First-in Human study evaluating the safety, tolerability and efficacy of ENB003 in combination with Pembrolizumab in solid tumors. The study is separated into two parts. Part A is a 3+3 dose escalation to define the recommended RP2D; this part will include metastatic melanoma, platinum resistant ovarian cancer, and pancreatic cancer patients subjects, but other solid tumors will be allowed. Once the RP2D is selected, the study will be expanded into metastatic melanoma, platinum resistant ovarian cancer, and pancreatic cancer subjects. A small number of sarcoma subjects will be included, as exploratory.
Part A: Dose Escalation (with Run-in) A 7-day run-in period of ENB-003 monotherapy, will be administered to all Part A subjects on Days -7, -5 and -3, prior to initiating combination therapy with pembrolizumab at Day 1. ENB-003 will also be administered on Days 1, 3 and 5 in Cycle 1. In subsequent cycles, ENB-003 will be administered on Days 1, 3, 5, 8, 10, and 12 of alternate 21-day treatment cycles, starting with Cycle 3. Dose escalation will follow a standard 3+3 design, with the following doses being administered during Part A: * 150 µg ENB-003 * 300 µg ENB-003 * 500 µg ENB-003 * 750 µg ENB-003 * 1000 µg ENB-003 and 2000 µg ENB-003. For 2000 µg doses and above, ENB003 will be administered every 21 day cycle. Pembrolizumab will be administered as 200 mg on Day 1 of each 21-day cycle in all Part A cohorts. Part B: Dose Expansion Twelve (12) subjects with malignant melanoma, ovarian cancer, or pancreatic cancer will receive 1 x 21-day treatment cycle of ENB-003 at the recommended phase 2 dose (RP2D) selected in Part A + pembrolizumab. If dose limiting toxicities (DLT) occur in no more than 3 subjects , Part B will be expanded with an additional 27 subjects, plus 6 additional subjects with sarcoma. A review of efficacy will be conducted by a Data Safety Monitoring Board (DSMB) in Part B once 39 RP2D subjects (including 9 malignant melanoma subjects, 16 ovarian cancer subjects and 14 pancreatic cancer subjects) have completed their scheduled 12 week CT/MRI scans. Upon approval by the DSMB, a maximum of 64 further subjects will be treated at the RP2D.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
137
ENB003 is selective Endothelin B Receptor Antagonist
anti-PD1
Cedars Sinai-The Angeles Clinic
Los Angeles, California, United States
MD Anderson Cancer Center
Houston, Texas, United States
Border Medical Oncology
Albury, New South Wales, Australia
Blacktown Oncology
Blacktown, New South Wales, Australia
Kinghorn-St Vincent's Hospital
Darlinghurst, New South Wales, Australia
Part A: Incidence of Treatment-Emergent Adverse Events of ENB003 in combination with pembrolizumab, as assessed by NCI CTCAE Version 5
Based on observed or reported AEs. AEs will be evaluated and classified according to NCI CTCAE Version 5.0
Time frame: assessed on every visit while subjects are in the study up to 2 years
Part B: Efficacy of ENB003 in combination with pembrolizumab
Melanoma and Ovarian Cancer: • ORR, based on RECIST (evaluated in the context of ETBR expression)
Time frame: up to 2 years while subjects remain in the study
Part B: Efficacy of ENB003 in combination with pembrolizumab
Pancreatic Cancer: • 6-months OS (evaluated in the context of ETBR expression) Note, these outcomes will be measured by tumor type and not in an aggregate as both the futility and final analysis are independently powered for each tumor type
Time frame: up to 2 years while subjects remain in the study
Part B Efficacy Progression-free survival (PFS),
defined as time from first dosing to date of first observed progression, based on RECIST, or death from any cause (whichever comes first).
Time frame: up to 2 years
Part B Efficacy: Duration of response
based on RECIST
Time frame: up to 2 years
Part B Efficacy: Time to progression
defined as time from first dosing to date of first observed progression, based on RECIST
Time frame: up to 2 years
Part B Efficacy: Overall survival
defined as time from first dosing to date of death
Time frame: up to 2 years
pharmacokinetic (PK) of ENB-003-AUC
AUC, measured through blood samples from 0 up to 8 hrs, for all subjects in the dose escalation and the first 12 subjects in the dose expansion
Time frame: at 05,10,15, 20, 30 45, 60 and 90 minutes, 2 hours, 3 hours, 5 hours, and 8 hours after administration of the ENB003, on Days -7 and -5 during dose escalation and days 1 and 5 during dose expansion
pharmacokinetic (PK) of ENB-003-Cmax
Cmax, measured through blood samples from 0 up to 8 hrs, for all subjects in the dose escalation and the first 12 subjects in the dose expansion
Time frame: at 05,10,15, 20, 30 45, 60 and 90 minutes, 2 hours, 3 hours, 5 hours, and 8 hours after administration of the ENB003, on Days -7 and -5 during dose escalation and days 1 and 5 during dose expansion
pharmacokinetic (PK) of ENB-003-Tmax
Tmax, measured through blood samples from 0 up to 8 hrs, for all subjects in the dose escalation and the first 12 subjects in the dose expansion
Time frame: at 05,10,15, 20, 30 45, 60 and 90 minutes, 2 hours, 3 hours, 5 hours, and 8 hours after administration of the ENB003, on Days -7 and -5 during dose escalation and days 1 and 5 during dose expansion
pharmacokinetic (PK) of ENB-003-T1/2
t1/2, measured through blood samples from 0 up to 8 hrs, for all subjects in the dose escalation and the first 12 subjects in the dose expansion
Time frame: at 05,10,15, 20, 30 45, 60 and 90 minutes, 2 hours, 3 hours, 5 hours, and 8 hours after administration of the ENB003, on Days -7 and -5 during dose escalation and days 1 and 5 during dose expansion
pharmacokinetic (PK) of ENB-003-Vss
Vss measured through blood samples from 0 up to 8 hrs, for all subjects in the dose escalation and the first 12 subjects in the dose expansion
Time frame: at 05,10,15, 20, 30 45, 60 and 90 minutes, 2 hours, 3 hours, 5 hours, and 8 hours after administration of the ENB003, on Days -7 and -5 during dose escalation and days 1 and 5 during dose expansion
pharmacokinetic (PK) of ENB-003-CL
CL measured through blood samples from 0 up to 8 hrs, for all subjects in the dose escalation and the first 12 subjects in the dose expansion
Time frame: at 05,10,15, 20, 30 45, 60 and 90 minutes, 2 hours, 3 hours, 5 hours, and 8 hours after administration of the ENB003, on Days -7 and -5 during dose escalation and days 1 and 5 during dose expansion
Exploratory: IHC assessment of ETBR
changes in immunohistochemistry (IHC) for Endothelin B Receptor (ETBR) based on tissue staining measured as a percent of the tissue sample stained, after administration of ENB-003 in combination with pembrolizumab (for subjects with accessible tumors, in whom biopsies can be safely performed).
Time frame: single sample taken between day 5-8
Exploratory: IHC assessment of PD-L1
changes in immunohistochemistry (IHC) for PDL-1 receptor based on tissue staining measured as a percent of the tissue sample stained, after administration of ENB-003 in combination with pembrolizumab (for subjects with accessible tumors, in whom biopsies can be safely performed).
Time frame: single sample taken between day 5-8
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