This is an open-label, multicentre dose escalation/expansion study to assess safety and tolerability of MIV 818 as either monotherapy or in combination with 1) lenvatinib, a tyrosine kinase inhibitor used as a standard of care for the treatment of HCC or 2) pembrolizumab, a PD-1 inhibitor. The monotherapy parts of the study will include patients with various solid tumours that have spread to the liver, or alternatively originating in the liver. Evaluations of MIV-818 in combination with lenvatinib or pembrolizumab will only include patients with HCC.
This study will be conducted in three phases. The initial phase, 1a, will enroll up to 12 subjects and include a total of one dose escalation per patient. Once pre-defined criteria for starting phase 1b monotherapy has been met among the enrolled patients in phase 1a, the next phase of the study will be initiated. Phase 1b monotherapy will enroll up to 30 patients in a 3+3 design with interpatient dose escalations. All dose escalation decisions will be made by a safety review committee that will meet regularly during the study conduct. When the MTD has been established, the SRC will provide a RP2D for monotherapy. Phase 1b combination constitutes an interpatient dose escalation to identify the RP2D for MIV-818 when used in combination with 1) lenvatinib and 2) pembrolizumab therapy. This part of the study will enroll up to 36 patients in a 3+3 design with interpatient dose escalations. Safety review will be performed by the SRC to determine the RP2D of MIV 818 for use in combination with lenvatinib and pembrolizumab. The SRC may recommend that the selected dose of MIV-818 is further evaluated in up to 30 patients in the Phase 2a expansion part of the study.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
53
MIV-818 - oral capsules; pembrolizumab - IV
MIV-818 - oral capsules; lenvatinib - oral capsules
Antwerp University Hospital
Antwerp, Belgium
University Hospitals Gasthuisberg
Leuven, Belgium
CHA Bundang Medical Center
Gyeonggi-do, South Korea
Pusan National University Hospital
Pusan, South Korea
Asan Medical Center
Seoul, South Korea
Samsung Medical Center
Seoul, South Korea
Seoul National University Hospital
Seoul, South Korea
Severance Hospital
Seoul, South Korea
Hospital Clinic Carrer Rosselló 161
Barcelona, Spain
Hospital Vall Hebrón
Barcelona, Spain
...and 8 more locations
Incidence and Severity of Adverse Events (AEs)
Percentage of participants with an adverse event, graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 5.0
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Incidence and magnitude of clinically significant changes in red blood cell count, white blood cell count and platelet count
Change from baseline
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Incidence and magnitude of clinically significant changes in aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
Change from baseline
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Incidence and magnitude of clinically significant changes in bilirubin
Change from baseline
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Incidence of clinically significant changes in vital sign - Systolic and diastolic blood pressure
Millimeter of mercury (mmHg)
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Incidence of clinically significant changes in vital sign - Pulse rate
Beats per minute (BPM)
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Incidence of clinically significant changes in vital sign - Body Temperature
Celsius (°C)
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Incidence of clinically significant changes in vital signs - Weight
Kilograms (kg)
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Incidence of clinically significant changes in ECGs
QT interval (milli second (ms))
Time frame: Participants monitored throughout treatment period and during follow-up, up to 6 months
Preliminary efficacy by means of RECIST evaluation
1. ORR will be assessed by monitoring tumor response and progression using RECIST v1.1 2. ORR will be assessed by monitoring tumor response and progression using mRECIST 3. ORR will be assessed by monitoring tumor response and progression using RECIST v 1.1 in liver lesions only
Time frame: Participants monitored throughout treatment period every 6 weeks until disease progression, up to 6 months
Plasma levels of α fetoprotein (AFP)
Time frame: Participants monitored throughout treatment period every 6 weeks until disease progression, up to 6 months
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