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MGD019 DART® Protein in Unresectable/Metastatic Cancer

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ClinicalTrials.gov Identifier: NCT03761017
Recruitment Status : Recruiting
First Posted : December 3, 2018
Last Update Posted : April 28, 2021
Sponsor:
Information provided by (Responsible Party):
MacroGenics

Brief Summary:
The purpose of this study is to evaluate the safety and tolerability, pharmacokinetics (PK) pharmacodynamics and preliminary antitumor activity of MGD019.

Condition or disease Intervention/treatment Phase
Solid Tumor, Adult Advanced Cancer Squamous Cell Non Small Cell Lung Cancer Colorectal Cancer Prostate Cancer Metastatic Cutaneous Melanoma Biological: MGD019 Phase 1

Detailed Description:
This Phase 1, open-label study will characterize safety, dose-limiting toxicities (DLTs), and maximum tolerated/administered dose (MTD/MAD) of MGD019. Dose escalation will occur in a 3+3+3 design in patients with advanced solid tumors of any histology. Once the MTD/MAD is determined, a Cohort Expansion Phase will be enrolled to further characterize safety and initial anti-tumor activity in patients with specific tumor types anticipated to be sensitive to dual checkpoint blockade.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 287 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: 3+3+3 dose escalation design followed by cohort expansion at MTD/MAD
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1, First-in-Human, Open-Label, Dose Escalation and Cohort Expansion Study of MGD019, a Bispecific DART® Protein Binding PD-1 and CTLA-4 in Patients With Unresectable or Metastatic Neoplasms
Actual Study Start Date : December 12, 2018
Estimated Primary Completion Date : January 2022
Estimated Study Completion Date : December 2023

Resource links provided by the National Library of Medicine

MedlinePlus Genetics related topics: Melanoma

Arm Intervention/treatment
Experimental: MGD019
Bispecific DART protein binding PD-1 and CTLA-4
Biological: MGD019
Bispecific DART protein binding PD-1 and CTLA-4




Primary Outcome Measures :
  1. Incidence of treatment-emergent adverse events [ Time Frame: 30 days after last dose ]
    Safety is based on evaluation of adverse events (AEs) and serious adverse events (SAEs) from the time of study drug administration through the End of Study visit.


Secondary Outcome Measures :
  1. Cmax [ Time Frame: up to 108 weeks ]
    Maximum Plasma Concentration of MGD019

  2. Tmax [ Time Frame: up to 108 weeks ]
    Time to reach maximum (peak) plasma concentration of MGD019

  3. AUC [ Time Frame: up to 108 weeks ]
    Area Under the Plasma Concentration versus Time Curve of MGD019

  4. Ctrough [ Time Frame: up to 108 weeks ]
    Trough plasma concentration of MGD019

  5. CL [ Time Frame: up to 108 weeks ]
    Total body clearance of the drug from plasma of MGD019

  6. Vss [ Time Frame: up to 108 weeks ]
    Apparent volume of distribution at steady state of MGD019

  7. t1/2 [ Time Frame: up to 108 weeks ]
    Terminal half life of MGD019

  8. Percent of patients with anti-drug antibodies against MGD019 [ Time Frame: up to 108 weeks ]
    Immunogenicity

  9. Preliminary anti-tumor activity of MGD019 [ Time Frame: Every 12 - 24 weeks while patient is on treatment ]
    Efficacy assessed using conventional Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1)

  10. Radiographic progression-free survival (PFS) in metastatic castration-resistant prostate cancer (mCRPC) [ Time Frame: up to 2 years post last treatment ]
    Time from first dose to first occurrence of radiographic progression, or death

  11. Prostate specific antigen (PSA) response rate in mCRPC [ Time Frame: up to 2 years post last treatment ]
    Percent of patients with 50% or more decline in PSA and confirmed 3 weeks later

  12. Best PSA percent change in mCRPC [ Time Frame: up to 2 years post last treatment ]
    Best percent change in PSA from baseline

  13. Duration of PSA response [ Time Frame: up to 2 years post last treatment ]
    Time from PSA response to time of PSA progression



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Dose escalation: Patients with histologically proven, unresectable, locally advanced or metastatic solid tumors for whom no approved therapy with demonstrated clinical benefit is available or patients who are intolerant to standard therapy.
  • Cohort Expansion Phase:
  • Checkpoint inhibitor-naïve squamous cell NSCLC, including:

    1. Patients that have progressed during or following treatment with platinum-based chemotherapy for advanced disease. Patients harboring an activating epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) rearrangement must have progressed following at least one available EGFR or ALK targeted therapy.
    2. Patients with previously untreated squamous cell NSCLC without activating mutations for whom checkpoint inhibitor therapy is not approved or available.
  • Advanced non-microsatellite instability-high colorectal cancer (CRC) with recurrence, progression, or intolerance to standard therapy consisting of at least 2 prior standard regimens. CRC harboring an activating EGFR mutation must have progressed during or following at least one available EGFR targeted therapy. Patients who are inappropriate candidates for or have refused treatment with these regimens are also eligible. Patients should have received no more than 4 prior lines of systemic therapy.
  • Checkpoint inhibitor-naïve and chemotherapy-naïve (i.e., docetaxel-naïve) mCRPC that has progressed during or following no more than 2 prior lines of an androgen receptor antagonist or androgen synthesis inhibitor (e.g., enzalutamide or abiraterone, respectively), if approved and available, with a PSA value of at least 2 ng/mL and meeting at least one of the following:
  • Progression in measurable disease (RECIST v1.1).
  • Appearance of 2 or more new bone lesions according to Prostate Cancer Working Group 2 (PCWG-2).
  • Rising PSA defined as at least two sequential rises in PSA.
  • Cutaneous melanoma that has progressed during or following systemic treatment for unresectable, locally advanced, or metastatic disease. Patients will have received PD-(L)1 and/or CTLA-4 pathway inhibitors where available and indicated. No more than 3 prior systemic regimens are allowed.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
  • Life expectancy ≥ 12 weeks.
  • Measurable disease as per RECIST 1.1 for the purpose of response assessment must either (a) not reside in a field that has been subjected to prior radiotherapy or (b) have demonstrated clear evidence of radiographic progression since the completion of prior radiotherapy and prior to study enrollment.
  • All patients must have an identified formalin-fixed, paraffin embedded (FFPE) tumor specimen (up to 20 slides or a block) for immunohistochemical evaluation of pharmacodynamic markers of interest. Patients may undergo a fresh tumor biopsy during the screening period if a tumor sample is not available. Patients in the mCRPC expansion cohort with bone only disease not amenable to fresh biopsy may be eligible in consultation with the Sponsor.
  • Acceptable laboratory parameters and adequate organ reserve.

Exclusion Criteria:

  • In patients who have previously received an immune checkpoint inhibitor (e.g., anti-PD-L1, anti-PD-1, anti-CTLA-4), toxicities related to the checkpoint inhibitor must have resolved to ≤ Grade 1 or baseline. Patients with well controlled immune endocrinopathies secondary to prior checkpoint therapy are eligible.
  • Patients with symptomatic CNS metastases. Patients with history of prior CNS metastasis must have been treated, must be asymptomatic, and must not have concurrent treatment for the CNS disease, progression of CNS metastases on magnetic resonance imaging (MRI) or computed tomography (CT) for at least 14 days after last day of prior therapy for the CNS metastases, or concurrent leptomeningeal disease or cord compression.
  • Patients who sustained the following Grade 3 immune checkpoint inhibitor related AEs are ineligible: Ocular AE, changes in liver function tests that met the criteria for Hy's law (> 3 × ULN of either ALT or AST with concurrent > 2 × ULN of total bilirubin and without alternate etiology), neurologic toxicity, colitis, renal toxicity, pneumonitis.
  • Patients who have received prior therapy with a combination of monoclonal antibodies against PD-1/PD-L1 and CTLA-4 will be excluded in the Cohort Expansion (this does not apply to the melanoma expansion cohort).
  • Patients with any history of known or suspected autoimmune disease with certain exceptions
  • History of prior allogeneic bone marrow, stem-cell, or solid organ transplantation.
  • History of trauma or major surgical procedure within 4 weeks prior to initiation of study drug administration.
  • Systemic antineoplastic therapy, or investigational therapy (for all tumor types) or androgen receptor antagonist/androgen synthesis inhibitor for mCRPC (e.g., enzalutamide or abiraterone, respectively) within the 4 weeks prior to initiation of study drug administration.
  • Treatment with radiation therapy within 2 weeks prior to initiation of study drug administration.
  • Radioligand (e.g., radium-223) within 6 months prior to initiation of study drug administration for mCRPC in the Cohort Expansion Phase.
  • Serum testosterone > 50 ng/dl or > 1.7 nmol/L for mCRPC in the Cohort Expansion Phase.
  • Confirmed or presumed COVID-19/SARS-CoV-2 infection. While SARS-CoV-2 testing is not mandatory for study entry, testing should follow local clinical practice guidelines/standards. Patients with a positive test result for SARS-CoV-2 infection, known asymptomatic infection, or presumed infection are excluded. Patients may be considered eligible after a resolved SARS-CoV-2 infection once he or she remains afebrile for at least 72 hours and after other SARS-CoV-2-related symptoms have fully recovered to baseline for a minimum of 72 hours

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03761017


Contacts
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Contact: Rosetta Cavallo 240.552.8104 cavallor@macrogenics.com

Locations
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United States, Massachusetts
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02215
Contact: Sejal Batra    617-726-2000    SBATRA4@mgh.harvard.edu   
Principal Investigator: Gregory Cote, MD         
United States, Michigan
START Midwest Recruiting
Grand Rapids, Michigan, United States, 49546
Contact: Katie L. Robinson, BSN, RN    616-389-1739    Katie.Robinson@startmidwest.com   
Principal Investigator: Manish Sharma, MD         
United States, Oregon
Providence Portland Medical Center Recruiting
Portland, Oregon, United States, 97213
Contact: Christina Lopez    503-215-2614    CanRsrchStudies@providence.org   
Principal Investigator: Rachel Sanborn, MD         
United States, Pennsylvania
UPMC Hillman Cancer Center Not yet recruiting
Pittsburgh, Pennsylvania, United States, 20850
Contact: Krystle Easton    412-623-7957    mientkiewiczk@upmc.edu   
Principal Investigator: Jason Luke, MD         
United States, Tennessee
The Sarah Cannon Research Institute / Tennessee Oncology Recruiting
Nashville, Tennessee, United States, 37203
Contact: Sheetal Champaneria    615-329-6875    Sheetal.Champaneria@sarahcannon.com   
Principal Investigator: Johanna Bendell, MD         
Sponsors and Collaborators
MacroGenics
Investigators
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Study Director: Bradley Sumrow, MD MacroGenics
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Responsible Party: MacroGenics
ClinicalTrials.gov Identifier: NCT03761017    
Other Study ID Numbers: CP-MGD019-01
First Posted: December 3, 2018    Key Record Dates
Last Update Posted: April 28, 2021
Last Verified: April 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by MacroGenics:
Checkpoint blockade
Additional relevant MeSH terms:
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Melanoma
Neoplasms
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Nerve Tissue
Nevi and Melanomas