Phase 1/2, Open-label, Multi-center, First-in-human Study of the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics and Anti-tumor Activity of STX-003 Delivered by Intravenous Injection in Patients with Advanced Solid Tumors as a Monotherapy or in Combination with Pembrolizumab.
Inclusion Criteria:
Inclusion Criteria (Phase 1 and Phase 2)
Hematology:
ANC ≥ 1,000 cells/mm3.
Platelet count ≥ 75,000 cells/mm3.
Hemoglobin ≥ 8.0 g/dL.
Coagulation:
PT/INR or PT must be ≤ 1.5 × ULN.
aPTT ≤ 1.5 × ULN unless undergoing anticoagulation therapy.
• Liver:
Albumin ≥ 3.5 g/dL or within the normal range of the local reference laboratory.
AST and ALT < 2 × ULN.
Bilirubin ≤ 1.5 × ULN (except participants with documented Gilbert's syndrome who may be enrolled if the conjugated bilirubin is within normal limits) or ≤ 5 × ULN with liver metastases.
Phase 2 Inclusion Criteria
13. NSCLC :
Histologically or cytologically documented findings consistent with NSCLC not amenable to curative surgery, radiation, or other therapy.
Biomarker confirmed as PD-L1+ per local institutional standard practice.
Patients with known activating EGFR, STK11 or KEAP1 mutations as well as ALK/ROS1 fusions, are not eligible.
Prior treatment (for advanced, metastatic or [neo]adjuvant) should have included a platinum-based therapy and a PD-1/L1 pathway checkpoint inhibitor, unless the patient is not a candidate for or has refused viable therapies due to inability to tolerate treatment (i.e. cell therapy) or potential side effects (i.e. checkpoint inhibitor toxicity).
14. Melanoma : Histologically or cytologically documented findings consistent with advanced cutaneous melanoma not amenable to curative surgery, radiation, or other therapy. Acral, mucosal and uveal melanoma are excluded.
Patients who are not candidates for or have refused available therapies due to inability to tolerate treatment (i.e. cell therapy) or potential side effects (i.e. checkpoint inhibitor toxicity) are also eligible.
Received an anti-PD-1/PD-L1 inhibitor as monotherapy or in combination with anti-CTLA-4 inhibitor and have either primary or secondary checkpoint inhibitor resistance asper SITC consensus definition, unless deemed intolerable by the Investigator. Patients with BRAF V600E mutant melanoma should have received a BRAF inhibitor as monotherapy or in combination with other targeted agents (MAPK kinase MEK inhibitors), unless deemed intolerable by the Investigator.
Exclusion Criteria:
Exclusion Criteria (Phase 1 and 2)
Medical Conditions
Cardiovascular exclusions
Recent medical concerns exclusions
Virology evaluation should be conducted at Screening to include serum HIV antibody, HBc antibody, HBsAg antigen, and HCV antibody. Patients with a positive antibody evaluation for HCV and/or HBc should undergo evaluation to measure HCV RNA or HBV DNA, respectively.
Untreated CNS tumor, epidural tumor or metastasis, or brain metastasis. Patients with any primary CNS malignancy including glioma and current, active, or progressing CNS malignancy, including carcinomatosis meningitis, are excluded.
Patients with treated brain metastases are eligible if there is no evidence of progression for at least 4 weeks after CNS-directed treatment, as ascertained by clinical examination and brain imaging (MRI or CT scan) during the Screening period and are off systemic steroids (for at least 2 weeks prior to first dose).
Another primary malignancy that has not been treated with curative intent (discuss with MM), except for non-metastatic cutaneous basal cell or squamous cell carcinoma, or non-muscle invasive bladder cancer.
Serious illness considered by the Investigator as incompatible with participating in this clinical study.
Major surgery within 4 weeks of first dose of study drug.
Any condition that, in the opinion of the Investigator, would interfere with evaluation of the investigational product or interpretation of the patients' safety or study results.
4. Prior/Concomitant Therapy
Prior treatment with STX-003 or other VEEV-based replicating RNA.
Prior IL-12 therapy.
Receipt of any live vaccine within 30 days prior to the first dose of study treatment.
Use of another systemic anticancer therapy within 3 weeks prior to C1D1 or 5 halflives, whichever is shorter or use of radiotherapy within 1 week prior to C1D1 5. Prior/Concurrent Clinical Study Experience
Previously enrolled in this study.
Actively enrolled in another clinical study unless it is an observational (noninterventional) clinical study or the follow-up component of an interventional study.
Known severe hypersensitivity (Grade ≥ 3) to study treatment or any of the excipients of the products.
Other Exclusions
stx-003-study@strandtx.com
STX-003 administered intravenously, at ascending doses across sequential cohorts, once per cycle for up to 35 cycles (approximately 24 months).
STX-003 administered intravenously, at ascending doses across sequential cohorts, once per cycle in combination with pembrolizumab for up to 35 cycles (approximately 24 months).
STX-003 administered intravenously, at 4 planned dose expansion cohorts in patients with advanced cancers with high unmet need, once per cycle for up to 35 cycles (approximately 24 months).
STX-003 administered intravenously, at 4 planned dose expansion cohorts in patients with advanced cancers with high unmet need, once per cycle for up to 35 cycles (approximately 24 months).
ashley.maheu@scri.com615-329-7274
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