Subjects With Metastatic or Locally Advanced Solid Tumors, and Expansion Into Select Solid Tumors (Cervical)

Completed · Phase 1/Phase 2

Conditions studied: Cervical Cancer

In brief

This is a Phase 1/2, open-label study of AGEN1884 in combination with AGEN2034 in subjects with locally advanced, recurrent and/or metastatic solid tumors including cervical cancer. AGEN2034 is a novel, fully human monoclonal immunoglobulin G4 (IgG4) antibody, designed to block program cell death-1 (PD-1). AGEN1884 is a novel, fully human monoclonal immunoglobulin G1 (IgG1) antibody, designed to block cytotoxic T-lymphocyte antigen-4 (CTLA-4).

Key facts

Study ID

NCT03495882

Run by

Agenus Inc.

People needed

154

Starts

2017-12-18

Expected to finish

2022-07-15

Last updated by the study team

2023-07-05

Who can join

Age: 18 and older. Sex: female. Healthy volunteers: not accepted.

You may qualify if…

• To be eligible for participation in this trial the subject must:
• Voluntarily agree to participate by giving written informed consent. (Participation in pharmacogenomics testing is optional.)
• Be ≥18 years of age.
• Diagnosis:
• Phase 1: Male or female having a histologically or cytologically confirmed diagnosis of a locally advanced, recurrent, and/or metastatic solid tumor for which no standard therapy is available or standard therapy has failed.
• Phase 2:
• I. Female having (1) a histologically or cytologically confirmed diagnosis of squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix, and (2) locally advanced, recurrent, and/or metastatic disease at the time of enrollment. Histologic confirmation of the original primary tumor is required via pathology report.
• Note: The following cervical tumors are not eligible: minimal deviation/adenoma malignum, gastric type adenocarcinoma, clear cell carcinoma, and mesonephric carcinoma.
• II. Has cervical cancer and has relapsed after a platinum-based treatment (first line) regimen for locally advanced, recurrent, and/or metastatic disease; Note: Subjects who only received platinum-based chemotherapy concurrently with primary radiation (e.g., weekly cisplatin) or adjuvant chemotherapy following completion of radiation therapy (e.g., paclitaxel and carboplatin for ≤4 cycles) and progressed within 6 months after treatment completion will be eligible as this systemic therapy will be considered first line.
• Measurable Disease:
• Phase 1: Have objective evidence of disease; the presence of measurable disease is not required.
• Phase 2: Have measurable disease on imaging based on RECIST version 1.1. Note: Subjects must have at least one "target lesion" to be used to assess response, as defined by RECIST version 1.1. Tumors within a previously irradiated field will be designated as "non-target" lesions unless progression is documented, or a biopsy is obtained to confirm persistence at least 90 days following completion of radiation therapy.
• Note: Measurable disease by RECIST 1.1 must be confirmed by independent central radiologic review prior to first dose. Subjects without centrally confirmed measurable disease at baseline will not be eligible for this trial.
• Have a life expectancy of at least 3 months and an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
• Have adequate organ function as indicated by the following laboratory values:
• Adequate hematological function defined by absolute neutrophil count (ANC) ≥1.5 x 10\^9/L, platelet count ≥100 x 10\^9/L, and hemoglobin
• ≥8 g/dL (without transfusions within 1 week of first dose).
• Adequate hepatic function based on a total bilirubin level <1.5 x the institutional upper limit of normal (IULN), aspartate aminotransferase (AST) level ≤2.5 x IULN, alanine aminotransferase (ALT) level ≤2.5 x IULN, and alkaline phosphatase ≤2.5 IULN.
• Adequate renal function defined as creatinine ≤1.5 x IULN OR calculated creatinine clearance ≥50 mL/min for subjects with creatinine levels >1.5 x IULN (if no local guideline is available, creatinine clearance should be calculated using the Cockcroft-Gault Method).
• Adequate coagulation defined by international normalized ratio (INR) or prothrombin time ≤1.5 x IULN (unless the subject is receiving anticoagulant therapy); and activated partial thromboplastin time (aPTT) ≤1.5 x IULN (unless the subject is receiving anticoagulant therapy)
• Other than the cancer for which the subject is enrolled, have no history of prior malignancy, with the exception of basal cell carcinoma of the skin, superficial bladder cancer, squamous-cell carcinoma of the skin, or has undergone potentially curative therapy with no evidence of that disease recurrence for 5 years since initiation of that therapy.
• Note: In Phase 2, the history and time requirement for no evidence of disease for 5 years does not apply to the cancer for which the subject is enrolled in the trial.
• In Phase 2, subjects must provide a sufficient and adequate formalin fixed paraffin embedded (FFPE) tumor tissue sample preferably from the most recent biopsy of a tumor lesion, collected either at the time of or after the diagnosis of locally advanced, recurrent, and/or metastatic disease has been made AND from a site not previously irradiated. If no tumor tissue is available, a fresh biopsy will be required.
• Note: Tissue from needle or excisional biopsy or from resection is required.
• Female subjects must have a negative serum pregnancy test at screening (within 72 hours of first dose of study drug) if of childbearing potential or be of non- childbearing potential. Non-childbearing potential is defined as (by other than medical reasons):

You may not qualify if…

• The subject must be excluded from participating in the trial if the subject:
• Is currently participating and receiving trial therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment.
• Has an inadequate washout period prior to first dose of study drug defined as:
• Received systemic cytotoxic chemotherapy or biological therapy within 3 weeks before first dose,
• Received radiation therapy within 3 weeks before first dose, or
• Had major surgery within 4 weeks before first dose.
• Has received prior therapy with:
• Any antibody/drug targeting T-cell co-regulatory proteins (immune checkpoints) such as anti-PD-1, anti-PD-L1, or anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4) antibodies
• For Phase 2: >1 systemic treatment regimen for the locally advanced recurrent, and/or metastatic cervical cancer for which the subject is considered for the study. Subjects who received a systemic regimen immediately after progressing within 6 months of completing chemotherapy concurrent with primary radiation or adjuvant chemotherapy after radiation will only be considered as having 1 prior systemic regimen for the purpose of this criterion.
• Note: In Phase 1, prior treatment with a CTLA-4 antibody is permissible for subjects with metastatic melanoma.
• Has persisting toxicity related to prior therapy of National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 (NCI-CTCAE) Grade >1 severity.
• Note: Sensory neuropathy or alopecia of Grade ≤2 is acceptable.
• Is expected to require any other form of systemic or localized antineoplastic therapy while on trial (including maintenance therapy with another agent, radiation therapy, and/or surgical resection).
• Has known severe hypersensitivity reactions to fully human monoclonal antibodies (NCI-CTCAE Version 4.03 Grade ≥3), any history of anaphylaxis, or uncontrolled asthma.
• Is receiving systemic corticosteroid therapy ≤7 days prior to first dose of study treatment or receiving any other form of systemic immunosuppressive medication (corticosteroid use on study for management of immune-related adverse events (AE), and/or a premedication for intravenous (IV) contrast allergies/reactions is allowed). Subjects who are receiving daily corticosteroid replacement therapy are an exception to this rule. Examples of permitted therapy are daily prednisone at doses of 5 to 7.5 mg or equivalent hydrocortisone dose, and steroid therapy administered by topical, intraocular, intranasal, and/or inhalation routes.
• Has a central nervous system (CNS) tumor, metastasis(es), and/or carcinomatous meningitis identified either on the baseline brain imaging obtained during the screening period OR identified prior to consent.
• Note: Subjects with history of brain metastases that have been treated may participate provided they show evidence of stable supra-tentorial lesions at screening (based on 2 sets of brain images performed ≥4 weeks apart, and obtained after the brain metastases treatment). In addition, any neurologic symptoms that developed either as a result of the brain metastases or their treatment must have resolved or be minimal and be expected as sequelae from treated lesions. For individuals who received steroids as part of brain metastases treatment, steroids must be discontinued ≥7 days prior to first dose of study drug.
• Has active or history of autoimmune disease that has required systemic treatment within 2 years of the start of study treatment (i.e. with use of disease modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (i.e., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of immunosuppressive systemic treatment.
• Note: Subjects with diabetes type 1, vitiligo, psoriasis, hypo-, or hyperthyroid disease not requiring immunosuppressive treatment are eligible.
• Has had an allogeneic tissue/solid organ transplant.
• Has or had interstitial lung disease (ILD) OR has had a history of pneumonitis that has required oral or IV corticosteroids.
• Has an active infection requiring IV systemic therapy.
• Has known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
• Has known active Hepatitis B, Hepatitis C, or tuberculosis. Active Hepatitis B is defined as a known positive HBsAg result. Active Hepatitis C is defined by a known positive Hep C Ab result and known quantitative HCV RNA results greater than the lower limits of detection of the assay.
• Has clinically significant (i.e., active) cardiovascular disease: cerebral vascular accident/stroke or myocardial infarction within 6 months of enrollment, unstable angina, congestive heart failure (New York Heart Association class ≥II), or serious uncontrolled cardiac arrhythmia requiring medication.

Where it is running

• Comprehensive Care and Research Center — Goodyear, Arizona, United States
• City of Hope National Medical Center — Duarte, California, United States
• University of Miami — Miami, Florida, United States
• BRCR Medical Center, Inc — Plantation, Florida, United States
• Augusta University — Augusta, Georgia, United States
• Cancer Treatment Centers of America — Zion, Illinois, United States
• Ochsner Cancer Institute — New Orleans, Louisiana, United States
• West Michigan Cancer Center — Kalamazoo, Michigan, United States
• University of Oklahoma — Oklahoma City, Oklahoma, United States
• Chattanooga's Program In Women's Oncology — Chattanooga, Tennessee, United States
• CliniCore International — Baytown, Texas, United States
• Providence Regional Cancer System — Aberdeen, Washington, United States
• Swedish Cancer Institute — Seattle, Washington, United States
• Linear Clinical Research — Perth, Western Australia, Australia
• Mater Research — South Brisbane, Australia
• Icon Cancer Care South Brisbane — South Brisbane, Australia
• Scientia Clinical Research — Sydney, Australia
• Clínica de Pesquisas e Centro de Estudos em Oncologia Ginecológica e Mamária Ltda. — São Paulo, Brazil
• IBCC - Instituto Brasileiro de Controle do Câncer — São Paulo, Brazil
• LLC Arensia Exploratory Medicine — Tbilisi, Georgia
• Magyar Honvedseg Egeszsegugyi Kozpont — Budapest, Hungary
• Orszagos Onkologiai Intezet — Budapest, Hungary
• Debreceni Egyetem — Debrecen, Hungary
• Bacs-Kiskun Megyei Korhaz — Kecskemét, Hungary
• Pecsi Tudomanyegyetem — Pécs, Hungary

Full record on ClinicalTrials.gov

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