This is a Phase 1, open-label, dose escalation and expansion study of MT-8421 (an Engineered Toxin Body (ETB)) as monotherapy and in combination with nivolumab in patients with selected advanced solid cancer types. MT-8421 is an investigational drug that specifically targets and depletes cytotoxic T-lymphocytes-associated protein 4 (CTLA-4) expressing cells in an effort to directly dismantle the tumor microenvironment for the treatment of patients with advanced solid tumors.
This study is conducted in two parts. The study will enroll up to 200 total participants (up to 40 in Part A and up to 160 in Part B). Part A (Dose Escalation) is designed to estimate the maximum tolerated dose (MTD) of MT-8421 as monotherapy and in combination with nivolumab. Part B (Dose Expansion) is designed to identify the dose(s) to be studied in Phase 2. The drug being tested in this study is called MT-8421. The study will evaluate safety, tolerability, efficacy, pharmacokinetics, pharmacodynamics, and immunogenicity of MT-8421 as monotherapy and in combination with nivolumab in patients with selected advanced solid cancer types. MT-8421 will be given as an intravenous (IV) infusion on Days 1, 8, 15, and 22 of a 28-day cycle. H1 and H2 blockers and anti-pyretics will be given to all patients as pre-medication prior to each dose in Cycle 1. Anti-pyretics will be required for 24 hours after the first dose in Cycle 1. Use of pre-medication will be at the discretion of the Investigator for subsequent doses. In Parts A and B, a subject may participate for the following three (3) periods: * Screening Period- up to 28 days before the first dose of MT-8421 * Treatment Period- active period where a subject will receive doses of MT-8421 over a 28-day treatment period. * Follow-up Period- up to 24 months after the second short term follow up visit. In both parts of the study, participants can receive MT-8421 until their cancer worsens, side effects prevent further study treatment, or until the participant leaves the study for other reasons decided by the participant, the study doctor, or the sponsor of the study. After the second short term follow up visit participants will have a check -up of their disease every 12 weeks for 24 months. The overall duration of the study will vary for each participant because study treatment will continue until unacceptable toxicity, withdrawal of consent, death, termination of the study by the sponsor, or fulfilment of another discontinuation criterion.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
15
The Angeles Clinic
Los Angeles, California, United States
Horizon Oncology Research, LLC
Lafayette, Indiana, United States
Washington University in St. Louis
St Louis, Missouri, United States
Weill Cornell Medicine
New York, New York, United States
NEXT Oncology
Fairfax, Virginia, United States
Number of participants with Adverse Events
Evaluation of safety and tolerability of MT-8421 as measured by number of participants with Adverse Events, dose limiting toxicities (DLTs), abnormal physical exam findings, abnormal laboratory test results, abnormal radiographic findings, and/or patient reported symptoms
Time frame: 28 day cycle
To confirm the recommended Phase 2 dose (RP2D) of MT-8421 as monotherapy and in combination with nivolumab in patients with selected advanced solid tumor types.
Incidence of AEs
Time frame: 28 day cycle
Proportion of participants with objective response
Objective response rate (ORR) defined as the proportion of participants with either a complete response or a partial response as determined by investigator assessment using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
Time frame: Up to two years (Part B)
Objective response rate to assess preliminary efficacy
Objective response rate (ORR) defined as the proportion of participants with either a complete response or a partial response as determined by investigator assessment using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
Time frame: Up to two years (Parts A)
Duration of response to assess preliminary efficacy
Duration of response defined for participants with confirmed complete response or partial response as the time from the first documented tumor response to the date of radiographic progression progressive disease per RECIST v1.1
Time frame: Up to two years (Parts A)
Time to response to assess preliminary efficacy
Time to response defined as the time from the date of the first dose of the study treatment to the date of the first documentation of response (partial response or better) per RECIST v1.1
Time frame: Up to two years (Parts A)
Progression-free survival to assess preliminary efficacy
Progression free survival defined as the time from the start of treatment with MT-8421 to the date of radiographic progressive disease per RECIST v1.1 or death from any cause, not including clinical progression
Time frame: Up to two years (Parts A)
Disease control rate to assess preliminary efficacy
Disease control rate defined as proportion of patients who have achieved complete response, partial response and stable disease
Time frame: Up to two years (Parts A)
Characterize the pharmacokinetic (PK) profile of MT-8421 given as monotherapy and in combination with nivolumab in patients with selected advanced solid tumor types
Maximum observed plasma concentration (Cmax)
Time frame: Up to two years (Parts A)
Characterize the pharmacokinetic (PK) profile of MT-8421 given as monotherapy and in combination with nivolumab in patients with selected advanced solid tumor types
Half-life (t1/2)
Time frame: Up to two years (Parts A and B)
Characterize the pharmacokinetic (PK) profile of MT-8421 given as monotherapy and in combination with nivolumab in patients with selected advanced solid tumor types
Area under the concentration-time curve (AUC) from time zero to the last measurable concentration (AUC0-t), total exposure (AUC0-∞)
Time frame: Up to two years (Parts A and B)
Characterize the pharmacokinetic (PK) profile of MT-8421 given as monotherapy and in combination with nivolumab in patients with selected advanced solid tumor types
Clearance (CL)
Time frame: Up to two years (Parts A and B)
Characterize the pharmacokinetic (PK) profile of MT-8421 given as monotherapy and in combination with nivolumab in patients with selected advanced solid tumor types
Volume of distribution at steady-state (Vss)
Time frame: Up to two years (Parts A and B)
Evaluate the immunogenicity of MT-8421 in patients with selected advanced solid tumors.
Anti-drug antibodies (ADA), Neutralizing antibodies (NAb)
Time frame: Up to two years (Parts A and B)
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