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The primary purpose of this study is to see if Sym021 is safe and tolerable as monotherapy, in combination with either Sym022 or Sym023, and in Combination with both Sym022 and Sym023 for patients with locally advanced/unresectable or metastatic solid tumor malignancies or lymphomas that are refractory to available therapy or for which no standard therapy is available.
Part 1 of this study will evaluate the safety, tolerability, and dose-limiting toxicities (DLTs) to establish the maximum tolerated dose (MTD) and/or the selected dose of sequential escalating doses of Sym021 when administered once every 2 weeks (Q2W) by IV infusion to patient cohorts with locally advanced/unresectable or metastatic solid tumor malignancies or lymphomas that are refractory to available therapy or for which no standard therapy is available
Part 2 of the study will evaluate the safety, tolerability, and DLTs to establish the MTD and/or the selected dose of sequential escalating doses of Sym022 when administered Q2W in combination with a fixed dose of 3 mg/kg of Sym021, each by IV infusion to patient cohorts with locally advanced/unresectable or metastatic solid tumor malignancies or lymphomas that are refractory to available therapy or for which no standard therapy is available
Part 3 of the study will evaluate of the safety, tolerability, and DLTs to establish the MTD and/or the selected dose of sequential escalating doses of Sym023 when administered Q2W in combination with fixed doses of 3 mg/kg of Sym021 and either 1, 3 or 5 mg/kg of Sym022, each by IV infusion to patient cohorts with locally advanced/unresectable or metastatic solid tumor malignancies or lymphomas that are refractory to available therapy or for which no standard therapy is available.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sym021 Dose Level 1 | Experimental | Part 1, Sym021 monotherapy dose level 1 |
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| Sym021 Dose Level 2 | Experimental | Part 1, Sym021 monotherapy dose level 2 |
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| Sym021 Dose Level 3 | Experimental | Part 1, Sym021 monotherapy dose level 3 |
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| Arm A: Sym021+Sym022 Dose Level 1 | Experimental | Part 2, Arm A: Sym021 RP2D in combination with dose level 1 of Sym022 |
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| Arm A: Sym021+Sym022 Dose Level 2 | Experimental | Part 2, Arm A: Sym021 RP2D in combination with dose level 2 of Sym022 |
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| Arm A: Sym021+Sym022 Dose Level 3 | Experimental | Part 2, Arm A: Sym021 RP2D in combination with dose level 3 of Sym022 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sym021 | Drug | Sym021 is a humanized antibody that binds PD-1 with sub-nanomolar affinity and blocks binding of the inhibitory ligands PD-L1 and PD-L2, thus releasing PD-1-mediated inhibition of the immune response. |
| Measure | Description | Time Frame |
|---|---|---|
| Part 1: Assessment of treatment emergent adverse events (AEs) meeting DLT criteria. | Assess the safety and tolerability of Sym021 monotherapy on a Q2W schedule. Assessment based on the occurrence of AEs meeting DLT criteria measured during Cycle 1. | 12 months |
| Part 2: Assessment of treatment emergent adverse events (AEs) meeting DLT criteria. | Assess the safety and tolerability of the Sym021 RP2D in combination with sequential escalating doses of Sym022 or Sym023 on a Q2W schedule. Assessment based on the occurrence of AEs meeting DLT criteria measured during Cycle 1. | 12 months |
| Part 3: Assessment of treatment emergent adverse events (AEs) meeting DLT criteria. | Assess the safety and tolerability of the Sym021 RP2D in combination with sequential escalating doses of Sym022 and Sym023 on a Q2W schedule. Assessment based on the occurrence of AEs meeting DLT criteria measured during Cycle 1. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of the immunogenicity of Sym021 as a single agent and in combination with Sym022 and Sym023. | Serum sampling to assess the potential for anti-drug antibody (ADA) formation. | 24 months |
| Evaluation of objective response (OR) or stable disease (SD). |
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Inclusion Criteria:
Exclusion Criteria:
Drugs and Other Treatments Exclusion Criteria:
Part 2 Combination Dose-Escalations ONLY: Prior therapy with:
Part 3 Combination Dose-Escalations ONLY: Prior therapy with:
Any antineoplastic agent for the primary malignancy (standard or investigational) within 4 weeks or 5 plasma half-lives, whichever is shortest, prior to first study drug administration and during study, with exceptions.
Any other investigational treatments within 2 weeks prior to and during study; includes participation in any medical device or supportive care therapeutic intervention trials.
Radiotherapy, with exceptions.
Use of live vaccines against infectious diseases 4 weeks prior to first study drug administration and during study.
Immunosuppressive or systemic hormonal therapy within 2 weeks prior to first study drug administration and during study, with exceptions.
Prophylactic use of hematopoietic growth factors within 1 week prior to first study drug administration and during Cycle 1 of study.
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| Name | Affiliation | Role |
|---|---|---|
| Lillian Siu, MD, FRCPC | Princess Margaret Cancer Centre | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| South Texas Accelerated Research Therapeutics (START) Midwest | Grand Rapids | Michigan | 49503 | United States | ||
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| Arm A: Sym021+Sym022 Dose Level 4 | Experimental | Part 2, Arm A: Sym021 RP2D in combination with dose level 4 of Sym022 |
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| Arm B: Sym021+Sym023 Dose Level 1 | Experimental | Part 2, Arm B: Sym021 RP2D in combination with dose level 1 of Sym023 |
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| Arm B: Sym021+Sym023 Dose Level 2 | Experimental | Part 2, Arm B: Sym021 RP2D in combination with dose level 2 of Sym023 |
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| Arm B: Sym021+Sym023 Dose Level 3 | Experimental | Part 2, Arm B: Sym021 RP2D in combination with dose level 3 of Sym023 |
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| Arm B: Sym021+Sym023 Dose Level 4 | Experimental | Part 2, Arm B: Sym021 RP2D in combination with dose level 4 of Sym023 |
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| Arm B: Sym021+Sym023 Dose Level 5 | Experimental | Part 2, Arm B: Sym021 RP2D in combination with dose level 5 of Sym023 |
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| Sym021+Sym022+Sym023 Dose Level 1 | Experimental | Part 3, Sym021 in combination with Sym022 and Sym023 |
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| Sym021+Sym022+Sym023 Dose Level 2 | Experimental | Part 3, Sym021 in combination with Sym022 and Sym023 |
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| Sym021+Sym022+Sym023 Dose Level 3 | Experimental | Part 3, Sym021 in combination with Sym022 and Sym023 |
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| Sym021+Sym022+Sym023 Dose Level 4 | Experimental | Part 3, Sym021 in combination with Sym022 and Sym023 |
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| Sym021+Sym022+Sym023 Dose Level 5 | Experimental | Part 3, Sym021 in combination with Sym022 and Sym023 |
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| Sym022 | Drug | Sym022 is a recombinant, fully human antibody that binds LAG-3 and blocks the LAG-3/major histocompatibility complex class II (MHC-II) interaction, thus allowing for increased T-cell proliferation and cytokine production. |
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| Sym023 | Drug | Sym023 is a recombinant, fully human antibody that binds TIM-3 and induces activation of immune cells. |
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Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1), Response Evaluation Criteria in Lymphomas 2017 (RECIL 2017), or Immunotherapeutics Response Evaluation Criteria in Solid Tumors (iRECIST), depending on tumor type. |
| 24 months |
| Time to progression (TTP) of disease. | Based on time of enrollment to first evidence of progression on imaging studies, as assessed by RECIST v1.1, RECIL 2017, or iRECIST, depending on tumor type. | 24 months |
| Area under the concentration-time curve in a dosing interval (AUC) | Will be estimated using non-compartmental methods and actual timepoints. | 24 months |
| Maximum concentration (Cmax) | Will be derived from observed data. | 24 months |
| Time to reach maximum concentration (Tmax) | Will be derived from observed data. | 24 months |
| Trough concentration (Ctrough) | Will be derived from observed data. | 24 months |
| Terminal elimination half-life (T½) | Will be estimated using non-compartmental methods and actual timepoints. | 24 months |
| Clearance (CL) | Will be estimated using non-compartmental methods and actual timepoints. | 24 months |
| The University of Texas MD Anderson Cancer Center |
| Houston |
| Texas |
| 77030 |
| United States |
| NEXT Oncology | San Antonio | Texas | 78240 | United States |
| Princess Margaret Cancer Centre | Toronto | Ontario | M5G 2M9 | Canada |
| ID | Term |
|---|---|
| D009362 | Neoplasm Metastasis |
| D008223 | Lymphoma |
| ID | Term |
|---|---|
| D009385 | Neoplastic Processes |
| D009369 | Neoplasms |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009370 | Neoplasms by Histologic Type |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C000711728 | spartalizumab |
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