determines it is in the best interest of the patient to discontinue participation in the study. For sites participating in the sub-study, patients with platinum -resistant ovarian cancer will have the option to enroll in this sub-study to evaluate potential changes in the QTc interval following administration of XMT-1536
University of Oklahoma
Oklahoma City, Oklahoma, United States
DES: Maximum tolerated dose or recommended Phase 2 dose
Evaluate adverse events and concomitant medication use after XMT-1536 (upifitamab rilsodotin) doses
Time frame: Up to 36 weeks, from the date of first dose until unacceptable side effects or a dose-limiting toxicity is met
DES and EXP: Safety and Tolerability
Evaluate incidence and severity of adverse events
Time frame: First dose up until 30 days after study termination
EXP: Anti-neoplastic effects of XMT-1536 (upifitamab rilsodotin)
Monitor tumor size
Time frame: Every 6 weeks for up to 36 weeks
UPLIFT: Investigator-assessed objective response rate (ORR) of XMT-1536 (upifitamab rilsodotin) in the ITT-Higher NaPi2b population
Confirmed ORR is defined as the proportion of patients who have achieved a confirmed complete response (CR) or partial response (PR) per RECIST v1.1 after the initiation of study treatment.
Time frame: Every 8 weeks until disease progression or up to 24 months
QTc Sub-study: Evaluation of the concentration response analysis of XMT-1536 versus the change in QTcF values
"The concentration-QTcf change from baseline deltaQTcF analysis and analysis of central tendency for deltaQTcF
Time frame: 60 minutes prior to first dose, up to 26 hours after Cycle 3 dose
DES and EXP: Time of maximum observed concentration of XMT-1536 (upifitamab rilsodotin)
Determine the pharmacokinetics of XMT-1536 (upifitamab rilsodotin)
Time frame: Daily for one week after first dose; weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
DES and EXP: Maximum concentration of XMT-1536 (upifitamab rilsodotin)
Determine the pharmacokinetics of XMT-1536 (upifitamab rilsodotin)
Time frame: Daily for one week after first dose; weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
DES and EXP: Area under the concentration curve of the last measurable concentration of XMT-1536 (upifitamab rilsodotin)
Determine the pharmacokinetics of XMT-1536 (upifitamab rilsodotin)
Time frame: Daily for one week after first dose; weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
DES: Anti-neoplastic effects of XMT-1536 (upifitamab rilsodotin)
Monitor tumor size
Time frame: Every 6 weeks for up to 36 weeks
DES and EXP: Anti-drug antibody and neutralizing antibody
Analyze blood for antibodies to XMT-1536 (upifitamab rilsodotin) and neutralizing antibodies
Time frame: Every 6 weeks for up to 36 weeks
UPLIFT: Confirmed Investigator-assessed objective response rate of XMT-1536 (upifitamab rilsodotin) regardless of NaPi2b expression
Assess the confirmed investigator-assessed objective response rate of XMT-1536 (upifitamab rilsodotin) regardless of NaPi2b expression
Time frame: Every 8 weeks until disease progression or up to 24 months
UPLIFT: Confirmed objective response rate by independent radiology review (IRR) for patients with high NaPi2b and overall
Assess the confirmed objective response rate by IRR for patients with high NaPi2b (TPS \>/=75) and overall
Time frame: Every 8 weeks until disease progression or up to 24 months
UPLIFT: Duration of objective response (DOR)
Assess the duration of objective response (DOR) in patients who achieve a response
Time frame: 4 weeks after first response and every 8 weeks until disease progression or up to 24 months
UPLIFT: Incidence and severity of adverse events
Evaluate incidence and severity of adverse events
Time frame: First dose up until 60 days after study termination
QTc Sub-Study: Evaluation of the effect of XMT-1536 on QTcF in patients with platinum-resistant HGSOC by timepoint analysis
Con.-QTc evaluation
Time frame: 60 minutes prior to first dose, up to 26 hours after Cycle 3 dose
QTc Sub-Study: Evaluation of the effect of XMT-1536 on the PR-interval (PR), QRS duration (QRS), Heart Rate (HR), and ECG morphology
Con.-QTc evaluation
Time frame: 60 minutes prior to first dose, up to 26 hours after Cycle 3 dose
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