The open label, first-in-human, phase 1, dose escalation component in refractory solid tumors has been completed. The Maximum Tolerated Dose and Recommended Phase 2 Dose (RP2D) was determined to be 1.5mg/kg. The Expansion Phase of this study is currently enrolling subjects with non small cell lung cancer (NSCLC), head and neck squamous cell carcinoma (HNSCC), cervical and uterine cancers who progressed on front line therapy. Subjects will be treated with NEO-201 at the RP2D (1.5 mg/kg) every 2 weeks in combination with pembrolizumab, given 1 day after the NEO-201, at 400 mg IV every 6 weeks.
The experimental drug called NEO-201 (the "study drug") is a monoclonal antibody that is being tested and is not approved for use in the United States by the FDA. As stated above the RP2D was determined at 1.5 mg/kg and in the current Expansion Phase it will be administered in combination with pembrolizumab. . A safety lead in will be conducted in the first 3 to 6 subjects to evaluate toxicity prior to expanding accrual. The safety lead-in will be 42 days in length, consisting of 1 dose of pembrolizumab and 3 doses of NEO-201 followed by a 2-week assessment for safety, in subjects with any of the expansion cohorts' targeted disease types. The third patient in the safety lead in must complete the 30-day assessment (1 dose of pembrolizumab and 3 doses of NEO-201 followed by a 2-week safety evaluation) and be evaluated for toxicity prior to treating additional patients. Following completion of the lead-in, expansion cohorts will accrue subjects with NSCLC, HNSCC, cervical and uterine cancers who progress on frontline therapy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
121
NEO-201 will be given intravenously every 2 weeks in combination with pembrolizumab. In each cycle subjects will receive 3 doses of NEO 201 and one dose of pembrolizumab.
National Cancer Institute
Bethesda, Maryland, United States
INOVA Schar Cancer Institute
Fairfax, Virginia, United States
Determine the safety of the combination of NEO-201 with pembrolizumab the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
To evaluate toxicity a safety lead in of 3 to 6 subjects will be conducted. The safety lead in will be 42 days long, consisting of 3 doses of NEO-201 and 1 dose of pembrolizumab followed by a 2 week assessment. All appropriate treatment areas will have access to a the CTCAE version 5.0. A copy of the CTCAE version 5.0 can be downloaded from the CTEP web site http://ctep.cancer.gov/protocolDevelopment/electronic\_applications/ctc.htm.
Time frame: 1.5 years
Determine Objective Response Rate (either Complete Response or Partial Response) as determined by RECIST v1.1 guidelines
For the purposes of this study, subjects will be re-evaluated for response every 12 weeks. Response will be evaluated in this study using the new international criteria proposed by the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1) \[Eur J Ca 45:228-247, 2009\]. Changes in the largest diameter (unidimensional measurement) of the tumor lesions and the shortest diameter in the case of malignant lymph nodes are used in the RECIST criteria.
Time frame: 1.5 years
Determine Progression Free Survival as determined by RECIST v1.1 guidelines
For the purposes of this study, subjects will be re-evaluated for progression every 12 weeks. Progression will be evaluated in this study using the new international criteria proposed by the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1) \[Eur J Ca 45:228-247, 2009\]. Changes in the largest diameter (unidimensional measurement) of the tumor lesions and the shortest diameter in the case of malignant lymph nodes are used in the RECIST criteria.
Time frame: 1.5 years
Toxicities including treatment emergent adverse events and the character and incidence of Grade 1-4 toxicities.
• Describe the character and incidence of Grade 1-4 toxicities based on CTCAE v5.0 that occur in adults receiving NEO-201 in combination with pembrolizumab.
Time frame: 1.5 years
Characterize the area under the concentration-time curve (AUC) of the pharmacokinetics (PK) of NEO-201 combination therapy with pembrolizumab.
Quantifiable samples will be drawn at the following time points (during the first 2 Cycles, each Cycle is 42 Days) from the first 6 patients who consent. * Cycle1 Day1 (pre dose) * 1 hour post dose 1, Cycle1 Day1 * 4 hours post dose 1, Cycle1 Day1 * Cycle1 Day2 * Cycle1 Day4 * Cycle1 Day6 * Cycle1 Day8 * Cycle1 Day15 (pre dose) * Cycle2 Day1 (pre dose) * 1 hour post dose, Cycle2 Day1 * 4 hours post dose, Cycle2 Day1 * Cycle2 Day2 * Cycle2 Day4 * Cycle2 Day6 * Cycle2 Day8 * Cycle2 Day15 (pre dose)
Time frame: 1.5 years
Characterize Peak Plasma Concentration (Cmax) of the pharmacokinetics (PK) of NEO-201 in combination with pembrolizumab.
The reported maximum plasma concentration (Cmax) (Peak concentration) will be determined using a precise validated Elisa method for each dose level on samples collected at the following time points (during the first 2 Cycles, each Cycle is 42 Days) * Cycle1 Day1 (pre dose) * 1 hour post dose 1, Cycle1 Day1 * 4 hours post dose 1, Cycle1 Day1 * Cycle1 Day2 * Cycle1 Day4 * Cycle1 Day6 * Cycle1 Day8 * Cycle1 Day15 (pre dose) * Cycle2 Day1 (pre dose) * 1 hour post dose, Cycle2 Day1 * 4 hours post dose, Cycle2 Day1 * Cycle2 Day2 * Cycle2 Day4 * Cycle2 Day6 * Cycle2 Day8 * Cycle2 Day15 (pre dose)
Time frame: 1.5 years
Characterize the Minimum Plasma Concentration (Cmin) of the pharmacokinetics (PK) of NEO-201 in combination with pembrolizumab.
The reported minimum plasma concentration (Cmin) (Trough concentration) will be determined using a precise validated Elisa method for each dose level on samples collected at the following time points (during the first 2 Cycles, each Cycle is 42 Days). * Cycle1 Day1 (pre dose) * 1 hour post dose 1, Cycle1 Day1 * 4 hours post dose 1, Cycle1 Day1 * Cycle1 Day2 * Cycle1 Day4 * Cycle1 Day6 * Cycle1 Day8 * Cycle1 Day15 (pre dose) * Cycle2 Day1 (pre dose) * 1 hour post dose, Cycle2 Day1 * 4 hours post dose, Cycle2 Day1 * Cycle2 Day2 * Cycle2 Day4 * Cycle2 Day6 * Cycle2 Day8 * Cycle2 Day15 (pre dose)
Time frame: 1.5 years
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