Phase 2A study, assessing the antitumor activity and the safety profile of GM102, a new compound (monoclonal antibody), administered alone or in combination with chemotherapy in patients with locally advanced or metastatic colorectal cancer. The primary objective of the study is to evaluate the antitumor activity of GM102 single agent and in combination with trifluridine/tipiracil.
GM102 is a humanized low fucose monoclonal antibody with a high affinity to AMHRII receptor (fetal receptor mediating the activity of AMH, reexpressed in a variety of solid tumors). GM102 acts through engagement of immune cells (macrophages, natural killer (NK) cells) to trigger ADCC (antibody dependent cellular cytotoxicity) and phagocytosis of tumor cells. AMRHII expression was found in 73% of primary colorectal tumors tested. Advanced/metastatic colorectal cancer (CRC) remains an unmet need disease, with few therapeutic options beyond two or three lines of therapy. CRC is characterized by a tumor microenvironment (TME) particularly rich in macrophages and more specifically macrophages capable of tumor phagocytosis. The pattern of the TME remains a major prognostic factor in the metastatic setting. C201 consists in two parallel cohorts and an expansion of cohort II for patients with advanced or metastatic colorectal cancer in two different settings of the disease: * Cohort I (GM102 as a single agent) in refractory patients, having exhausted all therapeutic options. Patients will receive GM102 alone at the dose of 7 mg/kg administered by intravenous infusion at Day 1, Day 8, Day 15 and Day 22 of each 28-day cycle * Cohort II (GM102 in combination with trifluridine/tipiracil) in patients candidate to receive single agent trifluridine/tipiracil, after at least two lines of treatment for the advanced or metastatic disease. Patients will receive GM102 at the dose of 7 mg/kg administered by intravenous infusion at Day 1, Day 8, Day 15 and Day 22 and trifluridine/tipiracil at 35 mg/m² per dose twice daily orally administered on Days 1 to 5 and Days 8 to 12 of each 28-day cycle. * Cohort II expansion (GM102 in combination with trifluridine/tipiracil) same as cohort II except a loading dose of 10 mg/kg q1w during 28-day cycle 1 Patients will be treated with GM102 (Cohort I) or GM102 and trifluridine/tipiracil (Cohort II and Cohort II expansion) until confirmed progression or toxicity. A Trial Steering Committee (TSC) will analyze and qualify GM102 activity and toxicities and will provide recommendations on the Investigational Medicinal Product (IMP) continuation.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
65
GM102 7 mg/kg weekly
Lonsurf 35 mg/m² twice daily during 10 days per cycle
GM102 7 mg/kg weekly after a loading dose of 10 mg/kg q1w during 28-day cycle 1
Cliniques Universitaires Saint-Luc
Brussels, Belgium
UZ Gasthuisberg
Ghent, Belgium
UZ Leuven
Leuven, Belgium
University Hopistal Olomouc
Olomouc, Czechia
University Hospital Motol
Prague, Czechia
Overall Response Rate (ORR)
ORR from the end of cycle 2 and subsequently confirmed at least 4 weeks later using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
Time frame: Through study completion, an average 1 year
Progression Free Survival (PFS) at 6 months
Proportion of patients without documented progression at 6 months
Time frame: 6 months after the first infusion
Immune Overall Response Rate (iORR)
ORR using immune Response Evaluation Criteria In Solid Tumors (iRECIST)
Time frame: Through study completion, an average 1 year
Clinical Benefit Rate (CBR)
CBR at 8 and 16 weeks defined as the number of non-progressors using RECIST 1.1 and iRECIST criteria
Time frame: up to 4 months
Tumor Growth Rate (TGR) before and under treatment
Percentage of variation in TGR
Time frame: up to 2 months
Progression Free Survival (PFS)
Time elapsed from the date of first infusion to the date of documented progression or death
Time frame: Through study completion, an average 1 year
Overall Survival (OS)
Time elapsed from the date of first infusion to the date of death
Time frame: Through study completion, an average 1 year
Incidence of Serious Adverse Event (SAE) and Treatment Emergent Adverse Event (TEAE)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Number of events
Time frame: Through study completion, an average 1 year
Pharmacodynamics evaluation
Tumor Immune MicroEnvironment analysis and evolution changes: quantity/density and quality of immune cells
Time frame: Up to 2 months
Exposure to murlentamab
PK parameters analysis
Time frame: At days 1 and 15 of cycles 1, 2 (each cycle is 28 days) and End of Treatment for cohort I and II, an average of one year; days 1, 8,15 and 22 of cycles 1, 2 (each cycle is 28 days) and End of Treatment for cohort II expansion, an average of one year
Exposure to trifluridine
Trifluridine plasma concentrations only for cohort II
Time frame: At days 1 and 15 of cycles 1, 2 (each cycle is 28 days) and End of Treatment, an average of one year
Evidence of anti-murlentamab antibodies (ADA)
Presence of ADA
Time frame: Baseline, beginning of every even cycle in pre-dose (each cycle is 28 days) and at the End of Treatment, an average of one year
AMHRII (Anti-Mullerian Hormone type II receptor) expression
AMHRII membrane expression in percentage
Time frame: Up to 2 months