This study was designed as a Phase 1/randomized Phase 2 open-label study of modified(m) FOLFIRINOX ± BNT321 for adjuvant therapy in pancreatic ductal adenocarcinoma (PDAC) patients post R0 or R1 resection. The Phase 1, dose escalation part of this study was planned to be a limited evaluation of two planned BNT321 dose levels (DLs) in combination with mFOLFIRINOX chemotherapy (24 weeks) followed by BNT321 monotherapy (24 weeks). Following completion of the dose escalation Phase 1 and identification of the recommended Phase 2 dose (RP2D), the study was designed as a 2-arm, randomized Phase 2 of mFOLFIRINOX ± BNT321 to evaluate the efficacy of mFOLFIRINOX + BNT321 versus mFOLFIRINOX alone as adjuvant therapy in PDAC patients post R0 or R1 resection. Treatment cycles were every 2 weeks (14 days).
The Phase 1 part of the study was planned to be a limited dose finding evaluation, whereby a minimal number of BNT321 DLs were planned to be tested for safety and tolerability in combination with mFOLFIRINOX chemotherapy. Dose escalation was planned to be conducted using a 3+3 design, with up to six additional participants treated at the Phase 1 defined combination maximum tolerated dose (MTD). Two BNT321 DLs were initially planned, 0.5 mg/kg and a second DL 2. Following evaluation of safety profile for DL 2, additional BNT321 DLs could have been evaluated following safety data review, discussion, and approval by the safety review committee (SRC), and health authority review and approval. Approximately 20 participants were planned to be enrolled into the Phase 1 part. Following completion of the dose escalation Phase 1 and identification of the RP2D, the study was planned to proceed to a randomized Phase 2 part. For this part, an independent data monitoring committee was planned to be be established prior to the inclusion of the first participant in this phase. The randomized Phase 2 was designed to enroll up to 300 participants to enable a robust statistical evaluation of the study's Phase 2 primary endpoint, i.e., median disease-free survival (mDFS). Additional evaluations for Phase 2 were planned to include determination of combination regimen safety and tolerability, determination of overall survival (OS), pharmacokinetic (PK), and pharmacodynamic (PD) analyses including anti-drug antibody (ADA), complement-dependent cytotoxicity (CDC), antibody-dependent cell-mediated cytotoxicity (ADCC) assessments, cytokine and circulating tumor DNA (ctDNA) assessments. The study was terminated early by the sponsor due to strategic reprioritization and not due to safety concerns. At the time of the termination, only one dose level (i.e., 0.5 mg/kg) of BNT321 was tested.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
1
Intravenous infusion
Intravenous infusion
Intravenous infusion
Intravenous infusion
Valkyrie Clinical Trials
Los Angeles, California, United States
Medical University of South Carolina (MUSC)
Charleston, South Carolina, United States
Phase 1 - The Number and Percentage of Participants With at Least One Dose of Investigational Medicinal Product (IMP) Reporting Treatment Emergent Adverse Events (TEAEs)
TEAEs graded per Common Toxicity Criteria for Adverse Events version 5.0 (CTCAE v5.0), including Grade ≥3, serious, fatal TEAE by relationship.
Time frame: from the start of study drug treatment until the end of study (i.e., 164 days)
Phase 1 - The Number and Percentage of Participants With at Least One Dose of IMP Reporting Occurrence of Dose Limiting Toxicities (DLTs)
For all Phase I cohorts the DLT assessment period was planned to encompass the treatment cycles of the first two consecutive BNT321 doses, i.e., 28 days within treatment Cycles 2 and 3. To be considered a DLT, an AE must have met the following three criteria: * Occurred during the DLT assessment period of BNT321. * Was considered BNT321-related (i.e., definitely related or possibly related). * Occurred in the presence of adequate supportive care (e.g., Grade 3 vomiting despite use of an appropriate anti-emetic regimen). In addition, to be considered a DLT, an AE must have met at least one of the additional criteria using CTCAE v5.0 as specified in the protocol.
Time frame: up to 28 days after first dose of BNT321
Phase 2 - Disease-free Survival (DFS)
DFS was defined as the time from randomization to occurrence of any of the following events, whichever occurs first: * Locoregional recurrence or distant metastases as determined by an independent central radiology assessment. * Occurrence of second primary (same or other) cancer as determined by an independent central radiology assessment. * Death from any cause.
Time frame: up to 60 months
Phase 1 and 2 - OS
OS was defined as the time from first dose of study treatment to death from any cause.
Time frame: up to 60 months
Phase 1 and 2 - Relapsed Free Survival (RFS)
RFS is defined as the time from randomization to occurrence of any of the following events, whichever occurs first: * Locoregional recurrence or distant metastasis as determined by the investigator. * Death from any cause.
Time frame: up to 60 months
Phase 1 and 2 - PK Assessments: Mean Area Under the Curve (AUC) Values Derived From Serum Concentration of IMP
Mean AUC from participants who are dosed with at least one dose of IMP and who have evaluable PK data in Cycles 2 and 3 followed by sparse sampling through end of study (EOT).
Time frame: up to 48 weeks
Phase 1 and 2 - PK Assessments: Mean Observed Maximum Concentration (Cmax) Derived From Serum Concentration of IMP
Mean Cmax from participants who are dosed with at least one dose of IMP and who have evaluable PK data in Cycles 2 and 3 followed by sparse sampling through EOT.
Time frame: up to 48 weeks
Phase 1 and 2 - PK Assessments: Median Time to Reach Cmax (Tmax) Derived From Serum Concentration of IMP
Median tmax from participants who are dosed with at least one dose of IMP and who have evaluable PK data in Cycles 2 and 3 followed by sparse sampling through EOT.
Time frame: up to 48 weeks
Phase 1 and 2 - Percentage of Participants With Detectable Anti-drug Antibody (ADA)
Percentage of participants who are dosed with at least one dose of IMP and with detectable ADA formation in Cycles 1 and 3, followed by sparse sampling through EOT
Time frame: up to 48 weeks
Phase 1 and 2 - Percentage of Participants With Detectable and Durable ADCC and/or CDC Activity
Percentage of participants who are dosed with at least one dose of IMP with detectable and durable (measurable throughout time on study) ADCC and/or CDC activity in Cycles 2 and 4, followed by sparse sampling through EOT
Time frame: up to 48 weeks
Phase 1 and 2 - Change From Baseline for Participant-reported Health-related Quality of Life (HRQoL) Using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30)
Change from baseline at end of Cycle 12 for participant-reported HRQoL using EORTC QLQ-C30
Time frame: up to 60 months
Phase 1 and 2 - Change From Baseline for Participant-reported HRQoL Using EORTC Quality of Life Questionnaire for Pancreatic Cancer (QLQ-Pan26) Questionnaires
Change from baseline at end of Cycle 12 for participant-reported HRQoL using EORTC QLQ-Pan26 questionnaires
Time frame: up to 60 months
Phase 1 and 2 - Change From Baseline in Combined Item Scores From EORTC QLQ-C30
Change from baseline at end of Cycle 12 in combined item scores from EORTC QLQ-C30
Time frame: up to 60 months
Phase 1 and 2 - Change From Baseline in Combined Item Scores From EORTC QLQ-Pan26
Change from baseline at end of Cycle 12 in combined item scores from EORTC QLQ-Pan26.
Time frame: up to 60 months
Phase 2 - Occurrence of TEAEs Including Grade ≥3, Serious, Fatal TEAE by Relationship
Time frame: up to 12 months
Phase 2 - Occurrence of Dose Reduction and Discontinuation of IMP Due to TEAE
Occurrence within a participant.
Time frame: up to 12 months
Phase 2 - Occurrence of Abnormal Laboratory Parameters
Occurrence within a participant.
Time frame: up to 48 weeks
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