This is an Open-label, Phase 1b/2 Study of the Pressure-Enabled Hepatic Artery Infusion (HAI) of SD-101, a TLR9 agonist, Alone or in Combination with Intravenous Checkpoint Blockade in Adults with Hepatocellular Carcinoma (HCC) and Intrahepatic Cholangiocarcinoma (ICC).
All patients will receive 2 cycles of SD-101. Each cycle consists of 3 consecutive weekly infusions and Cycles 1 and 2 are separated by one month. Escalating doses of SD-101 will be administered alone (Cohort A), together with pembrolizumab (Cohort B), and together with combined ipilimumab and nivolumab (Cohort C). Cohort B will begin dosing at the minimum anticipated biological effect level (MABEL (2mg SD-101)). Cohort C will begin one dose level below the MTD or optimal dose from Cohort B to optimize safety when adding CPI to SD-101. Following determination of the recommended MTD or optimal dose of SD-101 and which checkpoint inhibitor (CPI) regimen(s) are tolerated, the study will progress to Phase 2. Patients in Phase 2 will receive the SD-101 dose selected from Phase 1b together with systemic single- or double-agent checkpoint blockade. The choice of single- or double-agent CPI therapy together with SD-101 for Phase 2 will consider safety data in addition to response rates from Cohorts B and C in Phase 1b.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
23
SD-101 doses will be delivered via HAI using the PEDD method of administration.
During Phase 1b, Cohort B, pembrolizumab will be administered together with SD-101.
During Phase 1b, Cohort C, nivolumab will be administered together with ipilimumab and SD-101.
University of Colorado
Aurora, Colorado, United States
Columbia University
New York, New York, United States
Rhode Island Hospital
Providence, Rhode Island, United States
MD Anderson Cancer Center
Houston, Texas, United States
Phase 1b: To Determine the Safety of SD-101 Alone, in Combination with Pembrolizumab, and in Combination with Nivolumab and Ipilimumab
As a measure of safety, adverse events will be graded according to CTCAE v5.0.
Time frame: 12 months
Phase 1b: To Determine the Maximum Tolerable Dose (MTD) or Optimal Dose of SD-101 alone, in Combination with Pembrolizumab, and in Combination with Nivolumab and Ipilimumab
A standard 3+3 dose-escalation design will be employed to determine the MTD or optimal dose.
Time frame: 12 months
Phase 2: To Assess Overall Response Rate (ORR)
As a measure of activity, ORR will be assessed. ORR will be assessed using Response Evaluation Criteria in Solid Tumours (RECIST) v1.1.
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of iRECIST for Immune Based Therapeutics
As a measure of activity, iRECIST will be utilized to determine ORR.
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of modified RECIST (mRECIST) for Immune Based Therapeutics
As a measure of activity, mRECIST will be utilized to determine ORR.
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
As a measure of activity, RECIST 1.1 will be utilized to determine hepatic-specific response rate (HRR).
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
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During Phase 1b, Cohort C, ipilimumab will be administered together with nivolumab and SD-101.
As a measure of activity, RECIST 1.1 will be utilized to determine overall progression-free survival (PFS).
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
As a measure of activity, RECIST 1.1 will be utilized to determine clinical benefit (complete response \[CR\] + partial response \[PR\] + stable disease \[SD\]).
Time frame: 12 months
Phase 2: To Assess Treatment-Emergent Adverse Events of the Chosen MTD or Optimal Dose of SD-101 in Combination with CPI
As a measure of safety, adverse events will be graded according to CTCAE v5.0.
Time frame: 6 months
Phase 2: Assess Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
As a measure of activity, RECIST 1.1 will be utilized to determine duration of response (DOR).
Time frame: 12 months
Phase 2: To Assess Overall Survival (OS)
As a measure of activity, OS will be assessed. The events for the assessment of 12-month OS are death events.
Time frame: 12 months