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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT03319628




Registration number
NCT03319628
Ethics application status
Date submitted
17/10/2017
Date registered
24/10/2017
Date last updated
25/01/2023

Titles & IDs
Public title
First-in-Human Study of XMT-1536 in Cancers Likely to Express NaPi2b
Scientific title
A Phase 1b/2, First-in-Human, Dose Escalation and Expansion Study of XMT-1536 In Patients With Solid Tumors Likely to Express NaPi2b
Secondary ID [1] 0 0
XMT-1536-1
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Platinum Resistant Ovarian Cancer 0 0
Non Small Cell Lung Cancer Metastatic 0 0
Condition category
Condition code

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - upifitamab rilsodotin

Experimental: Dose Escalation - XMT-1536 (upifitamab rilsodotin) treatment is administered in groups of patients who will receive doses that increase over time.
This cohort is closed to enrollment.

Experimental: Dose Expansion - Ovarian Cancer - Once the maximum tolerated dose or recommended Phase 2 dose is achieved in dose escalation, new groups of patients will receive XMT-1536 (upifitamab rilsodotin) at this fixed-dose.
This cohort is closed to enrollment.

Experimental: Dose Expansion - NSCLC adenocarcinoma - Once the maximum tolerated dose or recommended Phase 2 dose is achieved in dose escalation, new groups of patients will receive XMT-1536 (upifitamab rilsodotin) at this fixed-dose.
This cohort is closed to enrollment.

Experimental: Pivotal Cohort (UPLIFT) - Patients with platinum-resistant ovarian cancer will receive XMT-1536 (upifitamab rilsodotin) to further confirm the efficacy

Experimental: QTc Sub-Study - For sites participating in the sub-study, patients with platinum -resistant ovarian cancer will have the option to enroll in this sub-study to evaluate potential changes in the QTc interval following administration of XMT-1536.


Treatment: Drugs: upifitamab rilsodotin
XMT-1536 will be administered once every 28 days until disease progression, unacceptable toxicity, or either the patient or study physician determines it is in the best interest of the patient to discontinue participation in the study.
For sites participating in the sub-study, patients with platinum -resistant ovarian cancer will have the option to enroll in this sub-study to evaluate potential changes in the QTc interval following administration of XMT-1536
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
DES: Maximum tolerated dose or recommended Phase 2 dose
Timepoint [1] 0 0
Up to 36 weeks, from the date of first dose until unacceptable side effects or a dose-limiting toxicity is met
Primary outcome [2] 0 0
DES and EXP: Safety and Tolerability
Timepoint [2] 0 0
First dose up until 30 days after study termination
Primary outcome [3] 0 0
EXP: Anti-neoplastic effects of XMT-1536 (upifitamab rilsodotin)
Timepoint [3] 0 0
Every 6 weeks for up to 36 weeks
Primary outcome [4] 0 0
UPLIFT: Investigator-assessed objective response rate (ORR) of XMT-1536 (upifitamab rilsodotin) in the ITT-Higher NaPi2b population
Timepoint [4] 0 0
Every 8 weeks until disease progression or up to 24 months
Primary outcome [5] 0 0
QTc Sub-study: Evaluation of the concentration response analysis of XMT-1536 versus the change in QTcF values
Timepoint [5] 0 0
60 minutes prior to first dose, up to 26 hours after Cycle 3 dose
Secondary outcome [1] 0 0
DES and EXP: Time of maximum observed concentration of XMT-1536 (upifitamab rilsodotin)
Timepoint [1] 0 0
Daily for one week after first dose; weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
Secondary outcome [2] 0 0
DES and EXP: Maximum concentration of XMT-1536 (upifitamab rilsodotin)
Timepoint [2] 0 0
Daily for one week after first dose; weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
Secondary outcome [3] 0 0
DES and EXP: Area under the concentration curve of the last measurable concentration of XMT-1536 (upifitamab rilsodotin)
Timepoint [3] 0 0
Daily for one week after first dose; weekly until 28 days after first dose; immediately before and after and 1 week after all subsequent doses
Secondary outcome [4] 0 0
DES: Anti-neoplastic effects of XMT-1536 (upifitamab rilsodotin)
Timepoint [4] 0 0
Every 6 weeks for up to 36 weeks
Secondary outcome [5] 0 0
DES and EXP: Anti-drug antibody and neutralizing antibody
Timepoint [5] 0 0
Every 6 weeks for up to 36 weeks
Secondary outcome [6] 0 0
UPLIFT: Confirmed Investigator-assessed objective response rate of XMT-1536 (upifitamab rilsodotin) regardless of NaPi2b expression
Timepoint [6] 0 0
Every 8 weeks until disease progression or up to 24 months
Secondary outcome [7] 0 0
UPLIFT: Confirmed objective response rate by independent radiology review (IRR) for patients with high NaPi2b and overall
Timepoint [7] 0 0
Every 8 weeks until disease progression or up to 24 months
Secondary outcome [8] 0 0
UPLIFT: Duration of objective response (DOR)
Timepoint [8] 0 0
4 weeks after first response and every 8 weeks until disease progression or up to 24 months
Secondary outcome [9] 0 0
UPLIFT: Incidence and severity of adverse events
Timepoint [9] 0 0
First dose up until 60 days after study termination
Secondary outcome [10] 0 0
QTc Sub-Study: Evaluation of the effect of XMT-1536 on QTcF in patients with platinum-resistant HGSOC by timepoint analysis
Timepoint [10] 0 0
60 minutes prior to first dose, up to 26 hours after Cycle 3 dose
Secondary outcome [11] 0 0
QTc Sub-Study: Evaluation of the effect of XMT-1536 on the PR-interval (PR), QRS duration (QRS), Heart Rate (HR), and ECG morphology
Timepoint [11] 0 0
60 minutes prior to first dose, up to 26 hours after Cycle 3 dose

Eligibility
Key inclusion criteria
General Inclusion Criteria (for Dose Escalation, Expansion, and UPLIFT):

- ECOG performance status 0 or 1

- Measurable disease as per RECIST, version 1.1

- Resolution of all acute toxic effects of prior therapy or surgical procedures to
=Grade 1 (except alopecia, stable immune-related toxicity such as hypothyroidism on
hormone replacement, adrenal insufficiency on =10 mg daily prednisone [or equivalent],
chronic Grade 2 peripheral sensory neuropathy after prior taxane therapy).

- Cardiac left ventricular ejection fraction (LVEF) =50% or = the institution's lower
limit of normal by either Echo or MUGA scan

- Adequate organ function as defined by the following criteria:

1. Absolute neutrophil count (ANC) =1500 cells/mm3

2. Platelet count =100,000/mm3

3. Hemoglobin =9 g/dL

4. In patients not on anticoagulation therapy: INR, activated partial thromboplastin
time (aPTT), and prothrombin time (PT) all within 1.2 times the institution's
upper limit of normal (ULN). Patients on anticoagulation therapy are allowed if
their relevant laboratory values are within the therapeutic window.

5. Estimated glomerular filtration rate (GFR) =45 mL/min

6. Total bilirubin =ULN

7. g. Patients with asymptomatic elevations in unconjugated bilirubin due to Gilbert
syndrome or stable chronic hemolytic anemia (e.g., hereditary spherocytosis,
sickle cell disease, thalassemia intermedia) may be eligible after discussion
with the Sponsor Medical Monitor.

- Aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT)
=1.5 times the institutional ULN.

- Albumin =3.0 g/dL

- Able to provide informed consent.

General
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Exclusion Criteria (for Dose Escalation, Expansion, and UPLIFT) :

- Major surgery within 28 days of starting study treatment, systemic anti-cancer therapy
within the lesser of 28 days or 5 half-lives of the prior therapy before starting
study treatment, or recent radiation therapy with unresolved toxicity or within a time
window of potential toxicity.

- Patients with untreated CNS metastases (including new and progressive brain
metastases), history of leptomeningeal metastasis or carcinomatous meningitis.

- Current known active infection with HIV, hepatitis B virus, or hepatitis C virus.

- Prior history of liver disease such as liver cirrhosis, hepatic fibrosis

- Current severe, uncontrolled systemic disease (e.g., clinically significant
cardiovascular, pulmonary, or metabolic disease) or intercurrent illness that could
interfere with per-protocol evaluations.

- Current use of either constant or intermittent supplementary oxygen therapy.

- History of suspected pneumonitis or interstitial lung disease.

- Pregnant or nursing women.

- History of other malignancy within the last 2 years, except for appropriately treated
carcinoma in situ of the cervix, non-melanoma skin carcinoma, or other malignancy with
a similar expected curative outcome.

- Active corneal disease, or history of corneal disease within 12 months prior to
enrollment

- Use of strong CYP450 3A inhibitors or inducers that cannot be discontinued while
receiving study treatment

- Oxygen saturation on room air <93%

Ovarian Cancer Inclusion Criteria for UPLIFT:

- Histological diagnosis of high grade serous ovarian cancer, which includes fallopian
tube, or primary peritoneal cancer, that is metastatic or recurrent.

- Platinum-resistant disease

1. Patients who have only had 1 line of platinum-based therapy must have received at
least 4 cycles of platinum, must have had a response [complete response/remission
(CR) or partial response/remission (PR)], and then progressed between 3 months
and = 6 months after the date of the last dose of platinum

2. Patients who have received 2 to 4 lines of prior therapy must have received at
least 4 cycles of platinum and then progressed within 6 months after the date of
the last dose of platinum

- One to 4 prior lines of systemic therapy for ovarian cancer

a. Prior treatment with bevacizumab is required for patients with 1 to 2 prior lines
of therapy

- Patients must be willing to provide an archival tumor tissue block or slides or if not
available, undergo procedure to obtain a new tumor biopsy using a low-risk, medically
routine procedure

Ovarian Cancer Exclusion Criteria for UPLIFT:

- Low-grade, clear cell, endometrioid, mucinous, carcinosarcoma, germ-cell, mixed
histology, or stromal tumors

- Prior treatment with mirvetuximab soravtansine or another ADC containing an
antitubulin payload

- Primary platinum-resistant disease, defined by a lack of response or by progression
within 3 months after completing front-line, platinum-containing therapy.

- Participation in DES or EXP segments of this study

Ovarian Cancer Inclusion Criteria for QTc sub-study:

Note: patients must meet all UPLIFT cohort inclusion criteria in order to participate in
the QTc sub-study

• Study patient has agreed to remain in the clinic for the additional QTc related study
activities on the Day 1 of Cycle 1 and Cycle 3.

Ovarian Cancer Exclusion Criteria for QTc sub-study:

- Use of strong CYP450 3A inducers.

- Uncontrolled cardiac arrhythmias, for example, atrial fibrillation with a ventricular
response at rest > 100 beats per minute. left bundle branch block (LBBB)

- Known abnormality of any cardiac valve (either stenosis or regurgitation) that is
greater than moderate in severity.

- Subjects not in sinus rhythm at screening with HR >45- <100

- Any ECG abnormality that can interfere with the measurement of the QT interval

Study design
Purpose of the study
Treatment
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Phase 1/Phase 2
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
12/12/2017
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
31/12/2024
Actual
Sample size
Target
444
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
VIC
Recruitment hospital [1] 0 0
Austin Health - Olivia Newton John Cancer Center - Heidelberg
Recruitment hospital [2] 0 0
Blacktown Road - Blacktown
Recruitment hospital [3] 0 0
Chris OBrien Lifehouse - Camperdown
Recruitment hospital [4] 0 0
Chris O'Brien Lifehouse - Camperdown
Recruitment hospital [5] 0 0
Royal Brisbane and Women's Hospital - Herston
Recruitment hospital [6] 0 0
Peter MacCallum Cancer Center - Melbourne
Recruitment hospital [7] 0 0
Icon Cancer Centre South Brisbane - South Brisbane
Recruitment postcode(s) [1] 0 0
- Heidelberg
Recruitment postcode(s) [2] 0 0
2148 - Blacktown
Recruitment postcode(s) [3] 0 0
2050 - Camperdown
Recruitment postcode(s) [4] 0 0
- Camperdown
Recruitment postcode(s) [5] 0 0
4029 - Herston
Recruitment postcode(s) [6] 0 0
3000 - Melbourne
Recruitment postcode(s) [7] 0 0
4201 - South Brisbane
Recruitment outside Australia
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Alabama
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United Kingdom
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Northwood

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Mersana Therapeutics
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
First-in-human, Phase 1b/2 safety study of the antibody-drug conjugate (ADC) XMT-1536
(upifitamab rilsodotin) administered as an intravenous infusion once every four weeks.
Patients with tumor types likely to express NaPi2b were enrolled in dose escalation. Patients
with platinum-resistant ovarian cancer and non-small cell lung cancer (adenocarcinoma
subtype) were enrolled in the expansion segment of this study. Patients with
platinum-resistant, high-grade serous ovarian cancer are being enrolled in the UPLIFT segment
of this study. In addition to safety assessments, the pharmacokinetics of the drug will be
assessed along with ADC activity. A QTc sub-study has been added for the UPLIFT cohort for a
sub-set of sites.
Trial website
https://clinicaltrials.gov/ct2/show/NCT03319628
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Leslie DeMars, MD
Address 0 0
Mersana Therapeutics
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Jamie Barrett
Address 0 0
Country 0 0
Phone 0 0
617-715-8214
Fax 0 0
Email 0 0
[email protected]
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT03319628