The primary objective of the phase 1 portion of this study is to determine the recommended dose of bemarituzumab in combination with 5-fluorouracil, leucovorin and oxaliplatin (modified FOLFOX6) to use in the phase 2 portion of the trial.
Phase 1 is an open-label dose-escalation of bemarituzumab in combination with modified FOLFOX6 (mFOLFOX6). Eligible patients will have unresectable locally advanced or metastatic GI cancer of any type and be candidates to receive at least 2 doses of mFOLFOX6 chemotherapy. Phase 1 consists of 2 dosing cohorts of bemarituzumab in combination with mFOLFOX6 to determine the recommended dose of bemarituzumab in combination with mFOLFOX6 for the phase 2 portion of the study (see study record NCT03694522).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Administered by intravenous infusion over approximately 30 minutes
Modified FOLFOX6 regimen consists of the following: * Oxaliplatin 85 mg/m² IV infusion over 120 minutes * Leucovorin 400 mg/m² IV infusion over 120 minutes, or 200 mg/m² levo-leucovorin if leucovorin is unavailable * 5-fluorouracil (5-FU) 400 mg/m² bolus over approximately 5 minutes then 5-FU 2400 mg/m² as a continuous IV infusion over approximately 48 hours.
The University of Arizona Cancer Center
Tucson, Arizona, United States
Marin Cancer Care
Greenbrae, California, United States
Innovative Clinical Research Institute
Whittier, California, United States
The University of Chicago Medical Center
Chicago, Illinois, United States
Number of Participants With Treatment-related Adverse Events ≥ Grade 2
A treatment-related adverse event (TRAE) is defined as an adverse event (AE) with an onset date on or after the date of first dose of study treatment, or an event present before treatment that worsened after treatment, and with an onset date prior to 28 days after the last date of dose, for which the investigator assessed as related to investigational product The investigator classified the severity of each AE using the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI-CTCAE), version 5.0 on a scale from mild (Grade 1), moderate (Grade 2), severe (Grade 3), life-threatening (Grade 4), or death due to the AE (Grade 5).
Time frame: From first dose of study drug up to 28 days after last dose; Actual median (min, max) duration of treatment emergent period was 19.3 (12.3, 22.3) weeks in the bemarituzumab 6 mg/kg group and 19.4 (4.0, 35.4) weeks in the bemarituzumab 15 mg/kg group.
Number of Participants With Dose Limiting Toxicities (DLTs)
DLTs were defined as any of the following events considered by the investigator to be related to study drug: * Absolute neutrophil count (ANC) \< 0.5 × 10⁹/L \> 5 days duration or febrile neutropenia. * Platelets \< 25 × 10⁹/L or \< 50 × 10⁹/L with bleeding requiring medical intervention or for \> 3 days. * Grade 4 anemia. * Any Grade 2-3 ophthalmologic AE not resolving within 7 days. * Any Grade 4 ophthalmologic AE. * Any Grade 4 laboratory value. * Any Grade 3 laboratory values that are not of clinical significance according to investigator and Sponsor agreement if they do not resolve within 72 hours. * Aspartate aminotransferase/alanine aminotransferase (AST/ALT) ≥ 3× upper limit of normal (ULN) and concurrent total bilirubin ≥ 2× ULN not related to liver involvement with cancer. * Any non-hematological AE ≥ Grade 3 (except nausea, vomiting, and diarrhea). * Grade 3 nausea, vomiting or diarrhea not resolving with supportive care in 72 hours. * Grade 4 nausea, vomiting or diarrhea.
Time frame: 28 days
Number of Participants With Treatment-emergent Adverse Events
Treatment-emergent adverse events are defined as adverse events (AEs) that started or worsened between the start of study drug and 28 days after permanent discontinuation of study drug. A serious AE is defined as any untoward medical occurrence that at any dose: * Resulted in death; * Was life-threatening; * Required inpatient hospitalization or prolongation of existing hospitalization; * Resulted in persistent or significant disability or incapacity; * Was a congenital anomaly or birth defect. The investigator assessed the causality/relationship between the study treatment and each AE, and assessed the severity of each AE according to the guidelines provided in NCI-CTCAE, version 5.0 on a scale from mild (Grade 1), moderate (Grade 2), severe (Grade 3), life-threatening (Grade 4), or death due to the AE (Grade 5). Ocular events associated with symptomatic corneal involvement and symptomatic and asymptomatic retinal involvement were events of special interest in this study.
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Karmanos Cancer Institute
Detroit, Michigan, United States
Wilmont Cancer Institute
Rochester, New York, United States
Tennessee Cancer Specialists
Knoxville, Tennessee, United States
Time frame: From first dose of study drug up to 28 days after last dose; Actual median (min, max) duration of the treatment emergent period was 19.3 (12.3, 22.3) weeks in the bemarituzumab 6 mg/kg group and 19.4 (4.0, 35.4) weeks in the bemarituzumab 15 mg/kg group.
Maximum Observed Serum Concentration (Cmax) of Bemarituzumab
Time frame: Cycle 1 day 1 at predose, 0.25, 4, 48, and 168 hours after end of infusion, and for participants in Cohort 2 day 8 at 0.25 and 4 hours end of infusion; Cycle 2 day 1 at predose, 0.25 and 48 hours after end of infusion.
Observed Serum Concentration of Bemarituzumab at the End of the Dose Interval (Ctrough)
Time frame: Cycle 1 day 14 predose for cohort 1 and day 8 predose for cohort 2; Cycle 2 day 14 predose
Area Under the Observed Concentration-time Curve From the Time of Dosing to Day 14 (AUC0-14)
Area under the observed concentration-time curve from the time of dosing to Day 14 (0-336h) calculated by log-linear trapezoidal approximation.
Time frame: Cycle 1 day 1 at predose, 0.25, 4, 48, and 168 hours after end of infusion, and for participants in Cohort 2 day 8 at 0.25 and 4 hours after the end of infusion.
Terminal Half-life (t1/2) of Bemarituzumab
Time frame: Cycle 1 day 1 at predose, 0.25, 4, 48, and 168 hours after end of infusion, and for participants in Cohort 2 day 8 at 0.25 and 4 hours after end of infusion.
Number of Participants With Treatment Induced Anti-bemarituzumab Antibodies
Postbaseline treatment induced antidrug antibody (ADA) positive is defined as participants with * ADA negative at baseline and ADA positive at any postbaseline timepoint, or * ADA positive at baseline and ADA positive with titer of at least 4-fold of the baseline titer at one or more postbaseline timepoint.
Time frame: Samples were collected for ADA analysis predose on day 1 of Cycles 1, 2, 3, 7, and 10 and at 28 days following the last dose.