The primary objective is to assess the safety and tolerability of TAB004 as monotherapy and in combination with toripalimab in subjects with selected advanced solid malignancies, including lymphoma, and to evaluate the recommended Phase 2 dose. The secondary objectives are to: 1) describe the pharmacokinetic (PK) profile of TAB004 monotherapy and in combination with toripalimab and to describe the PK profile of toripalimab when administered with TAB004, 2) evaluate antitumor activity of TAB004 monotherapy and in combination with toripalimab; and 3) determine the immunogenicity of TAB004 monotherapy and in combination with toripalimab and to determine the immunogenicity of toripalimab when administered with TAB004. The exploratory objectives are to: 1) evaluate pharmacodynamic effects of TAB004 on its target receptor BTLA, as well as effects on the immune system; 2) evaluate biomarkers that may correlate with activity of TAB004 as monotherapy and in combination with toripalimab; 3) evaluate the utility of BTLA ligand, herpesvirus-entry mediator (HVEM), and additional exploratory biomarkers that could aid in selection of appropriate subjects for TAB004 monotherapy and in combination with toripalimab.
OVERVIEW: This is a Phase 1, multi-center, open-label, dose-escalation study of TAB004, a recombinant humanized IgG4κ monoclonal antibody specific to BTLA when administered alone and in combination with toripalimab, a human IgG4k monocloncal antibody that specifically binds to the programmed death 1 (PD-1). It is estimated that up to 499 subjects with selected advanced solid malignancies (i.e.; non-small cell lung cancer \[NSCLC\], melanoma, renal cell carcinoma (RCC), urothelial carcinoma (UC), or other tumors), including lymphoma will be enrolled in the study. Subjects must have a histologically or cytologically confirmed advanced unresectable or metastatic solid tumor, including lymphoma. The study has 4 parts; Part A dose-escalation, Part B cohort expansion, Part C dose-escalation and Part D cohort expansion. In Part A, up to 24 subjects will be enrolled who must have received, or be ineligible for, or intolerant of, all available approved or standard therapies know to confer clinical benefit including immunotherapy, or for whom no standard therapy exists. In Part B, C and D, subjects must have received at least one line of therapy for advanced or metastatic disease, but are not required to have received all standard therapies known to confer clinical benefit. Part A is the monotherapy dose-escalation portion of the study. Four TAB004 dose levels are planned and include: 0.3, 1, 3 and 10 mg/kg. Part A will be the traditional 3 + 3 design with 3 to 6 subjects per dose level (cohort) and will receive their assigned dose every 21 days in the absence of a dose limiting toxicity (DLT) that would prevent further dosing. Part B is the monotherapy cohort expansion portion of the study and will consist of up to 50 subjects in each advanced solid tumor indication (up to 200 subjects) that may include but not be limited to lymphoma, melanoma, NSCLC, or other tumors with agreement of the Sponsor. Part C is the combination therapy dose-escalation portion of the study. Four dose levels are planned as follows: Cohort 1 - TAB004 20 mg and toripalimab 240mg; Cohort 2 - TAB004 70 mg and toripalimab 240 mg; Cohort 3 -TAB004 200 mg and toripalimab 240 mg; Cohort 4- TAB004 500 mg and toripalimab 240 mg. Part C will be the traditional 3 + 3 design with 3 to 6 subjects per dose level (cohort) and will receive their assigned doses every 21 days in the absence of a DLT that would prevent further dosing. Part D is the combination therapy cohort expansion portion of the study. Up to 50 subjects will be enrolled in each advanced solid tumor indication (melanoma, NSCLC, RCC, UC, lymphoma) (up to 250 subjects). Doses of TAB004 and toripalimab will be determined based upon safety and efficacy data from Part C. Tumor response will be evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST v1.1), the immune-related Response Evaluation Criteria in Solid Tumors (irRECIST), or the New Response Evaluation Criteria in Lymphoma (RECIL) 2017. In the absence of confirmed disease progression and intolerable toxicities, subjects will be allowed to continue TAB004 (Part A and B) or TAB004 and toripalimab (Part C and D) administration every 21 days for up to 2 years. DOSAGE AND ADMINISTRATION TAB004 doses are 0.3, 1, 3, 10 mg/kg, 20mg, 70mg, 200mg and 500mg. Toripalimab dose is 240mg. TAB004 alone or TAB004 plus toripalimab will be administered as a 60-minute i.v. infusion for the first dose and may be decreased at the investigators discretion to 30 minutes in subsequent infusions. SAFETY EVALUATIONS Assessment of safety will be determined by vital sign measurements, clinical laboratory tests, Eastern Cooperative Oncology Group (ECOG) performance status evaluations, diagnostic imaging, physical examinations, electrocardiograms, and the incidence and severity of adverse events. Safety will also include evaluations of immune safety and immunogenicity. Blockade of BTLA pathway and PD-1 pathway by monoclonal antibodies has been demonstrated in several syngeneic mouse models to enhance specific T cell responses and inhibit tumor growth. In studies of BTLA deficient mice, diseases such as asthma, autoimmune involvement of the central nervous system, and systemic lupus erythematosus were exacerbated. Particular attention will be given to symptoms related to those diseases. The occurrence of adverse events that may follow enhanced T-cell activation such as pneumonitis, colitis, nephritis, severe skin reactions, endocrinopathies, or other immune-related adverse events (irAEs) will be evaluated for subjects receiving TAB004 alone or in combination with toripalimab. An irAE is a clinically significant adverse event of any organ that is associated with drug exposure, of unknown etiology, and is consistent with an immune-mediated mechanism. EFFICACY EVALUATIONS will include best overall response, objective response rate, duration of response or duration of stable disease, progression free survival and overall response. PHARMACOKINETIC EVALUATIONS Pharmacokinetic parameters include AUC0-inf, AUC0-last, AUC0-21d, Cmax, Cmin trough, Tmax, t1/2, CL, accumulation and Vss. STATISTICAL METHODS Part A and Part C are based on the 3+3 design for dose escalation and safety evaluation requirements. In Part B and Part D, sample size is estimated using Simon's two-phase design minimax method. All PK/Pharmacodynamic, immunogenicity, and safety data will be summarized and presented by cohort as well as overall for the study, using descriptive statistics (number of subjects, mean, median, standard deviation, minimum, and maximum) for continuous variables and using frequencies and percentages for discrete variables. ORR and the associated 2-sided 95% exact confidence limits will be calculated. The proportion of subjects who have experienced best response as CR, PR, SD, or progressive disease (PD) will be provided by cohorts in Part B and Part D.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
499
Recombinant humanized IgG4κ monoclonal antibody specific to BTLA for injection
a human IgG4k monoclonal antibody that specifically binds to the programmed death 1 (PD-1)
University of Alabama at Birmingham
Birmingham, Alabama, United States
RECRUITINGUniversity of Arizona College of Medicine-Tucson
Tucson, Arizona, United States
RECRUITINGUCLA Health Westwood Cancer Care
Los Angeles, California, United States
RECRUITINGUniversity of California Irvine (UCI) Medical Center
Orange, California, United States
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Treatment-related adverse events as assessed by CTCAE v4.0
Time frame: 2 years
Objective Response Rate (ORR) by RECIST 1.1
ORR
Time frame: 2 years
Duration of Response (DOR) by RECIST 1.1
DOR
Time frame: 2 years
Disease Control Rate (DCR) by RECIST 1.1
DCR
Time frame: 2 years
Time to response (TTR) by RECIST 1.1
TTR
Time frame: 2 years
Progression-free survival (PFS) by RECIST 1.1
PFS
Time frame: 2 years
Overall survival (OS) by RECIST 1.1
OS
Time frame: 2 years
BTLA receptor occupancy (RO) of blood
RO
Time frame: 2 years
Maximum Plasma Concentration (Cmax) after single dose injection of TAB004 and for toripalimab
Cmax
Time frame: 2 years
Peak Time (Tmax) after single dose injection of TAB004 and for toripalimab
Tmax
Time frame: 2 years
Area Under the Curve (AUC) after single dose injection of TAB004 and for toripalimab
AUC
Time frame: 2 years
t1/2 after single dose injection of TAB004 and for toripalimab
t1/2 half life
Time frame: 2 years
Plasma clearance (CL) after single dose injection of TAB004 and for toripalimab
Plasma clearance (CL)
Time frame: 2 years
Apparent volume of distribution (V) after single dose injection of TAB004 and for toripalimab
volume of distribution (V)
Time frame: 2 years
Minimum Plasma Concentration (Cmin) of steady state after multiple dose injection of TAB004 and for toripalimab
Cmin
Time frame: 2 years
Apparent volume of distribution of steady state (Vss) after multiple dose injection of TAB004 and for toripalimab
volume of distribution of steady state (Vss)
Time frame: 2 years
The presence of anti-drug antibody (ADA) after multiple dose injection of TAB004 and for toripalimab
ADA
Time frame: 2 years
Accumulation after multiple dose in injection of TAB004 and for toripalimab
Accumulation
Time frame: 2 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
University of California San Francisco (UCSF) Medical Center-Mission Bay
San Francisco, California, United States
RECRUITINGUniversity of California at San Francisio
San Francisco, California, United States
RECRUITINGBoca Raton Clinical Research (BRCR)
Boca Raton, Florida, United States
WITHDRAWNWinship Cancer Institute at Emory University
Atlanta, Georgia, United States
RECRUITINGUniversity of Iowa Hospitals
Iowa City, Iowa, United States
RECRUITINGUniversity of Maryland Medical Center
Baltimore, Maryland, United States
RECRUITING...and 14 more locations