Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| Shanghai Junshi Bioscience Co., Ltd. | OTHER |
| CTI Clinical Trial and Consulting Services | OTHER |
Not provided
Not provided
Not provided
Not provided
The primary objective is to assess the safety and tolerability of TAB004 as monotherapy and in combination with toripalimab in subjects with selected advanced solid malignancies, including lymphoma, and to evaluate the recommended Phase 2 dose.
The secondary objectives are to: 1) describe the pharmacokinetic (PK) profile of TAB004 monotherapy and in combination with toripalimab and to describe the PK profile of toripalimab when administered with TAB004, 2) evaluate antitumor activity of TAB004 monotherapy and in combination with toripalimab; and 3) determine the immunogenicity of TAB004 monotherapy and in combination with toripalimab and to determine the immunogenicity of toripalimab when administered with TAB004.
The exploratory objectives are to: 1) evaluate pharmacodynamic effects of TAB004 on its target receptor BTLA, as well as effects on the immune system; 2) evaluate biomarkers that may correlate with activity of TAB004 as monotherapy and in combination with toripalimab; 3) evaluate the utility of BTLA ligand, herpesvirus-entry mediator (HVEM), and additional exploratory biomarkers that could aid in selection of appropriate subjects for TAB004 monotherapy and in combination with toripalimab.
OVERVIEW: This is a Phase 1, multi-center, open-label, dose-escalation study of TAB004, a recombinant humanized IgG4κ monoclonal antibody specific to BTLA when administered alone and in combination with toripalimab, a human IgG4k monocloncal antibody that specifically binds to the programmed death 1 (PD-1). It is estimated that up to 499 subjects with selected advanced solid malignancies (i.e.; non-small cell lung cancer [NSCLC], melanoma, renal cell carcinoma (RCC), urothelial carcinoma (UC), or other tumors), including lymphoma will be enrolled in the study.
Subjects must have a histologically or cytologically confirmed advanced unresectable or metastatic solid tumor, including lymphoma.
The study has 4 parts; Part A dose-escalation, Part B cohort expansion, Part C dose-escalation and Part D cohort expansion. In Part A, up to 24 subjects will be enrolled who must have received, or be ineligible for, or intolerant of, all available approved or standard therapies know to confer clinical benefit including immunotherapy, or for whom no standard therapy exists.
In Part B, C and D, subjects must have received at least one line of therapy for advanced or metastatic disease, but are not required to have received all standard therapies known to confer clinical benefit.
Part A is the monotherapy dose-escalation portion of the study. Four TAB004 dose levels are planned and include: 0.3, 1, 3 and 10 mg/kg. Part A will be the traditional 3 + 3 design with 3 to 6 subjects per dose level (cohort) and will receive their assigned dose every 21 days in the absence of a dose limiting toxicity (DLT) that would prevent further dosing.
Part B is the monotherapy cohort expansion portion of the study and will consist of up to 50 subjects in each advanced solid tumor indication (up to 200 subjects) that may include but not be limited to lymphoma, melanoma, NSCLC, or other tumors with agreement of the Sponsor.
Part C is the combination therapy dose-escalation portion of the study. Four dose levels are planned as follows: Cohort 1 - TAB004 20 mg and toripalimab 240mg; Cohort 2 - TAB004 70 mg and toripalimab 240 mg; Cohort 3 -TAB004 200 mg and toripalimab 240 mg; Cohort 4- TAB004 500 mg and toripalimab 240 mg. Part C will be the traditional 3 + 3 design with 3 to 6 subjects per dose level (cohort) and will receive their assigned doses every 21 days in the absence of a DLT that would prevent further dosing.
Part D is the combination therapy cohort expansion portion of the study. Up to 50 subjects will be enrolled in each advanced solid tumor indication (melanoma, NSCLC, RCC, UC, lymphoma) (up to 250 subjects). Doses of TAB004 and toripalimab will be determined based upon safety and efficacy data from Part C.
Tumor response will be evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST v1.1), the immune-related Response Evaluation Criteria in Solid Tumors (irRECIST), or the New Response Evaluation Criteria in Lymphoma (RECIL) 2017.
In the absence of confirmed disease progression and intolerable toxicities, subjects will be allowed to continue TAB004 (Part A and B) or TAB004 and toripalimab (Part C and D) administration every 21 days for up to 2 years.
DOSAGE AND ADMINISTRATION TAB004 doses are 0.3, 1, 3, 10 mg/kg, 20mg, 70mg, 200mg and 500mg. Toripalimab dose is 240mg. TAB004 alone or TAB004 plus toripalimab will be administered as a 60-minute i.v. infusion for the first dose and may be decreased at the investigators discretion to 30 minutes in subsequent infusions.
SAFETY EVALUATIONS Assessment of safety will be determined by vital sign measurements, clinical laboratory tests, Eastern Cooperative Oncology Group (ECOG) performance status evaluations, diagnostic imaging, physical examinations, electrocardiograms, and the incidence and severity of adverse events.
Safety will also include evaluations of immune safety and immunogenicity. Blockade of BTLA pathway and PD-1 pathway by monoclonal antibodies has been demonstrated in several syngeneic mouse models to enhance specific T cell responses and inhibit tumor growth. In studies of BTLA deficient mice, diseases such as asthma, autoimmune involvement of the central nervous system, and systemic lupus erythematosus were exacerbated. Particular attention will be given to symptoms related to those diseases. The occurrence of adverse events that may follow enhanced T-cell activation such as pneumonitis, colitis, nephritis, severe skin reactions, endocrinopathies, or other immune-related adverse events (irAEs) will be evaluated for subjects receiving TAB004 alone or in combination with toripalimab.
An irAE is a clinically significant adverse event of any organ that is associated with drug exposure, of unknown etiology, and is consistent with an immune-mediated mechanism.
EFFICACY EVALUATIONS will include best overall response, objective response rate, duration of response or duration of stable disease, progression free survival and overall response.
PHARMACOKINETIC EVALUATIONS Pharmacokinetic parameters include AUC0-inf, AUC0-last, AUC0-21d, Cmax, Cmin trough, Tmax, t1/2, CL, accumulation and Vss.
STATISTICAL METHODS Part A and Part C are based on the 3+3 design for dose escalation and safety evaluation requirements. In Part B and Part D, sample size is estimated using Simon's two-phase design minimax method.
All PK/Pharmacodynamic, immunogenicity, and safety data will be summarized and presented by cohort as well as overall for the study, using descriptive statistics (number of subjects, mean, median, standard deviation, minimum, and maximum) for continuous variables and using frequencies and percentages for discrete variables.
ORR and the associated 2-sided 95% exact confidence limits will be calculated. The proportion of subjects who have experienced best response as CR, PR, SD, or progressive disease (PD) will be provided by cohorts in Part B and Part D.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAB004 0.3 mg/kg repeat dose every 21 days up to 2 years | Experimental |
| |
| TAB004 1 mg/kg repeat dose every 21days up to 2 years | Experimental |
| |
| TAB004 3 mg/kg repeat dose every 21 days up to 2 years | Experimental |
| |
| TAB004 10 mg/kg repeat dose every 21 days up to 2 years | Experimental |
| |
| TAB004 200mg repeat dose every 21 days up to 2 years | Experimental |
| |
| TAB004 20mg and Torpalimab 240mg repeat dose every 21 days up to 2 years | Experimental |
| |
| TAB004 70mg and Torpalimab 240mg repeat dose every 21 days up to 2 years | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TAB004 | Drug | Recombinant humanized IgG4κ monoclonal antibody specific to BTLA for injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 | Treatment-related adverse events as assessed by CTCAE v4.0 | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) by RECIST 1.1 | ORR | 2 years |
| Duration of Response (DOR) by RECIST 1.1 | DOR | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation analysis of HVEM expression of tumor and ORR | BTLA ligand expression with ORR, PD-L1 expression with ORR | 3 years |
| Correlation analysis of HVEM expression of tumor and DCR | BTLA ligand expression with DCR,PD-L1 expression with DCR |
Inclusion Criteria:
1. Able to understand and willing to sign the Informed Consent Form;
2. Male or female ≥ 18 years;
3. Subjects with histologically or cytologically confirmed advanced unresectable or metastatic solid tumor, including lymphoma that have progressed following prior treatment. In Part A, subjects must have received, or be ineligible for or intolerant of all available approved or standard therapies known to confer clinical benefit including immunotherapy, or for whom no standard therapy exists; in Part B, subjects with advanced or metastatic solid tumors, including but not limited to lymphoma, melanoma, NSCLC, or other tumors with agreement of the Sponsor, who must have received at least one line of therapy for advanced or metastatic disease, but are not required to have received all standard therapies known to confer clinical benefit; In Part C, subjects must have received at least one line of therapy for advanced or metastatic disease but are not required to have received all standard therapies known to confer clinical benefit; In Part D, subjects with advanced or metastatic solid tumors that may include but not limited to lymphoma, melanoma, NSCLC, RCC or UC who must have received at least one line of therapy for advanced or metastatic disease, but are not required to have received all standard therapies known to confer clinical benefit.
4. Measurable disease per RECISTv1.1 and iRECIST, or RECIL 2017 for lymphoma
5. ECOG performance status of 0 or 1 with life expectancy of 3 months in the opinion of the investigator.
6. Adequate organ and marrow function, as defined below:
7. Willingness to provide consent for biopsy samples (In Part A, fresh pre-treatment biopsies will be requested from subjects with safely accessible lesions. For subjects who cannot provide a fresh pre-treatment biopsy, request for the most recent accessible archival specimen will be required. In Part B, C and D, fresh pre-treatment biopsies will be required from subjects with safely accessible lesions. The most recent archival specimens will also be requested).
8. Females of childbearing potential who are sexually active with a nonsterilized male partner must use effective contraception from time of screening, and must agree to continue using such precautions for 90 days after the final dose of TAB004 or toripalimab; cessation of birth control after this point should be discussed with a responsible physician. Periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of birth control.
9. Females of childbearing potential are defined as those who are not surgically sterile (i.e., bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy) or postmenopausal (defined as at least 12 months with no menses confirmed by follicle-stimulating hormone [FSH] levels. FSH testing will be conducted at the Screening visit to confirm post-menopausal status).
10. Subjects must use effective contraception. Nonsterilized males who are sexually active with a female partner of childbearing potential must use effective contraception from Day 1 and for 90 days after receipt of the final dose of TAB004 or toripalimab.
Exclusion Criteria:
Note: Local treatment of isolated lesions for palliative intent is acceptable (e.g., by local surgery or radiotherapy).
Note: Subjects with the following are not excluded: vitiligo; alopecia; Grave's disease not requiring systemic treatment other than thyroid hormone replacement (within the past 2 years) psoriasis not requiring systemic treatment; controlled celiac disease; subjects with a history of autoimmune hypothyroidism requiring only thyroid hormone replacement therapy; And type 2 diabetes, provided that it is adequately controlled.
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Richard Curry, MD | Contact | 800-753-2389 | rcurry@ctifacts.com |
| Name | Affiliation | Role |
|---|---|---|
| Sheng Yao, PhD | TopAlliance Biosciences, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Alabama at Birmingham | Recruiting | Birmingham | Alabama | 35294 | United States |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| TAB004 200mg and Torpalimab 240mg repeat dose every 21 days up to 2 years | Experimental |
|
| TAB004 500mg and Torpalimab 240mg repeat dose every 21 days up to 2 years | Experimental |
|
|
| Toripalimab | Drug | a human IgG4k monoclonal antibody that specifically binds to the programmed death 1 (PD-1) |
|
|
| Disease Control Rate (DCR) by RECIST 1.1 | DCR | 2 years |
| Time to response (TTR) by RECIST 1.1 | TTR | 2 years |
| Progression-free survival (PFS) by RECIST 1.1 | PFS | 2 years |
| Overall survival (OS) by RECIST 1.1 | OS | 2 years |
| BTLA receptor occupancy (RO) of blood | RO | 2 years |
| Maximum Plasma Concentration (Cmax) after single dose injection of TAB004 and for toripalimab | Cmax | 2 years |
| Peak Time (Tmax) after single dose injection of TAB004 and for toripalimab | Tmax | 2 years |
| Area Under the Curve (AUC) after single dose injection of TAB004 and for toripalimab | AUC | 2 years |
| t1/2 after single dose injection of TAB004 and for toripalimab | t1/2 half life | 2 years |
| Plasma clearance (CL) after single dose injection of TAB004 and for toripalimab | Plasma clearance (CL) | 2 years |
| Apparent volume of distribution (V) after single dose injection of TAB004 and for toripalimab | volume of distribution (V) | 2 years |
| Minimum Plasma Concentration (Cmin) of steady state after multiple dose injection of TAB004 and for toripalimab | Cmin | 2 years |
| Apparent volume of distribution of steady state (Vss) after multiple dose injection of TAB004 and for toripalimab | volume of distribution of steady state (Vss) | 2 years |
| The presence of anti-drug antibody (ADA) after multiple dose injection of TAB004 and for toripalimab | ADA | 2 years |
| Accumulation after multiple dose in injection of TAB004 and for toripalimab | Accumulation | 2 years |
| 3 years |
| Correlation analysis of HVEM expression of tumor and PFS | BTLA ligand expression with PFS, PD-L1 expression with PFS | 3 years |
| Correlation analysis of HVEM expression of tumor and OS | BTLA ligand expression with OS, PD-L1 expression with OS | 3 years |
| University of Arizona College of Medicine-Tucson | Recruiting | Tucson | Arizona | 85721 | United States |
|
| UCLA Health Westwood Cancer Care | Recruiting | Los Angeles | California | 90095 | United States |
|
| University of California Irvine (UCI) Medical Center | Recruiting | Orange | California | 92868 | United States |
|
| University of California San Francisco (UCSF) Medical Center-Mission Bay | Recruiting | San Francisco | California | 22902 | United States |
|
| University of California at San Francisio | Recruiting | San Francisco | California | 94158 | United States |
|
| Boca Raton Clinical Research (BRCR) | Withdrawn | Boca Raton | Florida | 33432 | United States |
| Winship Cancer Institute at Emory University | Recruiting | Atlanta | Georgia | 30322 | United States |
|
| University of Iowa Hospitals | Recruiting | Iowa City | Iowa | 52242 | United States |
|
| University of Maryland Medical Center | Recruiting | Baltimore | Maryland | 21201 | United States |
|
| Massachusetts General Hospital | Recruiting | Boston | Massachusetts | 02114 | United States |
|
| Karmanos Cancer Institute | Recruiting | Detroit | Michigan | 48201 | United States |
|
| Washington University | Recruiting | St Louis | Missouri | 63110 | United States |
|
| University of Nebraska Medical Center | Suspended | Omaha | Nebraska | 68105 | United States |
| Northwell Health | Not yet recruiting | New Hyde Park | New York | 11042 | United States |
|
| New York Presbyterian / Weill Cornell Medical Center | Active, not recruiting | New York | New York | 10021 | United States |
| Carolina BioOncology Institute | Active, not recruiting | Huntersville | North Carolina | 28078 | United States |
| UC Health - University of Cincinnati Medical Center | Suspended | Cincinnati | Ohio | 45219 | United States |
| The Ohio State University Wexner Medical Center The James Cancer Hospital and Solove Research Institute | Recruiting | Columbus | Ohio | 43210 | United States |
|
| Thomas Jefferson University | Recruiting | Philadelphia | Pennsylvania | 19107 | United States |
|
| Sarah Cannon Research Institute | Active, not recruiting | Nashville | Tennessee | 37203 | United States |
| University of Texas Southwestern Medical Center Harold C. Simmons Comprehensive Cancer Center | Recruiting | Dallas | Texas | 75390-8565 | United States |
|
| MD Anderson Cancer Center | Recruiting | Houston | Texas | 77030 | United States |
|
| University of Wisconsin | Recruiting | Madison | Wisconsin | 53792 | United States |
|
| ID | Term |
|---|---|
| D009362 | Neoplasm Metastasis |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D008545 | Melanoma |
| D008223 | Lymphoma |
| ID | Term |
|---|---|
| D009385 | Neoplastic Processes |
| D009369 | Neoplasms |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract 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 |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| C000656314 | toripalimab |
Not provided
Not provided
Not provided