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This is a phase Ib, open, mono-center, dose-escalation, tolerability and pharmacokinetic study evaluating the Recombinant Humanized Anti-PD-1 mAb for Injection in combination with Axitinib in patients with advanced kidney cancer and melanoma who have failed in routine systemic treatment.
This is a phase Ib, open, mono-center, dose-escalation, tolerability and pharmacokinetic study evaluating the Recombinant Humanized Anti-PD-1 mAb for Injection in combination with Axitinib in patients with advanced kidney cancer and melanoma who have failed in routine systemic treatment.The study will be conducted in 2 parts: dose escalation and cohort expansion.
18 to 24 patients will be enrolled in dose escalation part.This part is to analyze safety and efficacy of the humanized anti-PD-1 antibody in combination with axitinib and to confirm dose-limiting toxicity (DLT), maximum tolerated dose (MTD) and recommended dose (RD). After finishing the dose escalation part, we will enroll other patients for each tumor types of recommended dose group to ensure each group have 10 patients. This part is to further analyze safety and efficacy of the humanized anti-PD-1 antibody.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| humanized anti-PD-1monoclonal antibody | Experimental | humanized anti-PD-1 monoclonal antibody is to be injected intravenously 1mg/kg or 3mg/kg Q2w PLUS axitinib 5 mg orally Q2w until disease progresses or unacceptable tolerability occurs |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| humanized anti-PD-1 monoclonal antibody Toripalimab | Biological | humanized anti-PD-1 monoclonal antibody Toripalimab is a programmed death-1 (PD-1) immune checkpoint inhibitor antibody, which selectively interferes with the combination of PD-1 with its ligands, PD-L1 and PD-L2, resulting in the activation of lymphocytes and elimination of malignancy theoretically. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 | Safety assessments including vital signs, laboratory tests, and adverse event monitoring | 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| PD-1 receptor occupancy of blood | To test the PD - 1 receptor share in the blood | 3 years |
| Objective Response Rate (ORR) by irRC and RECIST 1.1 | The treatment effect of JS001 in combination with axitinib, will be assessed using irRC and RECIST 1.1 to determine tumor response. |
| Measure | Description | Time Frame |
|---|---|---|
| correlation analysis of PD-L1 expression of tumor and ORR | correlation analysis of PD-L1 expression of tumor and objective response rate | 3 years |
| correlation analysis of PD-L1 expression of tumor and DOR |
Inclusion Criteria:
hemoglobin ≥ 9.0 g/dL; neutrophils ≥ 1500 cells/ µL; platelets ≥ 100 x 10^3/ µL; total bilirubin ≤ 1.5 x upper limit of normal (ULN); aspartic transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 x ULN without, and ≤ 5 x ULN with hepatic metastasis; serum creatinine ≤1╳ULN,creatinine clearance >50ml/min (Cockcroft-Gault equation) INR, aPTT≤1.5 x ULN; Urine protein + 1 or less, if the urine protein > 1 +, need to collect 24 hours urinary protein determination, the total amount should be 1 gram or less
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jun Guo | Peking University Cancer Hospital & Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Cancer Hospital | Beijing | Beijing Municipality | 100142 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22056247 | Background | Rini BI, Escudier B, Tomczak P, Kaprin A, Szczylik C, Hutson TE, Michaelson MD, Gorbunova VA, Gore ME, Rusakov IG, Negrier S, Ou YC, Castellano D, Lim HY, Uemura H, Tarazi J, Cella D, Chen C, Rosbrook B, Kim S, Motzer RJ. Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): a randomised phase 3 trial. Lancet. 2011 Dec 3;378(9807):1931-9. doi: 10.1016/S0140-6736(11)61613-9. Epub 2011 Nov 4. | |
| 26137411 |
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|
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| 3 years |
| Duration of Response (DOR) by irRC and RECIST 1.1 | The treatment effect of JS001 in combination with axitinib, will be assessed using irRC and RECIST 1.1 to determine duration of response. | 3 years |
| Disease Control Rate (DCR) by irRC and RECIST 1.1 | The treatment effect of JS001 in combination with axitinib, will be assessed using irRC and RECIST 1.1 to determine disease control rate. | 3 years |
| Time to response (TTR) by irRC and RECIST 1.1 | The treatment effect of JS001 in combination with axitinib, will be assessed using irRC and RECIST 1.1 to determine time to response. | 3 years |
| Progression-free survival(PFS) by irRC and RECIST 1.1 | The treatment effect of JS001 in combination with axitinib, will be assessed using irRC and RECIST 1.1 to determine progression-free survival time. | 3 years |
| Overall survival (OS) by irRC and RECIST 1.1 | The treatment effect of JS001 in combination with axitinib, will be assessed using irRC and RECIST 1.1 to determine overall survival. | 3 years |
| PK Parameter: Maximum Plasma Concentration (Cmax) | Maximum Plasma Concentration (Cmax) after single dose injection of Anti-PD-1 Monoclonal Antibody (mAb) in combination with axitinib | 3 years |
| PK Parameter: Peak Time (Tmax) | Peak Time (Tmax) after single dose injection of Anti-PD-1 mAb in combination with axitinib | 3 years |
| PK Parameter: t1/2 | t1/2 after single dose injection of Recombinant Humanized Anti-PD-1 mAb in combination with axitinib | 3 years |
| PK Parameter: Area Under the Curve (AUC) | Area Under the Curve (AUC) after single dose injection of Anti-PD-1 mAb in combination with axitinib | 3 years |
| PK Parameter: Plasma clearance (CL) | Plasma clearance (CL) after single dose injection of Anti-PD-1 mAb in combination with axitinib | 3 years |
| PK Parameter: Apparent volume of distribution (V) | Apparent volume of distribution (V) after single dose injection of Anti-PD-1 mAb in combination with axitinib | 3 years |
| PK Parameter: Minimum Plasma Concentration (Cmin) | Minimum Plasma Concentration (Cmin) of steady state after multiple dose injection of Anti-PD-1 mAb in combination with axitinib | 3 years |
| PK Parameter: Average Plasma Concentration (Cav) | Average Plasma Concentration (Cav) of steady state after multiple dose injection of Anti-PD-1 mAb in combination with axitinib | 3 years |
| PK Parameter: degree of fluctuation (DF) | degree of fluctuation (DF) of steady state after multiple dose injection of Anti-PD-1 mAb in combination with axitinib | 3 years |
| PK Parameter: Apparent volume of distribution of steady state (Vss) | Apparent volume of distribution of steady state (Vss) after multiple dose injection of Anti-PD-1 mAb in combination with axitinib | 3 years |
correlation analysis of PD-L1 expression of tumor and duration of response
| 3 years |
| correlation analysis of PD-L1 expression of tumor and DCR | correlation analysis of PD-L1 expression of tumor and disease control rate | 3 years |
| correlation analysis of PD-L1 expression of tumor and TTR | correlation analysis of PD-L1 expression of tumor and time to response | 3 years |
| correlation analysis of PD-L1 expression of tumor and PFS | correlation analysis of PD-L1 expression of tumor and progression-free survival | 3 years |
| correlation analysis of PD-L1 expression of tumor and OS | correlation analysis of PD-L1 expression of tumor and overall survival | 3 years |
| Background |
| Du Four S, Maenhout SK, De Pierre K, Renmans D, Niclou SP, Thielemans K, Neyns B, Aerts JL. Axitinib increases the infiltration of immune cells and reduces the suppressive capacity of monocytic MDSCs in an intracranial mouse melanoma model. Oncoimmunology. 2015 Jan 22;4(4):e998107. doi: 10.1080/2162402X.2014.998107. eCollection 2015 Apr. |
| 35193932 | Derived | Li S, Wu X, Yan X, Zhou L, Chi Z, Si L, Cui C, Tang B, Mao L, Lian B, Wang X, Bai X, Dai J, Kong Y, Tang X, Feng H, Yao S, Flaherty KT, Guo J, Sheng X. Toripalimab plus axitinib in patients with metastatic mucosal melanoma: 3-year survival update and biomarker analysis. J Immunother Cancer. 2022 Feb;10(2):e004036. doi: 10.1136/jitc-2021-004036. |
| ID | Term |
|---|---|
| D007680 | Kidney Neoplasms |
| D008545 | Melanoma |
| ID | Term |
|---|---|
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D012878 | Skin Neoplasms |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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