This is a first-in-human Phase 1/2, non-randomized, multi-centre, open-label clinical study designed to investigate safety, tolerability, PK, and preliminary anti-tumour activity of \[225Ac\]-FPI-1434 (radioimmuno-therapeutic agent) in patients with solid tumours that demonstrate uptake of \[111In\]-FPI-1547 (radioimmuno-imaging agent), and to establish the maximum tolerated dose (MTD) and/or the recommended Phase 2 dose (RP2D) of repeat doses of \[225Ac\]-FPI-1434 Injection in patients with solid tumours that demonstrate uptake of \[111In\]-FPI-1547 (radioimmuno-imaging agent).
This study consists of a Phase 1 portion and a Phase 2 portion. Phase 1 includes the following cohorts: Single dose-ascending cohorts and Multi- dose ascending cohorts of \[225Ac\]-FPI-1434 and Multi- dose ascending cohorts evaluating administration of FPI-1175 (cold antibody), followed by, \[225Ac\]-FPI-1434 (cold + hot), with cycles repeating every 42 days. And Cold Antibody Sub-study evaluating administration of ascending doses of FPI-1175 followed by \[111In\]-FPI-1547. The Phase 2 will evaluate \[111In\]-FPI-1547 and \[225Ac\]-FPI-1434 with or without FPI-1175 in tumour-specific cohorts. The decision to utilize FPI-1175 in the Phase 2 portion of the study will be determined based on Phase 1 data, including safety, tolerability, pharmacokinetic and dosimetry results.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
78
\[111In\]-FPI-1547 is a targeted radioimmuno-imaging agent that consists of FPI-1175, an insulin-like growth factor-1 receptor (IGF-1R)-targeting humanized monoclonal antibody, a bifunctional chelate, and Indium-111, a radionuclide. Patients will receive \[111In\]-FPI-1547 Injection of 185 MBq (5 mCi) for imaging.
\[225Ac\]-FPI-1434 is a targeted alpha radioimmuno-therapeutic agent that consists of FPI-1175, an insulin-like growth factor-1 receptor (IGF-1R)-targeting humanized monoclonal antibody, a bifunctional chelate, and Actinium-225, an alpha-emitting radionuclide. Patients will receive multiple doses of \[225Ac\]-FPI-1434 Injection. Dose is per cohort assignment.
FPI-1175 is an insulin-like growth factor-1 receptor (IGF-1R)-targeting humanized monoclonal antibody without a radioisotope. Patients will receive FPI-1175 Infusion at a dose per cohort assignment.
\[225Ac\]-FPI-1434 is a targeted alpha radioimmuno-therapeutic agent that consists of FPI-1175, an insulin-like growth factor-1 receptor (IGF-1R)-targeting humanized monoclonal antibody, a bifunctional chelate, and Actinium-225, an alpha-emitting radionuclide. Patients will receive a single dose of \[225\]-FPI-1434 Injection. Dose is per cohort assignment.
City of Hope
Duarte, California, United States
Dana-Farber Cancer Institute
Boston, Massachusetts, United States
Masonic Cancer Center, University of Minnesota
Minneapolis, Minnesota, United States
Roswell Park Comprehensive Cancer Center
Buffalo, New York, United States
Memorial Sloan Kettering Cancer Center
New York, New York, United States
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Royal Adelaide Hospital
Adelaide, South Australia, Australia
Austin Hospital
Heidelberg, Victoria, Australia
Juravinski Cancer Center - Hamilton Health
Hamilton, Ontario, Canada
...and 3 more locations
Dose Escalation: Incidence of adverse events (AEs).
Phase 1
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Single-Dose Escalation: Incidence of dose limiting toxicities (DLTs).
Phase 1
Time frame: 8 weeks.
Multi-Dose Escalation: Incidence of DLTs.
Phase 1
Time frame: 6 weeks.
Dose Escalation: Incidence of clinically significant clinical laboratory abnormalities.
Phase 1
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Dose Escalation: Changes in electrocardiogram (ECG) parameters (PR, QRS, QT, and QTc intervals).
Phase 1
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
Cold Antibody Sub-Study: Changes in uptake of [111In]-FPI-1547 Injection following FPI-1175 Infusion in selected regions of interest on SPECT/CT images.
Phase 1
Time frame: Within two weeks of the first [111In]-FPI-1547 Injection.
Cold Antibody Sub-Study: Changes in radiation dose estimates for selected tissues, organs and whole body both for [111In]-FPI-1547 and [225Ac]-FPI-1434 Injection at various dose levels following FPI-1175 Infusion.
Phase 1
Time frame: Within two weeks of the first [111In]-FPI-1547 Injection.
Evaluate anti-tumour activity of [225Ac]-FPI-1434 regimen
Phase 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 injection.
Objective response rate (ORR) RECIST v1.1.
Phase 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold Antibody Sub-Study: Tumour uptake of [111In]-FPI-1547 in selected regions of interest on SPECT/CT images.
Phase 1 and 2
Time frame: Dose Escalation: Within one week of the [111In]-FPI-1547 Injection. Cold-Antibody Sub-Study: Within two weeks of the first [111In]-FPI-1547 Injection.
Dose Escalation: Radiation doses for selected organs and whole body both for [111In]-FPI-1547 Injection and [225Ac]-FPI-1434 Injection.
Phase 1 and 2
Time frame: Within one week of the [111In]-FPI-1547 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Changes in radiation absorbed doses for tumour lesions for [225Ac]-FPI-1434.
Phase 1 and 2
Time frame: Dose Escalation: Within one week of the [111In]-FPI-1547 Injection. Cold-Antibody Sub-Study: Within two weeks of the first [111In]-FPI-1547 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Clearance for radioactivity and for the targeting antibody.
Phase 1 and 2
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Area under the curve (AUC) for radioactivity and for the targeting antibody.
Phase 1 and 2
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Cmax for radioactivity and for the targeting antibody.
Phase 1 and 2
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Half-life for radioactivity and for the targeting antibody.
Phase 1 and 2
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
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Dose Escalation and Cold-Antibody Sub-Study: Objective response rate (ORR) (sum of complete and partial response) per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 or Prostate Cancer Working Group 3 (PCWG3) guidelines.
Phase 1
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Dose Escalation: Changes in the corrected QT (QTc) interval in milliseconds after [225Ac]-FPI-1434 treatment, compared to baseline.
Phase 1 and 2
Time frame: Approximately 24 hours from the time of [225Ac]-FPI-1434 Injection administration.
Dose Escalation and Cold-Antibody Sub-Study: Changes in human growth hormone (hGh) following [111In]-FPI-1547 Injection and [225Ac]-FPI-1434 Injection.
Phase 1 and 2
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Changes in insulin-like growth factor 1 (IGF-1) following [111In]-FPI-1547 Injection and [225Ac]-FPI-1434 Injection.
Phase 1 and 2
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Changes in insulin-like growth factor binding protein 3 (IGFBP-3) following [111In]-FPI-1547 Injection and [225Ac]-FPI-1434 Injection.
Phase 1 and 2
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
Cold Antibody Sub-Study: Incidence of AEs.
Phase 1 and 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Cold Antibody Sub-Study: Incidence of clinically significant clinical laboratory abnormalities.
Phase 1 and 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Cold Antibody Sub-Study: Changes in ECG parameters (PR, QRS, QT, and QTc intervals).
Phase 1 and 2
Time frame: 4 weeks post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Time to response (TTR).
Phase 1 and 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Duration of response (DoR).
Phase 1 and 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Progression free survival (PFS).
Phase 1 and 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Time to Progression (TTP).
Phase 1 and 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Disease control rate (DCR).
Phase 1 and 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.
Dose Escalation and Cold-Antibody Sub-Study: Overall survival (OS).
Phase 1 and 2
Time frame: Approximately one year post final [225Ac]-FPI-1434 Injection.