The goal of this first in human clinical trial is to test BI-1910 administered as single agent and in combination with pembrolizumab in subjects with advanced/metastatic solid tumors whose disease has progressed after standard therapy. The main questions it aims to answer are: * how safe and tolerable is BI-1910 * what is maximum tolerated or administrated dose * to determine recommended dose for further clinical trials Participants will receive infusions of BI-1910 alone or combination with pembrolizumab every 3 weeks.
This is a Phase 1/2a, open-label, dose-escalation, multicenter, FIH, consecutive-cohort, clinical trial of BI-1910, as a single agent and in combination with pembrolizumab, in subjects with advanced/metastatic solid tumors whose disease has progressed after standard therapy. The trial comprises 2 phases: a Phase 1 with Parts A and B, and a Phase 2a with Parts A and B. Phase 1 Part A consists of a dose escalation of BI-1910 as a single agent to evaluate safety and tolerability and to determine the RP2D as a single agent (sRP2D) in subjects with advanced/metastatic solid tumors whose disease has progressed after standard therapy. Phase 1 Part B consists of a dose escalation of BI-1910 in combination with pembrolizumab to evaluate the safety and tolerability of the combination treatment and to allow selection of the RP2D for BI-1910 in combination with pembrolizumab (cRP2D) in subjects with advanced/metastatic solid tumors whose disease has progressed after standard therapy. Phase 2a will assess BI-1910 administered as a single agent (Part A) and in combination with pembrolizumab (Part B) at the respective hypothesized RP2D(s) determined in Phase 1. Phase 2a expansion will be conducted in indication specific cohorts of subjects. The aim of the Phase 2a is to urther assess the safety and tolerability of BI-1910 as a single agent (Part A) and in combination with pembrolizumab (Part B), characterize its PK and pharmacodynamics, and assess preliminary antitumor activity by ORR, DoR, and progression-free survival (PFS), as measured by RECIST v1.1 and iRECIST.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
35
BI-1910 administered as a flat-dose IV infusion once every 3 weeks
Pembrolizumab be administered as an IV infusion at its standard flat dose (200 mg) once every 3 weeks prior to the BI-1910 infusion
Rigshospitalet
Copenhagen, Denmark
Universitätsklinikum Essen
Essen, Germany
Hospital HM Nou Delfos
Barcelona, Spain
HM Sanchinarro
Madrid, Spain
Hospital Fundacion Jimenez Diaz
Madrid, Spain
Hospital universitario Virgen del Rocio
Seville, Spain
Lund University Hospital
Lund, Sweden
Karolinska University Hospital, Solna
Stockholm, Sweden
Occurrence of adverse events (AEs)
AEs will be assessed by the investigators by severity and will be graded according to the NCI CTCAE v5.0 or higher and causality between AEs and the exposure to the study treatment.
Time frame: From the start of the study treatment for up to 2 years and 90 days.
Occurrence of serious adverse events (SAEs)
SAEs will be assessed by the investigators by severity and will be graded according to the NCI CTCAE v5.0 or higher and causality between SAEs and the exposure to the study treatment
Time frame: From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Frequency of AEs leading to discontinuation of study treatment
All adverse events leading to premature study treatment discontinuation will be analyzed descriptively utilizing corresponding MedDRA, System Organ Classes, and Preferred Terms.
Time frame: From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Frequency of dose interruptions and dose reductions.
Study treatment modifications will be summarized in 2 categories: dose reduction and dose interruptions. The number and percentage of subjects who have any dose reduction or interruption and have at least 1 dose reduction or interruption will be summarized. Lastly, the primary reason for each form of study treatment modification will also be summarized.
Time frame: From the start of the study treatment for up to 2 years
Changes from baseline in laboratory parameters
These include clinical laboratory assessments (hematology, clinical chemistry, urinalysis), additional CRP assessment, coagulation, thyroid, pregnancy, and viral serology assessments Safety laboratory results will be graded by NCI CTCAE v5.0 (or higher). If no grading exists, values will be classified into low/normal/high based on laboratory normal ranges. Each parameter will be presented by descriptive statistics at each visit, including change from baseline.
Time frame: From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Changes from baseline in temperature (C or F)
Temperature (C or F) will be measured in a seated or supine position after 5 minutes' rest and will be summarized by descriptive statistics at each visit, including change from baseline.
Time frame: From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Changes from baseline in Respiratory Rate (Breaths/Min)
Respiratory rate (breaths/min) will be measured in a seated or supine position after 5 minutes' rest and will be summarized by descriptive statistics at each visit, including change from baseline.
Time frame: From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Changes from baseline in Blood Pressure (mmHg)
Systolic and diastolic blood pressure (mmHg) will be measured in a seated or supine position after 5 minutes' rest and will be summarized by descriptive statistics at each visit, including change from baseline.
Time frame: From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Changes from baseline in O2 Saturation (%)
O2 Saturation (%) will be measured in a seated or supine position after 5 minutes' rest and will be summarized by descriptive statistics at each visit, including change from baseline.
Time frame: From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Changes from baseline in weight
Weight (kg or lb) and body surface area (m2) will be collected at Screening and on each dose day before any study treatment is administered and will be summarized by descriptive statistics at each visit, including change from baseline. Height (cm or in) will be recorded at baseline only
Time frame: From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Occurrence of dose limiting toxicities (DLTs)
All adverse events meeting the DLT criteria will be considered a DLT potentially related to the study treatment, regardless of Investigator/Sponsor causality assessment, excluding toxicities that are clearly related to disease progression or inter-current illness. DLTs will be considered by the safety monitoring committee for the purposes of dosing decisions.
Time frame: During phase 1 Part A: from the first dose of BI-1910 for 21 days. During phase 1 part B: from the first dose of BI-1910 for 42 days.
identification of dose/dose range fulfilling favorable PK and pharmacodynamic profile, with acceptable safety
based on the totality of the efficacy, safety, PK, and pharmacodynamic endpoints
Time frame: During phase 2a from screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Maximum Concentration (Cmax) of BI-1910
Maximum concentration (Cmax), obtained directly from the observed concentration-versus-time data will be determined.
Time frame: From the start of the study treatment for up to 2 years and 90 days.
Serum concentration-time curve [AUC] of BI-1910
Area under the serum concentration-time curve will be determined.
Time frame: From the start of the study treatment for up to 2 years and 90 days.
Terminal half-life (t½) of BI-1910
Terminal half-life will be determined, a minimum of 3 points will be used for estimation
Time frame: From the start of the study treatment for up to 2 years and 90 days.
Recommended dose range (RDR)
RDR is defined as the range between the minimal reproducibly active dose (MRAD), and the MTD or MAD. MRAD is the lowest dose level at which subjects experience tumor shrinkage and/or relevant PK/pharmacodynamic parameters indicate biological activity.
Time frame: During phase 1 From screening for up to 28 days, throughout treatment for up to 2 years and through follow-up for up to 90 days
Incidence and titer of antidrug antibodies (ADAs).
The detection and characterization of antibodies to BI-1910 will be performed. The samples collected will also be evaluated or BI-1910 serum concentration to enable interpretation of the antibody data. Antibodies may be further characterized and/or evaluated for their ability to neutralize the activity of the study treatments.
Time frame: From the start of the study treatment for up to 2 years and 90 days.
Objective response rate (ORR).
Objective response rate based on the best objective response, defined as achieving confirmed CR and/or PR measured by RECIST 1.1 and iRECIST,
Time frame: During phase 2a from from the start of the study treatment for up to 2 years and 30 days
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Duration of response (DoR).
Defined as the time from the first assessment of PR or CR to the follow-up first assessment of PD measured by RECIST 1.1 and iRECIST.
Time frame: During phase 2a from from the start of the study treatment for up to 2 years and 30 days