This is a phase 1/phase 2, multicenter, open-label study to evaluate the safety, tolerability, PK, PD, immunogenicity and preliminary efficacy of M701 in patients with treatment of malignant pleural effusions caused by NSCLC.
This study is consisted of two phase, Phase Ib and II: Phase 1b includes dose escalation phase and cohort expansion phase. In dose escalation phase, up to 4 dose-escalation cohorts will be sequentially enrolled with regular "3+3" design. DLTs will be evaluated during the first treatment cycle, which is 28 days. In cohort expansion phase, after the RP2D was identified, participants were enrolled in an open-ended manner. Participants were assigned to groups A(3 injections), B (4 injections)and C(6 injections) on a 1:1:1 basis to evaluate the dose frequency. Phase II:The dose and dosing frequency of M701 drug for the Phase II clinical trial were determined based on a combination of the tolerance1 and efficacy of M701 in the Phase Ib trial. Then the participants were randomly divided into two groups: the test group(M701) and the control group(cisplatin or pleural effusions suctions). The pleural effusions response (ORR) and Puncture Free Survival (PuFS)will be evaluated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
116
M701 pleural infusion on Days 1,4,7 and 10.
Pleural effusion drainage via Ultra-sound guidance on Day 1.
Cisplatin pleural infusion (30-50mg/m2) on Day 1.
Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)
Hangzhou, Zhejiang, China
RECRUITINGDose Limiting Toxicities (DLTs)
Dose limiting toxicities during the first 28 days after the first administrations of study drug in each cohort.
Time frame: From the time of the first dose (Day 1) until the forth dosing (Day 28)
Incidence of AEs
Incidence and severity of AEs, including but not limited to vital signs, physical examination, laboratory tests. All AEs will be classified as Grades 1 through 5 as defined by NCI CTCAE v5.0.
Time frame: From the start of administration to the end of the study or 28 days after the administration is stopped
Puncture-free survival (PuFS)
The time from removing the thoracic drainage tube after last intrapleural infusion to the time when re-drainage is required (based on the time when puncture and drainage occur) or death, whichever occurs first.
Time frame: The time from removing the thoracic drainage tube after last intrapleural infusion to the time when re-drainage is required or death, assessed up to 12 months after enrollment or randomization.
Area under the curve (AUC) of M701
The endpoints for assessment of PK of M701 include serum concentrations of M701 at different timepoints after M701 administration.
Time frame: From the time of first dosing (Day 1) until disease progression or toxicity intolerance(up to 16 days)
Maximum observed concentration (Cmax) of M701
The endpoints for assessment of PK of M701 include serum concentrations of M701 at different timepoints after M701 administration.
Time frame: From the time of first dosing (Day 1) until disease progression or toxicity intolerance(up to 16 days)
Minimum observed concentration (Cmin) of M701
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The endpoints for assessment of PK of M701 include serum concentrations of M701 at different timepoints after M701 administration.
Time frame: From the time of first dosing (Day 1) until disease progression or toxicity intolerance(up to 16 days)
Half-time (t1/2) of M701
Half-time (t1/2) of M701
Time frame: From the time of first dosing (Day 1) until disease progression or toxicity intolerance(up to 16 days)
Anti-drug antibodies(ADAs) titer
The immunogenicity of M701 will be assessed by summarizing the number of subjects who develop detectable anti-drug antibodies (ADAs).
Time frame: From the time of first dosing (Day 1) until disease progression or toxicity intolerance(up to 16 days)
Neutralizing antibody titer
The immunogenicity of M701 will be collected by testing the antibody titer of the neutralizing antibody.
Time frame: From the time of first dosing (Day 1) until disease progression or toxicity intolerance(up to 16 days)
Concentrations of tumor biomarker in pleural effusions
As tumor biomarkers, concentrations of CEA, CyFra21-1, SCC and NSE in malignant pleural effusions will be examined at Day 1 and Day10.
Time frame: From the time of first dosing (Day 1) until disease progression or toxicity intolerance(up to 56 days)
Expression level of EpCAM-positive cells in pleural effusions
The number and expression levels of EpCAM-positive cells in pleural effusions will be measured by pathological methods (including cytospin, immunohistochemical techniques, etc.)
Time frame: From the time of first dosing (Day 1) until disease progression (up to 56 days)
Ratio of EpCAM-positive tumour cell/leucocyte
Ratio of EpCAM positive tumour cell/leucocyte in pleural effusions will be measured by FACS method.
Time frame: From the time of first dosing (Day 1) until disease progression (up to 56 days)
Rate of with successful pleurodesis (4/8 weeks)
the rate of patients with successful pleurodesis at 4 weeks / 8 weeks
Time frame: From the time of first dosing (Day 1) until disease progression (up to 56 days)
Puncture-free survival rate at 8 and 14 weeks after the first intrapleural dose.
Puncture-free survival rate at 8 and 14 weeks after the first intrapleural dose.
Time frame: 8 weeks and 14 weeks following the first dose .
Pleural signs and symptoms
Using the Lister Quadruple Scale to record pleural effusions at 4 weeks/ 8 weeks.
Time frame: From the time of first dosing (Day 1) until disease progression (up to 56 days)
Puncture-free survival (PuFS)
The time from removing the thoracic drainage tube after last intrapleural infusion to the time when re-drainage is required (based on the time when puncture and drainage occur) or death, whichever occurs first.
Time frame: The time from removing the thoracic drainage tube after last intrapleural infusion to the time when re-drainage is required or death, assessed up to 12 months after enrollment or randomization.
Time to Next Puncture (TTNP)
Defined to be the period from the end of the treatment (based on the time when the thoracic drainage tube is removed, the same as the starting time point of PuFS) to the time when the subject requires another thoracic puncture for drainage.
Time frame: The time from removing the thoracic drainage tube after last intrapleural infusion to the time when re-drainage is required, assessed up to 12 months after enrollment or randomization.
Quality of life score
Evaluated according to the EORTC quality of life scale QLQ-C30 (V3.0) and scale QLQ-LC13 (see Appendix 3 for details)
Time frame: From Day 1 (enrollment or randomization) to the end of the study , up to 1 year.