This phase I/II trial tests the safety, side effects, and effectiveness of axatilimab in combination with retifanlimab and paclitaxel for the treatment of patients with a solid tumor that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced) or that has spread from where it first started (primary site) to other places in the body (metastatic). Axatilimab is a monoclonal antibody that may interfere with the ability of tumor cells to grow and spread. Immunotherapy with monoclonal antibodies, such as retifanlimab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Paclitaxel is in a class of medications called antimicrotubule agents. It stops cancer cells from growing and dividing and may kill them. Giving axatilimab in combination with retifanlimab and paclitaxel may be safe, tolerable and/or effective in treating patients with advanced or metastatic solid tumors.
PRIMARY OBJECTIVES: I. Phase Ib: Determine the safety and tolerability of the combination of axatilimab, retifanlimab, and paclitaxel in patients with advanced solid tumors. II. Phase II: Determine the efficacy of the combination of axatilimab, retifanlimab, and paclitaxel in patients with advanced solid tumors. SECONDARY OBJECTIVES: I. Determine the safety and tolerability of the combination of axatilimab, retifanlimab, and paclitaxel in patients with advanced solid tumors treated in phase II. II. Explore treatment related changes in the tumor microenvironment (TME) following treatment with the combination of axatilimab, retifanlimab, and paclitaxel in advanced solid tumors. III. Assess predictive biomarkers of response in peripheral blood. OUTLINE: Patients receive axatilimab intravenously (IV) over 30 minutes on day -8, prior to cycle 1. Beginning in cycle 1 day 1, patients receive axatilimab IV over 30 minutes on days 8 and 22 of each cycle, retifanlimab IV over 30-60 minutes on day 1 of each cycle, and paclitaxel IV over 60 minutes on days 1, 8, and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo tumor biopsy, computed tomography (CT) scan, and blood sample collection throughout the study and may undergo magnetic resonance imaging (MRI) and/or positron emission tomography (PET) scan throughout the study. After completion of study treatment, patients are followed up at 30 and 90 days.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
38
Given IV
Undergo tumor biopsy
Undergo blood sample collection
Undergo CT scan
Undergo MRI
Given IV
Undergo PET scan
Given IV
OHSU Knight Cancer Institute
Portland, Oregon, United States
RECRUITINGIncidence of dose limiting toxicities (phase Ib)
Will be coded by system organ class, MedDRA preferred term, and severity grade using Common Terminology Criteria for Adverse Events (version 5.0).
Time frame: From the first dose of axatilimab (day -8) to the end of cycle 1 (cycle is 28 days starting from cycle 1 day 1 [first dose of retifanlimab and paclitaxel])
Recommended phase 2 dose of the study drug combination (phase Ib)
Time frame: From the first dose of axatilimab (day -8) to the end of cycle 1 (cycle is 28 days starting from cycle 1 day 1 [first dose of retifanlimab and paclitaxel])
Clinical benefit rate (phase Ib/II)
Defined as percentage of participants with complete response or partial response confirmed by scans at least 4 weeks apart, or stable disease for \> 4 months. Will be reported with exact 95% confidence interval.
Time frame: From screening assessment to the end of cycle 6 assessment (each cycle is 28 days starting from cycle 1 day 1 [first dose of retifanlimab and paclitaxel])
Incidence of ≥ grade 3 toxicities possibly or definitely related to study drugs
Will be categorized and tabulated for reporting. The analyses for reporting may include descriptive statistical analyses of the overall set of phase II adverse events.
Time frame: From the first dose of axatilimab (day -8) to 90 days after the end of treatment visit (an average of 6 months)
Changes in immune cell composition and functionality
Will be characterized in peripheral blood using flow cytometry (FC) and candidate protein biomarkers will be identified in tumor tissue using multiplexed immunohistochemistry. Changes in immune cell composition and functionality at the biopsy during cycle 2 will be assessed by paired t-test.
Time frame: From screening until cycle 2 day 1 biopsy (each cycle is 28 days starting from cycle 1 day 1 [first dose of retifanlimab and paclitaxel])
Change in immune cell population
To assess predictive biomarkers of response in peripheral blood, changes in immune cell populations in peripheral blood, including reduced presence of CD14dimCD16+ monocytes and increased presence of CD8+ T effector memory subsets, at the end of the study between responders and non-responders will be assessed using repeated measures of analysis of covariance over time to accommodate a longitudinal nature of peripheral blood draws for flow cytometry.
Time frame: From screening to end of treatment visit (an average of 6 months)
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