This phase Ib/II trial studies the side effects and best dose of EMB-01 when given together with osimertinib in patients with EGFR-mutant non-small cell lung cancer that has spread to other places in the body (advanced or metastatic) and has progressed on standard treatment. EMB-01 and osimertinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth in this type of cancer. EMB-01 in combination with osimertinib may work better in treating patients with EGFR-mutant advanced non-small cell lung cancer.
PRIMARY OBJECTIVES: I. To evaluate the maximum tolerated dose (MTD) and to establish the recommended phase II dose (RP2D) of EMB-01 given in combination with osimertinib in patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC). (Phase Ib) II. To preliminarily assess efficacy and further evaluate the safety and tolerability of EMB-01 plus osimertinib at the RP2D in advanced EGFR-mutant NSCLC patients who progressed on prior EGFR tyrosine kinase inhibitor (TKI) treatment. The primary endpoint is objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. (Phase II) SECONDARY OBJECTIVES: I. To assess the pharmacokinetics (PK) of EMB-01 and osimertinib. II. To assess the immunogenicity of EMB-01 and osimertinib. III. To evaluate preliminary antitumor activity of EMB-01 and osimertinib. (Phase I) IV. To continue to evaluate the antitumor activity of EMB-01 and osimertinib such as progression free survival, best overall response, duration of response, and clinical benefit rate. (Phase II) EXPLORATORY OBJECTIVES: I. To explore the relationships between pharmacokinetics, biomarkers, adverse event profiles, and anticancer activity of EMB-01 combined with osimertinib. OUTLINE: This is a phase Ib, dose-escalation study of EMB-01 and osimertinib followed by a phase II study. Patients receive EMB-01 intravenously (IV) weekly. Patients also receive osimertinib orally (PO) once daily (QD) on days 1-28. Treatment cycles repeat every 28 days for 2 years in the absence of disease progression or unacceptable toxicity. After the completion of study treatment, patients are followed up at 30 days and then every 3 months thereafter.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
115
EMB-01 is a bispecific antibody against epidermal growth factor receptor (EGFR) and the receptor tyrosine kinase Met (cMET).
Osimertinib is an approved, third-generation EGFR tyrosine kinase inhibitor
Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine
Orange, California, United States
Dana-Farber Cancer Institute
Boston, Massachusetts, United States
Guangdong Provincial People's Hospital
Guangzhou, Guangdong, China
Maximum tolerated dose (MTD) of EMB-01 and osimertinib (Phase Ib only)
Time frame: Up to 28 days
Rate of Adverse Events (AE) and Serious Adverse Events (SAE)
Adverse events and serious adverse events as assessed by CTCAE v5.0
Time frame: From enrollment up to 30 days after the last dose
Recommended phase II dose (RP2D) of EMB-01 and osimertinib (Phase Ib)
Time frame: Up to 28 days
Objective Response Rate (ORR) (Phase II only)
Objective response rate, measured by RECIST 1.1
Time frame: From first dose until the date of first documented progression or date of death from any cause, whichever comes first, up to 2 years
Best Overall Response (BOR)
Best overall response as assessed by RECIST v1.1
Time frame: From first dose until the date of first documented progression or date of death from any cause, whichever comes first; up to 2 years
Duration of Response (DoR)
Duration of response as assessed by RECIST v1.1
Time frame: From first dose until the date of first documented progression or date of death from any cause, whichever comes first; up to 2 years
Clinical Benefit Rate (CBR)
Clinical benefit rate as assessed by RECIST v1.1
Time frame: From first dose until the date of first documented progression or date of death from any cause, whichever comes first; up to 2 years
Progression Free Survival (PFS)
Progression free survival as assessed by RECIST v1.1
Time frame: From first dose until the date of first documented progression or date of death from any cause, whichever comes first; up to 2 years
Cmax
Maximum measured plasma concentration of EMB-01
Time frame: From predose up to 3 months after first dose
Tmax
Time to maximum plasma concentration
Time frame: From predose up to 30 days after the last dose
Ctrough
Minimum serum concentration
Time frame: From predose up to 30 days after the last dose
Immunogenicity profile of EMB-01
Blood samples will be collected from patients post-treatment for assessment of the presence of anti-drug antibodies and neutralizing antibodies.
Time frame: From predose up to 30 days after the last dose
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