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Phase I/II Study of the Safety, Pharmacokinetics, and Preliminary Clinical Activity of BT8009 in Patients With Nectin-4 Expressing Advanced Malignancies


Description

This study is a Phase I/II, multicenter, first-in-human, open-label dose-escalation study of BT8009 given as a single agent and in combination with pembrolizumab in participants with advanced solid tumors associated with Nectin-4 expression or in participants with advanced solid tumor malignancies having renal insufficiency. The primary endpoints are: Dose limiting toxicities (Parts A-1 and A-2), Overall response rate per RECIST v1.1 (Part B), Safety and tolerability (Part C), and characterization of the pharmacokinetics (Part D).This study will assess the safety and tolerability of BT8009 alone and in combination with pembrolizumab in patients with select advanced solid tumors. BT8009 will be given as a single agent in 3 different dosing schedules- weekly (28 day cycle), biweekly (28 day cycle) or dosing on day 1 and day 8 of a 3-weekly (21 day cycle) and in combination with pembrolizumab. There are three parts to this study. Part A is a dose escalation in patients with select advance

Trial Eligibility

Key Inclusion Criteria * Life expectancy ≥12 weeks. * Patients must have measurable disease per RECIST 1.1. * Part A-1 cohorts: * Must have exhausted all standard treatment options, including appropriate targeted therapies; or patients for which no standard therapy is considered appropriate * Patients with advanced, histologically confirmed urothelial (transitional cell) carcinoma that recurred after or has been refractory to prior therapy (fresh tumor biopsy or an archived sample must be submitted); or * Patients with advanced, histologically confirmed pancreatic, breast, non-small-cell lung cancer (NSCLC), gastric, esophageal, head and neck, or ovarian tumors that recurred after or has been refractory to prior therapy (fresh tumor biopsy or an archived sample testing for Nectin-4 expression). * Part A-2: * Must have exhausted all standard treatment options, including appropriate targeted therapies; or patients for which no standard therapy is considered appropriate * Patients with advanced, histologically confirmed urothelial (transitional cell) carcinoma that have progressed following prior therapy * Cohort B-1: Histologically documented urothelial carcinoma, previously treated with enfortumab vedotin (EV). Patients with resectable, locally advanced urothelial carcinoma are ineligible. Must have had progression or recurrence of urothelial cancer during or following receipt of most recent therapy. * Cohort B-2 and B-3: Histologically documented urothelial carcinoma, not previously treated with enfortumab vedotin (EV). Patients with resectable, locally advanced urothelial carcinoma are ineligible. Must have had progression or recurrence of urothelial cancer during or following receipt of most recent therapy. * Cohort B-4: Patients with histologically confirmed non-mucinous epithelial ovarian, fallopian tube, or primary peritoneal cancer that is Stage III or IV according to the International Federation of Gynecology and Obstetrics (FIGO) or tumor, node and metastasis staging criteria that have progressed following prior therapy. * Cohort B-5: Patients with triple-negative breast cancer confirmed negative for estrogen receptor (ER) and progesterone receptor (PR) and negative for human epidermal growth factor receptor 2 (HER2) (i.e., triple-negative) that have progressed following prior therapy. * Cohort B-6: Patients with histologically confirmed non-small cell lung cancer (NSCLC) with no actionable mutations, such as Epidermal Growth Factor Receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) fusion oncogene, or ROS1 that have progressed following prior therapy. * Cohort B-7: Locally advanced or metastatic, histologically confirmed urothelial (transitional cell) carcinoma, ineligible for cisplatin, no prior systemic anticancer treatment for advanced urothelial carcinoma. * Cohort C renal insufficiency cohort: Patients with histologically documented urothelial carcinoma, ovarian, triple negative breast, or non-small cell lung cancer that have been previously treated with a locally approved therapy. Key Exclusion Criteria (all patients): * Clinically relevant troponin elevation * Uncontrolled diabetes * Known active or untreated CNS and/or carcinomatous meningitis * Grade ≥2 peripheral neuropathy * Active keratitis or corneal ulcerations * Patients with uncontrolled hypertension * History of another malignancy within 3 years before first dose of BT8009 or residual disease from a previously diagnosed malignancy (with some exceptions). * Active systemic infection requiring therapy, or fever within the last 14 days prior to first dose of BT8009. * Prior Stevens-Johnson syndrome/toxic epidermal necrolysis on any MMAE-conjugated drug * Parts A-2 and B-7 Pembrolizumab Combination Cohorts: * Prior organ transplant (including allogeneic) * Diagnosis of clinically relevant immunodeficiency * History of interstitial lung disease * Parts B-2 and B-3: Prior treatment with enfortumab vedotin Other protocol-defined Inclusion/Exclusion criteria may apply

Study Info

Organization

BicycleTx Limited


Primary Outcome

Parts A-1, A-2 and C: Number of participants with treatment emergent adverse events, receiving BT8009 as a monotherapy or in combination with pembrolizumab to assess safety and tolerability.


Outcome Timeframe From cycle 1 day 1 until 30 days after the end of treatment or approximately 1 year

NCTID NCT04561362

Phases PHASE1,PHASE2

Primary Purpose TREATMENT

Start Date 2020-07-17

Completion Date 2025-12

Enrollment Target 329

Interventions

DRUG BT8009

DRUG Pembrolizumab

Locations Recruiting

Sarah Cannon Research Institute at HealthONE

United States, Colorado, Denver


Ocala Oncology Center

United States, Florida, Ocala


Advent Health

United States, Florida, Orlando


Horizon Oncology Research

United States, Indiana, Lafayette


Norton Cancer Institute, Downtown

United States, Kentucky, Louisville


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