The primary purpose of this study is to evaluate the tolerability and safety profile of ASP1951 when administered as a single agent and in combination with pembrolizumab in participants with locally advanced (unresectable) or metastatic solid tumors; characterize the pharmacokinetic profile of ASP1951 when administered as a single agent and in combination with pembrolizumab; and determine the recommended phase 2 dose (RP2D) of ASP1951 and/or maximum tolerated dose (MTD) when administered as a single agent and in combination with pembrolizumab. This study will also evaluate the anti-tumor effect of ASP1951 when administered as a single agent and in combination with pembrolizumab.
This is a dose-escalation and expansion study of ASP1951. The study consists of 3 periods for monotherapy and combination therapy: screening, treatment and follow up, followed by an optional Re-treatment period for participants that qualify. The monotherapy escalation cohorts will evaluate escalating dose levels of ASP1951 in participants with locally advanced (unresectable) or metastatic solid tumor malignancies including but not limited to squamous cell carcinoma of the head and neck (SCCHN), colorectal cancer, metastatic castration-resistant prostate cancer (mCRPC) and cervical cancer. The combination escalation cohorts will evaluate escalating dose levels of ASP1951 in combination with a fixed dose of pembrolizumab. For dose expansion, the tumor-specific cohorts will include participants with squamous cell carcinoma of the head and neck (SCCHN), non-small cell lung cancer (NSCLC) (all PD-L1 status), NSCLC PDL1 high, and cervical cancer, as well as participants with any tumor types that respond to study drug treatment during dose escalation. Participants may reinitiate study drug treatment in the optional Re-treatment period after confirmation that the participant meets all the re-treatment eligibility criteria. After discontinuation of study drug, all participants will complete an end-of-treatment visit, along with 30-day and 90 day safety follow-up visits from the last dose of study drug.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
119
Intravenously (IV)
Intravenously (IV)
Arizona Clinical Research Cent
Tucson, Arizona, United States
University of California
Sacramento, California, United States
University of Florida, Davis C
Gainesville, Florida, United States
Emory University
Atlanta, Georgia, United States
Augusta University
Augusta, Georgia, United States
Safety and tolerability assessed by Dose Limiting Toxicity (DLT)
A DLT is defined as any of the prespecified Adverse Events (AEs) (graded using National Cancer Institute Common Terminology Criteria for Adverse Events \[NCI-CTCAE\] version 4.03) that the investigator (or sponsor) cannot clearly attribute to a cause other than study drug.
Time frame: Up to 5 years
Safety and tolerability assessed by adverse events (AEs)
Initial and retreatment. An AE is any untoward medical occurrence in a participant administered a study drug, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product whether or not considered related to the medicinal product. AEs will be coded using the medical dictionary for regulatory activities (MedDRA) and graded using NCI-CTCAE 4.03.
Time frame: Up to 5 years
Safety and tolerability assessed by immune-related AEs (irAEs)
Initial and retreatment. Most frequent immune-related AEs include rash, oral mucositis, dry mouth, colitis/diarrhea, hepatitis, pneumonitis, and endocrinopathies (hypophysitis, hypothyroidism, hyperthyroidism, adrenal insufficiency and Type 1 diabetes mellitus). In the event a participant is diagnosed with an irAE, then it should be reported as an AE.
Time frame: Up to 5 years
Safety and tolerability assessed by infusion-related reactions (IRRs)
Initial and retreatment. IRRs are considered AEs of special interest. In the event a participant is diagnosed with an IRR, then it should be reported as an AE.
Time frame: Up to 5 years
Safety and tolerability assessed by serious adverse events (SAEs)
Initial and retreatment. An AE is considered "serious" if it results in any of the following outcomes: results in death; is life-threatening; results in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions; results in congenital anomaly or birth defect; requires inpatient hospitalization (except for planned procedures as allowed per study) or leads to prolongation of hospitalization (except if prolongation of planned hospitalization is not caused by an AE). Hospitalization for treatment/observation/examination caused by AE is to be considered as serious; and other medically important events.
Time frame: Up to 5 years
Number of participants with laboratory value abnormalities and/or adverse events related to treatment
Initial and retreatment. Number of participants with potentially clinically significant laboratory values.
Time frame: Up to 5 years
Safety and tolerability assessed by 12- lead electrocardiogram (ECG)
Initial and retreatment. ECGs should be obtained after the participant has rested in supine position (or semi-recumbent, if supine is not tolerated) for 10 minutes. Any clinically significant adverse changes on the ECG will be reported as AEs.
Time frame: Up to 5 years
Number of participants with vital signs abnormalities and/or adverse events related to treatment
Initial and retreatment. Number of participants with potentially clinically significant vital sign values.
Time frame: Up to 5 years
Number of participants with Physical Exam abnormalities and/or adverse events related to treatment
Initial and retreatment. Number of participants with potentially clinically significant physical exam values.
Time frame: Up to 5 years
Safety and tolerability assessed by ECOG performance status
Initial and retreatment. The Eastern Cooperative Oncology Group (ECOG) scale will be used to assess performance status. Grades range from 0 (fully active) to 4 (completely disabled). Negative change scores indicate an improvement. Positive scores indicate a decline in performance.
Time frame: Up to 5 years
Pharmacokinetics (PK) of ASP1951 in serum: AUClast
Initial monotherapy escalation treatment only. Area under the concentration time curve from the time of dosing to the last measurable concentration (AUClast) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: AUCinf
Initial monotherapy escalation treatment only. Area under the concentration time curve from the time of dosing extrapolated to time infinity (AUCinf) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: AUCinf%extrap
Initial monotherapy escalation treatment only. Percentage of AUCinf due to extrapolation from time of the last measurable concentration to time infinity (AUCinf %extrap) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: AUCtau
Initial monotherapy escalation treatment only. Area under the concentration time curve from the time of dosing to the start of next dosing interval (AUCtau) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: Cmax
Initial monotherapy escalation treatment only. Maximum concentration (Cmax) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: Ctrough
Initial monotherapy escalation and retreatment. Concentration immediately prior to dosing at multiple dosing (Ctrough) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 48 weeks
Pharmacokinetics (PK) of ASP1951 in serum: tmax
Initial monotherapy escalation treatment only. Time of the maximum concentration (tmax) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: t 1/2
Initial monotherapy escalation treatment only. Terminal elimination half-life (t1/2) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: tlast
Initial monotherapy escalation treatment only. Time of last measurable concentration (tlast) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: CL
Initial monotherapy escalation treatment only. Total clearance after intravenous dosing (CL) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: Vz
Initial monotherapy escalation treatment only. Volume of distribution after intravenous dosing during the terminal elimination phase (Vz) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: Vss
Initial monotherapy escalation treatment only. Volume of distribution at steady state after intravenous dosing (Vss) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: AUClast
Initial combination escalation treatment only. Area under the concentration time curve from the time of dosing to the last measurable concentration (AUClast) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: AUCinf
Initial combination escalation treatment only. Area under the concentration time curve from the time of dosing extrapolated to time infinity (AUCinf) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: AUCinf%extrap
Initial combination escalation treatment only. Percentage of AUCinf due to extrapolation from time of the last measurable concentration to time infinity (AUCinf %extrap) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: AUCtau
Initial combination escalation treatment only. Area under the concentration time curve from the time of dosing to the start of next dosing interval (AUCtau) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: Cmax
Initial combination escalation treatment only. Maximum concentration (Cmax) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: Ctrough
Initial combination escalation and retreatment. Concentration immediately prior to dosing at multiple dosing (Ctrough) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 48 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: tmax
Initial combination escalation treatment only. Time of the maximum concentration (tmax) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: t 1/2
Initial combination escalation treatment only. Terminal elimination half-life (t1/2) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: tlast
Initial combination escalation treatment only. Time of last measurable concentration (tlast) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: CL
Initial combination escalation treatment only. Total clearance after intravenous dosing (CL) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: Vz
Initial combination escalation treatment only. Volume of distribution after intravenous dosing during the terminal elimination phase (Vz) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: Vss
Initial combination escalation treatment only. Volume of distribution at steady state after intravenous dosing (Vss) will be recorded from the pharmacokinetic (PK) serum samples collected.
Time frame: Up to 10 weeks
Recommended Phase 2 Dose (RP2D) of ASP1951
RP2D of ASP1951 as a single agent is determined using available data on safety, pharmacokinetics, pharmacodynamics and efficacy of ASP1951.
Time frame: Up to 5 years
RP2D of ASP1951 in combination with pembrolizumab
RP2D of ASP1951 in combination with pembrolizumab is determined using available data on safety, pharmacokinetics, pharmacodynamics and efficacy of ASP1951.
Time frame: Up to 5 years
Maximum Tolerated Dose (MTD) of ASP1951
MTD is defined as the dose level at which the posterior mean of DLT rate estimated using Bayesian CRM is closest but does not exceed the target DLT rate of 33%, based on the profile of DLTs collected.
Time frame: Up to 5 years
MTD of ASP1951 in combination with pembrolizumab
MTD is defined as the dose level at which the posterior mean of DLT rate estimated using Bayesian CRM is closest but does not exceed the target DLT rate of 33%, based on the profile of DLTs collected.
Time frame: Up to 5 years
Objective Response Rate (ORR) per Response Evaluation Criteria In Solid Tumors (RECIST) V1.1 and modified RECIST 1.1 for immune-based therapeutics (iRECIST)
Initial and retreatment. ORR is defined as the proportion of participants for each dose level whose best overall response is rated as confirmed complete response (CR) or partial response (PR).
Time frame: Up to 5 years
Duration of Response (DOR) per RECIST V1.1 and iRECIST
Initial and retreatment. DOR is defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date of radiographical progression/death or date of censoring.
Time frame: Up to 5 years
Persistence of response after discontinuation per RECIST V1.1 and iRECIST
Initial and retreatment. Persistence of response is defined as the time from the date of treatment discontinuation to the date of radiographical progression or date of censoring.
Time frame: Up to 5 years
Disease Control Rate (DCR) per RECIST V1.1 and iRECIST
Initial and retreatment. DCR is defined as the proportion of participants for each dose level whose best overall response is rated as confirmed CR, PR or stable disease (SD).
Time frame: Up to 5 years
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