MARIO-3 is a Phase 2 multi-arm combination cohort study designed to evaluate IPI-549, Infinity Pharmaceutical's first-in-class, oral immuno-oncology product candidate targeting immune-suppressive tumor-associated myeloid cells through selective inhibition of phosphoinositide-3-kinase (PI3K)-gamma, in combinations with Tecentriq and Abraxane (nab-paclitaxel) in front-line triple negative breast cancer (TNBC) and in combination with Tecentriq and Avastin (bevacizumab) in front-line renal cell cancer (RCC).
MARIO-3 (Macrophage Reprogramming in Immuno-Oncology) is a prospective Phase 2 multi-arm, multicenter, open-label, combination cohort study designed to evaluate IPI-549, Infinity Pharmaceutical's first-in-class, oral immuno-oncology product candidate targeting immune-suppressive tumor-associated myeloid cells through selective inhibition of phosphoinositide-3-kinase (PI3K)-gamma. IPI-549 will be administered in combinations with Tecentriq and Abraxane (nab-paclitaxel) in front-line triple negative breast cancer (TNBC) and in combination with Tecentriq and Avastin (bevacizumab) in front-line renal cell cancer (RCC). This study will enroll approximately 90 treatment-naïve patients across the following disease cohorts. Cohort A will be composed of patients with locally advanced and/or metastatic triple-negative breast cancer (TNBC). Cohort B will be composed of patients with locally advanced and/or metastatic renal cell carcinoma (RCC). The primary objective of MARIO-3 is to evaluate the complete response (CR) rate per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 following combination treatment with IPI-549 and front-line treatment in patients with TNBC and RCC. Its secondary objectives include evaluation of the safety, objective response rate (ORR), time to CR (TTCR), time to response (TTR), duration of CR (DOCR), duration of response (DOR), and progression-free survival (PFS).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
91
IPI-549 is an oral, selective inhibitor of phosphoinositide-3-kinase gamma (PI3K-gamma). It is an orally-administered capsule that will be dosed at either 20mg/day, 30mg/day, or 40mg/day to patients in both cohorts A and B depending on the results of the safety run-in phase for each cohort.
Atezolizumab is a fully humanized, engineered monoclonal antibody of IgG1 isotype against the protein programmed cell death-ligand 1 (PD-L1). 840 mg of the drug will be administered intravenously (IV) on days 1 and 15 in combination of each 28-day cycle for patients with TNBC. 1200mg will be administered IV on day 1 of each 21-day cycle to patients with RCC.
Nab-paclitaxel is a nanoparticle albumin-bound formulation of paclitaxel (Taxol), a mitotic inhibitor chemotherapy, with less toxicity than solvent-based (sb) paclitaxel and achieves a 33% higher tumor uptake in preclinical models. Nab-paclitaxel will be administered intravenously (IV) at 100 mg/m2 on days 1, 8 and 15 of each 28-day cycle for patients with TNBC.
Bevacizumab is an anti-vascular endothelial growth factor (anti-VEGF) recombinant monoclonal antibody that is approved by the FDA for the treatment of multiple solid tumors in combination with chemotherapy. It will be administered at 15 mg/kg IV on day 1 of each 21-day cycle to patients with RCC.
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Complete Response (CR) rate (change in target lesion size).
Complete Response (CR) rate is defined per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 as disappearance of all target and non-target lesions.
Time frame: CR rate assessments will be conducted through month 12 for Cohort A (TNBC) and through month 18 for Cohort B (RCC) until unacceptable toxicity, confirmed progression of disease, withdrawal of consent, or other treatment discontinuation criteria are met.
Incidence of treatment-emergent adverse events (TEAEs)
Treatment emergent adverse events (TEAE) are undesirable events not present prior to medical treatment, or an already present event that worsens either in intensity or frequency following the treatment.
Time frame: TEAE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Incidence of serious adverse events (SAEs), including deaths
Serious adverse events include death, life-threatening events, initial or prolonged hospitalization, disability or permanent damage, or require an intervention to prevent impairment.
Time frame: SAE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Incidence of adverse events (AEs) leading to treatment discontinuation
An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An adverse event (AE) can therefore be any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.
Time frame: AE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Changes from baseline in electrocardiograms (ECGs)
ECGs assess heart problems by measuring the electrical activity generated by the heart as it contracts. The components that will be assessed during the ECG are P wave, QRS complex, ST segment, and T wave.
Time frame: ECG assessments will be performed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Objective response rate (ORR)
ORR is defined as best response of CR or partial response (PR), as determined by RECIST v1.1.
Time frame: ORR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Time to Complete Remission (TTCR)
TTCR is defined as the time from the first dose of study treatment to CR.
Time frame: TTCR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Time to response (TTR)
TTR is defined as the time from the first dose of study treatment to first objective response (CR or PR) in patients with CR or PR.
Time frame: TTR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Duration of Complete Remission (DOCR)
DOCR is defined as the time from the first CR to documented disease progression in patients with CR.
Time frame: DOCR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Duration of response (DOR)
DOR is defined as the time from the first objective response (CR or PR) to documented disease progression in patients with CR or PR.
Time frame: DOR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Progression-free survival (PFS)
PFS is defined as the time from the first dose of study treatment to documented disease progression or death due to any cause.
Time frame: PFS will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Population Pharmacokinetics (PK) of IPI-549
Population PK estimates (variability in drug concentrations within the study population measured in ng/mL) includes inter- and intra-subject variability and covariate effects.
Time frame: PK assessments will be performed on day 1 of each 28-day cycle through cycle 2 for cohort A (TNBC) at and on day 1 of each 21-day cycle through cycle 2 for cohort B (RCC).
Pharmacokinetics (PK) of Atezolizumab
Concentration of Atezolizumab in the blood at predose measured in ug/mL.
Time frame: PK assessments will be performed on day 1 of cycle 1, on day 1 of cycles 2 through 4, C8D1, C16D1 for both cohorts. Cohort A (TNBC) has a 28-day cycle and cohort B (RCC) has a 21-day cycle.
Changes from baseline in pulse rate
Pulse rate as measured in beats per minute (bpm).
Time frame: Pulse rate will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in temperature
Temperature as measured in celsius.
Time frame: Temperature will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in respiration rate
Respiration rate as measured in breaths per minute.
Time frame: Respiration rate will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in blood pressure
Systolic and diastolic blood pressure as measured in mmHg.
Time frame: Blood pressure will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
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