Lung Cancer Clinical Trial

Safety And Efficacy Study Of Avelumab Plus Chemotherapy With Or Without Other Anti-Cancer Immunotherapy Agents In Patients With Advanced Malignancies

Summary

This is a Phase 1b/2, open label, multicenter, safety and clinical activity study of avelumab in combination with chemotherapy as first-line treatment of adult patients with locally advanced or metastatic solid tumors. Initially, avelumab will be evaluated in combination with pemetrexed and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) (Cohort A1) and in combination with gemcitabine and cisplatin in patients with cisplatin-eligible urothelial (bladder) cancer (UC) (Cohort A2). As more information is learned about other anti-cancer immunotherapy agents, in future portions of the study, avelumab may be combined with chemotherapy and other anti-cancer immunotherapy agents in patients with these same or different tumor types.

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Full Description

This is a Phase 1b/2, open label, multicenter, safety, clinical activity, pharmacokinetic (PK), and pharmacodynamics (PD) study of avelumab in combination with chemotherapy with or without other anti-cancer immunotherapies, as first-line treatment of adult patients with locally advanced or metastatic solid tumors. Initially, avelumab will be evaluated in combination with pemetrexed and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) (Cohort A1) and with gemcitabine and cisplatin in patients with cisplatin-eligible urothelial cancer (UC) (Cohort A2).

Given the growing preclinical and clinical indications that combinations of anti-cancer immunotherapies potentially improve patient outcomes compared to results seen with single agents, in portions of the study to be added in the future, avelumab will be evaluated in combination with both standard-of-care chemotherapy and other anti-cancer immunotherapies in patients with advanced malignancies. Each cohort in the study will consist of a Phase 1b lead-in portion to evaluate safety and a Phase 2 cohort expansion to evaluate safety and efficacy.

In the Phase 1b safety lead-in portion, up to 12 patients will be enrolled into each cohort and evaluated for dose-limiting toxicities (DLT) during the first 2 cycles of treatment. If investigational products administration in a cohort is deemed safe in the Phase 1b lead-in, enrollment may be expanded into the Phase 2 cohort expansion. Up to approximately 40 patients in each cohort (including those enrolled in the Phase 1b lead-in and those enrolled in the Phase 2 cohort expansion) will be enrolled and treated with avelumab plus chemotherapy in the initial portion of the study and, in future portions of the study, with avelumab plus chemotherapy with or without other anti-cancer immunotherapies.

In the Phase 1b lead-in portions of NSCLC Cohort A1 and UC Cohort A2, avelumab is dosed at 800 mg fixed dose every 3 weeks. Under Protocol Amendment 4, avelumab is dosed at 1200 mg fixed dose every 3 weeks in the Phase 1b lead-in portions of NSCLC Cohort A3 and in UC Cohort A4, in combination with the same standard-of-care chemotherapy doublets used in Cohort A1 and Cohort A2, respectively. For each tumor type, the study treatment combination with the highest avelumab dose determined to be safe may be advanced into Phase 2 cohort expansion.

View Eligibility Criteria

Eligibility Criteria

Inclusion Criteria:

Histological diagnosis of locally advanced (primary or recurrent) or metastatic solid tumor that is not amenable for treatment with curative intent as follows:

For all groups:
Measurable disease by RECIST v1.1 with at least 1 measurable lesion, and availability of tumor specimen 18 months or less old.
No prior systemic treatment for unresectable locally advanced or metastatic disease for the tumor type under study. If prior systemic chemotherapy treatment was given in the adjuvant or neo-adjuvant setting or as part of radiotherapy chemotherapy treatment, disease-free interval after stop of systemic treatment must be more than 6 months for non-squamous NSCLC and more than 12 months for UC;
Cohort A1 and Cohort A3: Non-squamous NSCLC, with no activating EGFR mutations, ALK or ROS1 translocations/rearrangements. If monotherapy pembrolizumab is available as a standard of care treatment option, patients must have a tumor proportion score (TPS) <50% for PD L1 (via the 22C3 pharmDx or the Ventana (SP263) PD L1 IHC assay).
Cohort A2 and Cohort A4: Transitional cell carcinoma of the urothelium including the bladder, urethra, renal pelvis, and ureter.
ECOG performance status 0 or 1
Estimated life expectancy of at least 90 days
Adequate bone marrow, renal, and liver function
Negative serum pregnancy test at screening
Signed and dated informed consent

Exclusion Criteria:

Prior immunotherapy with any antibody or drug specifically targeting T cell co-stimulation or immune checkpoint pathways.
Patients with known symptomatic central nervous system metastases requiring steroids.
Diagnosis of other malignancy within 2 years prior to enrollment except adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the bladder, breast, or cervix, or low grade (Gleason ≤6) prostate cancer
Use of immunosuppressive medication at the time of enrollment
Active or prior autoimmune disease that might deteriorate when receiving an immuno-stimulatory agent.
Prior organ transplantation including allogenic stem cell transplantation
Active infection requiring systemic therapy
Known history of HIV or AIDS
Hepatitis B virus (HBV) or hepatitis C virus (HCV) infection at screening
Administration of live vaccine within 4 weeks prior to study entry
Known prior severe hypersensitivity to the investigational products or any component in their formulations,
Known prior severe hypersensitivity to platinum-related compounds for all cohorts, to pemetrexed for patients enrolled in Cohort A1 and Cohort A3, and to gemcitabine for patients enrolled in Cohort A2 and Cohort A4
Persisting toxicity related to prior therapy (NCI CTCAE v4.03 Grade > 1)
Known history of colitis, inflammatory bowel disease, pneumonitis, pulmonary fibrosis.
Ongoing cardiac dysrhythmias of NCI CTCAE v4.03 Grade 2 or prolongation of the QTcF interval to >480 msec.
Clinically significant (ie, active) cardiovascular disease: cerebral vascular accident/stroke (<6 months prior to enrollment), myocardial infarction (< 6 unstable angina, congestive heart failure, or serious cardiac arrhythmia requiring medication.
Major surgery ≤28 days or major radiation therapy ≤14 days prior to enrollment.
Participation in other studies involving investigational drug(s) within 28 days prior to study entry.
Concurrent treatment with a prohibited medication.
Other acute or chronic medical or psychiatric condition
Pregnant female patients; breastfeeding female patients; fertile male patients and female patients of childbearing potential who are unwilling or unable to use at least 1 highly effective method of contraception as outlined in this protocol for the duration of the study and for at least 90 days after the last dose of chemotherapy (for male and female patients) or at least 30 days after the last dose of avelumab (for female patients), whichever is longer.

Study is for people with:

Lung Cancer

Phase:

Phase 1

Estimated Enrollment:

67

Study ID:

NCT03317496

Recruitment Status:

Active, not recruiting

Sponsor:

Pfizer

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There are 38 Locations for this study

See Locations Near You

University of Arizona Cancer Center - North Campus
Tucson Arizona, 85719, United States
Banner-University Medical Center Tucson
Tucson Arizona, 85724, United States
Montefiore Medical Center - Einstein Center for Cancer Care
Bronx New York, 10461, United States
Montefiore Medical Center - Moses Division
Bronx New York, 10467, United States
Stony Brook Cancer Center
Stony Brook New York, 11794, United States
Stony Brook University
Stony Brook New York, 11794, United States
Duke University Medical Center/Duke Cancer Center
Durham North Carolina, 27710, United States
Investigational Chemotherapy Service
Durham North Carolina, 27710, United States
Chris O'Brien Lifehouse
Camperdown New South Wales, 2050, Australia
St Vincent's Hospital Sydney
Darlinghurst New South Wales, 2010, Australia
St Vincent's Public Hospital Sydney
Darlinghurst New South Wales, 2010, Australia
Western Health, Sunshine Hospital
St Albans Victoria, 3021, Australia
Kingston Health Sciences Centre -
Kingston Ontario, K7L 2, Canada
Fakultni nemocnice Olomouc, Klinika nuklearni mediciny
Olomouc , 779 0, Czechia
Fakultni nemocnice Olomouc, Ustav klinicke a molekularni patologie
Olomouc , 779 0, Czechia
Fakultni nemocnice Olomouc
Olomouc , 779 0, Czechia
Thomayerova nemocnice
Prague , 140 5, Czechia
Thomayerova nemocnice
Prague , 14059, Czechia
Centrum nuklearni mediciny s.r.o.
Prague , 180 8, Czechia
Centrum nuklearni mediciny s.r.o.
Prague , 190 6, Czechia
Vseobecna fakultni nemocnice v Praze
Praha 2 , 120 0, Czechia
Vseobecna fakultni nemocnice v Praze
Praha 2 , 128 0, Czechia
Vseobecna fakultni nemocnice v Praze
Praha 2 , 128 0, Czechia
Vseobecna fakultni nemocnice v Praze
Praha 2 , 128 2, Czechia
Orszagos Onkologiai Intezet "C" Belgyogyaszati - Onkologiai es Klinikai Farmakologiai Osztaly
Budapest , 1122, Hungary
AOU Ospedali Riuniti di Ancona Umberto I - GM Lancisi - G Salesi
Torrette Di Ancona AN, 60126, Italy
IRCCS Istit.Scient.Romagnolo per lo Studio e la Cura dei Tumori
Meldola FC, 47014, Italy
Centro di Ricerca di Fase 1, ASST Monza-Ospedale San Gerardo
Monza MB, 20900, Italy
Oncologia, ASST Monza-Ospedale San Gerardo
Monza MB, 20900, Italy
Istituto Europeo di Oncologia (IEO)
Milano MI, 20141, Italy
Istituto Nazionale Tumori di Napoli IRCCS Fondazione Pascale
Napoli , 80131, Italy
Hospital Universitario Vall d'Hebron
Barcelona , 08035, Spain
Hospital Clinic I Provincial
Barcelona , 08036, Spain
Hospital Universitario Fundacion Jimenez Diaz
Madrid , 28040, Spain
Hospital Universitario 12 de Octubre
Madrid , 28041, Spain
Fundacion Instituto Valenciano de Oncologia
Valencia , 46009, Spain
Royal Cornwall Hospital
Truro Cornwall, TR1 3, United Kingdom
The Platinum Medical Centre
London England, NW8 7, United Kingdom
The Wellington Hospital - South
London England, NW8 9, United Kingdom
Sarah Cannon Research Institute UK
London England, W1G 6, United Kingdom
The Harley Street Clinic
London England, W1G 7, United Kingdom
HCA Pharmacy Department
London England, W1G 8, United Kingdom
The Harley Street Clinic
London England, W1G 8, United Kingdom
The Princess Grace Hospital
London England, W1U 5, United Kingdom
Weston Park Hospital
Sheffield South Yorkshire, S10 2, United Kingdom
Sir Bobby Robson Cancer Trials Research Centre
Newcastle upon Tyne , NE7 7, United Kingdom

How clear is this clinincal trial information?

Study is for people with:

Lung Cancer

Phase:

Phase 1

Estimated Enrollment:

67

Study ID:

NCT03317496

Recruitment Status:

Active, not recruiting

Sponsor:


Pfizer

How clear is this clinincal trial information?

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