This is an early development study of ASP388B in people with solid tumors. In this study, ASP388B will be given to people for the first time. It will be given by itself or together with standard cancer therapies. The main aims of the study are to check the safety of ASP388B and find the most suitable dose.
This study will be in 2 parts. In Part 1, different small groups of people with solid tumors will receive lower to higher doses of ASP388B. Some groups will receive ASP388B by itself, and other groups will receive ASP388B with standard cancer therapies. Any medical problems will be recorded for each dose. This is to find suitable doses of ASP388B to use in Part 2 of the study, and to include the tumor types that responded well to ASP388B.
In Part 2, other different small groups of people with the specific tumor types (from Part 1) will receive the most suitable doses worked out from Part 1. Some groups will receive ASP388B by itself, and other groups will receive ASP388B with standard cancer therapies.
In both parts of the study, ASP388B will be given once in 3-week cycles. The standard cancer therapies will be given according to their approved label. ASP388B and the standard cancer therapies will be given slowly through a tube into a vein. This is called an infusion.
In both parts of the study, safety checks will be done at each visit, and the doctors will continue to check for medical problems throughout the study.
Inclusion Criteria:
For the ASP388B monotherapy dose escalation (excluding the tumor-specific backfill participants), the following criteria apply:
Participant has a confirmed diagnosis of locally advanced unresectable or metastatic solid tumors.
Participant has progressed on, is ineligible for, or has refused all available standard therapies (no limit to the number of prior treatment regimens).
Prior exposure to B7-H3, STING agonist or TopI directed therapy is allowed.
Participant must have one of the following malignancies (for all tumor types, any compounds of neuroendocrine histology is ineligible): HNSCC, ESCC, mCRPC, sqNSCLC, SCLC
mCRPC
For sqNSCLC
For SCLC
For the ASP388B 2L+HNSCC monotherapy dose expansion (including the tumor-specific backfill participants from the monotherapy dose escalation), the following criteria apply:
Participant has histologically or cytologically confirmed HNSCC.
Participant has evidence of radiographic progression on or after the last regimen received.
Participant has locally advanced or metastatic disease that is not amenable to curative intent treatment.
Participant has progressed, relapsed or discontinued treatment due to toxicity after local guidelines/SOC regimen for locally advanced or metastatic disease, and has not received ≤ 3 prior lines of anticancer therapy in the locally advanced or metastatic setting.
No prior exposure to B7-H3, STING agonist or TopI directed therapy is allowed.
For the ASP388B 2L+ESCC monotherapy dose expansion (including the tumor-specific backfill participants from the monotherapy dose escalation), the following criteria apply:
Participant has histologically or cytologically confirmed ESCC.
Participant has evidence of radiographic progression on or after the last regimen received.
Participant has locally advanced or metastatic disease that is not amenable to curative intent treatment.
Participant has progressed, relapsed or discontinued treatment due to toxicity after local guidelines/SOC regimen for locally advanced or metastatic disease, and has not received ≤ 3 prior lines of anticancer therapy in the locally advanced or metastatic setting. o Neoadjuvant or adjuvant cytotoxic regimens will count as a prior regimen if relapsed or progressed ≤ 6 months after completion.
No prior exposure to B7-H3, STING agonist or TopI directed therapy is allowed.
For the ASP388B 1L HNSCC (Excluding NPC and Salivary Gland Tumors) combination therapy dose escalation and expansion (including the tumor-specific backfill participants from combination therapy dose escalation), the following criteria apply: (ASP388B + Pembrolizumab + Carboplatin + 5-FU):
Participant has histologically or cytologically confirmed HNSCC excluding nasopharyngeal cancer (NPC) and salivary gland tumors.
Participant has recurrent or metastatic disease that is incurable by local therapies.
Participant has had no prior systemic therapy administered with the exception of systemic therapy completed > 6 months prior if given as part of multimodal treatment with curative intent for nonmetastatic disease stages.
No prior exposure to B7-H3, STING agonist or TopI directed therapy is allowed.
For the ASP388B 1L ESCC combination therapy dose escalation and expansion (including the tumor-specific backfill participants from combination therapy dose escalation), the following criteria apply: (ASP388B + Pembrolizumab + Oxaliplatin + 5-FU):
Participant has histologically or cytologically confirmed ESCC.
Participant has had no prior systemic therapy administered with the exception of systemic therapy completed > 6 months prior if given as part of multimodal treatment with curative intent for nonmetastatic disease stages.
No prior exposure to B7-H3, STING agonist or TopI directed therapy is allowed.
Participant has a predicted life expectancy ≥ 12 weeks.
Participant has at least 1 measurable lesion per RECIST v1.1. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
Participant has an ECOG performance status of 0 or 1.
Participant has adequate organ function as indicated by laboratory values (If a participant has received a recent blood transfusion, the laboratory tests must be obtained ≥ 14 days after any blood transfusion.
Female participant is not pregnant and at least 1 of the following conditions apply:
Female participant must not be breastfeeding or lactating starting at screening and throughout the investigational period and for 5 half-lives (approximately 7 months after final study intervention administration or after at least 9 months for participants with 1L ESCC receiving combination therapy, or per local labeling requirements, whichever is longer).
Male participant must agree to use contraception with female partner(s) of childbearing potential (including breastfeeding partner) throughout the treatment period and for 4 months after final study intervention administration or after at least 9 months for participants with 1L ESCC receiving combination therapy, or per local labeling requirements, whichever is longer.
Male participant must agree to remain abstinent or use a condom with pregnant partner(s) for the duration of the pregnancy throughout the investigational period and for 4 months after final study intervention administration or after at least 9 months for participants with 1L ESCC receiving combination therapy, or per local labeling requirements, whichever is longer.
Exclusion Criteria:
Participant weighs < 40 kg during screening.
Participant has known active central nervous system (CNS) metastases. NOTE: A participant with CNS metastases that have been treated with surgery and/or radiation therapy, who is no longer taking pharmacologic doses of glucocorticoids and is neurologically stable, is eligible. Prophylactic use of anticonvulsants is permitted.
Participant has any of the following:
Participant has active or prior autoimmune or inflammatory disorders requiring systemic therapy within the past 2 years including inflammatory skin conditions, inflammatory bowel disease (e.g., ulcerative colitis or Crohn's disease), diverticulitis (with the exception of diverticulosis), celiac disease, systemic lupus erythematosus, Sarcoidosis syndrome, Wegener syndrome (granulomatosis with polyangiitis), Graves' disease, rheumatoid arthritis, hypophysitis or uveitis. The following are exceptions to this criterion:
Participant has leptomeningeal disease as a manifestation of the current malignancy.
Participant has a known additional malignancy that requires active treatment, with the exception of any of the following:
Participant has a known history of HIV infection with AIDS-related complications. HIV testing will be conducted per local requirements.
Participant has clinically significant cardiac disease, defined as any of the following:
Participant has a history of pleurodesis with impaired lung mechanics, recent (< 6 weeks) pleurodesis or pleural surgery (decortication, pleurectomy), drug-induced fibrosing ILD, trapped lung, complicated pleural effusion, uncontrolled malignant pleural effusion, idiopathic pulmonary fibrosis, pneumonectomy, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, noninfectious ILD/pneumonitis, fibrotic lung disease or connective tissue disorder with pulmonary involvement. Any participant with a history of radiation pneumonitis that required treatment (e.g., steroid) will be excluded, regardless of resolution. NOTE: Participant with previously diagnosed Grade 1 radiation pneumonitis is allowed to be screened for the study. However, radiation pneumonitis must be confined to the previously irradiated area of the lung and be completely resolved.
Participant has current Grade ≥ 1 ILD/pneumonitis, evidence of active pneumonitis on screening chest CT scan, or suspected ILD/pneumonitis that cannot be ruled out by imaging at screening. NOTE: If participant requires intermittent use of bronchodilators, inhaled steroids or local steroid injections, they will not be excluded.
Participant has pericardial disease related to prior radiation therapy.
Participant has a confirmed SpO2 < 92% at screening.
Participant requires chronic oxygen supplementation therapy inclusive of noninvasive ventilation or bilevel positive airway pressure.
Participant has any lung or heart disease (e.g., asthma, COPD, congestive heart failure) with uncontrolled symptoms or recent exacerbation or which may confound pulmonary safety assessments.
Participant is at a significant risk of bleeding due to medical condition(s) or recent major bleeding (e.g., bleeding in critical site or requiring transfusions).
Participant has current peripheral neuropathy Grade ≥ 2 (specific for platinum-containing cohorts only).
Participant has a history of Grade ≥ 2 hearing loss (specific for platinum-containing cohorts only).
Participant has received any strong inhibitors of CYP3A and CYP1A2 within 1 week or 5 half-lives (whichever is longer) or strong inducers of CYP3A within 2 weeks or 5 halflives (whichever is longer) before the first dose of ASP388B.
Participant has received prior B7-H3 targeting agents, STING agonists or TopI inhibitor (exception: monotherapy dose escalation cohorts).
Participant has received prior radiation therapy within 2 weeks of the first dose of study intervention. Participant must have recovered from all radiation-related toxicities and not require corticosteroids. A 1-week washout is permitted for palliative radiation (≤ 3 weeks of radiotherapy) to non-CNS disease.
Participant is receiving anticoagulants (vitamin K antagonists or direct oral anticoagulants) or antiplatelet agents. Low dose aspirin is allowed.
Participant has received prior immuno-oncology anticancer therapy within 6 weeks prior to the first dose of study intervention. Participant has received any other prior anticancer therapy within 28 days or 5 half-lives, whichever is longer, of the first dose of study intervention.
Astellas.registration@astellas.com
Participants with head and neck squamous cell carcinoma (HNSCC) \[including nasopharyngeal cancer (NPC)\], esophageal squamous cell carcinoma (ESCC), metastatic castration-resistant prostate cancer(mCRPC), squamous non-small cell lung cancer (sqNSCLC) or small cell lung cancer (SCLC) will receive the dose based on the assigned dose level of ASP388B in 21-day cycles.
Participants with HNSCC excluding NPC, will receive ASP388B in 21-day cycles with dose level(s) selected from dose escalation.
Participants with ESCC will receive ASP388B in 21-day cycles with dose level(s) selected from dose escalation.
Participants with HNSCC excluding NPC and salivary gland tumors will receive ASP388B in 21-day cycles at dose level(s) based on emerging data.
Participants with ESCC will receive ASP388B in 21-day cycles at dose level(s) based on emerging data.
Participants with HNSCC excluding NPC and salivary gland tumors will receive ASP388B in 21-day cycles at dose level(s) based on emerging data.
Participants with ESCC will receive ASP388B in 21-day cycles at dose level(s) based on emerging data.
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