DAREON™-5: A Study to Test Whether Different Doses of BI 764532 Help People With Small Cell Lung Cancer or Other Neuroendocrine Cancers

Официальное название

DAREON™-5: An Open-label, Multi-center Phase II Dose Selection Trial of Intravenous BI 764532, a DLL3-targeting T Cell Engager, in Patients With Relapsed/Refractory Extensive-stage Small Cell Lung Cancer and in Patients With Other Relapsed/Refractory Neuroendocrine Carcinomas

Обзор

This study is open to adults with small cell lung cancer and other neuroendocrine tumours. The study is in people with advanced cancer for whom previous treatment was not successful or no standard treatment exists. The purpose of this study is to find a suitable dose of BI 764532 (also called obrixtamig) that people with advanced cancer can tolerate. 2 different doses of BI 764532 are tested in this study. Another purpose is to check whether BI 764532 can make tumours shrink. BI 764532 is an antibody-like molecule (DLL3/CD3 bispecific) that may help the immune system fight cancer. The study has 3 parts. In Part 1, participants are put into 2 groups randomly, which means by chance. Participants have an equal chance of being in either group. One group gets dose 1 of BI 764532 and the other group gets dose 2 of BI 764532. In Part 2 and Part 3, all participants receive the same dose of BI 764532. Part 2 and Part 3 are open to people with a certain kind of tumour called extrapulmonary neuroendocrine carcinoma. All participants receive BI 764532 as an infusion into a vein when starting treatment. If there is benefit for the participants and if they can tolerate it, the treatment is given up to the maximum duration of the study. During this time, participants visit the study site regularly. The total number of visits depends on how they respond to and tolerate the treatment. The first study visits include an overnight stay to monitor participants´ safety. Doctors record any unwanted effects and regularly check the general health of the participants.

Вмешательства

• Препарат BI 764532, dose 1
  BI 764532, dose 1
• Препарат BI 764532, dose 2
  BI 764532, dose 2
• Устройство Ventana DLL3 RxDx assay
  Ventana DLL3 RxDx assay

Первичные конечные точки

• Part 1: Objective response (OR), defined as a best overall response of confirmed complete response (CR) or confirmed partial response (PR) [Срок оценки: up to 26 months]
• Part 1: Occurrence of treatment-emergent adverse events (TEAEs) during the on-treatment period [Срок оценки: up to 26 months]
• Part 2: Objective response (OR) [Срок оценки: up to 27 months]
• Part 3: Occurrence of treatment-emergent adverse events (TEAEs) during the on-treatment period [Срок оценки: up to 23 months]
• Part 3: Objective response (OR) by blinded independent central review [Срок оценки: up to 23 months]

Вторичные конечные точки (11)

• Part 1: Duration of objective response (DOR) based on investigator assessment [Срок оценки: up to 26 months]
• Part 1: Progression-free survival (PFS) based on investigator assessment [Срок оценки: up to 26 months]
• Part 1: Disease control (DC), defined as best overall response of CR or PR or stable disease (SD) based on investigator assessment [Срок оценки: up to 26 months]
• Part 1, 2, and 3: Overall survival (OS), defined as the time from treatment start until death from any cause [Срок оценки: up to 26 months]
• Part 1, 2, and 3: Change from baseline in EORTC QLQ-C30 physical functioning domain score [Срок оценки: at baseline, at month 26]
• Part 1, 2, and 3: Change from baseline in EORTC QLQ-C30 role functioning domain score [Срок оценки: at baseline, at month 26]
• Part 1, 2, and 3: Occurrence of treatment-emergent AEs leading to study drug discontinuation during the on-treatment period [Срок оценки: up to 26 months]
• Part 2 and 3: Duration of objective response (DOR) based on blinded independent central review [Срок оценки: up to 27 months]
• Part 2 and 3: Progression-free survival (PFS) based on blinded independent central review [Срок оценки: up to 27 months]
• Part 2 and 3: Disease control (DC) based on blinded independent central review [Срок оценки: up to 27 months]
• Part 2: Occurrence of treatment-emergent adverse events (TEAEs) during the on-treatment period [Срок оценки: up to 27 months]

Критерии участия

Критерии включения

• Male or female participants ≥18 years old and at least at the legal age of consent in countries where it is greater than 18 years at the time of signature of the informed consent form (ICF).
• Signed and dated written informed consent in accordance with International Council for Harmonisation-Good Clinical Practice (ICH-GCP) and local legislation prior to admission to the trial.
• Part 1: Histologically or cytologically confirmed, cancer of the following histologies:

• Small cell lung cancer (SCLC)
• Extra-pulmonary neuroendocrine carcinoma (epNEC) (except Merkel cell carcinoma (MCC), Medullary thyroid cancer (MTC) and Neuroendocrine prostate cancer (NEPC))
• Large cell neuroendocrine carcinoma (LCNEC) of the lung Patients with tumours with mixed histologies for any above type are eligible only if the neuroendocrine carcinoma/small tumour cells component is predominant and represents at least 50% of the overall tumour tissue.

Patients must have progressed or recurred after standard of care therapy

• SCLC: after at least two prior lines of therapy, including at least one platinum-based regimen; in countries where standard of care in first line therapy includes PD-L1 inhibitor treatment patients should have received the combination of platinum-based regimen plus PD-L1 inhibitor unless they have been unable to receive checkpoint inhibitor treatment.
• Therapy includes PD-L1 inhibitor treatment; patients should have received the combination of platinum-based regimen plus PD-L1 inhibitor unless they have been unable to receive checkpoint inhibitor treatment.
• epNEC/LCNEC: after at least one platinum-based regimen. Part 2 and part 3: Histologically or cytologically confirmed epNEC (except MCC, MTC and NEPC) with centrally assessed DLL3 high expression status. Patients must have progressed or recurred after at least one platinum-based regimen.
• Eastern Cooperative Oncology Group (ECOG) score of 0 or 1.,
• Measurable lesions as defined per Response Evaluation Criteria In Solid Tumours (RECIST) v 1.1 within 21 days prior to the first dose of BI 764532.
• Part 1: Availability of archival tumour tissue sample Part 2 and part 3: Availability of archival formalin-fixed paraffin-embedded (FFPE) tumour tissue sample. Following specimens are not allowed: Fine Needle Aspiration (FNA), Cytology samples, decalcified bone samples.
• Adequate organ function as defined in the protocol.
• All toxicities related to previous anti-cancer therapies have resolved = Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 prior to trial treatment administration (except for alopecia, peripheral neuropathy, fatigue and endocrinopathies controlled by replacement therapy which must be = CTCAE Grade 2 and amenorrhea/menstrual disorders which can be any grade).
• Women of childbearing potential (WOCBP) and men able to father a child must be ready and able to use acceptable methods of birth control per ICH M3 (R2) that result in a low failure rate of less than 1% per year when used consistently and correctly. A list of contraception methods meeting these criteria and instructions on the duration of their use is provided in the participant information
• Only for Part 3, at the timepoint of Screening 02:

• For Cycle 1, patients should be willing to stay within 1 hour driving distance for 48 hours after IMP administration and confirm availability of a caregiver for the same timeframe.
• Patients should be considered suitable by the investigator to follow instructions applicable to the reduced monitoring cohort, such as taking their temperature and administration of oral medication at home if needed.

Критерии исключения

• Untreated or symptomatic brain metastases. (Part 2 and part 3: identified during the mandatory assessment by brain MRI within 21 days before first trial drug administration.) Participants with treated, stable brain metastases are eligible provided they meet the following criteria:

• Radiotherapy or surgery for brain metastases was completed at least 2 weeks prior to the first administration of BI 764532.
• Patient is off steroids for at least 7 days (physiologic doses of steroids are permitted), and the patient is off anti-epileptic drugs for at least 7 days or on stable doses of anti-epileptic drugs for malignant central nervous system (CNS) disease.
• Presence of leptomeningeal disease or, part 2 and part 3: epidural disease including spinal cord compression.
• Part 1: Active/previous history of interstitial lung disease or non-infectious pneumonitis (any grade).

Part 2 and part 3: Active/previous history of interstitial lung disease, pulmonary fibrosis, organizing pneumonia or non-infectious pneumonitis (any grade). Patients with a history of therapy-related pneumonitis that is considered clinically resolved are eligible.

• Participants who experienced severe, life-threatening immune-mediated adverse events or infusion-related reactions including those that lead to permanent discontinuation while on treatment with immuno-oncology agents.
• Prior anti-cancer therapy:

• Patients who have been treated with any other anti-cancer drug within 4 weeks or within 5 half-life periods (whichever is shorter) prior to first administration of BI 764532.
• Patients who have been treated with extensive field radiotherapy including whole brain irradiation within 2 weeks prior to first administration of BI 764532.
• Previous treatment with Delta-like ligand 3 (DLL3)-targeting T cell engagers or cell therapies.
• Diagnosis of immunodeficiency or systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of BI 764532. Physiological replacement of steroids is allowed.
• Unresolved toxicity from prior anti-tumour therapy, defined in the inclusion criteria.

Further exclusion criteria apply.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

США · 16 центров

• Infirmary Cancer Care — Mobile
• Mayo Clinic-Arizona — Phoenix
• Valkyrie Clinical Trials — Los Angeles
• University of California San Francisco — San Francisco
• Mayo Clinic Cancer Center — Jacksonville
• University of Miami — Miami
• H. Lee Moffitt Cancer Center and Research Institute — Tampa
• Indiana University — Indianapolis
• … и ещё 8 центров

Япония · 7 центров

• Aichi Cancer Center Hospital — Aichi, Nagoya
• National Cancer Center Hospital East — Chiba, Kashiwa
• Sendai Kousei Hospital — Miyagi, Sendai
• Osaka International Cancer Institute — Osaka, Osaka
• Kindai University Hospital — Osaka, Sakai
• National Cancer Center Hospital — Tokyo, Chuo-ku
• Japanese Foundation for Cancer Research — Tokyo, Koto-ku

Китай · 6 центров

• West China Hospital, Sichuan University — Чэнду
• Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine — Ханчжоу
• Qilu Hospital, Shangdong University — Цзинань
• 960 Hospital of the Chinese People's Liberation Army — Цзинань
• The Second Affiliated Hospital to Nanchang University — Nanchang
• Shanghai Chest Hospital — Шанхай

Германия · 6 центров

• Evangelische Lungenklinik Berlin — Berlin
• Universitätsklinikum Carl Gustav Carus Dresden — Dresden
• Universitätsklinikum Erlangen — Erlangen
• Asklepios Fachkliniken München-Gauting — Gauting
• LungenClinic Grosshansdorf GmbH — Großhansdorf
• Universitätsmedizin der Johannes Gutenberg-Universität Mainz — Mainz

Испания · 5 центров

• Hospital del Mar — Barcelona
• Hospital Universitari Vall d'Hebron — Barcelona
• Hospital Universitario 12 de Octubre — Madrid
• Hospital Universitario Virgen de la Victoria — Málaga
• Hospital Clinico Universitario de Valencia — Valencia

Великобритания · 4 центра

• Leicester Royal Infirmary — Leicester
• University College Hospital — London
• The Christie Hospital — Manchester
• Freeman Hospital — Newcastle upon Tyne

Франция · 3 центра

• HOP Intercommunal — Créteil
• Hôpital Cochin — Paris
• HOP Civil — Strasbourg

South Korea · 3 центра

• Severance Hospital — Seoul
• Asan Medical Center — Seoul
• Samsung Medical Center — Seoul

Тайвань · 3 центра

• NCKUH — Tainan
• Taipei Veterans General Hospital — Taipei
• Chang Gung Memorial Hospital, Linkou — Taoyuan County

Бельгия · 2 центра

• Universitair Ziekenhuis Gent — Ghent
• UZ Leuven — Leuven

Болгария · 2 центра

• Multiprofile Hospital For Active Treatment-Uni Hospital Ltd. — Panagyurishte
• MHAT Heart and brain — Pleven

Португалия · 2 центра

• Hospital CUF Descobertas-Lisboa-69316 — Lisbon
• Hospital CUF Porto — Porto

Идентификаторы

NCT: NCT05882058 · 1438-0005 · 2023-504247-13-00 · U1111-1292-4406

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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