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A phase 1, multicenter, open label, non-randomized dose escalation and dose expansion study to examine the maximum tolerated dose, (MTD), minimum effective dose (MED) and/or recommended dose for expansion (RDE) of intratumoral ONM-501 as monotherapy and in combination with a PD-1 checkpoint inhibitor in patients with advanced solid tumors and lymphomas.
This Phase 1, multi-center trial will consist of three parts: monotherapy dose escalation; combination therapy dose finding; and combination therapy dose expansion exploring two doses in specific tumor indication(s). Each dosing cycle of ONM-501 will be 21 days. ONM 501 will be administered as intratumoral injections once per week for three weeks (on Days 1, 8, and 15), followed by three weeks without ONM-501 administration. The monotherapy dose escalation will utilize an accelerated titration method.
The combination agent will be administered according to standard protocol, once every three weeks. This phase will evaluate ONM-501 in combination with approved immune checkpoint inhibitor (ICI) cemiplimab. Enrollment in this phase will follow a "Rolling 6" or 6+0 methodology - up to 6 patients will be enrolled in a staggered format; dose escalation of ONM-501 will be permitted.
Once the recommended doses for expansion (RDEs) are determined for ONM-501 + ICI combination or ONM-501 monotherapy, the expansion phase of this study will be initiated. The expansion phase will enroll patients in one to three indication-specific expansion cohorts.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part 1a: Monotherapy Dose Escalation | Experimental | ONM-501 will be administered as intratumoral injections once per week for three weeks, followed by three weeks without ONM-501 administration. Each dosing cycle will be 21 days. |
|
| Part 1b: ONM-501 in Combination with cemiplimab | Experimental | ONM-501 will be administered as intratumoral injections once per week for three weeks followed by three weeks without ONM-501 administration. Each dosing cycle will be 21 days. The combination agent will be administered according to standard protocol, once every three weeks. |
|
| Part 2: RDE ONM-501 in Combination with cemiplimab in indication-specific expansion cohorts | Experimental | Once the recommended doses for expansion (RDEs) are determined for ONM-501 + ICI combination or ONM-501 monotherapy, the expansion phase of the study will be initiated. The expansion phase will enroll patients in one to three indication-specific expansion cohorts. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ONM-501 | Drug | Intratumoral injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Dose Escalation and Expansion Phases: Number of Participants Reporting one or More Treatment-emergent Adverse Events (TEAEs) and Based on TEAEs Severity | AE incidence will be coded using Medical Dictionary for Regulatory Activities (MedDRA) terminology. AE severity will be graded according to NCI CTCAE version 5.0 or later. Grade 1 scales as Mild (asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated); Grade 2 scales as Moderate (minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental Activities of Daily Living [ADL]); Grade 3 scales as Severe (severe or medically significant but not immediately life threatening hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL); Grade 4 scales as Life-threatening consequences, urgent intervention indicated, and Grade 5 scales as Death related to Adverse Event (AE) | Up to approximately 24 months |
| Dose Escalation and Expansion Phases: Number of Participants with Dose-Limiting Toxicities (DLTs) | DLT will be defined as the occurrence of any of the following events in the first 28 days of treatment in the dose escalation cohorts in Part 1 of the study or in the first 28 days of treatment for the first 6 patients at any dose in Part 1b (DLT observation periods). Any adverse event resulting in a dose hold or delay of ≥ 28 days will be considered a DLT. Toxicity will be evaluated according to NCI CTCAE version 5.0. | Up to approximately 24 months |
| Dose Escalation and Expansion Phases: Number of Participants Reporting One or More Treatment Emergent Serious Adverse Event (SAEs) | AE incidence will be coded using Medical Dictionary for Regulatory Activities (MedDRA) terminology. AE severity will be graded according to NCI CTCAE version 5.0 or later. | Up to approximately 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Dose Escalation and Expansion Phases: Cmax | Cmax is defined as the Maximum Observed Plasma Concentration for ONM-501 | Dose Escalation and Expansion Phases: Cycle 1 Day 1 and Cycle 1 Day 8 (each cycle is 21 days): predose and at multiple timepoints (up to 24 hours). |
| Dose Escalation and Expansion Phases: t1/2z |
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Inclusion Criteria:
Exclusion Criteria: Patients will be excluded from this study if they meet any of the following criteria (Part 1a and Part 1b).
Additional Exclusion Criteria for ONM-501 in Combination with cemiplimab (Part 1b)
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Trials@OncoNanoMed.com | Contact | (682) 285-1411 | trials@onconanomed.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| California Research Institute | Active, not recruiting | Los Angeles | California | 90027 | United States | |
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In Part 1a patients will receive ONM-501 as a single agent; in Part 1b patients will receive ONM-501 in combination with Cemiplimab; Part 2 will be an expansion of ONM-501 in combination with Cemiplimab.
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| Cemiplimab | Drug | Intravenous administration of 350 mg |
|
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t1/2z is defined as the Terminal Disposition Phase Half-life for ONM-501 |
| Dose Escalation and Expansion Phases: Cycle 1 Day 1 and Cycle 1 Day 8 (each cycle is 21 days): predose and at multiple timepoints (up to 24 hours). |
| Dose Escalation and Expansion Phases: Tmax | Tmax is defined as the Time to Reach the Maximum Plasma Concentration (Cmax) for ONM-501 | Dose Escalation and Expansion Phases: Cycle 1 Day 1 and Cycle 1 Day 8 (each cycle is 21 days): predose and at multiple timepoints (up to 24 hours). |
| Dose Escalation and Expansion Phases: AUCt | AUCt is defined as the Area Under the Concentration-time Curve from Time 0 to Time t for ONM-501 | Dose Escalation and Expansion Phases: Cycle 1 Day 1 and Cycle 1 Day 8 (each cycle is 21 days): predose and at multiple timepoints (up to 24 hours). |
| Dose Escalation and Expansion Phases: AUCinf | AUCinf is defined as the Area Under the Concentration-time Curve from Time 0 to Infinity for ONM-501 | Dose Escalation and Expansion Phases: Cycle 1 Day 1 and Cycle 1 Day 8 (each cycle is 21 days): predose and at multiple timepoints (up to 24 hours). |
| Dose Escalation and Expansion Phases: CL/F | CL/F is defined as the apparent clearance of ONM-501 (CL/F), where F is the fraction of the dose absorbed. | Dose Escalation and Expansion Phases: Cycle 1 Day 1 and Cycle 1 Day 8 (each cycle is 21 days): predose and at multiple timepoints (up to 24 hours). |
| Dose Escalation and Expansion Phases: Vz/F | Vz/F is defined as the apparent volume of distribution of ONM-501 (CL/F), where F is the fraction of the dose absorbed. | Dose Escalation and Expansion Phases: Cycle 1 Day 1 and Cycle 1 Day 8 (each cycle is 21 days): predose and at multiple timepoints (up to 24 hours). |
| Expansion Phase Only: Objective Response Rate (ORR) | Objective response will be defined as a best response of CR or PR. The objective response rate (ORR) will be calculated as the proportion of patients in the Efficacy Analysis Set who achieve an objective response. ORR will be assessed based on Response Evaluation Criteria in Solid Tumor (RECIST) version 1.1. Characterize the plasma pharmacokinetics (PK) of IT ONM-501 as monotherapy and in combination with cemiplimab Evaluate additional measures of clinical benefit including: Duration of Response (DOR), Progression Free Survival (PFS) by RECIST and Overall Survival | Up to approximately 24 months |
| Expansion Phase Only: Duration of Response (DOR) | DOR analyses will be conducted for those patients in the Efficacy Analysis Set who achieve an objective response and is defined as the time from first objective status assessment of CR or PR until documentation of objective disease progression or death from any cause. Patients who do not progress and do not die will be censored on the date of last adequate tumor assessment. If no further adequate post-treatment tumor assessments were obtained for a patient, DOR will be censored at the date of the objective response (i.e., zero duration). DOR will be assessed based on RECIST v1.1. | Up to approximately 24 months |
| Expansion Phase Only: Progression-Free Survival (PFS) | PFS is defined as the time from administration of the first dose of ONM-501 until documentation of objective disease progression or death from any cause. Patients who do not progress and do not die will be censored on the date of last adequate tumor assessment. If no adequate post treatment tumor assessments were obtained for a patient, PFS will be censored at Day 1 (i.e., zero duration). The PFS analysis will be conducted using the Safety Analysis Set. Assess the biological effects of IT ONM-501 demonstrated by changes in immune cells, immune cell markers, serum cytokines (such as TNF-⍺, IFN-⍺, IFN-β, and others consistent with activation of the cGAS-STING pathway) and gene expression patterns | Up to approximately 24 months |
| Expansion Phase Only: Overall Survival (OS) | OS is defined as the time from the date of first dose administration to the date of death. | Up to approximately 24 months |
| BRCR Global |
| Withdrawn |
| Tamarac |
| Florida |
| 33321 |
| United States |
| Gabrail Cancer Center Research | Completed | Canton | Ohio | 44718 | United States |
| Ohio State University | Completed | Columbus | Ohio | 43210 | United States |
| Allegheny Health Network | Completed | Pittsburgh | Pennsylvania | 15224 | United States |
| UPMC Hillman Cancer Center | Completed | Pittsburgh | Pennsylvania | 15232 | United States |
| University of Texas Southwestern Medical Center | Completed | Dallas | Texas | 75390 | United States |
| MD Anderson Cancer Center | Active, not recruiting | Houston | Texas | 77030 | United States |
| Virginia Cancer Specialists, PC | Completed | Fairfax | Virginia | 22031 | United States |
| St Vincent's Hospital | Recruiting | Darlinghurst | New South Wales | 2010 | Australia |
|
| Cancer Care Wollongong | Recruiting | Wollongong | New South Wales | 2500 | Australia |
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| University of the Sunshine Coast Clinical Trials | Recruiting | Buderim | Queensland | 4556 | Australia |
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| Tasman Oncology Research | Recruiting | Southport | Queensland | 4215 | Australia |
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| Princess Alexandra Hospital | Metro South Health | Recruiting | Woolloongabba | Queensland | 4102 | Australia |
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| Southern Oncology Clinical Research Unit | Completed | Bedford Park | South Australia | Australia |
| St John of God Subiaco Hospital | Active, not recruiting | Subiaco | Western Australia | 6008 | Australia |
| ID | Term |
|---|---|
| D064726 | Triple Negative Breast Neoplasms |
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D008224 | Lymphoma, Follicular |
| D008228 | Lymphoma, Non-Hodgkin |
| D020522 | Lymphoma, Mantle-Cell |
| D001749 | Urinary Bladder Neoplasms |
| D000098943 | Uveal Melanoma |
| D012008 | Recurrence |
| D002583 | Uterine Cervical Neoplasms |
| D002278 | Carcinoma in Situ |
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| D012878 | Skin Neoplasms |
| D009362 | Neoplasm Metastasis |
| D009369 | Neoplasms |
| D008223 | Lymphoma |
| D001733 | Bites and Stings |
| D001943 | Breast Neoplasms |
| D008545 | Melanoma |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D016393 | Lymphoma, B-Cell |
| D009370 | Neoplasms by Histologic Type |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D001745 | Urinary Bladder Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D014604 | Uveal Neoplasms |
| D005134 | Eye Neoplasms |
| D005128 | Eye Diseases |
| D014603 | Uveal Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D014594 | Uterine Neoplasms |
| D005833 | Genital Neoplasms, Female |
| D002577 | Uterine Cervical Diseases |
| D014591 | Uterine Diseases |
| D005831 | Genital Diseases, Female |
| D000091662 | Genital Diseases |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D002294 | Carcinoma, Squamous Cell |
| D006258 | Head and Neck Neoplasms |
| D009385 | Neoplastic Processes |
| D011041 | Poisoning |
| D064419 | Chemically-Induced Disorders |
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| C000627974 | cemiplimab |
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