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Study BT5528-100 in Patients With Advanced Solid Tumors Associated With EphA2 Expression

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04180371
Recruitment Status : Recruiting
First Posted : November 27, 2019
Last Update Posted : November 27, 2019
Sponsor:
Information provided by (Responsible Party):
Bicycle Tx Limited

Brief Summary:

This clinical trial is evaluating a drug called BT5528 alone and in combination with nivolumab in participants with advanced solid tumors that are believed to be associated with EphA2 expression. The main goals of this study are to:

  • Find the recommended dose of BT5528 that can be given safely to participants alone and in combination with nivolumab
  • Learn more about the side effects of BT5528
  • Learn more about BT5528 therapy alone and in combination with nivolumab.

Condition or disease Intervention/treatment Phase
Non Small Cell Lung Cancer Ovarian Cancer Triple Negative Breast Cancer Gastric Cancer Pancreatic Cancer Urothelial Cancer Drug: BT5528 Drug: Nivolumab Phase 1 Phase 2

Detailed Description:

BT5528 consists of a bicyclic peptide (Bicycle®) which binds to EphA2, and is covalently attached to a spacer and a protease cleavable peptide linker attached to MMAE.

The Phase I/II multi-center, open-label trial will evaluate BT5528 administered once-weekly as a single agent and in combination with nivolumab. The Phase I portion is a dose escalation primarily designed to assess the safety and tolerability of BT5528 and to determine a recommended Phase II dose (RP2D). Following selection of a recommended Phase II dose (RP2D), a dose expansion portion will be initiated with the primary objective of evaluating the clinical activity of BT5528.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 152 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I/II Study of the Safety, Pharmacokinetics, and Preliminary Clinical Activity of BT5528 in Patients With Advanced Malignancies Associated With EphA2 Expression
Actual Study Start Date : November 7, 2019
Estimated Primary Completion Date : December 31, 2022
Estimated Study Completion Date : December 31, 2023


Arm Intervention/treatment
Experimental: Phase I - Dose escalation (BT5528)
Cohorts of participants will receive increasing doses of BT5528. It is expected that up to 48 participants will participate in this dose escalation arm.
Drug: BT5528
Participants will receive a 60-minute intravenous infusion of BT5528 once a week (Days 1, 8, 15, and 22) on a 4-week cycle at the selected dose.

Experimental: Phase I - Dose escalation combination (BT5528 & nivolumab)
Cohorts of participants will receive increasing doses of BT5528 and a standard dose of nivolumab. It is expected that up to 24 participants will participate in this dose escalation combination arm.
Drug: BT5528
Participants will receive a 60-minute intravenous infusion of BT5528 once a week (Days 1, 8, 15, and 22) on a 4-week cycle at the selected dose.

Drug: Nivolumab
Participants will receive nivolumab at 480mg intravenous infusion every 4 weeks.
Other Name: Opdivo

Experimental: Phase II - Dose expansion (BT5528)
A cohort of non-small cell lung cancer participants will receive the selected dose of BT5528. It is expected that up to 40 participants will participate in this dose expansion arm.
Drug: BT5528
Participants will receive a 60-minute intravenous infusion of BT5528 once a week (Days 1, 8, 15, and 22) on a 4-week cycle at the selected dose.

Experimental: Phase II - Dose expansion combination (BT5528 & nivolumab)
A cohort of non-small cell lung cancer participants will receive the selected dose of BT5528 in combination with a standard dose of nivolumab. It is expected that up to 40 participants will participate in this dose expansion arm.
Drug: BT5528
Participants will receive a 60-minute intravenous infusion of BT5528 once a week (Days 1, 8, 15, and 22) on a 4-week cycle at the selected dose.

Drug: Nivolumab
Participants will receive nivolumab at 480mg intravenous infusion every 4 weeks.
Other Name: Opdivo




Primary Outcome Measures :
  1. Phase I: Number of participants receiving BT5528 alone and in combination with nivolumab with treatment-emergent adverse events [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until 30 days post last dose ]
    Safety reported as incidence of treatment-emergent adverse events

  2. Phase I: Maximum tolerated dose (MTD) by the number of participants with dose limiting toxicities from BT5528 treatment alone and in combination with nivolumab [ Time Frame: At the end of Cycle 1 (each cycle is 28 days) ]
    Maximum Tolerated Dose (MTD)

  3. Phase II: Objective response rate by RECIST 1.1 in participants with selected solid tumor indications receiving BT5528 treatment alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months) ]
    Objective Response Rate (ORR)

  4. Phase II: Duration of response by RECIST 1.1 in participants with selected solid tumor indications receiving BT5528 treatment alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Duration of Response (DOR)

  5. Phase II: Clinical benefit rate by RECIST 1.1 in participants with selected solid tumor indications receiving BT5528 treatment alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Clinical benefit rate

  6. Phase II: Time to tumor progression by RECIST 1.1 in participants with selected solid tumor indications receiving BT5528 treatment alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Time to Progression (TTP)

  7. Phase II: Progression free survival by RECIST 1.1 in participants with selected solid tumor indications receiving BT5528 treatment alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Progression free survival (PFS)

  8. Phase II: Progression free survival at 6 months by RECIST 1.1 in participants with selected solid tumor indications receiving BT5528 treatment alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months) ]
    Progression free survival (PFS)

  9. Phase II: Overall survival at 1 year in participants with selected solid tumor indications receiving BT5528 treatment alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until death or loss of follow-up or withdrawal of consent (assessed every 3 months for up to 1 year) ]
    Overall survival (OS)


Secondary Outcome Measures :
  1. Phase I: Objective response rate by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Objective Response Rate (ORR)

  2. Phase I: Duration of response by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Duration of Response (DOR)

  3. Phase I: Clinical benefit rate by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Clinical benefit rate

  4. Phase I: Time to tumor progression by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Time to progression (TTP)

  5. Phase I: Progression free survival time by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months then every 16 weeks up to 12 months ]
    Progression free survival (PFS)

  6. Phase I: Progression free survival at 6 months by RECIST 1.1 in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or loss of follow-up or withdrawal of consent (assessed every 8 weeks up to 6 months) ]
    Progression free survival (PFS)

  7. Phase I: Overall survival time at 12 months in participants with advanced solid tumors with high EphA2 levels receiving BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until death or loss of follow-up or withdrawal of consent (assessed every 3 months up to 12 months ]
    Overall survival (OS)

  8. Phase II: Determination of the number of participants with non-small cell lung cancer receiving BT5528 alone and in combination with nivolumab with treatment-emergent adverse events [ Time Frame: From Cycle 1 Day 1 (each cycle is 28 days) until 30 days post last dose ]
  9. All phases: Maximum observed plasma concentration (Cmax) of BT5528 in plasma from all participants taking BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1,and end of each cycle (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or withdrawal of consent(assessed up to 12 months ]
  10. All phases: Minimum observed plasma concentration (Cmin) of BT5528 in plasma from all participants taking BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1,and end of each cycle (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or withdrawal of consent(assessed up to 12 months ]
  11. All phases: Area under the plasma concentration versus time curve (AUC) of BT5528 in plasma from all participants taking BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1,and end of each cycle (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or withdrawal of consent(assessed up to 12 months ]
  12. All phases: Biological terminal half-life (t1/2) of BT5528 in plasma from all participants taking BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1,and end of each cycle (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or withdrawal of consent(assessed up to 12 months ]
  13. All phases: Number of participants positive for anti-drug antibodies (ADA) from all participants receiving BT5528 alone and in combination with nivolumab [ Time Frame: From Cycle 1,and end of each cycle (each cycle is 28 days) until disease progression or death or new anti-cancer therapy or withdrawal of consent(assessed up to 12 months ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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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

General Inclusion:

  • Written informed consent, according to local guidelines, signed and dated by the patient or by a legal guardian prior to the performance of any study-specific procedures, sampling or analyses
  • Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1
  • Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
  • Acceptable renal, hepatic, hematologic and coagulation functions
  • Negative pregnancy test for women of childbearing potential
  • Male participants with female partners of childbearing potential and female participants of childbearing potential are required to follow highly effective contraception
  • Availability of archived tumor samples or willingness to provide fresh tumor biopsy during screening

Additional inclusion criteria for Phase I (dose escalation phase, with BT5528 alone or in combination with nivolumab):

  • Have advanced, histologically confirmed malignant solid tumors historically known for high expression of EphA2 that recurred after previous therapy and are candidates for a Phase I study due to lack of approved or standard options for treatment

Additional inclusion criteria for Phase II (dose expansion phase, with BT5528 alone or in combination with nivolumab):

  • Participants with metastatic recurrent disease histologically confirmed to be adenocarcinoma subtype of NSCLC (adeno-NSCLC) are eligible and must have exhausted all standard treatment options including progression on or after platinum-based chemotherapy

Exclusion criteria (all participants):

  • Chemotherapy treatments within 14 days prior to first dose of study treatment, other anticancer treatments, treatment within 28 days or 5 half-lives, whichever is the shorter
  • Experimental treatments within 4 weeks of first dose of BT5528
  • Current treatment with strong inhibitors or inducers of CYP3A4 or strong inhibitors of P-gp
  • Uncontrolled, symptomatic brain metastases
  • Any condition, therapy or laboratory abnormality that might confound the results of the study, interfere with the patient's participation, or is not in the best interest of the patient to participate in the opinion of the investigator including but not limited to specific cardiovascular criteria
  • Thromboembolic events and/or bleeding disorders 3 months (e.g., deep vein thrombosis [DVT] or pulmonary embolism [PE]) prior to first dose

Additional Exclusion Criteria (BT5528 in combination with nivolumab):

  • Prior organ transplant (including allogeneic)
  • Diagnosis of clinically relevant immunodeficiency
  • Active systemic infection requiring therapy
  • More than 10 mg daily prednisone equivalent or other strong immunosuppressant
  • History of autoimmune disease except alopecia or vitiligo
  • History of interstitial lung disease

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): NCT04180371


Contacts
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Contact: Bicycle Tx Limited 617-945-8155 clinicalstudies@bicycletx.com

Locations
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United States, Florida
Florida Cancer Specialists Recruiting
Sarasota, Florida, United States, 34232
Contact: Judy Wang, MD         
United States, Oklahoma
Stephenson Cancer Center (Oklahoma University) Not yet recruiting
Oklahoma City, Oklahoma, United States, 73104
Contact: Debra Richardson, MD         
United States, Pennsylvania
Thomas Jefferson University, Sidney Kimmel Cancer Center Not yet recruiting
Philadelphia, Pennsylvania, United States, 19107
Contact: Babar Bashir, MD         
United States, Tennessee
Tennessee Oncology, PLLC Recruiting
Nashville, Tennessee, United States, 37203
Contact: Johanna Bendell, MD         
Sponsors and Collaborators
Bicycle Tx Limited
Investigators
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Study Chair: Johanna Bendell Tennessee Oncology

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Responsible Party: Bicycle Tx Limited
ClinicalTrials.gov Identifier: NCT04180371    
Other Study ID Numbers: BT5528-100
First Posted: November 27, 2019    Key Record Dates
Last Update Posted: November 27, 2019
Last Verified: November 2019
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 Bicycle Tx Limited:
EphA2
Additional relevant MeSH terms:
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Triple Negative Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Neoplasms
Breast Diseases
Skin Diseases
Nivolumab
Antineoplastic Agents, Immunological
Antineoplastic Agents