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| Name | Class |
|---|---|
| Asher Biotherapeutics, Inc. | INDUSTRY |
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This study is a first-in-human, open-label, nonrandomized, single center Phase 1 dose-escalation study to assess the safety, pharmacokinetics, pharmacodynamics, immunogenicity, and preliminary antitumor activity of AB821 monotherapy given every 2 weeks (Q2W) or every 3 weeks (Q3W) in participants with recurrent locally advanced or metastatic melanoma and other immune-responsive solid tumors. Immune-responsive solid tumors are defined as those for which immune checkpoint inhibitors form part of the standard-of-care therapy.
Phase 1 Dose-Escalation Participants with recurrent locally advanced or metastatic melanoma and immune-responsive solid tumors will be enrolled into dose-escalation cohorts. Patients with melanoma are required to have previously been treated with an inhibitor of PD1/L1, while patients with other solid tumors are required to have had previous systemic treatment regimen that may or may not include an inhibitor of PD1/L1. For DL3 and above, n ≥3; for DL1 and DL2, n=1, unless a Grade ≥2 AE or a DLT is observed, in which case the cohort will be expanded to at least 3 participants before further dose escalation. This will help determine the MTD or MAD and select the recommended Phase 1b or Phase 2 dose (RP1bD or RP2D).
Under protocol versions up to and including V 4.0, participants in dose-escalation cohorts were enrolled at least 48 hours apart, treated on a Q2W schedule, and followed for dose-limiting toxicities for 28 days (completion of two 14-day cycles of treatment).
Dose-Escalation Backfill Cohorts ased on emerging safety, PK, and pharmacodynamic data, additional participants may be enrolled in backfill cohorts, backfill slots may be used for other tumor types, not only melanoma, upon discussion with the sponsor-investigator at or below dose levels that cleared the dose-limiting toxicity (DLT) assessment and were determined to be safe and tolerable by the Data and Safety Monitoring Board (DSMB). Up to a maximum of 20 total participants may be enrolled in backfill cohorts, at the RP2D or at lower levels deemed efficacious to better assess safety and efficacy based on emerging data. Dose levels and justification are described in Section 4.3.
This study consists of a Screening phase, a Treatment phase, an end of treatment (EOT) Visit, a 30-, 60-, 90- day Safety Follow-up (SFU) phase, and a long-term follow-up (LTFU) phase. Upon completion of the SFU phase post EOT, ongoing safety, disease progression, survival status, and subsequent anticancer therapies will be assessed in the LTFU period.
During the treatment phase, participants who demonstrate disease progression per RECIST criteria may be allowed to continue AB821 if, in the opinion of the treating investigator, the participant is tolerating study treatment and deriving clinical benefit from continuing study treatment. If further progression is noted on subsequent imaging, participants may be allowed to continue on study based on discussion with the sponsor-investigator.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AB821 | Experimental | AB821 is intended to be administered as a 30-minute IV infusion every 2 or 3 weeks. Dosage is calculated per body weight. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AB821 | Drug | AB821 will be administered via IV infusion using weight-based dosing. AB821 will be administered over 30 minutes +/- 10 minutes. Participants will receive AB821 on Day 1 of each 14 or 21 day cycle for up to two years. |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of Dose-Limiting Toxicities (DLTs) in patients with advanced melanoma | The primary objective of this outcome measure is to assess the number of participants experiencing dose-limiting toxicities (DLTs) during the study period. DLTs are specific adverse events (AEs) that are considered significant enough to prevent an increase in dose or continuation of treatment. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Frequency of Serious Adverse Events (SAEs) in patients with advanced melanoma | This outcome measure aims to record the number of participants who experience serious adverse events (SAEs) while receiving AB821. An SAE is defined as any event that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, or is a congenital anomaly/birth defect. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Frequency of Treatment-Emergent Adverse Events (TEAEs) in patients with advanced melanoma | This measure will track the number of participants experiencing treatment-emergent adverse events (TEAEs) during the study. TEAEs are adverse events that emerge following the start of treatment with AB821 and are not present prior to treatment or represent an exacerbation of a pre-existing condition. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Frequency of Adverse Events of Special Interest (AESIs) in patients with advanced melanoma | This outcome measure focuses on the number of participants who experience adverse events of special interest (AESIs). AESIs are pre-specified medical occurrences that have been identified as important to monitor due to their potential impact on the risk-benefit profile of AB821. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Concentration (Cmax) of AB821 in Serum | The objective of this outcome measure is to determine the maximum concentration (Cmax) of AB821 in the serum of participants. Cmax represents the highest concentration that AB821 reaches in the bloodstream after administration. This parameter provides important insights into the peak level of drug exposure. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
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Inclusion Criteria:
≥18 years at the time consent is signed.
Ability to provide written informed consent for the study.
ECOG PS of 0 or 1.
Participants of childbearing potential must not be pregnant at enrollment and agree to comply with contraception requirements. Participants with partners of childbearing potential must also comply with contraception requirements.
Adequate organ function as defined below. Specimens must be collected within seven days prior to the start of the study treatment (i.e., Cycle 1 Day 1 [C1D1]) including:
ANC> 1500/ul Platelet count>100,000 Hb>9 g/dl Calculated creatinine clearance> 50 mL/min Total bilirubin greater than or equal to 1.5 x ULN or direct bilirubin greater than or equal to ULN for participants with total bilirubin > 1.5 x ULN PT INR > 1.5 x ULN unless on anticoagulation Albumin > 3g/dl
Life expectancy of ≥12 weeks, per treating investigator's judgment.
For Melanoma participants: Participants with unresectable or metastatic melanoma that have progressed on or after PD-1/PD-L1 checkpoint blockade (alone or with either CTLA-4 or LAG-3 checkpoint blockade).
For other tumor types: Must have a recurrent histologically or cytologically proven metastatic or locally advanced solid tumor (non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC), Merkel-cell carcinoma, bladder cancer, or squamous cell carcinoma of the head and neck (SCCHN)), meeting each of the following:
Has measurable disease per RECIST v1.1 as assessed by the local site investigator/radiology.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Stephanie Ladd | Contact | 203-785-5702 | stephanie.ladd@yale.edu |
| Name | Affiliation | Role |
|---|---|---|
| Harriet Kluger, MD | Yale University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yale University | Recruiting | New Haven | Connecticut | 06510 | United States |
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| Frequency of Adverse Events (AEs) Leading to Dose Interruption in patients with advanced melanoma | The objective of this measure is to document the number of participants who experience adverse events that result in a temporary interruption of AB821 administration. The interruptions could be due to the severity of the adverse event making it necessary to halt the dosing temporarily. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Frequency of Adverse Events (AEs) Leading to Treatment Discontinuation in patients with advanced melanoma | This outcome measure will track the number of participants who experience adverse events leading to the permanent discontinuation of treatment with AB821. These events warrant stopping the treatment altogether to ensure participant safety. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Frequency of Deaths in patients with advanced melanoma | The primary objective of this measure is to record the number of participants who die during the study period, irrespective of the cause. This encompasses any deaths occurring within the timeframe of the study and helps to monitor the overall impact of the study treatment on participant mortality. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Assessing the immunogenicity of AB821 in patients with advanced melanoma | The secondary outcome measure will evaluate the immunogenicity of AB821 by monitoring the frequency and titer of anti-drug antibody (ADA) formation against AB821. Additionally, this measure will assess the potential effect of ADA formation on observed safety, pharmacokinetics (PK), and pharmacodynamics (PD) of AB821. The immunogenicity analysis aims to understand the immune response triggered by AB821 and its impact on the therapeutic's overall safety and efficacy profile. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Objective Response Rate (ORR) of AB821 in Patients with Advanced Melanoma | The objective response rate (ORR) will be determined according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. ORR is defined as the percentage of subjects achieving either a complete response (CR) or partial response (PR). | Screening, day 1 of cycle 4 (each cycle is 14 days), end of treatment and at long term follow up |
| Duration of Response (DOR) of AB821 in Patients with Advanced Melanoma | The duration of response (DOR) will be evaluated in subjects who have achieved a complete response (CR) or partial response (PR) as per RECIST v1.1 criteria. DOR is defined as the time from the initial response to documented disease progression or death. | Screening, day 1 of cycle 4 (each cycle is 14 days), end of treatment and at long term follow up |
| Disease Control Rate (DCR) of AB821 in Patients with Advanced Melanoma | Disease control rate (DCR) will be assessed according to the RECIST v1.1 criteria. DCR includes the percentage of subjects achieving complete response (CR), partial response (PR), or stable disease (SD). | Screening, day 1 of cycle 4 (each cycle is 14 days), end of treatment and at long term follow up |
| Progression-Free Survival (PFS) of AB821 in Patients with Advanced Melanoma | Progression-free survival (PFS) will be measured as the time from the start of treatment with AB821 to the first documentation of disease progression or death from any cause, based on RECIST v1.1 criteria. | Screening, day 1 of cycle 4 (each cycle is 14 days), end of treatment and at long term follow up |
| Overall Survival (OS) of AB821 in Patients with Advanced Melanoma | : Overall survival (OS) will be assessed as the time from the start of treatment with AB821 to the time of death from any cause. | Screening, day 1 of cycle 4 (each cycle is 14 days), end of treatment and at long term follow up |
| Time to Maximum Concentration (tmax) of AB821 in Serum | This outcome measure aims to identify the time to reach the maximum concentration (tmax) of AB821 in the serum. tmax is the duration it takes after administration for AB821 to reach its peak concentration in the bloodstream. This parameter helps in understanding the absorption rate of the drug. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Area Under the Curve from Time Zero to Last Measurable Concentration (AUC0-last) of AB821 in Serum | The objective of this measure is to calculate the area under the concentration-time curve from time zero to the last measurable concentration (AUC0-last) of AB821 in serum. AUC0-last provides an integrated measure of the overall exposure to AB821 over time. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Clearance (CL) of AB821 in Serum | This outcome measure focuses on determining the clearance (CL) of AB821 from the serum. CL represents the volume of serum from which AB821 is completely removed per unit time. This parameter is crucial for understanding how efficiently the drug is eliminated from the body. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |
| Half-life (t½) of AB821 in Serum | The objective of this measure is to determine the half-life (t½) of AB821 in serum. t½ is the time taken for the concentration of AB821 in the serum to reduce to half its maximum level. This parameter gives an indication of the duration AB821 remains active in the body. | From the date of enrolment to the final follow up visit, approximately two years after the first dose |