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Development of new treatments for diseases such as multiple myeloma is a focus for research. The research being conducted is on treatment called Anti-KIR (1-7F9), which activates the body's own cells to kill tumor cells. This is different from many other treatments where chemicals are given to kill tumor cells. The purpose of the study is to determine a safe dose of Anti-KIR (1-7F9) to administer in humans and to gain information about its effectiveness in the treatment of multiple myeloma.
Trial Design:
The trial is an open-label, dose-escalation trial to determine the safety and tolerability of Anti-KIR (1-7F9) in subjects with relapsed or refractory multiple myeloma (RRMM). A 3+3 design will be employed for the first dosing cycle at each dose level. The 7 planned dose levels are 0.0003 mg/kg, 0.003 mg/kg, 0.015 mg/kg, 0.075 mg/kg, 0.3 mg/kg, 1.0 mg/kg and 3.0 mg/kg. The subjects will receive up to a total of 4 administrations of Anti-KIR (1-7F9) with a dosing interval between each administration of 4 weeks. Safety, toxicity, PK (pharmacokinetic) and PD (pharmacodynamic) obtained in the first 4 weeks after dosing per group will be the basis for dose-escalation decisions. There will be follow-up visits every week the one month after the first administration and every two weeks following the second, third and fourth administrations. After the last administration there will be follow-up visits every month until KIR occupancy is no longer detected.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Anti-KIR (1-7F9) | Drug | human monoclonal antibody |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose (MTD) of IPH2101 as Determined by Number of Participants With Dose-Limiting Toxicities (DLTs) Related to IPH2101 Treatment | The maximum tolerated dose (MTD) is the highest dose level below the maximum administered dose (MAD) where none or 1 out of 6 subjects have a DLT. | From start of the treatment to end of study |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Plasma Concentration (Cmax) of IPH2101 After Cycle 1 Administration | Cmax was obtained from the plasma concentration versus time data after IV administration of IPH2101. | Anti-KIR (1-7F9) concentrations were measured prior to infusion at 0.167, 1, 3, 6, 12 and 24 hours and then on Days 7, 14 and 21 after the start of the first dose administration |
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Inclusion Criteria:
3a. One prior therapy for multiple myeloma, Measurable disease, as defined by persistent presence of serum and/or urine monoclonal protein or abnormal serum free light chain ratio following the prior treatment.
a. Only for the last seven patients enrolled into the cohort 7 or Maximal Tolerated Dose (MTD).
4. Full recovery from acute toxicities of prior anti-MM therapies. 5. Peripheral blood (Natural Killer) NK cells (Absolute CD16, 56)≥ 0.05 x 109/L (50/mm3) 6. Detectable binding of Anti-KIR (1-7F9) to subject NK cells 7. Age ≥ 18 years 8. Eastern Cooperative Oncology Group (ECOG) performance status of 0,1 or 2 9. Clinical laboratory values at screening:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sherif Farag, MD, PhD | Indiana University | Principal Investigator |
| Don Benson, Jr., MD, PhD | Division of Haematology/Oncology - Ohio State University | Principal Investigator |
| Swaminathan Padmanabhan, MD | CTRC Institute for Drug Development - University of Texas at San Antonio | Principal Investigator |
| Sundar Jagannath, MD | Mount Sinai Hospital, New York | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Indiana University Cancer Center | Indianapolis | Indiana | 46202 | United States | ||
| Mont Sinai Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23033266 | Derived | Benson DM Jr, Hofmeister CC, Padmanabhan S, Suvannasankha A, Jagannath S, Abonour R, Bakan C, Andre P, Efebera Y, Tiollier J, Caligiuri MA, Farag SS. A phase 1 trial of the anti-KIR antibody IPH2101 in patients with relapsed/refractory multiple myeloma. Blood. 2012 Nov 22;120(22):4324-33. doi: 10.1182/blood-2012-06-438028. Epub 2012 Oct 1. |
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32 subjects were enrolled and 21 subjects were screen failures
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| ID | Title | Description |
|---|---|---|
| FG000 | 0.0003 mg/kg | 3+3 design was employed for the first dosing cycle at each dose level. The 7 dose levels were 0.0003 mg/kg, 0.003 mg/kg, 0.015 mg/kg, 0.075 mg/kg, 0.3 mg/kg, 1.0 mg/kg, and 3.0 mg/kg. The subjects received up to a total of 4 administrations of Anti-KIR (1-7F9) with a dosing interval between each administration of 4 weeks. |
| FG001 | 0.003 mg/kg | |
| FG002 | 0.015 mg/kg | |
| FG003 | 0.075 mg/kg | |
| FG004 | 0.3 mg/kg | |
| FG005 | 1 mg/kg | |
| FG006 | 3 mg/kg |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | 0.0003 mg/kg | |
| BG001 | 0.003 mg/kg | |
| BG002 | 0.015 mg/kg |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Maximum Tolerated Dose (MTD) of IPH2101 as Determined by Number of Participants With Dose-Limiting Toxicities (DLTs) Related to IPH2101 Treatment | The maximum tolerated dose (MTD) is the highest dose level below the maximum administered dose (MAD) where none or 1 out of 6 subjects have a DLT. | All treated participants who received at least one dose of the study drug and were evaluable for DLT | Posted | Number | Number of participants with DLT | From start of the treatment to end of study |
|
Adverse events were collected from screening and until the end of study at each study visit. Maximal study duration according to dose level was 4 to 9 months.
All participants who received at least one dose of the study drug (safety population).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 0.0003 mg/kg | 3+3 design was employed for the first dosing cycle at each dose level. The 7 dose levels were 0.0003 mg/kg, 0.003 mg/kg, 0.015 mg/kg, 0.075 mg/kg, 0.3 mg/kg, 1.0 mg/kg, and 3.0 mg/kg. The subjects received up to a total of 4 administrations of Anti-KIR (1-7F9) with a dosing interval between each administration of 4 weeks. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headeache | Nervous system disorders | MedDRA 11.1 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| fatigue | General disorders | MedDRA 11.1 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Renaud Buffet Senior Director, Clinical Development and Translational Research | Innate Pharma | +33430303032 | renaud.buffet@innate-pharma.fr |
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| ID | Term |
|---|---|
| D009101 | Multiple Myeloma |
| ID | Term |
|---|---|
| D054219 | Neoplasms, Plasma Cell |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D020141 | Hemostatic Disorders |
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| ID | Term |
|---|---|
| C558235 | IPH-2101 |
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| Area Under the Plasma-concentration-time Curve [AUC (INF)] of IPH2101 After Cycle 1 Administration | AUC(INF), area under the plasma concentration-time curve from zero to the last time of the last quantifiable concentration within the dosing interval was calculated for Cycle 1. | Anti-KIR (1-7F9) concentrations were measured prior to infusion at 0.167, 1, 3, 6, 12 and 24 hours and then on Days 7, 14 and 21 after the start of the first dose administration |
| Number of Evaluable Patients With Stable Disease. "Evaluable" is Defined as 2 Consecutive M Protein Assessments | Disease Response Assessment by Principal Investigator and Sponsor(Efficacy Population).Stable Disease was defined as not meeting criteria for complete response, very good partial response, partial response, or progressive disease | From start of the treatment to end of study or disease progression |
| New York |
| New York |
| 10029 |
| United States |
| Ohio State University Medical Center | Columbus | Ohio | 43210 | United States |
| Cancer Therapy Research Center at UTHSCSA | San Antonio | Texas | 78229-4427 | United States |
| BG003 | 0.075 mg/kg |
| BG004 | 0.3 mg/kg |
| BG005 | 1 mg/kg |
| BG006 | 3 mg/kg |
| BG007 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG001 | IPH2101 0.003 mg/kg | Participants were administered an IV dose of 0.003 mg/kg IPH2101 every 4 weeks for 4 cycles. Initially, 3 participants were treated at one dose level. If no dose limiting toxicity (DLT) was observed, the dose was escalated to next higher level. If a DLT was observed among 1 of 3 treated participants in the first course at a dose level, 3 participants were additionally enrolled and treated at the same dose level. If no further DLT was observed during the first course in these additional participants, the dose was escalated to next higher dose level. |
| OG002 | IPH2101 0.015 mg/kg | Participants were administered an IV dose of 0.015 mg/kg IPH2101 every 4 weeks for 4 cycles. Initially, 3 participants were treated at one dose level. If no dose limiting toxicity (DLT) was observed, the dose was escalated to next higher level. If a DLT was observed among 1 of 3 treated participants in the first course at a dose level, 3 participants were additionally enrolled and treated at the same dose level. If no further DLT was observed during the first course in these additional participants, the dose was escalated to next higher dose level. |
| OG003 | IPH2101 0.075 mg/kg | Participants were administered an IV dose of 0.075 mg/kg IPH2101 every 4 weeks for 4 cycles. Initially, 3 participants were treated at one dose level. If no dose limiting toxicity (DLT) was observed, the dose was escalated to next higher level. If a DLT was observed among 1 of 3 treated participants in the first course at a dose level, 3 participants were additionally enrolled and treated at the same dose level. If no further DLT was observed during the first course in these additional participants, the dose was escalated to next higher dose level. |
| OG004 | IPH2101 0.3mg/kg | Participants were administered an IV dose of 0.3mg/kg IPH2101 every 4 weeks for 4 cycles. Initially, 3 participants were treated at one dose level. If no dose limiting toxicity (DLT) was observed, the dose was escalated to next higher level. If a DLT was observed among 1 of 3 treated participants in the first course at a dose level, 3 participants were additionally enrolled and treated at the same dose level. If no further DLT was observed during the first course in these additional participants, the dose was escalated to next higher dose level. |
| OG005 | IPH2101 1mg/kg | Participants were administered an IV dose of 1 mg/kg IPH2101 every 4 weeks for 4 cycles. Initially, 3 participants were treated at one dose level. If no dose limiting toxicity (DLT) was observed, the dose was escalated to next higher level. If a DLT was observed among 1 of 3 treated participants in the first course at a dose level, 3 participants were additionally enrolled and treated at the same dose level. If no further DLT was observed during the first course in these additional participants, the dose was escalated to next higher dose level. |
| OG006 | IPH2101 3 mg/kg | Participants were administered an IV dose of 3mg/kg IPH2101 every 4 weeks for 4 cycles. Initially, 3 participants were treated at one dose level.If MTD this is not reached at 3mg/kg, 7 subjects will be enrolled at this dose to obtain more data from a larger subject pool to better evaluate safety, PK, PD and signs of efficacy. |
|
|
| Secondary | Maximum Plasma Concentration (Cmax) of IPH2101 After Cycle 1 Administration | Cmax was obtained from the plasma concentration versus time data after IV administration of IPH2101. | Posted | Geometric Mean | Geometric Coefficient of Variation | ng/mL | Anti-KIR (1-7F9) concentrations were measured prior to infusion at 0.167, 1, 3, 6, 12 and 24 hours and then on Days 7, 14 and 21 after the start of the first dose administration |
|
|
|
| Secondary | Area Under the Plasma-concentration-time Curve [AUC (INF)] of IPH2101 After Cycle 1 Administration | AUC(INF), area under the plasma concentration-time curve from zero to the last time of the last quantifiable concentration within the dosing interval was calculated for Cycle 1. | Posted | Geometric Mean | Geometric Coefficient of Variation | ng*hours/ml | Anti-KIR (1-7F9) concentrations were measured prior to infusion at 0.167, 1, 3, 6, 12 and 24 hours and then on Days 7, 14 and 21 after the start of the first dose administration |
|
|
|
| Secondary | Number of Evaluable Patients With Stable Disease. "Evaluable" is Defined as 2 Consecutive M Protein Assessments | Disease Response Assessment by Principal Investigator and Sponsor(Efficacy Population).Stable Disease was defined as not meeting criteria for complete response, very good partial response, partial response, or progressive disease | Posted | Number | Number of participants | From start of the treatment to end of study or disease progression |
|
|
|
| 1 |
| 4 |
| 4 |
| 4 |
| EG001 | 0.003 mg/kg | 0 | 3 | 3 | 3 |
| EG002 | 0.015 mg/kg | 0 | 3 | 3 | 3 |
| EG003 | 0.075 mg/kg | 5 | 6 | 6 | 6 |
| EG004 | 0.3 mg/kg | 0 | 3 | 3 | 3 |
| EG005 | 1 mg/kg | 0 | 3 | 3 | 3 |
| EG006 | 3 mg/kg | 3 | 10 | 10 | 10 |
| Non cardiac chest pain | General disorders | MedDRA 11.1 | Systematic Assessment |
|
| Infection | Infections and infestations | MedDRA 11.1 | Systematic Assessment |
|
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| Decreased platelets | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| Acute Renal failure | Renal and urinary disorders | MedDRA 11.1 | Systematic Assessment |
|
| Increased creatinine | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| progression of disease | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 11.1 | Systematic Assessment |
|
| worsening back pain | Musculoskeletal and connective tissue disorders | MedDRA 11.1 | Systematic Assessment |
|
| worsening nausea | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| Dehydration | Metabolism and nutrition disorders | MedDRA 11.1 | Systematic Assessment |
|
| Pneumonia | Infections and infestations | MedDRA 11.1 | Systematic Assessment |
|
| Streptococcal pneumonia | Infections and infestations | MedDRA 11.1 | Systematic Assessment |
|
| infection with grade 4 neutrophil | Infections and infestations | MedDRA 11.1 | Systematic Assessment |
|
| elevated creatinine | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| chills | General disorders | MedDRA 11.1 | Systematic Assessment |
|
| Non Cardiac chest pain | General disorders | MedDRA 11.1 | Systematic Assessment |
|
| pyrexia | General disorders | MedDRA 11.1 | Systematic Assessment |
|
| edema peripheral | General disorders | MedDRA 11.1 | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| vomiting | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| upper respiratory tract infection | Infections and infestations | MedDRA 11.1 | Systematic Assessment |
|
| Pneumonia | Infections and infestations | MedDRA 11.1 | Systematic Assessment |
|
| Sinusitis | Infections and infestations | MedDRA 11.1 | Systematic Assessment |
|
| Urinary tract infection | Infections and infestations | MedDRA 11.1 | Systematic Assessment |
|
| hemoglobin decreased | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| neutrophil count decreased | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| blood creatinin increased | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| lymphocyte count decreased | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| platelet count decreased | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| white blood cell count decreased | Investigations | MedDRA 11.1 | Systematic Assessment |
|
| hyponatremia | Metabolism and nutrition disorders | MedDRA 11.1 | Systematic Assessment |
|
| anorexia | Metabolism and nutrition disorders | MedDRA 11.1 | Systematic Assessment |
|
| dehydration | Metabolism and nutrition disorders | MedDRA 11.1 | Systematic Assessment |
|
| hyperglycemia | Metabolism and nutrition disorders | MedDRA 11.1 | Systematic Assessment |
|
| hypocalcemia | Metabolism and nutrition disorders | MedDRA 11.1 | Systematic Assessment |
|
| cough | Respiratory, thoracic and mediastinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA 11.1 | Systematic Assessment |
|
| back pain | Musculoskeletal and connective tissue disorders | MedDRA 11.1 | Systematic Assessment |
|
| musculoskeletal pain | Musculoskeletal and connective tissue disorders | MedDRA 11.1 | Systematic Assessment |
|
| headache | Nervous system disorders | MedDRA 11.1 | Systematic Assessment |
|
| rash | Skin and subcutaneous tissue disorders | MedDRA 11.1 | Systematic Assessment |
|
| anemia | Blood and lymphatic system disorders | MedDRA 11.1 | Systematic Assessment |
|
| tachycardia | Cardiac disorders | MedDRA 11.1 | Systematic Assessment |
|
| sinus operation | Surgical and medical procedures | MedDRA 11.1 | Systematic Assessment |
|
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| D014652 |
| Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D006474 | Hemorrhagic Disorders |
| D008232 | Lymphoproliferative Disorders |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |