Clinical Trial 21641

• Overview

  Study Title:

  First-in-Human, Phase 1/1b, Open-label, Multicenter Study of Bifunctional EGFR/TGF_ Fusion Protein BCA101 Alone and in Combination with Pembrolizumab in Patients With EGFR-Driven Advanced Solid Tumors

  Summary:

  This is a Phase 1/1b, open-label study, which consists of dose escalation parts (Part A) followed by expansion cohorts (Part B) for both single agent BCA101 and combination BCA101 plus pembrolizumab. The study population in dose escalation (Part A) of single agent BCA101 consists of subjects with EGFR-driven advanced solid tumors refractory to standard of care or for whom no standard of care is available. Dose escalation (Part A) of combination BCA101 and pembrolizumab consists of subjects with either Squamous Cell Carcinoma of the Head and Neck (HNSCC) or Squamous Cell Carcinoma of the Anal Canal (SCCAC) whose tumors are refractory to standard of care or for whom no standard of care is available. Once the maximum tolerated dose (MTD) / recommended dose (RD) of single agent BCA101 is determined, the study will continue with expansion cohorts (Part B) with select tumor types. Expansion cohorts for single agent BCA101 will include cutaneous squamous cell carcinoma. Planned expansion cohorts for the combination of BCA101 and pembrolizumab include: 1) HNSCC and 2) SCCAC.

  Objective:

  Primary Objective: * To characterize the safety and tolerability of single agent BCA101 and BCA101 in combination with pembrolizumab or encorafenib and to identify recommended doses and indications for future studies by assessing the incidence and severity of adverse events (AEs), serious adverse events (SAEs), dose adjustments, as well as laboratory values, vital signs, and electrocardiograms (ECGs). Secondary Objectives: * To evaluate preliminary activity of single agent BCA101 and BCA101 in combination with pembrolizumab or encorafenib by assessing the clinical benefit rate (CBR) and objective response rate (ORR). * To characterize BCA101 with assessment of pharmacokinetics (PK), immunogenicity, and pharmacodynamic profiles of each arm by assessing drug concentration within serum/plasma, anti-drug antibodies (ADAs), and the changes from baseline pharmacodynamic markers in peripheral blood mononuclear cells and tumor tissue.

• Treatments

  Therapies:

  Immunotherapy

  Medications:

  BCA101 (); Pembrolizumab (Keytruda)

• Inclusion Criteria

  Inclusion Criteria:
  • Must have measurable disease amendable to biopsy and be willing to undergo both a pre-treatment and on-treatment biopsy, as well as provide archival tumor if available from the primary tumor (a paraffin embedded tumor tissue block sufficient to obtain at least 10 sections of 4 to 5 micrometer thickness).
  • Must have a performance status of ≤1 on the Eastern Cooperative Oncology Group Performance Scale.
  • Must have evaluable or measurable disease (computed tomography [CT]/magnetic resonance imaging [MRI] scans performed within 21 days before the screening visit are acceptable) demonstrating measurable disease, i.e., at least 1 unidimensional measurable lesion as defined by Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST 1.1) and Immune Response Evaluation Criteria in Solid Tumors (iRECIST).
  • Tumor eligibility: PART B (Cohort expansion): Single agent BCA101 - patients with the following tumor type will be eligible:
  • Expansion Cohort 1: Cutaneous Squamous Cell Carcinoma (CSCC) - i. patients must have received (or been intolerant to or ineligible for) prior anti-PD-1 therapy in the metastatic or locally advanced setting.
  • No prior history of treatment with anti-EGFR antibodies in the unresectable/metastatic setting (prior treatment with radiotherapy in the adjuvant setting is allowed).
  • Combination BCA101 and pembrolizumab - patients with the following tumor types will be eligible: Expansion Cohort 2: Head and Neck Squamous Cell Carcinoma (HNSCC), metastatic or unresectable, recurrent with a Combined Positive Score (CPS) equal to or greater than 1, as determined by an CLIA-approved laboratory test. Primary tumor locations of oropharynx, oral cavity, hypopharynx, or larynx. Participants may not have a primary tumor site of nasopharynx (any histology).
  • Patients should not have had prior systemic therapy administered in the recurrent or metastatic setting. (Systemic therapy which was completed >6 months prior to signing consent if given as part of multimodal treatment for locally advanced disease is allowed) Prior neoadjuvant therapy with immune checkpoint inhibitors is allowed if completed >6 months prior to study drug initiation. No prior history of anti-EGFR antibodies (with the exception of radiosensitizing agents and multimodal treatment for locally advanced disease).
  • Patients must provide tissue for PD-L1 biomarker analysis from a core or excisional biopsy (fine needle aspirate is not sufficient): A newly obtained biopsy (within 90 days prior to start of study treatment) is preferred but an archival sample is acceptable.
  • Patients must have results from testing of human papillomavirus (HPV) status for oropharyngeal cancer Expansion Cohort 3: Squamous Carcinoma of the Anal Canal (SCAC), locally advanced/unresectable or metastatic.
  • Patients must have received (or been intolerant to or ineligible for) at least 1 prior line of chemotherapy and received no more than 2 prior lines of systemic treatments for treatment of unresectable and/or metastatic disease. No prior history of immune checkpoint inhibitors.
  • Other criteria may apply

• Exclusion Criteria

  Exclusion Criteria:
  • For Part A: Exposure to anti-EGFR antibodies within 4 weeks of the first dose of study drug.
  • Prior treatment with any anti-TGFβ therapy.
  • Prior history of Grade ≥ 2 intolerance or hypersensitivity reaction to cetuximab or other anti-EGFR therapy or other murine proteins or prior discontinuation of therapy in the setting of toxicity related to treatment.
  • Pregnant or breastfeeding women.
  • Any condition requiring systemic treatment with either corticosteroids (>10 mg daily of prednisone or equivalent) or other immunosuppressive medication within 14 days prior to the first dose of study drug, with the exception of topical, intranasal, intrabronchial, or ocular steroids.
  • Known history of a hematologic malignancy (or solid tumor other than the ones indicated for this study), unless the patient has undergone potentially curative therapy with no evidence of that disease for 2 years. Does not include tumors with a negligible risk of metastasis or death (e.g. adequately treated basal or squamous cell carcinoma, stage 1 prostate cancer, or carcinoma in situ of the cervix or carcinoma in situ of the breast). Subjects enrolling in the CSCC cohort may have chronic lymphocytic leukemia as long as the patient is not on active treatment.
  • Known cases of human immunodeficiency virus (HIV) are excluded if patients have a CD4+ T-cell (CD4+) count > Patients with chronic HBV infection with active disease who meet the criteria for anti-HBV therapy and are not on a suppressive antiviral therapy prior to initiation of study treatment
  • Patients with a known history of hepatitis C who have not completed curative antiviral treatment or have a HCV viral load above the limit of quantification
  • Other criteria may apply

If you are interested in learning more about clinical trials, our clinical trial navigators can discuss your options and recommend opportunities that may be suitable for you. Call 813-745-6100 or 1-800-679-0775 (toll-free) or submit a clinical trials inquiry form.