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The purpose of this first-in-human study is to evaluate the safety, pharmacokinetics (PK) and pharmacodynamics of OPT-302 administered as monthly intravitreal injections for 3 months with and without Lucentis™ in patients with wet age related macular degeneration (AMD). This study will be conducted in two parts: Part 1 will comprise an open label, sequential dose escalation and Part 2 a randomized dose expansion.
OPT-302 is a soluble form of VEGFR-3 comprising the extracellular domains 1-3 of human vascular endothelial growth factor receptor (VEGFR)-3 and the Fc fragment of human IgG1. It functions by binding and neutralizing the activity of vascular endothelial growth factor (VEGF)-C and VEGF-D on endogenous VEGFR-2 and VEGFR-3.
VEGF-C and VEGF-D promote blood vessel development (angiogenesis) by binding and activating VEGFR-2 and VEGFR-3. VEGF-C is also a potent inducer of vascular permeability or leakage. Angiogenesis and vascular leakage are key hallmarks of wet AMD. Approved therapies for wet AMD include Eylea™ and Lucentis™ which block the activity of VEGF-A, but not VEGF-C or VEGF-D which are alternate members of the same family of molecules.
VEGF-C and VEGF-D can stimulate blood vessel growth and leakage through the same pathway as VEGF-A (via VEGFR-2), as well as through pathways that are independent of VEGF-A (via VEGFR-3). Published studies have also indicated that VEGF-C and VEGF-D play an important role in mediating resistance to therapies that block VEGF-A such as Lucentis™ and Eylea™.
Combination therapy with OPT-302 an anti-VEGF-A agent provides a more complete blockade of the VEGF family. This strategy targets functional redundancy in the VEGF pathway and mechanisms of 'resistance' or sub-response to VEGF-A inhibition.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part 1 Dose escalation - Cohort 1 | Experimental | Dose Level 1 of OPT-302 in combination with Lucentis™ |
|
| Part 1 Dose escalation - Cohort 2 | Experimental | Dose Level 2 of OPT-302 in combination with Lucentis™ |
|
| Part 1 Dose escalation - Cohort 3 | Experimental | Dose Level 3 of OPT-302 in combination with Lucentis™ |
|
| Part 1 Dose escalation - Cohort 4 | Experimental | Dose Level 3 of OPT-302 monotherapy |
|
| Part 2 Dose expansion - Cohort 5 | Experimental | OPT-302 (at Maximum Tolerated Dose [MTD] or highest dose tested in Part 1) in combination with Lucentis™ |
|
| Part 2 Dose expansion - Cohort 6 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| OPT-302 | Drug | OPT-302 will be administered by intravitreal injection once every month for 3 months |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety (Adverse Events) | Subject incidences of ophthalmic and systemic Adverse Events during study and follow-up period | Up to 1 month after the last dose |
| Measure | Description | Time Frame |
|---|---|---|
| Mean change in Best Corrected Visual Acuity (BCVA) from baseline | Mean change in Early Treatment Diabetic Retinopathy Study (ETDRS) BCVA from baseline | 6 months |
| Mean change in central retinal thickness from baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Exploratory: Changes in the systemic blood levels of angiogenesis-related biomarkers | Change in systemic blood levels of angiogenesis-related biomarkers including, but not limited to: Vascular Endothelial Growth Factor A (VEGF-A), VEGF-C, VEGF-D, soluble VEGFR-2 and soluble VEGFR-3. | 3 months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Clinical Research | Opthea Limited | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Opthea Investigative Site | Phoenix | Arizona | 85014 | United States | ||
| Opthea Investigative Site |
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OPT-302 (at MTD or highest dose tested in Part 1) monotherapy |
|
| Lucentis™ | Drug | Lucentis™ (0.5 mg) will be administered by intravitreal injection once every month for 3 months |
|
|
Changes in intra- or sub-retinal fluid measured as mean change in central retinal thickness or macula volume by Spectral Domain Optical Coherence Tomography (SD-OCT)
| 6 months |
| Mean change in Choroidal Neovascularization (CNV) lesion area from baseline | Change in CNV size according to fluorescein angiogram | 6 months |
| Mean number of retreatment injections of anti-VEGF-A therapy during long term follow-up (week 12 to 24) | 3 months |
| Need for 'rescue therapy' with ranibizumab in subjects receiving OPT-302 monotherapy | 3 months |
| Assess the Pharmacokinetic profile of OPT-302 alone and in combination with ranibizumab following intravitreal administration | Mean systemic OPT-302 Concentration-Time profile | Up to 28 days post-dose |
| Anti-OPT-302 antibody formation | Incidence of anti-OPT-302 antibody formation | Pre-dose and up to 3 months post-dose |
| Beverly Hills |
| California |
| 90211 |
| United States |
| Opthea Investigative Site | Sacramento | California | 95819 | United States |
| Opthea Investigative Site | Santa Maria | California | 93454 | United States |
| Opthea Investigative Site | Fort Myers | Florida | 33912 | United States |
| Opthea Investigative Site | Pensacola | Florida | 32503 | United States |
| Opthea Investigative Site | Winter Haven | Florida | 33800 | United States |
| Opthea Investigative Site | Wichita | Kansas | 67214 | United States |
| Opthea Investigative Site | Bloomfield | New Jersey | 07003 | United States |
| Opthea Investigative Site | Charlotte | North Carolina | 28210 | United States |
| Opthea Investigative Site | Cleveland | Ohio | 44122 | United States |
| Opthea Investigative Site | West Columbia | South Carolina | 29169 | United States |
| Opthea Investigative Site | Abilene | Texas | 79606 | United States |
| Opthea Investigative Site | Willow Park | Texas | 76087 | United States |
| ID | Term |
|---|---|
| D005128 | Eye Diseases |
| D008268 | Macular Degeneration |
| D012164 | Retinal Diseases |
| D012162 | Retinal Degeneration |
| D009389 | Neovascularization, Pathologic |
| ID | Term |
|---|---|
| D015785 | Eye Diseases, Hereditary |
| D008679 | Metaplasia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000069579 | Ranibizumab |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
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