AFM24-102 is a Phase 1/2a open-label, non-randomized, multicenter, dose escalation, and expansion study evaluating AFM24 in combination with atezolizumab in patients with selected EGRF-expressing advanced solid malignancies whose disease has progressed after treatment with previous anticancer therapies.
There will be 2 parts in this study: a dose escalation phase (phase 1) and an expansion phase (phase 2a). Patients will qualify to receive the investigational drugs (AFM24 + atezolizumab) in the dose escalation phase or the expansion phase only if they are deemed eligible following the safety lead-in phase. Seven days before the planned first combination treatment, patients will receive a single dose of AFM24 and will be observed for any adverse events for 1 week. The aim of the dose escalation phase is to determine the maximum tolerated dose (MTD)/recommended phase 2 dose (RP2D) of AFM24 in combination with atezolizumab. The dose escalation phase will be followed by the expansion phase once the MTD/RP2D of AFM24 in combination with atezolizumab has been determined. The expansion phase of the study is intended to collect preliminary evidence of efficacy and to further confirm the safety of AFM24 in combination with atezolizumab. The tumor types planned to be studied in the AFM24/atezolizumab combination study will be: * Non-small cell lung cancer (EGFR-WT), with disease progression after chemotherapy and PD1/PD-L1 targeted therapy * Gastric/GEJ cancer if intolerant to or with disease progression after standard platinum-based chemotherapy * Pancreatic/hepatocellular/biliary tract cancer with disease progression after standard of care (SOC) therapy or if there is no appropriate SOC available for their condition * Advanced or metastatic NSCLC harboring a targetable EGFR kinase domain mutation with disease progression on or after received ≥1 prior lines of treatment for advanced disease, including a Tyrosine-Kinase Inhibitor (TKI) for EGFR mutations
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
112
intravenous infusion
intravenous infusion
USC Norris Comprehensive Cancer Center
Los Angeles, California, United States
University of Chicago Medical Center
Chicago, Illinois, United States
Phase 1: Incidence of Dose Limiting Toxicities (DLTs) During Cycle 1
The number of patients with dose limiting toxicities (DLTs) in the first cycle, as assessed by the National Cancer Institute Common Technology Criteria for Adverse Events (CTCAE) v5.0
Time frame: During cycle 1 (each cycle has 28 days)
Phase 2a: Overall Response Rate (Complete Response [CR] or Partial Response [PR])
Tumor assessment by RECIST v1.1 by investigator. Best overall response was used to define the Overall Response Rate (CR or PR). Best overall response is CR or PR if a CR or PR assessed at least 42 days after Cycle 1 Day 1 was confirmed by subsequent tumor assessment at least 4 weeks later.
Time frame: Tumor assessments were conducted during last week of cycle 2, 4, 6, 8, 10, 12 and every 3 cycles thereafter (each cycle has 28 days), up to approximately 97 weeks.
Incidence of Patients With TEAEs
Number of patients with treatment-emergent adverse events (TEAEs) non-serious or serious
Time frame: From first drug administration up to 30 (non-serious TEAEs) or 56 (serious TEAEs) days after last dose AFM24, until start of a subsequent anticancer treatment, or data cut-off date, whichever is sooner. Up to approx. 35 (phase 1) and 105 weeks (phase 2a).
Incidence of Patients With SAEs
Number of patients with treatment-emergent serious adverse events (serious TEAEs)
Time frame: From first drug administration up to 56 days after the last dose of AFM24, until the start of a subsequent anticancer treatment, or data cut-off date, whichever is sooner. Up to approximately 35 (phase 1) and 105 weeks (phase 2a).
Pharmacokinetics (PK) of AFM24
Maximum plasma concentration (Cmax) on Cycle 1 Day 22
Time frame: During cycle 1 (each cycle has 28 days)
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Johns Hopkins University
Baltimore, Maryland, United States
Independent Public Teaching Hospital #4 in Lublin, Department of Clinical Oncology and Chemotherapy
Lublin, Poland
European Health Center Otwock Fryderyk Chopin Hospital, Department of Clinical Oncology
Otwock, Poland
MED-Polonia, Sp. z o.o. (LLC)
Poznan, Poland
Janusz Korczak Provincial Specialist Hospital in Slupsk Limited Liability Company
Słupsk, Poland
Maria Sklodowska-Curie - National Research Institute of Oncology, Early Phase Research Department
Warsaw, Poland
Seoul National University Bundang Hospital
Seongnam-si, South Korea
Severance Hospital, Yonsei University Health System
Seoul, South Korea
...and 6 more locations
Pharmacokinetics (PK) of AFM24
Minimum plasma concentration (Cmin) Corresponding to Ctrough levels at the end of the dosing interval at Cycle 1 Day 22
Time frame: During cycle 1 (each cycle has 28 days)
Pharmacokinetics (PK) of AFM24
Area under the concentration-time curve over the dose interval (AUCtau) on Cycle 1 Day 22
Time frame: During cycle 1 (each cycle has 28 days)
Pharmacokinetics (PK) of AFM24
Time to Cmax (Tmax) on Cycle 1 Day 22
Time frame: During cycle 1 (each cycle has 28 days)
Frequency of Patients Developing Anti-drug Antibodies (ADAs) Against AFM24
Measurement of ADAs before and during treatment with AFM24 in combination with atezolizumab Patients with at least one ADA-positive result at baseline or post-baseline counted as developing anti-drug antibodies (ADAs) against AFM24
Time frame: Ph 1 within 2h prior to: each drug intake (Cycle 1), 1st + 3rd drug intake (Cycle 2 onwards) and at EOT, up to 27 weeks. Ph 2a within 2h prior to: 1st drug intake (Cycle 1 and Cycle 3 onwards), 1st + 3rd drug intake (Cycle 2) and at EOT, up to 97 weeks.
Phase 1: Overall Response Rate (Complete Response [CR] or Partial Response [PR])
Tumor assessment by RECIST v1.1 by investigator. Best overall response was used to define the Overall Response Rate (CR or PR). Best overall response is CR or PR if a CR or PR assessed at least 42 days after Cycle 1 Day 1 was confirmed by subsequent tumor assessment at least 4 weeks later.
Time frame: Tumor assessments were conducted during last week of cycle 2, 4, 6, 8, 10, 12 and every 3 cycles thereafter (each cycle has 28 days), up to approximately 27 weeks.
Phase 2a: Progression-free Survival
Progression-Free Survival (PFS) was defined as (date of first progression - date of first study drug injection)/30.4375. Patients without progression or death were censored. Tumor assessment by RECIST v1.1 by investigator.
Time frame: From the first treatment received until the first progression disease assessed by investigator or death.
Phase 2a: Duration of Response
Duration of Response (DOR) was defined as (date of first progression or death - date of first response (unconfirmed))/30.4375. Patients without response were excluded from the analysis. Patients without progression or death were censored. Tumor assessment by RECIST v1.1 by investigator.
Time frame: From the date of first response (unconfirmed) until progression disease assessed by investigator or death.
Phase 2a: Clinical Benefit Rate (CR or PR [Any Duration] or Stable Disease Equal or > 24 Weeks)
Tumor assessment by RECIST v1.1 by investigator. Best overall response was used to define the Clinical benefit rate (CR or PR or SD ≥24 weeks). Best overall response is CR or PR if a CR or PR assessed at least 42 days after Cycle 1 Day 1 was confirmed by subsequent tumor assessment at least 4 weeks later. Best overall response is SD if SD or unconfirmed CR or unconfirmed PR at least 42 days after C1D1. Best overall response SD counts for Clinical benefit rate if SD ongoing for at least 24 weeks.
Time frame: Tumor assessments were conducted during last week of cycle 2, 4, 6, 8, 10, 12 and every 3 cycles thereafter (each cycle has 28 days), up to approximately 97 weeks.
Phase 2a: Disease Control Rate (DCR) (Complete Response [CR] or Partial Response [PR] or Stable Disease [SD])
Tumor assessment by RECIST v1.1 by investigator. Best overall response was used to define the Disease Control Rate (CR or PR or SD). Best overall response is CR or PR if a CR or PR assessed at least 42 days after Cycle 1 Day 1 was confirmed by subsequent tumor assessment at least 4 weeks later. Best overall response is SD if SD or unconfirmed CR or unconfirmed PR at least 42 days after C1D1.
Time frame: Tumor assessments were conducted during last week of cycle 2, 4, 6, 8, 10, 12 and every 3 cycles thereafter (each cycle has 28 days), up to approximately 97 weeks.