This clinical trial is evaluating a drug called HMBD-001 (an anti-HER3 monoclonal antibody) in participants with advanced HER3 positive solid tumours. The main aims are to find out the best dose of HMBD-001 that can be given to participants alone and in combination with other anti-cancer agents, more about the potential side effects of HMBD-001 and how they can be treated, and what happens to HMBD-001 inside the body and how it affects cancer cells.
HMBD-001 is a type of drug called a monoclonal antibody. It works by targeting a protein called HER3, which is found in high numbers in some types of cancers including those that contain fusions in a gene called NRG1. By attaching itself to this protein, it may then work to kill the cancer cells or to stop them growing. This is a first-in-human clinical trial that has two parts: Part A is a 'dose escalation' phase where small groups of participants will receive increasing doses of HMBD-001 on its own (as a single agent) to find the safest dose that best targets cancer cells. Part B is a 'dose expansion' phase where larger groups of participants with specific cancer types that are known to have high levels of the protein HER3 or that have a confirmed NRG1 gene fusion will receive the highest doses of HMBD-001 considered to be safe as monotherapy from Part A in combination with other anti-cancer drugs that are already licensed for use. In Part B Arm 1, participants will receive HMBD-001 in combination with enzalutamide. Enzalutamide is a drug used to treat prostate cancer. Prostate cancer is known to be sensitive to androgens (hormones associated with male characteristics), and enzalutamide blocks the action of androgens by limiting the binding of androgens to androgen receptors. This slows the growth of prostate cancer cells and may kill them. The main aims of the clinical trial are to find out: * The best dose of HMBD-001 alone and in combination with other anti-cancer drugs that should be given to participants. * More about the potential side effects of HMBD-001 when given alone and in combination with other anti-cancer agents, and how they can be managed. * What happens to HMBD-001 inside the body and how it affects cancer cells. * The potential anti-tumour activity of HMBD-001 as a single agent and in combination with other anti-cancer agents in specific tumour types of HER3-expressing tumours or tumours with NRG1 gene fusions.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
81
Participants with advanced solid tumours will receive their assigned dose level of HMBD-001 diluted in 0.9% sodium chloride, administered once a week as a 120-minute intravenous (IV) infusion. Cycles are 28 days with no break in between; administration may continue for up to 6 cycles but may continue for longer if the participant is deemed to be benefitting.
Participants with metastatic castration resistant prostate cancer (mCRPC) confirmed as HER3 positive with no PTEN loss or with a NRG1 fusion rearrangement will receive the HMBD-001 recommended Phase 2 dose (RP2D) as determined in Part A, diluted in 0.9% sodium chloride and administered once a week as a 120-minute IV infusion, in combination with enzalutamide administered at a fixed dose of 160 mg once daily, in 28-day cycles with no break between cycles. Immediately before commencing combination therapy, participants may receive one 28-day cycle of enzalutamide monotherapy to confirm that their disease does not respond to enzalutamide alone. HMBD-001 may be administered for up to 6 cycles; enzalutamide may be continued until disease progression or unacceptable toxicity.
Royal Marsden NHS Foundation Trust
London, United Kingdom
The Christie Hospital
Manchester, United Kingdom
Freeman Hospital, Newcastle
Newcastle, United Kingdom
Churchill Hospital
Oxford, United Kingdom
Number of Participants Who Experienced Dose Limiting Toxicities (DLTs); Part A
DLTs graded for severity using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0, measured by count of participants per arm.
Time frame: From first dose onwards until completion of Cycle 1 (28 days)
Number of Participants Who Experienced DLTs; Part B Arm 1
DLTs graded for severity using the NCI CTCAE v5.0, measured by count of participants per arm.
Time frame: From first dose of combination therapy onwards until completion of Cycle 1 (28 days)
Number of adverse events (AEs) by arm considered to be at least possibly related to HMBD-001 (Part A and Part B Arm 1)
Number of AEs related to HMBD-001 given as a single agent and in combination with enzlutamide, graded according to NCI CTCAE v5.0.
Time frame: From the date of written informed consent until the end of the safety follow-up period (maximum [max] 42 weeks per participant)
Number of Grade 3, 4 and 5 AEs by arm considered to be at least possibly related to HMBD-001 (Part A and Part B Arm 1)
Number of Grade 3, 4 and 5 AEs related to HMBD-001 given as a single agent and in combination with enzalutamide, graded according to NCI CTCAE v5.0.
Time frame: From the date of written informed consent until the end of the safety follow-up period (max 42 weeks per participant)
Overall response rate (ORR) within 6 cycles of HMBD-001 (Part B Arm 1)
Proportion of participants who achieve a best response of complete response (CR) or partial response (PR), based on Response Evaluation Criteria in Solid Tumours (RECIST) v1.1 and/or Prostate Cancer Working Group 3 (PCWG3) Criteria as applicable, within 6 cycles of HMBD-001 in combination with enzalutamide.
Time frame: From baseline radiological disease assessment until 28 days after last dose of HMBD-001 (max 36 weeks per participant)
ORR within 6 cycles of HMBD-001 (Part A)
Proportion of participants who achieve a best response of CR or PR, based on RECIST v1.1 and/or PCWG3 Criteria as applicable, within 6 cycles of HMBD-001 monotherapy.
Time frame: From baseline radiological disease assessment until 28 days after last dose of HMBD-001 (max 32 weeks per participant)
Maximum observed serum concentration (Cmax) of HMBD-001 (Part A and Part B Arm 1)
Cmax of HMBD-001 in serum, analysed via enzyme linked immunosorbent assay (ELISA). Not all participants will be analysed at all timepoints.
Time frame: Up to 31 timepoints from first dose until 28 days after the last dose of HMBD-001 (max 28 weeks per participant)
Minimum observed serum concentration (Cmin) of HMBD-001 (Part A and Part B Arm 1)
Cmin of HMBD-001 in serum, analysed via ELISA. Not all participants will be analysed at all timepoints.
Time frame: Up to 31 timepoints from first dose until 28 days after the last dose of HMBD-001 (max 28 weeks per participant)
Area under the serum concentration-time curve (AUC) of HMBD-001 (Part A and Part B Arm 1)
AUC of HMBD-001, analysed via ELISA. Not all participants will be analysed at all timepoint
Time frame: Up to 31 timepoints from first dose until 28 days after the last dose of HMBD-001 (max 28 weeks per participant)
Terminal elimination half-life (t½) of HMBD-001 (Part A and Part B Arm 1)
t½ of HMBD-001 in serum, analysed via ELISA. Not all participants will be analysed at all timepoints.
Time frame: Up to 31 timepoints from first dose until 28 days after the last dose of HMBD-001 (max 28 weeks per participant)
Steady state volume of distribution of HMBD-001 in serum (Part A and Part B Arm 1)
Volume of distribution of HMBD-001 in serum at steady state, analysed via ELISA. Not all participants will be analysed at all timepoints.
Time frame: Up to 31 timepoints from first dose until 28 days after the last dose of HMBD-001 (max 28 weeks per participant)
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Total body clearance of HMBD-001 (Part A and Part B Arm 1)
Total body clearance of HMBD-001 measured in serum, analysed via ELISA. Not all participants will be analysed at all timepoints.
Time frame: Up to 31 timepoints from first dose until 28 days after the last dose of HMBD-001 (max 28 weeks per participant)
ORR within 8 and 16 weeks of commencing HMBD-001 (Part A and Part B Arm 1)
Proportion of participants achieving a best response of CR, or PR according to RECIST v1.1 and/or PCWG3 Criteria as applicable, within 8 and 16 weeks of commencing HMBD-001 as monotherapy and in combination with enzalutamide.
Time frame: From baseline radiological disease assessment up to 16 weeks post first HMBD-001 administration (max 24 weeks per participant)
Disease control rate within 6 cycles of HMBD-001 (Part A and Part B Arm 1)
Proportion of participants achieving a best response of CR, PR or stable disease (SD), based on RECIST v1.1 and/or PCWG3 Criteria as applicable, within 6 cycles of HMBD-001 as monotherapy and in combination with enzalutamide.
Time frame: From baseline radiological disease assessment up to 28 days post last HMBD-001 administration (max 36 weeks per participant)
Duration of response (Part A and Part B Arm 1)
The median duration in days from the first observation of a CR or PR, according to RECIST v1.1 and/or PCWG3 Criteria as applicable, until either progressive disease (PD) or death from any cause, in participants with a confirmed CR or PR.
Time frame: From the date of first recorded response until 24 months after the last enrolled participant's first dose of HMBD-001 (max 48 months per participant)
Duration of clinical benefit (Part A and Part B Arm 1)
The median duration in days from the first administration of HMBD-001 until either PD or death from any cause, in participants who achieve a CR, PR, or SD for at least 24 weeks, according to RECIST v1.1 and/or PCWG3 Criteria as applicable.
Time frame: From the date of first recorded response until 24 months after the last enrolled participant's first dose of HMBD-001(max 48 months per participant)
Progression free survival (Part B Arm 1)
The median duration in days from first dose of HMBD-001 to death from any cause or PD according to RECIST v1.1 and/or PCWG3 Criteria as applicable.
Time frame: From first dose of HMBD-001 until 24 months after the last enrolled participant's first dose of HMBD-001 (max 48 months per participant)
Overall survival (Part B Arm 1)
The median time from first dose of HMBD-001 to death from any cause.
Time frame: From first dose of HMBD-001 until 24 months after the last enrolled participant's first dose of HMBD-001 (max 48 months per participant)